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Objective:To explore the effect of cluster nursing in robot-assisted surgery for the treatment of reducible atlantoaxial dislocation.Methods:A retrospective cohort study was conducted to analyze the clinical data of 41 patients with reducible atlantoaxial dislocation treated by robot-assisted surgery in Honghui Hospital affiliated to Xi′an Jiaotong University from January 2019 to December 2021, including 28 males and 13 females; aged 18-79 years [(45.2±10.3)years]. Ninteen patients received cluster nursing (cluster nursing group), with operating room nursing team set up on the basis of routine nursing and performed cluster nursing in line with evidence-based medicine. Twenty-two patients received routine nursing (routine nursing group). The operation time, intraoperative blood loss, frequency of intraoperative C-arm fluoroscopy, time of drainage tube placement and chief surgeon′s satisfaction for nursing were compared between the two groups. The degree of pain was evaluated by pain numerical score (NRS) at 12 hours, 24 hours, 48 hours, 72 hours, 1 month and 3 months after operation and at the last follow-up. The neck disability index (NDI) was assessed at 1 day before operation, 1 month after operation, 3 months after operation and at the last follow-up. The complications were observed.Results:All patients were followed up for 12-18 months [(16.7±3.7)months]. The operation time, intraoperative blood loss, frequency of C-arm fluoroscopy and time of drainage tube placement in cluster nursing group were (82.9±10.4)minutes, (105.9±11.8)ml, (3.8±0.6)times and (1.5±0.4)days, while those in routine nursing group were (125.7±12.8)minutes, (208.4±13.8)ml, (9.7±2.3)times and (3.6±0.6)days, respectively (all P<0.01). The chief surgeon′s satisfaction for nursing was 94.7% (18/19) in cluster nursing group and was 68.2% (15/22) in routine nursing group ( P<0.05). The NRS in cluster nursing group was (6.2±0.4)points, (6.0±0.7)points, (4.9±1.1)points, (2.7±0.5)points, (1.9±0.4)points, (1.8±0.4)points and (1.5±0.3)points at 12 hours, 24 hours, 48 hours, 72 hours, 1 month and 3 months after operation and at the last follow-up, while it was (7.6±0.6)points, (6.8±1.2)points, (5.8±1.5)points, (4.2±0.8)points, (3.4±0.7)points, (2.6±0.5)points and (2.2±0.5)points in routine nursing group ( P<0.05 or 0.01). There was no significant difference in the NDI between the two groups at 1 day before operation, but the NDI in cluster nursing group was 20.6±4.5, 14.6±2.8 and 10.7±2.5 at 1 month and 3 months after operation and at the last follow-up, while it was 26.9±4.1, 18.7±3.3 and 13.7±1.7 in routine nursing group (all P<0.01). There was no hematoma, infection or implant-related complications in both groups .Conclusion:For robot-assisted surgery in the treatment of reducible atlantoaxial dislocation, cluster nursing is associated with shortened operation time and time of drainage tube placement, decreased intraoperative blood loss and frequency of intraoperative fluoroscopy, increased chief surgeon′s satisfaction for nursing, reduced pain and accelerated functional recovery.
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HIV cluster detection and response (CDR) is a critical strategy to end the HIV epidemic by offering information to identify prevention and care services gaps. The risk metrics for HIV clusters can be classified into three groups: growth-based metrics, characteristic-based metrics, and phylogeny-based metrics. When identifying HIV risk clusters, the public health response can reach people in the affected networks, including people with undiagnosed HIV, people with diagnosed HIV who might not be accessing HIV care or other services, and people without HIV who would benefit from prevention services. To provide references for HIV precise prevention in China, we summarized the risk metrics and the intervention measures for CDR.
Subject(s)
Humans , HIV Infections/prevention & control , Acquired Immunodeficiency Syndrome/epidemiology , Public Health , Epidemics/prevention & control , China/epidemiologyABSTRACT
Objective::Camptosorus sibiricus is a kind of herbal medicine and famous folk medicine. However, the bioactivities or pharmacological effects of the C. sibiricus remain to be unclear. Therefore, it is necessary to make a systematic study on chemical constituents from C. sibiricus, so as to further study its potential medicinal value, and provide certain chemical basis and foundation for the comprehensive development and the search for pharmacological activity. Method::Various column chromatographic technologies, (silica gel, Sephadex LH-20 and ODS column chromatography) as well as HPLC were adopted to separate chemical constituents of C. sibiricus extract. The structure of the purified compounds was elucidated by nuclear magnetic resonance (NMR) and high-resolution electrospray ionization-mass spectrometry (HR-ESI-MS). Result::Totally 10 compounds have been isolated from water extract of C. sibiricus. By spectroscopic methods, they were elucidated as 7-dien-3-on-9-O-β-D-glucoside (1), bridelionoside F (2), (3R, 5S, 6S, 7E, 9S)-megastigm, an-7-ene-3, 5, 6, 9-tetrol 9-O-β-D-glucopyranoside (3), (6S, 7E, 9R)-roseoside (4), (3S, 5S, 6R, 9R)-3-hydroxy-5, 6-epoxy-β-ionol-9-O-β-glucopyranoside (5), 6, 9-dihydroxy-4, 7-megastigmadien-3-one (6), (3R, 6R, 7E, 9R)-3, 9-dihydroxy-4, elaphoside A (7), ptelatoside-A (8), n-butyl-a-β-D-fructofuranoside (9), dibutylphthalate(10)based on physical and chemical properties. Conclusion::All compounds were obtained from C. sibiricus for the first time. The discovery of these compounds further enriched the chemical constituents of C. sibiricus, and provided experimental and scientific basis for the comprehensive development and utilization of C. sibiricus.
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Objective@#To investigate the awareness of pubertal knowledge and its influencing factors among primary school students in Chinese rural areas, and to provide evidences for improving awareness level and popularizing scientific, reasonable, and suitable sex education.@*Methods@#Sixteen primary schools consisting of rural registered students in Guizhou and Anhui Province were selected by multi-stage cluster sampling method, and a questionnaire survey for 2 506 senior students (grade five and six) was conducted to explore the awareness of pubertal knowledge and its influencing factors among primary school students in Chinese rural areas.@*Results@#The total awareness rate of pubertal knowledge was 62.7% among primary school students in Guizhou and Anhui rural areas, and the awareness rates were relatively low for the questions about the difference between male and female pubertal development and understanding of sexual attitude; female students, only-child students and grade six students got a bit better awareness of pubertal knowledge than male students, non-only-child students and grade five students respectively; grade[OR=0.72(0.61-0.86)], peer acceptance [OR=0.70(0.53-0.96)], family intimacy [OR=0.75(0.63-0.88)] had effect on awareness of pubertal knowledge.@*Conclusion@#The awareness of pubertal knowledge among primary school students in Guizhou and Anhui rural areas need further improvement, especially for male students, non-only-child students and grade five students in the questions about the difference between male and female pubertal development and understanding of sexual attitude. It is necessary to improve the awareness of pubertal knowledge by enhancing peer acceptance, promoting family intimacy, and popularizing scientific, reasonable, and suitable sex education.
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Through deeply analyzing the classification and coding of medical devices system,as well as existing problems in China,it proposed to build a medical devices classification and coding System,which was unified from state level and a platform for collection as well as surveillance for the information of medical devices,so as to improve the standardized management of the medical devices in China.
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BACKGROUND: Studies have shown that mild hypothermia therapy can regulate the apoptosis, proliferation and differentiation of neural stem cells (NSCs). OBJECTIVE: To explore the effect of mild hypothermia therapy combined with subarachnoid NSCs transplantation on functional recovery from spinal cord injury (SCI) in rats. METHODS: The 20 of 110 Sprague-Dawley rats were randomly selected as sham group, and the remaining 90 rats were used to make spinal cord injury models using modified Allen's method. After modeling, 80 successful models were randomized into SCI, mild hypothermia, NSCs, and combined groups (n=20 per group). Rats in the mild hypothermia group were placed onto an ice blanket at a temperature of (34.0±0.5) ℃ for 3 days. Rats in the NSCs group were raised at 37 ℃ and implanted with 1×104/L NSCs suspension (1 mL, once a day, for continuous 3 days) into the subarachnoid space at 6 hours after modeling. Rats in the combined group were given the combined treatment of mild hypothermia and NSCs transplantation. Motor functional assessment for the bilateral rat lower limbs was performed based on Basso, Beattie and Bresnahan scoring and inclined plate test at 1, 3 days and 1, 2, 3, 4 weeks after modeling. At 4 weeks after modeling, pathological detection by hematoxylin-eosin staining was done; RT-PCR was used to detect expression of Caspase-3, BCL-2 and Syn around the injured region; and electrophysiological recovery of the nerves was assessed based on somatosensory and motor evoked potentials. RESULTS AND CONCLUSION: (1) Lower limb motor function of the rats was improved after NSCs transplantation, mild hypothermia therapy or their combined use, especially in the combined group. (2) At 4 weeks after modeling, there was significant reduced Caspase-3 and significantly increased Bcl-2 and Syn in the combined group compared with the SCI group (both P < 0.05). (3) At 4 weeks after modeling, cystic cavities in the spinal cord formed in the SCI group, became smaller in the NSCs and mild hypothermia groups, and almost disappeared in the combined group. (4) At 4 weeks after modeling, the latency of somatosensory and motor evoked potentials was shortest in the combined group, followed by the NSCs and mild hypothermia groups, and longest in the SCI group. A significant difference was found among groups (P < 0.05). The amplitudes of somatosensory and motor evoked potentials were ranked as follows: combined group > NSCs group and mild hypothermia group > SCI group, and there was also a significant difference among groups (P < 0.05). In summary, the combined use of mild hypothermia and NSCs transplantation via the subarachnoid space can promote synaptic regeneration,reduce Caspase-3 mRNA expression, increase Bcl-2 and Syn mRNA expression, and improve motor and electrophysiological functions of the lower limbs in rats.
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The paper summarizes the relevant documents of the new payment fee schedule released in China,and elaborates the status of the management of the new payment fee schedule management,coupled with analysis of the new payment fee schedule issued by the provinces (autonomous regions and municipalities),which helps to put forward policy-oriented suggestions for the management of the new payment fee schedule.