Objective:To evaluate the quality of critical patient handover practice between emergency room and intensive care unit (ICU) nurses, and to provide a basis for structured handover process.Methods:From March to July 2023, a total of 223 pairs of nurses in emergency room and ICU (including EICU) of 5 Class 3 Grade A general hospitals in Suzhou were selected as the research objects by using cross-sectional survey method and convenience sampling method. Self-designed general information questionnaire and Patient Handover Practice Quality Scale were used to investigate the included 223 pairs of nurses in emergency room and ICU on the current situation of handover time and quality.Results:A total of 211 pairs of nurses were included, including 286 females (67.8%) and 136 males (32.2%). The average age of emergency department nurses was (27.31 ± 2.17) years old, and ICU nurses was (26.96 ± 3.04) years old. The total scores of the patient handover practice Quality Scale for nurses in the emergency room and ICU were (45.25 ± 6.26) and (43.55 ± 7.19) points respectively, and the scores of the information transmission dimension were (20.47 ± 5.43) and (17.66 ± 3.45) points. The scores of common understanding dimension were (7.59 ± 2.31) and (8.58 ± 2.46) points. The scores of work atmosphere dimension were (7.93 ± 2.11) and (8.39 ± 2.29) points. The scores of handover situation dimension were (5.33 ± 1.30) and (5.70 ± 1.53) points, and the differences were statistically significant ( t values were - 6.35-4.22, all P<0.05). There were statistically significant differences in the scores of handover practice quality between emergency room nurses and ICU nurses according to specialization, education background, working years and job category ( t values were - 4.91-2.56, all P<0.05). Conclusions:Emergency room nurses and ICU nurses have different requirements and expectations for handover procedures, so it is necessary to build a structured handover practice framework and carry out personalized handover practice training, in order to achieve the consistency of handover content and improve the quality of critical patients handover practice.

Objective:To evaluate the effectiveness of remote pulmonary rehabilitation in the elderly COPD patients in order to provide evidence-based basis for the clinical practice and promotion of remote pulmonary rehabilitation.Methods:We searched databases including Web of Science, PubMed, Cochrane Library, Embase, CINAHL,China Biology Medicine disc, China National Knowledge Internet, VIP, and Wanfang and selected all randomized controlled trials (RCTs) that reported the effects of telerehabilitation on the elderly patients with COPD. The retrieval time was from the establishment of the database to April 26, 2023. Meta-analysis was performed by RevMan 5.3.Results:A total of 24 RCTs involving 2 980 patients with COPD were finally included. Meta-analysis results showed that telerehabilitation in the elderly patients with COPD can improve the lung function (FEV 1/FVC) ( MD=2.09, 95% CI 0.30-3.89, P<0.05), quality of life ( MD=-0.66, 95% CI -1.05--0.26, P<0.05), anxiety ( MD=-0.69, 95% CI -1.32--0.05, P<0.05) and depression ( MD=-0.81, 95% CI -1.59--0.04, P<0.05), and the subgroup for the lung function (FEV 1/FVC) of the elderly patients with COPD emphasized that physical activity, intervention time ≤24 weeks, intervention frequency 1-3 times per week, and use of network platform, there were significant differences between those subgroups (all P<0.01). But there was no statistically significant difference in improving the exercise capacity ( MD=-1.54, 95% CI -14.83-11.75, P>0.05). Conclusions:Telerehabilitation in pulmonary can be considered a supplementary intervention for improving the lung function (FEV 1/FVC), the quality of life and the psychological condition on the elderly patients with COPD.

Objective To view and compare the clinical characteristics of renal tubular acidosis in adults and children.Methods Clinical data of patients with renal tubular acidosis diagnosed by Shandong Provincial Hospital affiliated to Shandong University from Jan 1991 to Sep 2017 were reviewed.The difference and consistency in clinical characteristics of renal tubular acidosis between adults and children were analyzed.Results Data from 206 adults and 60 children were analyzed.89.81％ cases in adults were secondary to other diseases,mainly primary Sjogren's syndrome.Most children patients (81.67％) were idiopathic,others largely originated from inherited metabolic diseases.The most common subtype of both was distal renal tubular acidosis.Proximal renal tubular acidosis was easier to be found in idiopathic renal tubular diseases of children.Chief complaints or starting symptoms were mainly composed of polydipsia with polyuria (41.4％) and fatigue (35.3％).Children were typical of growth retardation,rickets and digestive symptoms.The rate of missed diagnosis and misdiagnosis was 41.4 percent.Routine therapy consisted of healing metabolic acidosis and electrolyte disorders,treating underlying diseases and preventing complications.The majority of patients (95.5％) improved after treatments.Conclusions Renal tubular acidosis possesses various underlying diseases,diverse clinical manifestation and high rate of misdiagnosis.Given the high incident of secondary types,investigation of underlying disease,especially autoimmune diseases such as Sjogren's syndrome,is of great importance in adults.Most children patients suffer from primary renal tubular acidosis.Attention should be paid to them in order to reduce the rate of misdiagnosis and teratogenicity.

Objective To investigate the risk factors of acute kidney injury (AKI) in patients undergoing cardiac valve surgery with cardiopulmonary bypass (CPB).Methods A retrospective cohort database study was conducted, involving 1 349 patients undergoing heart valve surgery with CPB technique.Logistic regression was used to screen out the risk factors of AKI after the surgery.Results Of the 1 349 patients, the incidence of AKI in valve surgery was 28.4%.One year older (OR=1.05, 95%CI 1.03-1.06, P<0.001), diabetes (OR=2.11, 95%CI 1.22-3.68, P=0.008), anemia (OR=1.50, 95%CI 1.05-2.21, P=0.026), each additional basic serum creatinine of 1 mg/dl (OR=1.01, 95%CI 1.01-1.02, P=0.001), each additional operation time of 1 hour (OR=1.28, 95%CI 1.15-1.41, P<0.001), plasma transfusion during surgery (OR=1.50, 95%CI 1.14-1.97, P=0.004) were the independent risk factors for AKI in multivariate logistic regression model.Conclusion AKI is a common and serious complication following cardiac valve surgery.More attention should be paid to the patients with elder age, anemia, prolonged operation time, diabetes, increased basic serum creatinine and requirement of plasma transfusion during surgery.

This study aims to evaluate the ability of C-arm cone-beam CT to detect intracranial hematomas in canine models. Twenty one healthy canines were divided into seven groups and each group had three animals. Autologous blood and contrast agent (3 mL) were slowly injected into the left/right frontal lobes of each animal. Canines in the first group, the control group, were only injected with autologous blood without contrast agent. Each animal in all the 7 groups was scanned with C-arm cone-beam CT and multislice computed tomography (MSCT) after 5 minutes. The attenuation values and their standard deviations of the hematoma and uniformed brain tissues were measured to calculate the image noise, signal to noise ratio (SNR) and contrast to noise ratio (CNR). A scale with scores 1-3 was used to rate the quality of the reconstructed image of different hematoma as a subjective evaluation, and all the experimental data were processed with statistical treatment. The results revealed that when the density of hematoma was less than 65 HU, hematomata were not very clear on C-arm CT images, and when the density of hematoma was more than 65 HU, hematomata showed clearly on both C-arm CT and MSCT images and the scores of them were close. The coherence between the two physicians was very reliable. The same results were obtained with C-arm cone-beam CT and MSCT grades in measuring SD value, SNR, and CNR. The reasonable choice of density detection range of intracranial hematoma with C-arm cone-beam CT could be effectively applied to monitoring the intracranial hemorrhage during interventional diagnosis and treatment.
Animals ; Cone-Beam Computed Tomography ; Disease Models, Animal ; Dogs ; Hematoma ; diagnosis ; Image Processing, Computer-Assisted ; Intracranial Hemorrhages ; diagnosis ; Multidetector Computed Tomography ; Signal-To-Noise Ratio

Objective To establish a rat model of nonalcoholic fatty liver disease (NAFLD) using high-fat diet,and to dynamically observe the influence of the changes in gut microbiota on the development and progression of NAFLD in rats during and after modeling.Methods Sprague-Dawley rats were given high-fat diet to establish the model of NAFLD,and these rats were randomly divided into high-fat group,antibiotic pretreatment group,antibiotic treatment group,restricted diet group,and control group.The rats were sacrificed in different feeding periods,and 16sRNA fluorescent quantitative PCR was used to analyze the changes in ileocecal microbiota in rats.The liver pathological scores were determined,and enzymatic colorimetry was used to measure blood lipid level in serum and liver homogenate.The sample mean t-test was used for comparison between groups.Results Compared with the high-fat group,the restricted diet group showed the most significant improvements in quality of life and biochemical parameters.In the restricted diet group,the number of probiotics (Bifidobacterium and Lactobacillus) at the end of the ileum gradually increased and tended to increase over the time of intervention,and the most significant difference between this group and the high-fat group occurred at the 10th week (Bifidobacterium:0.91±0.23 vs 0.28±0.12,P ＜ 0.05;Lactobacillus:0.78±0.04 vs 0.21±0.03,P ＜ 0.05),while the number of enterococci decreased.There were no significant differences in enteric bacilli between groups (all P ＞ 0.05).At the 10th week,the liver pathological scores in the control group,antibiotic treatment group,and restricted diet group were 1.13±1.74,4.86±0.86,and 2.94±1.91,respectively,significantly lower than 7.09±2.03 in the high fat group (all P ＜ 0.05).Conclusion Diet structure change and antibiotic intervention can adjust gut microecology,alleviate the lesions of NAFLD,and thus provide new strategies for the prevention and treatment of NAFLD from the perspective of microecology.

Objective To explore the effects of continuing nursing health education on postoperative rehabilitation of patients with gastric cancer. Methods A total of 98 cases of patients with gastric cancer radical were selected from December 2011 to December 2012 in our hospital according to the random number table method and were divided into observation group and control group. The patients of control group were given routine nursing, while the patients of observation group were given continuity of nursing health education based on the control group. We evaluated self satisfaction after nursing intervention of pain control, and assessed the score of self-rating anxiety scale ( SAS) , self-rating depression scale ( SDS) and quality of life self-rating scale. Results After intervention in the intervention group, the patients′ satisfaction to pain control method, to pain control education and all care, and family satisfaction scores were (42. 15 ± 14. 21), (44. 26 ± 13. 2), (16.69 ±2.20), that all were higher than these of the control group (t=3. 658, 5. 698, 4. 265; P<0. 05). Before the implementation of continuity of nursing health education, two groups of patients with SAS scores and SDS scores and the patient′s appetite, sleep quality and mental status, level of understanding of cancer, family understanding and cooperation, and daily life six dimensions related to the pain and psychological differences had no statistical significance (P>0. 05);continuity of nursing health education after implementation, the SAS scores and SDS scores were (30. 58 ± 8. 64), (35. 21 ± 9. 02) in the observation group that all were obviously lower than these of the control group (t=2. 245, 2. 014;P<0. 05); after the intervention group in appetite, sleep quality and mental status, the understanding of cancer, family understanding and cooperation, the score in the daily life were (3. 52 ± 0. 78), (4. 36 ± 1. 25), (3. 92 ± 1. 14), (4. 25 ± 0. 42), (3. 78 ± 0. 87), (4. 21 ± 0. 62);in six dimensions, related to the pain and psychological in the observation group were better than those of the control group (t=3. 145, 2. 896, 3. 859, 5. 697, 4. 021, 4. 256; P<0. 05). Conclusions Continuity nursing health education can reduce gastric cancer patients with postoperative pain and the degree of anxiety and depression patients, improve the patient′s quality of life and is good for stomach cancer patients with postoperative recovery.

OBJECTIVETo explore the incidence of chromosome 1 abnormality in myelodysplastic syndrome（MDS）to couple its association with clinical presentation and prognosis.

METHODSR- band karyotype analyses were performed in 672 cases of MDS between 2010 and 2013. Clinical data of those with abnormal chromosome l were collected and then analyzed factors affecting the prognosis.

RESULTSOf 672 cases of patients with MDS, chromosome 1 aberration［der（1）, dup（1）, －1 were most frequent］ were found in 41（6.1%）cases. 1q trisomy was found in 18/41（43.9%）cases, and the most common patterns were duplication of the long arm as well as unbalanced translocation with other chromosomes. Of 41 patients with chromosomal 1 abnormality, 32 cases were accompanied with other chromosomal aberration, usually involving 3 or more abnormal chromosomal karyotypes, e.g., chromosome 8, 7 abnormalities. According to IPSS-R scoring system, 19 patients were diagnosed with very high risk, 10 patients high risk, 10 patients intermediate risk and 2 patients low risk MDS. 9 patients transformed into acute leukemia with median transforming time of 7.18（0.56-54.28）months. Median survival of 36 cases after 2010 was 17.48（95% CI 14.38-20.58）months. There were significant differences on median survival between RAEB and non-RAEB groups（χ²=10.398, P=0.001）, and between with more than 3 chromosome abnormalities and with less than 3 groups（χ²=3.939, P=0.047）. RAEB was identified as an independent risk factor for the prognosis of MDS with chromosome 1 abnormality.

CONCLUSIONChromosome 1 aberration was not rare in MDS. 1q trisomy was the most common abnormal karyotype in China, which often accompanied with other chromosomal abnormalities. The prognosis of MDS patients with chromosome 1 abnormality was poor, especially worse in those diagnosed with RAEB-1, RAEB-2 and with more than 3 chromosome abnormality. For patients whose percentage of bone marrow blasts less than 5%, the prognosis of patients with 1q trisomy was better than those without 1q trisomy. RAEB was identified as an independent risk factor for the prognosis of MDS with chromosome 1 abnormality.

Abnormal Karyotype ; Acute Disease ; Anemia, Refractory, with Excess of Blasts ; Bone Marrow ; China ; Chromosome Aberrations ; Chromosome Banding ; Chromosomes, Human, Pair 1 ; genetics ; Humans ; Karyotyping ; Leukemia ; diagnosis ; genetics ; Myelodysplastic Syndromes ; diagnosis ; genetics ; Prognosis ; Risk Factors ; Trisomy

OBJECTIVETo explore the clinical significance of ten-eleven-translocation methylcytosine dioxygenase 2 (TET2) mRNA expression levels in adult acute myeloid leukemia patients with normal cytogenetics (CN-AML).

METHODSExpression levels of TET2 mRNA were measured by real-time PCR in 157 adult CN-AML, and its clinical impact in CN-AML was evaluated as well.

RESULTSTET2 gene expression levels from bone marrow mononuclear cells (BMMNCs) [7.29(3.41-9.99)] and CD34+ cells [6.02(5.64-6.54)] in CN-AML were significantly lower than those [BMMNCs: 8.13(6.68-9.04), P=0.026; CD34+ cells: 6.48(5.97-7.12), P=0.034] in healthy control. And TET2 mRNA level at diagnosis [7.32(6.11-8.41)] was obviously lower than that at complete remission [8.39(7.76-8.79), P<0.01]. CN-AML patients with lower levels of TET2 mRNA showed worse survival rate [(32.7±5.9)%] at 18-month than those with higher levels [(48.6±6.9)%, P=0.041]. In multivariate analysis, lower level of TET2 mRNA was an independent prognostic factor for OS [hazard ratio(HR)2.032, 95% confidence interval (CI)1.272-3.247, P=0.003] and event-free survival [HR 1.532, 95% CI 1.014-2.314, P=0.043].

CONCLUSIONThe level of TET2 mRNA is significantly lower in patients with CN-AML and it is an independent negative prognostic factor. TET2 could be an important factor for the molecular-based risk stratification in CN-AML.

Adult ; Cytogenetic Analysis ; Cytogenetics ; DNA-Binding Proteins ; genetics ; Disease-Free Survival ; Gene Expression ; Gene Expression Profiling ; Gene Expression Regulation, Neoplastic ; Humans ; Leukemia, Myeloid, Acute ; genetics ; Proto-Oncogene Proteins ; genetics ; Real-Time Polymerase Chain Reaction

OBJECTIVETo explore the expression and clinical significance of Musashi2 (MSI2) gene in de novo acute myeloid leukemia (AML).

METHODSReal-time quantitative PCR (RQ-PCR) was used to measure the expression of MSI2 gene in 181 de novo AML patients. Correlation between the expression level and clinical features of such patients was explored.

RESULTSTranscript of the MSI2 gene was detected in 181 AML patients, with the median expression level being 2.341 (0.1124-58.8566). By contrast, CD34+ cells from 10 healthy controls had a much lower expression level (P=0.012), and the expression level of MSI2 in 24 patients with complete remission was significant lower than de novo patients (P=0.021). Based on the median expression level, such patients were divided into low expression group and high expression group. Patients from the high expression group had significantly higher rate of high white blood cell count (78% vs. 63%, P=0.034). Compared with MSI2-low group, FLT3-ITD mutation were much more common in MSI2-high group (28% vs. 7%, P=0.002). The expression level of MSI2 in aberrant karyotypes was much higher than that in favorable karyotypes (the median expression level was 2.7726 and 2.0733, P=0.035). Kaplan-Meier analysis showed that the overall survival in high expression group of MSI2 was lower than the low expression group, with the median survival time being 28 months and 12 months, respectively (P=0.045).

CONCLUSIONDe novo AML patients have a higher level of MSI2 gene expression. And the latter is much more common in those with high white blood cell count and aberrant karyotypes, and has a positive correlation with FLT3-ITD mutation. High expression of MSI2 gene may be a predictor for poorer prognosis among AML patients.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Leukemia, Myeloid, Acute ; genetics ; metabolism ; Male ; Middle Aged ; Mutation ; RNA-Binding Proteins ; genetics ; metabolism ; Young Adult