Objective:With the continuous advancement of aging in China,the number of older inpatients has increased sharply.Older patients have a high demand for planning their discharge services.Nurses serve as the leader of di...Objective:With the continuous advancement of aging in China,the number of older inpatients has increased sharply.Older patients have a high demand for planning their discharge services.Nurses serve as the leader of discharge planning for patients;there is a lack of reliable evaluation tool to evaluate the core competitiveness of nurses who implement discharge planning for older patients in China.The purpose of this study was to validate the index for the core competence of nurses who lead discharge planning for older patients developed by a project team through the Delphi method in the early stage.Methods:A cross-sectional questionnaire survey with 3-stage stratified sampling was used to select 1075 nurses from 17 public general hospitals in Ningxia,China.Results:The index consists of 4 first-level indicators,13 second-level indicators,and 57 third-level indicators.The results show that 57 third-level indicators had good discrimination.With exploratory factor analysis(EFA),4 common factors that explained 72.79%of the total variance were extracted.The Cronbach's a was 0.98,and the retest reliability within a 14-d interval was 0.86.The confirmatory factor analysis(CFA)results show that the fit of the index structure was good.The criterion validity was 0.73.Conclusions:The index presented excellent psychometric proper ties and can be used to measure the core competence of nurses in implementing discharge planning for older patients in China.展开更多
Background:Acute pancreatitis(AP),known for its rapid onset and significant incidence and mortality rates,presents a clinical challenge due to the limited availability of effective treatments and preventive measures.A...Background:Acute pancreatitis(AP),known for its rapid onset and significant incidence and mortality rates,presents a clinical challenge due to the limited availability of effective treatments and preventive measures.Anemarsaponin B(ASB)has emerged as a potential therapeutic agent,demonstrating capabilities in reducing immune inflammation,positioning it as a promising candidate for AP treatment.Methods:We investigated the effects of ASB on AP in mice,induced by caerulein and lipopolysaccharide(LPS).Peripheral blood samples were collected 24 h post-induction with caerulein to assess of key biomarkers including lipase,amylase,TNF-α,IL-1β,IL-6,SOD,and GSH-Px.A range of techniques such as immunohistochemistry staining,immunofluorescence staining,Western blotting,and quantitative Polymerase Chain Reaction(q-PCR),were employed to measure the expression of critical genes.Additionally,pancreas samples from the mice were harvested for microbiome and metabolome sequencing,with the data analyzed to understand the impact of ASB on AP.Results:Our study revealed that,compared to the sham group,the AP group exhibited significantly higher serum levels of lipase,amylase,and cytokines,while levels of SOD and GSH Px were notably lower.Treatment with ASB led to a substantial decrease in the levels of lipase,amylase,and cytokines,and an increase in SOD and GSH-Px levels.q-PCR analysis of pancreatic histiocytes corroborated these serum findings.Hematoxylin and Eosin(H&E)staining indicated significant alterations in the pathological changes in the pancreas,lungs,and small intestine of the AP model due to ASB.Immunofluorescence assays demonstrated that ASB alleviated the apoptosis of pancreatic histiocytes in the AP model.Western Blot and histological analyses showed that ASB reduced the phosphorylation of TAK,p38,JNK,and ERK proteins,as well as the levels of TRAF6 protein in the AP model.Furthermore,metabolomic and gut microbiota analysis identified 27 differential metabolites and 34 differential species.The combined metabolome and microbiome analysis suggested an association between certain microbes(e.g.,unclassified-Saprospiraceae and unclassified-Micavibrionales)and metabolites(e.g.,LysoPE(0:0/20:0),PC(DiMe(13,5)/PGJ2)),and Heptanoic acid,indicating potential pathways through which ASB may exert its therapeutic effects in AP.Conclusions:ASB exhibits therapeutic efficacy in treating AP induced by caerulein combined with lipopolysaccharide(LPS),primarily through modulating the mitogenactivated protein kinase(MAPK)signaling pathway.This discovery offers fresh perspectives for AP drug development,underscoring the potential of targeting specific cellular pathways.Additionally,the intricate interplay observed between the gut microbiota and metabolites following ASB treatment highlights novel therapeutic targets,suggesting that manipulating the gut microbiome and metabolome could be a viable strategy in AP management.These findings pave the way for further research into comprehensive treatment approaches that incorporate both pharmacological intervention and microbiota modulation.展开更多
Product detection based on state abstraction technologies in the software product line(SPL)is more complex when compared to a single system.This variability constitutes a new complexity,and the counterexample may be v...Product detection based on state abstraction technologies in the software product line(SPL)is more complex when compared to a single system.This variability constitutes a new complexity,and the counterexample may be valid for some products but spurious for others.In this paper,we found that spurious products are primarily due to the failure states,which correspond to the spurious counterexamples.The violated products correspond to the real counterexamples.Hence,identifying counterexamples is a critical problem in detecting violated products.In our approach,we obtain the violated products through the genuine counterexamples,which have no failure state,to avoid the tedious computation of identifying spurious products dealt with by the existing algorithm.This can be executed in parallel to improve the efficiency further.Experimental results showthat our approach performswell,varying with the growth of the system scale.By analyzing counterexamples in the abstract model,we observed that spurious products occur in the failure state.The approach helps in identifying whether a counterexample is spurious or genuine.The approach also helps to check whether a failure state exists in the counterexample.The performance evaluation shows that the proposed approach helps significantly in improving the efficiency of abstraction-based SPL model checking.展开更多
By studying high-quality development process of Henan agriculture and rural areas empowered by digital inclusive finance,it is found that the construction of digital financial infrastructure in Henan Province is relat...By studying high-quality development process of Henan agriculture and rural areas empowered by digital inclusive finance,it is found that the construction of digital financial infrastructure in Henan Province is relatively complete,and the level of deposit and loan of rural enterprises and farmers is constantly improving,and the market and government are constantly upgrading the financial risk insurance compensation mechanism.At the same time,there are also problems such as insufficient demand and supply of digital finance,single digital financial products,and weak market supervision.Based on this,some implementation paths are proposed,such as continuing to strengthen the construction of rural financial infrastructure in Henan Province,improving farmers’financial literacy,and enriching digital financial products and services.The government should continue to improve the construction of market system,and broaden the market supervision and management,to actively promote the digitalization of agricultural finance to enable the high-quality development of agriculture and rural areas in Henan Province.展开更多
AIM To investigate the incidence and risk factors of portosplenomesenteric vein thrombosis(PSMVT) in the early stage of severe acute pancreatitis(SAP).METHODS Patients with SAP in a tertiary care setting from January ...AIM To investigate the incidence and risk factors of portosplenomesenteric vein thrombosis(PSMVT) in the early stage of severe acute pancreatitis(SAP).METHODS Patients with SAP in a tertiary care setting from January 2014 to December 2016 were retrospectively reviewed. All contrast-enhanced computed tomography(CT) studies were reassessed and reviewed. Clinical outcome measures were compared between SAP patients with and without PSMVT in the early stage of the disease. Univariate and multivariate logistic regression analyses were sequentially performed to assess potential risk factors for the development of PSMVT in SAP patients. A receiver operating characteristic(ROC) curve was generated for the qualifying independent risk factors.RESULTS Twenty-five of the one hundred and forty(17.86%) SAP patients developed PSMVT 6.19 ± 2.43 d after acute pancreatitis(AP) onset. PSMVT was confirmed by contrast-enhanced CT. Multivariate stepwise logistic regression analyses showed that Balthazar's CT severity index(CTSI) scores [odds ratio(OR): 2.742; 95% confidence interval(CI): 1.664-4.519; P = 0.000], hypoalbuminemia(serum albumin level < 25 g/L)(OR: 32.573; 95%CI: 2.711-391.353; P = 0.006) and gastrointestinal wall thickening(OR: 4.367, 95%CI: 1.218-15.658; P = 0.024) were independent risk factors for PSMVT developed in patients with SAP. The area under the ROC curve for Balthazar's CTSI scores was 0.777(P = 0.000), the sensitivity was 52%, and the specificity was 93% at a cut-off value of 5.5.CONCLUSION High Balthazar's CTSI scores, hypoalbuminemia and gastrointestinal wall thickening are independent risk factors for PSMVT developed in the early stage of SAP.展开更多
BACKGROUND Gastrointestinal(GI)dysfunction is a common and important complication of acute pancreatitis(AP),especially in patients with severe AP.Despite this,there is no consensus means of obtaining a precise assessm...BACKGROUND Gastrointestinal(GI)dysfunction is a common and important complication of acute pancreatitis(AP),especially in patients with severe AP.Despite this,there is no consensus means of obtaining a precise assessment of GI function.AIM To determine the association between acute gastrointestinal injury(AGI)grade and clinical outcomes in critically ill patients with AP.METHODS Patients with AP admitted to our pancreatic intensive care unit from May 2017 to May 2019 were enrolled.GI function was assessed according to the AGI grade proposed by the European Society of Intensive Care Medicine in 2012,which is mainly based on GI symptoms,intra-abdominal pressure,and feeding intolerance in the first week of admission to the intensive care unit.Multivariate logistic regression analysis was performed to assess the association between AGI grade and clinical outcomes in critically ill patients with AP.RESULTS Among the 286 patients included,the distribution of patients with various AGI grades was 34.62%with grade I,22.03%with grade II,32.52%with grade III,and 10.84%with grade IV.The distribution of mortality was 0%among those with grade I,6.35%among those with grade II,30.11%among those with grade III,and 61.29%among those with grade IV,and AGI grade was positively correlated with mortality(χ2=31.511,P<0.0001).Multivariate logistic regression analysis showed that age,serum calcium level,AGI grade,persistent renal failure,and persistent circulatory failure were independently associated with mortality.Compared with the Acute Physiology and Chronic Health Evaluation II score(area under the curve:0.739 vs 0.854;P<0.05)and Ranson score(area under the curve:0.72 vs 0.854;P<0.01),the AGI grade was more useful for predicting mortality.CONCLUSION AGI grade is useful for identifying the severity of GI dysfunction and can be used as a predictor of mortality in critically ill patients with AP.展开更多
This paper proposes a novel method of lane detection,which adopts VGG16 as the basis of convolutional neural network to extract lane line features by cavity convolution,wherein the lane lines are divided into dotted l...This paper proposes a novel method of lane detection,which adopts VGG16 as the basis of convolutional neural network to extract lane line features by cavity convolution,wherein the lane lines are divided into dotted lines and solid lines.Expanding the field of experience through hollow convolution,the full connection layer of the network is discarded,the last largest pooling layer of the VGG16 network is removed,and the processing of the last three convolution layers is replaced by hole convolution.At the same time,CNN adopts the encoder and decoder structure mode,and uses the index function of the maximum pooling layer in the decoder part to upsample the encoder in a counter-pooling manner,realizing semantic segmentation.And combined with the instance segmentation,and finally through the fitting to achieve the detection of the lane line.In addition,the currently disclosed lane line data sets are relatively small,and there is no distinction between lane solid lines and dashed lines.To this end,our work made a lane line data set for the lane virtual and real identification,and based on the proposed algorithm effective verification of the data set achieved by the increased segmentation.The final test shows that the proposed method has a good balance between lane detection speed and accuracy,which has good robustness.展开更多
基金supported by the Talent training project of General Hospital of Ningxia Medical University(No.XM2020163)the Nursing Young Talents Training Program of General Hospital of Ningxia Medical University(No.dangfa[2020]39)。
文摘Objective:With the continuous advancement of aging in China,the number of older inpatients has increased sharply.Older patients have a high demand for planning their discharge services.Nurses serve as the leader of discharge planning for patients;there is a lack of reliable evaluation tool to evaluate the core competitiveness of nurses who implement discharge planning for older patients in China.The purpose of this study was to validate the index for the core competence of nurses who lead discharge planning for older patients developed by a project team through the Delphi method in the early stage.Methods:A cross-sectional questionnaire survey with 3-stage stratified sampling was used to select 1075 nurses from 17 public general hospitals in Ningxia,China.Results:The index consists of 4 first-level indicators,13 second-level indicators,and 57 third-level indicators.The results show that 57 third-level indicators had good discrimination.With exploratory factor analysis(EFA),4 common factors that explained 72.79%of the total variance were extracted.The Cronbach's a was 0.98,and the retest reliability within a 14-d interval was 0.86.The confirmatory factor analysis(CFA)results show that the fit of the index structure was good.The criterion validity was 0.73.Conclusions:The index presented excellent psychometric proper ties and can be used to measure the core competence of nurses in implementing discharge planning for older patients in China.
基金sponsored by Natural Science Foundation of Chongqing,China(cstc2021jcyjmsxmX0724,cstc2020jcyj-msxmX0434),Chongqing Key Specialty Fund of Clinical Pharmacy.
文摘Background:Acute pancreatitis(AP),known for its rapid onset and significant incidence and mortality rates,presents a clinical challenge due to the limited availability of effective treatments and preventive measures.Anemarsaponin B(ASB)has emerged as a potential therapeutic agent,demonstrating capabilities in reducing immune inflammation,positioning it as a promising candidate for AP treatment.Methods:We investigated the effects of ASB on AP in mice,induced by caerulein and lipopolysaccharide(LPS).Peripheral blood samples were collected 24 h post-induction with caerulein to assess of key biomarkers including lipase,amylase,TNF-α,IL-1β,IL-6,SOD,and GSH-Px.A range of techniques such as immunohistochemistry staining,immunofluorescence staining,Western blotting,and quantitative Polymerase Chain Reaction(q-PCR),were employed to measure the expression of critical genes.Additionally,pancreas samples from the mice were harvested for microbiome and metabolome sequencing,with the data analyzed to understand the impact of ASB on AP.Results:Our study revealed that,compared to the sham group,the AP group exhibited significantly higher serum levels of lipase,amylase,and cytokines,while levels of SOD and GSH Px were notably lower.Treatment with ASB led to a substantial decrease in the levels of lipase,amylase,and cytokines,and an increase in SOD and GSH-Px levels.q-PCR analysis of pancreatic histiocytes corroborated these serum findings.Hematoxylin and Eosin(H&E)staining indicated significant alterations in the pathological changes in the pancreas,lungs,and small intestine of the AP model due to ASB.Immunofluorescence assays demonstrated that ASB alleviated the apoptosis of pancreatic histiocytes in the AP model.Western Blot and histological analyses showed that ASB reduced the phosphorylation of TAK,p38,JNK,and ERK proteins,as well as the levels of TRAF6 protein in the AP model.Furthermore,metabolomic and gut microbiota analysis identified 27 differential metabolites and 34 differential species.The combined metabolome and microbiome analysis suggested an association between certain microbes(e.g.,unclassified-Saprospiraceae and unclassified-Micavibrionales)and metabolites(e.g.,LysoPE(0:0/20:0),PC(DiMe(13,5)/PGJ2)),and Heptanoic acid,indicating potential pathways through which ASB may exert its therapeutic effects in AP.Conclusions:ASB exhibits therapeutic efficacy in treating AP induced by caerulein combined with lipopolysaccharide(LPS),primarily through modulating the mitogenactivated protein kinase(MAPK)signaling pathway.This discovery offers fresh perspectives for AP drug development,underscoring the potential of targeting specific cellular pathways.Additionally,the intricate interplay observed between the gut microbiota and metabolites following ASB treatment highlights novel therapeutic targets,suggesting that manipulating the gut microbiome and metabolome could be a viable strategy in AP management.These findings pave the way for further research into comprehensive treatment approaches that incorporate both pharmacological intervention and microbiota modulation.
基金supported by the Fund of ExcellentYouth Scientific and Technological Innovation Team of Hubei’s Universities(Project No:T201818)Science and Technology Research Program of Hubei Provincial Education Department(Project No:Q20143005)Guiding project of scientific research plan of Hubei Provincial Department of Education(Project No:B2021261).
文摘Product detection based on state abstraction technologies in the software product line(SPL)is more complex when compared to a single system.This variability constitutes a new complexity,and the counterexample may be valid for some products but spurious for others.In this paper,we found that spurious products are primarily due to the failure states,which correspond to the spurious counterexamples.The violated products correspond to the real counterexamples.Hence,identifying counterexamples is a critical problem in detecting violated products.In our approach,we obtain the violated products through the genuine counterexamples,which have no failure state,to avoid the tedious computation of identifying spurious products dealt with by the existing algorithm.This can be executed in parallel to improve the efficiency further.Experimental results showthat our approach performswell,varying with the growth of the system scale.By analyzing counterexamples in the abstract model,we observed that spurious products occur in the failure state.The approach helps in identifying whether a counterexample is spurious or genuine.The approach also helps to check whether a failure state exists in the counterexample.The performance evaluation shows that the proposed approach helps significantly in improving the efficiency of abstraction-based SPL model checking.
文摘By studying high-quality development process of Henan agriculture and rural areas empowered by digital inclusive finance,it is found that the construction of digital financial infrastructure in Henan Province is relatively complete,and the level of deposit and loan of rural enterprises and farmers is constantly improving,and the market and government are constantly upgrading the financial risk insurance compensation mechanism.At the same time,there are also problems such as insufficient demand and supply of digital finance,single digital financial products,and weak market supervision.Based on this,some implementation paths are proposed,such as continuing to strengthen the construction of rural financial infrastructure in Henan Province,improving farmers’financial literacy,and enriching digital financial products and services.The government should continue to improve the construction of market system,and broaden the market supervision and management,to actively promote the digitalization of agricultural finance to enable the high-quality development of agriculture and rural areas in Henan Province.
基金funded by the foundation of the Key Laboratory of Ethnomedicine(Minzu University of China),the Ministry of Education(KLEM-ZZ201903,KLEM-ZZ2020GD01)the Natural Science Foundation of Ningxia(2021AAC03358)funded by the National Natural Science Foundation of China(81901682)
基金Supplementary information is linked to the online version of the paper on Cell Research website.
Acknowledgments This work was supported by the National Natural Scientific Foundation of China (30901714, 30671070 and 30771107), the Ministry of Science and Technology of China (2007CB914500), the Ministry of Education of China (NCET-06-0530), the Ministry of Health of China (WKJ2006-2-014), the Postdoctoral Science Foundation of China (20070421179), the Department of Science and Technology of Zhejiang Province (2009F80032), and the Natural Scientific Foundation of Zhejiang Province, China (R205291, Y206103 and 2007R10G2010103).
基金the National Natural Science Foundation of China,No.81760120
文摘AIM To investigate the incidence and risk factors of portosplenomesenteric vein thrombosis(PSMVT) in the early stage of severe acute pancreatitis(SAP).METHODS Patients with SAP in a tertiary care setting from January 2014 to December 2016 were retrospectively reviewed. All contrast-enhanced computed tomography(CT) studies were reassessed and reviewed. Clinical outcome measures were compared between SAP patients with and without PSMVT in the early stage of the disease. Univariate and multivariate logistic regression analyses were sequentially performed to assess potential risk factors for the development of PSMVT in SAP patients. A receiver operating characteristic(ROC) curve was generated for the qualifying independent risk factors.RESULTS Twenty-five of the one hundred and forty(17.86%) SAP patients developed PSMVT 6.19 ± 2.43 d after acute pancreatitis(AP) onset. PSMVT was confirmed by contrast-enhanced CT. Multivariate stepwise logistic regression analyses showed that Balthazar's CT severity index(CTSI) scores [odds ratio(OR): 2.742; 95% confidence interval(CI): 1.664-4.519; P = 0.000], hypoalbuminemia(serum albumin level < 25 g/L)(OR: 32.573; 95%CI: 2.711-391.353; P = 0.006) and gastrointestinal wall thickening(OR: 4.367, 95%CI: 1.218-15.658; P = 0.024) were independent risk factors for PSMVT developed in patients with SAP. The area under the ROC curve for Balthazar's CTSI scores was 0.777(P = 0.000), the sensitivity was 52%, and the specificity was 93% at a cut-off value of 5.5.CONCLUSION High Balthazar's CTSI scores, hypoalbuminemia and gastrointestinal wall thickening are independent risk factors for PSMVT developed in the early stage of SAP.
基金Supported by the National Natural Science Foundation of China,No.81760120
文摘BACKGROUND Gastrointestinal(GI)dysfunction is a common and important complication of acute pancreatitis(AP),especially in patients with severe AP.Despite this,there is no consensus means of obtaining a precise assessment of GI function.AIM To determine the association between acute gastrointestinal injury(AGI)grade and clinical outcomes in critically ill patients with AP.METHODS Patients with AP admitted to our pancreatic intensive care unit from May 2017 to May 2019 were enrolled.GI function was assessed according to the AGI grade proposed by the European Society of Intensive Care Medicine in 2012,which is mainly based on GI symptoms,intra-abdominal pressure,and feeding intolerance in the first week of admission to the intensive care unit.Multivariate logistic regression analysis was performed to assess the association between AGI grade and clinical outcomes in critically ill patients with AP.RESULTS Among the 286 patients included,the distribution of patients with various AGI grades was 34.62%with grade I,22.03%with grade II,32.52%with grade III,and 10.84%with grade IV.The distribution of mortality was 0%among those with grade I,6.35%among those with grade II,30.11%among those with grade III,and 61.29%among those with grade IV,and AGI grade was positively correlated with mortality(χ2=31.511,P<0.0001).Multivariate logistic regression analysis showed that age,serum calcium level,AGI grade,persistent renal failure,and persistent circulatory failure were independently associated with mortality.Compared with the Acute Physiology and Chronic Health Evaluation II score(area under the curve:0.739 vs 0.854;P<0.05)and Ranson score(area under the curve:0.72 vs 0.854;P<0.01),the AGI grade was more useful for predicting mortality.CONCLUSION AGI grade is useful for identifying the severity of GI dysfunction and can be used as a predictor of mortality in critically ill patients with AP.
基金the National Natural Science Foundation of China(61772386)Joint fund project(nsfc-guangdong big data science center project),project number:U1611262,Hubei University of Science and Technology,Master of Engineering,special construction,project number:2018-19GZ01,Hubei University of Science and Technology Teaching Reform Project,project number:2018-XB-023,S201910927028.
文摘This paper proposes a novel method of lane detection,which adopts VGG16 as the basis of convolutional neural network to extract lane line features by cavity convolution,wherein the lane lines are divided into dotted lines and solid lines.Expanding the field of experience through hollow convolution,the full connection layer of the network is discarded,the last largest pooling layer of the VGG16 network is removed,and the processing of the last three convolution layers is replaced by hole convolution.At the same time,CNN adopts the encoder and decoder structure mode,and uses the index function of the maximum pooling layer in the decoder part to upsample the encoder in a counter-pooling manner,realizing semantic segmentation.And combined with the instance segmentation,and finally through the fitting to achieve the detection of the lane line.In addition,the currently disclosed lane line data sets are relatively small,and there is no distinction between lane solid lines and dashed lines.To this end,our work made a lane line data set for the lane virtual and real identification,and based on the proposed algorithm effective verification of the data set achieved by the increased segmentation.The final test shows that the proposed method has a good balance between lane detection speed and accuracy,which has good robustness.