Construction of "Internet + nursing" quality evaluation index system based on the perspective of service objects / 中国实用护理杂志

Objective:To construct a set of quality evaluation index system of "Internet + nursing" with clear evaluation criteria with the service objects as the evaluation subject and Service Quality model as the theoretical framework, and to provide an objective basis for the quality evaluation of "Internet + nursing".Methods:CNKI, Wanfang databases, VIP, PubMed, and Web of Science were searched from establishment to November 2021. The article determined the quality evaluation items of "Internet + nursing" based on the perspective of service objects by means of literature analysis, field research and Delphi expert inquiries. Analytic hierarchy process was used to confirm the weight of each indicator.Results:In this study, 22 experts were consulted for 2 rounds.The effective recovery rate of the two rounds of questionnaires were 100%. The judgment basis coefficient was 0.936, familiarity coefficient was 0.945 and authority coefficient was 0.941; in the first round, the Kendall harmony coefficients assigned to the importance of the first and second level indicators were 0.187 and 0.122, and the Kendall harmony coefficients assigned to the feasibility were 0.183 and 0.125; in the second round, the Kendall harmony coefficients assigned to the importance of the first and second level indicators were 0.241 and 0.190, and the Kendall harmony coefficients assigned to the feasibility were 0.218 and 0.166 (both P<0.01). The final evaluation index system for the "Internet + nursing" based on the perspective of service objects included 7 first-class indicators and 33 second-class indicators. Conclusions:The "Internet + nursing" quality evaluation index system constructed in this study based on the perspective of service objects is scientific, reliable and practical, which can be used as an evaluation tool for the current "Internet + nursing" quality evaluation and strategy optimization.

Application effect evaluation of the best evidence for the prevention of radial artery occlusion after transradial coronary angiography or intervention / 中国实用护理杂志

Objective:To apply the best evidence for the prevention of radial artery occlusion after transradial coronary angiography or intervention to clinical practice and evaluate its effect.Methods:This was a quasi-experimental study. Based on the evidence continuous quality improvement model, evidence-based practice method was used to obtain the best evidence, formulated review indicators, analyzed the obstacles in the practice process and took action strategies. The 88 patients who underwent transradial coronary angiography or intervention in the Cardiology Department of Qilu Hospital of Shandong University (Qingdao) from June 1 to 30, 2020 were selected as the baseline review group by convenience sampling. The 94 patients who underwent this treatment from September 1 to 30, 2020 were selected as the evidence application group. The baseline review group used the original perioperative management plan, and the evidence application group used the perioperative management plan based on the best evidence. The implementation rate of each review indicator, the incidence of radial artery occlusion, the degree of compression pain, and the comfort level of patients were compared between the two groups.Results:The implementation rates of review indicators 1, 2, 3, 5, 6, 7, 8 in the evidence application group were 100.0% (94/94), 100.0% (94/94), 11.7(11/94), 88.3% (83/94), 100.0% (94/94), 100.0%(94/94), 85.1%(80/94), respectively, which were higher than those in the baseline review group(all 0), except for the review indicator 4, the differences were statistically significant ( χ2 values were 9.00-178.02, all P<0.05). The incidence of radial artery occlusion and the incidence of pain Numerical Rating Scale>3 points in the evidence application group were 2.1% (2/94) and 3.2% (3/94), respectively, which were lower than 14.8% (13/88) and 23.9% (21/88) in the baseline review group; the comfort level of patients in the evidence application group was 96.8% (91/94), which was higher than 63.6% (56/88) in the baseline review group. The differences were statistically significant ( χ2 = 8.01, 15.21, 30.10, all P<0.05). Conclusions:The best evidence for the prevention of radial artery occlusion after transradial coronary angiography or intervention can be applied to clinical practice, which can standardize the behavior of medical staff, reduce the incidence of postoperative radial artery occlusion, reduce the degree of compression pain, and improve the comfort of patients.

Effect of Rapamycin on Exosomes and PD-1/PD-L1 in Human Erythroleukemia HEL Cells / 肿瘤防治研究

Objective To determine the effect of rapamycin(Rapa) on JAK2, ABCA3, and the immune checkpoint PD-1/PD-L1 in exosomes derived from JAK2 V617F positive HEL cells. Methods Human erythroleukemia HEL cells (JAK2 V617F mutation-positive) were cultured in vitro, and rapamycin was added at concentrations of 10, 50, and 100 nmol/L. The control group was established and cell proliferation inhibition rate was detected by CCK-8. Based on the inhibition rate of cell proliferation, cells intervened with 10 and 50 nmol/L Rapa were selected. Exosomes were extracted using a kit and identified by Western blot and flow cytometry. JAK2, ABCA3, and PD-1/PD-L1 mRNA changes in exosomes were detected by fluorescent quantitative PCR. The expression of exosome PD-1/PD-L1 protein was determined by flow cytometry. Results The exosomes extracted with the exosome kit all expressed characteristic CD9, CD63, and CD81 proteins, which were consistent with the general characteristics of exosomes. JAK2 mRNA can be detected in exosomes from HEL cells; Rapa reduced exosome production by HEL cells, and dose-dependently decreased gene expression of JAK2, ABCA3, and PD-L1 in exosomes. In addition, Rapa inhibited exosomal PD-L1 protein expression and had no significant effect on PD-1 protein expression. Conclusion HEL cells may transmit JAK2 mutant gene signals via exosomes. Rapa can reduce the production of exosomes and inhibits JAK2 mutated signals delivered by exosomes and suppresses PD-L1 protein expression.

Effect of Z type in patients with stroke-related pneumonia / 中国实用护理杂志

Objective:To explore the effect of Z type lateral decubitus position in patients with stroke-related pneumonia.Methods:Totally 52 patients with stroke-related pneumonia admitted to the neurology care unit in Qilu Hospital of Shandong University (Qingdao) were randomly divided into the control group and the observation group with 26 cases in each group from February to December 2021.The control group adopted routine position management, and the observation group adopted the Z type lateral decubitus position to observe. The differences in sputum volume, clinical pulmonary infection score (CPIS), blood oxygen saturation change, and hospital stay between the two groups were compared.Results:The SpO 2 was 0.966 ± 0.210 in the observation group and 0.948 ± 0.223 in the control group on the 7th day after the implementation of the measures. There was a significant difference between the two groups ( t=3.07, P<0.01). The sputum aspiration volume of the observation group was (30.65 ± 10.01), (39.27 ± 11.30), (36.92 ± 12.94) ml on the 1st, 3rd, 7th day after the implementation of the measures, which were significantly higher than those of the control group (24.81 ± 9.55), (28.92 ± 9.40), (27.65 ± 7.85) ml. The differences were statistically significant ( t=2.16, 3.59, 3.12, P<0.05). On the 7th day after implementation, the CPIS score of the observation group was 4.54 ± 1.63, which was better than that of the control group 5.46±1.61 ( t=-2.06, P<0.05). The average length of stay in the observation group was (13.35 ± 2.74) d, which was significantly shorter than (15.46 ± 4.42) d in the control group ( t=-2.07, P<0.05). Conclusions:The use of Z type lateral decubitus position has a positive significance for the rehabilitation and recovery of patients with stroke-related pneumonia. This position can promote sputum drainage and improve patients pulmonary function, accelerate the dissipation of patient inflammation, and reduce the length of hospital stay.

Influencing factors of quality of life in 216 patients with Crohn′s disease and their correlation with readiness for hospital discharge and mindful attention awareness / 中华消化杂志

Objective:To explore the factors influencing the quality of life in patients with Crohn′s disease (CD) and their correlation with readiness for hospital discharge and mindful attention awareness.Methods:From January 20, 2016 to May 20, 2021, 216 patients with CD hospitalized in the Department of Gastroenterology, Qilu Hospital of Shandong University (Qingdao) were selected. Self-designed general information questionnaire, inflammatory bowel disease questionnaire (IBDQ), readiness for hospital discharge scale (RHDS), mindful attention awareness scale (MAAS), hospital anxiety and depression scale and Pittsburgh sleep quality index (PSQI) were used to conduct questionnaire surveys in patients. Factors influencing the quality of life of CD patients were analyzed. Mann-Whitney U test and independent sample t test were used for the comparison between two groups; Kruskal-Wallis H test and one-way analysis of variance were used for comparison between multiple groups; Pearson analysis was used for correlation analysis, and multiple linear regression method was used for multivariate analysis. Results:The results of univariate analysis showed that the quality of life was poor in CD patients with spouse, primary school education or below, living in cities, sleep disorders, anxiety, depression, and severe activity. The total IBDQ scores were lower than those with no spouse, junior high school to senior high school and above, living in villages and towns, no sleep disorders, no anxiety, no depression, and in remission and mild to moderate activity (46.23±29.77 vs. 117.45±42.23; 11.00 (6.25, 30.75) vs. 79.00 (56.00, 113.00) and 114.00 (72.50, 157.50); 37.12±30.67 vs. 69.43±24.78 and 126.76±41.54; 42.67±23.18 vs. 124.58±36.52; 50.35±27.23 vs. 122.42±42.41; 51.97±37.29 vs. 113.96±44.18; 11.00 (6.75, 18.00) vs. 154.00 (135.50, 164.50), 97.00(79.00, 112.00) and 49.00(36.75, 62.25)), and the differences were statistically significant ( t=-14.40, H=60.56, F=117.61, t=-20.17, -15.20 and -10.87, and H=148.98; all P<0.001). The results of correlation analysis showed that the RHDS score was positively correlated with the scores of each dimension and total scores of IBDQ ( r=0.646 to 0.781, all P<0.001); the MAAS score was positively correlated with the scores of each dimension and total scores of IBDQ ( r=0.331 to 0.382, all P<0.001). The results of multiple linear regression analysis demonstrated that readiness for hospital discharge, level of mindful attention awareness, education level, place of residence, sleep disorders, whether with anxiety and disease activity were the influencing factors of the quality of life of CD patients ( t=4.19, 5.38, 2.36, 2.88, 2.85, 3.11 and -7.22, all P<0.05). Conclusions:The quality of life is poor in CD patients with primary school education or below, live in cities, sleep disorders, anxiety, severe activity, low readiness for hospital discharge and low level of mindful attention awareness. Doctors and nurses should pay attention to these patients and improve their quality of life.

Curative effect of entecavir combined with glucocorticoid in the treatment of early stage hepatitis B liver failure / 中国医师进修杂志

Objective To observe the curative effect of entecavir combined with glucocorticoid in early stage hepatitis B liver failure. Methods The clinical data of 100 patients with early stage hepatitis B liver failure from February 2012 to February 2017 were retrospectively analyzed. Among them, 50 patients were treated with entecavir combined with glucocorticoid (treatment group), and 50 patients were treated with entecavir (control group). The alanine aminotransferase (ALT), total bilirubin (TBil), total cholesterol (TC), prothrombin activity (PTA), hepatitis B virus (HBV)-DNA, tumor necrosis factor (TNF)-α, interleukin (IL)-6 and IL-10 levels were compared between 2 groups. Results The ALT, TBil, TC and PTA levels 1, 2, 4 and 8 weeks after treatment in treatment group were significantly lower than those in control group, and there were statistical differences (P<0.05); there was no statistical difference in HBV-DNA between 2 groups (P>0.05). The TNF-α, IL-6 and IL-10 levels 4 weeks after treatment in treatment group were significantly lower than those in control group: (2.5 ± 0.5) μg/L vs. (3.2 ± 0.7) μg/L, (16.8 ± 2.2) μg/L vs. (22.1 ± 2.4) μg/L and (7.3 ± 1.2) μg/L vs. (9.1 ± 1.8) μg/L, and there were statistical differences (P<0.05). Eight weeks after treatment, the effective rate and survival rate in treatment group were significantly higher than those in control group: 80％ (40/50) vs. 54％ (27/50) and 94％ (47/50) vs. 78％ (39/50), and there were statistical differences (P<0.01 or <0.05).In the treatment group, there was no serious adverse reaction during glucocorticoid therapy,and the patients recovered after withdrawal or reduction of glucocorticoid. Conclusions Entecavir combined with glucocorticoid has a significant effect on patients with early stage hepatitis B liver failure. It could improve survival rate, and the adverse effects of glucocorticoid are less.

Analysis of clinical characteristics and death risk factors in patients infected with severe fever with thrombocytopenia syndrome bunyavirus / 中国医师进修杂志

Objective The study the clinical characteristics and death risk factors in patients infected with severe fever with thrombocytopenia syndrome bunyavirus (SFTSV). Methods The clinical data of 56 patients infected with SFTSV from May 2011 to October 2016 were retrospectively analyzed. The clinical characteristics and laboratory examination results were compared between cured patients and death patients. The death risk factors were analyzed by two classification Logistic regression analysis. Results Among the 56 cases, 40 cases were cured and 16 cases were dead, and the time of onset to death was (12 ± 3) d. All patients showed symptoms including fever and weakness. Bone marrow biopsy was performed in 26 cases, and hemophagocytic phenomenon was found in 21 cases. Compared with cured patients, the death patients were older; the rate of underlying diseases was higher; fever time was longer; the incidences of skin and/ or gastrointestinal bleeding, neuropsychiatric symptoms, abnormal troponin and arrhythmias were higher, platelet, CD4+and CD8+were lower; the levels of activated partial thromboplastin time (APTT), creatine kinase (CK), lactate dehydrogenase (LDH), viral load, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were higher, and there were statistical differences (P＜0.01 or ＜0.05). Two classification Logistic regression analysis result showed that viral load ≥ 5 lgTCID50/ml, age ≥ 70 years, platelet ＜ 20 × 109/L, CK ＞ 1 200 U/L, fever time ＞ 8 d, APTT ≥ 120 s, troponin elevation and neuropsychiatric symptoms were the independent risk factors of death in patients infected with SFTSV (P＜0.01 or＜0.05). Conclusions The high viral load, high age, lower platelet, increased CK, prolonged fever time and APTT, elevated troponin and neuropsychiatric symptoms were independent risk factors of death in patients infected with SFTSV. Early identification for the risk factors of death may improve the prognosis.

Expressions of histamine receptors in pediatric mid-urethral striated muscles and mouse striated myogenesis / 中华实用儿科临床杂志

Objective To explore the expressions of histamine receptor subtypes (H1, H2, H3, H4 receptor) in children's mid-urethral striated muscles and during mouse C2C12 striated myogenesis.Methods Children's mid-urethral striated muscle samples were paraffin embedded and tissue sections were made, then immunohistochemical staining was used to check H1, H2, H3, H4 receptors.C2C12 myogenesis was induced, the early differentiation early markers of desmin, middle marker of myogenin, late marker of myosin heavy chain and histamine 4 receptor subtype mRNA were checked by quantitative real-time polymerase chain reaction.Immunofluorescence staining was done to check 3 differentiation markers and histamine H3 receptor protein.Results During myogenesis, the expression of desmin mRNA in the differentiation of 2,4,6 days were 12,68,60 times as many as that of the undifferentiated myoblasts;the expression of myogenin mRNA in the differentiation of 2,4,6 days were 631,1 408,914 times as many as that of the undifferentiated myoblasts;the expression of myosin heavy chain mRNA in the differentiation of 2,4,6 days were 7 718,9 448,286 288 times as many as that of the undifferentiated myoblasts.The expression level of H1 receptor mRNA in the differentiation of 6 days was about 25％ to undifferentiated cells;the expression of H2 receptor mRNA in undifferentiated cells and differentiated cells groups had no significant difference (F =1.47, P ＞ 0.05);the expression of H3 receptor mRNA in the differentiation of 2,4,6 days was 28,103,198 times to undifferentiated cells;H4 receptor mRNA was not detected.In immunofluorescence staining, H3 receptor protein staining intensity increased with the differentiation.Immunohistochemistry of pediatric urethral striated staining indicated that H1, H2, H3 receptor staining was positive,H1 receptor showed strong positive staining, H3 receptor moderate positive staining,and H2 receptor showed weak positive staining.Conclusions Histamine receptor subtypes of H1 receptor, H2 receptor and H3 receptor were found during mouse striated myogenesis and in the children's mid-urethral striated muscles.The increasing expression of H3R with myogenesis might indicate it plays a role in mature striated muscle cells.

Histamine H3 receptor inhibited electrically evoked cytoplasmic calcium in differentiated skeletal C2C12 myoblasts / 中国病理生理杂志

AIM:To explore the expression and possible function of histamine H3 receptor (H3R) in striated myogenesis and the differentiated C2C12 cells.METHODS: H3R and myogenesis late marker myosin heavy chain (MHC) were detected at mRNA and protein levels during C2C12 myogenesis.H3R antagonist ciproxifan was added and the expression of the myogenesis early marker desmin, intermediate markers myogenin and MHC was detected.Differentia-ted myoblasts were loaded with Fluo-4 calcium indicator dye and the effect of R-( a)-methylhistamine ( RMeHA) on the cy-toplasmic calcium concentration was determined under the 200 mA electrical stimulation.RESULTS: The expression of H3R and MHC was increased during myogenesis.Ciproxifan incubation had no influence on the 3 striated myogenesis mar-kers (P>0.05).In C2C12 myoblasts, RMeHA (10 nmol/L~100 μmol/L) effectively diminished cytoplasmic calcium peak when the cells were electrically paced (P<0.05).The best inhibitory effect of RMeHA was observed at dose of 100 nM for 10 min and 20 min, which was higher than that for 5 min (P<0.05).CONCLUSION: H3R might have little effect on the myogenic differentiation, but diminishes cytoplasmic calcium peak of the differentiated myoblasts under electri-cal stimulation.

Expression and significance of COX-2, bd-2, Caspase-3 in diffuse large B-cell lymphoma / 白血病·淋巴瘤

Objective To explore the expressions and correlation of COX-2, bcl-2 and Caspase-3 in diffuse large B-cell lymphoma(DLBCL). Methods The expression of COX-2, bcl-2 and Caspase-3 was studied in 29 cases of DLBCL and 10 cases of reactivited lymphoid tissue with immunohistochemistry of PowerVisionTM. Results The expression of COX-2 and bcl-2 are seperately 68.9 % and 72.4 %. The expression of COX-2 had correlation with Ann Arbor stage. The expression of COX-2 was positively correlated with that of bcl-2, the expression of bcl-2 was negatively correlated with that of Caspase-3, the expression of COX-2 was negatively correlated with that of Caspase-3. Conclusion COX-2, bcl-2 and Caspase-3 may be involved in the carcinogenesis of DLBCL, and their expression may be helpful in estimating the histology grade and prognosis of DLBCL.

Effect of ?-elemene on proliferation of human multiple myeloma cells / 中成药

AIM: To investigate the effects of ?-elemene,extracted from curcuma wenyujin,on proliferation, cell cycle and apoptosis of human multiple myeloma RPMI-8226 cells. METHODS: The effect of ?-elemene on the growth of human multiple myeloma RPMI-8226 cells was studied through MTT assay,cell cycle and apoptosis was studied by combined Annexin-V protein iodide staining,The morphological changes was studied by combining Hoechst33342-PI staining. RESULTS: ?-elemene inhibited the proliferation of RPMI-8226 cells in a time-and dose- dependent manner. Compared with the control cells,the proportions of the RPMI-8226 cells in the G0 /G1 phase rose,and the proportions of the RPMI-8226 cells in the S and G2 /M phases fell decreased. RPMI-8226 cells treated with ?-elemene for 48 h induced apoptosis in a dose-dependent manner. CONCLUSION: ?-elemene is able to inhibit the proliferation of RPMI-8226 cells by arresting the cell cycle and inducing the cell apoptosis.