Construction and Application of a Training Program for ICU Nurses to Manage Artificial Airway Gasbags to Prevent Ventilator-Associated Pneumonia.

Purpose: To construct a training program for ICU nurses to manage artificial airway gasbags to prevent ventilator-associated pneumonia (VAP) and explore its application in ICU nurses. Methods: From January to March 2023, 17 experts were consulted using the Delphi method to construct the draft of the training program. 52 ICU nurses were selected from a third-level, first-class hospital in Henan Province. They received training using the program for 4 weeks. The training effects were evaluated by examining the theoretical knowledge, testing operation skills, and the ICU medical staff gasbag management knowledge-attitude-behavior questionnaire before and one week after the training in April 2023. Results: The coefficients of expert authority for the two round inquiries were 0.816 and 0.837, respectively. The coordination coefficient of expert opinions ranges from 0.2 to 0.3. The final training program for ICU nurses on managing artificial airway gasbags to prevent VAP was constructed and included 4 primary indicators, 25 secondary indicators, 47 tertiary indicators. After the training by the program, the scores of the ICU nurses' theoretical knowledge (before, 73.73 ± 8.54 VS after, 88.31 ± 6.29; t = 11.017, P<0.001) and technical operation (before, 75.29 ± 7.48 VS after, 86.92 ± 4.72; t = 8.986, P<0.001) were significantly increased. The total scores of the ICU nurses' knowledge-attitude-behavior on gasbag management (before, 76.67 ± 10.68 VS after, 109.04 ± 9.87; t = 19.916, P<0.001) were also significantly increased compared to the performance before training. Conclusion: The training program for ICU nurses on managing artificial airway gasbags to prevent VAP based on the Miller pyramid model is scientific and practical and can enhance the knowledge-attitude-behavior level of ICU nurses. This training program constructed in this study can be recommended and applied after further verification for the ICU nurses to manage the artificial airway gasbags in order to reducing the occurrence of the VAP in the clinical practice.

Application value of miRNA-182 as a biomarker for cancer diagnosis: a systematic review with meta-analysis.

Aim: This study aims to establish the potential reliability and validity of miRNA-182 as a diagnostic tool in oncology, and hence to contribute to the decision-making process in clinical settings. Materials & methods: To further evaluate the role of miRNA-182 as a cancer biomarker, we conducted a search of the PubMed, Cochrane Library, Wanfang and China National Knowledge Infrastructure databases of existing literature. Conclusion: These results suggest that miRNA-182 could function as a potential molecular marker for cancer detection and diagnosis. The effect of miRNA-182 on tumor development should be further studied to confirm these results and add to the current understanding of its role in cancer.

A meta-analysis involves integrating the results from various studies to create a comprehensive understanding or view of the research topic. This review with meta-analysis presents an exhaustive evaluation of the effectiveness of a tiny molecule in our cells that helps control what our genes do named miRNA-182 as a signal that indicates a certain disease or condition for a variety of cancer types which we also called biomarkers. By assembling and analyzing a broad spectrum of research papers, the study assesses the specificity, sensitivity and overall diagnostic accuracy of miRNA-182 in cancer detection. The analysis incorporates diverse studies, ensuring an inclusive assessment of miRNA-182 across different types and stages of cancer. The review presents data from numerous clinical trials and studies, providing an in-depth examination of the variations in miRNA-182 levels between cancer patients and healthy individuals. Meta-analysis findings suggest that miRNA-182 demonstrates high diagnostic precision, surpassing traditional biomarkers in certain instances. This evidence underscores its potential value in clinical settings, notably in cancers where early detection is essential for effective treatment. Highlighting the emerging significance of miRNA biomarkers in the study of cancer, this review emphasizes the potential of miRNA-182 in enhancing early cancer detection, which could profoundly influence treatment outcomes. The findings propose that miRNA-182 may substantially improve early cancer detection and patient outcomes, indicating a substantial stride forward in tools and tests used to detect and understand cancer. Finally, the review advocates for larger, more diverse sample sizes and standardization of methodologies. These improvements will further validate miRNA-182's reliability as a cancer biomarker, establishing its diagnostic capabilities and promoting its integration into clinical practice.

One-Pot Method Synthesis of Bimetallic MgCu-MOF-74 and Its CO2 Adsorption under Visible Light.

A magnesium-based metal-organic framework (Mg-MOF-74) exhibits excellent CO2 adsorption under ambient conditions. However, the photostability of Mg-MOF-74 for CO2 adsorption is poor. In this study, Mg x Cu1-x -MOF-74 was synthesized by using a facile "one-pot" method. Furthermore, the effects of synthesis conditions on the CO2 adsorption capacity were investigated comprehensively. X-ray diffraction, Fourier transform infrared, scanning electron microscopy, thermo gravimetric analysis, inductively coupled plasma atomic emission spectroscopy, ultraviolet-visible spectroscopy and photoluminescence spectroscopy, and CO2 static adsorption-desorption techniques were used to characterize the structures, morphology, and physicochemical properties of Mg x Cu1-x -MOF-74. CO2 uptake of Mg x Cu1-x -MOF-74 under visible light illumination was measured by the CO2 static adsorption test combined with the Xe lamp. The results revealed that Mg x Cu1-x -MOF-74 exhibited excellent photocatalytic activity. Furthermore, the CO2 adsorption capacity of Mg x Cu1-x -MOF-74 was excellent at a synthesis temperature and time of 398 K and 24 h in dimethylformamide (DMF)-EtOH-MeOH mixing solvents, respectively. Mg x Cu1-x -MOF-74 retained a crystal structure similar to that of the corresponding monometallic MOF-74, and its CO2 uptake under visible light was superior to that of the corresponding monometallic MOF-74. Particularly, the CO2 uptake of Mg0.4Cu0.6-MOF-74 under Xe lamp illumination for 24 h was the highest, up to 3.52 mmol·g-1, which was 1.18 and 2.09 times higher than that of Mg- and Cu-MOF-74, respectively. The yield of the photocatalytic reduction of CO2 to CO was 49.44 µmol·gcat -1 over Mg0.4Cu0.6-MOF-74 under visible light for 8 h. Mg2+ and Cu2+ functioned as open alkali metal that could adsorb and activate CO2. The synergistic effect between Mg and Cu metal strengthened Mg x Cu1-x -MOF-74 photostability for CO2 adsorption and broadened the scope of its photocatalytic application. The "bimetallic" strategy exhibits considerable potential for use in MOF-based semiconductor composites and provides a feasible method for catalyst design with remarkable CO2 adsorption capacity and photocatalytic activity.

Protein corona-driven nanovaccines improve antigen intracellular release and immunotherapy efficacy.

During vaccine delivery in vivo, the vaccine carrier dynamically adsorbs the surrounding proteins or biomacromolecules to form a protein corona layer, which determines the physiological and therapeutic responses of the vaccine. Although the importance of the protein corona effect in drug delivery is widely accepted, understanding of the rational use of the protein corona to improve antigen controlled release is still sparse. Here, we constructed a protein corona-driven nanovaccine (PCNV), which has the dual effects of resisting the protein corona-induced antigen extracellular release and promoting protein corona-triggered antigen cytosolic release under reductive conditions. Specifically, the nanovaccine was formulated via the assembly of fluorinated dendrigraft-poly-lysine and cleavable antigen-CpG conjugate. Before entering antigen-presenting cells (APCs), the anchoring effect of CpG was used to avoid the dissociation of antigens from the carrier even under the protein corona effect. While nanovaccine enters the APCs, the intracellular reducing conditions can induce a break in the disulfide bond between CpG and antigen. Notably, at the same time, the intracellular protein corona effect triggers antigen release from the carrier and achieves efficient antigen presentation. In addition, the PCNV produced a significant prophylactic and therapeutic antitumor response in the mouse model. Therefore, the rational use of the protein corona effect provides an effective strategy for vaccine delivery.

[Effect of abnormal lipid metabolism on immune microenvironment in tumors].

The abnormality in lipid metabolism is an indication for malignant tumors and closely related to anti-tumor immune response. This abnormality is characterized by aberrant changes in metabolic signals, lipid transporters, metabolic substrates, metabolic enzymes and metabolites in lipid metabolism, which are mainly manifested as abnormal lipid accumulationin tumor cells. Aberrant lipid accumulation in the tumor microenvironment (TME) can affect both the phenotype and function of tumor infiltrating immune cells, which helps to construct an immunosuppressive tumor microenvironment and leads to immune escape of tumor cells. The anti-tumor immunotherapy can be improved by regulating the function of immune cells through targeting the abnormal molecules or pathways in lipid metabolism.

The application of intracavitary electrocardiogram for tip location of femoral vein catheters in chemotherapy patients with superior vena cava obstruction.

BACKGROUND: Most studies focused on the application of intracavitary electrocardiogram (IC-ECG) location in superior vena cava access catheterization, this study aimed to explore the effect of IC-ECG for tip location of femoral vein catheters in chemotherapy patients with superior vena cava obstruction (SVCO). METHODS: A total of 158 patients placed catheters through superficial femoral vein from July 2016 to May 2019 were enrolled in the randomized controlled study. The patients were divided into two groups by envelope lottery method: X-ray location was used in the control group (n = 79); IC-ECG location was used in the observation group (n = 79). The catheters should be located at or near the inferior vena cava (IVC)-right atrium (RA) junction (above the level of diaphragm within the IVC). The general information of patients, clinical catheterization effects and catheter-related complications were compared between the groups. RESULTS: No significant differences in general information, catheter obstruction, catheter-related thrombosis, catheter exit-site bleeding and infection were found between the groups. The rate of successful insertion at the first attempt and patient satisfaction in the observation group were significantly higher than that in the control group (p < 0.05). The time and cost of location and the incidence of catheter-related complications in the control group were 32.57 min and 140.51 Yuan and 21.5%, which were significantly higher than 6.94 min and 13.59 Yuan and 7.6% in the observation group (p < 0.05). CONCLUSION: IC-ECG accurately located the tip of femoral vein catheters, reduced the incidence of catheter-related complications and the time and cost of location, improved patient satisfaction.

Nurses' Attitudes and Knowledge of Peripherally Inserted Central Catheter Maintenance in Primary Hospitals in China: A Cross-Sectional Survey.

BACKGROUND AND AIM: The promotion of peripherally inserted central catheter (PICC) maintenance in primary hospitals can benefit discharged patients with PICCs living in remote areas a lot. Yet, no primary hospitals had introduced PICC maintenance technology in Hunan province, China. The present study aimed to evaluate nurses' attitudes and knowledge of PICC maintenance in primary hospitals in Hunan province, China. MATERIALS AND METHODS: From November 2018 to January 2019, a total of 560 nurses from 28 community hospitals and 28 township hospitals in 14 cities across Hunan were recruited in the present study. All nurses were registered nurses engaged in clinical work related to intravenous infusion, and their attitudes and knowledge of PICC maintenance were measured by a self-designed questionnaire that was based on literature review and expert consultation. RESULTS: The response rate was 93.6% (560 of 598). Almost all participants could realize the importance and necessity of PICC maintenance. More than 90% of the participants expressed interest in PICC maintenance and showed strong demands for relevant training. However, the nurses' correct response rate of most knowledge items was at a low level (7.14-57.68%), with only three items exhibiting the correct response rate of 90% or higher. The factors influencing the nurses' PICC maintenance knowledge included their nursing experience, professional title, work setting, and department. CONCLUSION: Although nurses in primary hospitals had a positive attitude toward PICC maintenance, their knowledge level was unsatisfactory, which might be a barrier to the promotion of PICC maintenance technology in primary hospitals in Hunan province, China. Multiple parties should get involved and take measures to improve the nurses' PICC maintenance knowledge, including the government, nursing associations, large-scale hospitals, and primary hospitals themselves. Besides, new training models and dynamic assessment methods should be explored to improve training effectiveness in the future.

Nurses' knowledge of peripherally inserted central catheter maintenance and its influencing factors in Hunan province, China: a cross-sectional survey.

OBJECTIVES: The present study aimed to assess the level of knowledge on peripherally inserted central catheter (PICC) maintenance among nurses in China and to analyse the related factors influencing this variable. DESIGN: A cross-sectional survey. SETTING: Ninety-one hospitals at three different levels in Hunan Province, China: county hospitals, municipal hospitals and provincial hospitals. PARTICIPANTS: A total of 4110 registered nurses engaged in clinical work related to intravenous infusion. PRIMARY AND SECONDARY OUTCOME MEASURES: Nurses' knowledge of PICC maintenance was measured by the score of an anonymous, self-reported questionnaire. RESULTS: The mean score of PICC maintenance among 4110 nurses was 72.86±14.86. 83.5% of the participants exhibited a score of 60 or above, and 34.1% of them exhibited a good grade with a score of 80 or above. The difference in the correct rate among different dimensions was statistically significant (H=17.721, p<0.01). The generalised linear model indicated that the factors influencing the nurses' PICC maintenance knowledge included gender, age, professional title, work setting and previous history of PICC maintenance training. CONCLUSIONS: In conclusion, the knowledge of PICC maintenance was at a medium level among nurses in Hunan province, China. Multiple steps should be taken to improve the nurses' PICC maintenance knowledge, including disseminating PICC maintenance knowledge in multiple ways, such as courses, lectures, seminars and new media. Particular attention should be given to populations who responded poorly in this survey, and targeted education for nurses should be distributed based on their performance on specific dimensions, such as the replacement of dressing and needle-free connectors. In addition, the quality of the nurses' practical performance could be measured in the future.

Thrombotic risk factors in patients with superior vena cava syndrome undergoing chemotherapy via femoral inserted central catheter.

OBJECTIVE: Our study aimed to scrutinize the incidence and risk factors of femoral inserted central catheter (FICC)-related thrombosis in patients with superior vena cava syndrome (SVCS) undergoing chemotherapy. METHODS: A retrospective analysis of patients with SVCS undergoing chemotherapy who received FICC catheterization at the Xiangya Hospital, Central South University, Changsha City, Hunan Province between May 2012 and February 2019 was performed. Both asymptomatic thrombosis and symptomatic thrombosis were diagnosed by color doppler ultrasound (CDUS). Univariate and multivariate logistic regression analyses were performed to identify patient-, insertion-, and catheter-related factors. RESULTS: Eight hundred and seventy-four patients with SVCS undergoing chemotherapy, with a total of 157,180 catheter days were enrolled in our study. FICC-related thrombosis was detected in 144 patients, and yielding an overall incidence of 16.47% or 0.92 events per 1000 catheter days. Of these, 19(2.17%) patients had symptomatic thrombosis. The mean time interval between FICC insertion and thrombosis onset was (10.40 ±â€¯6.32) days and the mean catheter indwelling time was (179.84 ±â€¯46.15) days. The history of deep venous thrombosis, treatment with vascular endothelial growth factor (VEGF) inhibitor (bevacizumab), puncture site (mid-thigh, groin), tip position and catheter size showed association with FICC-related thrombosis. Treatment with VEGF inhibitor [odds ratio (OR) = 2.779; 95%confidence interval (CI): 1.860-4.153; P < 0.001] and puncture site at the groin (OR = 10.843; 95%CI: 6.575-17.881; P < 0.001) were identified as independent risk factors of FICC-related thrombosis. CONCLUSION: Treatment with VEGF inhibitor and puncture site at the groin during FICC catheterization were considered as high-risk factors in FICC-related thrombosis.

[Construction of the competency model for junior caregivers for the elderly based on the combination of medical and endowment model].

OBJECTIVE: To construct a competency model for junior caregivers for the elderly and to provide a reference for the selection, evaluation and training for the junior caregivers for the elderly.
 Methods: Firstly, we drafted the primary competency model for junior caregivers for the elderly through literature review. Then, we used Delphi method to carry out 2 rounds of questionnaire survey for 20 experts to optimize the indicators for primary model. The weight of each indicator is determined by analytic hierarchy process (AHP) and expert sequencing method.
 Results: The effective recovery rates of the two-round questionnaire were 87% and 100%, respectively. The expert authority coefficient was 0.70-0.93, and the average authority coefficient was 0.80. The final version of the competency model for junior caregivers for the elderly included 4 first-grade indexes, 11 second-grade indexes and 37 third-grade indexes.
 Conclusion: The competency model for the junior caregivers for the elderly is reliable and can be used as the reference standard for the selection, evaluation and training for the junior caregivers for the elderly.

Arsenic removal from water by metal-organic framework MIL-88A microrods.

Fe-based metal-organic framework MIL-88A microrods were synthesized by hydrothermal method, which were used to adsorb As(V) in water for the first time. The experimental results indicated that MIL-88A has a very fast adsorption rate towards arsenic in water. The kinetic and isothermal data for arsenic removal were better fitted to the pseudo-second-order kinetic model and Langmuir model, respectively, implying a chemical and monolayer adsorption for As(V) on MIL-88A microrods. Two rate-controlling processes during adsorption were revealed by the intraparticle diffusion model. The maximum adsorption capacity of MIL-88A reached 145 mg g-1, higher than those of Fe-based MIL adsorbents reported previously, which probably originates from its unique microstructure with abundant OH- groups and an unusual large swelling towards water. These show that Fe-based MIL-88A is a good candidate for arsenic removal.

Comparison of two types of catheters through femoral vein catheterization in patients with lung cancer undergoing chemotherapy: A retrospective study.

PURPOSE:: This study aimed to investigate the effects and complications of different types of peripherally inserted central catheters through femoral vein catheterization in patients with lung cancer undergoing chemotherapy. METHODS:: A retrospective analysis of 158 patients with lung cancer undergoing implantation of a venous access through femoral vein catheterization was performed. The patients were divided into two groups by convenience sampling: the single-lumen silicone Groshong peripherally inserted central catheters with valved tip were used in patients in group A, the single-lumen power-injectable polyurethane peripherally inserted central catheters with no valve were used in patients in group B. The gravity flow rate and indwelling time of the catheter and incidences of total obstruction, transient obstruction, irreversible obstruction, catheter-related thrombosis, catheter breakage, and accidental dislodgment were compared between the two groups. RESULTS:: The catheter indwelling time and incidences of irreversible obstruction, catheter-related thrombosis, and accidental dislodgment in the two groups were not statistically significantly different ( p > 0.05). The catheter gravity flow rate and incidences of total obstruction, transient obstruction, and catheter breakage were statistically significantly different between the two groups ( p < 0.01). CONCLUSION:: Single-lumen power-injectable peripherally inserted central catheters with no valve had a high gravity flow rate, were strong and not prone to rupture, tolerant to high-pressure injection, and were more suitable for femorally inserted central venous catheterization in patients with lung cancer undergoing chemotherapy.