Liquid biopsy, analyzing circulating tumor-derived components, including ctDNA, circulating tumor cells, microRNAs, and exosomes, has emerged as a key tool in precision oncology. This review synthesizes evidence from the past five years, covering biological mechanisms, analytical platforms, clinical applications, and implementation barriers. Evidence from multiple clinical studies suggests ctDNA shows higher sensitivity for metastatic disease monitoring than conventional biomarkers such as CA15-3 and circulating tumor cells. For minimal residual disease detection, tumor-informed assays demonstrate sensitivity of 88%-100% and provide a median lead time of 8-15 months before clinical relapse. Despite these advances, early-stage cancer detection remains suboptimal, cost-effectiveness evidence is limited, and disparities in access are increasing. We critically evaluate current technologies and translational gaps and highlight the need for standardized clinical integration pathways. Overall, liquid biopsy is transitioning from a complementary diagnostic tool toward a longitudinal framework for cancer management, although substantial methodological and systemic challenges remain.

Objective This study aimed to develop and compare machine learning models for predicting clinical outcomes—Complete Remission (CR), partial relief (PR), and Relapse—in patients with idiopathic membranous nephropathy (IMN). We specifically evaluated whether incorporating temporal summary features derived from longitudinal laboratory data could enhance predictive performance beyond baseline measurements. Methods We conducted a retrospective cohort study of 336 IMN patients from Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou (2021–2024). Predictors included demographic characteristics, lifestyle factors (smoking, alcohol consumption), and laboratory parameters. For each laboratory variable, we constructed a comprehensive feature set comprising baseline values, mean, maximum, minimum, and change from 0–12 weeks. The dataset was partitioned into training and test sets, and we compared three machine learning approaches: Random Forest (RF), XGBoost, and Multinomial Logistic Regression (MLR), using 5-fold cross-validation for hyperparameter tuning. Results The tree-based ensemble models demonstrated superior predictive capability. XGBoost achieved the highest overall accuracy (0.754), followed closely by random forest. Multinomial Logistic Regression showed moderately lower performance. Critically, models utilizing the temporal summary feature set consistently outperformed those relying solely on baseline data across all algorithms. Conclusions Tree-based ensemble models, particularly XGBoost and Random Forest, effectively predict clinical outcomes in idiopathic membranous nephropathy when incorporating temporal feature engineering from longitudinal laboratory data. XGBoost demonstrated superior performance in relapse prediction (AUC = 0.948), while Random Forest achieved balanced multiclass performance (Macro-AUC = 0.935). These approaches offer promising avenues for risk stratification and personalized treatment planning in IMN management, warranting further validation in multi-center settings.

BACKGROUND:The Sanqi Qushi Formula (SQQS) is a traditional Chinese medicine comprising seven herbs, namely Astragali Radix, Curcumae Rhizoma, Notoginseng Radix Et Rhizoma, Radix Padoniae Rubra, Smilacis Glabrae Rhizoma, Atractylodis Macrocephalae Rhizoma, and Cordyceps Sinensis. While SQQS is widely used in clinics to treat membranous nephropathy (MN), the molecular mechanisms responsible for its therapeutic effects remain unclear. PURPOSE:This study sought to explore the nephroprotective activity of SQQS, as well as its molecular mechanism in treating MN. METHODS:The nephroprotective effects of SQQS were assessed in experimental Passive Heymann nephritis (PHN) rats. The chemical components of SQQS's freeze-dried powder and rat plasma were identified using UPLC-Q-Exactive-MS. For the mechanism exploration, network pharmacology was integrated with RNA-seq transcriptomics to explore its underlying multi-dimensional correlations. To investigate whether SQQS could alleviate podocyte damage by inhibiting GPX4 deficiency-mediated ferroptosis, a RSL3-induced podocyte model was established. The protein expression in the candidate signaling pathway was evaluated. Molecular docking experiments, molecular dynamics simulation analyses (MDS), bioactivity tests, and surface plasmon resonance technology (SPR) were conducted to explore the pharmacodynamic molecule of SQQS. RESULTS:SQQS administration significantly ameliorated 24 h proteinuria, elevated serum albumin (ALB), and reduced the levels of serum creatinine (Scr), blood urea nitrogen (BUN), and total cholesterol (TC). Besides, SQQS alleviated glomerular pathological damage in PHN rats, decreased IgG and C3 deposition, and reversed the aberrant expression of podocyte damage-related protein. Moreover, SQQS treatment alleviated mitochondrial injury, upregulated the levels of glutathione peroxidase 4 (GPX4), cystine/glutamate antiporter xCT, glutathione (GSH), and superoxide dismutase (SOD), and reduced malondialdehyde (MDA) content and Acyl-CoA synthetase long chain-family member 4 (ACSL4) expression, as well as iron deposition in PHN rats. A total of 248 compounds were detected in the freeze-dried powder of SQQS, with 105 compounds identified in the rat plasma, of which 41 components were common to both in vitro and in plasma samples. Integrative investigations using network pharmacology and RNA-seq transcriptomics identified the JNK/FoxO1/GPX4 signaling pathway as a candidate therapeutic target. Further studies exhibited that SQQS reduced nuclear FoxO1 and p-JNK, and elevated p-FoxO1 and total FoxO1. In vitro experiments with SQQS-containing serum (SQQSCS) increased cell viability and reduced Fe2+ levels, oxidative stress, lipid peroxidation, and mitochondrial injury. Furthermore, our results indicated that SQQSCS yielded a significant regulatory effect on the proteins of the JNK/FoxO1/GPX4 signaling pathway. A core protein intervention experiment showed that SQQS promotion of GPX4 expression was related to the nuclear translocation of FoxO1, regulated by p-JNK. Finally, molecular docking, molecular dynamics simulations, bioactivity tests, and SPR studies showed that Baicalein and Paeoniflorin, two major compounds in SQQS, upregulated the expression of GPX4 to inhibit ferroptosis in PHN rats by targeting JNK1. CONCLUSIONS:These results suggest that SQQS may alleviate podocyte damage by inhibiting GPX4 deficiency-mediated ferroptosis through targeting JNK1 to decrease the nuclear translocation of FoxO1.

OBJECTIVE: To reach consensus on the diagnostic criteria of syndrome of dampness obstruction in idiopathic membranous nephropathy(IMN) patients by literature research and expert investigation(interviews and a Delphi method). METHODS: Our study was consistent with T/CACM 1336-2020. We searched the monographs and references published in the past 40 years(1983-2022), and established the diagnostic criteria pool of waterdampness syndrome and dampness-turbidity syndrome in Traditional Chinese Medicine(TCM) based on literature by using frequency statistics and correlation analysis. Expert investigation(interview method and two rounds of Delphi method) was used to form the diagnostic criteria of water-dampness syndrome and dampnessturbidity syndrome of idiopathic membranous nephropathy. Clinical diagnostic test research was carried out, and compared with “Diagnostic Criteria for dampness syndrome”(T/CACM 1454-2023) to evaluate the authenticity, reliability and clinical application value of the standard. RESULTS: A total of 122 relevant guides, standards, monographs and documents were included through searching books and Chinese databases. Four experts were interviewed and two rounds of delphi method(75 experts nationwide) were carried out. The experts' opinions are relatively concentrated and the differences are small. Based on the weight of each index, the diagnostic criteria indexes of water-dampness syndrome and dampness-turbidity syndrome were selected. After discussion by the core group members, the diagnostic model of "necessary symptoms and optional symptoms" was established, and the final diagnostic criteria of waterdampness syndrome and dampness-turbidity syndrome were established. One hundred and ninety-one inpatients and outpatients of Guangdong Provincial Hospital of Chinese Medicine from January 2021 to February 2023 were included in Diagnostic test study. There was no statistical difference in gender, age and course of disease(P > 0.05). The sensitivity and specificity of the trial standard were 90.34% and 73.33% respectively, while the sensitivity and specificity of T/CACM 1454-2023 were 99.43% and 6.67%, respectively. CONCLUSIONS: The consensus-based diagnostic criteria for IMN can be widely incorporated in TCM. A further clinical study will be conducted to analyze the diagnosis value and cut-off score of our IMN criteria.

Gut microbiota and intratumoral microbiota have been recognized as critical regulators of tumor initiation and progression, with their metabolites exerting multifaceted effects on cancer development. This review systematically summarizes the roles and mechanistic classifications of microbial metabolites in tumor metabolic reprogramming, highlighting three principal regulatory layers: direct modulation of metabolic enzyme activity, regulation via signaling pathways, and immunometabolic modulation. Furthermore, it discusses the potential of microbial metabolites in regulating immune cell metabolism and enhancing immunotherapeutic efficacy, alongside summarizing the progress of relevant clinical studies. Finally, the review emphasizes that despite significant advances, current research still faces multiple challenges. Future investigations integrating cutting-edge technologies are essential to accelerate the translation of fundamental findings into clinical applications and to promote the development of metabolite-centered precision therapeutic strategies.

Background:Idiopathic membranous nephropathy (IMN) is a rare autoimmune disorder that causes nephrotic syndromes in adults. Conventional immunosuppressive therapies often exhibit limited efficacy in achieving remission and may result in notable adverse reactions, warranting the exploration of novel therapeutic approaches for IMN treatment. Traditional Chinese medicine (TCM), which is extensively used for kidney disease management, is a promising alternative. Objective:This study aimed to examine the safety and efficacy of TCM alone or in combination with Western medicine for the management of patients diagnosed with IMN. Methods:This study employed a systematic search of English and Chinese electronic databases to identify randomized controlled trials (RCTs) that examined the application of TCM in the treatment of IMN. RCTs that met the predetermined inclusion and exclusion criteria and assessed the safety and efficacy of TCM alone or in combination with Western medicine in patients with IMN were included in the analysis. The methodological quality of the included studies was evaluated by using a risk-of-bias tool. All statistical analyses were performed using the RevMan software (version 5.4.2). The evidence was evaluated on the https://www.gradepro.org/website. Results:This study included 29 randomized controlled trials (RCTs) involving 1982 patients with moderate methodological quality that met the inclusion criteria. The results showed that, compared to Western medicine alone therapy, the use of TCM alone or in combination with Western medicine significantly improved total remission (TR) rate (risk ratios [RR] 1.38, 95% confidence interval [CI] 1.29-1.46, I2 = 0%, P < 0.00001), complete remission (CR) rate (RR 1.78, 95% CI 1.48-2.15, I2 = 0, P < 0.00001), partial remission (PR) rate (RR 1.27, 95% CI 1.161.40, I2 = 0%, P < 0.00001), and serum albumin (ALB) levels (MD: 4.05, 95% CI: 3.02-5.09, I2 = 91%, P < 0.00001). TCM alone or in combination with Western medicine also reduced proteinuria levels (mean difference [MD]: 1.05, 95% CI: 1.30 to -0.79, I2 = 95%, P < 0.00001), serum creatinine (SCr) levels (MD: 7.47, 95% CI: 13.70 to -1.24, I2 = 97%, P = 0.02), and serum antibodies against M-type phospholipase A2 receptor levels (aPLA2Rab) (MD: 19.24, 95% CI: 33.56 to -4.93, I2 = 87%, P = 0.008). Moreover, the efficacy of combined TCM and Western medicine is superior to that of Western medicine alone in reducing the incidence of infection, hepatotoxicity, and thrombosis. Although the primary and secondary outcomes were consistent, the evidence was generally moderate. Conclusion:The results of this study suggest that TCM alone or in combination with Western medicine may be a feasible alternative therapeutic approach for the treatment of IMN. Nevertheless, additional, rigorously designed, high-quality, and extensive clinical trials are imperative to provide substantial evidence regarding the effectiveness of TCM in managing IMN.

BACKGROUND:Membranous nephropathy (MN) is a chronic glomerular disease that leads to nephrotic syndrome in adults. The aim of this study was to identify novel biomarkers and immune-related mechanisms in the progression of MN through an integrated bioinformatics approach.METHODS:The microarray data were downloaded from the Gene Expression Omnibus (GEO) database. The differentially expressed genes (DEGs) between MN and normal samples were identified and analyzed by the Gene Ontology analysis, the Kyoto Encyclopedia of Genes and Genomes analysis and the Gene Set Enrichment Analysis (GSEA) enrichment. Hub The hub genes were screened and identified by the weighted gene co-expression network analysis (WGCNA) and the least absolute shrinkage and selection operator (LASSO) algorithm. The receiver operating characteristic (ROC) curves evaluated the diagnostic value of hub genes. The single-sample GSEA analyzed the infiltration degree of several immune cells and their correlation with the hub genes.RESULTS:We identified a total of 574 DEGs. The enrichment analysis showed that metabolic and immune-related functions and pathways were significantly enriched. Four co-expression modules were obtained using WGCNA. The candidate signature genes were intersected with DEGs and then subjected to the LASSO analysis, obtaining a total of 6 hub genes. The ROC curves indicated that the hub genes were associated with a high diagnostic value. The CD4+ T cells, CD8+ T cells and B cells significantly infiltrated in MN samples and correlated with the hub genes.CONCLUSIONS:We identified six hub genes (ZYX, CD151, N4BP2L2-IT2, TAPBP, FRAS1 and SCARNA9) as novel biomarkers for MN, providing potential targets for the diagnosis and treatment.

CD19+CD24hiCD38hi regulatory B cells exert immunosuppressive functions by producing IL-10, but their role in idiopathic membranous nephropathy (IMN) remains elusive. Here, we investigated the frequency and functional changes of circulating CD19+CD24hiCD38hi B cells and evaluated the correlation of CD19+CD24hiCD38hi B cells with clinical features and T helper cell subsets in IMN patients. Compared with healthy controls (HCs), IMN patients showed an increased frequency of CD19+CD24hiCD38hi B cells, but a significant reduction in the percentage of CD19+CD24hiCD38hi B cells was observed 4 weeks after cyclophosphamide treatment. The frequency of CD19+CD24hiCD38hi B cells was positively correlated with the levels of 24h urinary protein, but negatively correlated with serum total protein and serum albumin, respectively. CD19+CD24hiCD38hi B cells in IMN patients displayed a skewed pro-inflammatory cytokine profile with a higher level of IL-6 and IL-12, but a lower concentration of IL-10 than their healthy counterparts. Accompanied by upregulation of Th2 and Th17 cells in IMN patients, the percentage of CD19+CD24hiCD38hi B cell subset was positively associated with Th17 cell frequency. In conclusion, CD19+CD24hiCD38hi B cells were expanded but functionally impaired in IMN patients. Their altered pro-inflammatory cytokine profile may contribute to the pathogenesis of IMN.

Objective To explore the application effect of check-list nursing round in clinical teaching. Methods A total of 96 nursing students who practiced in the Second Affiliated Hospital of Guangzhou University of Chinese Medicine from December 2019 to November 2021 were selected and randomly divided into observation group and control group according to random number table method, with 48 students in each group. The control group adopted the conventional ward round method in nursing clinical teaching, and the observation group adopted the check-list nursing ward round mode to teach. The two groups of students were compared in the theoretical assessment results, logical thinking assessment of disease analysis, skill assessment results and the level of nurse-patient communication. Results The students in the observation group were higher than those in the control group in theoretical assessment and logical thinking assessment of disease analysis, The difference was statistically significant (P ＜ 0.01). Conclusion The application effect of check-list nursing round in clinical nursing teaching is remarkable, worthy of clinical promotion.

目的:调查分析原发性膜性肾病常见的中医证型分布特点.方法:以系统整理文献资料为基础,结合临床专家及方法学专家意见,制作原发性膜性肾病中医证型专家调查问卷,采取线上发放问卷、线上回收的方式进行调查.结果:文献调研发现膜性肾病多为本虚标实证,本证以脾肾阳虚证为主,标证以湿热证居多.专家调查共发放问卷72份,回收71份,回收率为98.61％(71/72),常见证型本证以脾肾气虚证、脾肾阳虚证为主,标证以水湿证、湿热证、湿浊证为主.专家所在单位按照地理干湿区域划分为湿润区和半湿润区,两组水湿证和湿热证比较,差异无统计学意义(P＞0.05).湿润地区湿浊证频率(77.97％)高于半湿润地区(50.00％),水气证频率(22.03％)低于半湿润区(50.00％),差异均有统计学意义(P＜0.05).结论:原发性膜性肾病属于本虚标实之证,虚以脾肾气(阳)虚证为主,实以湿证为主,在湿润区尤以湿浊证为典型表现,提示了三因制宜的重要性.

目的 了解血液透析患者的心理痛苦现状并分析心理痛苦与自我管理行为及希望水平的相关性.方法 选取2017年1月-2019年7月在我院肾内科住院部的114例血透患者做为研究对象,采用患者一般资料、心理痛苦筛查量表、自我管理行为量表和中文版Herth希望量表进行调查.结果 血液透析患者的心理痛苦评分为(69.99±8.60)分,处于中度水平;心理痛苦与自我管理行为及希望水平呈负相关(r=-0.532,P＜0.01;r=--0.497,P＜0.01);性别、文化程度、家庭月收入、医疗付费、居住情况及每周透析次数与心理痛苦存在相关性;回归分析发现,性别、文化程度、家庭月收入、工作情况、居住情况及透析次数与心理痛苦存在线性关系;文化程度、婚姻状况、居住情况及生活自理能力与自我管理存在线性关系;文化程度、婚姻状况、家庭月收入、工作情况及透析时间与患者希望水平存在线性关系.结论 血液透析患者心理痛苦普遍存在,医护人员应积极关注患者心理痛苦现状,提高患者自我管理能力和希望水平.

血液透析是提高终末期肾脏病患者生活质量的重要方式之一[1] ,我国近10年内的血液透析患者血管通路仍主要以动静脉内瘘为主[2].而功能良好的血管通路不仅能延长透析患者的生命,还可提高其生活质量[3].尽可能地延长透析通路的使用时间对于保障患者生存质量具有重要意义[4].然而,在临床上,内瘘穿刺处止血按压的时间和力度都会对内瘘产生直接的影响,按压时间过长或力度过大均可能造成血栓形成;时间过短或力度过小又可能导致穿刺处出血、血肿进而压迫内瘘,造成内瘘堵塞[5～7].并发症的发生都会影响内瘘的使用时限,导致其失去功能.

[目的]制定肾病科中药沐手技术规范,进而规范中药沐手技术的操作流程及评价标准.[方法]采用理论研究结合临床实践方法,初步拟定中药沐手技术操作规范及评价标准,应用德尔菲(Delphi)专家咨询法,对16名专家进行两轮问卷咨询及28名专家现场咨询,定量分析各项相关指标的权重.[结果]制定中药沐手技术规范流程为核对—评估—告知—准备—实施—记录6个环节.[结论]运用德尔菲专家咨询法制定肾病科《中药沐手技术规范》,具有较高的科学性、全面性及客观性,使肾病科的特色中医技术操作能在每个重点环节及全过程进行规范,并以程序化的形式进行规定,从一定程度上杜绝护理人员在操作过程中的随意性,从而确保中药沐手护理技术的操作质量与效果.

Membranous nephropathy (MN) is one of the leading causes of nephrotic syndrome in adults. However, the current treatment of MN has been a matter of fierce debate for decades, and the needs for more advanced pharmaceuticals are critical for improving the treatment strategies. Sanqi oral solution (SQ), mainly consisting of Radix Astragali and Radix Notoginseng, is a formulated product to treat chronic kidney disease for over 20 years with good efficiency in clinic, while the role of SQ on MN remains unclear. In this study, by establishing an experimental rat model of membranous nephropathy induced by cationic Bovine Serum Albumin (C-BSA), we tried to investigate the effects of SQ. We found that administration of SQ ameliorated MN by reducing proteinuria, elevating serum albumin, and ameliorating pathological renal damages. SQ also significantly reduced the C3 and IgG depositions, and restored podocin and synaptopodin expressions. Furthermore, SQ inhibited the activation of nuclear factor-kappa B (NF-κB) signaling pathway. Our results provide evidence that SQ exerts a novel therapeutic effect on MN via reducing proteinuria, ameliorating renal damage and restoring podocyte injuries, which are associated with the suppression of NFκB.

目的 从文献计量学角度分析中国知识资源总库(China national knowledge infrastructure,CNKI)刊载的有关动静脉内瘘的临床研究现状与发展趋势,为动静脉内瘘的研究提供参考.方法 检索CNKI数据库有关动静脉内瘘的研究文献,时间范围限定在2013年1月1日～2017年12月31日.使用Note Express软件对纳入的1462篇文献的发文时间、关键词、期刊、基金、机构及文献共引等统计分析,采用Excel表格进行绘图.结果 近5年的发文量逐年上升,对动静脉内瘘护理及并发症的研究为本领域的研究热点.《中国血液净化》杂志在该领域的研究名列首位.国家及地方政府对该研究给予了一定的支持.结论 动静脉内瘘的研究态势发展良好,发展空间较大.《中国血液净化》杂志对该研究成果的传播起到促进作用.希望国家及地方政府加大对动静脉内瘘研究的关注与支持.

Background: Rheumatoid Arthritis (RA) is a systemic autoimmune disease leading to joint destruction. The prevention of bone and cartilage destruction has received increased attention in recent years.Objective: To evaluate the current evidences regarding the bone-protecting efficacy of Chinese medicine or the combination of Chinese medicine and Western medicine for RA.Methods: We comprehensively searched PubMed, Embase, the Cochrane Library (www.thecochranelibrary.com), the China National Knowledge Infrastructure (CNKI), the Database for Chinese Technical Periodicals (VIP), and SinoMed. We then performed a systematic review and cumulative meta-analysis of all randomized controlled trials (RCTs) assessing the two therapy methods.Results: Sixteen studies including 1,171 patients were included in the final analysis. The results showed that Chinese medicine could significantly improve the bone mineral density (BMD) (mean difference [MD] = 0.05 /g·cm−2, 95% CI [0.03, 0.08], P < 0.00001), and decrease the serum matrix metalloproteinase 3 (MMP-3) ([SMD] = −2.84, 95% CI [−4.22, −1.47], P < 0.0001).Conclusions: Chinese medicine may provide an efficiently alternative choice for the treatment of RA in terms of the bone-protecting efficiency. Given the inherent limitations of the included studies, future well-designed RCTs are required to confirm and update the findings of this analysis.

终末期肾病患者重要的替代疗法之一就是维持性血液透析[1]. 维持性血液透析治疗延长了终末期肾病患者的生存时间,但长期透析治疗会使患者更多依赖家庭的照顾和支持. 由此不仅增加家庭的经济与照护负担,也使患者出现抑郁、内疚、负担感等不良情绪,这种心理体验被称为自我感受负担( SPB) [2]. 有研究表明,患者的自我感受负担越重,生活质量越差,身体、情感、功能和健康水平越低,抑郁症状发生率就越高[3]. 目前国内外对SPB关注较多,且被广泛用于慢性病、癌症等人群的研究[4]. 有研究表明[5] ,患者的疲劳程度尤其是虚弱与SPB呈正相关. 因此,本研究尝试探讨维持性血液透析患者疲劳状况对自我感受负担的影响,予开展干预性研究提供依据,以帮助患者自我管理,提高生活质量.

Objective To study the correlation between sleep quality and anxiety in patients with chronic kidney diseases (CKD).Method Toally 118 patients with CKD were investigated with Pittsburgh sleep quality index (PSQI) and self-rating anxiety scale (SAS).Results About 75.42％ (89/118) patients had poor quality of sleep.The scores by PSQI and the dimensions were higher than those of the norms (all P＜0.05),but the total scores by PSQI and the factors of sleep quality,time of falling sleep,duration of sleep,use of hypnosis drugs were all significantly lower than those of the insomnia group (all P＜0.01).35.59％ (42/118) of the patients had anxiety and the score of SAS was significantly higher than that of the national norm (P＜0.01).The total scores of PSQI,sleep quality,sleep time,sleeping time,sleep disorder,daytime function were positively related to the score of SAS (P＜0.01).Conclusions The quality of sleep is poor in the CKD patients and there is a positive correlation between the quality of sleep and the anxiety.It is necessary to strengthen the knowledge-related health education and to provide emotional support and individualized nursing services for CKD patients so as to relieve their anxiety and improve their sleep quality.

Context • For patients undergoing hemodialysis, the native arteriovenous fistula (AVF) is the primary approach to vascular access (VA). VA failure is the main cause of morbidity and mortality in hemodialysis patients. It has been reported in recent studies that the primary failure rate can be as high as 50%. Objective • The study investigated the effects of iontophoretic administration of Salvia miltiorrhiza (SM) on the maturation of the AVF. Design • The study was a randomized, controlled trial. Setting • The study occurred in Guangdong Provincial Hospital of Traditional Chinese Medicine (Guangzhou, China). Participants • Participants were 40 patients with chronic kidney disease at stage 4 or 5. Intervention • Participants were randomly assigned to one of 2 groups (n = 20 each) after they had received an AVF operation. Patients in the control group were given routine care, and patients in the intervention group were given routine nursing in combination with an iontophoretic SM injection on a targeted area of the fistula after surgery. Outcome Measures • The blood flow of the AVF, the diameter of the artery vein shunt, and the thickness of the AVF from the vascular wall to the skin were observed. Results • The maturation rates of the AVFs after 1 mo were 50% and 85% in the control group and the intervention group, respectively. A significant difference existed between the 2 groups (P < .05). The results of the surgery were significantly different for the control and intervention groups, with the blood flows of the AVF being 1182.05 ± 547.10 mL/min and 705.55 ± 278.63 mL/min (P < .05), respectively, and the diameters of the artery vein shunts being 4.51 ± 1.47 mm and 3.54 ± 0.67 mm (P < .05), respectively, after treatment. Conclusions • Iontophoretically mediated, transdermal delivery of an SM injection to a targeted area of the AVF can significantly shorten the time to maturity of the fistulae.

目的:观察在肾内科实习生中采用微信带教实施后的带教效果情况.方法:将2014年3月-2015年1月入肾内科实习的护生24例,按照随机数字分组,分为对照组与观察组各12名,对照组采用以往传统的面对面带教方式进行实习生带教,观察组在对照组的基础上增加了微信带教,与面对面的带教方法相结合.实习结束之后采用护生管床考核和理论考试、操作考试来评价两组护理实习生的带教实习效果.结果:在出科理论考试、管床考核和操作考试成绩方面观察组显著高于对照组,差异具有统计学意义(P＜0.01).结论:微信带教能提高护生知识掌握的系统性和规范性,同时还可以提高护生对学习内容掌握的全面性,增强了护生学习的主动性和积极性,推进了师生之间和谐关系的发展.