Evidence Summary of the nursing of spinal fixation in emergency adult patients with traumatic spinal cord injury / 中国实用护理杂志

Objective:To summarize the relevant evidence for the management of fixation in traumatic spinal cord injury patients, which provides a reference for the clinical care and care of patients.Methods:A systematic search was conducted for evidence related to spinal injuries from domestic and foreign databases, relevant guideline websites, etc. The types of literature were best practice, expert consensus, systematic review, evidence summary, clinical decision-making, etc. The search time was from the establishment of databases to January 31, 2022. Three researchers used the Multidimensional Systematic Review Tool to evaluate systematic review literature. Five researchers used the guideline research and evaluation tool AGREE Ⅱ to evaluate clinical practice guidelines, and used the Australian JBI Evidence-Based Health Care Center (2016) to evaluate expert consensus and expert opinion with the authenticity evaluation tool for expert opinions and professional consensus articles. And extracted and summarized evidence according to the subject.Results:Finally, 10 articles were included, including 4 clinical decision-making, 4 guidelines and 2 systematic evaluations. The 30 pieces of evidence include the assessment, prevention, cervical spinal fixation, and management after traumatic spinal cord injury.Conclusions:The evidence emphasizes the importance of standardized assessment of cervical risk factors in all emergency adult patients with traumatic spinal cord injury. In the emergency department, we need to improve the ability of spinal evaluation and fixation in patients with penetrating neck injury, optimize the timeliness process of emergency trauma, reduce the occurrence of potential complications, and improve patient outcomes.

Antagonistic activity and application of Bacillus velezensis strain Bv-303 against rice bacterial-blight disease caused by Xanthomonas oryzae pv. oryzae / 生物工程学报

In this study, a new Bacillus velezensis strain Bv-303 was identified and its biocontrol effect against rice bacterial-blight (BB) disease caused by Xanthomonas oryzae pv. oryzae (Xoo) was investigated. Cell-free supernatant (CFS) of strain Bv-303 under different growth conditions were prepared to test the antagonistic activity and stability against Xoo by the Oxford-cup method in vitro. The antibacterial effect of strain Bv-303 to BB disease in rice were further analyzed in vivo by spraying the cell-culture broth (CCB), CFS and cell-suspension water (CSW), respectively, on the rice leaves inoculated with Xoo. Additionally, rice seeds germination rate and seedling growth under the strain Bv-303 CCB treatment were tested. The results showed that the strain Bv-303 CFS significantly inhibited Xoo growth by 85.7%‒88.0% in vitro, which was also stable under extreme environment conditions such as heat, acid, alkali and ultraviolet light. As tested in vivo, spraying the CCB, CFS or CSW of strain Bv-303 on the Xoo-infected leaves enhanced rice plant resistance to BB disease, with CCB showing the highest increase (62.7%) in disease-resistance. Notably, CCB does not have negative effects on rice seed germination and seedling growth. Therefore, strain Bv-303 has great potential for biocontrol of the rice BB disease.

Identification of risk factors for urethrovesical anastomotic leakage following laparoscopic radical prostatectomy / 中华泌尿外科杂志

Objective:To investigate the risk factors of urethrovesical anastomotic leakage after laparoscopic radical prostatectomy.Methods:The clinical data of 292 patients who underwent laparoscopic radical prostatectomy in the Tenth People's Hospital Affiliated to Tongji University from January to December 2021 were retrospectively analyzed. According to whether there was anastomotic leakage, the patients were divided into leakage group (27 cases) and non-leakage group (265 cases). There were no significant differences in age [(71.5±6.5) years vs. (70.2±6.4) years], body mass index [(24.5±3.6) kg/m 2 vs. (24.2±3.0) kg/m 2], prostate volume[40(27.3, 63.2)ml vs. 38(28.1, 56.2)ml], Gleason score, clinical stage, and risk classification between the leakage group and the non-leakage group ( P>0.05), but the total prostate-specific antigen in the leakage group was significantly higher than that in the non-leakage group[20.0 (9.6, 79.0) ng/ml vs. 13.7 (8.5, 25.0) ng/ml, P=0.049]. Propensity score matching (PSM) was used to match the above indicators between the leakage group and the non-leakage group as 1∶1, so that the baseline of the two groups was balanced. The perioperative indicators of the matched two groups of patients were compared and analyzed. Statistically significant indicators were selected and included in univariate and multivariate logistic regression to analyze the risk factors of anastomotic leakage after radical prostatectomy. Finally, the receiver operating characteristic (ROC) curve was drawn, and the area under the curve (AUC) was calculated. The accuracy of each factor in predicting urine leakage was obtained. Results:After PSM, 24 cases were successfully matched. The leakage group had shorter membranous urethral length (MUL) [(15.5±2.2)mm vs. (17.5±1.5)mm, P<0.001], thinner membranous urethral wall thickness (UWT) [(9.5±1.9)mm vs. (10.6±1.5)mm, P=0.024], longer anastomotic time of urethrovesical neck[(21.6±4.1)min vs. (16.9±2.9)min, P<0.001] and higher failure rate of water injection test [16.7% (4/24) vs. 4.2% (1/24), P=0.045] than the non-leakage group. There was no significant difference in other indicators between the two groups. The results of multivariate logistic regression analysis showed that short MUL ( OR=0.544, 95% CI 0.335-0.884, P=0.014), narrow UWT ( OR=0.538, 95% CI 0.313-0.924, P=0.025) and long anastomotic time of urethrovesical neck ( OR=1.519, 95% CI 1.122-2.110, P=0.009) were independent risk factors for anastomotic urine leakage. ROC curve analysis showed that the AUC of MUL, UWT, and anastomotic time were 0.789 (95% CI 0.651-0.927), 0.715 (95% CI 0.562-0.868), and 0.842 (95% CI 0.731-0.953), respectively. Conclusions:Narrow and short membranous urethra and long anastomosis time in patients with laparoscopic radical prostatectomy may be independent risk factors for postoperative anastomotic leakage, which may predict the occurrence of anastomotic leakage.

Decoding Cortical Glial Cell Development / 神经科学通报·英文版

Mouse cortical radial glial cells (RGCs) are primary neural stem cells that give rise to cortical oligodendrocytes, astrocytes, and olfactory bulb (OB) GABAergic interneurons in late embryogenesis. There are fundamental gaps in understanding how these diverse cell subtypes are generated. Here, by combining single-cell RNA-Seq with intersectional lineage analyses, we show that beginning at around E16.5, neocortical RGCs start to generate ASCL1

Homeobox Gene Six3 is Required for the Differentiation of D2-Type Medium Spiny Neurons / 神经科学通报·英文版

Medium spiny neurons (MSNs) in the striatum, which can be divided into D1 and D2 MSNs, originate from the lateral ganglionic eminence (LGE). Previously, we reported that Six3 is a downstream target of Sp8/Sp9 in the transcriptional regulatory cascade of D2 MSN development and that conditionally knocking out Six3 leads to a severe loss of D2 MSNs. Here, we showed that Six3 mainly functions in D2 MSN precursor cells and gradually loses its function as D2 MSNs mature. Conditional deletion of Six3 had little effect on cell proliferation but blocked the differentiation of D2 MSN precursor cells. In addition, conditional overexpression of Six3 promoted the differentiation of precursor cells in the LGE. We measured an increase of apoptosis in the postnatal striatum of conditional Six3-knockout mice. This suggests that, in the absence of Six3, abnormally differentiated D2 MSNs are eliminated by programmed cell death. These results further identify Six3 as an important regulatory element during D2 MSN differentiation.

Exploration and construction of the new generation of intelligent ICU unit based on 5G and artificial intelligence technology / 中华急诊医学杂志

Objective:To explore the new generation of intelligent ICU Unit based on 5G and artificial intelligence technology.Methods:This study was conducted at the Second Affiliated Hospital, Zhejiang University School of Medicine from May 2019 to August 2020. Based on a multidisciplinary team including medical, nursing, hospital management, clinical medical engineering, 5G technology, information technology, artificial intelligence technology, logistics service, etc, was assembled to intelligently design and reconstruct an intelligent ICU Unit of Emergency ICU.Results:Based on 5G technology, a new intelligent ICU unit environment was constructed to realize remote and high-speed interaction of multi-dimensional information in ICU, including intelligent assistance of remote monitoring, remote ward rounds, remote consultation and family visits. An intelligent hospital infection prevention and control system was established including automatic identification and alarm of hand hygiene and personal protection.Conclusions:The new generation of intelligent ICU unit combined with 5G and artificial intelligence technology has changed the mode of medical service for critically ill patients and improved the service level, which is worthy of further exploration and application.

A pressure injury risk prognosis model for severe trauma patients based on Braden scale combined with microcirculation indicators / 中华急诊医学杂志

Objective:Based on Braden scale, combined with local skin temperature and local tissue oxygen saturation as microcirculation indicators, to construct a pressure injury risk prognosis model for severe trauma patients, and develop a visual nomogram.Methods:All the trauma patients in the Emergency Intensive Care Unit (EICU) of a tertiary hospital in Zhejiang Province from June 1, 2020 to August 31, 2020 were selected. The Braden scale was used to assess the risk of pressure injury in the patient and measure the patient’s sacral injury. The skin temperature and blood oxygen saturation at the pressure site were used as indicators for microcirculation evaluation. Multivariate Logistic regression was used to construct a prognostic model and visual nomogram for severe trauma patients with stress injury based on Braden score combined with microcirculation evaluation indicators, and compared with the prediction model constructed by the Braden scale alone. The discrimination degree was judged by the area under the receiver operating characteristic curve. The C index performed internal verification of the model, H-L goodness-of-fit test, and the overall discrimination index to observe and predict the effect of the model.Results:A total of 152 patients were enrolled in this study, of which 33 (21.71%) had pressure injuries. The area under the curve of the Braden scale combined with local skin temperature and local tissue oxygen saturation was 0.866, and the internal verification C index of the model was 0.847. The H-L goodness of fit test result was 8.37 ( P=0.051), indicating that the model had good discrimination and consistency. The overall discrimination index of the model was 0.144 ( P=0.023). Conclusions:The Braden scale combined with local microcirculation indicators to construct a prognostic model of stress injury in severe trauma patients has good discrimination and consistency, and the predictive power of the Braden scale is improved by 14.4%. The construction of a nomogram can provide clinical rapid convenient and reliable forecasting tool.

Effect of peer education on improving compliance of cardiac rehabilitation in patients with coronary heart disease / 中国实用护理杂志

Objective:To evaluate the effect of peer education on improving compliance of cardiac rehabilitation in patients with coronary heart disease.Methods:Totally 64 patients were randomly divided into two groups, namely, the experimental group and the control group with 32 cases in each group. Patients in the experimental group received routine education, nursing, and rehabilitation, plus the peer education treatment, whereas the control group only received routine treatment. The time lasts for 6 months. The compliance of cardiac rehabilitation and the score of China Questionnaire of Quality of Life in Patients with Cardiovascular Diseases (CQQC) were measured after 1 month, 3month and 6 month.Results:After 1, 3, and 6 months of intervention, the compliance of cardiac rehabilitation in the intervention group increased by 18.75%, 21.37%, and 21.88%, respectively, compared with the control group. After the first and third months of intervention, there was a statistically significant difference in the compliance rate of rehabilitation exercise between the intervention group and the control group ( χ2 values were 18.050, 16.946, respectively, P <0.05), and at the sixth month after intervention, the compliance of the two groups of patients with cardiac rehabilitation was not statistically significant ( χ2 value was 6.489, P> 0.05). After 1, 3, and 6 months of intervention, the quality of life scores of the intervention group were (88.68 ± 6.65), (81.90 ± 6.78), and (76.33 ± 5.90) points, and the quality of life scores of the control group were (84.75 ± 4.72), (75.67 ± 5.88), and (74.71 ± 9.47) points. There was significant difference in the scores of the two groups in the first and third months after the intervention ( t values were 2.235, 2.520, respectively, P<0.05); and in the sixth month after the intervention, the difference in the scores of the two groups wasn`t statistically significant ( t value was 1.049, P >0.05). Conclusion:Peer education can improve the compliance of cardiac rehabilitation and the score of CQQC in patients with coronary heart disease in 3 month, but further research is needed to confirm the long-term effect of peer education.

A review on cardiac positron emission tomography/magnetic resonance imaging in diagnosis of cardivascular diseases / 生物医学工程学杂志

There are various examination methods for cardiovascular diseases. Non-invasive diagnosis and prognostic information acquisition are the current research hotspots of related imaging examinations. Positron emission tomography (PET)/magnetic resonance imaging (MRI) is a new advanced fusion imaging technology that combines the molecular imaging of PET with the soft tissue contrast function of MRI to achieve their complementary advantages. This article briefly introduces several major aspects of cardiac PET/MRI in the diagnosis of cardiovascular disease, including atherosclerosis, ischemic cardiomyopathy, nodular heart disease, and myocardial amyloidosis, in order to promote cardiac PET/MRI to be more widely used in precision medicine in this field.

Advances in mechanism of macrophage pyroptosis in Mycobacterium tuberculosis infection / 中华微生物学和免疫学杂志

Pyroptosis is an inflammatory programmed cell death dependent on caspase, and partic-ipates in the development of infectious diseases. Mycobacterium tuberculosis can reside in macrophages, and therefore Mycobacterium tuberculosis infection is closely related to the pyroptosis of macrophages. This review reviewed and discussed the molecular mechanism of interactions between Mycobacterium tuberculosis and macrophage inflammasomes. It is helpful to further understand the occurrence and development of tuberculo-sis and provide new ideas for the prevention and control of Mycobacterium tuberculosis infection with the in-depth study of the mechanism of macrophage pyroptosis.

Multi-level exploration of the cultivation of logical thinking ability of graduate students in major of clinical laboratory diagnostics / 中华医学教育探索杂志

Clinical laboratory diagnostics is an important secondary discipline in clinical medicine.Postgraduate students in clinical laboratory diagnostics are indispensable members of the future medical team.In view of the current situation about insufficiency of logical thinking ability of these graduates,this paper starts from the aspects of thought,theory,practice and effect test,and then enumerates examples to explore the reasonable training strategy of multi-level graduate students' logical thinking ability,in order to benefit the current graduate students in this major.