Dietary antioxidant intake is associated with heart failure: Results from the NHANES 2003-2019.

BACKGROUND: Growing evidence has shown that antioxidant diets protect against heart failure (HF). However, the association between the composite dietary antioxidant index (CDAI), an important measure of overall antioxidants in the diet, and HF has received little attention. OBJECTIVE: The purpose of this study was to examine the relationship between the CDAI and HF. METHODS: A secondary cross-sectional analysis of the 2003 to 2019 National Health and Nutrition Examination Survey (NHANES) was performed. Weighted multivariable logistic regression was used to test the association between the CDAI and HF in four different models, with subgroup analysis and an interaction test subsequently performed. RESULTS: A total of 37,390 participants were included. The HF groups had lower CDAI levels than those in the non-HF group (0.29 ± 0.04 vs. -0.74 ± 0.16, p < 0.0001). After adjusting for demographic characteristics, lifestyle factors, and disease history, a negative association was found between the CDAI and HF (OR: 0.97, 95 % CI: 0.94, 1.00). There was an inverse trend whereby increasing the CDAI was associated with decreasing the odds of HF (p for trend < 0.001). The subgroup analysis and interaction test showed no significant dependence on demographic characteristics, lifestyle factors, and disease history with regard to this association (all p for interaction > 0.05). CONCLUSION: The CDAI was inversely associated with HF in US adults, with higher CDAI levels possibly being associated with a lower incidence of HF, suggesting that dietary antioxidants may help prevent HF.

Associations Between Composite Dietary Antioxidant Index and Gout: National Health and Nutrition Examination Survey 2007-2018.

Introduction: To explore the relationship between the composite dietary antioxidant index (CDAI) and gout to provide support for preventing gout through dietary intervention. Methods: Eligible participants from the 2007 to 2018 National Health and Nutrition Examination Survey aged 20 years and older were included in this cross-sectional study. The weighted chi-square test was used to compare the categorical variables difference between CDAI quartiles groups. The weighted univariate and binary logistic regression analysis were used to test the association between variables and gout. The weighted multivariable logistic regression was used to test the association of CDAI and gout in 4 different models. Subgroup analysis on the associations of CDAI with gout was conducted with stratified factors. Results: The final participants were 26,117, 13,103 (50.17%) were female, 8718 (33.38%) were 40-59 years, 11,200 (42.88%) were white and 1232 (4.72%) had gout. After adjusting for all covariates, the CDAI was associated with gout (odds ratio (OR), .97; 95% CI: .95-1.00). Participants in the highest CDAI quantile group were at low risk of gout (odds ratio (OR), .65; 95% CI: .50-.84) versus those in the lowest quantile group. Subgroup analysis and interaction test showed no significant dependence on diabetes mellitus (DM), marital status, alcohol status, hypertension, poverty income ratio (PIR), education level, body mass index (BMI), smoke status, age, sex, race, and chronic kidney disease (CKD) on this association (all p for interaction >.05). Conclusions: Composite dietary antioxidant index was inversely associated with gout in US adults, and dietary antioxidant intervention might be a promising method in the therapy of gout and greater emphasis should be placed on zinc, selenium, carotenoids, vitamins A, C, and E.

Instruments for measuring patient health education competence among nursing personnel: protocol for a COSMIN-based systematic review.

INTRODUCTION: Health education, as a crucial strategic measure of disease prevention and control in the 21st century, has become an important part of healthcare. As the main deliverers of patient health education, nursing personnel's patient health education competence (PHEC) has received much attention. Instruments for assessing the PHEC of nursing personnel have been developed internationally, but there is a lack of systematic reviews and evaluations of the psychometric properties of these instruments. To effectively select appropriate PHEC assessment instruments in specific contexts, a systematic and comprehensive review and evaluation of these measurement instruments are needed. The goal of this systematic review is to systematically evaluate the psychometric properties of existing PHEC instruments. METHODS AND ANALYSIS: In this study, eight databases will be searched between 1 March 2023 and 31 2023 to retrieve studies that include instrument(s) measuring the PHEC of nursing personnel. Two researchers will independently perform literature screening, data extraction and literature evaluation. In case of disagreement, a third researcher will be involved in the resolution. The measurement properties of PHEC assessment instruments will be systematically reviewed based on the consensus-based standards for the selection of health measurement instruments (COMSIN) methodology and guideline. ETHICS AND DISSEMINATION: Ethical approval is not applicable for this study. We will share the findings from the study at national and/or international conferences and in a peer-reviewed journal in the fields of health education and/or patient education. PROSPERO REGISTRATION NUMBER: CRD42023393293.

Experiences of healthcare workers following occupational exposure to COVID-19 at the early stages of the pandemic: A phenomenological qualitative study.

AIM: To explore the experiences of healthcare workers (HCWs) following occupational exposure to coronavirus disease 2019 (COVID-19) during the early stage of the pandemic. DESIGN: A Husserl descriptive phenomenological study design was employed. METHODS: Convenient and snowball sampling was used. In-depth semi-structured telephone interviews were conducted from February to March 2020 with the frontline HCWs who were exposed to COVID-19 during work. Data analysis was conducted following the 7-step analysis method developed by Colaizzi. RESULTS: Fifteen HCWs participated in the study. Four themes were identified, including (1) traumatic experiences since the occupational exposure; (2) getting through the hard time; (3) struggling to return to work; (4) reflections on occupational exposures. CONCLUSION: The HCWs had traumatic and painful experiences after the occupational exposure. But they returned to work with strong resilience, professional obligation and social support. Training and supervision, and adequate supply of personal protective equipment are suggested to prevent professional exposure. Social and organizational support should be provided for the exposed HCWs.

Proteomic analysis of skeletal muscle in Chinese hamsters with type 2 diabetes mellitus reveals that OPLAH downregulation affects insulin resistance and impaired glucose uptake.

Type 2 diabetes mellitus (T2DM) is a metabolic disease controlled by a combination of genetic and environmental factors. The Chinese hamster, as a novel animal model of spontaneous T2DM with high phenotypic similarity to human disease, is of great value in identifying potential therapeutic targets for T2DM. Here, we used tandem mass tag (TMT) quantitative proteomics based on liquid chromatography-tandem mass spectrometry to assess the skeletal muscles of a Chinese hamster diabetes model. We identified 38 differentially abundant proteins, of which 14 were upregulated and 24 were downregulated. Further analysis of the differentially abundant proteins revealed that five of them (OPLAH, GST, EPHX1, SIRT5, ALDH1L1) were associated with oxidative stress; these were validated at the protein and mRNA levels, and the results were consistent with the proteomic analysis results. In addition, we evaluated the role of OPLAH in the pathogenesis of T2DM in human skeletal muscle cells (HSKMCs) by silencing it. The knockdown of OPLAH caused an increase in reactive oxygen species content, decreased the GSH content, inhibited the PI3K/Akt/GLUT4 signaling pathway, and reduced glucose uptake. We propose that OPLAH downregulation plays a role in insulin resistance and glucose uptake disorders in HSKMCs possibly via oxidative stress, making it a new therapeutic target for T2DM.

Prognostic value of PaO2/FiO2, SOFA and D-dimer in elderly patients with sepsis.

OBJECTIVE: To investigate the prognostic value for predicting mortality of partial pressure of oxygen/fraction of inspired oxygen (PaO2/FiO2), the Sequential Organ Failure Assessment (SOFA) score and D-dimer in elderly patients with sepsis. METHODS: This retrospective cohort study enrolled elderly patients with sepsis admitted to the intensive care unit (ICU) between January 2019 and October 2020. Patients were divided into a survival group and a non-survival group. Biomarkers, SOFA, Acute Physiology and Chronic Health Evaluation II and Glasgow Coma Scale scores were recorded within 24 h after admission to the ICU. RESULTS: A total of 135 elderly patients with sepsis were enrolled in the study: 89 were in the survival group and 46 were in the non-survival group at 28 days. Univariate and multivariate regression analyses demonstrated that PaO2/FiO2, SOFA and D-dimer were independently associated with 28-day mortality. The predictive performance for mortality of the combination of PaO2/FiO2, SOFA score and D-dimer (area under the receiver operating characteristic curve of 0.926) was higher than the values for the individual factors (0.761, 0.745 and 0.878, respectively). CONCLUSION: The combination of PaO2/FiO2, SOFA score and D-dimer represents a promising tool and biomarker for predicting 28-day mortality of the elderly patients with sepsis.

A systematic review and meta-analysis of the effect of resistance exercise therapy on the prognosis of patients after percutaneous coronary intervention.

BACKGROUND: Exercise rehabilitation therapy after percutaneous coronary intervention (PCI) can accelerate physical recovery, improve cardiovascular work efficiency, and reduce the incidence of arterial restenosis. This study aimed to investigate the effect of resistance exercise therapy after PCI by literature search and meta-analysis. METHODS: The databases of Embase, Cochrane library, PubMed, and Ovid were searched for all published English language articles related to resistance exercise after PCI from January 2000 to January 2021. After screening the literature according to the inclusion and exclusion criteria and assessing the risk of bias, RevMan 5.4 software was used to analyze and obtain a forest plot and funnel plot. RESULTS: A total of 7 articles were included in this study for quantitative analysis, involving 776 patients all together. Meta-analysis showed that compared with conventional intervention methods, resistance exercise could reduce the maximum exercise load after PCI [mean difference (MD) =-25.27, 95% confidence interval (CI): -31.97 to -18.57, Z=7.39, P<0.00001], reduce the peak oxygen consumption of exercise after PCI (MD =-2.36, 95% CI: -3.09 to -1.64, Z=6.42, P<0.00001), increase left ventricular ejection fraction (LVEF; MD =4.06, 95% CI: 0.72 to 7.40, Z=2.38, P=0.02), increase the 6-minute walk distance (6MWD; MD =18.23, 95% CI: 0.22 to 36.23, Z=1.98, P=0.05), and improve the quality of life of patients after surgery (MD =5.81, 95% CI: 1.49 to 10.14, Z=2.63, P=0.008). DISCUSSION: Resistance training can improve the physical activity, cardiac function, and quality of life of patients after PCI.

Application of Self-Adhesive Soft Silicone Common Foam Dressing in Reducing Intraoperative Pressure Ulcers in Elderly ICU Patients.

Pressure ulcer (PU), also called pressure injury, is localized damage to the skin and underlying soft tissues, usually over bony prominences, as a result of sustained mechanical loads applied to the tissues. However, in many situations, complete off-loading of sacral PUs is not possible. Minimising the exposure of wounds and their surroundings to elevated mechanical loads is crucial for healing. We for the first time reported the application of Meipicang in the prevention and treatment of intraoperative pressure ulcers in elderly ICU patients with severe illness. We found that the pressure ulcer risk score (20.15 ± 2.17) in the dressing group after intervention was higher than that (17.42 ± 3.62) in the regular group. The incidence of pressure sores in the dressing group was 3.77% lower than the 18.88% in the regular group. The psychological concern score (31.41 ± 3.15) of the dressing group was higher than that (26.92 ± 3.43) of the regular group. The trust score (29.57 ± 2.61) of the dressing group was higher than the score (24.28 ± 2.29) of the regular group. The score of physiological problems in the dressing group (34.69 ± 3.82) is higher than that in the regular group (29.88 ± 3.54). The skin complication rate of the dressing group was 5.56% lower than that of the regular group (22.64%). The comfort score (92.46 ± 4.15) of the dressing group was higher than that (80.59 ± 5.43) of the regular group. The nursing satisfaction score (94.53 ± 3.72) of the dressing group was higher than that (81.79 ± 4.61) of the regular group. To conclude, in this study, we found that the Meipicang dressing can reduce the incidence of pressure ulcers in ICU patients with severe ICU and improve the comfort and nursing satisfaction of elderly ICU patients with severe ICU, which is worthy of promotion.

Anxiety and depression levels of the general population during the rapid progressing stage in the coronavirus disease 2019 outbreak: a cross-sectional online investigation in China.

OBJECTIVE: The outbreak of COVID-19 has major impacts on the psychological health of the public. This study aimed to investigate the anxiety and depression levels of the general population during the rapid progressing stage of COVID-19 pandemic in China and to explore the associated factors. DESIGN AND SETTING: A cross-sectional online survey. PARTICIPANTS: 2651 Chinese people. MEASURES: The Hospital Anxiety and Depression Scale was used to measure their psychological health. A structured questionnaire collected possible associated factors, including sociodemographic characteristics, health information, contact history-related information, experience and perceptions, knowledge and education and adopted precautions. Multiple linear regression was conducted to explore the factors associated with anxiety and depression. RESULTS: The mean score of anxiety and depression was 4.35 and 4.38, respectively. The rates of people with anxiety and depressive symptoms (with >7 score in the subscale) were 14.15% and 17.35%, respectively. Participants without political party membership, with contact history of COVID-19, going out or gathering, taking Chinese medicine herbs, being unsatisfied with current precautions, perceiving higher risks of infection, lower knowledge and poorer health presented higher anxiety and depression levels. Moreover, those who were females, married, lived alone and wore mask were more anxious; whereas people who were younger, experienced public health crisis, did not take precautions (regular work-rest, exercise) had higher depression level. CONCLUSIONS: During the rapid progressing stage of COVID-19 pandemic in China, one-seventh and one-sixth respondents presented anxiety and depression symptoms, respectively. The risk factors for anxiety and depression included the following: without political party membership, with contact history of COVID-19, going out or gathering, wearing masks, taking Chinese medicine herbs, being unsatisfied with current precautions, perceiving higher susceptibility, lower knowledge and poorer health status. Extensive information and psychological support should be provided to improve the mental health of the general population.

Liver proteomics analysis reveals abnormal metabolism of bile acid and arachidonic acid in Chinese hamsters with type 2 diabetes mellitus.

Non-obese, spontaneous, and genetically predisposed type 2 diabetic Chinese hamsters exhibit metabolic abnormalities similar to those observed in human T2DM. Here, tandem mass tag (TMT)-based quantitative proteomics technology was used to screen and identify differentially abundant proteins in the liver that are associated with diabetes in Chinese hamsters. GO and KEGG pathway enrichment analysis were conducted to validate the findings, as well as qRT-PCR and western blotting. In total, 103 proteins were identified in the livers of diabetic hamsters, of which 48 were up-regulated and 55 were down-regulated. KEGG pathway enrichment analysis further demonstrated that linoleic acid metabolism, arachidonic acid metabolism, bile secretion, and other pathways were affected. Moreover, AQP9 and EPHX1 were significantly down-regulated in the bile secretion pathway, whereas PTGES2, Cyp2c27, and Cyp2c70 were associated with the arachidonic acid metabolic pathway. Serum levels of bile acid (BA) and arachidonic acid (AA) in diabetic Chinese hamsters were significantly higher than those in control hamsters. Cumulatively, our findings indicate that the five candidate proteins may be associated with abnormal BA and AA metabolism, suggesting their involvement in pathological changes in the livers of Chinese hamsters with T2DM. SIGNIFICANCE: The liver proteomics of Chinese hamsters describes differentially abundant proteins associated with T2DM, while promoting this animal model as an appropriate and ideal platform for investigating underlying molecular mechanisms of T2DM. This study reveals abnormal bile acid and arachidonic acid metabolism in T2DM hamsters, which may provide insights for studying the relationship between candidate proteins and KEGG pathways to elucidate the underlying molecular mechanism associated with T2DM.

miR-34a-5p suppresses the invasion and metastasis of liver cancer by targeting the transcription factor YY1 to mediate MYCT1 upregulation.

BACKGROUND: In recent years, microRNAs (miRNAs) are reported to act as molecular biomarkers for cancer diagnosis, treatment, and prognosis (including liver cancer) and to be involved in the development and progression of cancer and other physiological and pathological changes. However, the role of miR-34a-5p in liver cancer is still largely unknown. METHODS: In our study, the expression of miR-34a-5p in liver cancer tissues and HCC cell lines was detected by qRT-PCR. The CCK-8, scratch wound-healing motility and Transwell assays were used to evaluate the effect on cell proliferation, migration and invasion. The expression of YY1, E-cadherin, N-cadherin and vimentin was analysed by western blotting. The dual luciferase assay was performed to confirm whether YY1 is a target of miR-34a-5p. The combination of YY1 and MYCT1 was detected by chromatin immunoprecipitation (ChIP) assay. RESULTS: The results showed that miR-34a-5p was downregulated in liver cancer tissues and HCC cell lines. Overexpression of miR-34a-5p inhibited the proliferation, migration and invasion of liver cancer cells. YY1 was a direct target of miR-34a-5p, and the expression of YY1 could reverse the influence of miR-34a-5p on the proliferation, migration and invasion of liver cancer cells. YY1 inhibited MYCT1 expression by directly binding to its promoter region, and knockdown of MYCT1 reversed the influence of miR-34a-5p on the proliferation, migration and invasion of liver cancer cells. CONCLUSION: Our results suggest that miR-34a-5p could inhibit the invasion and metastasis of hepatoma cells by targeting YY1-mediated MYCT1 transcriptional repression.

Small intestine proteomics coupled with serum metabolomics reveal disruption of amino acid metabolism in Chinese hamsters with type 2 diabetes mellitus.

Type 2 diabetes mellitus (T2DM) is a metabolic disorder characterized by hyperglycemia, with metabolic disturbances resulting from defects in insulin secretion, insulin resistance (IR), or both. Chinese hamsters have potential value as non-obese animal models of spontaneous T2DM for studying the pathogenesis and molecular characteristics of diabetes. In this study, the molecular characteristics of the Chinese hamster diabetes animal model were investigated through small intestine proteomics and serum metabolomics. A total of 213 differentially abundant proteins and 14 differentially abundant metabolites were identified through liquid chromatography-tandem mass spectrometry (LC-MS/MS) and gas chromatography-time of flight mass spectrometry (GC-TOF/MS) analysis, respectively. Annotation by bioinformatics analysis revealed that these differentially abundant proteins in the small intestine were commonly associated with abnormal glucose and lipid metabolism, IR, impaired insulin secretion, amino acid metabolism disorders, and inflammatory dysregulation. Moreover, differentially abundant metabolites in the serum were amino acids and were related to diabetic IR. Through the analysis of small intestine proteomics and serum metabolomics in the Chinese hamster diabetes model, we provide a preliminary understanding of the diabetic characteristics of this model from a molecular perspective. This study provides data incentivizing the popularization and application of Chinese hamsters in T2DM research. SIGNIFICANCE: Spontaneous rodent models of diabetes, such as Chinese hamsters, effectively summarizes the clinical characteristics of type 2 diabetes and has high applicative value for studying the pathophysiology of diabetes. In order to explore the potential value of the Chinese hamster diabetes animal model in the study of the T2DM molecular mechanism, we performed small intestine proteomic analysis and serum metabolomic analysis in Chinese hamsters for the first time. After an integrated analysis of proteomics and metabolomics, we have a preliminary understanding of the diabetic characteristics of this model from a molecular perspective. Further, we found that in the occurrence and development of T2DM, the metabolic abnormalities of this model are particularly prominent, especially the metabolism of amino acids. These findings not only provide basic data in support of the popularization and application of the current model in T2DM research, but also provide a new perspective for the exploration of mechanisms related to T2DM.

Willingness of Chinese nurses to practice in Hubei combating the coronavirus disease 2019 epidemic: A cross-sectional study.

AIMS: To investigate the willingness of Chinese nurses to practice in Hubei combating the coronavirus disease 2019 and to explore the associated factors. DESIGN: A cross-sectional survey. METHODS: Clinical nurses were conveniently recruited by an online link in three provinces out of Hubei, including Hunan (Central south), Chongqing (Southwest) and Xinjiang (Northwest) during 4-10 February 2020. A structured questionnaire was distributed by an online investigation system. Information on sociodemographic characteristics, willingness, possible influencing factors (previous experience, health status, training conditions, perceptions on volunteering to practice in Hubei, family attitude, and insurance) was collected. Binary logistic regression was conducted to explore the association of different factors with the willingness decision of nurses. RESULTS: A total of 11,183 nurses participated in this survey and a high proportion of them were willing to volunteer to practice in Hubei combating the epidemic. Nurses who were likely to volunteer had the following characteristics: younger, unmarried, members of the Communist Party of China, with senior professional qualification, working in critical care departments, with support from their families, with adequate training and learning, with good health status and low levels of anxiety. The regression model could explain 31.1% of the variances of the willingness decision of nurses. CONCLUSIONS: A high proportion of nurses in China were willing to practice in Hubei during the coronavirus disease 2019 epidemic. Adequate training and psychological support would facilitate nurses to volunteer during the outbreak of an infectious disease. IMPACT: The study identified a high proportion of nurses in China were willing to practice in Hubei combating the coronavirus disease 2019 epidemic. The findings will provide valuable references for nurses and decision makers to formulate better plans for increasing nursing workforce during such kind of public health crisis.

Effects of alternate-day fasting on body weight and dyslipidaemia in patients with non-alcoholic fatty liver disease: a randomised controlled trial.

BACKGROUND: Alternate-day fasting (ADF) is a novel diet therapy that may achieve reduction in body weight and improvement of dyslipidaemia, but the impact of this diet on patients with non-alcoholic fatty liver disease (NAFLD) remains unknown. The aim of this study was to evaluate the effects of ADF on the body weight and lipid profile of individuals with NAFLD. METHODS: NAFLD patients (n = 271) were randomised to the ADF group, time-restricted feeding (TRF) group, or the control group and subjected to the respective diet for 12 weeks. Anthropometric measurements (body weight, fat mass/fat-free mass) were performed, and plasma lipids were analysed enzymatically. RESULTS: Within 4 weeks, the body weight decreased significantly (P < 0.001) in the ADF group by 4.56 ± 0.41 kg (6.1 ± 0.5%) and the TRF group by 3.62 ± 0.65 kg (4.83 ± 0.9%) compared to the control group, and it decreased even more after 12 weeks in both groups (ADF: - 4.04 ± 0.54 kg, 5.4 ± 0.7%; TRF: - 3.25 ± 0.67 kg, 4.3 ± 0.9%). Fat mass was significantly reduced by ADF (- 3.49 ± 0.37 kg; 11 ± 1.2%) and TRF (- 2.91 ± 0.41 kg; 9.6 ± 1.3%), with ADF leading to a further reduction in fat mass after 12 weeks (- 3.48 ± 0.38 kg; 11 ± 1.2%). Total cholesterol was significantly decreased at both time points in the ADF group (- 0.91 ± 0.07 mmol/L; 18.5 ± 1.5%) compared to the control and TRF groups. Both ADF (- 0.64 ± 0.06 mmol/L; 25 ± 1.9%) and TRF (0.58 ± 0.07 mmol/L; 20 ± 1.7%) achieved a significant reduction in serum triglycerides (P < 0.001) after 12 weeks. Changes in fat free mass, HDL, LDL, fasting insulin, glucose, liver stiffness, and systolic or diastolic blood pressure did not differ between the groups. CONCLUSIONS: ADF appears to be an effective diet therapy for individuals with NAFLD that can achieve weight loss and improvement of dyslipidaemia within a relatively short period of time (4 to 12 weeks). Potential preventive effects of ADF on cardiovascular disease need to be confirmed by future investigations. TRIAL REGISTRATION: ChiCTR1900024411, this trial was retrospectively registered on July 10, 2019.

Knockdown of lncRNA CCEPR suppresses colorectal cancer progression.

Long non-coding RNAs (lncRNAs) serve important roles in colorectal cancer. The aim of the present study was to investigate the expression and role of cervical carcinoma expressed PCNA regulatory (CCEPR) lncRNA in colorectal cancer progression. The results demonstrated that CCEPR expression was significantly higher in colorectal cancer tissues when compared with paired adjacent normal tissues. In addition, CCEPR expression was significantly higher in patients with advanced colorectal cancer (stage III/IV) than those with early-stage colorectal cancer (stage I/II). High CCEPR expression was significantly associated with poor differentiation, advanced clinical stage, positive lymph node metastasis and distant metastasis. Of particular note, patients with colorectal cancer exhibiting high CCEPR expression levels had shorter survival rates when compared with patients with low CCEPR expression. In vitro experiments demonstrated that the expression of CCEPR was increased in colorectal cancer cell lines when compared with a normal colon cell line. Knockdown of CCEPR significantly inhibited colorectal cancer cell proliferation, colony formation and cell cycle progression, as well as cell migration and invasion. Finally, silencing of CCEPR downregulated matrix metalloproteinase (MMP)-2 and MMP-9 expression and suppressed epithelial-mesenchymal transition in colorectal cancer cells. In conclusion, the results of the present study suggest that CCEPR may exert an oncogenic role in colorectal cancer, and CCEPR may be a promising molecular target for colorectal cancer treatment.

[Expert consensus on the first responder of the first aid].

OBJECTIVE: To improve the popularization of the knowledge of the first responders and promote the establishment of the awareness of the first aid, First Aid Professional Committee of Chinese Aging Well Association formulated the Expert consensus on the first responder of the first aid. This consensus aims at the critical and weak link of emergency medical service system (EMSS) in China, providing the public with the first responders action guidance, and guiding the public how to effectively rescue the "first scene", "first time" and "first responder" in the event of sudden injury or illness. Strengthen risk pre-control, environmental control and overall joint control in the "first scene" of different emergencies were emphasized. How to correctly judge, recognize, call for help and give first aid in the "first time" were presented. The first aid skills of the "first responder" should include cardiopulmonary resuscitation (CPR), automated external defibrillator (AED) defibrillation, Heimlich (abdominal impingement), hemostasis, dressing, fixation, and handling. The best place, the best training method and the best communication way to popularize the first aid knowledge and skills were proposed, and the first responder action plan was jointly promoted from various social levels such as policy, law, science and technology, culture and so on. This consensus refers to relevant foreign guidelines and scientific basis and combines with Chinese actual national conditions to provide guidance for the first responders' action and training, aiming to promote the development of first aid in China.

Maternal factors and preoperative nutrition in children with mild cases of congenital heart disease.

AIM: The preoperative poor nutrition of children with congenital heart disease (CHD) impacts the postoperative rehabilitation process of pediatric CHD cases. The factors of these children's preoperative poor nutrition, excluding the disease, have been underreported. The aim was to investigate the preoperative nutritional status of children with CHD who required a simple surgical repair and to analyze the maternal characteristics that are associated with poor nutrition in these sick children. METHODS: This was a cross-sectional survey. The weight and height of the children were measured, maternal data were collected via a questionnaire and a univariate analysis and multivariate logistic regression were used to analyze the association between maternal factors and the preoperative poor nutrition of the children with CHD. RESULTS: A total of 119 children with simple CHD were recruited to the study. The prevalence of poor nutrition was higher in the children with CHD ("cases") than in the healthy children ("controls"). An increased risk of poor nutrition was associated with lower mothers' perception, education level, understanding of the disease, and higher anxiety. CONCLUSIONS: Paying attention to maternal anxiety, depression, and knowledge and providing interventions for the mothers of children with CHD are important in order to promote the nutritional status of these children.