To research and design a new type of distal radial artery puncture compression hemostatic device,to solve the problem of distal radial artery puncture and compression hemostat that has not been clinically applied in China.The hemostatic device was mainly composed of hemostatic part,pressure regulating part,fixing part and visual window.The hemostatic device can accurately compress the puncture point,and it was convenient for medical staff to observe the wound through the visual window,find out abnormal conditions such as bleeding or hematoma in time,and take measures to deal with them,which greatly improved the hemostatic effect and comfort of the postoperative puncture point.The new hemostatic device has the advantages of reasonable design and simple clinical operation,which is worthy of clinical promotion.

Objective:To explore the risk factors of severe acute kidney injury (AKI) in septic patients, and to establish an hour-specific prediction model.Methods:Based on the information of septic patients in the Medical Information Mart for Intensive Care-Ⅳ (MIMIC-Ⅳ) database, general information, comorbidities, vital signs, severity scoring system, laboratory indicators, invasive operations and medication use were recorded. The enrolled patients were randomized into a training set and a validation set according to a ratio of 7∶3. AKI was diagnosed according to the guidelines of Kidney Disease: Improving Global Outcome (KDIGO). Based on Lasso regression and Cox regression, the risk factors of severe AKI (AKI stage 2 and stage 3) in septic patients were analyzed and hour-specific prediction model were established. Consistency index (C-index), area under the receiver operator characteristic curve (AUC) and calibration curve were used to assess the predictive efficacy of the model.Results:A total of 20 551 septic patients were enrolled, including 14 385 patients in the training set and 6 166 patients in the validation set. Multivariate Cox regression analysis showed that atrial fibrillation [hazard ratio ( HR) = 1.266, 95% confidence interval (95% CI) was 1.150-1.393], heart failure ( HR = 1.348, 95% CI was 1.217-1.493), respiratory failure ( HR = 1.565, 95% CI was 1.428-1.715), heart rate ( HR = 1.004, 95% CI was 1.002-1.007), mean arterial pressure ( HR = 1.245, 95% CI was 1.126-1.377), lactic acid ( HR = 1.051, 95% CI was 1.025-1.077), simplified acute physiology score Ⅱ (SAPSⅡ, HR = 1.019, 95% CI was 1.016-1.023), serum creatinine ( HR = 1.171, 95% CI was 1.127-1.216), anion gap ( HR = 1.024, 95% CI was 1.010-1.038), serum potassium ( HR = 1.155, 95% CI was 1.079-1.236), white blood cell count ( HR = 1.006, 95% CI was 1.003-1.009) and furosemide use ( HR = 0.414, 95% CI was 0.368-0.467) were independently associated with severe AKI in septic patients (all P < 0.01). The above predictors were applied to construct an hour-specific prediction model for the occurrence of severe AKI in septic patients. The C-index of the prediction model was 0.723 and 0.735 in the training and validation sets, respectively. The AUC for the occurrence of severe AKI at 12, 24, and 48 hours were 0.795 (95% CI was 0.782-0.808), 0.792 (95% CI was 0.780-0.805), and 0.775 (95% CI was 0.762-0.788) in the training set, and the AUC were 0.803 (95% CI was 0.784-0.823), 0.791 (95% CI was 0.772-0.810), and 0.773 (95% CI was 0.752-0.793) in the validation set, respectively. The calibration curves of the two cohorts were in good agreement. Conclusion:The hour-specific prediction model effectively identifies high-risk septic patients for developing severe AKI within 48 hours, aiding clinicians in stratifying patients for early therapeutic interventions to improve outcomes.

Objective To discuss the current status of the discharge readiness in patients with Budd-Chiari syndrome undergoing interventional therapy,and to analyze its influencing factors.Methods A cross-sectional survey in 150 patients with Budd-Chiari syndrome,who were admitted to the Department of Interventional Radiology of a certain grade Ⅲ-A hospital in Xuzhou City of China between September 2022 and September 2023,was conducted.The revised Discharge Preparation Scale,the Discharge Guidance Quality Scale,and the self-designed general data collection form were used as the study tools.Results The results of the survey showed that the mean discharge readiness score in the 150 patients with Budd-Chiari syndrome undergoing interventional therapy was(102.59±7.88)points,and the quality of discharge guidance,education level,and per capita monthly household income,and the current disease status were the key factors affecting the patient's readiness for discharge(P＜0.001).Conclusion The overall level of readiness for discharge in patients with Budd-Chiari syndrome undergoing interventional therapy is high,but nurses should make key assessment of the current disease status,the discharge intentions and concerns of patients with low-education level and low-income,based on which give targeted health guidance so as to improve patient's readiness for discharge.(J Intervent Radiol,2024,33:674-678)

Objective To study the speech recognition rates of patients with mild to moderate sensorineural hearing loss with or without cochlear dead regions under quiet and different signal-to-noise ratio,and the difference of speech recognition rates between the two groups under the same test conditions.Methods A total of 44 ears with mild to moderate sensorineural hearing loss were selected via pure tone audiometry.The patients were divided into non-cochlear dead regions group and cochlear dead regions group according to the results of the threshold equalizing noise test.The monosyllabic speech test materials(MSTMs)were used to assess the speech recognition score of the two groups of patients in quiet and speech spectrum noise environments(SNR=6,3,0,-3 dB).Results There were 1～2 cochlear dead regions in the dead regions group mostly in 3～4 kHz regions.Speech recognition of the two groups of patients in different test environments decreased with the reduction of signal-to-noise ratio(P＜0.05)and there were significant differences in speech recognition scores between the two groups under different SNR con-ditions(P＜0.05).Conclusion The speech recognition scores of patients with mild to moderate sensorineural deaf-ness decreased significantly with the decrease of signal-to-noise ratio.Under each signal-to-noise ratio,the speech recognition scores of the cochlear dead regions group was lower than that of the non-cochlear dead regions group.It is necessary to carry out cochlear dead regions test for patients with mild to moderate sensorineural hearing loss.

Objective:The aim of this study is to analyze the development of speech ability in Mandarin-speaking infants and children with normal hearing using MUSS and to provide a normal value control for the evaluation of speech ability in children with hearing loss.Methods:From September 2012 to January 2023, a total of 256 infants and children aged 1-60 months in Mandarin language environment participated in this study. 200 infants and children aged from 1 to 60 months were finally included, whose hearing was considered normal according to the history collection, high-risk registers for hearing loss and hearing screening. All infants and children were divided into 10 groups with 20 infants or children in each group. They were: 1 month, 2-3 months, 4-6 months, 7-9 months, 10-12 months, 13-18 months, 19-24 months, 25-36 months, 37-48 months, and 49-60 months. Using SPSS 19.0 software for data analysis, we calculated regression equations based on fitting curves.Results:The language ability of infants and children with normal hearing increased with age and reached ceiling at 56.5months.The regression equation was: score=-0.009 3×(age) 2+2.179×(age)+6.718 6, r2=0.85; age=0.003 9×(score) 2+0.148 4×(score)+2.708, r2=0.85. Conclusions:The speech ability of infants and children with normal hearing shows an increasing trend with age. Scores of different speech skills can be predicted according to their age. Age can also be predicted according to their scores of different speech skills.

Objective:To analyze the risk factors of acute kidney injury (AKI) in hip fracture patients with serious underlying diseases and establish a prediction nomogram.Methods:Clinical information of hip fracture patients admitted to the intensive care unit (ICU) of Beth Israel Deaconess Medical Center (BIDMC) was analyzed using the Medical Information Mart for Intensive Care (MIMIC)-IV. Patient comorbidities, disease scores, vital signs and laboratory tests, surgical modalities, invasive procedures, and drug use were recorded. According to the diagnostic criteria of AKI in the Kidney Disease Improving Global Outcome (KDIGO) guideline, the enrolled patients were randomly divided into training set and validation set. Based on logistic regression analysis, least absolute shrinkage and selection operator (LASSO) logistic regression algorithm was used to analyze the risk factors of AKI after admission, and the corresponding prediction model was calculated.Results:A total of 474 patients were enrolled, including 331 in the training set and 143 in the validation set. According to the diagnostic criteria of AKI of KDIGO guidelines, the patients were divided into AKI group (159 cases) and non-AKI group (172 cases). Univariate analysis showed that age ( t=2.61, P=0.009), coronary heart disease (χ 2=2.08, P=0.038), heart failure (χ 2=2.60, P=0.009), hemoglobin ( t=1.89, P=0.059), platelets ( t=1.81, P=0.070), urea nitrogen ( t=2.83, P=0.005), blood creatinine ( t=3.65, P<0.001), blood sodium ( t=2.55, P=0.011), blood glucose ( t=2.52, P=0.012), anion gap ( t=3.44, P=0.001), diastolic blood pressure ( t=2.72, P=0.007), mean arterial pressure ( t=2.16, P=0.031), SOFA score ( t=3.69, P<0.001), simplified acute physiological function score II (SAPSII) score ( t=2.95, P=0.003), as well as furosemide (χ 2=2.03, P=0.042), vancomycin (χ 2=1.70, P=0.089), vasoactive medications (χ 2=3.74, P<0.001) and use of invasive mechanical ventilation (χ 2=4.81, P<0.001) were risk factors associated with the development of AKI in hip fracture patients. Multivariate logistic regression analysis showed that age ( OR=1.03, P<0.001), coronary heart disease ( OR=2.05, P=0.069), hemoglobin ( OR=0.88, P=0.050), blood creatinine ( OR=1.37, P=0.009), blood sodium ( OR=1.07, P=0.026), anion gap ( OR=1.09, P=0.028) and vasoactive medications ( OR=3.83, P=0.018) and the use of invasive mechanical ventilation ( OR=6.56, P<0.001) were independent predictors of the development of AKI in hip fracture patients with serious underlying diseases. The area under the curve of the nomogram prediction model constructed by the above 8 predictors was 0.789, and the calibration curve of the nomogram was close to the ideal diagonal. Decision curve analysis showed that the net benefit of the model was significant. Conclusion:The incidence of AKI is high in hip fracture patients with serious underlying diseases. Age, coronary heart disease, hemoglobin, serum creatinine, serum sodium, anion gap, vasoactive drugs, and invasive mechanical ventilation can predict the occurrence of AKI to a certain extent. Combined with the risk factors, the construction of the corresponding prediction model can predict and manage the diagnosis and treatment of AKI in patients with hip fracture complicated with severe underlying diseases.

Objective:To explore the changes and influencing factors of psychological distress in patients with primary acute myocardial infarction (AMI) in different periods, and to provide reference for the management of psychological distress in patients with primary AMI.Methods:This was a longitudinal, prospective, observational study. From June 2021 to September 2022, 118 patients with primary AMI in Peking Union Medical College Hospital and Peking University First Hospital were selected as the research objects. The psychological distress level of patients was investigated on the points of 24 hours after illness (T 1), before discharge (T 2), 1 month after discharge (T 3), 3 months after discharge (T 4), 6 months after discharge (T 5) and 12 months after discharge (T 6), and the influencing factors were analyzed. Results:The detection rate of psychological distress in 6 follow-up survey nodes was 66.95% (79/118), 48.31% (57/118), 29.66% (35/118), 24.58% (29/118), 19.49% (23/118) and 15.25% (18/118) respectively. Education level, family per capita income and disease awareness had significant effects on the psychological distress of patients with primary AMI at the time points from T 1 to T 6 ( β values were - 1.262 to - 0.212, all P<0.05). Conclusions:The level of psychological distress in primary AMI patients decreased with time. Nursing staff should pay attention to the trajectory and influencing factors of psychological pain, and formulate targeted intervention measures to reduce the level of psychological pain and promote the comprehensive rehabilitation of patients.

This paper reviews the definition, status quo, assessment tools, influencing factors and intervention measures of psychological pain in patients with acute myocardial infarction (AMI), aiming to improve the nursing staff 's attention to psychological pain in patients with acute myocardial infarction and provide a basis for the formulation of psychological pain intervention measures.

Objective:To investigate the current situation of critical thinking ability of nurses in Catheterization Room in China, and analyze its influencing factors, so as to provide reference for improving the critical thinking ability of nurses in Catheterization Room.Methods:In July 2020, the catheterization nurses from 154 hospitals, including Class Ⅲ Grade A, Class Ⅲ Grade B and Class Ⅱ Grade A, in 28 provincial capital cities of China were investigated with general information questionnaire and Chinese Critical Thinking Disposition Inventory (CTDI-CV) , by convenience sampling method. 422 questionnaires were collected in this survey, 408 were valid, and the effective rate was 96.68%.Results:The total score of critical thinking ability of the 408 catheterization nurses was (247.92±33.77) , which was at a low level as a whole. There were 361 nurses (88.48%) without positive critical thinking, 42 (10.29%) with positive critical thinking, and 5 (1.23%) with strong positive critical thinking. Binary Logistic regression analysis showed that nurse level, education background, professional title and position were the main influencing factors of critical thinking ability of nurses in Catheterization Room ( P<0.05) . Conclusions:The critical thinking attitude of nurses in Catheterization Room is generally negative, which is far from positive, and needs to be further improved. The nursing department should give more tendentious policies and support to the nurses in the Catheterization Room. At the same time, the nursing managers in the Catheterization Room should actively take measures to improve the critical thinking ability of nurses.

Objective To study the in vitro killing effect of novel small molecule inhibitors, ribosomal S6 kinase1 (RSK1) inhibitor (BI-D1870) and polo-like kinase 1 (PLK1) inhibitor (BI2536), combined with recombinant attenuated vesicular stomatitis virus VSVΔM51 on various glioma cells. Methods (1) In vitro cultured GL261, CT2A and HS68 cells were divided into control group, rapamycin group, BI-D1870 group, BI-2536 group, VSVΔM51 group, rapamycin +VSVΔM51 group, BI-D1870+VSVΔM51 group, and BI2536+VSVΔM51 group; pretreatments with 100 nmol/L rapamycin, 10 μmol/L BI-D1870, and 100 nmol/L BI-2536 for 2 h were given to the cells from the above groups, respectively, and then, they were infected with VSVΔM51 virus at 0.1 mutiplicity of infection (MOI); at 72 h after treatments, the cell survival rate was determined by Alarma Blue method; VSV△M51 virus was infected at 10 MOI one h after pretreatment with the above drugs, apoptosis of GL261 cells was detected by cleaved caspase-3 staining 24 h after that; the expression of apoptotic protein polyadp-ribosomal polymerase (PARP) was detected by Western blotting; Annexin V-FITC/propidium iodide double staining was used to detect the cell apoptosis. (2) GL261 and CT2A cells were divided into VSVΔM51 group, rapamycin+VSVΔM51 group, BI-D1870+VSVΔM51 group, and BI2536+ VSVΔM51 group; VSV△M51 virus was infected at 0.1 MOI one h after pretreatment with the above drugs,; 48 h after treatments, fluorescence microscope was used to detect the expression of green fluorescent protein (GFP); IVIS200 in vivo imaging system was used to detect the changes of cell virus luciferase in the 4 groups. (3) Fifteen CT2A intracranial implanted glioma model mice were divided into VSVΔM51 group, BID-1870+VSVΔM51 group and BI2536+VSVΔM51 group according to random number table method (n=5); mice in the latter two groups were intraperitoneally injected with BI-1870 (100 mg/kg) or intravenously injected with BI-2536 (20 mg/kg); 24 h after that, mice in the three groups were intravenously injected with virus VSVΔM51; virus luciferase was detected by IVIS200 in vivo imaging system 24 and 72 h after treatments; the grouping and treatments of GL261 intracranial glioma model mice were the same as above, the expression of virus GFP was observed under fluorescence microscope 48 h after treatments, and virus titers of these mice were detected by virus plaque assay. Results (1) As compared with the control group, rapamycin group, BI-D1870 group, BI-2536 group, and VSVΔM51 group, the rapamycin+VSVΔM51 group, BI-D1870+VSVΔM51 group, and BI2536+VSVΔM51 group had significantly lower cell survival rate (P<0. 05); cleaved Caspase-3 staining showed no cell apoptosis in the control group, a small amount of apoptotic corpuscles in the rapamycin group, BI-D1870 group, BI-2536 group, and VSVΔM51 group, but obvious increased amount of apoptotic corpuscles in the rapamycin+VSVΔM51 group, BI-D1870+VSVΔM51 group, and BI2536+ VSVΔM51 group; Western blotting indicated that GL261 and CT2A cells from the control group, rapamycin group, BI-D1870 group, BI-2536 group, and VSVΔM51 group had lower cleaved PARP expression level than those from the rapamycin+VSVΔM51 group, BI-D1870+VSVΔM51 group, and BI2536+VSVΔM51 group. The results of Annexin V-FITC/propidium iodide double staining were consistent with those of cleaved Caspase-3 staining. (2) As compared with VSVΔM51 group and rapamycin+VSVΔM51 group, BI-D1870+VSVΔM51 group and BI2536+VSVΔM51 group had significantly increased GFP expression and statistically higher intensity of virus luciferase (P<0.05). (3) CT2A cells in the VSVΔM51 group, BID-1870+VSVΔM51 group and BI2536+VSVΔM51 group had increased intensity of virus luciferase successively, with significant differences (P<0.05); GL261 cells in the VSVΔM51 group, BID-1870+VSVΔM51 group and BI2536+VSVΔM51 group had increased virus titers successively, with significant differences (P<0.05). Conclusion Both small molecule inhibitors promote the replication of VSVΔM51 virus and enhance the killing effect on glioma cells, and its synergistic effect is obviously better than rapamycin.