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Objective To investigate the effect of early thoracic paracentesis drainage for pleural effusion with a small or moderate volume on acute lung injury in patients with severe acute pancreatitis (SAP). Methods A retrospective analysis was performed for the clinical data of 107 patients with SAP who were admitted to The General Hospital of Western Theater Command from January 2015 to December 2021, and according to whether thoracic paracentesis drainage was performed within the first three days after admission, the patients were divided into thoracic paracentesis drainage group (TPD group with 51 patients) and non-thoracic paracentesis drainage group (N-TPD group with 56 patients).The two groups were compared in terms of laboratory markers and clinical outcome on days 5 and 10 after admission.The independent-samples t test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between two groups. Results Compared with the N-TPD group, the TPD group had a significantly shorter length of stay in the intensive care unit, a significantly shorter length of hospital stay, and significantly lower hospital costs (all P < 0.05), while there were no significant differences between the TPD group and the N-TPD group in mortality rate (9.8% vs 14.3%, χ 2 =0.502, P =0.478) and the incidence rate of sepsis (29.4% vs 44.6%, χ 2 =2.645, P =0.104).The TPD group had a significant reduction in the incidence rate of acute respiratory distress syndrome (ARDS)( χ 2 =6.038, P =0.043), as well as a significantly lower incidence rate of moderate ARDS than the N-TPD group (7.8% vs 21.4%, χ 2 =3.874, P =0.049).Compared with the N-TPD group, the TPD group had a significantly lower rate of use of mechanical ventilation (35.3% vs 57.2%, χ 2 =6.735, P =0.034) and a significantly lower proportion of patients receiving invasive mechanical ventilation (9.8% vs 26.8%, χ 2 =5.065, P =0.024).Compared with the N-TPD group, the TPD group had a significantly lower incidence rate of pulmonary infection (23.5% vs 42.9%, χ 2 =4.466, P =0.035) and a significantly shorter duration of systemic inflammatory response syndrome (11.2±5.0 days vs 16.8±4.7 days, t =5.949, P < 0.001).Compared with the N-TPD group, the TPD group had significantly better laboratory markers (high-sensitivity C-reactive protein, interleukin-1, interleukin-6, interleukin-8, tumor necrosis factor-α, arterial partial pressure of oxygen, oxygen saturation, and oxygenation index) and incidence rate of respiratory failure on days 5 and 10 after admission (all P < 0.05).On day 10 after admission, the TPD group had significantly better APACHE Ⅱ score and modified Mashall score than the N-TPD group (both P < 0.05). Conclusion For SAP patients with a small or moderate volume of pleural effusion, early thoracic paracentesis drainage can effectively improve acute lung injury, alleviate systemic inflammatory response, shorten the length of hospital stay, and reduce hospital costs.
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Acute pancreatitis-associated ascites fluid (PAAF) is a common complication in patients with acute pancreatitis (AP) and is closely associated with the severity of AP, the development of local and systemic complications, and prognosis. PAAF may originate from the leakage of abdominal blood vessels, lymphatic vessels, and pancreatic duct. Recent studies have found that early removal of PAAF by abdominal paracentesis drainage can help to reduce systemic inflammation and alleviate pancreatitis-associated organ injury, thereby improving the conditions of patients with severe AP and reducing mortality. However, it is still not completely clear how PAAF aggravates systemic inflammatory response, participates in pancreatic injury and damage of distal organs, and leads to the aggravation of disease conditions in patients with AP. Therefore, this article gives an overview of PAAF and summarizes related studies in recent years, so as to provide directions for exploring the pathophysiological process and treatment of AP.
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Background Benzo[a]pyrene (BaP) has neurotoxicity, which can induce the loss of hippocampal neurons in humans and animals and lead to spatial learning and memory dysfunction, but its mechanism is still unclear. Objective To observe the ferroptosis of mouse hippocampal neuron HT22 cells induced by 7,8-dihydroxy-9,10-epoxybenzo[a]pyrene (BPDE), an active metabolite of BaP, and to explore its potential mechanism, so as to provide a basis for the study of BaP neurotoxicity mechanism. Method Mouse hippocampal neuron HT22 cells were selected and divided into four groups: solvent control group and low, medium, and high concentration BPDE exposure groups (0.25, 0.50, and 0.75 μmol·L−1). Cell survival was detected by CCK8 method. Cell morphology and ultrastructure were observed under light and electron microscopes. The levels of reactive oxygen species (ROS) and Fe2+ were detected by fluorescence probe method. Iron, 4-hydroxynonenoic acid (4-HNE), malondialdehyde (MDA), glutathione (GSH), and glutathione peroxidase (GSH-PX) levels were detected with commercial kits. The expression levels of acyl-CoA synthase long chain family member 4 (ACSL4), cyclooxygenase 2 (COX2), solute carrier family 7 member 11 (SLC7A11), and glutathione peroxidase 4 (GPX4) were detected by Western blotting. After interventions with ferroptosis inhibitors 20 μmol·L−1 deferoxamine (DFO) and 10 μmol·L−1 ethyl 3-amino-4-cyclohexylaminobenzoate (Fer-1), the cell survival rate of each BPDE exposure group and the changes of the ferroptosis characteristic indicators and protein expression levels were observed. Results With the increase of BPDE concentration, the survival rate of HT22 cells decreased gradually, and the survival rate of each BPDE group was significantly lower than that of the solvent control group (P<0.01). Under light microscope, the number of cells in the high concentration BPDE group was significantly reduced, and atrophic cells and reduced synapses were recorded. Under electron microscope, the HT22 cells in the high concentration BPDE group showed mitochondrial shrinkage, decreased crista, and increased mitochondrial membrane density. Compared with the solvent control group, the levels of intracellular lipid ROS, Fe2+, 4-HNE, and MDA significantly increased in the high concentration group (P<0.01), the GSH and GSH-PX levels were significantly decreased (P<0.01), the protein expression levels of ASCL4 and COX2 were significantly increased (P<0.01), and the protein expression levels of SCL7A11 and GPX4 were significantly decreased (P<0.01). The ferroptosis inhibitors DFO and Fer-1 significantly reversed the cell survival rate (P<0.01), the ferroptosis characteristic indicators (ROS, Fe2+, 4-HNE, MDA, GSH, and GSH-PX levels) (P<0.01), and the expression levels of ferroptosis-related proteins (ACSL4, COX2, SLC7A11, and GPX4) (P<0.01) in the high concentration BPDE group. Conclusion BPDE can induce ferroptosis in mouse hippocampal neuron HT22 cells, which may be related to the inhibition of SLC7A11/GSH/GPX4 axis and the induction of iron metabolism disorder.
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Objective:To investigate the current situation and influencing factors of patients′ satisfaction with nursing humanistic care, and to provide reference for improving the quality of such care provided by hospitals.Methods:From July to August 2022, outpatients and inpatients in 30 provinces were selected by multi-stage stratified sampling as the survey objects. A cross-sectional survey was conducted on an online platform, using the general information questionnaire and Chinese version of methodist health care system nurse caring instrument revised by the research group. The latter instrument consists of 12 dimensions. namely care coordination, competence, teaching/learning, emotional support, respect for individuality, physical comfort, availability, helping/trusting relationship, patient/family engagement, physical environment, spiritual environment and outcomes. Descriptive analysis was performed on the data collected by the questionnaires, and independent sample t-test and one-way ANOVA were used to analyze the influencing factors of patient satisfaction. Results:A total of 107 hospitals were selected for questionnaire survey, including 86 tertiary hospitals and 21 secondary hospitals, and 29 108 valid questionnaires were recovered. The patient satisfaction with nursing humanistic care scored (5.40±0.86); the top three dimensions were competence (5.50±0.89), emotional support (5.47±0.88) and helping/trusting relationship (5.46±0.86); the lowest scoring dimensions were teaching/learning (5.38±1.01), spiritual environment (5.36±1.04) and patient/family engagement (5.11±1.28). Differences with gender, age, marital status, child status, educational level, occupation, place of residence, economic region, per capita monthly income of the family, type of medical insurance, medical department visited and surgery or not presented significant differences on the patient satisfaction with nursing humanistic care scores ( P<0.05). Conclusions:The satisfaction of patients with hospital′s nursing humanistic care in China was at the middle to upper level. In the future, health education for patients should be strengthened, and a mode of family-engaged nursing humanistic care should be constructed in line with the Chinese cultural background. In the process of nursing services, the particularity of patient groups should be considered to better meet their needs.
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Defining and visualizing the three-dimensional (3D) structures of pharmaceuticals provides a new and important tool to elucidate the phenomenal behavior and underlying mechanisms of drug delivery systems. The mechanism of drug release from complex structured dosage forms, such as bilayer osmotic pump tablets, has not been investigated widely for most solid 3D structures. In this study, bilayer osmotic pump tablets undergoing dissolution, as well as after dissolution in a desiccated solid state were examined, and visualized by synchrotron radiation micro-computed tomography (SR-μCT). In situ formed 3D structures at different in vitro drug release states were characterized comprehensively. A distinct movement pattern of NaCl crystals from the push layer to the drug layer was observed, beneath the semi-permeable coating in the desiccated tablet samples. The 3D structures at different dissolution time revealed that the pushing upsurge in the bilayer osmotic pump tablet was directed via peripheral "roadways". Typically, different regions of the osmotic front, infiltration region, and dormant region were classified in the push layer during the dissolution of drug from tablet samples. According to the observed 3D microstructures, a "subterranean river model" for the drug release mechanism has been defined to explain the drug release mechanism.
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Changes in structure of oral solid dosage forms (OSDF) elementally determine the drug release and its therapeutic effects. In this research, synchrotron radiation X-ray micro-computed tomography was utilized to visualize the 3D structure of enteric coated pellets recovered from the gastrointestinal tract of rats. The structures of pellets in solid state and in vitro compendium media were measured. Pellets in vivo underwent morphological and structural changes which differed significantly from those in vitro compendium media. Thus, optimizations of the dissolution media were performed to mimic the appropriate in vivo conditions by introducing pepsin and glass microspheres in media. The sphericity, pellet volume, pore volume and porosity of the in vivo esomeprazole magnesium pellets in stomach for 2 h were recorded 0.47, 1.55 × 108 μm3, 0.44 × 108 μm3 and 27.6%, respectively. After adding pepsin and glass microspheres, the above parameters in vitro reached to 0.44, 1.64 × 108 μm3, 0.38 × 108 μm3 and 23.0%, respectively. Omeprazole magnesium pellets behaved similarly. The structural features of pellets between in vitro media and in vivo condition were bridged successfully in terms of 3D structures to ensure better design, characterization and quality control of advanced OSDF.
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Objective:To investigate the traditional Chinese medical (TCM) constitution status of young and middle-aged residents and to analyze related influencing factors.Methods:A cross-sectional study was conducted to obtain data of 1 082 young and middle-aged residents in China from April to May 2019. The general characteristic, habits, emotional status and TCM constitution types of young and middle-aged residents were been collected.Results:The number of normal constitution types was 415(38.35%, 415/1 082), and the number of biased constitution types was 667(61.65%, 667/1 082) which was dominated by qi-deficiency constitution (16.70%, 344/2 060), yang-deficiency constitution (16.17%, 333/2 060) and damp-heat constitution (15.97%, 329/2 060). The Logistic regression analysis showed that the dietary regularity, taking vigorous exercise and taking moderate exercise were the protective factors of the biased constitution types of young and middle-aged residents( OR values were 0.624, 0.704, 0.704, all P<0.05), while the female, meat-based diet, anxiety and depression were the risk factors of the biased constitution types of young and middle-aged residents( OR values were 2.009-2.568, all P<0.01). Conclusions:The biased constitution is common among young and middle-aged residents. The risk factors of biased constitution are unhealthy lifestyle, anxiety and depression,which suggest the community to develop actively interventions to adjust the lifestyle and strengthen the maintenance of mental health of young and middle-aged residents.
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Metal-organic frameworks (MOFs), comprised of organic ligands and metal ions/metal clusters
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Objective:To describe the current status quo of humanistic care quality of psychiatric nurses in China, analyze its influence factors, and explore the relationship between humanistic care quality, professional values and sense of organizational support of psychiatric nurses.Methods:Using multi-stage stratified cluster sampling method selected, totally 5 003 nurses from 43 the psychiatric hospitals or psychiatric department in general hispitals were investigated with general information questionnaire, Nursing Caring Characters Assessment Tool, Perceived Organizational Support Scale (POS) and Nurses Professional Values Scale-Revised (NPVS-R) from May to August, 2018.Results:In 5 003 psychiatric nurses, the total score of Nursing Caring Characters Assessment Tool was 4.21 ± 0.63. The humanistic care knowledge dimension and humanistic care ability dimension were better (4.27±0.65, 4.21 ± 0.63), while the humanistic care concept dimension and humanistic care perception dimension were weaker(4.16±0.66, 4.17±0.66). The results of structural equation model showed that personal background, care environment, sense of organizational support and professional values had influence on the humanistic care quality of psychiatric nurses, and the standardized total effect values were 0.047, 0.106, 0.508 and 0.512 respectively.Conclusions:The overall level of humanistic care quality of psychiatric nurses is good, but there is still room for further improvement, especially the concept and perception of humanistic care. in order to meet the growing needs of the public for nursing services and the needs of nursing professional development and discipline development, caring for the environment, personal background, sence of organizational support and professional values are important factors affecting the quality of humanistic care of psychiatric nurses.
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Objective@#To evaluate the reliability and validity of Chinese-version Good Death Inventory among oncology nurse specialists.@*Methods@#A further revision has been made in the Chinese-version Good Death Inventory from Taiwan experts through expert review and preliminary experiment. The reliability and validity of the Chinese-version GDI was evaluated among 180 oncology nurse specialists.@*Results@#The Chinese-version of GDI was easy to understand. Most respondents finished the whole scale in 25 minutes and the valid response rate of the scale was100%. The I-CVI value of each item was 0.67-1.00, S-CVI/Ave was 0.938. KMO was 0.832, and the revised Chinese-version GDI consisted of 54 items in 18 dimensions (Core 10 Domains and Optional 8 Domains). The total scale′ s Cronbach′ s alpha coefficient was 0.950, split-half reliability coefficient was 0.832. Cronbach′ s alpha of Core 10 Domains was 0.938 and that of Optional 8 Domains was 0.876.@*Conclusions@#The Chinese-version GDI is a valid scale to measure end-of-life care comprehensive outcomes from Chinese oncology nurse specialists′ perspective.
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Acute pancreatitis (AP) is a local and systemic inflammation process which is characterized by extensive infiltration of inflammatory cells and outbreak of inflammatory factors.Recent researches have shown that macrophage play a critical role in the process of AP,in particular,peritoneal macro phage as a main innate immune cell in the peritoneal cavity which has been reported not only serve as the first line in host defense,but also help maintaining the immune homeostasis and coordinate the repair and regenerate response by regulating the polarization of their phenotype.Recently,peritoneal macrophages could interact with ascetic fluid of AP patient,and further affect the development and resolution of inflammation.In this review,authors focused on the role and regulatory mechanism of peritoneal macrophage in the progress of AP.
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Objective To investigate the current situation and influencing factors of professional competence of master of nursing (MN)students. Methods 317 MN students were engaged in the investigation using self-designed questionnaire. Results The total score of MN student's professional competence was 72.56 ± 10.51. The time for nursing service before MN study, time for nursing internship during MN study and frequency of instructor's guidance were the main influencing factors ofprofessional competence (P<0.01). Conclusion MN student's professional competence is relatively good. Nursing educators should develop more detailed clinical study plan for those lack of clinical experience, strengthen advanced nursing practice theory study, and provide more opportunities for professional practice, make good conditions for their clinical practice and pay attention to the practical effect of specialized nursing.At the same time,the instructors of MN students should give more guidance to ensure the cultivation quality.
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Objective To understand the humanistic Care quality status of master of nursing specialist (MNS), and put forward the structural equation model of influencing factors of humanistic care quality. Methods using convenient sampling, the survey came from 191 postgraduates of MNS from 14 universities, using the nurses' Humanistic Care quality questionnaire, the professional ability Self-Assessment questionnaire, the care ability evaluation scale and the self setting general situation questionnaire. Results The total quality of humanistic care was in the middle level (125.43 ± 16.27), among which, the highest sharing of humanistic care (4.56±0.57) and the lowest sharing of humanistic care (4.18 ± 0.63). Through the analysis of the influence factors, the humanistic care education and the awareness of caring will influence the development of humanistic care quality by influencing the master's caring ability and professional ability. Conclusion To strengthen humanistic care education, to create a caring education and practice environment, to learn caring and experience care, and then to care and strengthen the professional ability to better provide quality care services for patients.
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Objective To study the impact of early abdominal paracentesis drainage (APD) on the clinical course in patients with severe acute pancreatitis and massive peritoneal effusion.Methods From January 2012 to January 2017,107 patients with severe acute pancreatitis treated at the Chengdu Military General Hospital were retrospective studied.According to whether the patients underwent abdominal paracentesis drainage within a week of hospital admission,they were divided into the APD group (n=66) and the Non-APD group (n=41).The APD group was further subgrouped into the 0-2 d (within 48 h),3-5 d and 6 -7 d subgroups.The mortality rates,progression rates,length of stay,cost of stay,organ failure rates and inflammatory state of each subgroup of the APD were statistically analyzed and compared.Results 22 patients in the Non-APD group progressed in four weeks to require percutaneous catheter drainage (PCD).The rate of progression was 53.7％,and the mortality rate was 22％.In the APD group,21 patients underwent PCD treatment within 4 weeks.The rate of progression was 31.8％ and the mortality rate was 9.1％.In the APD group,the progression rate for the patients in the 0-2 d subgroup was 6.9％,and the in-hospital mortality rate was O.When compared with the other subgroups,the 0 to 2 d subgroup of patients had significantly lower progression and in-hospital mortality rates,lower hospitalization duration and hospitalization costs.These patients at 1 week after hospitalization also had significantly better inflammatory indexes,less incidence of organ failure and better disease severity scores (P＜0.05).Conclusions The results confirmed the effectiveness of APD in treating patients with severe acute pancreatitis with significant peritoneal effusion.Puncture treatment within 48 hours significantly improved prognosis of patients.The best time window of APD treatment for patients with severe acute pancreatitis with massive abdominal fluid is within 48 hours of hospitalization.
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Objective To study the protective effects of human umbilical cord-derived mesenchymal stem cells (ucMSCs)against severe acute pancreatitis (SAP) in rats.Methods A total of 135 Sprague-Dawley male rats were randomly divided into Sham group,SAP group and SAP+ucMSCs group (45 each).SAP+ucMSCs group:Severe acute pancreatitis was induced by injecting 5％ sodium taurocholate (0.1ml/100g) into the common bilio-pancreatic duct and then CM-DiI-labeled ucMSCs at 1 × 107cells/kg were injected via the tail vein.All the rats were sacrificed 12,24 and 72 hours after SAP.The 72h death rate was counted.Pathological changes in the pancrease were detected by HE staining and pathological score was graded,ucMSCs colonization was observed by fluorescence microscopy.The serum levels of amylase,lipase,TNF-α,IL-1β,IL-4 and IL-10 were determined by ELISA.Results ucMSCs colonize the injured area of pancreatic tissue,the 72h death rate was reduced,and the serum amylase and lipase were also reduced significantly.Moreover,ucMSCs significantly reduced the pathological score of the pancrea and the level of proinflammatory cytokines (TNF-α and IL-1β),but the levels of anti-inflammatory cytokines were increased (IL-4 and IL-10).Conclusion Transplantation of ucMSCs can reduce the severity of pancreatic injury and inflammation in SAP rats.
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Referring to the statistical model for the SNP haplotype phasing which was based on the allele frequencies and advised by Browning SR, we investigated and deduced the phasing method of STR haplotype with linkage disequilibrium inpaternity testing preliminarily. Haplotype phasing of two X-STRs in linkage disequilibrium were illustrated. This method provides an idea for the haplotype phasing of STR markers, which is helpful for interpreting the typing results of STR more scientifically and accurately.
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Objective T o establish a query table of IB S critical value and identification pow er for the detection system s w ith different num bers of ST R loci under different false judgm ent standards. Methods Sam ples of 267 pairs of full siblings and 360 pairs of unrelated individuals w ere collected and 19 auto-som al ST R loci w ere genotyped by G oldeneyeTM 20A system . T he full siblings w ere determ ined using IB S scoring m ethod according to the 'R egulation for biological full sibling testing'. T he critical values and identification pow er for the detection system s w ith different num bers of ST R loci under different false judgm ent standards w ere calculated by theoretical m ethods. Results A ccording to the form al IB S scoring criteria, the identification pow er of full siblings and unrelated individuals w as 0.7640 and the rate of false judgm ent w as 0. T he results of theoretical calculation w ere consistent w ith that of sam ple observation. T he query table of IB S critical value for identification of full sibling detection system s w ith different num bers of ST R loci w as successfully established. Conclusion T he IB S scoring m ethod defined by the regulation has high detection efficiency and low false judgm ent rate, w hich provides a relatively conservative result. T he query table of IB S critical value for identification of full sibling detection sys-tem s w ith different num bers of ST R loci provides an im portant reference data for the result judgm ent of full sibling testing and ow ns a considerable practical value.
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Objective To explore the effective procedures and practices to solve the ethical dilemma of nursing, and to building nursing ethics decision path. Methods Using inductive-deductive method, summarize predecessors′ research on nursing ethics mode and decision-making process, and establish nursing ethical decisions paths, then display the application based on clinical case. Results Six-steps-Nursing ethics decision path was established, and tested. Conclusions Pay attention to strengthen the cultivation of nurses nursing ethics accomplishment and ability of the decision.
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Objective To investigate the genetic polymorphism of 90 autosomal SNPs in Guangdong Han population and assess their value in forensic medicine based on next generation sequencing. Methods Blood samples were collected from 100 unrelated individuals. Through using AutoMate ExpressTM Nucleic Acid Extraction System, DNA was extracted. HID-Ion AmpliSeq? Identity Panel was applied for library preparation while Ion OneTouch? 2 system (OT2) was employed for emulsion PCR (emPCR). NGS was performed on the Ion PGM? system. Sequencing results were analysed using the Torrent Suite v4.4.2 with the HID_SNP_Genotyper v4.3.1 plugin. The forensic parameters were calculated and compared with GoldeneyeTM 20A systems. Results According to the Bonferroni correction, the genotypes of 90 autosomal SNPs were in accordance with Hardy-Weinberg equilibrium and no linkage disequilibrium was observed. The average Ho of 90 autosomal SNPs was 0.423, the average DP was 0.560 and the average PIC was 0.329. The CDP (cumulative power of discrimination) of 90 autosomal SNPs system was 1-1.20×10-33, which was greater than that of 20A System. The CPEtri (cumulative excluding probability of trio paternity) was 0.999 999 911 and the CPEduo (cumulative excluding probability of duo paternity) was 0.999 882. Both of these two parameters were below that of 20A System. Conclusion It suggested that the 90 autosomal SNPs System can be applied to forensic individual discrimination and trio paternity testing independently. Besides, it is supposed to be used in the duo paternity testing as an assistant measure.
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Objective:To explore the relations of psychological stress reactions to workplace violence and so-cial acknowledgement among emergency nurses.Methods:Totally 444 emergency nurses from 8 tertiary hospitals and 1 second A hospital in Beijing were selected.Psychological stressful reactions were measured with the Impact of Event Scale-Revised (IES-R).The social acknowledgment from general society and family to victims was assessed with the Social Acknowledgment Questionnaire (SAQ).Results:Among the 444 samples,96.8% sustained verbal assaults,43.2% underwent physical assaults,32.0% encountered threats,and 4.3% suffered sexual assaults.The results of ANOVA analysis indicated that nurses who suffered 3 types of violence had higher scores of IES-R than the ones who endured one type of violence and 2 types of violence[(22.0 ±16.1)vs.(15.4 ±15.6),(18.1 ± 16.1),Ps <0.01)].Similarly,those nurses who suffered 4 types of violence had higher scores of IES-R than the ones who enduredone type of violence and 2 types of violence [(33.4 ±17.1)vs.(15.4 ±15.6),(18.1 ±16.1), Ps <0.01].Regressive analysis showed that family disapproval,general disapproval,and violence types predicted psychological stress reactions,(β=0.13 -0.40,P <0.05,adjust R2 =0.27).Conclusion:It suggests that violence types,social disapproval and family disapproval may play vital roles in predicting the degree of posttraumatic dis-tress in emergency nurses after suffering from hospital violence.