Objective:To investigate the efficacy of an extracorporeal diaphragm pacemaker (EDP) combined with airway clearance technology (ACT) in the treatment of pulmonary infection in older adult patients with dementia and its impact on diaphragmatic mobility and thickness.Methods:A total of 60 patients with dementia and pulmonary infections who received treatment at The Second Hospital of Jinhua from June 2022 to February 2023 were included in this prospective study. These patients were randomly divided into an observation group and a control group, with 30 patients in each group. The control group received ACT treatment, while the observation group received EDP treatment on the basis of ACT treatment. Two groups were treated for 4 successive weeks. Efficacy was compared between the two groups. Before and after treatment, sputum color score, sputum quality score, diaphragmatic mobility, and diaphragmatic thickness were compared between the two groups.Results:The overall response rate in the observation group was 93.33% (28/30), which was significantly higher than 73.33% (22/30) in the control group ( Z = 2.08, P = 0.038). After treatment, the sputum color score, sputum quality score, and sputum volume in the observation group were (0.46 ± 0.12) points, (0.34 ± 0.10) points, and (8.47 ± 1.23) mL, respectively, which were significantly lower than (0.89 ± 0.17) points, (0.76 ± 0.18) points, and (13.25 ± 2.87) mL, respectively, in the control group ( t = 11.32, 11.17, 8.38, all P < 0.001). After treatment, the diaphragmatic mobility and thickness in the observation group were (13.52 ± 0.51) mm and (0.52 ± 0.06) mm, respectively, which were significantly greater than (12.76 ± 0.41) mm and (0.44 ± 0.04) mm, respectively, in the control group ( t = -6.36, -6.08, both P < 0.001). Conclusion:The combined application of EDP and ACT shows a significant therapeutic effect on patients with dementia and pulmonary infection, effectively improving their pulmonary function, increasing the mobility and thickness of the diaphragm, and alleviating difficulties in breathing.

Objective:To analyze the status quo, hotspots and fronts of emergency nursing training research at home and abroad in the past ten years, and to provide reference and ideas for the efficient development of emergency nursing training in China.Methods:CiteSpace 6.2.R2 software was used to visually analyze the Chinese and English literatures on emergency nursing training included in CNKI and Web of Science core databases from January 1, 2013 to June 1, 2023.Results:A total of 1 177 Chinese literatures and 1 163 English literatures were included. The number of foreign articles in this field increased year by year, while the number of domestic articles showed a downward trend since 2018. There were many stable core author groups and core institution groups in foreign countries, while there was less cooperation among domestic authors and institutions. The common research hotspots and frontiers at home and abroad focused on broadening the training audience of emergency nursing, innovating the training methods of emergency nursing, strengthening the evaluation of the effect of emergency nursing training, and paying attention to the training experience and needs of nurses. Foreign researches also focused on specialized nurses, interprofessional education and nurses′mental health, etc, and the research direction was diversified.Conclusions:The development stages of emergency nursing training researches at home and abroad are different, and the research hotspots are different. In the future, we should learn from foreign research, strengthen interdisciplinary cooperation, improve the depth and breadth of research, and strengthen the cooperation between authors, institutions and countries to promote the high-quality development of emergency nursing training research in China.

Abstract The concepts and theoretical mechanisms of interpersonal psychotherapy are discussed in detail. The review focuses on the effectiveness of interpersonal psychotherapy on depression among adolescents and the expansion of its applications. The feasibility of localized adapted interpersonal psychotherapy interventions in adolescent depression groups is proposed, to provide a reference for the applied practice of interpersonal psychotherapy.

Objective:To explore the application effect of flipped classroom teaching combined with micro-classes and PBL in the training of refresher nurses.Methods:Using the cluster sampling method, 35 refresher nurses from March 2017 to February 2018 were collected as the control group, and 38 refresher nurses from March 2018 to February 2019 were included as the observation group. The control group received the theoretical knowledge training of respiratory specialty by traditional teaching method, and the observation group received theoretical knowledge training of respiratory specialty by using flipped classroom teaching combining micro-classes and PBL. Before and after the training, the special theory assessment with the same difficulty was carried out, and the clinical teaching evaluation was carried out after the training.Results:After the training, the special theory assessment scores of the observation group were significantly higher than those of the control group ( t=7.560, P<0.05), with significant differences. Compared with the control group, the clinical teaching evaluation scores of the nurses in the observation group were significantly improved ( t=24.657, P<0.05), with significant differences, especially in the nurses' learning attitude, learning ability, teaching style and teaching satisfaction scores. Conclusion:The flipped classroom teaching combining micro-classes and PBL can significantly improve the special theory assessment scores of refresher nurses, promote the internalization of specialized knowledge, turn to active learning from the passive mode, change the learning attitude of refresher nurses, improve their recognition of clinical teachers and realize teaching benefits as well as learning benefits.

Hospital is a crowded place, and the population health management is very important. In the context of the normalized control of COVID-19, it is crucial to establish a set of insensitive, intelligent and effective crowd diversion management strategies. By deeply integrating information technologies such as big data processing, movement tracking and face recognition, Hangzhou Ninth People′s Hospital built a set of crowd health management and population diversion work mechanism, which included temperature monitoring, health code inspection and epidemiological history investigation. The mechanism could effectively promote the efficiency and accuracy of hospital population health screening under the situation of normalized epidemic prevention and control.

Objective:To compare the clinical features and outcomes of cancer-related and non-cancer-related sepsis in children who were admitted pediatric intensive care unit (PICU).Methods:The clinical history of patients with sepsis, who were admitted to PICU in Shanghai Children′s Hospital, Shanghai Jiao Tong University from August 2016 to July 2019, were retrospectively reviewed. A total of 768 patients were divided into the cancer-related sepsis group (135 cases) and the non-cancer-related sepsis group (633 cases). The patients in the cancer-related group were further categorized into three subgroups including hematological malignancy (80 cases), solid tumor (43 cases) and hemophagocytic lymphohistiocytosis (HLH) (12 cases). The variables of clinical features, laboratory tests, pathogens, management strategies and in-hospital mortality were compared between the two groups by student t test, Mann-Whitney U test or Chi-square test. Results:The patients with cancer-related sepsis accounted for 17.6% of all patients (135/768). Regarding the site of initial infection, the incidence of gastrointestinal infection (43.0% (58/135) vs. 28.6% (181/633), χ 2=10.718, P=0.001), blood stream infection (29.6% (40/135) vs. 17.1% (108/633), χ 2=11.297, P=0.001) and skin and soft tissue infection (22.2% (30/135) vs. 4.1% (26/633), χ 2=54.013, P<0.01) were higher in the patients with cancer-related sepsis than in those with non-cancer-related sepsis. On first PICU admission, the levels of hemoglobin (71 (61, 83) vs. 106 (92, 116) g/L, Z=13.594, P<0.01), white blood cell (1.4 (0.3, 5.2) vs. 9.8 (5.8, 15.1)×10 9/L, Z=11.213, P<0.01), platelet count (51 (15, 121) vs. 286 (192, 384)×10 9/L, Z=13.336, P<0.01), CD19 +cells (0.106 (0.008, 0.274) vs. 0.325 (0.224, 0.454), Z=6.555, P<0.01), and neutrophil (0.449 (0.170, 0.730) vs. 0.683 (0.537, 0.800), Z=5.974, P<0.01) were significantly lower in patients with cancer-related sepsis; however, the levels of C-reactive protein (82 (25, 155) vs. 36 (11, 86) mg/L, Z=-5.257, P<0.01), procalcitonin (1.5 (0.3, 12.0) vs. 0.8 (0.2, 4.0) μg/L, Z=-2.767, P=0.006), CD8 +cells (0.329 (0.253, 0.514) vs. 0.209 (0.156, 0.275), Z=-5.699, P<0.01), interleukin (IL) -6 (0.1 (0.1, 522.4) vs. 0.1 (0.1, 0.1) ng/L, Z=-2.747, P=0.006), IL-8 (0.1 (0.1, 177.0) vs. 0.1 (0.1, 4.5) ng/L, Z=-2.087, P=0.037), and IL-10 (0.1 (0.1, 42.7) vs. 0.1 (0.1, 6.6) ng/L, Z=-2.148, P=0.032) were significantly higher in patients with cancer-related sepsis. Similarly, the rate of continuous renal replacement therapy (CRRT) (34.8% (47/135) vs. 16.9% (107/633), χ 2=26.267, P<0.01) and the use of intravenous immunoglobulin (IVIG) (83.0% (112/135) vs. 66.2% (419/633), χ 2=14.667, P<0.01) were significantly higher in cancer-related sepsis group. Moreover, the incidence of co-infection with fungi was also higher in cancer-related sepsis group (14.1% (19/135) vs. 0.5%(3/633), χ 2=73.965, P<0.01), and so was the number of multiple organ dysfunction (3 (2, 5) vs. 2 (1, 3), Z=-6.988, P<0.01). Finally, the in-hospital mortality rate of cancer-related sepsis and non-cancer-related sepsis were 36.3% (49/135) and 9.3% (59/633), respectively, also significantly different (χ 2=67.000, P<0.01). There was no difference in the in-hospital mortality among children with hematologic tumors, solid tumors and HLH (35.0% (28/80) vs. 32.6% (14/43) vs. 7/12, χ 2=2.838, P=0.242). Conclusions:The site of initial infection, inflammatory markers on PICU admission, and co-infection pathogen during hospitalization are different between patients with cancer-related sepsis and non-cancer-related sepsis. Besides, the in-hospital mortality of cancer-related sepsis is about 4-fold that of non-cancer-related sepsis. The monitoring of clinical features and organ dysfunction, and timely treatment are crucial for cancer-related sepsis.

Objective To investigate the genetic characteristics of patients with thalassemia gene in Ningbo City.Methods Totally 313 patients with thalassemia gene diagnosed during March 2015 to April 2016 in Ningbo First Hospital were included in the study.The results of routine blood test,hemoglobin electrophoresis and gene test,as well as the gender and origin distribution of patients with thalassemia gene were analyzed.Results Of the 313 patients who carried the thalassemia gene,there were 289 females and 24 males with a median age of 29 years,ranging from 1 d to 57 years after birth.And of the 313 patients,75 carried the α-thalassemia gene,230 β-thalassemia and 8 composite thalassemia.The average value of hemoglobin was around 100 g/L and the average value of erythrocyte mean corpuscular volume (MCV) was less than 80 ft.Abnormal hemoglobin was usually found in α-thalassemia.81.74％ (188/230) of β-thalassemia had abnormal hemoglobin electrophoresis.Most of the patients were women who were diagnosed of anemia in routine prenatal examination.The number of patients,who came from Ningbo City or one of whose grandparents came from Ningbo City,was closed to 50％.Among 20 α-thalassemia patients coming from Ningbo City,genotype of--sea was the commonest genotype,accounted for 70.00％ (14/20).Among 82 β3-thalassemia patients coming from Ningbo,genotype of IVS-Ⅱ-654 was commonest genotype,accounted for 54.88％ (45/82).Genotypes of 2 composite thalassemia coming from Ningbo City were αcs compound IVS-Ⅱ-654 and-α3.7 compound CD41-42.Conclusions In Ningbo City,the incidence of thalassemia in women in Ningbo is higher than that in men.The morbidity of β-thalassemia genotype is apparently higher than that of α-thalassemia,and genotype of IVS-Ⅱ-654 in β3-thalassemia patients is the commonest genotype.

Objective? To expLore the knowLedge, attitude and practice status quo of puLmonary rehabiLitation among nurses in respiratory department, and to provide theoreticaL basis for cLinicaL training and quaLity controL. Methods? From JuLy to August 2018, a totaL of 134 respiratory nurses who participated in a continuing education training course in Sichuan Province were convenientLy seLected as the research objects. The questionnaire of knowLedge, attitude and practice of Lung rehabiLitation of nursing staff was used to investigate them. The univariate anaLysis of knowLedge, attitude and practice of Lung rehabiLitation of nursing staff were anaLyzed by t test and variance anaLysis. ResuLts? The totaL score of knowLedge, attitude and practice in puLmonary rehabiLitation among nurses was (101.63±19.58). The average scores of the three dimensions from high to Low were attitude (4.07±0.98), practice (3.08±1.09) and knowLedge (3.03±1.01). There were statisticaL differences in the totaL score of knowLedge, attitude and practice of nurses with different professionaL titLes and whether they had received Lung rehabiLitation training or not (P＜0.05). ConcLusions? The knowLedge, attitude and practice of puLmonary rehabiLitation of nursing staff in respiratory department need to be improved. Nursing administrators shouLd strengthen guidance and training of puLmonary rehabiLitation and strengthen nurses' abiLity to impLement puLmonary rehabiLitation so as to ensure the effective impLementation of puLmonary rehabiLitation in cLinicaL work.

Objective To systematically analyze the research trend of home non-invasive positive pressure ventilation in China. Methods The related literature in CBM database, CNKI database, Wanfang database and VIP database about home non-invasive positive pressure ventilation were reviewed and analyzed by Bibliometric. Results There were 214 articles retrieved, which had an increasing tendency.They were distributed in 135 kinds of journals and 28 provinces.The most research type was the experimental research(39.72%)and the research content focused on clinical effects of home non-invasive ventilation (47.67%). The average duration of researches was 12.33 months and the average interval for follow-up was 6.33 weeks. Conclusions Providing scientific and effective long-term medical support, optimizing the application process of home non-invasive ventilation and formulating scientific clinical standard should be the future research direction.

Aim To investigate the effect of magnesi-um isoglycyrrhizinate (MgIG)on radiation -induced pulmonary fibrosis in mice and the mechanism.Meth-ods Fifty female C57BL/6 mice were randomly divid-ed into control group,irradiation (RT)group,MgIG group,RT +MgIG group and RT +dexamethasone (DXM)group,with 1 0 mice in each group.Except for control group and MgIG group,the remaining mice were given a single 1 5Gy 60 Co γray on whole lung. The mice in each group were administered 2 h before irradiation and each day after irradiation:MgIG group and RT +MgIG group were administered with MgIG (1 00 mg·kg -1 )by intraperitoneal injection;control group and RT group were administered with normal sa-line (20 mL·kg -1 )by intraperitoneal injection;RT+DXMgroup was administered with DXM(0.5 mg· kg -1 )by intraperitoneal injection.After 1 2 weeks,the mice were sacrificed and lung tissues were taken out. The degree of alveolitis and pulmonary fibrosis were observed by HE staining and Masson staining.The ex-pressions of type Ⅰ collagen,type Ⅲ collagen and TGF-β1 protein were detected by immunohistochem-isty.Results The alveolitis,pulmonary fibrosis and expressions of type Ⅰ collagen,type Ⅲ collagen, TGF-β1 ,p-Smad2,p-Smad3 increased significantly in RT group compared with control group (P <0.05 ), and were significantly lower in RT +MgIG group and RT +DXMgroup than those in RT group(P <0.05). Conclusion MgIG can improve radiation-induced pulmonary fibrosis in mouse lung tissue,and its mech-anism may be related to the influence of MgIG on TGF-βsignaling pathway.