This study summarized the nursing experience of 2 pediatric heart transplant surgeries.Perioperative care included preoperative maintenance of cardiac function,volume management,infection prevention measures,and psychological preparation.Early postoperative care involved circulatory monitoring,management of right heart dysfunction,use of immunosuppressants,observation of rejection reactions,control of postoperative infections,nutritional support,psychological care,and home continuity care.The postoperative rehabilitation effect of the children is satisfactory after multi-team special treatment and nursing care.The postoperative hospitalization time for the 2 patients were 20 and 30 days.After discharge,2 patients showed good recovery during follow-up.

Objective:To investigate the therapeutic efficacy and prognosis of multiple myeloma (MM) patients with early relapse and the influencing factors of early relapse.Methods:The clinical data of 164 patients with newly diagnosed MM admitted to Affiliated Hospital of Hebei University from January 2018 to January 2021 were retrospectively analyzed, and 53 cases (32.3%) relapsed at the end of the follow-up. According to the recurrence within 12 months or not, the patients were divided into early relapse group and advanced relapse group; the clinical characteristics, overall response rate (ORR) and overall survival (OS) of both groups were compared. Logistic regression was used to analyze if the following indexes including age, gender, albumin, lactate dehydrogenase (LDH), β 2-microglobulin (β 2-MG), hemoglobin, creatinine, serum calcium, bone marrow plasma cell ratio, extramedullary disease, high-risk fluorescent in situ hybridization (FISH) were the influencing factors of the early relapse. Based on 7 published clinical trials, simplified early relapse MM (S-ERMM) scoring system was constructed to subgroup all relapsed patients. The difference in risk stratification between early relapsed patients and advanced relapsed patients was compared. Results:The median follow-up time of 164 newly diagnosed MM patients was 26 months (12-48 months). Among 53 relapsed MM patients, 24 cases had early relapse and 29 cases had advanced relapse. The ORR of patients with early relapse was decreased compared with that of those with advanced relapse [70.8% (17/24) vs. 89.7% (26/29), χ2 = 3.04, P = 0.001]. The median OS of the early relapse group was shorter than that of the advanced relapse group (24 months vs. not reached, P < 0.001). The OS of patient in the early relapse group with the best response ≥ complete remission (CR), ≥ very good partial remission (VGPR) and ≥ partial remission (PR) during initial induction therapy was worse than that of those in the advanced relapse group, and the differences were statistically significant ( P values were 0.008, 0.011, 0.012, respectively). Multivariate Logistic regression analysis showed low albumin (<35 g/L vs. ≥35 g/L: OR = 1.644, 95% CI 1.076-2.511, P = 0.022) and high LDH (< the upper limit of normal value vs. ≥ the upper limit of normal value: OR = 0.998, 95% CI 0.985-1.011, P = 0.030) were independent influencing factors of early relapse. Among 24 early relapse patients, there were 5 cases (20.8%), 13 cases (54.2%), 6 cases (25.0%), respectively in the S-ERMM scoring system low-risk, middle-risk, high-risk groups; among 29 advanced relapse patients, there were 18 cases (62.1%),9 cases (31.0%), 2 cases (6.9%), respectively in the S-ERMM scoring system low-risk, middle-risk, high-risk groups; the difference in risk stratification of the S-ERMM scoring system between the early relapse group and the advanced relapse group was statistically significant ( χ2 = 9.09, P = 0.003). Conclusions:MM patients with early relapse have poor therapeutic efficacy and prognosis. The prognosis is not affected by the depth of remission to first-line therapy. Low albumin and high LDH may be independent risk factors of MM patients with early relapse.

Objective:To explore the efficacy of venetoclax plus azacitidine (VA) in the treatment of patients with newly diagnosed chronic myelomonocytic leukemia (CMML).Methods:The clinical data of 4 newly diagnosed CMML-2 patients treated with VA regimen in the Affiliated Hospital of Hebei University from February 2022 to March 2023 were retrospectively analyzed, and the related literature was reviewed.Results:All 4 CMML-2 patients achieved the effect of ≥ partial bone marrow remission (PMR) after 1 course of treatment, and with the deepened extension of treatment course, the overall response rate and complete remission (CR) rate was 100% and 50%, respectively. In terms of dose adjustment, the dose and usage day of venetoclax were determined by using dynamic frailty assessment and adverse events. Among the 2 patients who achieved CR, 1 patient initially received venetoclax 200 mg for 14 days, and 1 patient received venetoclax 400 mg for 28 days and then the usage reduced to venetoclax 200 mg for 14 days due to hematological adverse events. All 4 patients maintained CR status. The most common grade 3 and 4 adverse events were neutropenia and thrombocytopenia.Conclusions:The first-line application of VA regimen in the treatment of newly diagnosed CMML-2 patients may achieve faster remission and better safety compared with traditional HMA monotherapy.

Objective:To build an evaluation index system for the post competency of nurses in Kidney Intensive Care Unit (KICU) , so as to provide references for the post access management and training system setting of KICU nurses.Methods:Through literature review and semi-structured interview, the post competency evaluation index system of nurses in KICU was preliminarily constructed. Using the purposive sampling method, a total of 15 nursing experts were selected for 2 rounds of expert letter consultation from March to June 2021, and the indicators at all levels were screened, revised and improved. The evaluation index system for the post competency of nurses in KICU was established.Results:The effective recovery rates of the two rounds of questionnaires were both 100.00% (15/15) , the expert authority coefficients were respectively 0.85 and 0.87 and the Kendall harmony coefficients of total indicators were respectively 0.332 and 0.341 ( P<0.01) . The final evaluation index system of post competency of nurse in KICU included 4 first-level indicators, 16 second-level indicators and 51 third-level indicators. Conclusions:The constructed evaluation index system of post competency for KICU nurses is scientific and reliable, which can provide references for the post access management and training system setting of KICU nurses.

Objective:To explore the clinical value of continuous renal replacement therapy (CRRT) nursing team in the treatment of critically ill patients.Methods:From October 2019 to October 2020, convenience sampling was used to select 78 critically ill patients admitted to the Intensive Care Unit (ICU) of the Second People's Hospital of Lianyungang as the research object. The patients were divided into the control group and the observation group by random number table method, 39 cases in each group. The control group carried routine nursing, and the observation group implemented high-quality nursing by the CRRT nursing team. The incidence of complications, quality of life, and anxiety and depression scores were compared between the two groups.Results:After intervention, the incidence of complications in the observation group was lower than that in the control group, and the difference was statistically significant ( P<0.05) . The quality of life score of the observation group was higher than that of the control group, and the anxiety and depression score was lower than that of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:High-quality nursing based on the CRRT nursing team can reduce the incidence of complications in critically ill patients in ICU, improve the quality of daily life, and relieve the negative emotions of patients, which has clinical application value.

Objective:To evaluate the effectiveness and safety of preemptive nasogastric tube placement for improving nutritional status and clinical outcomes in hospitalized infants with congenital heart disease.Methods:Children from 0 to 12 months with congenital heart disease hospitalized in cardiovascular center of Children's Hospital of Fudan University from February to July 2018 were selected as control group through continuous sampling. Children hospitalized were selected from September 2018 to February 2019 as intervention group. The control group followed the current feeding method, the intervention group used preemptive nasogastric tube placement. The nutritional indicators, feeding indicators and clinical outcomes of the two groups were compared to evaluate the intervention effect.Results:The serum albumin and prealbumin of the children in the intervention group were (36.81±4.59) g/L and (162.74±48.17) g/L, which were higher than those in the control group (34.80±5.21) g/L and (142.98± 33.96) g/L, the difference between the two groups was statistically significant ( t values were -2.721, -3.169, both P<0.05); the daily enteral intake, calorie intake and single enteral calorie intake of children in the intervention group were (124.93±27.97) ml·kg -1·d -1, (376.48±88.53) kj·kg -1·d -1, (48.39±9.13) kj·kg -1·time -1, higher than the control group (114.74±30.63) ml·kg -1·d -1, (330.01±90.75) kj·kg -1·d -1, (44.24±13.31) kj·kg -1·time -1, the difference between the two groups was statistically significant ( t values were -2.511, -3.750, -2.382, all P<0.05). the incidence of feeding difficulties in the intervention group was 4.95% (5/101) lower than 14.68% (16/109) of the control group, the difference between the two groups was statistically significant ( χ2 value was 5.513, P<0.05); the proportion of children in the intervention group reaching the target feeding amount when discharged from the hospital was 97.03% (98/101), higher than 84.40% (92/109) of the control group, the difference between the two groups was statistically significant ( χ2 value was 9.699, P<0.05). Conclusions:Preemptive nasogastric tube placement is safety and effectively for patients with congenital heart disease in clinical infants. but it still needs a large sample for a long time to confirm its effectiveness.

Objective:To explore the prevalence and risk factors of cardiac events in different ethnic groups in Xinjiang region.Methods:This retrospective cohort study was based on big data from the health checkup population. A total of 7 899 cases were included from the Physical Examination Center of Xinjiang Uygur Autonomous Region People′s Hospital form 2015 January 1 to December 31, 2017.The population were divided into Uyghur group (2 630 cases), Kazak group (2 636 cases), and the Han nationality group (2 633 cases). Telephone follow-up was conducted once a month after the health checkup, the preset follow-up time for all personnel was 2 years, with the occurrence of cardiac events as the end point. Once cardiac events occurred, the follow-up would be stopped. The risk factors of cardiac events in different ethnic groups were evaluated by statistical analysis.Results:The median follow-up time of the 7 899 included healthy examinees was 1.27 years, and 200 cases of cardiac events occurred, with an incidence rate of 2.53%. The values of body mass index (BMI), the levels of triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) of Uyghur and Kazak were higher than those of Han (all P<0.05). The cardiac events in Uyghur, Kazak and Han group were 75 cases (2.85%), 85 cases (3.22%) and 40 cases (1.52%). There was no significantly statistical difference between Uyghur group and Kazak group in the incidence of cardiac events, while it was significantly lower in the Han group than the other two groups (both P<0.05). Univariate analysis showed that BMI, TC, TG, HDL-C and LDL-C were the risk factors of cardiac events; multivariate Cox regression analysis showed that ethnic groups ( HR=4.34, 95% CI: 1.14―8.13); HDL-C ( HR=3.32, 95% CI: 1.89―5.74) and LDL-C ( HR=2.47, 95% CI: 1.21―7.45) were independent risk factors for cardiac events. Conclusions:Ethnic factor is one of the independent risk factors for the occurrence of cardiac events in Xinjiang, and Uyghur and Kazak have a higher incidence of cardiac events. HDL-C and LDL-C are also important risk factors for cardiac events.

Objective Toexplorethecorrelationanalysisofmammographyandclinicalcharacteristicsassociatedwiththerecurrence ofearlystageoftripleGnegativebreastcancer(TNBC).Methods Thedataofmammographyandclinicalcharacteristicsof231TNBC patientsfromJanuary2009to October2017 wereretrospectivelyanalyzed,andthenthedifferencesofmammographyandclinical characteristicswerecomparedbetweenthepatientswithrecurrence(n＝64)andthosewithoutrecurrence(n＝167).Results Compared withthepatientswithoutrecurrence,thepresenceoffamilyhistoryinpatientswithrecurrencewashigherthanthosewithoutrecurrence (12.5%vs3.6%,P＜0.05).Thehistologicalgradesofthepatientswithrecurrenceweremainlyshowedasgrade2(6.3%)and3(93.7%), andthehistologicalgradeinpatientswithrecurrencewashigherthanthosewithoutrecurrence(P＜0.05).Themammographicfindingsin TNBCshowedthatthepatientswithrecurrenceweremorelikelytohavedensebreasttissue(84.4%),axillarylymphnodesinvasion (53.1%)andlowercalcification(12.5%)(P＜0.05).Multivariatelogisticregressionanalysisshowedthatthefamilyhistoryofbreast cancer(P＝0.01,OR＝2.54),histologicalgradeof2(P＝0.01,OR＝2.23)and3(P＜0.001,OR＝3.79),mammographicdensity breasttissue(P＝0.02,OR＝2.32),calcification(P＝0.02,OR＝0.45),andaxillarylymphnodesinvasion(P＝0.03,OR＝1.75)were statisticallysignificancewithTNBCrecurrence.Conclusion Thefamilyhistory,histologicalgrade,thepresenceofdensebreasttissue andaxillarylymphnodesinvasionsatmammographywereassociatedwiththeincreasedriskofrecurrenceinTNBC,whilethepresenceof calcificationwasrelatedtothelowerriskofrecurrenceinTNBC.

OBJECTIVE： To analyze the development situation of pharmacoeconomic evaluation research in China， and to provide reference for pharmacoeconomics discipline construction. METHODS： China journal full-text database was searched by computer. The searching time was from database establish to Dec. 2018. After collecting the academic papers with the theme of “pharmacoeconomic evaluation”， statistical analysis was made on publication year， source journals， institutions， authors， cooperation publication， citation information and keywords of papers by bibliometric method. RESULTS & CONCLUSIONS： A total of 1 197 literatures were included. The earliest literature was published in 1993， and the largest number （104 pieces） was published in 2015. The literatures came from 289 journals. Among which， China Pharmacy published the largest number of literatures （123 pieces）； the first author came from 619 institutions， which mainly were China Pharmaceutical University （124 pieces）； a total of 2 352 authors were involved， and 923 literatures were completed by two or more authors， with co-authorship rate of 77.1％. The total number times of authors was 3 480， and the degree of cooperation was 2.91. As of April 19， 2019， 975 literatures had been cited. The cited rate was 81.4％， the average citation frequency was 5.83 times， and the H-index was 29. There were a total of 1 922 keywords in the literatures， the top three keywords in the list of frequency were pharmacoeconomics （805 times）， cost-effectiveness analysis （209 times）， and pharmacoeconomic evaluation （98 times）. It could be seen that the research literatures on pharmacoeconomic evaluation in China were published earlier and widely distributed； the research content of the literatures was comprehensive， and some literatures had high influence. But the total number of literatures is still small and is distributed unevenly， and the number of core authors is insufficient， and related research needs to be further developed.

Objective To examine the development of traditional Chinese medicine (TCM) in China and provide reference for the construction of a discipline through a literature review of TCM physique and statistical analyses of papers published between 2008 and 2017. Methods We searched the Chinese journal full?text database for TCM physique research papers, and used bibliometrics to statistically analyze the papers. Results We obtained 2 905 papers from 381 journals, 1 021 institutions, and 6 740 authors. The number of papers increases with the publication time. The cited rate was 87.2%. Each paper was cited 8.74 times. The H?index was 51 and co?authored rate was 83.7%. The cooperation degree was 3.78 with 3 354 words appearing in the keywords of the papers. Conclusion In the past ten years, research on TCM constitution has advanced, strengthening core scientific research. Research quality is high, and the research contents cover a wide range. With the spread of research tentacles, the prospect of further research on this subject is worth looking forward to.