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Objective:To explore the effects of the scaffolding-based flipped classroom approach in the teaching of Infectious Disease Nursing. Methods:We assigned 152 students of nursing and midwifery majors of grade 2018 (experimental group) to be taught using the scaffolding-based flipped classroom approach and 182 students of grade 2017 (control group) to be taught using the traditional lecture method. Teaching effects were evaluated through students' exam performance and a questionnaire survey. Numerical data were analyzed using the χ2 test and t test with the use of SPSS 18.0, and text data were processed using NVivo 11 for thematic analysis. Results:The experimental group and control group showed significant differences in the interim exam score (83.19±7.96 vs. 79.62±3.14, P<0.001) and final exam score (78.47±6.92 vs. 73.16±8.24, P<0.001). The students of grade 2018 had a high level of participation in online learning. The questionnaire results showed that the scaffolding-based flipped classroom was well recognized in terms of students' overall perception, perceived course quality, perceived value of learning, and satisfaction and the open-ended question, with low scores for learner complaints and loyalty. Conclusions:The scaffolding-based flipped classroom is feasible in the teaching of Infectious Disease Nursing, which can improve students' academic performance and overall competence.
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Scrotal mass is a common problem in the outpatient department of urology, accounting for 1% of all emergency patients. The diagnosis of scrotal masses is challenging due to the overlapping symptoms and signs of various scotal masses. Failure to correctly identify and treat scrotal masses, such as testicular torsion, testicular cancer, varicocele, and hydrocele, may lead to infertility, testicular loss, or even death. Misdiagnosis or missed diagnosis of scrotal masses may result in infertility, testicular loss, or even death. Therefore, we must maintain a high degree of vigilance and accurately identify scrotal masses that may affect life and testicular function. A full understanding of the manifestations and differences of various scrotal masses can help clinicians make accurate diagnoses and provide optimal treatment plans. The most critical aspect is to exclude emergency situations that may endanger life or testicular function, such as testicular torsion, testicular cancer, and necrotizing fasciitis, which require immediate medical attention. Scrotal ultrasonography is the best method for distinguishing scrotal masses based on their origin. Magnetic resonance imaging is the best tool for diagnosing scrotal hematoma. However, good clinical judgment and decision-making are still the most important factors for successful treatment of scrotal masses. The purpose of this article is to describe correct evaluation methods for scrotal masses and identify potential conditions that may threaten testicular survival, enabling accurate pathological diagnosis, evaluation, and treatment plans for each scrotal mass.
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Objective To investigate the clinical efficacy of percutaneous closure of foramen ovale guided by transthoracic echocardio-graphy with simply delivery sheath.Methods The clinical data of patients with patent foramen ovale underwent interventional closure and percutaneous closure guided by transthoracic echocardiography with simply delivery sheath in our hospital from January 2020 to December 2022 were analyzed retrospectively,the patients were divided into interventional closure group(40 cases)and simply delivery sheath group(39 cases).The operation time,incidence of surgical complications,and surgical success rates of patients in the two groups were compared.The closure effect were evaluated by ultrasound immediately after surgery.All the patients were followed up for 6 months after surgery to evaluate remission of the symptoms.Results The surgical success rate of simply delivery sheath group(100%)was higher than that of interventional closure group(90.0%),with statistically significant difference(P<0.05).The operation time of simply delivery sheath group was longer than that of interventional closure group,with statistically significant difference(P<0.05).One patient in the interventional closure group had small amount of pericardial effusion during the operation.Two patients had decreased blood pressure and slowed heart rate in simply delivery sheath group,and symptoms disappeared after treatment.There was no significant difference in the incidence of complications between the two groups(P>0.05).After 6-month follow-up,all occluders were in good position and no residual leakage was found.The symptoms of headache or dizziness disappeared in 28 patients in interventional closure group,significantly relieved in 8 patients;the symptoms of headache or dizziness disappeared in 30 patients in simply delivery sheath group,and significantly relieved in 9 patients.Conclusion Percutaneous closure for patent foramen ovale under the guidence of transthoracic echocardiography with simply delivery sheath is safe and feasible with satisfactory efficacy and higher successful rate without radiation hazard.It is worthy of clinical promotion.
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Objective To analyze the influencing factors of chronic obstructive pulmonary disease(COPD)complicating pulmonary interstitial fibrosis,and to establish a nomogram prediction model.Methods The clinical data of 195 patients with COPD admitted and treated in this hospital from January 2019 to Feb-ruary 2021 were retrospectively analyzed.The factors possibly affecting the patients with COPD complicating pulmonary interstitial fibrosis were collected,and the patients were divided into 2 groups according to whether having pulmonary interstitial fibrosis.The independent risk factors were analyzed and screened by the multi-variate logistic regression.Then the nomogram prediction model was constructed.Results Among the includ-ed 195 cases of COPD in this study,there were 50 cases(25.64％)of complicating pulmonary interstitial fi-brosis.The univariate and multivariate logistic regression analysis results showed that the smoking history,duration of COPD,frequency of acute exacerbations onset,serum transforming growth factor β1(TGF-β1),basic fibroblast growth factor(bFGF)and angiotensin Ⅱ(AngⅡ)were the independent influencing factors of COPD complicating pulmonary interstitial fibrosis(P＜0.05).The nomogram model was constructed accord-ing to the results of multivariate analysis results,and the area under the receiver operating characteristic(ROC)curve was 0.956(95％CI:0.930-0.983),the average absolute error of internal verification by the Bootstrap method was 0.025,and the prediction model performance basically fitted the ideal model.Conclusion The nomogram model constructed by this study for predicting the pulmonary interstitial fibrosis in COPD patients has high accuracy and distinction degree.
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OBJECTIVE To optimize the clinical drug list of diagnosis-related group （DRG）， reduce the drug cost of patients， and increase the DRG settlement rate. METHODS By selecting BR23 disease group in the department of neurology of a hospital as the research object， data mining technology was used to explore the medication rule of the disease group， and the key monitored drugs were scored by comprehensive evaluation of drugs， thus optimizing the clinical drug list of disease groups. The hospitalization information of patients enrolled in the disease group in December 2022 was selected as the pre-optimization data， and the hospitalization information of patients enrolled in the disease group in September 2023 was selected as the post-optimization data. The implementation effect of the optimized list was evaluated by comparing the medical quality and drug cost data between the two groups. RESULTS After optimizing the clinical drug list， the settlement rate of this disease group increased from 84.36% before optimization to 104.70%； there was significant reduction in hospitalization drug cost and total hospitalization cost （P＜ 0.05）； the consumption of key monitored drugs significantly decreased. CONCLUSIONS Data mining technology helps explore the clinical medication rules of disease groups， which can be used by pharmacists to improve the settlement rate of DRG through effective pharmaceutical intervention.
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Long-acting analgesia is a common clinical treatment method after surgery. The slow-release injection with long-acting analgesia has the advantages of less medication frequency and stable effect. In this study, the analgesic drug lappaconitine hydrobromide lyotropic liquid crystal injection was prepared, and its sustained release mechanism, drug release and pharmacodynamic characteristics were evaluated. The results of polarizing microscope and freeze-transmission electron microscope showed that the lyotropic liquid crystal injection of the liquid crystal precursor preparation of lappaconitine hydrobromide could be obtained by the combination of glycerol monooleate (GMO) and soybean lecithin (SPC) in different proportions. The results of dissolution study in vitro showed that the drug release rate of different forms of liquid crystal preparations was layered liquid crystal > cubic liquid crystal > hexagonal liquid crystal. The mathematical model fitting results of the release data showed that the external release of layered liquid crystal, cubic liquid crystal and hexagonal liquid crystal conforms to the Ritger-Peppas model, and the release mechanism was Fick diffusion. The results of pharmacodynamics study in vivo showed that the analgesic effect of lappaconitine hydrobromide lyotropic liquid crystal injection lasted for 3 days, and there was no abnormality in the incision and local tissue, showing good safety and tolerance. The study on drug release and elimination process of the in vivo gel repository showed that lappaconitine hydrobromide could be completely released from the lyotropic liquid crystal 3 days after administration, and the sustained-release materials could be gradually eliminated locally. All animal experiments were approved by the Experimental Animal Ethics Committee of the Shanghai Institute of Materia Medica, Chinese Academy of Sciences (No. 2021-08-GY-61) and the experiments were conducted in accordance with the relevant guiding principles and regulations. The lyotropic liquid crystal injection of lappaconitine hydrobromide prepared in this study presented a solution state at room temperature, and underwent phase transition in contact with the body fluid at the administration site, formed a drug depot and exerted a slow drug release effect. This preparation can reduce systemic toxicity, prolong the duration of analgesia, reduce the number of administrations, improve the compliance of postoperative patients, and provide a reference for the design of long-term sustained release analgesic preparations.
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Voiding dysfunction is common in children.The clinical manifestations include frequent micturition, urgent urination, micturition pain, delayed micturition, urinary incontinence, and enuresis.There may be only one symptom or multiple clinical manifestations at the same time, which is closely related to defecation dysfunction.Without timely diagnosis and treatment, in addition to affecting the quality of life, it often causes renal function damage and can even be life-threatening.Therefore, we should pay attention to the diagnosis and treatment of voiding dysfunction in children.
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Objective:To explore the clinical effects of intramuscular injection of oryzanol for 5 and 10 days in the treatment of menopausal syndrome.Methods:This study adopts a case-control study method.Twenty patients with menopausal syndrome admitted to Peking Union Medical College Hospital from July 2021 to March 2022 were selected and randomly divided into a control group and an observation group using a random number table method, with 10 patients in each group. The control group was given intramuscular injection of oryzanol once a day for 5 consecutive days on the basis of routine health education; On the basis of routine health education, the observation group was given intramuscular injection of oryzanol once a day for 10 consecutive days. Two groups of patients completed a total of 6 visits before treatment and on days 5, 10, 30, 60, and 90 of treatment. Baseline survey was conducted to record the basic information of patients, including demography data, menstruation, past history, surgical history, drug allergy and the main symptoms of climacteric syndrome, and the baseline hormone level of patients was detected. Compare the menopausal symptoms by modified K-score, Pittsburgh sleep quality index (PSQI) score, menopausal specific quality of life (MENQOL) score, post treatment injection site pain by visual analog score (VAS), and observe adverse reactions during treatment between the two groups of patients at each visit time point.The measurement data conforming to the normal distribution is expressed in xˉ± s. The comparison between the two groups is performed by t test, and the change trend of the two groups at each time point is compared by repeated measurement analysis of variance; The measurement data that do not conform to the normal distribution are represented by M( Q1, Q3), and the Kruskal Wallis test is used for comparison between groups; Counting data is represented by examples(%), Fisher's exact probability method is used for inter group comparison, and Wilcoxon rank sum test is used for rank data comparison. Results:The body mass of the control group was higher than that of the observation group [(62.50±11.88) kg vs (52.90±4.28) kg, t=2.40, P=0.027]. There was no statistical difference between the two groups in other demography data and previous history, sex hormone levels, menopausal symptoms, and menstrual conditions (all P>0.05). Compared with the baseline, the modified K-score, PSQI score, and MENQOL vascular dilation and contraction, psychological state, physiological state, and sexual life scores of the two groups of patients on the 5th, 10th, 30th, 60th, and 90th day of treatment were significantly reduced, and showed a gradually decreasing trend with the extension of observation time (the values in Group F were 36.37, 12.40, 18.69, 24.73, 40.77, and 18.39, respectively, P<0.001), but there was no statistically significant difference between the groups (all P>0.05). After treatment, the VAS score of the control group was 1 point in 2 cases, 2 points in 4 cases, and 3 points in 4 cases; The VAS score of the observation group was 1 in 4 cases, 2 in 3 cases, and 3, 5, and 6 in 1 case each. There was no statistically significant difference in VAS scores between the two groups ( Z=0.43, P=0.664), and no adverse events or serious adverse events were observed during the treatment period. Conclusions:Intramuscular injection of oryzanol injection for 5 and 10 days can improve menopausal symptoms, improve sleep quality and overall quality of life in patients with menopausal syndrome, and the overall effect is similar.
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Objective:To construct a novel cuproptosis-related gene signature (CRGS) for prediction of prognosis, immunotherapy response and drug sensitivity in patients with hepatocellular carcinoma (HCC).Methods:Data materials for this study were obtained from the international cancer genome consortium (ICGC), the cancer genome atlas (TCGA) database and Migort210 database, and protein expression profiles were obtained from the human protein atlas image classification database. Based on the TCGA cohort, the least absolute shrinkage and selection operator algorithm was applied to construct the CRGS and calculate the risk score for each HCC patient. HCC patients were grouped according to the median risk score: HCC patients in the TCGA cohort were divided into a high-risk group TCGA and a low-risk group TCGA with 184 cases in each group; HCC patients in the ICGC cohort were divided into a high-risk group ICGC and a low-risk group ICGC with 116 cases in each group. Patients in the Migort210 cohort were divided into a responder group ( n=68) and a non-responder group ( n=230) based on their response to immunotherapy. We assessed the value of CRGS in predicting the prognosis of HCC patients in the TCGA cohort and validated whether CRGS could be used to predict the prognosis of HCC patients in the ICGC dataset. To explore the role of CRGS in predicting immunotherapy response and drug sensitivity in HCC patients based on data from the TCGA cohort, and to apply the Migort210 immunotherapy cohort to validate the clinical value of CRGS in predicting immunotherapy in malignant tumors. Results:CRGS consists of four copper death-related genes: GLS, CDKN2A, LIPT1, and DLAT. Patients in the high-risk group TCGA had lower overall survival (OS), disease-specifical survival, and progression-free interval than those in the low-risk group TCGA (all P<0.01). OS of patients in the high-risk group ICGC was lower than that in the low-risk group ICGC ( P=0.022). Multivariate Cox regression analysis showed that CRGS was an independent risk factor for poor prognosis in HCC patients (TCGA: HR=2.991, 95% CI: 1.781-5.049, P<0.001; ICGC: HR=4.621, 95% CI: 1.685-12.674, P=0.033). Risk scores were positively correlated with the expression levels of CTLA4, PDCD1, CD80 and HLLA2 (all P<0.001). Patients in the high-risk group TCGA had lower tumor immune dysfunction and rejection scores than those in the low-risk group TCGA [-0.04(-0.07, -0.02) vs. -0.02(-0.04, 0) points], and the difference was statistically significant ( P<0.001). Patients in the responder group had a higher risk score than the non-responder group [1.70 (1.56, 1.90) vs. 1.63 (1.52, 1.80)], with a statistically significant difference ( P<0.05). The half-inhibitory concentrations (IC 50) for sunitinib, rapamycin and etanercept were higher in the high-risk group TCGA than that in the low-risk group TCGA, while the IC 50 for erlotinib was lower than that in the low-risk group TCGA, and the differences were all statistically significant (all P<0.001). Conclusion:The CRGS might be served as a potential biomarker to predict the prognoses, immunotherapy response, and drug sensitivity of patients with HCC.
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Objective:To investigate the predictive value of stone composition prediction method based on dual-source stone energy spectrum CT for uric acid stones.Methods:The clinical data of 204 patients with urinary stones, 159 males and 45 females, admitted to Shanghai Sixth People's Hospital from July 2020 to July 2022 were retrospectively analyzed. The average age was (50.7±14.3) years. There were 187 cases of upper urinary tract (kidney, ureter) stones and 17 cases of lower urinary tract (bladder, urethra) stones. All patients underwent preoperative dual-source stone energy spectroscopy CT, measuring CT values at 150 kV and 100 kV, respectively, and the calculated dual energy ratio (Ratio) was used to predict stone composition. Of the 204 cases in this group, 33 cases underwent percutaneous nephrolithotomy and 171 cases underwent ureteroscopic lithotripsy. Postoperative stone specimens were analyzed for stone composition by infrared spectroscopy. Subject work characteristic (ROC) curves were used to analyze the efficacy of preoperative dual-source stone energy spectrum CT to predict uric acid stones.Results:In 204 patients, preoperative CT predicted 28 cases of uric acid stones and 176 cases of non-uric acid stones, including 136 cases of calcium oxalate stones, 38 cases of hydroxyapatite, and 2 cases of cystine stones. Postoperative IR spectral analysis detected 26 cases of uric acid stones and 178 cases of non-uric acid stones, including 129 cases of calcium oxalate stones, 47 cases of hydroxyapatite, and 2 cases of cystine stones. Compared with the preoperative CT results, there were 2 false positives and no false negatives in the classification of uric acid stones. The ROC curve showed that the sensitivity of the CT value for predicting uric acid stones at 100 kV was 96.2%, the specificity was 99.5%, and the area under the ROC curve (AUC) was 0.995, with the best prediction value of 620 HU.The sensitivity of the CT value for predicting uric acid stones at 150 kV was 96.2%, specificity was 85.5%, AUC was 0.916, and the best predictive value was 597.5 HU. The sensitivity of using Ratio values for predicting uric acid stones was 100.0%, specificity was 97.9%, AUC was 0.996, and the best predictive value was 1.14. The CT values for uric acid stones at 100 kV and 150 kV were (558.58±77.07) HU and (521.12±83.54) HU, CT values for calcium oxalate stones were (1 335.26±301.82) HU and (878.21±200.21) HU, CT values for hydroxyapatite were (1 104.09±203.61) HU and (710.38±178.44) HU, respectively.The CT values of cystine stones were (684.5±67.18) HU and (573.5±67.10) HU, respectively, and the differences between uric acid stones and other components were statistically significant ( P<0.01). The Ratio values of uric acid stones, calcium oxalate stones, hydroxyapatite, and cystine stones were 1.08±0.06, 1.52±0.08, 1.62±0.40, and 1.19±0.02, respectively, and the differences were statistically significant ( P<0.01) when comparing uric acid stones with other components. Conclusion:The CT and Ratio values of dual-source stone energy spectrum CT can effectively distinguish uric acid stones from other types of stones, and the accuracy, sensitivity, and specificity of this method for predicting uric acid stones are high.
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AIM To prepare cucurbitacin B nanosuspensions,and to investigate their in vivo pharmacokinetics.METHODS The nanosuspensions were prepared by high-pressure homogenization method.With stabilizer type,stabilizer-drug ratio and homogeneous frequency as influencing factors,particle size and PDI as evaluation indices,the formulation was optimized by single factor test,after which the solubility and stability were determined,and crystalline form analysis was performed.Eighteen rats were randomly assigned into three groups and given intragastric administration of the 0.5%CMC-Na suspensions of cucurbitacin B,physical mixture and cucurbitacin B nanosuspensions(10 mg/kg),respectively,after which blood collection was made at 0.5,1,2,3,4,8,10,12 h,UPLC-MS/MS was adopted in the plasma concentration determination of cucurbitacin B,and main pharmacokinetic parameters were calculated.RESULTS The optimal formulation was hydroxypropyl cellulose+sodium dodecyl sulfate(1 ∶ 1)as stabilizer,3 ∶ 1 for stabilizer-drug ratio,80 MPa for homogeneous pressure,and 12 times for homogeneous frequency,the average particle size,PDI and Zeta potential were 200 nm,0.140 and-32 mV,respectively.The nanosuspensions demonstrated obviously higher solubility than that of raw medicine and physical mixture,along with good stability within 6 months.Cucurbitacin B existed in the nanosuspensions in an amorphous state.Compared with raw medicine and physical mixture,the nanosuspensions displayed shortened tmax(P<0.01),prolonged t1/2(P<0.05,P<0.01),and increased Cmax,AUC0-t,AUC0-∞(P<0.01),whose relative bioavailability was enhanced to 4.32 times as compared with that of raw medicine.CONCLUSION Nanosuspensions can improve the dissolution rate and oral bioavailability of cucurbitacin B.
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【Objective】 To explore the causes and management of nephrostomy catheter following percutaneous nephrostolithotomy (PCNL) entering the inferior vena cava. 【Methods】 A retrospective analysis was performed on the management of two cases of nephrostomy catheter entering the inferior vena cava. The causes, changes of minimally invasive treatment and prevention plans were discussed. 【Results】 Two patients underwent digital subtraction angiography (DSA) to restore the nephrostomy tube to the renal pelvis collecting system. No renal vein rupture or bleeding occurred during the operation, and the patients’ vital signs were stable. Nephrostomy tube was removed successfully after operation. The wound healing was good, and there was no secondary hemorrhage such as perirenal hematoma. The prognosis was good. 【Conclusion】 Although intravenous nephrostomy tube misplacement is an uncommon PCNL complication, the consequences are serous. One-step retraction displacement of nephrostomy tube to the renal collecting system can effectively manage nephrostomy catheter entering the inferior vena cava.
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More and more young patients survive from breast cancer with improvement of curative effect. The next challenge is to realize fertility demands of young breast cancer survivors. The safety issue, preservation of fertility and timing of pregnancy are the common focus of clinicians and patients. This review of relative researches points out that, with current evidence, pregnancy does not increase recurrence risk of young breast cancer survivors. To fulfill their wishes of being mothers, fertility protection should be included in their diagnosis and treatment, and multidisciplinary assessment of pregnancy timing is needed.
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Atherosclerotic cardiovascular disease(ASCVD)frequently results in sudden death and poses a serious threat to public health worldwide.The drugs approved for the prevention and treatment of ASCVD are usually used in combination but are inefficient owing to their side effects and single therapeutic targets.Therefore,the use of natural products in developing drugs for the prevention and treatment of ASCVD has received great scholarly attention.Andrographolide(AG)is a diterpenoid lactone compound extracted from Andrographis paniculata.In addition to its use in conditions such as sore throat,AG can be used to prevent and treat ASCVD.It is different from drugs that are commonly used in the prevention and treatment of ASCVD and can not only treat obesity,diabetes,hyperlipidaemia and ASCVD but also inhibit the pathological process of atherosclerosis(AS)including lipid accumulation,inflammation,oxidative stress and cellular abnormalities by regulating various targets and pathways.However,the pharmaco-logical mechanisms of AG underlying the prevention and treatment of ASCVD have not been corrobo-rated,which may hinder its clinical development and application.Therefore,this review summarizes the physiological and pathological mechanisms underlying the development of ASCVD and the in vivo and in vitro pharmacological effects of AG on the relative risk factors of AS and ASCVD.The findings support the use of the old pharmacological compound('old bottle')as a novel drug('novel wine')for the pre-vention and treatment of ASCVD.Additionally,this review summarizes studies on the availability as well as pharmaceutical and pharmacokinetic properties of AG,aiming to provide more information regarding the clinical application and further research and development of AG.
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Objective:To evaluate the relationship between mitochondrial calcium uniporter protein (MCU)-mediated mitochondrial dynamics and intestinal ischemia-reperfusion (I/R) injury in mice.Methods:Twenty-four wild-type adult male C57BL/6J mice, aged 6-8 weeks, weighing 18-20 g, were divided into 4 groups ( n=6 each) using a random number table method: sham operation group (S group), intestinal I/R group (IIR group), sham operation+ MCU inhibitor Ru360 group (S+ Ru360 group) and intestinal I/R + Ru360 group (IIR+ Ru360 group). The mouse model of intestinal I/R injury was prepared by clamping the root of the superior mesenteric artery for 45 min followed by 2 h of reperfusion in anesthetized animals. Small intestinal tissues were obtained at the end of reperfusion for examination of the intestinal mucosal injury which was scored according to Chiu and for determination of the content of malondialdehyde (MDA) (TBA method), activity of superoxide dismutase (SOD) (WST-8 method), content of lactic dehydrogenase (LDH) (colorimetric method), and expression of MCU, dynamin-related protein 1 (Drp1), recombinant human mitochondrial fission 1 protein (Fis1), mitofusin-1 (Mfn1) and Mfn2 (by Western blot). Results:Compared with S and S+ Ru360 groups, the Chiu′s score and contents of MDA and LDH were significantly increased, the activity of SOD was decreased, the expression of MCU, Drp1 and Fis1 was up-regulated, and the expression of Mfn1 and Mfn2 was down-regulated in IIR and IIR+ Ru360 groups ( P<0.05). Compared with IIR group, the Chiu′s score and contents of MDA and LDH were significantly decreased, the activity of SOD was increased, the expression of MCU, Drp1 and Fis1 was down-regulated, and the expression of Mfn1 and Mfn2 was up-regulated in IIR+ Ru360 group ( P<0.05). Conclusions:The mechanism underlying intestinal I/R injury may be related to MCU-induced promotion of mitochondrial fission, reduction of mitochondrial fusion and mediation of imbalance in mitochondrial dynamics in mice.
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Cardiac-resident macrophages (CRMs) play important roles in homeostasis, cardiac function, and remodeling. Although CRMs play critical roles in cardiac regeneration of neonatal mice, their roles are yet to be fully elucidated. Therefore, this study aimed to investigate the dynamic changes of CRMs during cardiac ontogeny and analyze the phenotypic and functional properties of CRMs in the promotion of cardiac regeneration. During mouse cardiac ontogeny, four CRM subsets exist successively: CX3CR1+CCR2-Ly6C-MHCII- (MP1), CX3CR1lowCCR2lowLy6C-MHCII- (MP2), CX3CR1-CCR2+Ly6C+MHCII- (MP3), and CX3CR1+CCR2-Ly6C-MHCII+ (MP4). MP1 cluster has different derivations (yolk sac, fetal liver, and bone marrow) and multiple functions population. Embryonic and neonatal-derived-MP1 directly promoted cardiomyocyte proliferation through Jagged-1-Notch1 axis and significantly ameliorated cardiac injury following myocardial infarction. MP2/3 subsets could survive throughout adulthood. MP4, the main population in adult mouse hearts, contributed to inflammation. During ontogeny, MP1 can convert into MP4 triggered by changes in the cellular redox state. These findings delineate the evolutionary dynamics of CRMs under physiological conditions and found direct evidence that embryonic and neonatal-derived CRMs regulate cardiomyocyte proliferation. Our findings also shed light on cardiac repair following injury.
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Abstract@#Allergic diseases can occur in all systems of the body, covering the whole life cycle, from children to adults and to old age, can be lifelong onset and even fatal in severe cases. Children account for the largest proportion of the victims of allergic disease, Children s allergies start from scratch, ranging from mild to severe, from less to more, from single to multiple systems and systemic performance, so the prevention and treatment of allergic diseases in children is of great importance, which can not only prevent high risk allergic conditions from developing into allergic diseases, but also further block the process of allergy. At present, there is no consensus on the management system of allergic children in kindergartens and primary schools. The "Consensus on Allergy Management and Prevention in Kindergartens and Primary Schools", which includes the organizational structure, system construction and management of allergic children, provides evidence informed recommendations for the long term comprehensive management of allergic children in kindergartens and primary schools, and provides a basis for the establishment of the prevention system for allergic children.
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Objective: To evaluate the thermal environment of different types of public places and the thermal comfort of employees, so as to provide scientific basis for the establishment of microclimate standards and health supervision requirements. Methods: From June 2019 to December 2021, 50 public places (178 times) of 8 categories in Wuxi were selected, including hotels, swimming pools (gymnasiums), bathing places, shopping malls (supermarkets), barber shops, beauty shops, waiting rooms (bus station) and gyms. In summer and winter, microclimate indicators such as temperature and wind speed were measured in all kinds of places, combined with the work attire and physical activity of employees in the places. Fanger thermal comfort equation and center for the built environment (CBE) thermal comfort calculation tool were used to evaluate the predicted mean vote (PMV), predicted percent dissatisfied (PPD) and standard effective temperature (SET) according to the American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE) 55-2020. The modification effects of seasonal and temperature control conditions on thermal comfort were analyzed. The consistency of GB 37488-2019 "Hygienic Indicators and Limits in Public Places" and ASHRAE 55-2020 evaluation results on thermal environment was compared. Results: The thermal sensation of hotel, barber shop staff and the gym front-desk staff were moderate, while the thermal sensation of swimming place lifeguard, bathing place cleaning staff and gym trainer were slightly warm in summer and winter. Waiting room (bus station) cleaning and working staff, shopping mall staff felt slightly warm in summer and moderate in winter. Service staff in bathing places felt slightly warm in winter, while staff in beauty salons felt slightly cool in winter. The thermal comfort compliance of hotel cleaning staff and shopping mall staff in summer was lower than that in winter (χ(2)=7.01, 7.22, P=0.008, 0.007). The thermal comfort compliance of shopping mall staff in the condition of air conditioning off was higher than that in the condition of air conditioning on (χ(2)=7.01, P=0.008). The SET values of front-desk staff in hotels with different health supervision levels were significantly different (F=3.30, P=0.024). The PPD value and SET value of the front-desk staff, and the PPD value of cleaning staff of hotels above three stars were lower than those of hotels below three stars (P<0.05). The thermal comfort compliance of front-desk staff and cleaning staff in hotels above three stars was higher than that in hotels below three stars (χ(2)=8.33, 8.09, P=0.016, 0.018). The consistency of the two criteria was highest among waiting room (bus station) staff (100.0%, 1/1) and lowest among gym front-desk staff (0%, 0/2) and waiting room (bus station) cleaning staff (0%, 0/1) . Conclusion: There are different degrees of thermal discomfort in different seasons, under the condition of air conditioning and health supervision, and the microclimate indicators can not fully reflect the thermal comfort of human body. The health supervision of microclimate should be strengthened, the applicability of health standard limit value should be evaluated in many aspects, and the thermal comfort of occupational group should be improved.
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Humans , Temperature , Cold Temperature , Air Conditioning , Wind , SeasonsABSTRACT
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was reported at the end of 2019 as a worldwide health concern causing a pandemic of unusual viral pneumonia and many other organ damages, which was defined by the World Health Organization as coronavirus disease 2019 (COVID-19). The pandemic is considered a significant threat to global public health till now. In this review, we have summarized the lessons learnt during the emergence and spread of SARS-CoV-2, including its prototype and variants. The overall clinical features of variants of concern (VOC), heterogeneity in the clinical manifestations, radiology and pathology of COVID-19 patients are also discussed, along with advances in therapeutic agents.
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Humans , COVID-19 , SARS-CoV-2 , Pneumonia, Viral/prevention & control , Global Health , China/epidemiologyABSTRACT
OBJECTIVE To build an “integration of drug storage and dispensing” intelligent drug validity management system in outpatient pharmacy， and to evaluate the effect of this system. METHODS The information technology was used to connect the drug information in the primary storage， the intelligent secondary storage and the rapid dispensing machine； an “integration of drug storage and dispensing” intelligent drug validity management system was constructed. At the same time， the implementation effects of drug validity management system in outpatient pharmacy of our hospital were evaluated one year before and after the construction of the system. RESULTS By using information technology， intelligent closed-loop management of batch number and expiration date information throughout the entire process of drug circulation in outpatient pharmacy of our hospital had been achieved， making it easy to track and trace drug information. After the establishment of the intelligent system， the time spent on managing drug validity every month was reduced from 103 people·h to 8 people·h； the number of near-expired drugs per month had decreased from （30.67±1.10）types to （17.67±1.17）types（P＜0.05）. CONCLUSIONS The intelligent drug validity management system in outpatient pharmacy based on the mode of “integration of drug storage and dispensing” makes the drug validity management in the outpatient pharmacy more scientific， reasonable and efficient.