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Objective Based on sentinel symptoms,a nursing intervention program for gastrointestinal symptom group of postoperative chemotherapy for lung cancer was constructed and its application effect was evaluated.Methods The nursing intervention program of gastrointestinal symptom group was constructed on the basis of ref-erence guidelines,qualitative interview and expert consultation.From January 2021 to January 2022,a total of 330 patients with postoperative chemotherapy for lung cancer in a tertiary hospital in Shenyang were selected as re-search subjects.The experimental group received the gastrointestinal symptoms group nursing intervention program on the basis of routine nursing,and the control group received routine care.Patients were investigated with the M.D.Anderson Symptom Inventory and the MOS 36-Item Short-Form Health Survey before 1st chemotherapy(T1),3rd chemotherapy(T2)and 5th chemotherapy(T3).Results After the intervention,the total scores of the 2 groups and the total scores of each symptom in T2 and T3 were statistically significant(P＜0.05),and the score of the experi-mental group was lower than that of the control group.For the scores of 6 dimensions of physiological function,physical pain,overall health,vitality,emotional function,mental health in 2 groups between different time points,the differences are statistically significant(P＜0.05).Conclusion The nursing intervention program of the gastroin-testinal symptom group based on sentinel symptoms is beneficial to reduce the severity of the gastrointestinal symp-tom group and improve the quality of life for postoperative chemotherapy for lung cancer patients.

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Foot ulcer prevention plays a crucial role in reducing the amputation rate among diabetic patients. With regard to the prevention of diabetic foot ulcers, the 2023 guidelines of the International Working Group of Diabetic Foot(IWGDF) were different from the 2019 counterpart. The most notable change is the addition of high-level evidence to support recommendations, primarily derived from randomized controlled studies. The 2023 guidelines also advocate for local skin temperature measurement, participation in ankle exercise training, and psychological intervention for foot ulcer prevention. This article conducts a comparative analysis of the two guidelines across six key dimensions: identification of high-risk feet, regular examination of high-risk feet, health education, ensuring appropriate daily footwear, addressing ulcer risk factors, and comprehensive foot care. Drawing from clinical insights, the application and prospective implications of the 2023 guidelines in China are also examined.

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Objective:To evaluate and compare dermoscopic features of toenail psoriasis and fingernail psoriasis.Methods:Between June 2020 and January 2022, 61 patients with confirmed toenail psoriasis and 80 with confirmed fingernail psoriasis were enrolled from the Department of Dermatology of Peking University First Hospital. Dermoscopy was performed on 139 affected toenails and 158 affected fingernails among the psoriasis patients, and dermoscopic characteristics were analyzed between the two groups by using the chi-square test.Results:The most common dermoscopic feature of nail psoriasis was pitting (223/297, 75.08%), followed by splinter haemorrhages (164/297, 55.22%), subungual hyperkeratosis (133/297, 44.78%), oil drop sign (126/297, 42.42%), complete onycholysis (121/297, 40.74%), linear margin of the proximal onycholysis (107/297, 36.03%) and linear erythema at the margin of the onycholysis (77/297, 25.93%). Compared with the patients with fingernail psoriasis, those with toenail psoriasis more commonly presented with subungual hyperkeratosis (81[58.27%] vs. 52[32.91%], P < 0.001), punctate/blocky haemorrhages (22[15.83%] vs. 11[6.96%], P < 0.05), longitudinal striae (34[24.46%] vs. 10[6.33%], P < 0.001), longitudinal nail splitting (24[17.27%] vs. 9[5.70%], P < 0.01), brown discoloration (14[10.07%] vs. 2[1.27%], P < 0.01), transverse grooves (17[12.23%] vs. 1[0.63%], P < 0.001) and leukonychia (10[7.19%] vs. 1[0.63%], P < 0.01) ; compared with the patients with toenail psoriasis, those with fingernail psoriasis more commonly presented with splinter haemorrhages (100[63.29%] vs. 64[46.04%], P < 0.01), oil drop sign (81[51.27%] vs. 45[32.37%], P < 0.01), linear erythema at the margin of the onycholysis (55[34.81%] vs. 22[15.83%], P < 0.001), partial onycholysis (50[31.65%] vs. 19[13.67%], P < 0.001) and red spots in the lunula (36[22.78%] vs. 12[8.63%], P < 0.01) . Conclusion:The dermoscopic features of toenail psoriasis were quite different from those of fingernail psoriasis, and features such as subungual hyperkeratosis, longitudinal streaks, and brown discoloration were more commonly presented in patients with toenail psoriasis.

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【Objective】 To study the changes in erythrocyte osmotic fragility(EOF) in patients with hypercythemia, polycythemia and anemia under a high altitude environment. 【Methods】 A total of 174 outpatients, inpatients and people undergoing physical examination in Tibet Autonomous Region People′s Hospital in October 2020 were enrolled and divided into four groups according to hemoglobin levels: the polycythemia group(n=42), the physiologic increase group(n=48), the anemia group(n=29) and the healthy control group(n=55). They were compared with 67 anemia patients and 67 healthy people in the laboratory of Peking Union Medical College Hospital in the same period as the plain control group. The classic EOF test method was used to compare the results of each group′s EOF. The concentrations of NaCl solution for starting hemolysis (STH) and NaCl solution for complete hemolysis (CTH) were included, and the data were statistically analyzed by SPSS software. 【Results】 There was a significant difference in CTH between Zang and Han healthy people (P<0.05). STH in high altitude polycythemia group(0.52) was higher than that in high altitude healthy control group(0.48) (P<0.001). Compared with plain, the median CTH of plateau anemia group(0.36) and plateau health control group(0.36) was significantly higher than that of plain anemia group(0.28) and plain control group(0.28) (P<0.001). Multivariate logistic regression analysis showed that plateau region, female polycythemia and anemia were risk factors for STH elevation. 【Conclusion】 This study finds that the EOF increases in the plateau population and patients with polycythemia, which provides reference for studying red blood cell disorders and blood transfusion strategy in the plateau region.

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This paper summarized the development of "Internet + nursing service" in the first six provinces and cities, analyzed its characteristics and advantages, combed the existing problems, so as to further promote and develop "Internet + nursing service", so that the service can truly benefit the people.

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This paper reviewed the development of "Internet + nursing service" at home and abroad, the needs of "Internet + nursing service" for the elderly with disabilities at home, and the factors affecting the use of "Internet + nursing service" by the elderly with disabilities at home. The aim was to provide reference for the further development of "Internet + nursing service" in the elderly with disability at home.

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Objective:To investigate the application of debate-based immersive experiential teaching in the nursing practice teaching of stomatology.Methods:A total of 82 nursing interns of stomatology in Beijing Tongren Hospital, Capital Medical University, were selected as research subjects and were then divided into control group and observation group using the lottery method, with 41 interns in each group. The interns in the control group received traditional teaching, while those in the observation group received debate-based immersive experiential teaching. The two groups were compared in terms of the scores of comprehensive evaluation indices, nursing thinking ability, empathy ability, and recognition of teaching. SPSS 22.0 was used to perform the chi-square test and the t-test. Results:Compared with the control group, the observation group had significant increases in the scores of theoretical examination, operation examination, nursing medical record writing, reading report writing, basic nursing, communication ability, and comprehensive performance and the total score of these dimensions ( P<0.05). Compared with the control group, the observation group also had significant increases in the scores of nursing thinking ability and empathy ability ( P<0.05). The observation group had a significantly higher degree of recognition of teaching than the control group ( P<0.05). Conclusion:In the nursing practice teaching of stomatology, debate-based immersive experiential teaching can improve the comprehensive ability, nursing thinking ability, and empathy ability of interns, with a relatively high degree of recognition of teaching.

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Comprehensive geriatric assessment clinic can identify geriatric syndrome as well as geriatric health problems, and provide comprehensive systematic diagnosis and treatment for older patients, which is conducive to reducing the number of outpatient visits and saving medical costs.However, the construction of comprehensive geriatric assessment clinic in China is just in the initial stage.There are no guiding opinions on the orientation, work content, work process, and quality management.Therefore, this consensus was conducted based on the latest evidence and expert opinions which aims to provide guidance for the construction of comprehensive geriatric assessment clinic.

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Objective:To develop a positive and effective questionnaire for positive psychological capital of patients with diabetic retinopathy, and provide a reference for evaluating positive psychological capital of patients with diabetic retinopathy.Methods:By reviewed the literature, the item pool was constructed based on the definition of the operational definition of positive psychological capital in patients with diabetic retinopathy, and an initial questionnaire was formed. Experts were invited to test the content validity of the questionnaire, and the structural validity, criterion-related validity, and the internal consistency of the questionnaire were tested by surveying 208 patients admitted to the First Hospital of China Medical University.Results:Finally Positive Psychological Capital Questionnaire for Diabetic Retinopathy Patients consisted of 18 items in 4 dimensions. Factor analysis extracted four factors of resilience, self-efficacy, hope and optimism, and the cumulative contribution rate was 55.448%. The correlation coefficient between this questionnaire and the positive psychological capital questionnaire was 0.704 ( P<0.05). The content validity index of the questionnaire was 0.94, the total Cronbach α coefficient was 0.835, and the split-half coefficient was 0.864. Conclusions:The positive psychological capital questionnaire for patients with diabetic retinopathy has good reliability and validity and can be used as a tool to measure the positive psychological capital level of patients with diabetic retinopathy.

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【Objective】 To retrospectively investigate the clinical transfusion status in Tibet Autonomous Region People′s Hospital, in order to provide data basis for further improvement of the rational and scientific blood use in our hospital. 【Methods】 Medical records of transfusion recipients in our hospital from 2014 to 2018 were investigated via HIS system, and such indicators as total clinical blood use, usage of whole blood and blood components, blood transfusion per capita, usage of blood components with different types. and the usage of red blood cells and plasma in each clinical department were retrospectively analyzed. 【Results】 The total clinical blood usage of our hospital increased from 3 930.5 U in 2014 to 4 949 U in 2018, with an annual growth rate of 5.93%. The average blood use per capita in 2014 and 2018 was 0.205 U vs 0.218 U, and incidence of blood component transfusion was 47.18% vs 99.02% The proportion of blood component (red blood cell and plasma) usage was 36.0%, 35.9%, 20.7% and 7.4% for blood type O, A, B and AB, respectively. The usage of total blood, red blood cell and plasma in internal and surgical departments were 13 883.8 U vs 7 080.8 U, 4 963.3 U vs 3 647.3 U and 6 055 U vs 1 170 U, respectively. 【Conclusion】 The total clinical blood usage and the proportion of blood component transfusion in our hospital is increasing year by year. Therefore, rational and scientific blood use should be further improved.

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The S1 protein of the infectious bronchitis virus (IBV) is a major structural protein that induces the production of the virus-neutralization antibodies. The monoclonal antibody against the IBV M41 S1 protein was used as a target for biopanning. After three rounds of biopanning, randomly selected phages bound to the monoclonal antibody. Sequence analysis showed that the dominant sequence was SFYDFEMQGFFI. Indirect competitive enzymelinked immunosorbent assay showed that SFYDFEMQGFFI is a mimotope of the S1 protein that was predicted by PepSurf. The mimotope may provide information for further structural and functional analyses of the S1 protein.

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Objective:To evaluate the effects of early skin-to-skin contact (SSC) in puerpera′s breastfeeding by using meta-analysis.Methods:An extensive search of related literature from The Cochrane Library, The Joanna Briggs Institute Library, PubMed, CINAHL, CNKI and Wanfang Database were performed. Randomized controlled trials (RCTs) comparing the effects of early skin-to-skin contact in puerpera′s breastfeeding were collected. Two researchers screened, appraised and extracted data according to the inclusion and exclusion criteria. Meta-analysis was conducted via RevMan 5.3 software.Results:Ten RCTs with 1 418 mother-infant dyads were included. Comparing with routine care, SSC significantly improved the effect of first breastfeeding ( SMD=1.29, 95% CI 0.81-1.76, P<0.001), reduced the mean time of first breastfeeding initiation ( SMD=-1.91, 95% CI -2.66--1.15, P<0.001), increased the duration of first breastfeeding ( SMD=10.77, 95% CI 9.28-12.25, P<0.001) and increased the proportion of exclusively breastfeed at 6 weeks of age ( RR=1.30, 95% CI 1.02-1.65, P=0.04). Conclusion:Early SSC can improve the effects of breastfeeding and could be popularized in puerpera.

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Objective:To evaluate the functional status and assistive facilities requirements for the elderly with disabilities in rural areas of Liaoning Province, and to provide reference for the configuration of assistive facilities and the construction of further rehabilitation management mode for the elderly with disabilities.Methods:A total of 929 disabled rural elderly people in 15 deep poverty-stricken areas in Liaoning Province from 2019 to 2020 were selected to evaluate the functional status and needs of assistive devices by using general information questionnaire, disability status questionnaire and assistive device evaluation form for disabled elderly people.Results:There were 149 cases (16.0%) with grade 1 disability, 465 cases (50.1%) with grade 2 disability, 178 cases (19.2%) with grade 3 disability and 137 cases (14.7%) with grade 4 disability. The elderly with disabilities mainly had difficulties in long-distance walking, bathing, toilet use, defecation control, short distance walking, squatting, and transfer. The proportion of disabled elderly was 89.8% (834/929), 84.9% (789/929), 82.6% (767/929), 79.9% (742/929), 76.6% (712/929), 76.1% (707/929) and 60.5% (562/929), respectively. With the increase of disability severity, bathing, short walking, metastasis, shopping and preparing meals accounted for the greater proportion of the elderly with disabilities, and the differences were statistically significant ( P< 0.01). The elderly with disabilities had the greatest demand for wheelchairs, followed by mattresses for preventing stress injuries and four-legged walking sticks, with a demand rate of 56.3% (523/929),9.4% (87/929) and 7.0% (65/929), respectively. The elderly with different levels of disability had different needs on ordinary wheelchair, pressured-injury mattress, four-legged walking stick, stool chair, wheelchair with toilet seat and common walking stick, and the needs had statistically significant differences ( P<0.01). Conclusions:The elderly with disabilities in rural areas of Liaoning Province are mainly moderate to severe, mainly physical disabilities, and have great obstacles in self-care and daily living activities, with the highest demand for ordinary wheelchairs, anti-stress injury mattresses and four-legged canes. In the future, further intervention measures and rehabilitation management models should be developed according to the assessment results of the functions and assistive devices of the elderly with disabilities in rural areas, so as to meet the nursing and rehabilitation needs of the elderly with disabilities and improve their life quality.

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Objective:To investigate the adherence of patients with chronic airway disease with inhalation therapy and to explore the influencing factors.Methods:A total of 180 outpatients with chronic airway disease were selected by convenient sampling. The general information, adherence of inhalation therapyquestionnaire, asthma knowledge questionnaire, chronic obstructive pulmonary disease (COPD) health literacy questionnaire (COPD-Q) were used to evaluate the general information, adherence of inhalation therapy and disease knowledge level of the patients. The severity of the disease was evaluated by asthma control test (ACT) score and COPD assessment test (CAT) score. ANOVA and t-test were used to analyze the adherence of patients with chronic airway disease, and multivariate linear regression was used to analyze the adherence. Results:The adherence score of asthma patients was 89.74 ± 7.27 and the adherence score of COPD patients was 86.80 ± 9.16, which were in the middle level. The risk factors of non-adherence of inhalation therapy were retirement, living alone and smoking. The effect of inhaled treatment time on the adherence of inhaled therapy is not linear, and the turning point of adherence decline occurs one year after the patients received inhaled therapy. The results of multiple linear regression showed that the effect of course and employment on the adherence of inhalation therapy was statistically significant.Conclusions:The adherence of chronic airway disease patients with inhalation therapy is not ideal, especially for the patients with long course, smoking, retirement and living alone, the medical staff should pay more attention, take appropriate intervention measures to improve the adherence of inhalation therapy.

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Objective:To explore the correlation between positive psychological capital and quality of life in patients with diabetic retinopathy, and to provide a reference for the development of targeted nursing measures to improve the quality of life of patients.Methods:A total of 226 patients with diabetic retinopathy who were hospitalized in the Department of Ophthalmology and Endocrinology of the First Affiliated Hospital of China Medical University from May to December in 2019 were selected by convenient sampling. The data were investigated by general data questionnaire, positive psychological capital questionnaire for patients with diabetic retinopathy, and National Eye Institute 25-Item Visual Function Questionnaire.Results:The positive psychological capital score of patients with diabetic retinopathy was (72.08±9.42) points; the quality of life score was (52.10±18.22) points; positive psychological capital was positively correlated with quality of life ( r value was 0.571, P<0.01). Conclusions:The positive psychological capital of patients with diabetic retinopathy is positively related to the quality of life. Nursing staff should take measures to improve the level of positive psychological capital of patients, promote their mental health, and improve their quality of life.

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The definition of visual impairment, the current status of visual impairment in the elderly, influencing factors related with visual impairment and management control modes are reviewed.There are three international standards of visual impairment including the WHO standard in 1972, the United States standard, and the WHO standard in 2003. The domestic standard is consistent with the WHO standard in 1972. Currently, with the global aging, the international and the Chinese situations of visual impairment are severe,and it is urgent to reduce the incidence of visual impairment. The visual impairment of the elderly is affected by various factors. A variety of management and control modes of visual impairment for the elderly have begun to bear fruit. The aim of the review is to provide the basis to screen for high-risk groups of visual impairment and provide timely intervention to reduce the prevalence of visual impairment in the older population.

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The S1 protein of the infectious bronchitis virus (IBV) is a major structural protein that induces the production of the virus-neutralization antibodies. The monoclonal antibody against the IBV M41 S1 protein was used as a target for biopanning. After three rounds of biopanning, randomly selected phages bound to the monoclonal antibody. Sequence analysis showed that the dominant sequence was SFYDFEMQGFFI. Indirect competitive enzymelinked immunosorbent assay showed that SFYDFEMQGFFI is a mimotope of the S1 protein that was predicted by PepSurf. The mimotope may provide information for further structural and functional analyses of the S1 protein.

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The incidence of type 1 diabetes(T1DM)has increased significantly worldwide and has become a major public health problem.At present, it is believed that the occurrence of T1DM is related to various factors such as genetic susceptibility, immunity and environment, but the specific cause and exact mechanism are still not fully explained.In recent years, with the understanding and research of gut micro-ecology, abnormalities in the composition or functionality of gut microbiota lead to a variety of diseases, for instance, gastrointestinal diseases, obesity, cardiovascular disease, multiple sclerosis, rheumatoid arthritis, systemic lupus erythematosus, type 2 diabetes and so on.Yet there are evidences indicating that an imbalance of gut microbiota is associated with the development of type 1 diabetes mellitus, and in the T1DM children, the ecology of gut microbiota is different from healthy children.However, there are few studies on the gut microbiota in children with diabetes.This article will review the progress of gut microbiota of children with type 1 diabetes.

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OBJECTIVES@#To analyze the clinical characteristics and prognosis of children with anti-N-methyl--aspartate receptor (NMDAR) encephalitis and to provide a basis for early clinical identification of this disease.@*METHODS@#The clinical data of 42 cases of anti-NMDAR encephalitis at Department of Pediatrics, Second Xiangya Hospital, Central South University from January 2015 to March 2018 were collected. The clinical features and followed-up outcomes were analyzed retrospectively.@*RESULTS@#There were 15 cases (35.7%) of males and 27 cases (64.3%) of females in 42 children, with a ratio of 1꞉1.8. They were aged from 4 months to 17 years, with an average of (9.20±4.66) years. The most common initial symptoms were seizures (47.6%, 20/42) and mental behavior disorder (35.7%, 15/42). During the course of the disease, 85.7% patients(36/42) had mental and behavior disorder, 85.7% patients (36/42) had epilepsy, 76.2% (32/42) had speech disorder, 66.7% patients (28/42) had dyskinesia, 66.7% patients (28/42) had the decreased level of consciousness, 61.9% patients (26/42) had autonomic instability, and 57.1% (24/42) patients had sleep disorder. All the children had positive antibody against NMDA receptor resistance encephalitis in cerebrospinal fluid. Head MRI showed the abnormal incidence was 50.0% (21/42), and the lesions involved in parietal lobe, frontal lobe, temporal lobe, occipital lobe, midbrain, thalamus, basal ganglia and optic nerve. There was a patient with optic nerve damage combined with myelin oligodendrocyte glycoprotein (MOG) antibody positive. Forty cases were examined by electroencephalogram (EEG), 92.5% cases (37/40) were abnormal, mainly showing diffuse slow waves, and δ brushes could be seen in severe cases. And there was 1 patient (2.4%) complicated with mesenteric teratoma. The mRS score (2.14±1.46) at discharge was significantly lower than the highest mRS score (3.88±1.38) during hospitalization (<0.05). After 3-39 months of follow-up, mRS score at 3 months after discharge was only 0.81±1.29, which was still improved compared with that at discharge, 76.2% cases (32/42) experienced complete or near-complete recovery (mRS score≤2), and 4.8% (2/42) cases relapsed. There was no mortality; the initial time of immunotherapy and the highest mRS score in the course of the disease were the factors affecting the prognosis. The earlier the starting time for immunotherapy and the lower mRS score in the course of the disease were, the better the prognosis was.@*CONCLUSIONS@#Seizures, mental and behavior disorder, dyskinesias, speech disorder and autonomic instability are common clinical manifestations of anti-NMDAR encephalitis in children. The effect of immunotherapy is significant, and the time to start immunotherapy and the severity of the disease are important factors affecting the prognosis. Anti-NMDAR encephalitis can be combined with other autoantibodies, but its clinical significance and mechanism need further study.

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This exploratory study attempted to establish the rules in diagnosis and treatment of diabetic foot, through interpretation and comparison of the guidelines for diabetic foot from domestic with international ones. The document provided comparison between Guidelines of International Working Group on Diabetic Foot (IWGDF) and Chinese Diabetes Society (CDS) in 2019, related to diabetic foot disease on: methodology, content, prevention, offloading, peripheral artery disease (PAD), infection, wound healing interventions, and classification of diabetic foot ulcers. Prevention of ulcers in persons with diabetes foot is very important, and a non-removable offloading device is the first-choice of offloading treatment; Surgical indications and reasonable treatment should be mastered in PAD; Different anti-infection treatments, including surgical debridement, should be used base on the severity of foot infection; There are lots of treatments to improve healing, however the Grand Standard of medical evidence is not very high; There are a larger number of proposed classifications and scoring systems for diabetic foot, but none of them could cover all the needs of diagnosis and treatment. Thus, the principles outlined have to be adapted or modified by our health care professionals, based on local circumstances, to develop a standardizated procedure in diagnosis and treatment of diabetic foot.