Analysis of serum protein electrophoresis results in patients with acute brucellosis / 中华地方病学杂志

Objective:To understand the results of serum protein electrophoresis in patients with acute brucellosis, and to provide objective indicators for clinical diagnosis and treatment of acute brucellosis patients.Methods:Thirty acute brucellosis patients diagnosed by the Center for Disease Prevention and Control of Donghe District, Baotou City from January to June 2021 were selected as the case group, and 30 local healthy persons who took physical examination during the same period were selected as the control group. Blood samples were collected from the two groups of people, serum was separated and serum protein electrophoresis was performed. Independent sample t-tests were used to compare total protein concentrations, protein fractions (albumin, α1-globulin, α2-globulin, β-globulin and γ-globulin) and albumin/globulin (A/G) ratio. Results:The age of patients in the case group was (52.35 ± 6.74) years old, with 25 males and 5 females. The course of the disease ranged from 0.3 to 2.6 months, with an average of 1.78 months. The age of people in the control group was (52.74 ± 5.47) years old, with 25 males and 5 females. There were no statistically significant difference in age and sex distuibution between the two groups ( P > 0.05). The concentrations of total protein and α2-globulin fractions were not significantly different between the two groups ( t = 0.78, 2.04, P > 0.05, respectively). Compared with the control group, the differences in the percentage of albumin, α1-globulin, β-globulin, γ-globulin in total protein and A/G ratio were statistically significant ( t = 4.78, 4.76, 2.89, 2.20, 3.65, P < 0.05). Conclusions:The percentage of serum albumin in total protein and A/G ratio decrease in patients with acute brucellosis, while the percentage of α1-globulin, β-globulin and γ-globulin in total protein increase. The percentage of albumin, α1-globulin, β-globulin, γ-globulin in total protein and A/G ratio can be uesed as objective indicators for clinical treatment of acute brucellosis.

Summary of evidence for non-pharmacological management of delirium in PICU patients / 中国小儿急救医学

Objective:To search and summarize the evidence for the non-pharmacological management of delirium of critically ill patients in PICU, and to provide evidence-based guidance for clinical practice.Methods:According to the "6S" evidence pyramid model, we searched computerized decision support system, websites of guidelines, and databases, and obtained the guidelines, clinical decisions, systematic reviews, and evidence summaries.After screening the articles, two researchers independently appraise articles using validated tools, and finally formed the evidence summary of delirium non-pharmacological management of critically ill patients in PICU.Results:Totally six articles were included for the evidence synthesis, including three guidelines, two systematic reviews, and one expert advice.Twenty pieces of evidence including four aspects were summarized, namely delirium screening, risk prediction, non-pharmacological prevention and management strategies, health care provider education and departmental standardization.Conclusion:The evidence summarized in this study can provide a reference to health care professionals.When we apply this evidence in the clinical setting, we should adapt it accordingly to the specific clinical setting to improve the effectiveness of the evidence.

Isolation of a foodborne Bacillus cereus strain and its effect on intestinal mucosal immunity-associated factors and gut microbial community in mice / 生物工程学报

Bacillus cereus is a common foodborne pathogen. Accidently eating food contaminated by B. cereus will cause vomiting or diarrhea, and even death in severe cases. In the present study, a B. cereus strain was isolated from spoiled rice by streak culture. The pathogenicity and drug resistance of the isolated strain were analyzed by drug sensitivity test and PCR amplification of virulence-associated gene respectively. Cultures of the purified strain were injected intraperitoneally into mice to examine their effects on intestinal immunity-associated factors and gut microbial communities, to provide references for the pathogenic mechanism and medication guidance of these spoilage microorganisms. The results showed that the isolated B. cereus strain was sensitive to norfloxacin, nitrofurantoin, tetracycline, minocycline, ciprofloxacin, spectinomycin, clindamycin, erythrocin, clarithromycin, chloramphenicol, levofloxacin, and vancomycin, but resistant to bactrim, oxacillin and penicillin G. The strain carries seven virulence-associated genes including hblA, hblC, hblD, nheA, nheB, nheC and entFM, which are involved in diarrhea-causing toxins production. After infecting mice, the isolated B. cereus strain was found to cause diarrhea in mice, and the expression levels of immunoglobulins and inflammatory factors in the intestinal mucosae of the challenged mice were significantly up-regulated. Gut microbiome analysis showed that the composition of gut microbial community in mice changed after infection with B. cereus. The abundance of the uncultured_bacterium_f_Muribaculaceae in Bacteroidetes, which is a marker of body health, was significantly decreased. On the other hand, the abundance of uncultured_bacterium_f_Enterobacteriaceae, which is an opportunistic pathogen in Proteobacteria and a marker of dysbacteriosis, was significantly increased and was significantly positively correlated with the concentrations of IgM and IgG. These results showed that the pathogenic B. cereus carrying diarrhea type virulence-associated gene can activate the immune system by altering the composition of gut microbiota upon infection.

Application value of delay-phase 99Tc m-PYP scintigraphy and SPECT imaging for diagnosis of transthyretin-related cardiac amyloidosis / 中华核医学与分子影像杂志

Objective:To investigate the application of different imaging methods of 99Tc m-pyrophosphate (PYP) in the diagnosis and pathological classification of cardiac amyloidosis (CA). Methods:A total of 31 patients (22 males, 9 females, age 21-81(57.2±13.4) years) with suspected CA who underwent 99Tc m-PYP dual-phase scintigraphy (early-phase: 1 h, delay-phase: 2-3 h) and SPECT/CT (1 h) between December 2018 and December 2019 in Peking Union Medical College Hospital were retrospectively included. Taking clinical diagnosis as the standard, the results of visual score (≥2, positive) and semi-quantitative values (heart to contralateral lung (H/CL)≥1.5, positive) of 99Tc m-PYP uptake in dual-phase scintigraphy and SPECT/CT imaging were analyzed. One-way analysis of variance and Bonferroni test were used to analyze the data. Results:Among 31 patients with suspected CA, 15 were clinically diagnosed as CA (5 patients with transthyretin-related CA (ATTR-CA) and 10 patients with light chain CA (AL-CA)) and 16 were diagnosed as non-CA. All 5 patients with ATTR-CA had positive dual-phase scintigraphy and SPECT/CT imaging results. Three out of 10 patients with AL-CA had positive early-phase scintigraphy whereas negative delay-phase scintigraphy and SPECT/CT imaging results. Sixteen patients who were clinically diagnosed as non-CA had negative dual-phase scintigraphy and SPECT/CT imaging results. The sensitivity (5/5), specificity (10/10), positive predictive value (5/5), negative predictive value (10/10) and accuracy (15/15) of delay-phase scintigraphy and SPECT/CT imaging were the same. Among 31 patients, 16 patients carried transthyretin-related (TTR) gene mutation, and 4 of them who clinically diagnosed as variant ATTR (ATTRv) had positive image findings while 12 of them who not clinically diagnosed as CA had negative image findings. There were significant differences in H/CL between ATTR-CA group and AL-CA group in early-phase (2.11±0.24 vs 1.31±0.07) and delay-phase (2.02±0.19 vs 1.30±0.05; F values: 75.41 and 87.15, Bonferroni test, both P<0.01). Conclusions:99Tc m-PYP delay-phase scintigraphy and SPECT/CT have high diagnostic efficiencies in ATTR-CA, helping to determine the pathological classification of CA; while early-phase scintigraphy has false positive results. Moreover, 99Tc m-PYP imaging is helpful to detect CA in patients with TTR gene mutation.

Advances on the assessment of sedation in pediatric intensive care unit / 中国小儿急救医学

Sedation therapy is an important part of the safety and comfort management of critically ill children.The accurate selection of a sedation assessment tool can help nurses effectively assess the level of sedation and guide clinical care.This review summarized the existing six commonly used sedation assessment scales in pediatric intensive care unit, such as the Ramsay Sedation Scale, Richmond Agitation-Sedation Scale and Comfort Scale and related sedation concepts.Our study aims to provide a reference for choosing a sedation assessment scale suitable for critically ill children and standardizing sedation nursing practice.

Feasibility and safety of bridge therapy with active fixed electrodes connected to external permanent pacemakers for patients with infective endocarditis after lead removal and before permanent pacemaker implantation / 中华心血管病杂志

Objective: To analyze the feasibility and safety of bridge therapy with active fixed electrodes connected to external permanent pacemakers (AFLEP) for patients with infective endocarditis after lead removal and before permanent pacemaker implantation. Methods: A total of 44 pacemaker-dependent patients, who underwent lead removal due to infective endocarditis in our center from January 2015 to January 2020, were included. According to AFLEP or temporary pacemaker option during the transition period, patients were divided into AFLEP group or temporary pacemaker group. Information including age, sex, comorbidities, indications and types of cardial implantable electionic device (CIED) implantation, lead age, duration of temporary pacemaker or AFLEP use, and perioperative complications were collected through Haitai Medical Record System. The incidence of pacemaker perception, abnormal pacing function, lead perforation, lead dislocation, lead vegetation, cardiac tamponade, pulmonary embolism, death and newly infection of implanted pacemaker were compared between the two groups. Pneumothorax, hematoma and the incidence of deep vein thrombosis were also analyzed. Results: Among the 44 patients, 24 were in the AFLEP group and 20 in the temporary pacemaker group. Age was younger in the AFLEP group than in the temporary pacemaker group (57.5(45.5, 66.0) years vs. 67.0(57.3, 71.8) years, P=0.023). Male, prevalence of hypertension, diabetes mellitus, chronic renal dysfunction and old myocardial infarction were similar between the two groups (all P>0.05). Lead duration was 11.0(8.0,13.0) years in the AFLEP group and 8.5(7.0,13.0) years in the temporary pacemaker group(P=0.292). Lead vegetation diameter was (8.2±2.4)mm in the AFLEP group and (9.1±3.0)mm in the temporary pacemaker group. Lead removal was successful in all patients. The follow-up time in the AFLEP group was 23.0(20.5, 25.5) months, and the temporary pacemaker group was 17.0(14.5, 18.5) months. In the temporary pacemaker group, there were 2 cases (10.0%) of lead dislocation, 2 cases (10.0%) of sensory dysfunction, 2 cases (10.0%) of pacing dysfunction, and 2 cases (10.0%) of death. In the AFLEP group, there were 2 cases of abnormal pacing function, which improved after adjusting the output voltage of the pacemaker, there was no lead dislocation, abnormal perception and death. Femoral vein access was used in 8 patients (40.0%) in the temporary pacemaker group, and 4 patients developed lower extremity deep venous thrombosis. There was no deep venous thrombosis in the AFLEP group. The transition treatment time was significantly longer in the AFLEP group than in the temporary pacemaker group (19.5(16.0, 25.8) days vs. 14.0(12.0, 16.8) days, P=0.001). During the follow-up period, there were no reinfections with newly implanted pacemakers in the AFLEP group, and reinfection occurred in 2 patients (10.0%) in the temporary pacemaker group. Conclusions: Bridge therapy with AFLEP for patients with infective endocarditis after lead removal and before permanent pacemaker implantation is feasible and safe. Compared with temporary pacemaker, AFLEP is safer in the implantation process and more stable with lower lead dislocation rate, less sensory and pacing dysfunction.

Analysis on the relationship between urbanization and health behavior in China: An empirical research based on China Health and Retirement Longitudinal Study (CHARLS) / 北京大学学报(医学版)

OBJECTIVE@#To explore the relationship between urbanization and residents ' health behaviors in China, and to clarify the impact of urbanization on health behaviors.@*METHODS@#Based on China Health and Retirement Longitudinal Study (CHARLS), we established a panel data fixed effect model tracked in 2011, 2013 and 2015 to analyze the effect of urbanization level on smoking cessation, drinking, sleep quality and physical exercise behavior. The ratio of population density, gross domestic product (GDP) per capita and output value of secondary and tertiary industries to GDP were used to represent the levels of urbanization.@*RESULTS@#From 2011 to 2015, China ' s urbanization levels showed an increasing trend, which showed that the ratio of population density, GDP per capita and output value of secondary and tertiary industries in GDP increased year by year. Smoking cessation increased with the increase of GDP per capita and the proportion of the output value of secondary and tertiary industries. Compared with the low-level, the drinking rate in the regions with per capita GDP of more than 45 000 yuan increased by 2.49%, and the drinking rate in the regions with secondary and tertiary industries for 80%-85% decreased by 2.48%. However, there was no significant difference with population density. The sleep quality decreased with the increase of per capita GDP. In regions where per capita GDP was more than 93%, the sleep quality decreased by 3.71% compared with the low-level which was not significantly different from the ratio of population density and the output value of secondary and tertiary industries. For low contrast, the exercise rate in regions with the population density of 400-600 people/km2 and over 800 people/km2 was reduced by 5.2% and 7.7% respectively. The exercise rate in regions with per capita GDP of 25 000-35 000 yuan and over 45 000 yuan was reduced by 3.26% and 3.73% respectively. The exercise rate in regions with secondary and tertiary industries accounting for more than 93% of GDP was 10.68% lower than that of the low-level regions.@*CONCLUSION@#Different dimensions of urbanization have different impacts on different health behaviors. The smoking cessation rate increases with the increase of urbanization level, which is related to the proportion of per capita GDP and the output value of secondary and tertiary industries. The exercise rate, related to the three dimensions, decreases with the increase of urbanization. Sleep quality is more closely related to per capita GDP, and the probability of good sleep quality decreases with the increase of urbanization level. However, there is no obvious trend between drinking rate and urbanization level, which needs further study.

Application of acellular bovine pericardium patch in implant based immediate breast reconstruction / 中华外科杂志

Objective: To examine the clinical effect of acellular bovine pericardium patch in implant based immediate breast reconstruction. Methods: The clinicopathological information of 141 breast cancer patients, who admitted to Department of Breast Reconstruction and Oncoplastic Surgery, Tianjin Medical University Cancer Hospital, underwent immediate mammoplasty with implants combined with acellular bovine pericardium patches were analyzed from June 2016 to October 2019. All patients were female, with the age of (38.8±8.5) years (range: 13 to 60 years). The body mass index was (21.9±2.5) kg/m2 (range: 16.0 to 32.3 kg/m2). There were 39 cases of duct carcinoma in situ, 46 cases of stage Ⅰ, 40 cases of stage Ⅱ and 16 cases of stage Ⅲ. All patients received nipple-areola-sparing mastectomy or skin-sparing mastectomy with sentinel lymph node biopsy or axillary lymph node dissection, and prosthesis implantation with sub-pectoralis combined with breast patch. The correlation of clinicopathological characters and complications was assessed by t test, χ2 test, Fisher's exact probability method and Logistic regression. Pre-and post-operative aesthetic, quality of life scores were recorded. Results: The operation time (M(IQR)) was 3.6(1.5) hours (range: 3.0 to 6.5 hours). The early postoperative complication rate was 22.0% (31/141), prosthesis removal was the main postoperative complication, accounting for 64.5% (20/31) of the total complications, of which 15 cases occurred in the first 30 patients. The follow-up time was 28(8) months (range: 20 to 53 months), The most frequent long-term complications were capsular contracture and implant displacement, with the incidence of 11.2% (14/125) and 10.4% (13/125), respectively. Multivariate analysis showed that prosthesis volume ≥300 ml (OR=8.173, 95%CI: 1.302 to 51.315, P=0.021) and peri-areolar incision (OR=7.809, 95%CI: 2.162 to 28.211, P<0.01) were independent relative factors for the occurrence of short-term postoperative local complications. After 2 years of operation, the score of breast appearance satisfaction was 71.7±15.5, postoperative effect satisfaction was 90.4±9.5, psychological satisfaction was 90.7±17.1, sexual satisfaction was 70.1±25.1. The immediate postoperative satisfaction rate at discharge was 95.4% (134/141), and 17.6% (22/125) of patients had the intention to received revision surgery. Conclusions: Prosthesis volume ≥300 ml and peri-areolar incision were independent realtive factors for short-term local complications after bovine pericardium patch combined with prosthesis implantation in the immediate breast reconstruction. After completing the learning curve, the postoperative complications of the procedure could be decreased.

Consensus to 99mTechnetium-Pyrophosphate Scintigraphy in the Diagnosis of Transthyretin-related Cardiac Amyloidosis / 罕见病研究

Transthyretin-related amyloid cardiomyopathy (ATTR-CM) is a disease caused by the depo-sition of insoluble amyloid fibers formed by the misfolding of transthyretin precursor protein in the intercellular space of cardiomyocytes. This lesion may lead to myocardial dysfunction, cogestive heart failure, and death.When diagnosed earlier, the patient can be treated with drugs as soon as possible to intervene in the progress of the disease, so as to effectively improve the patient's prognosis.99mtechnetium-pyrophosphate (99Tcm-PYP)single-photon emission computed tomography (SPECT) has been widely used in the imaging examination of cardiac amyloidosis (CA) in recent years. While achieving early non-invasive diagnosis, accurate pathological classification can be obtained through Perugini visual score analysis, semi-quantitative analysis of heart to contralateral lung (H/CL) ratio, and SPECT image analysis. This article presents the application, methods, and the precautions of 99Tcm-PYPSPECT in the diagnosis of ATTR-CM, aiming to provide clinical reference for the application of this technology.

Formins: the key regulators of plant cell morphology and development / 生物工程学报

Formins are widely distributed in eukaryotes such as fungi, plants and animals. They play crucial roles in regulating the polymerization of actin, coordinating the synergistic interactions between actin and microtubules, and determining cell growth and morphology. Unlike formins from fungi and animals, plant formins have been evolved into two plant-specific types. Generally, type Ⅱ formins are believed to regulate the polarized growth of cells, and type Ⅰ formins may regulate the cell expansion and division processes. Recent studies on the function of plant formins suggest it is inappropriate to classify the function of formins purely based on their structures. This review summarizes the domain organization of formins and their corresponding functions, as well as the underpinning mechanisms. Furthermore, the unsolved or unexplored issues along with future perspectives on plant formins are proposed and discussed.

Predicted 10-year Cardiovascular Disease Risk and Its Association with Sleep Duration among Adults in Beijing-Tianjin-Hebei Region, China / 生物医学与环境科学（英文）

Objective@#The study aims to predict 10-year cardiovascular disease (CVD) risk and explore its association with sleep duration among Chinese urban adults.@*Methods@#We analyzed part of the baseline data of a cohort that recruited adults for health screening by cluster sampling. The simplified Pittsburgh Sleep Quality Index (PSQI) and Framingham 10-year risk score (FRS) were used to measure sleep duration and CVD risk. Demographic characteristics, personal history of chronic diseases, lifestyle factors were collected using a questionnaire. Height, weight, total cholesterol (TC), and high-density lipoprotein cholesterol (HDL-C) were also measured. Multiple logistic regression models were performed to explore the association of sleep duration with the predicted CVD risk.@*Results@#We included 31, 135 participants (median age 44 years, 53.02% males) free of CVD, cerebral stroke, and not taking lipid-lowering agents. Overall, 14.05%, and 25.55% of participants were at medium and high predicted CVD risk, respectively. Short sleep was independently associated with increased odds of medium to high risk of predicted 10-year CVD among males ( @*Conclusion@#A substantial number of adults free of CVD were at high 10-year CVD risk. Short sleep was associated with increased odds of predicted CVD risk.

Research Progress on Chemical Constituents， Pharmacological Effect and Clinical Applications of Daturae Flos / 中国实验方剂学杂志

Daturae Flos is a traditional antitussive and antiasthmatic medicine， its flowers and leaves are rich in a variety of compounds， including withanolides， alkaloids， terpenes， flavonoids and amides. Because of its antiasthmatic， antitussive， antispasmodic and analgesia effect， it is traditionally used for the treatment of asthma， cough， cold pain in abdominal cavity， rheumatic arthralgia， infantile chronic eclampsia， and can also be used as raw material for surgical anesthesia. Modern pharmacological studies have shown that in addition to the traditional efficacy， Daturae Flos also has anti-inflammatory， immunosuppression， anti-convulsion and other effects， and is often used in the treatment of psoriasis， Parkinson's disease， epilepsy， rheumatoid arthritis and other diseases. At present， the chemical constituents of Daturae Flos are mainly focused on withanolides and alkaloids. At the same time， there is a lack of clear classification of chemical components and the distribution of chemical components in medicinal parts of this medicine， and little information is available for the pharmacological effects of polysaccharides. Based on this， this paper systematically searched relevant literature of Daturae Flos， and summarized and analyzed its chemical composition， pharmacological effect and clinical application， in order to provide reference for further development and utilization of Daturae Flos.

Intestinal stenting combined with surgery in patients with left colon cancer complicated by acute intestinal obstruction / 中华普通外科杂志

Objective:To evaluate intestinal stenting in patients of left colon cancer complicated with acute intestinal obstruction and analyze its short-term and long-term efficacy.Methods:Sixty patients who suffered from left colon cancer complicated with acute intestinal obstruction at the First Department of General surgery, Chengdu Second People's Hospital from Sep 2016 to Sep 2019 were retrospectively enrolled. According to treatment methods, the patients were divided into the stent implantation staged surgery group (24 patients ) and the control group receiving emergency surgery (36 patients).Results:There was no significant difference in perioperative course between the two groups. There was no significant difference in three year overall survival rate or recurrence and metastasis rate between the two groups. Preoperative bowel preparation rate in stent implantation group was obviously higher than the control group (100% vs. 44%, P=0.000). The laparoscopic surgery rate of the stent implantation group was higher than the control group (21% vs. 0, χ2=9.857， P=0.002). The enterostomy rate of the stent implantation group was lower than the control group (0 vs. 19%, χ2=10.237， P=0.005). There was a higher rate of one-stage excision and anastomosis in the stent implantation group than in the control group (100% vs. 81%, χ2=7.760， P=0.005).There was a higher lymph nodes deissection rate in the stent implantation group than in the control group, [11(7-14) vs. 6(3-10), Z=-2.672， P=0.006]. Conclusions:For patients who suffered from left colon cancer complicated with acute intestinal obstruction, the intestinal stent can improve the bowel preparation to a greater extent, which can increase the proportion of one-stage anastomosis and reduce enterostomy rate.

Individual mortality risk predictive system of patients with acute-on-chronic liver failure based on a random survival forest model / 中华医学杂志(英文版)

BACKGROUND@#The basis of individualized treatment should be individualized mortality risk predictive information. The present study aimed to develop an online individual mortality risk predictive tool for acute-on-chronic liver failure (ACLF) patients based on a random survival forest (RSF) algorithm.@*METHODS@#The current study retrospectively enrolled ACLF patients from the Department of Infectious Diseases of The First People's Hospital of Foshan, Shunde Hospital of Southern Medical University, and Jiangmen Central Hospital. Two hundred seventy-six consecutive ACLF patients were included in the present study as a model cohort (n = 276). Then the current study constructed a validation cohort by drawing patients from the model dataset based on the resampling method (n = 276). The RSF algorithm was used to develop an individual prognostic model for ACLF patients. The Brier score was used to evaluate the diagnostic accuracy of prognostic models. The weighted mean rank estimation method was used to compare the differences between the areas under the time-dependent ROC curves (AUROCs) of prognostic models.@*RESULTS@#Multivariate Cox regression identified hepatic encephalopathy (HE), age, serum sodium level, acute kidney injury (AKI), red cell distribution width (RDW), and international normalization index (INR) as independent risk factors for ACLF patients. A simplified RSF model was developed based on these previous risk factors. The AUROCs for predicting 3-, 6-, and 12-month mortality were 0.916, 0.916, and 0.905 for the RSF model and 0.872, 0.866, and 0.848 for the Cox model in the model cohort, respectively. The Brier scores were 0.119, 0.119, and 0.128 for the RSF model and 0.138, 0.146, and 0.156 for the Cox model, respectively. The nonparametric comparison suggested that the RSF model was superior to the Cox model for predicting the prognosis of ACLF patients.@*CONCLUSIONS@#The current study developed a novel online individual mortality risk predictive tool that could predict individual mortality risk predictive curves for individual patients. Additionally, the current online individual mortality risk predictive tool could further provide predicted mortality percentages and 95% confidence intervals at user-defined time points.

The research progress of total pancreatectomy with islet autotransplantation for chronic pancreatitis patients / 中华肝胆外科杂志

Chronic pancreatitis is a progressive chronic inflammatory disease of caused by gene and other environmental factors, and clinical manifestation includes recurrent abdominal pain and dysfunction of exocrine and endocrine. For the chronic pancreatitis therapy, surgical treatment mainly aims at the intractable pain which is unresponsive to medical and endoscopic treatment, as well as complications of chronic pancreatitis. Total pancreatectomy with islet autotransplantation (TPIAT) gradually becomes a major therapeutic option for chronic pancreatitis surgical treatment, because it relieves the abdominal pain, reduces the opioid dependent, improves the quality of life, and increases the opportunity of insulin independent. In the past few years, a range of researches have been focusing on islet isolation, surgical approach, curative effect and postoperative complication, improvement of islet function after operation. The purpose of this article is to summarize the progression of TPIAT related research in the recent years.

Optimization of polysaccharide extraction from Hippocampus by deep neural network and Box-Behnken design-response surface methodology / 中国中药杂志

In this paper, the extraction rate of crude polysaccharides and the yield of polysaccharides from Hippocampus served as test indicators. The comprehensive evaluation indicators were assigned by the R language combined with the entropy weight method. The Box-Behnken design-response surface methodology(BBD-RSM) and the deep neural network(DNN) were employed to screen the optimal parameters for the polysaccharide extraction from Hippocampus. These two modeling methods were compared and verified experimentally for the process optimization. This study provides a reference for the industrialization of effective component extraction from Chinese medicinals and achieves the effective combination of modern technology and traditional Chinese medicine.

Prevention and treatment of pediatric delirium / 中国小儿急救医学

Delirium is an acute, fluctuating state of brain dysfunction characterized by a change in consciousness and a reduced ability to concentrate, maintain, or transfer, which can lead to cognitive or perceptual disorders, hallucinations and sleep-arousal disorders.It cannot be better explained by pre-existing, occurring or developing diseases.At present, its pathogenesis is not clear, and is related to a variety of factors.Early and effective identification and evaluation is the premise, and the clinical practice strategy of prevention and treatment of pediatric delirium needs to be further studied.

Application of 99Tc m-pyrophosphate in transthyretin cardiac amyloidosis / 中华核医学与分子影像杂志

Objective:To evaluate the diagnostic value of 99Tc m-pyrophosphate (PYP) in transthyretin cardiac amyloidosis. Methods:From December 2018 to July 2019, 17 patients (9 males, 8 females, age: (53.4±13.0) years) with suspected cardiac amyloidosis underwent 99Tc m-PYP imaging in Peking Union Medical College Hospital were prospectively included. Visual score and semi-quantitative values (heart to contralateral ratio, H/CL) of 99Tc m-PYP uptake were used to diagnose transthyretin amyloidosis (ATTR). Biopsies and genetic measurements were also developed to evaluate the diagnostic value of the imaging. Results:Five of the 17 patients were diagnosed as ATTR with a visual score of 2-3, H/CL≥1.5, and confirmed with the biopsy or gene test. Four patients were diagnosed as ATTR with positive genetic results but no cardiac symptoms, and their visual scores were between 0 and 1 with H/CL<1.5. Considering the young age of the patients, amyloid deposition might have not yet caused visceral damage. Visual score of other 8 patients with negative 99Tc m-PYP imaging were also between 0 and 1 with H/CL<1.5, 2 of 8 were confirmed with light chain amyloidosis (AL) by biopsy, 3 were clinically diagnosed as AL and 3 were ATTR excluded. The accuracy of 99Tc m-PYP imaging for diagnosing ATTR was 11/11. Conclusion:99Tc m-PYP imaging is helpful for non-invasive diagnosis of transthyretin cardiac amyloidosis.

Construction and application of virtual simulation experimental teaching platform of nursing / 中华医学教育探索杂志

Virtual simulation experimental teaching is a major component of nursing education reform in colleges and universities, which makes space-unlimited cyber-learning and self-learning into reality and is helpful in the development of students' critical thinking and clinical nursing decision-making ability. Based on the "5E learning cycle" model, we have set up an experimental teaching system, and constructed a virtual simulation experimental platform of nursing, which comprises basic experimental skills, clinical experimental skills, comprehensive virtual simulation projects and training system of clinical thinking. The platform combines online learning and offline learning, virtual simulation and physical simulation together, and narrowes the gap between theoretical teaching and clinical practice. This platform has promoted the development of nursing skills, clinical thinking and comprehensive abilities for nursing students and been also ready for the design and development of virtual simulation experimental teaching projects in the future.

Prevention and treatment of pediatric delirium / 中国小儿急救医学

Delirium is an acute, fluctuating state of brain dysfunction characterized by a change in consciousness and a reduced ability to concentrate, maintain, or transfer, which can lead to cognitive or perceptual disorders, hallucinations and sleep-arousal disorders.It cannot be better explained by pre-existing, occurring or developing diseases.At present, its pathogenesis is not clear, and is related to a variety of factors.Early and effective identification and evaluation is the premise, and the clinical practice strategy of prevention and treatment of pediatric delirium needs to be further studied.