Objective:To carry out evidence-based nursing for standardized management of stress hyperglycemia in perioperative period of gastrointestinal tumor patients, and to formulate indicators, analyze obstacles and promoting factors, formulate action strategies.Methods:Guided by the Johns Hopkins evidence-based nursing model, evidence were searched, evaluated and summarized. Clinical indicators and review methods were formulated to carry out quality review. From November 2021 to April 2022, the medical staff and patients in the gastrointestinal surgery department of the First Affiliated Hospital of Anhui Medical University who met the inclusion criteria were conducted, and the incidence of compliance rate was calculated. Based on the results of the baseline review, the obstacles and contributing factors were analyzed.Results:A total of 26 pieces of best evidence were included and 14 indicators were formulated for 48 medical staff and 45 patients to clinical review, among which the compliance rate of 7 indicators was less than 60%. The main obstacle factors were lack of procedures and instruments for management of perioperative stress hyperglycemia in gastrointestinal tumor patients, lack of knowledge of medical staff, etc. The main promoting factors were organizational support, good atmosphere of medical team cooperation, strong willingness to change, etc.Conclusions:There is a big gap between the clinical practice and the best evidence of perioperative stress hyperglycemia management in patients with gastrointestinal tumor. Action strategies should be put forward for obstacles and promoting factors to promote evidence transformation.

Objective:To analyze the current situation of low copper diet management in children with hepatolenticular degeneration, so as to provide reference and help for individualized low copper diet guidance.Methods:Questionnaire survey and semi-structured interview were used. In the questionnaire survey, a total of 113 parents of children with hepatolenticular degeneration who were treated in the Pediatric Outpatient Department and ward of Chinese Academy of Medical Sciences, Peking Union Medical College Hospital from August 2021 to October 2022 were selected as the research objects. And a self-designed Low Copper Diet Status Questionnaire for Children with Hepatolenticular Degeneration was used for investigation. In the semi-structured interview, the purposive sampling method was used to recruit research objects that met the inclusion criteria. When the information reached saturation, they were no longer included, and finally 16 interviewees were included. Results:The results of the questionnaire showed that the items with the lowest accuracy in the part of the low-copper diet knowledge questionnaire for parents of children with hepatolenticular degeneration were "whether the food was edible according to the amount of copper in the food, for example, if the copper content in 100 g food exceeded 0.5 mg, it was forbidden to eat" and "in the following bean food (tofu, yuba, dried bean curd, oily bean curd), which one had the highest copper content". Among the 113 children, 55 were completely managed by their parents on a low copper diet, 53 children were jointly managed with their parents on a low copper diet, and 4 children were self-managed on a low copper diet. A total of 64 children currently followed the principle of a low copper diet, only consuming a few major categories of foods with low copper content. A total of 32 children ensured a diversified diet while ensuring that the total copper content in their daily food did not exceed the standard. The themes extracted from semi-structured interviews included insufficient awareness of low copper diet among parents of affected children, concerns about their children dining outside, doubts about how to balance low copper diet and nutritional balance among parents, and hopes that medical staff could provide some assistance in low copper diet guidance.Conclusions:The management of low-copper diet in children with hepatolenticular degeneration is poor. The parents of the affected children lack knowledge about low copper diet and have many confusions, and there is an urgent need for medical personnel to provide more specific, rich and practical guidance on low copper diet.

Premature ovarian insufficiency(POI),also known as"ovarian insufficiency",has an incidence of 1％～5％.The incidence has been on the rise in recent years,seriously affecting women's physical and mental health and quality of life.At present,the cause and mechanisms of POI are still unclear,and the method and applications of model construction are also confusing.Most models have some shortcomings in pertinence and stability.The limitations greatly limit research into the clinical diagnosis and treatment of POI.This paper summarizes and discusses the etiology and pathogenesis of POI and the construction of POI animal models to provide a comprehensive reference for those studying POI.

Objective:To understand the mental health status of fathers in neonatal intensive care unit and the intervention strategies for fathers′ mental health problems.Methods:Using the scoping review method as a framework, the studies on the mental health status of fathers with NICU in PubMed, CINAHL, Embase, Web of Science, Cochrane Library, PsycINFO, CNKI, WanFang Data, VIP and CBM were searched. The included studies were summarized and analyzed. The search time was from the database establishment to 30 August 2022. The content of literature extraction included author, country, publication time, research type, sample size, research variables, research content, and research results.Results:A total of twenty-five articles were included. Among them,11 literatures reported the mental health status of fathers of children in neonatal intensive care unit. Fathers experienced both negative and positive psychological changes after admission to the neonatal intensive care unit, including anxiety, depression, post-traumatic stress disorder, stress, sadness, and post-traumatic growth. Fourteen articles involved intervention strategies for mental health problems of fathers. Intervention strategies include enhancing social support (emotional support, peer support), stress management training (written disclosure, relaxation training, mindfulness therapy), information support, family integrated care (accompanied visits, kangaroo care).Conclusions:The admission of a newborn to the intensive care unit has caused many psychological problems for the father. However, there is still a lack of intervention strategies for fathers′ mental health problems, and it is still necessary for medical staff to take corresponding intervention measures according to fathers′ needs.

Objective:To investigate the morphological characteristics of skull base in children with hemifacial microsomia (HFM) by three-dimensional reconstruction and measurement of skull base.Methods:Three-dimensional spiral CT data of HFM children with unilateral involvement who had not received any treatment from the First Center of Maxillofacial Plastic Surgery, Plastic Surgery Hospital of the Chinese Academy of Medical Sciences from February 2010 to December 2020 were collected. The patients were divided into four groups according to the Pruzansky-Kaban classification standard: Ⅰ, Ⅱa, Ⅱb and Ⅲ. The three-dimensional reconstruction and measurement of the skull base were performed using Mimics 17.0 software. Linear measurements of the skull base included the distance from tuberculum sellae to optic canal (OT), foramen rotundum (FrT), foramen ovale (FT), internal acoustic meatus (IT), hypoglossal canal (HT), and the distance from anterior clinoid process to the lesser wing of the sphenoid bone (ClS) and the petrous ridge of the temporal bone (ClP). The measurement indexes of skull base angle included anterior cranial angle (ACA), middle cranial angle (MCA), posterior cranial angle (PCA), and petrous ridge angle (PRA). SPSS 26.0 software was used for statistical analysis of the measurement result. Paired t-test was used for comparison within each group, and one-way ANOVA was used for comparison between different types. P<0.05 was statistically significant. Results:A total of 40 children with HFM were collected, with 10 cases in each group. The result of skull base angle measurement showed that the MCA of the healthy side of typeⅠHFM was significantly larger than that of the affected side, and the MCA and PRA of the healthy side of type Ⅲ HFM were larger than those of the affected side ( P<0.05). There was no significant difference in the angle of skull base between the healthy side and the affected side of typeⅡa andⅡb HFM ( P>0.05). In terms of linear distance measurement of skull base, FrT and HT on the healthy side of typeⅠHFM were longer than those on the affected side; FrT, IT, HT and ClP on the healthy side of typeⅡa HFM were significantly longer than those on the affected side; IT, HT and ClP on the healthy side of typeⅡb HFM were longer than those on the affected side; and HT on the healthy side of type Ⅲ HFM was longer than those on the affected side ( P<0.05). The difference between FrT and ClP (affected / healthy) of four types of HFM was statistically significant ( P<0.05). Conclusions:The morphology of HFM is different between the affected side and the healthy side. As for the angle of skull base, MCA was obvious smaller in the affected side than that in the healthy side in the type Ⅰ and type Ⅲ HFM. As for the linear measurement, the distance from the hypoglossal canal to the tuberculum sellae on the affected side is shorter than that on the healthy side in each type HFM, indicating that the growth and development of the cranial base on the affected side is affected in a certain degree.

Objective:To investigate the morphological characteristics of skull base in children with hemifacial microsomia (HFM) by three-dimensional reconstruction and measurement of skull base.Methods:Three-dimensional spiral CT data of HFM children with unilateral involvement who had not received any treatment from the First Center of Maxillofacial Plastic Surgery, Plastic Surgery Hospital of the Chinese Academy of Medical Sciences from February 2010 to December 2020 were collected. The patients were divided into four groups according to the Pruzansky-Kaban classification standard: Ⅰ, Ⅱa, Ⅱb and Ⅲ. The three-dimensional reconstruction and measurement of the skull base were performed using Mimics 17.0 software. Linear measurements of the skull base included the distance from tuberculum sellae to optic canal (OT), foramen rotundum (FrT), foramen ovale (FT), internal acoustic meatus (IT), hypoglossal canal (HT), and the distance from anterior clinoid process to the lesser wing of the sphenoid bone (ClS) and the petrous ridge of the temporal bone (ClP). The measurement indexes of skull base angle included anterior cranial angle (ACA), middle cranial angle (MCA), posterior cranial angle (PCA), and petrous ridge angle (PRA). SPSS 26.0 software was used for statistical analysis of the measurement result. Paired t-test was used for comparison within each group, and one-way ANOVA was used for comparison between different types. P<0.05 was statistically significant. Results:A total of 40 children with HFM were collected, with 10 cases in each group. The result of skull base angle measurement showed that the MCA of the healthy side of typeⅠHFM was significantly larger than that of the affected side, and the MCA and PRA of the healthy side of type Ⅲ HFM were larger than those of the affected side ( P<0.05). There was no significant difference in the angle of skull base between the healthy side and the affected side of typeⅡa andⅡb HFM ( P>0.05). In terms of linear distance measurement of skull base, FrT and HT on the healthy side of typeⅠHFM were longer than those on the affected side; FrT, IT, HT and ClP on the healthy side of typeⅡa HFM were significantly longer than those on the affected side; IT, HT and ClP on the healthy side of typeⅡb HFM were longer than those on the affected side; and HT on the healthy side of type Ⅲ HFM was longer than those on the affected side ( P<0.05). The difference between FrT and ClP (affected / healthy) of four types of HFM was statistically significant ( P<0.05). Conclusions:The morphology of HFM is different between the affected side and the healthy side. As for the angle of skull base, MCA was obvious smaller in the affected side than that in the healthy side in the type Ⅰ and type Ⅲ HFM. As for the linear measurement, the distance from the hypoglossal canal to the tuberculum sellae on the affected side is shorter than that on the healthy side in each type HFM, indicating that the growth and development of the cranial base on the affected side is affected in a certain degree.

In recent years, virtual reality technology has gradually been applied to alleviate children's anxiety due to its immersive, interactive and imaginative characteristics. This article introduces the related concepts of virtual reality technology and its intervention mechanism on anxiety and the application status of virtual reality technology in alleviating preoperative anxiety, dental anxiety and anxiety in children with cancer, in order to provide reference and guidance for clinical practice.

Objective:To integrate the experience of healthy siblings of children with chronic diseases living with their sick siblings.Methods:Cochrane Library, PubMed, Embase, Web of Science, CINAHL, PsycINFO, China National Knowledge Infrastructure, Wanfang, VIP and China Biology Medicine disc were searched for qualitative research literature on life experience of siblings of children with chronic diseases. The retrieval period was from the database construction to January 5, 2022. The quality of literature was evaluated using the qualitative research quality evaluation standard of JBI Evidence-based Health Care Center in Australia (2016) and the results were integrated using the method of pooled integration.Results:A total of 18 studies were included, 32 complete results were extracted, and the similar results were summarized to obtain 9 new categories, which were integrated into 4 integrated results, respectively, the first integrating result was that the challenges and burdens faced by healthy siblings in the process of living with their sick compatriots made them physically and mentally exhausted, the second integrating result was that the family relationship and life within the family had changed since the diagnosis of the disease, the third integrating result was that healthy siblings had limited perception ability and they were eager for information support and social support, the fourth integrating result was that with the passage of time, healthy siblings continued to adjust and adapt themselves, developed coping strategies and achieved positive personal growth.Conclusions:Children suffering from chronic diseases can adversely affect the psychosocial functions of their healthy siblings. It is suggested that the government, medical and health institutions, the public and families of children with chronic diseases should pay more attention to the psychosocial needs and life challenges of healthy siblings of children with chronic diseases, help them improve their negative emotions, improve their quality of life and further promote the healthy growth of siblings.

OBJECTIVE：To investigate the activity of lycorine to the in vivo apoptosis of tumor cells in H 22-bearing mice and its mechanism. METHODS ：Kunming mice were inoculated subcutaneously with ascites of H 22 hepatoma mice in the armpit of forelimb to establish solid tumor model. After modeling ，mice were randomly divided into negative control group ，positive control group（hydroxycamptothecin 6 mg/kg），lycorine low-dose ，medium-dose and high-dose groups （10，20，40 mg/kg），with 10 mice in each group. Negative control group was given constant volume of normal saline intragastrically ，and administration groups were given relevant medicine intragastrically ，once a day ，for consecutive 7 days. After last medication ，the weight of tumor was detected and anti-tumor rate was calculated. Ascites tumor model of mice was established by intraperitoneal injection of H 22 hepatoma mice ascites ，and then were grouped with same method and given relevant medicine as above. After last medication ， survival time of mice was recorded and the life prolongation rate was calculated. The early apoptotic rate of tumor cells in mice was detected by flow cytometry. On the basis of normal control group （normal mice without tumor ），the mitochondrial membrane permeability of tumor cells in each group was investigated by Calcein AM staining. The changes of mitochondrial potential were investigated by Rhodamine 123 staining. Colorimetry and Western blot assay were adopted to detect the Caspase-3 activity and expression of apoptosis-related protein （Bcl-2，Bax，Cyt-C and Caspase- 9）. RESULTS ：Compared with negative control UN- group，the tumor weight of positive control group and lycorine PYSCT-2017208） groups were decreased significantly ，while the survival time was significantly prolonged ，and the early apoptotic rate of tumor cells was significantly increased （P＜0.05 or P＜0.01）；the anti-tumor rates were 39.41％ ， 23.36％ ， 36.50％ ， 56.93％，and life prolonga tion rates were 49.23％，29.09％， E-mail：ym913@yahoo.com.cn 50.19％，69.08％. Compared with normal control group ，the mitochondrial membrane permeability ，Caspase-3 protein activity and protein expression of Cyt-C and Caspase- 9 were significantly increased，while the mitochondrial membrane potential and Bcl- 2/Bax ratio were decreased significantly （P＜0.05 or P＜0.01）. Compared with negative control group ，mitochondrial membrane permeability and Bcl- 2/Bax ratio were decreased significantly in administration groups ，while mitochondrial permeability ，Caspase-3 protein activity and protein expression of Cyt-C and Caspase- 9 were significantly increased （P＜0.05 or P＜0.01）. CONCLUSIONS ：Lycorine can induce the apoptosis of tumor cells in H22-bearing mice ，the effects of which may be associated with opening mitochondrial membrane permeability transition pore to increase mitochondrial permeability ， decreasing mitochondrial membrane potential and up-regulating the expression of apoptosis-related proteins.

Objective:To preliminarily study the feasibility, safety and efficacy of transcatheter arterial chemoembolization (TACE) combined with selective portal vein embolization (SPVE) before surgical resection in the treatment of large liver cancer.Methods:A retrospective study was conducted on the clinical data of 17 patients with large liver cancer treated with TACE combined with SPVE from January 2016 to December 2019 at the Department of Hepatobiliary Surgery, the Sixth Medical Center of PLA General Hospital. The study included 15 males and 2 females, aged (59.17±10.30) years. The levels of alanine aminotransferase, tumor changes and patient survival were analyzed before operation, after TACE, and after SPVE.Results:Among the 17 patients, the levels of alanine aminotransferase on the 1st and 3rd day after SPVE was significantly higher than those after TACE [191.4 (30.5-1966.4) IU/L vs 125.3 (35.7-846.2) IU/L on the first day, and 298.5 (24.6-1334.2) IU/L vs 208.6 (21.6-775.6) IU/L on the 3rd day], all P<0.05. One month after the two combined embolism, among the 6 patients with a tumor diameter of 5-10 cm, 2 patients (33.3%) had complete remission, 3 patients (50.0%) had partial remission, and 1 patients (16.6%) had stable disease. For the tumor’s longest diameter, among the 11 patients with tumors >10 cm, 1 patient had complete remission (9.1%), 4 patients had partial remission (36.4%), 5 patients had stable diseases (45.5%), and 1 patient had disease progression (9.1%). Eventually, 11 patients underwent surgical exploration. The median residual liver volume before treatment was 329.5 (284.9-365.7) ml, and after the combined procedure 415.6 (354.7-718.8) ml. The median hyperplasia ratio was 28.1% (14.1%-51.3%). Eight patients finally underwent surgical resection. There was no death in the perioperative periods. The median tumor-free survival time was 17 (7-42) months, and the median survival time was 27 (7-42) months. Conclusion:For patients with large liver cancer with insufficient remnant liver volume, preoperative TACE+ SPVE has certain value in controlling tumor progression, promoting remnant liver hyperplasia, increasing surgical resection rate and improving prognosis.