As an integral part of worldwide healthcare,nursing still has a big task to make in conducting implementation research.Addressing the pressing challenges of closing the gap between evidence and nursing practice,and effectively disseminating and applying evidence within the nursing discipline,remains a top priority.This paper presents a compilation of the status of evidence implementation in clinical nursing from an implementation science perspective,including the theoretical framework of barriers to evidence implementation,common research methodologies,and research progress of related factors in the field of nursing.The goal of this work is to bring more insights to further advance the implementation of evidence in nursing.

Diabetes mellitus (DM) affects about 9.3% of the population globally. Hyperhomocysteinemia (HHcy) has been implicated in the pathogenesis of DM, owing to its promotion of oxidative stress, β-cell dysfunction, and insulin resistance. HHcy can result from low status of one-carbon metabolism (OCM) nutrients (e.g., folate, choline, betaine, vitamin B6, B12), which work together to degrade homocysteine by methylation. The etiology of HHcy may also involve genetic variation encoding key enzymes in OCM. This review aimed to provide an overview of the existing literature assessing the link between OCM nutrients status, related genetic factors, and incident DM. We also discussed possible mechanisms underlying the role of OCM in DM development and provided recommendations for future research and practice. Even though the available evidence remains inconsistent, some studies support the potential beneficial effects of intakes or blood levels of OCM nutrients on DM development. Moreover, certain variants in OCM-related genes may influence metabolic handling of methyl-donors and presumably incidental DM. Future studies are warranted to establish the causal inference between OCM and DM and examine the interaction of OCM nutrients and genetic factors with DM development, which will inform the personalized recommendations for OCM nutrients intakes on DM prevention.

OBJECTIVES: To study the early clinical efficacy of combined therapy of stage 4 neuroblastoma. METHODS: A retrospective analysis was performed on the medical data and follow-up data of 14 children with stage 4 neuroblastoma who were diagnosed in Hong Kong University-Shenzhen Hospital from January 2016 to June 2021. RESULTS: The median age of onset was 3 years and 7.5 months in these 14 children. Among these children, 9 had positive results of bone marrow biopsy, 4 had N-Myc gene amplification, 13 had an increase in neuron-specific enolase, and 7 had an increase in vanilmandelic acid in urine. Based on the results of pathological examination, differentiated type was observed in 6 children, undifferentiated type in one child, mixed type, in one child and poorly differentiated type in 6 children. Of all the children, 10 received chemotherapy with the N7 regimen (including 2 children receiving arsenic trioxide in addition) and 4 received chemotherapy with the Rapid COJEC regimen. Thirteen children underwent surgery, 14 received hematopoietic stem cell transplantation, and 10 received radiotherapy. A total of 8 children received Ch14.18/CHO immunotherapy, among whom 1 child discontinued due to anaphylactic shock during immunotherapy, and the other 7 children completed Ch14.18/CHO treatment without serious adverse events, among whom 1 child was treated with Lu177 Dotatate 3 times after recurrence and is still undergoing chemotherapy at present. The median follow-up time was 45 months for all the 14 children. Four children experienced recurrence within 2 years, and the 2-year overall survival rate was 100%; 4 children experienced recurrence within 3 years, and 7 achieved disease-free survival within 3 years. CONCLUSIONS Multidisciplinary combined therapy is recommended for children with stage 4 neuroblastoma and can help them achieve better survival and prognosis.
Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Child ; Child, Preschool ; Combined Modality Therapy ; Humans ; Infant ; Neuroblastoma/drug therapy* ; Positron-Emission Tomography ; Radionuclide Imaging ; Retrospective Studies ; Treatment Outcome

Objective:To summarize the experience of Bipartition osteotomy combined with craniofacial bone remodeling in the treatment of orbital hypertelorism and midfacial dysplasia.Methods:A retrospective analysis was done by the clinical data of two patients with orbital hypertelorism with maxillofacial malformation treated in the Shanghai Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine in July 2005 and August 2018. The Bipartition osteotomy via intracranial approach were applied for the two patients, one male and one female. The two patients aged 17 and 19, were suffered from degree Ⅰ orbital hypertelorism [interorbital distance(IOD) 32 mm and 34 mm]. With a frontal bone fenestration, the Monobloc osteotomy was done firstly to dislocate the cranio-orbital-maxilla bone graft, then the Bipartition osteotomy was performed according to the preoperative design through 3D computer aided design(CAD) and a V-shape bone graft was removed from the interorbital bone graft to split the hard palate longitudinally along the midline. After all, the whole facial bone was separated to two blocks: bilateral orbital-maxillary segments. Finally the midface had been remodeled by the bilateral orbital-maxillary segments which rotated and fixed internally. Self-rib nasal augmentation was done later. Patents’ complications, eye movement, visual acuity, olfactory sensation, nasal shape, IOD were measured through CT scan and the appearances were observed in the postoperative follow-up to determine the degree of improvement.Results:15 mm in width of interorbital bone was resected in both of the two patients, respectively. Postoperative IOD reduced by 17 mm, 19 mm, respectively. Mild cerebrospinal fluid leakage occurred in both patients after operation. They recovered after 5, 8 days of pillow-free horizontal position, respectively. The male patient developed local skin infection at the coronal incision and recovered after dressing change for 1 week. One week after operation, the female patient’s nose tip was partially broken near the nasal columella, and recovered after debridement and repairment. Follow up for 4-11 months showed that the eye movement, visual acuity, normal convergence and olfactory sensation were normal and no diplopia of 2 patients. The nasal appearances and orbital hypertelorisum of them were corrected obviously by follow-up after 4 months, but the nasal morphology and epicanthus still need further improvement.Conclusions:The Bipartition osteotomy can effectively treat the orbital hypertelorisum through the internal rotation fixation of bilateral orbital-maxillary segments, that makes the high arch palate lower and the occlusal plane of the upper jaw flattened.

Objective:To summarize the experience of Bipartition osteotomy combined with craniofacial bone remodeling in the treatment of orbital hypertelorism and midfacial dysplasia.Methods:A retrospective analysis was done by the clinical data of two patients with orbital hypertelorism with maxillofacial malformation treated in the Shanghai Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine in July 2005 and August 2018. The Bipartition osteotomy via intracranial approach were applied for the two patients, one male and one female. The two patients aged 17 and 19, were suffered from degree Ⅰ orbital hypertelorism [interorbital distance(IOD) 32 mm and 34 mm]. With a frontal bone fenestration, the Monobloc osteotomy was done firstly to dislocate the cranio-orbital-maxilla bone graft, then the Bipartition osteotomy was performed according to the preoperative design through 3D computer aided design(CAD) and a V-shape bone graft was removed from the interorbital bone graft to split the hard palate longitudinally along the midline. After all, the whole facial bone was separated to two blocks: bilateral orbital-maxillary segments. Finally the midface had been remodeled by the bilateral orbital-maxillary segments which rotated and fixed internally. Self-rib nasal augmentation was done later. Patents’ complications, eye movement, visual acuity, olfactory sensation, nasal shape, IOD were measured through CT scan and the appearances were observed in the postoperative follow-up to determine the degree of improvement.Results:15 mm in width of interorbital bone was resected in both of the two patients, respectively. Postoperative IOD reduced by 17 mm, 19 mm, respectively. Mild cerebrospinal fluid leakage occurred in both patients after operation. They recovered after 5, 8 days of pillow-free horizontal position, respectively. The male patient developed local skin infection at the coronal incision and recovered after dressing change for 1 week. One week after operation, the female patient’s nose tip was partially broken near the nasal columella, and recovered after debridement and repairment. Follow up for 4-11 months showed that the eye movement, visual acuity, normal convergence and olfactory sensation were normal and no diplopia of 2 patients. The nasal appearances and orbital hypertelorisum of them were corrected obviously by follow-up after 4 months, but the nasal morphology and epicanthus still need further improvement.Conclusions:The Bipartition osteotomy can effectively treat the orbital hypertelorisum through the internal rotation fixation of bilateral orbital-maxillary segments, that makes the high arch palate lower and the occlusal plane of the upper jaw flattened.

Objective:To investigate the status of cancer-related fatigue in lung cancer patients and its related influencing factors, thus to provide reference for clinical active intervention and improve the quality of life of patients.Methods:In this study, interviews and questionnaires were used to collect patient-related data.Seventy patients with lung cancer from January 2016 to January 2019 in Zhuji People's Hospital were selected in this study, and relevant information was collected and analyzed.The relevant influencing factors of cancer-related fatigue was analyzed.Results:The survey showed that the average score of cancer-related fatigue in lung cancer patients was (5.71±1.96)points, which was in moderate status, the behavioral dimension fatigue score was (5.95±2.38)points, the emotional dimension score was (5.48±2.37)points, the sensory dimension score was (5.46±2.38)points, and the cognitive/emotional dimension score was (4.79±2.11)points.Age, serum albumin level, surgery and anemia were the influencing factors of cancer-induced fatigue in patients with lung cancer( P<0.05). Sleep disorders, anxiety, depression were positively correlated with cancer-induced fatigue in patients with lung cancer( r=0.642, 0.350, 0.192, P=0.000, 0.000, 0.000). The average quality of life score of lung cancer patients was (84.14±6.52)points, which was negatively correlated with cancer-induced fatigue and functional areas, and positively correlated with symptom areas, insomnia and diarrhea( P<0.05). Conclusion:The cancer-induced fatigue of 70 patients with lung cancer in Zhuji People's Hospital is in moderate status, and the main influencing factors are age, serum albumin, surgery and anemia.The survey can provide a reference for subsequent clinical intervention for lung cancer patients.

Objective:To explore the clinical efficacy of Chaihu Shugansan combined with saccharomyces boulardii in treating functional dyspepsia (FD) in children and the effect on serum cytokines and gastrointestinal hormones expression. Method:Totally 120 cases were divided into control group (60 cases) and observation group (60 cases)．The control group was treated with Duopanlitong Pian 0.3 mg·kg^-1, po， tid， and Saccharomyces boulardii 0.25 g，po，bid. The observation group was treated with Chaihu Shugansan, po，qd， and saccharomyces boulardii 0.25 g，po，bid. Four weeks was a course of treatment．The changes of serum Gastric Hunger Hormone and cytokines, Hamilton depression scale (HAMD) score, symptoms improvement time and clinical effect in the two groups were observed. And the recurrence rate was observed after 6 months follow-up. Result:The total effective rate was compared between control group (76.67%，46/60) and observation group (96.15%，57/60)，with significant differences (P<0.01). After treatment, serum tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in both groups were decreased, while serum levels of ghrelin of both group were increased. However，the decreasing range and the increasing range of observation group were statistically obvious than those of control group (P<0.01). HAMD score and disappearance time of clinical symptoms in observation group was significantly different from those in control group (P<0.01). In adverse reactions during treatment, the control group was inferior to the observation group (P<0.05). After the 6-month follow-up, the recurrence rate in observation group was lower than that in control group (P<0.01). Conclusion:Chaihu Shugansan combined with Saccharomyces boulardii was effective in treatment of FD in children, with a low recurrence rate and good compliance. The mechanism may be related to the effective regulation of brain-intestinal axis, balance of intestinal flora, inhibition of inflammatory reaction, regulation of cytokines and gastrointestinal hormone levels.