Objective:To construct of evaluation index system and theory-skill-humanity (TSH) model for core competence of radiation specialist nurses, to provide reference for clinical training of radiation specialist nurses.Methods:In January 2023, the draft of the evaluation index system of core competence for radiation specialist nurses was development by literature reviews and semi-structured interviews; from February to March 2023, 20 experts were consulted with 2 rounds of Delphi consultations to determine the index system and determine indicator weights based on the importance assigned by experts to each indicator.Results:Among 20 experts, 17 were female and 3 were male, aged 35-65 (46.48 ± 8.19) years old. The effective recovery rate of the questionnaires was 100.0% (20/20) and 95.0% (19/20) in the first and second round, respectively. The authority coefficient of the experts was 0.937 in the second round, the Kendall coefficients of concordance in the first-level indexes, second-level indexes and third-level indexes were 0.448, 0.407, 0.464, respectively, the difference was statistically significant ( χ2 = 53.60, 148.81, 58.18, all P<0.001). The final evaluation index system of the core competence of radiation specialist nurses included 3 first-level indicators, 11 second-level indicators and 56 third-level indicators. Conclusions:The evaluation index system of the core competence of radiation specialist nurses constructed based on TSH model in the present study has certain feasibility and practicality, which can be used as the basis for the training and evaluation of radiation specialized nurses.

Objective To evaluate the application effect of joint inventory management method in drug procurement and control management in multiple hospital areas.Methods Based on the joint inventory management model,four pilot drugs were selected from a certain group hospital by reasonable data processing methods for research.The effects of the model application were compared and analyzed from aspects such as inventory cost,turnover situation,and supply situation.Results After applying the joint inventory management model led by the central hospital,the inventory and amount of drugs in the three pilot hospitals were significantly reduced,with the inventory reduced by 31.93%and the average inventory amount decreased by 16.23%;The inventory turnover days had significantly decreased,with the turnover days of all three branches decreasing by more than one day;The drug shortage rate had significantly decreased,with the most significant change among the pilot drugs being the doxorubicin liposome injection,which had a 6.7%decrease in the shortage rate;The comparison results of each group of data showed statistical significance(P＜0.05).Conclusion Adopting a central hospital led joint inventory management model in multiple hospital areas could significantly improve the effectiveness of drug procurement management and inventory management,which enhanced the efficiency of hospital fund utilization.

To prepare a lipid nanoparticle (LNP)-based subunit vaccine of Mycobacterium tuberculosis (Mtb) antigen EsxV and study its immunological characteristics, the LNP containing EsxV and c-di-AMP (EsxV: C: L) was prepared by thin film dispersion method, and its encapsulation rate, LNP morphology, particle size, surface charge and polyphase dispersion index were measured. BALB/c mice were immunized with EsxV: C: L by nasal drops. The levels of serum and mucosal antibodies, transcription and secretion of cytokines in lung and spleen, and the proportion of T cell subsets were detected after immunization. EsxV: C: L LNPs were obtained with uniform size and they were spherical and negatively charged. Compared with EsxV: C immunization, EsxV: C: L mucosal inoculation induced increased sIgA level in respiratory tract mucosa. Levels of IL-2 secreted from spleen and ratios of memory T cells and tissue-resident T cells in mice were also elevated. In conclusion, EsxV: C: L could induce stronger mucosal immunity and memory T cell immune responses, which may provide better protection against Mtb infection.
Animals ; Mice ; Mycobacterium tuberculosis ; Antigens, Bacterial ; Immunization ; Nanoparticles ; Vaccines, Subunit ; Mice, Inbred BALB C

Objective:To explore the mediating effect of social support between self-management ability and health-promoting lifestyle in elderly cancer patients with peripherally inserted central catheter (PICC) .Methods:This study was a cross-sectional study. From October 2018 to October 2019, convenience sampling was used to select 472 elderly cancer patients with PICC from two Class Ⅲ Grade A general hospitals in Henan Province as the research subject. The General Information Questionnaire, Cancer Patients PICC Self-management Scale (CPPSM) , Social Support Rating Scale (SSRS) and Health Promotion Lifestyle ProfileⅡ (HPLP-Ⅱ) were used for investigation. The mediating effect of social support between self-management ability and health-promoting lifestyle in elderly cancer patients with PICC was analyzed. A total of 472 questionnaires were distributed, and 467 valid questionnaires were recovered, with a valid recovery rate of 98.9%.Results:Among 467 elderly cancer patients with PICC, the scores of social support, self-management ability, and health-promoting lifestyle were (42.87±7.94) , (147.32±22.17) , and (114.93±25.20) , respectively. There was a positive correlation between social support and self-management ability ( r=0.244, P<0.01) , a positive correlation between social support and health-promoting lifestyle ( r=0.377, P<0.01) , and a positive correlation between self-management ability and health-promoting lifestyle ( r=0.471, P<0.01) . The results of the mediating effect analysis showed that social support played a partial mediating effect between the self-management ability and the health-promoting lifestyle of elderly cancer patients with PICC, accounting for 17.6% of the total effect. Conclusions:Social support is a mediating variable between self-management ability and health-promoting lifestyle in elderly cancer patients with PICC. Medical and nursing staff should pay attention to and improve the social support of elderly cancer patients with PICC, and take corresponding intervention measures to improve the health-promoting behavior and health level of elderly cancer patients.

Objective:To investigate the relationship of triglyceride (TG), fasting blood glucose (FPG) and triglyceride glucose product index (TyG) with the incidence of hypertension, and provide basic data for the prevention and treatment of hypertension in the population.Methods:A total of 23 581 individuals who met the research criteria in Jinchang cohort were selected as the research subjects, the Cox proportional hazard model was used to analyze the relationship of TG, FPG, and TyG with the risk of hypertension. A stratified analysis was conducted by sex.Results:After adjusting for confounding factors, compared with the normal TG group, the HR(95% CI) of the elevated TG margin group and the elevated group were 1.16 (1.01-1.34) and 1.49 (1.30-1.70), respectively in the total population. Among men, they were 1.13 (1.01-1.27) and 1.17 (1.06-1.30), and among women, they were 1.05 (0.88-1.26) and 1.06 (0.88-1.28). Compared with the normal FPG group, the HR (95% CI) of the FPG-impaired group were 1.29 (1.13-1.48) in the total population, 1.26 (1.08-1.48) in men and 1.59 (1.14-2.21) in women. Taking the lowest quartile array as a reference, the HR (95% CI) of the highest quartile array of TyG was 1.73 (1.45-2.07) in the total population, 1.32 (1.14-1.53) in men and 1.87 (1.37-2.54) in women. TG, FPG had a nonlinear dose-response relationship with the risk of hypertension, while TyG had a linear correlation with the risk of hypertension. Conclusions:Higher TG, FPG, and TyG levels are independent risk factors for the incidence of hypertension. People with higher TG, FPG and TyG are at high risk for hypertension, to which close attention should be paid in the prevention and treatment of hypertension.

Objective:To explore the relationship between lipid indicators and the incidence of diabetes, and to compare the diabetes prediction and identification power of traditional lipid combined lipid indicators, in order to explore the best alternative indicators for identifying and predicting diabetes.Methods:Based on the Jinchang cohort, a nested case-control study was conducted in 1 025 new cases of diabetes after excluding patients with malignant tumor and related endocrine, circulatory system disease, then an age (±2 years), gender matched 1∶1 control group of 1 025 cases was set to analyze the relationship between the incidence of diabetes and lipid parameters.Results:Among the traditional lipid parameters, the fourth quartile of TG, TC, and LDL-C indicated higher risks of developing diabetes, which was 14.00 times (95% CI: 9.73-20.15), 2.15 times (95% CI: 1.65-2.79) and 1.66 times (95% CI: 1.29-2.14) than that of the first quartile, respectively. The risk of developing diabetes indicated by the fourth quartile of HDL-C was 0.21 times than that indicated by the first quartile (95% CI: 0.15-0.28). In the combined lipid parameters, the fourth quartile of TG/HDL-C, TC/HDL-C, LDL-C/HDL-C and non-HDL-C indicated higher risks of developing diabetes, which was 14.86 times (95% CI: 10.35-21.34), 8.12 times (95% CI: 5.94-11.01), 5.85 times (95% CI:4.34-7.88) and 5.20 times (95% CI: 3.85-7.03) than that indicated by the first quartile, respectively. The areas under the ROC curve of TG, TC, HDL-C, LDL-C, TG/HDL-C, TC/HDL-C, LDL-C/HDL-C and non-HDL-C were 0.76 (95% CI: 0.74-0.78), 0.59 (95% CI: 0.57-0.61), 0.67 (95% CI: 0.65-0.69), 0.57 (95% CI: 0.55-0.59), 0.77 (95% CI: 0.75-0.78), 0.73 (95% CI: 0.71-0.75), 0.69 (95% CI: 0.67-0.71) and 0.66 (95% CI: 0.64-0.68), respectively. The optimal diabetes predicting point cuts of TG, TC, HDL-C, LDL-C, TG/HDL-C, TC/HDL-C, LDL-C/HDL-C and non-HDL-C were 1.40, 4.70, 1.28, 3.25, 1.17, 3.43, 2.46, and 3.58 mmol/L, respectively. Conclusions:Lipid metabolic disorder is a risk factor for diabetes. TG and TG/HDL-C are the good lipid metabolism indicators for the prediction of diabetic.

Objective:To explore the relationship of body mass index and blood pressure with the incidence of diabetes in Jinchang cohort.Methods:We designed a nested case-control study, a total of 29 572 workers who had no history of diabetes in baseline survey in Jinchang cohort were selected as the study cohort from June 2011 to December 2013. After 2 year follow-up, 1 021 workers with first diagnosed diabetes were selected as the case group, after 1∶1 matching according to the same gender and age ±2 years among those without diabetes, circulatory system, or endocrine system diseases during the same follow-up period, 1 021 controls was selected and 2 042 subjects were finally included. We used multivariate conditional logistic regression model, additive interaction model and multiplicative interaction model to explore the relationship of body mass index and blood pressure with the incidence of diabetes.Results:After adjusting for factors such as occupation, alcohol use, family history of diabetes, hyperuricemia, hypercholesterolemia, hypertriglyceridemia, low-HDL cholesterolemia and high-LDL cholesterolemia, multivariate conditional logistic regression analysis showed that the risk of diabetes increased with body mass index and blood pressure. Hypertension and overweight/obesity had a multiplicative interaction on the incidence of diabetes. The risks of diabetes in men and women with hypertension and overweight/obese were 2.04 times (95% CI: 1.54-2.69) and 3.88 times (95% CI: 2.55-5.91) higher than those in men and women with normal body weight and blood pressure, respectively. In the combination of BMI and blood pressure, obese individuals with SBP≥160 mmHg were 4.57 times (95% CI: 2.50-8.34) more likely to have diabetes than those with normal BMI and SBP, obese individuals with DBP≥90 mmHg were 3.40 times (95% CI: 2.19-5.28) more likely to have diabetes than those with normal BMI and DBP. Conclusions:Overweight/obesity and hypertension can increase the risk of diabetes. Health education about body weight and blood pressure controls should be strengthened to reduce the risk of diabetes.

Objective To investigate the value of prenatal diagnosis in identifying the etiology and predicting the prognosis of fetal pleural effusion (FPE).Methods Forty-two cases of FPE were recruited in this study from January 2012 to September 2016.Ultrasound scan and genetic tests were performed on all fetuses.Seven fetuses with severe FPE were given pleurocentesis.Pregnancy outcomes of all the fetuses were followed up.Results FPE was commonly accompanied with other abnormalities,such as ascites,hydrops,hydramnion,hygroma colli,abnormal posturing,joint contractures,arrhythmia and micromandible.Chromosomal abnormality was detected in 11 fetuses (26.2％),of which ten were further confirmed by karyotype analysis,including six with 45,X,three trisomy 21 and one trisomy 18,and one was detected with a 9.83 Mb uniparental disomy (UPD) located at 12q24.21q24.31 by gene chip.One fetus was diagnosed with--SEA/--SEA thalassemia.All of the 12 families decided to terminate the pregnancies after genetic counseling.Among the other 30 fetuses,seven with severe FPE and normal karyotype underwent pleurocentesis.Five of the seven cases were with favorable outcomes,one with progressive hydrops was aborted and one neonate with severe hydrops died after birth.Spontaneous regression of FPE with good outcome was found in two cases.Parents of the other 21 fetuses chose to terminate the pregnancies.Conclusions Prenatal diagnosis is important to identify the etiology and predict the outcome of FPE.Chromosomal abnormality is a relatively common cause of FPE,and 45,X and trisomy 21 are the most common abnormalities.Intrauterine intervention is beneficial for FPE without chromosomal or other definite genetic abnormalities.Genetic test may be of great value for pregnant counseling.

Objective To investigate the role of CD4+T cells in airway inflammation induced by respiratory syncytial virus (RSV) infection. Methods Animal models of acute RSV infection were estab-lished. Lung tissues were stained with hematoxylin and eosin (HE) to observe histopathological changes. Total number of CD4+T cells and the number of CD4+T cells secreting Th1/Th2 cytokines (IFN-γ, IL-4, IL-5 and IL-13) in spleen were detected by flow cytometry. Adoptive transfer of CD4+T cells was performed to identify the role of CD4+T cells in RSV-induced airway inflammation. Results RSV infection increased the total number of splenic CD4+T cells,particularly Th2-type CD4+T cells. The absolute numbers of IL-4/IL-5/IL-13-secreting CD4+T cells were increased significantly after RSV infection. Furthermore, adoptive transfer of CD4+T cells into BALB/c mice not only promoted the infiltration of mononuclear cells in lung,but also enhanced the secretion of Th2 cytokines during RSV infection. Conclusion CD4+T cells are involved in RSV-induced airway inflammation through secreting Th2 cytokines.

Type 2 innate lymphoid cells ( ILC2s) are recently identified members of the innate lymphoid cell ( ILC) family. These cells are capable of producing Th2-type cytokines such as IL-5 and IL-13 in response to epithelial cell-derived cytokines IL-25 and IL-33 and play critical roles in allergic diseases such as bronchial asthma. Further investigations on ILC2s will enhance the better understanding of type 2 immune responses and may provide new strategies for the treatment of allergic asthma. In this review, we fo-cus on the origin, location and biological function of ILC2s as well as their possible roles in the pathogenesis of bronchial asthma.