Objective:To construct a nursing quality evaluation index system for knee ligament injury to provide a basis for standardizing the nursing practice and improving the nursing quality of knee ligament injury.Methods:Based on the three-dimensional quality structure model of "structure-process-outcome" proposed by Donabedian, the quality evaluation index system for knee ligament injury specialties was constructed through literature review, brainstorming, and Delphi expert consultation from April to June 2023.Results:Sixteen experts were included in the inquiry. The effective recovery rate of the two rounds of expert correspondence questionnaires was 16/16, the expert authority coefficient was 0.95, and the Kendell harmony coefficients of the expert correspondence were 0.116 and 0.122, respectively (both P<0.05). The final constructed knee ligament injury specialty care quality evaluation index system contained 3 primary indicators (structural quality, process quality and outcome quality), 16 secondary indicators, and 69 tertiary indicators.Conclusions:The specialized nursing quality evaluation index system for knee ligament injury constructed in this study is scientific and reliable, which can provide a basis for the evaluation and assessment of the nursing quality of knee ligament injury specialties and promote the continuous improvement of their nursing quality.

BACKGROUND:As a unique structure of the cervical spine,the occurrence,development and progression of the uncovertebral joint directly affect the stability and range of motion of the cervical spine,and are also closely related to the pathogenesis of cervical spondylosis.A thorough understanding of the developmental characteristics of the uncovertebral joint is of great significance for the pathogenesis,diagnosis,and treatment of cervical spondylosis. OBJECTIVE:By using imaging and three-dimensional reconstruction technology to measure and observe the cervical uncinate process-related angle in a large sample of different age groups,the aim is to reveal the characteristics of its changes with age and vertebral growth,as well as its relationship with cervical spine stability. METHODS:Using a retrospective research design,we collected 1 447 cases of raw CT imaging data that meet the study requirements for complete cervical spine segments.The raw data were imported into Mimics 21.0 software in DICOM format for post-processing and measurement of angle of uncinate process and sagittal angle of uncinate process.The data were grouped based on gender,age,and side. RESULTS AND CONCLUSION:(1)With the increase of vertebral sequence,the angle of uncinate process increased in a V-shaped shape,and the lowest peak was at C5.The overall population showed a sharp peak with the increase of age,and the peak value mostly occurred in the age range of 30-39 years.(2)The sagittal angle of the uncinate process increased like a fishhook with the increase of the vertebral sequence,and the overall angle of the uncinate process increased with age,and the peak value mostly occurred in the age range of 20-29 years.The uncinate process angle and sagittal angle showed only partial significant differences between sides and genders(P<0.05).(3)It is concluded that the angle of the uncinate process increased with the increase of vertebral sequence in a V-shaped manner.The sagittal angle of the uncinate process increases like a fish hook with increasing vertebral order,while the two angles generally peak with increasing age.The angle of the uncinate process is about 131°,which may be closely related to the stability of the cervical spine,while the sagittal angle of the uncinate process is about 14°,and its function may play a certain role in limiting the excessive rotation of the cervical spine.

【Objective】 To investigate and analyze the current situation of blood donors’ complaints in Changsha Blood Center, find out the reasons and characteristics of the complaints, aimed at improving the satisfaction of blood donors and the quality of blood donation service. 【Methods】 The healthcare complaint analysis tool (HCAT) was used to encode and statistically analyze the complaints against our center from 2020 to 2022, and then a three-level framework for complaint management classification was constructed. 【Results】 Blood donors had relatively more appeals to the management of primary classification, accounting for 61.77%(126/204). For secondary classification, complaints mainly focused on the working system and process, accounting for 24.02%(49/204), and the problems related to policies and regulations such as free blood use and voluntary blood donation incentive mechanism, accounting for 22.55%(46/204), and the problems related to environment and facilities such as the adjustment of blood donation centers and blood donation time was not announced timely and not updated synchronously on the Baidu map, accounting for 15.2%(31/204). 【Conclusion】 In response to the demands of blood donors, blood centers should optimize the working process and improve the service model of " Internet + voluntary blood donation" and the service awareness of the staff. Further more, the complaint process should be gradually improved to solve the demands of blood donors in time.

The article summarizes the clinical experience of Professor JIA Chunsheng in treating cubital tunnel syndrome with various traditional Chinese medicine therapies,including superficial point-toward-point auricular acupuncture,ordinary acupuncture,fire-needle therapy,and oral Chinese medication,to inherit his academic characteristics,such as meridian-identified and stage-identified treatments,stressing the patient's body constitution and state,and emphasizing the holistic treatment,and to provide references for the popular science education and clinical treatment of cubital tunnel syndrome.

ObjectiveTo observe the effects of Agrimoniae Herba and Coptidis Rhizoma（XHC-HL） on the proliferation， migration， invasion， apoptosis， and autophagy of colorectal tumor cells and explore the mechanism of Agrimoniae Herba and Coptidis Rhizoma in inhibiting colorectal cancer by regulating chaperone-mediated autophagy（CMA）. MethodXHC-HL-containing serum was prepared， and human colorectal cancer cell lines HT29 and LOVO were cultivated and divided into blank group （20% blank serum）， low XHC-HL groups （5%， 10%， 20% drug-containing serum）， and a positive control group using 5-fluorouracil （5-FU）. Cell viability was measured using the cell counting kit-8 （CCK-8） method. Cell proliferation ability was assessed through 5-ethynyl-2′-deoxyuridine （EdU） staining. Scratch assays and Transwell migration tests were conducted to evaluate cell migration ability， and Transwell invasion assays were used to assess cell invasion ability. Apoptosis rates were determined by flow cytometry， and the impact of XHC-HL on yeast Atg6 homologous 1 （Beclin-1）， microtubule-associated protein1 light chain3 Ⅱ （LC3 Ⅱ）， and p62 was analyzed via Western blot. The influence of XHC-HL on CMA-related proteins and mRNA was examined using Western blot and real-time fluorescence quantitative polymerase chain reaction （Real-time PCR）. ResultCompared to that in the blank group， the vitality of colorectal cancer cells HT-29 and LOVO was significantly inhibited in XHC-HL groups and the 5-FU group （P<0.01）. Compared to that in the blank group， the proliferation of colorectal cancer cells HT-29 and LOVO was significantly inhibited in XHC-HL groups and the 5-FU group （P<0.05， P<0.01）. Compared to the blank group， there was a significant reduction in cell migration rates （P<0.01）， the number of cells migrating to the lower chamber （P<0.01）， and the number of invasive cells （P<0.01）， as well as and an increase in cell apoptosis （P<0.01） in XHC-HL groups and the 5-FU group （P<0.01）. Western blot results indicated that compared to that in the blank group， the expression levels of Beclin-1 and LC3 Ⅱ were increased（P<0.05，P<0.01）in XHC-HL groups and the 5-FU group， while the p62 levels were decreased（P<0.05，P<0.01）. Furthermore， the protein expression levels of lysosomal associated protein 2A （LAMP2A）， heat shock cognate protein 70 （HSC70）， and heat-shock protein 90 （HSP90） in XHC-HL groups and the 5-FU group were decreased to varying extents， whereas the expression levels of glyceraldehyde-3-phosphate dehydrogenase （GAPDH） were elevated （P<0.01）. The Real-time PCR results showed that compared to those in the blank group， the mRNA levels of LAMP2A， HSC70， and HSP90 were downregulated in XHC-HL groups and the 5-FU group， and the mRNA expression level of GAPDH was upregulated （P<0.01）. ConclusionXHC-HL can inhibit the proliferation， migration， and invasion of colorectal cancer cells by suppressing CMA activity， thus inducing autophagy and promoting apoptosis.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective Neuromuscular electrical stimulation(NMES)-evoked kinesthetic information in muscle spindle can be purely extracted from the mixed motor and sensory afferents using Ischemic nerve block(INB).This study aims to investigate the somatosensory cortical response evoked by NMES activating muscle spindle afferents in forearm.Methods All subjects performed four experimental tasks designed according to a 2×2 factors,including one factor of the INB state(without INB and within INB)and the other of the stimulation intensity(above and below motor threshold).During the experiment,we recorded EEG data with 64 channels and then beta event-related desynchronization(Beta ERD)were utilized quantize somatosensory cortical excitability evoked by the tasks.The subjective perception about the sensation and movement of the right hand were evaluated by a psychophysical test after the right wrist was performed by INB.Results INB significantly reduced beta ERD on the contralateral somatosensory cortex evoked by NMES above the motor threshold,and there was significant difference of NMES-evoked beta ERD values on the contralateral somatosensory cortex between above and below motor threshold.Meanwhile,contralateral dominance of NMES-evoked beta ERD on the somatosensory cortex was transferred to ipsilateral hemisphere under INB.Conclusion INB can significantly reduce NMES-evoked somatosensory cortical response above motor threshold and decrease cortical perception on the stimulus intensity,which may be due to INB resulting in rapid functional reorganization of somatosensory cortex.

【Objective】 To explore the application and effectiveness of holistic nursing based on SWOT in platelet collection at blood stations. 【Methods】 SWOT analysis was used to analyze the causes of adverse reactions to blood donation in platelet donors, put forward countermeasures and take holistic nursing measures. Routine nursing was adopted from January to June 2021, and holistic nursing based on SWOT analysis was adopted from July to December 2021. The adverse reactions and the nursing quality before and after the implementation of holistic nursing in the two groups were compared, and the satisfaction of blood donors to the nurses was analyzed. 【Results】 After the implementation of holistic nursing based on SWOT analysis, the incidence of adverse reactions in blood donation was 2%(2/100) in the observation group, significantly lower than 11%(11/100) in the control group(P<0.05). Nursing satisfaction score of the observation group was (93.10±4.97 points), significantly higher than that of the control group (78.12±5.36 points)(P<0.05). 【Conclusion】 The implementation of holistic nursing based on SWOT analysis can significantly reduce the incidence of adverse reactions in platelet donors and improve the satisfaction of blood donors with the nursing work, thus significantly improving the quality of nursing in the department.

The awake prone position plays an important role in the treatment of hypoxemia and the improvement of respiratory distress symptoms in non-intubated patients. It is widely used in clinical practice because of its simple operation, safety, and economy. To enable clinical medical staff to scientifically and normatively implement prone position for awake patients without intubation, the committees of consensus formulation, guided by evidence-based methodology and Delphi method, conducted literature search, literature quality evaluation and evidence synthesis around seven topics, including indications and contraindications, evaluation, implementation, monitoring and safety management, termination time, complication prevention and health education of awake prone position. After two rounds of expert letter consultation, Expert consensus on implementation strategy of awake prone positioning for non-intubated patients in China (2023) was formulated, and provide guidance for clinical medical staff.
Humans ; Consensus ; Prone Position ; Wakefulness ; China ; Dyspnea

Objective: To investigate the function of FAK / Twist1 signaling pathway during craniosynostosis closure. Methods: Ten days old rats were divided into a control group (n = 50) and a rotation group (n = 50) . Both of them were made a approximately 0. 5 cm circle bone window at the midpoint of the lambdoid suture of the rat.The bone flaps were left free without damaging the dura mater. The bone flaps in the control group were repositioned in situ , and the bone flaps in the rotation group were rotated 180 ° and repositioned 3 weeks later. Then the experiments were performance as followed :open field test , measurement of body weight , head circumference , bone flap area , and thickness of bone flap in the two groups , observation of cranial suture closure by microscopy and HE staining , FAK / Twist1 expression determined by Western blot , real⁃time PCR , and immunohistochemical staining in the bone flap and dure , respectively. Results: The cranial sutures was completely closed in the rotation groupand that was open in the control group through detecting by microscopic examination and HE staining. The thickness of the bone flap in the derotation group was greater than that in the control group , with statistical significance (P < 0. 01) . There were no significant differences between two groups in head circumference , weight , bone flap area , and operative area. The results of behavioral test showed that after the closure of cranial suture , the acsion of FAK was significantly increased in the calvaria and dura as well as Twsit1 was significantly decreased in the dura in rotating group measuring by Western blot , real⁃time PCR , and immunohistochemical staining (P < 0. 05) . Conclusion FAK/Twist1 may play an important role in craniosynostosis after rotation.