Objective To investigate current management of external auditory canal irrigation among the nurses in otolaryngology in Guangdong Province,and to provide a reference for development and promotion of a standardised procedure.Methods From January to February in 2022,a total of 48 head nurses or nursing backbone in otolaryngology department of 48 hospitals from 21 major cities in Guangdong Province were selected by convenience sampling.A questionnaire proposed by Otolaryngology Nursing Committee of Guangdong Nursing Association was used to investigate the knowledge,operation procedure and training management in external auditory canal irrigation.Results A total of 48 head nurses or nursing backbone responded to the survey.The survey revealed that 34(70.8%)of the participants had mastered the knowledge of external auditory canal irrigation and 38(79.2%)of them had mastered the knowledge on the irrigation indications.In terms of operation procedure,syringe was applied as irrigator in 43(89.6%)hospitals,disposable irrigation needle was applied as flushing connector in 24(50.0%)hospitals,body surface temperature test of operator or patient was carried out in 24(50.0%)hospitals and adjusted flushing pressure was applied according to patients'feedback in 37(77.1%)hospitals.Regarding the training of external auditory canal irritation,35(72.9%)hospitals did not ask patients to sign an informed consent before,29(60.4%)hospitals required qualifications for operator and 45(93.7%)hospitals had the training programs.Conclusions The knowledge of external auditory canal irrigation of otolaryngology nurses in Guangdong province needs to be improved.The management of procedure and training of external auditory canal irrigation shall be standardised.It is suggested that the profession should draw up the external auditory canal irrigation standard,and all hospitals strengthen the management and training in order to promote the standardisation of specialised nursing together.

Objective:To establish a set of scientific and reasonable indicator system of common prosperity in the field of health, so as to promote the construction and evaluation of the demonstration area of common prosperity with high quality of health.Methods:According to the requirements of promoting common prosperity demonstration area with high quality of health in Zhejiang province, the initial indicator pool was established through literature research and theoretical analysis in July 2021, and experts were convened to carry out expert brainstorming to determine indicator system in the form of meetings. Delphi method was used to conduct two rounds of expert consultation on the indicator system.Finally, the analytic hierarchy process and percentage weight method were used to calculate the indicator weight value.Results:The final indicator system included 4 first-level indicators and 30 second-level indicators. Among the first-level indicators, the weight values of the development, equilibrium, inclusiveness, and sustainability were 0.326 4, 0.242 8, 0.245 8, and 0.185 0. There were 8 second-level indicators in developmental indicator dimension, of which the indicator with the highest weight was the per capita health expectancy. The balance indicator dimension included 6 second-level indicators, of which the indicator with the highest weight was the per capita financing difference of basic medical insurance between the urban workers with the urban-rural residents. The inclusive indicator dimension included 6 second-level indicators, and the proportion of personal health expenditure to total health expenditure had the highest weight. The sustainability indicator dimension included 10 second-level indicators, and the proportion of government health expenditure in fiscal expenditure had the highest weight.Conclusions:The indicator system constructed in this research could provide certain guidance and reference for promoting the construction of common prosperity in health, and provide some reference for follow-up research in this field.

Objective:To evaluate the clinicopathologic characteristics and outcomes of HIV-negative plasmablastic lymphoma (PBL) .Methods:Medical records of 15 patients diagnosed with HIV-negative PBL in Changhai Hospital between January 2013 and August 2019 were reviewed, and clinicopathologic characteristics and outcomes were analyzed.Results:Median age was 59 years (range: 17-69) . All patients had extranodal involvement. According to the Cotswolds-modified Ann Arbor staging system, 1 (6.7%) , 2 (13.3%) , 3 (20.0%) , and 9 (60.0%) patients were classified as at Ⅰ,Ⅱ,Ⅲ and Ⅳ, respectively. Plasmablast and immunoblast proliferations were typical manifestations of PBL. Immunohistochemical staining showed tumor cells were diffusely positive for plasma cell markers CD38, CD138, and Mum-1, while negative for B cell markers CD20, CD10, PAX-5, and BCL-6. Median Ki-67 index was 80% (70%-90%) . Epstein-Barr virus-encoded RNA (EBER) expression was detected in 3 patients, and 1 of them was positive. All patients received chemotherapy, 80% combined with bortezomib as the first line, and responses were observed in 8 patients (6 complete and 2 partial responses) . Median progression-free survival (PFS) and overall survival (OS) were 6.8 (95% CI 2.5-11.1) months and 17.9 (95% CI 5.6-30.2) months, the 3-year PFS and OS rates were 21.2% (95% CI 1.4%-56.8%) and 38.5% (95% CI 12.0%-65.0%) , respectively. Conclusion:HIV-negative PBL with high invasiveness is extremely prone to extranodal involvement and most patients were at the advanced stage. Patients receiving an intensive therapy combined with bortezomib and bridged autologous stem cell transplantation may improve long-time survival.

Mood disorders/psychosis have been associated with dysfunctions in the default mode network (DMN). However, the relative contributions of DMN regions to state and trait disturbances in pediatric bipolar disorder (PBD) remain unclear. The aim of this study was to investigate the possible mechanisms of PBD through brain imaging and explore the influence of psychotic symptoms on functional alterations in PBD patients. Twenty-nine psychotic and 26 non-psychotic PBD patients, as well as 19 age- and sex-matched healthy controls underwent a resting-state functional MRI scan and the data were analyzed by independent component analysis. The DMN component from the fMRI data was extracted for each participant. Spearman's rank correlation analysis was performed between aberrant connectivity and clinical measurements. The results demonstrated that psychotic PBD was characterized by aberrant DMN connectivity in the anterior cingulate cortex/medial prefrontal cortex, bilateral caudate nucleus, bilateral angular gyri, and left middle temporal gyrus, while non-psychotic PBD was not, suggesting further impairment with the development of psychosis. In summary, we demonstrated unique impairment in DMN functional connectivity in the psychotic PBD group. These specific neuroanatomical abnormalities may shed light on the underlying pathophysiology and presentation of PBD.

OBJECTIVE： To explore the role of clinical pharmacists on anlotinib-induced ADR in patients with advanced lung cancer， and to provide reference for safe drug use in clinic. METHODS： For 3 typical cases of ADR caused by the treatment of advanced lung cancer with anlotinib， clinical pharmacists provided pharmaceutical care to patients from the aspects of the use of anlotinib， medication education， the prevention and treatment of ADR， and assisted clinicians to solve ADR related to anlotinib such as hemoptysis， liver injury， elevated blood pressure， proteinuria， etc. RESULTS： For one case of anlotinib-induced hemoptysis， clinical pharmacists analyzed that the degree of hemoptysis was mild. They suggested that anlotinib should be discontinued and treated symptomatically with cough relief and hemostasis. If necessary， pituitrin should be added. Anlotinib could be continued after hemoptysis control， which doctors adopted. No hemoptysis occurred during the treatment period. For the case of anlotinib caused liver function damage， clinical pharmacists analyzed it as mild cholestasis type. They suggested that no discontinuation of anlotinib should be given and adenosylmethionine treatment should be given， which doctors adopted. After 5 days of treatment， the patients’ liver function returned to normal， and no obvious liver function damage was found in the later period. For the case of anlotinib induced hypertension with proteinuria， the patient had a history of hypertension. For hypertension， clinical pharmacists strengthened medication education for patients， instructed patients to adjust diet， appropriately activities， reduce mental stress and monitor blood pressure. The psychological intervention and other non-drug antihypertensive effects were poor， and then clinical pharmacists suggested to modify the antihypertensive treatment for patients. Doctors adopted it and changed the former antihypertensive drug nitrendipine to angiotensin receptor blocker valsartan. After 2 weeks of treatment， blood pressure returned to normal. For urinary protein， clinical pharmacists recommend to discontinue the use of anlotinib， and the urinary protein returned to normal after 2 weeks. Clinical pharmacists recommend to reduce the dose of anlotinib to continue treatment， which the doctors adopted. No abnormal urinary protein was found in the later review. CONCLUSIONS： Clinical pharmacists should actively provide pharmaceutical care for lung cancer patients treated with anlotinib， and strengthen medication education so as to promote rational drug use in clinic.

Objective? To retrieve and analyze the related researches on intensive care unit(ICU) physical environment from 2013 to 2017, and to provide reference for further improvement of the physical environment and quality of medical and nursing care in ICU. Methods? Relevant literature on ICU physical environment included from 2013 to 2017 by the China National Knowledge Infrastructure(CNKI), Wanfang Data Knowledge Service Platform, VIP Database for Chinese Technical Periodicals, Sinomed, Pubmed, Web of Science,and Scopus database were retrieved and analyzed bibliometrically on the internal and external features of the articles by Excel and CiteSpace software. Results? A total of 287 domestic and oversea papers on ICU physical environment were retrieved, the number of published articles showed an overall stable trend. The biggest number of published articles went to Guangdong Province, accounting for 14.1% of the articles in Chinese language. The United States had the biggest number of published papers in English language (43.8%). Literature journals mainly focused on infection control, critical medicine and critical care nursing journals, with the largest number of articles published by a single author(23.0%). The main types of research were clinical research (79.1%), fund-supported literature accounted for 26.5% of all the articles, and research directions were mainly about infection (40.0%), "nosocomial infection" and "pathogenic bacteria", "environment" and"object surface", "premature infant" and "growth and development", "sleep" and "noise" were closely related. Conclusions? The researches on ICU physical environment involves aspects including object surface, noise, light, air quality, temperature and ward design. Infection control in ICU environment and the influences of ICU physical environment on patient's biological rhythm and the growth and development of preterm infants are hot research issues in recent years. However, the geographical distribution of research is not balanced,and the overall quality of research evidence needs to be improved.

OBJECTIVE: The aims of the present study were to explore the occurrence of childhood trauma and importantly to determine the impacts of childhood trauma on psychosocial features in a Chinese sample of young adults. METHODS: A survey was carried out in a group of 555 university students by using Childhood Trauma Questionnaire (CTQ), Self-rating Depression Scale (SDS), Self-rating Anxiety Scale (SAS), Dysfunctional Attitudes Questionnaire (DAS), Eysenck Personality Questionnaire (EPQ), and Social Support Rating Scale (SSRS). The moderate-severe cut-off scores for CTQ were used to calculate the prevalence of childhood trauma, and then psychosocial features were compared between individuals with and without childhood trauma. RESULTS: A proportion of 18.6% of university students had self-reported childhood trauma exposures. Subjects with childhood trauma reported higher scores of SDS, SAS, DAS, and psychoticism and neuroticism dimensions of EPQ (t=4.311–5.551, p < 0.001); while lower scores of SSRS and extraversion dimension of EPQ (t=-4.061– -3.039, p < 0.01). Regression analyses further revealed that scores of SAS and DAS were positively (Adjusted B=0.211–0.230, p < 0.05), while scores of SSRS were negatively (Adjusted B=-0.273– -0.240, p < 0.05) associated with specific CTQ scores. CONCLUSION: Childhood trauma is still a common social and psychological problem. Individuals with childhood trauma show much more depression, anxiety, distorted cognition, personality deficits, and lower levels of social support, which may represent the social and psychological vulnerability for developing psychiatric disorders after childhood trauma experiences.
Anxiety ; Asian Continental Ancestry Group* ; Cognition ; Depression ; Extraversion (Psychology) ; Humans ; Prevalence ; Young Adult*

Objective We increase the soluble expression of artificial tandem hybrid ubiquitin binding domains ( ThUBD) in prokaryotic cytoplasm of Escherichia coli BL21 ( DE3 ) , which offer an effective and special profiling for ubiquitin conjugates( UbC) .Methods Codon optimization of the ThUBD was performed, followed by analysis of codon relative adaptiveness based on relative frequency of synonymous codon ( RFSC) of E.coli.Further induced expression and yeast ubiquitin conjugate enrichment quantified the soluble ThUBD-S and tested the ability to bind UbC.Results The statistical result showed that the percentage of codon of the highest usage frequency was increased from 48%to 75%, and codon adaptation index( CAI) was increased from 0.63 to 0.88 after codon optimization, which might suggest a higher expression of the ThUBD in E.coli BL21 (DE3).The subsequent SDS-PAGE indicated that the soluble target protein was increased four times, which accounted for 13.06%of total cell lysis.Further ubiquitinated proteome of yeast demonstrated that the ability to bind and enrich UbC of optimized ThUBD-S did not change compared with original ThUBD.Conclusion The expression of ThUBD-S can quadruple after codon optimization.At the same time, codon optimization does not impact its soluble expression and the ability to bind UbC.

Objective To elxplore the effect of combined with tamsulosin and trazodone medication in treatment of chronic bacterial prostatitis(CAP,type Ⅲ). Methods118 cases of CAP were treated with oral levofioxacin + tamsulosin + trazodone for 4 ～ 12 weeks.Statistical analysis was conducted for total scores(including pain score,urinary symptom score and life quality score)according to NIH-CPSI. ResultsThe symptoms were improved in most cases.Before and after treatment,the total scores were of all cases(26.81 ± 3.69)VS(13.41 ± 5.31),the pain score was(12.81 ±2.52)VS(8.91 ±3.51),the urinary symptom score was(5.76 ± 1.89)VS(2.79 ± 1.38),and the life quality score was(9.12 ±3.21)VS(4.28 ±2.46).There was statistically significant difference between them (all P＜0.01). ConclusionLevofloxacin combined with tamsulosin and trazodone medication in treatment of CAP could produce obvious effects.

Objective To summarize the management experience for difficult access during rigid transurethral ureteroscopy.Methods Rigid transurethral ureteroscopy was conducted in 640 patients with ureteral stones from January 1995 to November 2004.Difficult ureteroscope access was encountered in 72 patients and overcame by adjusting the pressure of hydraulic irrigation,changing the position of patient,dilating the ureter,or performing the percutaneous nephrostomy.Results Of the 72 patients with difficult retrograde access,successful ureteroscopy was achieved in 54 patients and conversions to open ureterolithotomy were required in 18 patients.Intraoperative complications included partial mucosal laceration in 10 patients and ureteral perforation in 6 patients.Follow-up examinations with intravenous pyelography for 13~36 months(mean,16 months) in 56 patients revealed patent ureter.Conclusions The key to successful retrograde access of rigid ureteroscope lies in the acquaintance with normal and pathologic anatomy and physiology of the ureter and urologist's operative skills and experience.