1.Practical analysis on the application of individual scientific research performance assessment in tertiary public hospitals
Wen DING ; Yiying ZHU ; Jianhua MAO ; Qiang SHU
Chinese Journal of Medical Science Research Management 2024;37(1):50-57
Objective:To identify the strengths and weaknesses of hospital development through the application of individual scientific research performance assessment, thereby providing a basis for the formulation of science and technology policies.Methods:We established a research performance assessment system and conducted research performance assessments across the hospital for three consecutive years. The assessment results were analyzed in-depth, utilizing the Kruskal-Wallis test to determine if there were differences in the overall level of assessment scores between years and series; the Mann-Whitney test to analyze differences between the promoted and non-promoted groups; the χ2 test to analyze whether age, degree, gender, and maternity situations affected assessment grades. Results:From 2020 to 2022, the individual scientific research performance assessment scores showed an overall upward trend, with the average per capita assessment score increasing significantly from 35.26 points in 2020 to 74.04 points in 2022. There were statistical differences in the assessment scores of different professional titles, indicating that the senior professionals > the associate senior professionals > the intermediates. There was no significant difference between the promoted and non-promoted groups. Additionally, age, degree, gender, and maternity factors affected assessment grades.Conclusions:It has been preliminarily established that the assessment of individual scientific research performance can effectively steer the scientific innovation activities of researchers, and play a positive role in enhancing the overall scientific research strength. The findings from the data analysis indicate that the hospital is expected to continuously enhance its scientific research performance by focusing on newly recruited doctoral personnel, establishing a system of support and guidance, and providing preferential support to female researchers. The assessment results serve as a " benchmark" for management departments and provide data-driven insights for the development of science and technology policies.
2.Mechanism prediction and verification of Cistanche deserticola in the treatment of inflammatory bowel disease
Ming QIAO ; Yi ZHU ; Junping HU ; Jianhua YANG
China Pharmacy 2024;35(21):2582-2589
OBJECTIVE To investigate the mechanism of Cistanche deserticola in the treatment of inflammatory bowel disease (IBD). METHODS The active components of C. deserticola were screened based on TCMSP and literature reports. The targets of active ingredients were obtained via Swiss Target Prediction platform. Then the disease targets were obtained by searching GeneCards and OMIM databases. PPI network and “drug-compound-disease-target” network were constructed. The core components and core targets were screened. GO and KEGG enrichment analyses were performed, and molecular docking verification was conducted for core targets and core components. The IBD mice model was established and divided into model group, positive control group (dexamethasone, 0.4 mg/kg) and C. deserticola extract group (100, 200, 400 mg/kg); blank control group was set, with 8 mice in each group. Each group was given relevant medicine, once a day, for 7 consecutive days. Disease activity index (DAI) score and colon length were calculated, and the pathological morphology of the colon of mice was observed. The levels of inflammatory factors [interleukin-6 (IL-6), IL-1β, IL-10, myeloperoxidase (MPO),tumor necrosis factor-α (TNF-α)] in colon tissue, and protein expressions of core targets were detected. RESULTS A total of 39 active ingredients and 232 potential targets of C. deserticola in the treatment of IBD were obtained. The treatment of IBD with C. deserticola might be related to core components such as quercetin, suchilactone, β-sitosterol and cistanoside H, and core targets such as TNF, AKT1, STAT3, EGFR and SRC. GO and KEGG pathway analysis predicted that the biological processes of C. deserticola in the treatment of IBD were mainly related to protein phosphorylation, and negative regulation of apoptosis, mainly involving PI3K/AKT and EGFR tyrosine kinase inhibitor resistance signaling pathways. The results of molecular docking showed that the binding energy between the core components and core target of C. deserticola was less than -4.7 kJ/mol. Animal experiment results showed that after intervention with C. deserticola extract, the body weight and colon length of mice significantly increased (P<0.05 or P<0.01), while DAI decreased significantly (P<0.05 or P<0.01). The congestion and edema of colon mucosa were significantly reduced, and the pathological score of colon tissue was significantly decreased (P<0.05 or P<0.01); the levels of IL-6, IL-1β, MPO and TNF-α, as well as the protein expressions of PI3K, phosphorylated PI3K (p-PI3K), EGFR, TNF- α, STAT3, phosphorylated STAT3 (p-STAT3), AKT1, phosphorylated AKT1 (p-AKT1) and SRC in colon tissue were reduced significantly (P<0.05 or P<0.01), while the level of IL-10 was significantly increased in model group (P<0.01). CONCLUSIONS C. deserticola may alleviate IBD by regulating the SRC/EGFR/PI3K/AKT signaling pathway.
3.Observation of the clinical effect of semi-solidification enteral nutrition in neurocritical patients
Jie LI ; Yiming SU ; Shan ZHANG ; Jianwei LE ; Yadi SHAO ; Jihui YE ; Dingjun FENG ; Jianhua ZHU
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care 2024;31(4):413-417
Objective To observe the impact of semi-solidification enteral nutrition on feeding tolerance,nutritional and infection related indicators,and prognosis in neurocritical patients.Methods Adopting the prospective research method,the neurocritical patients who were admitted to the department of intensive care unit(ICU)of the First Affiliated Hospital of Ningbo University from December 2021 to May 2022 and had to stay in the nasogastric tube for enteral nutrition were selected as the study subjects,pectin was added to achieve the semi-solidification of enteral nutrition,and the patients were divided into pectin group and control group according to the principle of randomized control,with 25 cases in each group.Enteral nutrition was started within 24-48 hours of admission to the ICU in all patients,and pectin plus continuously pumped enteral nutrition preparation was given in the pectin group and continuously pumped enteral nutrition preparation in the control group,all of which was used continuously for more than 7 days.Differences in albumin,prealbumin,Glasgow coma scale(GCS),acute physiology and chronic health evaluation Ⅱ(APACHEⅡ),sequential organ failure assessment(SOFA),procalcitonin(PCT),interleukin-6(IL-6)and C-reactive protein(CRP)were compared between the two groups before and after 7 days of treatment,and enteral nutrition compliance rates at 3 days and 7 days of treatment,as well as the incidence of enteral nutrition intolerance(including vomiting,diarrhea,constipation,aspiration and bloating),along with the length of ICU stay and 28 days prognosis were observed.Results There were no statistically significant differences between the two groups in general clinical data[including gender,age and body mass index(BMI)]and pre-treatment GCS score,APACHEⅡ score,SOFA score,albumin,prealbumin,PCT,IL-6 and CRP levels.The incidence of vomiting,diarrhea,constipation,and bloating during enteral nutrition was significantly lower in the pectin group than those in the control group[vomiting:4.0%(1/25)vs.24.0%(6/25),diarrhea:8.0%(2/25)vs.32.0%(8/25),constipation:20.0%(5/25)vs.65.0%(13/25),bloating:12.0%(3/25)vs.36.0%(9/25),all P<0.05],but the difference in the incidence of aspiration compared with the control group was not statistically significant[4.0%(1/25)vs.16.0%(4/25),P>0.05].Caloric compliance with enteral nutrition was significantly higher in the pectin group than in the control group at both 3 days and 7 days of treatment[3 days of treatment:48.0%(12/25)vs.20.0%(5/25),7 days of treatment:88.0%(22/25)vs.60.0%(15/25),both P<0.05],and the prealbumin level was significantly higher in the pectin group than in the control group at the end of 7 days treatment(mg/L:248.08±43.99 vs.221.64±33.95,P<0.05).There was no statistically significant difference in the comparison of GCS score,APACHEⅡ score,SOFA score,PCT,IL-6,CRP,length of ICU stay,and 28 days mortality between the two groups after treatment.Conclusion The administration of semi-solidification enteral nutrition reduces the incidence of enteral nutrition intolerance,improves caloric intake and nutritional status in neurocritical patients,but has no significant effect on infection indicators and prognosis.
4.Development of a working model of evidence-based nursing practice in deep vein thrombosis prophylaxis
Yu WANY ; Yufang HAO ; Yufen MA ; Yuan XU ; Ranxun AN ; Haibo DENG ; Lei WANG ; Xiaojie WANG ; Jianhua SUN ; Jia LIU ; Liyun ZHU ; Xinjuan WU
Chinese Journal of Nursing 2024;59(15):1804-1811
Objective To construct an evidence-based practice model for nurses in preventing deep vein thrombosis(DVT)and provide a scientific and targeted theoretical basis for nurses to carry out evidence-based nursing practice in DVT prevention.Methods Based on the previous evidence-based nursing practice project on DVT prevention after hip and knee arthroplasty,the research team used theoretical analysis and brainstorming to develop a draft of the work model.Expert meetings were organized to validate the content of the draft using the Delphi method,leading to the finalization of the evidence-based practice model for nurses in preventing DVT.Results The Knowledge-to-Action(KTA)framework was selected as the basic framework for constructing the evidence-based nursing practice model for preventing DVT.Theoretical Domain Framework,Theory of Planned Behavior,and Social Cognitive Theory were chosen to explore the influencing factors of nurses'behavior change in preventing DVT through evidence-based practice.The authority coefficient of the participating experts was 0.904,indicating high reliability.The final model consisted of 6 key components:knowledge generation,problem identification,localization and adaptation,knowledge application,sustained knowledge use,and conceptual framework for behavior change through evidence-based practice.Conclusion Based on theoretical analysis and clinical practice,this study developed an evidence-based practice model for nurses in preventing DVT using the expert meeting.The research methodology was scientific,and the content was reliable,providing a theoretical basis for nurses to engage in evidence-based nursing practice for DVT prevention.
5.A case report of glans penis hemangioma
Zhaoyang LIU ; Zhengguo ZHANG ; Congwei WANG ; Changguo WANG ; Jianhua ZHU ; Zhankui JIA ; Jinjian YANG
Chinese Journal of Urology 2024;45(3):229-230
Hemangioma of the penile head is rare. This paper reported a patient, 16 years old, who was admitted to hospital due to the discovery of multiple masses on the head of the penis for more than two years. Physical examination showed that three vascular mass-like masses were distributed along the coronal sulcus at the 3, 9, and 12 points of the penile head, and the larger one was about 10 mm×5 mm size, blue-purple, soft, and painless. Ultrasound examination suggested that the patient had a penile head hemangioma. Surgical resection was performed, and the postoperative pathological diagnosis was penile head hemangioma.The follow-up of 3 months showed that the wound healed well without recurrence, and the penile head appearance was not obviously deform.
6.Proliferative Effect of Youguiyin and its Main Constituents Absorbed in the Blood on Rats Osteoblasts
Yaoyao ZHU ; Xi ZHU ; Jianhua ZHANG ; Hua YIN
Herald of Medicine 2024;43(12):1881-1887
Objective To identify the main blood absorbed constituents from Youguiyin and elucidate the proliferative effect of Youguiyin and its main blood absorbed constituents on osteoblasts in rats.Methods Ultra-performance liquid chromatography-mass spectrometry(UPLC-MS)technique was used to establish the analysis method for Youguiyin,individual herbal medicines and the medicated serum containing Youguiyin after oral administration in Sprague-Dawley rats.Osteoblasts of rats were isolated and cultured in vitro.The effect of Youguiyin,medicated serum,and its main blood absorbed components on osteoblast proliferation rate was evaluated by thiazole blue(MTT)assay.Results Ten components were detected in the blood serum of rats after oral administration of Youguiyin,namely aconitine,hypaconitine,mesaconitine,benzoylaconitine,benzoylhypaconitine,benzoylmesaconine from Aconiti Lateralis Radix Praeparata,cinnamic acid from Cinnamomi Cortex,morroniside,loganin from Corni Fructus,and pinoresinoldiglucoside from Eucommiae Cortex,respectively.Youguiyin decoction and seven components from Aconiti Lateralis Radix Praeparata and Cinnamomi Cortex showed a certain promoting proliferation effect on osteoblasts when the concentrations were 1 μg·mL-1,10 ng·mL-1,10 ng·mL-1,1 ng·mL-1,100 μg·mL-1,100 pg·mL-1,1 μg·mL-1 and 1 ng·mL-1,respectively.Besides,the effect onset was relatively rapid.The onset time of medicated serum containing Youguiyin was slow.Conclusions The ten chemical components absorbed in the blood from Youguiyin were identified.It was revealed that Youguiyin,medicated serum and the main components of Youguiyin absorbed in the blood can promote the proliferation of osteoblasts within a certain concentration range.
7.Clinical effects of free anterolateral thigh perforator flaps in repairing diabetic foot ulcers under a multi-disciplinary team cooperation model
Jianjun ZHAO ; Zhenjun XIE ; Guohong ZHAO ; Jianhua ZHANG ; Huawei SUN ; Huikai BAI ; Huifeng ZHANG ; Dongbin ZHANG ; Erhui XIAO ; Guosong ZHU
Chinese Journal of Burns 2024;40(8):756-761
Objective:To explore the clinical effects of free anterolateral thigh perforator flaps in repairing diabetic foot ulcers (DFUs) under a multi-disciplinary team (MDT) cooperation model.Methods:The study was a retrospective observational study. From June 2018 to December 2022, 49 DFU patients who met the inclusion criteria were admitted to the Department of Hand and Foot Microscopy and Wound Repair Surgery of Henan Provincial People's Hospital (People's Hospital of Zhengzhou University), including 28 males and 21 females, aged from 47 to 68 years, with type 2 diabetes history period ranging from 6 months to 21 years. Under a MDT cooperation model, the physicians from department of endocrinology comprehensively assessed the patients, stabilized the patients' general condition, and controlled their complications, the surgeons from department of vascular surgery assessed and improved the patients' lower limb blood supply, the physicians from department of infectious diseases provided anti-infection treatment plans, the physicians from department of anesthesiology and perioperative medicine assessed the patients' perioperative risk and ensured their perioperative safety, and according to the patients' condition, the physicians from departments such as cardiology, neurology, nutrition, and rehabilitation actively and timely participated in the treatment. The surgeons from department of hand and foot microscopy and wound repair surgery prepared the wound base and used free anterolateral thigh perforator flaps to repair the wounds. After once or multiple debridement in the first stage, the wound area ranged from 5.0 cm×4.5 cm to 17.0 cm×10.0 cm. After once or twice vacuum sealing drainage treatment, the free anterolateral thigh perforator flaps were used to repair the wounds with incision area of 6 cm×5 cm to 18 cm×11 cm in the second stage. The descending branches of lateral circumflex femoral artery and the accompanying veins of flaps were anastomosed to the arteries and veins in the recipient sites, respectively. The wounds in the flap donor sites were sutured directly. After surgery, whether the patient's perioperative period was stable, the survival of flaps, the healing of wounds in the flap donor and recipient sites were observed. During the follow-up, the texture and appearance of flaps, whether there was a new ulcer, and the patient's walking ability were observed.Results:All the patients had stable perioperative period. Among them, the flaps in 46 patients survived successfully; the flaps in 2 patients developed complete necrosis, including 1 case whose ulcer was healed after repair of pedicled flap from the lower leg, and 1 case who underwent amputation of the lower leg; the flap in 1 patient developed partial necrosis, which was healed after dressing change and skin grafting. The wounds in the flap donor and recipient sites healed well. During the postoperative follow-up of 6-24 months, the flaps had good texture and appearance with no new ulcers, and the patients had no obvious impairment in daily walk.Conclusions:The MDT cooperation model can sufficiently ensure the perioperative safety of DFU patients. The free anterolateral thigh perforator flaps can repair the DFU wounds achieving good clinical effects with high flap survival rate and decreased amputation rate.
8.Application value of Nectin-4 targeting radiotracer 68Ga-N188 in the diagnosis of pancreatic cancer
Jianxin WANG ; Yongsu MA ; Weikang LIU ; Xueqi CHEN ; Yiran CHEN ; Yu ZHU ; Jixin ZHANG ; Jianhua ZHANG ; Xing YANG ; Xiaodong TIAN ; Yinmo YANG
Chinese Journal of Digestive Surgery 2024;23(5):746-753
Objective:To investigate the application value of nectin-4 targeting radiotracer 68Ga-N188 in the diagnosis of pancreatic cancer. Methods:The prospective study was conducted. The clinicopathologic data of 16 patients diagnosed as pancreatic cancer on enhanced computed tomography (CT) who were admitted to the Peking University First Hospital from August to December 2022 were collected. There were 9 males and 7 females, aged (62±8)years. All patients underwent 18F-flurodeoxyglucose ( 18F-FDG) and 68Ga-N188 positron emission tomography (PET)/CT examination. Observation indicators: (1) distribution of 68Ga-N188 in different tissues and tumor primary lesion of patients; (2) expression of Nectin-4 and uptake of 68Ga-N188 in pancreatic cancer; (3) comparison of examination results between 68Ga-N188 and 18F-FDG PET/CT. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the independent sample t test. Count data were described as absolute numbers or percentages. Results:(1) Distribution of 68Ga-N188 in different tissues and tumor primary lesion of patients. Results of PET/CT examination showed that in 1 hour after injection, the maximum standard uptake value (SUVmax) and mean standard uptake value (SUVmean) of 68Ga-N188 in fat, muscle, skin, and brain tissues of 16 patients were 0.40±0.16 and 0.25±0.09, 0.68±0.20 and 0.44±0.12, 0.39±0.14 and 0.28±0.11, 0.09±0.04 and 0.05±0.02, respectively. In the tissues of the esophagus, liver, spleen, and pancreas, the above indicators were 1.53±0.48 and 1.16±0.31, 1.49±0.45 and 0.91±0.30, 1.40±0.30 and 1.02±0.24, 1.24±0.31 and 0.96±0.25, respectively. In tumor primary lesion, the above indicators were 3.28±1.02 and 2.14±0.62, respectively, showing significant differences in SUVmax and SUVmean compared with pancreatic tissue ( t=8.03, 6.75, P<0.05). The tumor background ratio in tumor primary lesion based on SUVmax was 1.82±0.58. (2) Expression of Nectin-4 and uptake of 68Ga-N188 in pancreatic cancer. Results of immunohistochemical staining in 16 patients showed that there were 7 patients with high Nectin-4 expression and 9 patients with low Nectin-4 expression. Results of PET/CT examination showed that the SUVmax of 68Ga-N188 in tumor primary lesion of the 7 patients with high Nectin-4 expression and 9 patients with low Nectin-4 expression were 3.77±1.10 and 2.64±0.68, showing a significant difference between them ( t=2.64, P<0.05). The SUVmax of 18F-FDG in tumor primary lesion of the 7 patients with high Nectin-4 expression and 9 patients with low Nectin-4 expression were 6.73±3.24 and 6.43±3.45, showing no significant difference between them ( t=0.17, P>0.05). (3) Comparison of examination results between 68Ga-N188 and 18F-FDG PET/CT. Of the 16 patients, cases with positive results of tumor primary lesion on 68Ga-N188 and 18F-FDG PET/CT were 14 and 11, respectively, for the 14 pancreatic cancer patients diagnosed by postoperative histopathology. Among them, cases with positive results of tumor primary lesion on 68Ga-N188 and 18F-FDG PET/CT were 3 and 1 for the 3 pancreatic cancer patients receiving evaluation for chemotherapy. The SUVmax of 18F-FDG in tumor primary lesion of the 3 patients with chemotherapy and the 11 patients without chemotherapy were 2.80±0.69 and 6.97±2.11, showing a significant difference between them ( t=3.29, P<0.05). The SUVmax of 68Ga-N188 in tumor primary lesion of the 3 patients with chemotherapy and the 11 patients without chemotherapy were 3.38±1.12 and 2.93±0.50, showing no significant difference between them ( t=0.66, P>0.05). Cases with positive results of lymph node metastases in 68Ga-N188 and 18F-FDG PET/CT were 6 and 4, respectively, for the 6 pancreatic cancer patients diagnosed with lymph node metastases by postoperative histopathology, and the SUVmax of 68Ga-N188 and 18F-FDG in lymph node metastases were 2.25±1.12 and 4.02±1.27. Conclusion:68Ga-N188 PET/CT can be used for imaging diagnosis of tumor primary lesion and lymph node metastases of pancreatic cancer.
9.Cognition and participation intention of patient-reported outcomes in patients with lower limb deep vein thrombosis: a qualitative study
Ranxun AN ; Yuan XU ; Lei WANG ; Yu WANG ; Haibo DENG ; Jianhua SUN ; Xiaojie WANG ; Liyun ZHU ; Qiaodan LU ; Xinyi ZHOU ; Yufen MA
Chinese Journal of Modern Nursing 2024;30(1):95-100
Objective:To explore the cognition and intention of patients with lower limb deep vein thrombosis (DVT) to participate in patient-reported outcomes (PROs), so as to provide references for the promotion, application, and practice of PROs in lower limb DVT patients in China.Methods:This study adopted the phenomenological qualitative research method. From February to June 2023, 13 lower limb DVT patients admitted to Peking Union Medical College Hospital were selected for semi-structured in-depth interviews. Colaizzi 7-step analysis method was used for analyzing and summarizing data.Results:Thirteen patients with lower limb DVT highly recognized their own value in participating in PROs, namely health benefits, prevention of DVT complications, and reduction of disease uncertainty. Lower limb DVT patients expected to receive support from healthcare professionals, families, and portable and simplified reporting formats to promote their participation in PROs. From the patient 's own perspective, they perceived that insufficient attention to DVT caused by lack of awareness of the hazards of DVT and limited understanding of PROs made it difficult for them to participate in PROs. Conclusions:Lower limb DVT patients have a high intention to participate in PROs. The application and promotion of PROs in lower limb DVT patients in China require joint support from various sectors of society, among which strengthening effective health education for patients and their families and providing multi-channel reporting forms are the key to promoting of PROs.
10.Development of the PICC-related Thrombosis Prevention Knowledge, Attitude, and Practice Questionnaire for Nurses and its reliability and validity
Ning ZHANG ; Yuan XU ; Haibo DENG ; Lei WANG ; Liyun ZHU ; Qiaodan LU ; Ranxun AN ; Xinyi ZHOU ; Yu WANG ; Jianhua SUN ; Yufen MA ; Xiaojie WANG
Chinese Journal of Modern Nursing 2024;30(4):453-460
Objective:To construct a tool to evaluate the knowledge, attitude, and practice of nurses in the prevention of thrombosis related to peripherally inserted central catheter (PICC) .Methods:From December 2022 to April 2023, based on the theory of knowledge, attitude, and practice, a preliminary draft of the PICC-related Thrombosis Prevention Knowledge, Attitude, and Practice Questionnaire for Nurses was formed through systematic literature review, two rounds of Delphi expert consultations, and pre-survey. In May 2023, convenience sampling was used to select 573 nurses from Chinese Academy of Medical Sciences & Peking Union Medical College Hospital as the research subject for a survey to conduct item analysis, validity testing, and reliability testing on the questionnaire.Results:The final version of the PICC-related Thrombosis Prevention Knowledge, Attitude, and Practice Questionnaire for Nurses included 20 knowledge items, 10 attitude items, and 10 practice items. In the content validity of the questionnaire, the average content validity index was 0.984, the overall consensus content validity index was 0.850, and the item level content validity index was 0.857 to 1.000. Exploratory factor analysis extracted three common factors with eigenvalues>1.000, with a cumulative variance contribution rate of 64.540% and factor loadings of 0.450 to 0.908 for each item. The total Cronbach's α coefficient of the questionnaire was 0.895, the half reliability coefficient was 0.947, and the retest reliability coefficient was 0.966.Conclusions:The PICC-related Thrombosis Prevention Knowledge, Attitude, and Practice Questionnaire for Nurses has good reliability and validity, and can be used to evaluate PICC-related thrombosis prevention knowledge, attitude, and practice among nurses.

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