The implantation of left ventricular assist device (LVAD) has significantly improved the quality of life for patients with end-stage heart failure. However, it is associated with the risk of complications, with unplanned readmissions gaining increasing attention. This article reviews the influencing factors, prediction methods and models, and intervention measures for unplanned readmissions in LVAD patients, aiming to provide scientific guidance for clinical practice, assist healthcare professionals in accurately assessing patients' conditions, and develop rational care plans.

Objective:To understand the status and coping strategies of death anxiety among military nurses participating in emergency public health incident response, and to provide references for improving their coping abilities.Methods:A purposive sampling and snowball sampling method were used to select 15 nurses from multiple military hospitals who supported the emergency public health incident. One-on-one semi-structured interviews were conducted, and the Colaizzi's seven-step analysis method was used to analyze the interview data.Results:Four themes were identified: the occurrence of death anxiety at different time points; the presence of significant outbreaks of death anxiety; multiple factors that help military nurses alleviate death anxiety; and the intrinsic motivation and gains of military nurses participating in the response.Conclusions:It is crucial to monitor the occurrence and changes in death anxiety among nurses throughout the entire cycle of emergency public health incidents. Managers should focus on value guidance, leverage individual positive strengths to cope with death anxiety, enhance information and social support, reinforce training on infectious disease prevention and death education, and reduce the level of death anxiety among military nurses and improve their coping abilities.

Objective To observe the value of MRI texture features combined with apparent diffusion coefficient(ADC)for differentiating uterine sarcoma(US)and cellular uterine leiomyoma(CUL).Methods Pelvic MRI data of 27 US patients(US group)and 34 CUL patients(CUL group)were retrospectively analyzed.The texture features of lesions were extracted from T2WI and diffusion weighted imaging(DWI),the ADC value were measured,and the average ADC value(ADCmean),the minimum ADC value(ADCmin)and standard ADC value(ADCst)were recorded.Then logistic regression(LR)models were constructed based on ADC value,optimal texture features alone and their combination,respectively,including LRADC,LRtexture and LRADC+texture models.Receiver operating characteristic curves were drawn,and the area under the curves(AUC)were calculated to evaluate the efficacy of each model for differentiating US and CUL.Results The ADCmean,ADCmin and ADCst in US group were all lower than those in CUL group(all P＜0.05).A total of 3 750 texture features were extracted from pelvic T2WI and DWI,5 optimal features were finally obtained,and the constructed LRADC+texture model and LRtexture model had similar efficacy of differentiating US and CUL(AUC=0.921,0.887;P＞0.05),which were both higher than that of LRADC model(AUC=0.696;both P＜0.05).The calibration curve of LRADC+texture model was basically consistent with the ideal curve,which had better clinical benefits than LRADC and LRtexture models.Conclusion MRI texture features combined with ADC value could improve efficacy for differentiating US and CUL.

Abstract: Objective To screen out a more universally applicable culture medium for the isolation and culturing of pathogenic fungi through comparing the performance of various universal fungal culture media, to optimize the fungal culturomics technique, and to better apply it to the culturomics research of pathogenic fungi. Methods Multiple common fungal culture media Sabouraud dextrose agar (SDA), potato dextrose agar (PDA), modified Dixon (mDixon), modified LeemingNotman agar (MLNA), etc., and a new pan-fungal medium (PF) were used to culture 40 strains of common pathogenic fungi to determine the growth states of strains under different conditions. Based on that, PF, SDA, PDA, mDixon and MLNA, a total of 5 culture media, were used to isolate and culture a simulated sample (suspension of Candida albicans and Aspergillus fumigatus), 10 human samples (4 fecal samples and 6 vaginal secretion samples) and 3 environmental samples. Results The positive growth rates of 40 strains of pathogenic fungi in the 7 media were as follows: PDA 95.0% (38/40), SDA 95.0% (38/40), BHI 95.0% (38/40), YPD 90.0% (36/40), mDixon 95.0% (38/40), MLNA 87.5% (35/40), PF 100.0% (40/40). For the simulated samples, PF could effectively promote the self-limited growth of filamentous fungi, performing better in isolation and culture. For the human samples and environmental samples, PF showed the same versatility as SDA and PDA. Conclusions In the isolation and culturing of pathogenic fungi, PF medium can effectively isolate and culture most fungal species. Meanwhile, PF can make the fast-growing fungi show self-limited growth and clear edges, and not easy to cross-contamination, which indicates it is conducive to the isolation and identification of single colonies. PF medium outperforms other common media in isolating strains from unknown samples in culturomics, which illustrates PF medium can be effectively used for the study of fungal culturomics.

Objective:In the context of China′s increasing standardized management requirements of clinical research, this article aims to explore the management methods of investigator-initiated trials in the new period, to provide possible reference for other medical institutions dedicated to clinical research.Methods:According to the requirements set forth by the＂Administrative Measures for Investigator-Initiated Trials in Medical and Health Institutions (Trial)", combined with the hospital management practice, experiences regarding the research management system construction and implementation, management system construction and its implementation effects are summarized and analyzed.Results:By exploring and summarizing the connotation of high-quality clinical research under the New Policy, tailored clinical research management system in our hospital was developed and implemented. And the hospital′s clinical research capability and level have been greatly improved, which enhancing the hospital academic influence, as well as its competence for serving the development of national and regional clinical research.Conclusions:Along with the rapid progress of clinical research, hospitals need to assure the compliance of national laws and regulations, and develop appropriate and applicable institutional management measures to empower the conduct of high quality clinical research.

Objective:To explore the correlation among psychological flexibility, pain stimulation and adaptation of patients with chronic pain.Methods:From July to September 2020, convenience sampling was used to select 491 patients admitted to the Department of Orthopedics in 5 Class Ⅲ Grade A hospitals in Beijing and Shanghai. The survey was conducted with the self-designed General Information Questionnaire, Psychological Inflexibility in Pain Scale (PIPS) , Pain Disability Index (PDI) , Tampa Scale of Kinesiophobia (TSK-11) and the Chinese version of World Health Organization Quality of Life-BREF (WHOQOL-BRIF) , and the structural equation model hypothesis was proposed.Results:Among patients with chronic pain, the total PIPS score, PDI score, and the total TSK-11 score were (51.06±14.35) , (31.41±18.31) and (30.42±6.43) respectively. The scores of physical health, psychological health, social relationships, environment, overall quality of life and general health were (12.55±2.19) , (13.04±2.42) , (14.29±2.97) , (12.98±2.79) , (3.17±0.98) and (2.73±0.99) respectively. Painful stimulation could produce exercise fear ( β=3.382, t=21.754, P<0.05) , and exercise fear affected stereotype psychology ( β=3.382, t=21.754, P<0.05) , and stereotype psychology had a direct negative impact on the quality of life ( β=-0.092, t=-6.516, P<0.05) . Conclusions:The pain stimulus of patients with chronic pain affects the patient's psychological flexibility through exercise fear, thereby further affecting the patient's quality of life.

Objective: To compare the weight loss and metabolic profile between a continuous energy-restricted diet and intermittent fasting diet in order to present an optimal nutritional weight reduction method for obese people in China. Methods: Sixty overweight or obese adults were selected and divided into two groups as the continuous energy-restricted diet group and the intermittent fasting diet group. Height, weight, waist circumference, body mass index(BMI), body fat, change of visceral fatarea, fasting glucose(FPG), triglyceride(TG), total cholesterol(TC), high density cholesterol(HDL), low density cholesterol(LDL), glutamic pyruvicaminotransferase(AST), signglutamic pyruvic transaminase(ALT), gamma-glutamyltranspeptidase(GGT), alkalinephosphatase (ALP), fasting insulin level(FINS) and HOMA-IR were assessed at baseline and 8 weeks after weight loss methods carried. Results: Both continuous energy-restricted diet and intermittent fasting diet resulted improvement on body shape indexes and a significant decrease in weight, waist circumference, BMI, body fat, visceral fat area and skeletal muscle(P<0.01)at 8 weeks. Both groups experienced improvements in biochemical outcomes and metabolic indicators at 8 weeks. A significant reduction in TC, AST, ALT, GGT, ALP, FINS and HOMA-IR(P<0.01 or P<0.05)were observed in continuous energy-restricted diet group. And a significant decline in TC, LDL, HDL, AST, ALT, GGT, ALP, FINS and HOMA-IR were observed in intermittent fasting diet group(P<0.01 or P<0.05). HDL was found significantly reduced in intermittent fasting diet group as compared with continuous energy-restricted diet group(P<0.01) at 8 weeks, however, there were no difference in weight loss, waist circumference, BMI, body fat, visceral fat area and other metabolic indicators at 8 weeks(P>0.05). Conclusion Both intermittent fasting diet and continuous energy-restricted diet have a similar effect on weight loss and metabolic indexes like blood glucose, HOMA-IR and blood lipid, but intermittent fasting diet can more significantly decrease HDL level.

Objective? To understand the current situation of hospital infection related knowledge-attitude-behavior among practice nursing students. Methods? From 1st October 2018 to 31th October 2018, we selected 73 practice nursing students at Beijing Jishuitan Hospital, Chaoyang Hospital and Tongren Hospital as subjects by convenience sampling. All of the students were investigated with the self-designed hospital infection knowledge-attitude-behavior questionnaire. Results? The average scores of items in knowledge dimension, attitude dimension and behavior dimension were (0.55±0.17), (3.30±0.59) and (3.29±0.44). There was a correlation between attitude and behavior of hospital infection among practice nursing students (r=-0.342, P＜0.05). Conclusions? Practice nursing students lack hospital infection related knowledge and their attitudes are irresolute, however their behavior is good. Hospital managers should increase related curriculums and provide pre-job training. Besides, teachers should make themselves an example to improve knowledge-attitude-behavior of students.

Objective To study the effect of atrial natriuretic peptide(ANP)deletion on melanoma growth. Methods A subcutaneous xenotransplanted melanoma model was established in ANP knockout mice and C57BL/6J mice. The tumor volume was measured at the sixth day after establishment of the subcutaneous transplantation. Tumor cell proliferation and tumor-induced angiogenesis were detected by immunohistochemical staining. Results The volume and weight of xenotransplanted melanoma were significantly decreased in the ANP knockout mice compared with those in the C57BL/6J mice. The proliferative tumor cells and microvessel density were significantly decreased in the tumor tissues of ANP knockout mice compared with those in the C57BL/6J mice. Conclusions ANP deletion significantly suppresses xenotransplanted melanoma growth through inhibiting the tumor cell proliferation and angiogenesis.

Objective To investigate the role of atrial natriuretic peptide (ANP) in lung metastasis of melanoma. Methods Melanoma B16F10 cells were intravenously injected into ANP knockout mice and C57BL／6J mice. After three weeks, the mice were sacrificed, and the lungs were removed, embedded, and examined by pathology using HE staining. The numbers of metastatic foci on the lung surface and micrometastatic foci in the lung tissues were counted. Results The ANP knockout mice displayed fewer metastatic foci on the lung surface and less micrometastatic foci in the lung tissues of ANP knockout mice than in the C57BL／6J mice. Conclusions ANP deletion significantly suppresses the metastasis of melanoma in the lung of mice.