Survey on the Readiness for Hospital Discharge and Its Influencing Factors among Patients with Cardiac Valve Replacement

Background: There are about 200,000 patients in China who need to undergo valve replacement surgery each year. With the promotion and application of the Fast-Track Surgery concept and the increase in hospital bed turnover rate, the average hospital stay of patients undergoing CVR surgery has been significantly shortened, and thus the patients are still in the recovery stage rather than fully recovered when they are discharged from the hospital. Good preparation for discharge can improve patients’ post-discharge self-care ability, reduce the risk of re-admission, and save medical resources. Objective: To describe the status of readiness for hospital discharge among postoperative patients that have undergone CVR, and to explore its influencing factors. Methods: The general information questionnaire, the Readiness for Hospital Discharge Scale and the Quality of discharge Teaching Scale were utilized to investigate 130 post-CVR patients admitted to the Cardiothoracic Surgery Department of a tertiary A-Class hospital in Guangzhou from July 2019 to October 2020. Results: The Readiness for Hospital Discharge Scale was at a moderate level with a total score of 163.88 ± 39.082, while the Quality of Discharge Teaching Scale was also at a moderate level with a total score of 194.09 ± 40.643. Multiple linear regression analysis revealed that the quality of discharge guidance, gender, and occupation were the influencing factors of CVR patient’s readiness for hospital discharge. These three variables jointly explained 45.8% of the total variation. Conclusion: The level of CVR patients’ readiness for hospital discharge is at a moderate level, and the quality of discharge guidance positively affects patients’ readiness for discharge. Therefore, in clinical work, attention should be paid to patient discharge guidance. Personalized health education should be implemented to improve the quality of patient guidance.

A high-quality genome provides insights into the new taxonomic status and genomic characteristics of Cladopus chinensis(Podostemaceae)

The Podostemaceae are ecologically and morphologically unusual aquatic angiosperms that survive only in rivers with pristine hydrology and high water quality and are at a relatively high risk of extinction.The taxonomic status of Podostemaceae has always been controversial.Here,we report the first high-quality genome assembly for Cladopus chinensis of Podostemaceae,obtained by incorporating Hi-C,Illumina and PacBio sequencing.We generated an 827.92 Mb genome with a contig N50 of 1.42 Mb and 27,370 annotated protein-coding genes.The assembled genome size was close to the estimated size,and 659.42 Mb of the assembly was assigned to 29 superscaffolds(scaffold N5021.22 Mb).A total of 59.20%repetitive sequences were identified,among which long terminal repeats(LTRs)were the most abundant class(28.97%of the genome).Genome evolution analysis suggested that the divergence time of Cladopus chinensis(106 Mya)was earlier than that of Malpighiales(82 Mya)and that this taxon diverged into an independent branch of Podestemales.A recent whole-genome duplication(WGD)event occurred 4.43 million years ago.Comparative genomic analysis revealed that the expansion and contraction of oxidative phosphorylation,photosynthesis and isoflavonoid metabolism genes in Cladopus chinensis are probably related to the genomic characteristics of this growing submerged species.Transcriptome analysis revealed that upregulated genes in the shoot group compared to the root group were enriched in the NAC gene family and transcription factors associated with shoot development and defense responses,including WUSCHEL(WUS),ASYMMETRIC LEAVES(ASL),SHOOT MERISTEMLESS(STM),NAC2,NAC8,NAC29,NAC47,NAC73,NAC83 and NAC102.These findings provide new insights into the genomic diversity of unusual aquatic angiosperms and serve as a valuable reference for the taxonomic status and unusual shoot apical meristem of Podostemaceae.

Analysis of the Current Status and Influencing Factors of the Readiness for Discharge of Patients after Prostate Cancer Surgery Based on the Concept of Enhanced Recovery after Surgery (ERAS)

Objective To investigate the level of readiness for discharge of patients after prostate cancer surgery based on the concept of Enhanced Recovery After Surgery (ERAS), and to explore its influencing factors, so as to provide references for improving the readiness for discharge of patients after prostate cancer surgery. Methods The general information questionnaire, the discharge preparation scale, and the discharge guidance quality scale were used to investigate 119 patients discharged from the urological surgery department of a tertiary A-level hospital in Guangzhou after radical prostatectomy. Results The total score of discharge readiness of patients after radical prostatectomy was 147.74 ± 35.71 points, which was at a lower middle level and the total score of discharge guidance quality was 180.68 ± 38.91 points, which was at a medium level. Multiple linear regression analysis showed that education level, family monthly income, Gleason score, whether to perform lymphatic dissection, whether to discharge with a urinary catheter, and the quality of discharge guidance were the main factors influencing the readiness for discharge of patients after prostate cancer surgery. Conclusion In clinical nursing work, it is necessary to implement individualized health education according to the characteristics and needs of different patients to improve the level of preparation for discharge of patients after prostate cancer surgery.

Insights into salvianolic acid B biosynthesis from chromosome-scale assembly of the Salvia bowleyana genome

Salvia bowleyanais a traditional Chinese medic-inal plant that is a source of nutritional supple-ments rich in salvianolic acid B and a potentialexperimental system for the exploration ofsalvianolic acid B biosynthesis in the Labiatae.Here,we report a high‐quality chromosome‐scalegenome assembly of S.bowleyana covering 462.44 Mb,with a scaffold N50 value of 57.96 Mband 44,044 annotated protein‐coding genes.Evolutionary analysis revealed an estimateddivergence time betweenS.bowleyanaand its close relativeS.miltiorrhiza of~3.94 millionyears.We also observed evidence of a whole‐genome duplication in theS.bowleyanagenome.Transcriptome analysis showed that SbPAL1(PHENYLALANINE AMMONIA‐LYASE1)ishighlyexpressed in roots relative to stem and leaves,paralleling the location of salvianolic acid Baccumulation.The laccase gene family in S.bowley anaoutnumbered their counterparts inbothS.miltiorrhiza and Arabidopsis thaliana,suggesting that the gene family has undergoneexpansion inS.bowleyana.Several laccasegenes were also highly expressed in roots,wheretheir encoded proteins may catalyze the oxida-tive reaction from rosmarinic acid to salvianolicacid B.Thesefindings provide an invaluable ge-nomic resource for understanding salvianolicacid B biosynthesis and its regulation,and will beuseful for exploring the evolution of the Labiatae.

Multi-omics Analyses Provide Insight into the Biosynthesis Pathways of Fucoxanthin in Isochrysis galbana

Isochrysis galbana is considered an ideal bait for functional foods and nutraceuticals of humans because of its high fucoxanthin(Fx)content.However,multi-omics analysis of the regulatory networks for Fx biosynthesis in I.galbana has not been reported.In this study,we report a high-quality genome assembly of I.galbana LG007,which has a genome size of 92.73 Mb,with a contig N50 of 6.99 Mb and 14,900 protein-coding genes.Phylogenetic analysis confirmed the monophyly of Haptophyta,with I.galbana sister to Emiliania huxleyi and Chrysochromulina tobinii.Evolutionary analysis revealed an estimated divergence time between I.galbana and E.huxleyi of~133 million years ago.Gene family analysis indicated that lipid metabolism-related genes exhibited significant expansion,including IgPLMT,IgOAR1,and IgDEGS1.Metabolome analysis showed that the content of carotenoids in I.galbana cultured under green light for 7 days was higher than that under white light,andβ-carotene was the main carotenoid,accounting for 79.09%of the total carotenoids.Comprehensive multi-omics analysis revealed that the content ofβ-carotene,antheraxanthin,zeaxanthin,and Fx was increased by green light induction,which was significantly correlated with the expression of IgMYB98,IgZDS,IgPDS,IgLHCX2,IgZEP,IgLCYb,and IgNSY.These findings contribute to the understanding of Fx biosynthesis and its regulation,providing a valuable reference for food and pharmaceutical applications.