Objective To understand the genotyping of human immunodeficiency virus (HIV) co-infected hepatitis C virus (HCV) patients in Yunnan Province, and to analyze the differences in viral load, biochemical indicators, and blood routine indicators among different genotypes, in order to provide a laboratory basis for the diagnosis and clinical treatment of HIV/HCV co-infected patients. Methods From November 2022 to June 2023, the serum samples and basic information of patients diagnosed with HIV/HCV co-infection were collected in the antiviral outpatient clinic of Yunnan Provincial Hospital of Infectious Diseases. The HCV viral load was detected by one-step qRT-PCR amplification, the positive samples were sequenced, and genotyping was determined based on NS5 gene sequence. The differences in biochemical and blood routine indexes between HIV patients co-infected with different HCV genotypes and low/high viral loads were analyzed. Results A total of 126 HIV/HCV co-infected patients were collected, including 20 HCV genotype 1 (15.9%), 91 HCV genotype 3 (72.2%), and 15 HCV genotype 6 (11.9%). The maximum and minimum viral load of the three HCV genotypes were as follows: HCV type 1 (1.0×108, 4.8×104 IU/mL), HCV type 3 (2.2×108, 2.9×102 IU/mL), and HCV type 6 (8.1×107, 6.8×104 IU/mL). The results showed that there was no significant difference between HIV co-infection with different genotypes of HCV and three HIV treatment schemes, including nucleoside reverse transcriptase inhibitors+integrase strand transfer inhibitors (NRTIs+INSTIs), nucleoside reverse transcriptase inhibitors+non-nucleoside reverse transcriptase inhibitors (NRTIs+NNRTIs) and nucleoside reverse transcriptase inhibitors+protease inhibitor (NRTIs+PLs), and the viral load of patients (P>0.05). The analysis of biochemical indexes such as total bilirubin (TBIL), direct bilirubin (DBIL), alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatinine (CREA), and blood routine indexes such as white blood cell (WBC), red blood cell (RBC), hemoglobin (HGB), platelet (PLT), mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobin concentration (MCHC) among different HCV genotypes and low/high viral loads showed that there was no significant difference in biochemical indexes and blood routine indexes between low/high viral loads of HIV co-infected HCV patients (P>0.05); however, the biochemical indicators TBIL, IBIL and MCHC were significantly different statistically between patients with genotype 3 HCV infection and those with genotype 1 HCV infection (P<0.05), while other biochemical and blood routine indexes were not statistically different among different HCV genotypes (P>0.05). Conclusions There are six subtypes of HCV co-infection in HIV patients in Kunming, Yunnan Province, including three genes of genotype 1, 3, and 6. Among them, genotype 3 HCV is the main prevalent genetic virus among HIV co-infected populations. The TBIL, IBIL and MCHC values of HIV patients co-infected with HCV type 3 are different from those infected with HCV type 1.

Objective:To explore the mediating effect of psychological resilience between structural empowerment and work engagement of clinical nurses.Methods:This study was a cross-sectional study. Using the convenient sampling method, a total of 1 723 nurses from three Class Ⅲ Grade A hospitals in Henan Province were selected as the research objects from March to May 2023. The survey was conducted using general information questionnaire, Conditions of Work Effectiveness Questionnaire-Ⅱ (CWEQ-Ⅱ), Nurses Psychological Resilience Scale and Utrecht Work Engagement Scale (UWES). Pearson correlation analysis was used to explore the correlation between structural empowerment, psychological resilience and job engagement. AMOS 24.0 software was used to establish the structural equation model and analyze the mediating effect.Results:A total of 1 723 questionnaires were sent out in this study, and 1 590 were effectively collected, with an effective recovery rate of 92.28%. The total scores of structural empowerment, psychological resilience and job engagement of 1 590 clinical nurses were (70.42±15.61), (96.84±13.15) and (62.24±11.02), respectively. Pearson correlation analysis showed that job engagement was positively correlated with structural empowerment and psychological resilience ( r=0.637, 0.670, P<0.01). The results of structural equation model showed that psychological resilience had a partial mediating effect between structural empowerment and job engagement. The mediating effect value was 0.321, accounting for 48.86% of the total effect. Conclusions:In this study, the structural empowerment, psychological resilience and job engagement of clinical nurses are above the medium level, and psychological resilience has a partial mediating effect between structural empowerment and job engagement. Nursing managers should fully empower nurses at the organizational level, take targeted measures to improve their psychological resilience and enhance their level of work engagement.

Objective:To explore the current status of catheterization technology training for tunnel peripherally inserted central catheter (PICC) intravenous therapy specialist nurses, so as to provide reference for promoting the application of this technology and conducting systematic specialized training.Methods:From May to June 2023, convenience sampling was used to select 279 intravenous therapy specialist nurses from 150 hospitals in 24 provinces, autonomous regions, and municipalities directly under the central government as the research subject. A self-designed questionnaire was used to survey the research subject in the form of an electronic questionnaire.Results:A total of 279 questionnaires were distributed, and 279 valid questionnaires were collected, with an effective response rate of 100.0% (279/279). The hospitals where 141 nurses were located implemented tunnel PICC catheterization technology, of which 93 nurses implemented this technology in their departments, 34 nurses were able to independently complete this technique. A total of 113 nurses received tunnel PICC training, and 141 nurses believed that the primary factor affecting the implementation and development of this technology was the level of technical mastery of specialist nurses, 248 nurses expressed that training effectiveness could be effectively improved through workshops.Conclusions:The training and promotion of tunnel PICC catheterization technology need to be strengthened. It is urgent to further increase the re-certification of intravenous therapy specialist nurses and perfect the platform and standardization of specialized training to improve the nursing quality of intravenous therapy.

Objective:To develop the Clinical Nurse Extra Task Load Scale and test its reliability and validity.Methods:Based on the job demand-control model, a primary scale was formed through literature search and qualitative interviews, as well as Delphi consultation and pre-survey. In September 2023, 813 clinical nurses from First Affiliated Hospital of Xinxiang Medical University and Xinxiang Central Hospital were selected for reliability and validity testing. In October 2023, 1 050 clinical nurses from First Affiliated Hospital of Xinxiang Medical University and Xinxiang Central Hospital were selected for investigation, and the reliability and validity of the scale were tested.Results:The final Clinical Nurse Extra Task Load Scale included two dimensions and a total of 12 items. The item-level content validity index was 0.86 to 1.00, and the scale-level content validity index was 0.84. Exploratory factor analysis extracted two common factors, with a cumulative variance contribution rate of 74.55%. Confirmatory factor analysis showed that χ 2/ df was 1.613, GFI was 0.928, CFI was 0.971, NFI was 0.928, IFI was 0.971, and RMSEA was 0.024. Cronbach's α coefficient of the work environment demand dimension was 0.897, Cronbach's α coefficient of individual behavior restriction was 0.955, Cronbach's α coefficient of the total scale was 0.950, and the split-half reliability was 0.850. Conclusions:The Clinical Nurse Extra Task Load Scale developed has a good reliability and validity, and can be used to evaluate and quantify the extra task load for clinical nurses.

Objective:To construct a hypoglycemia random forest prediction model for older adults with type 2 diabetes, and assess the model′s prognostication performance through internal and external verification.Methods:From August 2022 to January 2023, 300 older adults with type 2 diabetes in Beijing Hospital were selected. The demographic characteristics, medical history, laboratory tests, and other data of the patients were collected, and the data set was randomly divided into the training set and verification set in a ratio of 7∶3. The hypoglycemia prediction model for older adults with type 2 diabetes was constructed and optimized based on the random forest algorithm. The calibration curve was used to evaluate the model′s calibration, and the ROC was used to evaluate the model′s discrimination. The clinical applicability of the model was assessed by the decision curve analysis. The risk factors for hypoglycemia in the older adults were explored by prioritizing the contributions of variables in prediction. The Bootstrap method was used for internal validation, and the validation set was used for external validation.Results:Among the 300 older adults with type 2 diabetes, 128 cases (42.67%) experienced hypoglycemia within one week. The predictive contributions of risk factors in the model were ranked as follows: the number of episodes of hypoglycemia in one month, HDL-C, heart disease, diabetes knowledge and education, combination therapy, age, duration of diabetes, staple food restriction, glycosylated hemoglobin, and gender. The internal and external calibration curves of the hypoglycemia random forest model for the older adults with type 2 diabetes fluctuated around the diagonal, indicating that the calibration degree of the predictive model is good. The AUROC of internal verification was 0.823 (95% CI 0.752-0.894), the sensitivity and specificity were 0.867 and 0.698, respectively. The external verification was 0.859 (95% CI 0.817 - 0.902), and sensitivity and specificity were 0.789 and 0.804, respectively, showing that the overall discrimination of the prediction model was good. The DCA curves were far from the all-positive line and all-negative line, which indicated that the prediction model had good clinical applicability. Conclusions:The predictive effect of this model is good, and it is suitable for predicting the risk of hypoglycemia in older adults with type 2 diabetes, and it provides a reference for early hypoglycemia screening and predictive intervention for this kind of patients.

Objective:To explore the experience and demand of diabetic patients for exercise management platform and provide reference for building scientific exercise management platform module content for diabetic patients.Methods:Using the phenomenological research method, with data saturation as the sample size selection criteria, a total of 11 diabetic patients from Department of Endocrinology of two Class Ⅲ Grade A hospitals in Beijing from June to August 2021 were selected for semi-structured in-depth interviews. Colaizzi 7-step analysis method was used to analyze data and extract themes.Results:Diabetic patients had a high degree of acceptance to use the exercise management platform. The demand could be summarized into five themes, which are professional service demand, effect analysis demand, personalized monitoring demand, simplicity of operation demand and interest stimulating demand.Conclusions:The development of diabetes exercise management platform should be diversified and personalized. Multi-disciplinary professional cooperation teams should be used to provide scientific and high-quality services and guidance for diabetes patients on the platform, so as to help diabetes patients form regular and effective exercise habits.

Objective: To explore the expression of KIF20A (kinesin family member 20A) in colorectal cancer (CRC) tissues and adjacent normal tissues, and to analyze the relationship between KIF20A expression level and clinicopathological factors in CRC patients. Meth-ods: Data from The Cancer Genome Atlas (TCGA) database were used to analyze KIF20A mRNA expression in CRC tissues and adjacent normal tissues. A total of 105 paraffin samples were obtained from CRC patients who had undergone surgery at Huai He Hospital of Henan University, from January 2011 to December 2012. Immunohistochemical staining (IHC) was performed to examine KIF20A pro-tein expression in tumor samples for which complete clinical and pathological data were available. Statistical analyses were applied to analyze the association between KIF20A expression and the clinical data, as well as with survival outcomes. Results: Bioinformatics analysis showed that the mRNA expression level of KIF20A was upregulated in CRC tissues and normal tissues (P<0.001). IHC revealed significantly higher expression of KIF20A in CRC tissues from 67 patients (64%) and lower or undetectable expression in 38 patients (36%). The difference was statistically significant (P<0.05). Overexpression of KIF20A in CRC tissues was significantly associated with depth of invasion, lymphatic node metastasis, distant metastasis, and TNM stage (all P<0.05). Kaplan-Meier survival analysis showed that patients with high levels of KIF20A expression had poor prognosis compared to patients with low levels of KIF20A expression. Cox proportional hazard regression analysis revealed that KIF20A was an independent prognostic factor in patients with CRC. Conclusions:KIF20A is upregulated in CRC tissues and could serve as a novel prognostic biomarker for CRC patients.

Objective To investigate a new clinical classification of hepatolithiasis based on biliary anatomy and pathology in order to guide clinical decision-making.Methods The cases of hepatolithiasis admitted to our hospital from Mar 2015 to Aug 2018 were classified into six types and an additional type according to biliary anatomy,stone site and extent,liver pathological changes,and Oddi sphincter function.Results Of the214 cases of hepatolithiasis,5 cases (2.3％) were type Ⅰ;41 cases (19.2％) were type Ⅱ;76 cases (35.5％) were type Ⅲ;17 cases (7.9％) were type Ⅳ;29 cases (13.5％) were type Ⅴ;46 cases (21.5％) of type Ⅵ.The most common complication was incision infection (28 cases,13.1％),liver failure 0,and perioperative death 0.During the follow-up from 3 months to 3 years,there were 14cases of stone recurrence,the recurrence rate was 7.6％.Conclusion This classification scheme and the "individualized precise anatomical combined hepatectomy or segmental hepatectomy" based on this classification is safe and effective while enhancing the cure rate.

Objective To investigate the causes of misdiagnosis related to rheumatism diseasecases.Methods A search was performed in database WanFang to identify the misdiagnosed clinical cases reports which were published in Chinese Journal and a retrospective analysis was conducted.All data were analyzed by chi-square test and Fisher's exact test.Results We screened 705 citations and identified 215 articles on the rheumatic diseases,finally,187 reports and 195 cases in total with definite diagnosis were included,accounting for 25.5％ of the total number of misdiagnosed cases.Primary vasculitis (72 cases),rheumatoid arthritis (25 cases),spondyloarthropathy (17 cases),polymyositis (14 cases),systemic lupus erythematosus (13 cases) and Sj(o)gren's syndrome (SS) (12 cases) were amongst the top misdiagnosed rheumatic diseases.There was no difference between 1998-2006 and 2007-2015 in the overall misdiagnosis cases.Single disease comparison,polymyositis,spondyloarthropathy and IgG4 related disease were increased (P=0.002;P=0.034;P=0.060;respectively),while polymyositis was delayed (P=0.002).Rheumatism misdiagnosed cases reported mainly came from tertiary hospitals and the department of rheumatology.Conclusion Misdiagnosed rheumatism are common in clinic.Strengthen the physicians' continuous education,the validity of clinical thinking mode and rational use of diagnostic criteria are important to make correct diagnosis.

Objective To develop a quantitative immunohistochemistry assay for duck hepatitis B virus core antigen (DHB-cAg)in duck liver tissue.Methods By comparison with no repair antigen and repair antigen with high pressure,microwave and trypsin,the best solution of antigen retrieval was determined.By optimizing the parameter of image acquisition and de-ducting blank area,mean density of yellow areas was calculated using Image-Pro Plus 6.0 software.Using the assay devel-oped to determine the level of DHBcAg in liver tissue from duck infected by DHBV,anti-DHBV activity of DHBcMAb-TAT PTD conj ugate was examined.Results SABC method with no repair antigen was selected,which was better than other methods.DHBcAg expression in duck liver tissue could be objectively and accurately quantified by setting Image-Pro Plus 6.0 software parameters and calculating mean density of yellow areas.By comparison with the differences between mean densityat baseline of treatment and end of treatment,it was showed that DHBcMAb-TATPTD conjugate treatment dose-de-pendently reduced the levels of DHBcAg in liver tissue,which show that the assay developed could effectively evaluate the anti-DHBV activity of agent.Conclusion The immunohistochemistry assay developed in this study can objectively and accu-rately evaluate the level of DHBcAg in duck liver tissue.