Objective:To construct an evaluation framework with detailed indices for demonstration units (wards) of enteral nutrition nursing, in order to improve the competence of nurses in enteral nutrition nursing and inform the specialized development of enteral nutrition demonstration units (wards).Method:On the basis of literature review and expert discussion, a preliminary draft was developed, and the Delphi expert consultation method was used to conduct two rounds of consultation with 15 clinical experts in the field of enteral nutrition nursing from 15 tertiary hospitals.Results:The effective response rates of questionnaires in two rounds of consultations were both 100%. The first round of expert consultation showed an authority coefficient of 0.90 and a coefficient of variation of 0 to 0.167, while the second round showed an authority coefficient of 0.93 and a coefficient of variation of 0 to 0.113. The Kendall harmony coefficients were 0.338 and 0.368, respectively. Finally, the evaluation framework with detailed indices for the demonstration unit (ward) of enteral nutrition nursing was formed, which consisted of 3 primary indicators, 16 secondary indicators, 54 tertiary indicators, and 62 detailed items.Conclusions:The evaluation framework we developed for the demonstration unit of enteral nutrition nursing follows the diagnosis and treatment process of enteral nutrition management for inpatients, including the triad of structure, process, and outcome. The framework is objective and practical, and can inform the daily practice of enteral nutrition nursing demonstration units (wards) and the development of enteral nutrition nursing specialties.

Objective:To understand the nutritional nursing competence in the enteral nutrition demonstration wards at this stage, so as to inform subsequent training plan.Methods:From September to October in 2023, nurses from 287 institutions involved in the enteral nutrition demonstration ward construction project were selected using convenience sampling. Questionnaires on general characteristics and self-assessment scale on nutrition nursing competence were used for online survey. The status quo and influencing factors of nutrition nursing competence in included institutions were analyzed.Results:A total of 5 409 valid questionnaires were collected, with a response rate of 62.63%. The total score of nutrition nursing competence was 74.74±16.11, with the least subtotals in the domain of nutrtion knowledge. Multiple linear regression showed that influencing factors of nutrition nursing competence includes years of working, department, registered dietitian or not, nutrition management specialist or not, completion of the curriculum in enteral nutrition demonstration ward construction project, and training/supervision arranged by their department concerning nutrtion nursing and relevant evaluation criteria ( P<0.05). Conclusions:The nutritional nursing competence of clinical nurses in the wards involved in enteral nutrition demonstration ward construction project still needs to be improved. Seniors should take into consideration the varying nutritional nursing competence among junior nurses and nurses from different departments, and strengthen the training on nutrition knowledge. It should be encouraged for nurses to actively participate in nutritionist training. Actions including enhancing nutrition specialist training, establishing the multidisciplinary collaborative nutrition care team and conducting regular supervision and assessment should be implemented in the future, to improve the nutritional nursing competence among nurses.

Objective To investigate the value of improving the prediction accuracy of near-term risk for developing breast cancer by transforming the original mammography image and fusing the different types of image features using the algorithm of machine learning.Methods The craniocaudal (CC) full-field digital mammography (FFDM) of 185 women were downloaded from the clinical database at the university of Pittsburgh medical center.Firstly,the original gray images were segmented and transformed into virtual optical density images.Then the asymmetry features were separately extracted from original gray images and virtual optical density images.Two decision tree classifiers of the first stage were trained based on the features extracted from two types of image.And the scores output from the two classifiers were used as input to train the second stage of one decision tree classifier.Leave-one-case-out method was used to validate the prediction performance of near-term risk of breast cancer.Results Using two-stage decision tree fusion method to predict breast cancer,the area under the ROC curve (AUC) was 0.9612±0.0132.And the sensitivity,specificity and prediction accuracy were 96.63％(86/89),91.67％(88/96) and 94.05％(174/185).Conclusion The features extracted from virtual optical density image have higher discriminatory power of predicting breast cancer.Fusing the two kinds of image features twice by two-stage decision tree method can help to improve the prediction accuracy of near-term risk of breast cancer.

Objective: To explore the necessity for application of bone wax stanching bleeding at sternal edge in cardiac surgery by median sternotomy. Methods: A total of 445 patients who receive cardiac surgery by the same surgeon performing median sternotomy in our hospital from 2011-01 to 2014-12 were studied. According to application of bone wax stanching bleeding, the patients were divided into 2 groups: Bone wax group,n=210 and Non-bone wax group,n=235. Re-thoracotomy for hemostasis, 12 h, 24 h and total draining volume after the operation and time of closing incision were compared between 2 groups. Results: There were 2 patients and 1 patient received re-thoracotomy for hemostasis in Bone wax group and Non-bone wax group respectively, which was not related to bone marrow cavity bleeding. In Bone wax group and Non-bone wax group, the draining volume at 12 h post-operation were (451 ± 240) ml vs (483 ± 238) ml, at 24 h post-operation were (615 ± 304) ml vs (639 ± 285) ml and the total volume were (842 ± 467) ml vs (842 ± 364) ml, allP>0.05; the time of closing incision were (68.0 ± 23.0 ) min vs (66.0 ± 19.0 ) min,P>0.05; the total transfusion rates were 21% vs 19%,P>0.05. Conclusion: Application of bone wax at sternum edge could neither affecting the drainage nor the speed of closing incision in cardiac surgery and therefore, it might be given up.

Objective: To compare the convergent sliding of bilateral pectoral myocutaneous lfap method and conventional method for treating the early stage median sternotomy wound dehiscence in patients after cardiac surgery. Method: A total of 36 relevant patients treated in our hospital from 2010-04 to 2014-04 were studied and they were divided into 2 groups: Conventional group, the patients received sufficient draining and dressing changes followed by interrupted simple suture,n=16 and Convergent sliding group, the patients received convergent sliding of bilateral pectoral myocutaneous lfap,n=20. The clinical conditions after treatment were compared between 2 groups. Results: There were 6 patients received re-suture after the ifrst debridement because of poor healing in Conventional group, no such event happened in Convergent sliding group, P<0.05. All patients were discharged and no death occurred. In Conventional group and Convergent sliding group, the open drainage time were (7.2 ± 3.2) days and (3.3 ± 1.1) days,P<0.05; hospital stay time from the first debridement and suture were (10.4 ± 5.4) days and (8.2 ± 1.9) days,P>0.05; the median hospital stay time from discovering wound problem to wound healing and discharge were 13.0 (10.75, 19.5) days and 12.0 (10.0, 13.0) days, P>0.05. Conclusion: Compared to conventional method, convergent sliding of bilateral pectoral myocutaneous lfap method may obtain the better success rate of wound debridement and suture by shorter time for treating the early stage median sternotomy wound dehiscence in patients after cardiac surgery.

Objective To explore the clinical therapeutic effectiveness,safety and feasibility clinical of leflunomide and cyclophosphamide on lupus nephritis.Methods 34 cases with lupus nephritis were randomly divided into control group and observation group according to the time of admission during January 2013 to July 2014 in Shangdong Jining NO.1 People’s Hospital.17 cases in observation group were given leflunomide;17 cases in control group were given cyclophosphamide,six months was a period of treatment.Two groups were in the process of therapy observed and recorded changes in liver and lidney function indexes,serum albumin 24-hour urinary protein,anti-double stranded DNA antibody titers before and after treatment.At the end of a course, the basic activities of the two groups of lupus index were evaluation.Results The total effective rate in control group was 70.5%, and that was 88.2% in the observation group, there was no difference significant.Compared with the other indexes before and after treatment were statistically significance (P<0.05); the incidence of adverse events in the control group was 42.9%, the incidence of adverse events in the observation group was 14.3%, the difference was statistically significant (P<0.05).Conclusion Leflunomide in treatment of lupus nephritis has significant effect, less side effects and high safety.

Objective To study the characteristics of symptom distress and its inlfuencing factors in patients with primary liver cancer after transcatheter arterial chemoembolization (TACE). Methods A total of 108 patients with primary liver cancer receiving TACE in Department of Hepatobiliary Surgery, the Third Afifliated Hospital of Sun Yat-sen University from January 2012 to January 2013 were voluntarily enrolled in this study on the 3rd day after operation by convenience sampling method. There were 94 males and 14 females with age ranging from 26 to 72 years old and median age of 51 years old. The informed consents of all patients were obtained and the ethics committee approval was received. Cross-sectional study and questionnaire survey were used in the research. The questionnaire survey included questionnaire of general information, M.D. Anderson Symptom Inventory (MDASI), Social Support Measuring Questionnaire (SSS) and Medical Coping Modes Questionnaire (MCMQ). Multiple linear regression analysis was used to identify factors inlfuencing the symptom distress. Results The mean score of MDASI symptom subscale of patients during therapy was 3.0±1.6 with a mild degree of symptom distress. The score of MDASI life distress subscale of patients was 3.4±1.7, also with a mild degree of symptom distress. Work was most influenced by the symptoms, followed by emotion, joy of life, common activity, relation with others and walks. Fever, discomfort of stomach, abdominal distention, icteric skins and weight loss were common symptoms in sequence which distressed patients. The total score of social support was 42.2±6.7 which was at the middle level, and the sore of use of social support was 7.9±2.2. The score of 3 dimensions facing, avoiding, surrender were 2.5±0.5, 2.4±0.5, 2.0±0.6 respectively. Facing and avoiding were the common coping modes. Patients who had college educational degree or above, no job after being ill, low level of subjective support, surrender coping mode were more distressed by symptoms than the other patients (RR=0.320, 0.254, 0.569, 0.217;P<0.05). Conclusions Patients with primary liver cancer have mild symptom distress after TACE, and patients with college educational degree or above, no job after being ill, low level of subjective support, surrender coping mode are more distressed by symptoms than the other patients.

Objective To explore the characteristics of P300 of subjects with attention deficit/hyperactive disorder(ADHD).Methods 34 children with ADHD were selected as ADHD group and 32 healthy subjects were selected as the health control group.They were matched in age,gender,degree of education.The auditory Oddball paradigm was applied,the event-related long latency components (N2 and P3) from Cz and Pz were measured in each test.Results Compared with the health control group,at the Cz electrode,children with ADHD showed a significandy prolonged latency of target N2 [(277.2 ± 20.3) ms vs (259.0 ± 14.9) ms,t =3.70,P ＜ 0.01] and decreased amplitude of target P3[(4.1 ± 1.6) μμV vs (5.7 ±2.0) μμV,t =3.57,P＜ 0.01].At the Pz electrode,the patient showed a significantly prolonged latency [(342.4 ± 26.3) ms vs (324.6 ± 15.5) ms,t =3.33,P ＜ 0.01] and decreased amplitude of target P3 [(4.1 ± 1.9) μV vs (7.4 ± 2.2) μV,t =6.54,P ＜ 0.01],decreased amplitude of non-target P2 [(3.0±1.l)μμV vs (3.7 ±1.3) μV,t =2.30,P＜0.05].Conclusion This study provides direct evidence that ADHD subjects have abnormal indices of endogenous P300,which is suggested that P300 might be potentially objective indicator applied in evaluation of cognitive dysfunction in ADHD children.

Objective Aprotinin has been suspended in cardiac surgery since risks factors associated with mortality and other adverse events in western Literatures.This study was to investigate the effect of aprotinin on short-term outcomes in cardiac surgery in Chinese patients.Methods Two groups of patients who underwent cardiac surgery during equal period just before and after aprotinin was suspended in China.Aprotinin groupp(n=1699) was defined as operations from june 19,2007 to Dec 18,2007,when aprotinin was used in all the patients.Control group(n=2225)was defined as operations from Dec19,2007 to June 18,2008,when aprotinin was not umed.Postoperative outcomes between the two groups,including blood loes and transfusion requirement,in-hospital mortality and major adveme outcome events were compared,using univariate analysis and mulfivariable logistic regression analysis.Results Aprotinin group had less postoperative blood loes,transfusion requirement and reoperation for bleeching as compared with the control group.Application of aprotinin did not increase the risk of in-hospital mortality (0.5%vs.10%,P=0.08)and other major ad-verse events,including renal dysfunction,renal failure requiring dialysis,low cardiac output syndrome (LCOS),neurological and pulmonary complications.Aprltinin group also had and shorter mechanical ventilation time(P=0.04),a lowwer rate of delayed mechan-ical ventilation time(P=0.04)and a higher PaO2/FiO2 in the bolld gas analysis(P<0.001).which presented a better respiratory function.Multivariable Logistic regression analysis got identical results with univariate analysis.Conclusion The use of aprotinin in cardiac surgery could reduce blood loss and transfusion requirement significantly,and showed a protective effect on the lungs.In the mean time it did not increase the risk of mortality or major complications.We suggest further studies should be performed to make a decision of continuing or stopping the use of aprotinin in cardisc surgery in Chinese or Asian population.

To observe the growth of rat bone marrow mesenchymal cells (BMMCs) on decellular bovine pericardia in vitro and to investigate the effect of proteins pre-coating on cells retention and proliferation, bovine pericardia were decellularized using trypsin, DNase and Triton X-100 respectively. Then three proteins (fibronetin (FN), gelatin, collagen I) were coated on the surfaces of the bovine pericardia separately. BMMCs were harvested from rat thighbone marrow , then expanded and seeded onto decellular bovine pericardia with the proteins pre-coated . Decelluar bovine pericardia without coating were used as controls. The retention and growth of BMMSCs were observed by Hochest staining and analyzed by MTT method. It was shown that the retention and proliferation of BMMCs on FN group and gelatin group were significantly enhanced comparing with those on collagen I group and control group (P < 0.001). There was no significant difference between FN group and gelatin group (P > 0.05), nor between collagen I group and control group (P > 0.05). We conclude that the retention and proliferation of seeding cells on FN and gelatin could be significantly improved on decellular bovine pericardia (DBP) but not on collagen I.
Animals ; Bone Marrow Cells ; cytology ; Cattle ; Cells, Cultured ; Collagen Type I ; pharmacology ; Fibronectins ; pharmacology ; Gelatin ; pharmacology ; Mesenchymal Stromal Cells ; cytology ; physiology ; Pericardium ; cytology ; drug effects ; Rats ; Tissue Engineering ; methods ; Tissue Scaffolds