Topical agents for the prevention ofradiodermatitis in cancer patients: A systematic review / Agentes tópicos para prevenção de radiodermatiteem pacientes com câncer: revisão sistemática

Objetivo: Analisar as evidências sobre o efeito dos agentes tópicos empregados para a prevenção da radiodermatite em pacientes com câncer. Método: Revisão sistemática de estudos clínicos randomizados duplos-cegos construída conforme recomendações do Joanna Briggs Institute e busca nas bases de dados MEDLINE/PubMed, CINAHL, LILACS, Web of Science, Embase, Scopus, além da literatura cinzenta. Utilizaram-se a ferramenta de avaliação crítica do JBI para ensaios clínicos randomizados para avaliar a possibilidade de viés, o Grading of Recommendations, Assessment, Development and Evaluation para a qualidade das evidências e o Gradepro® para recomendá-las. Resultados: Selecionaram-se 13 estudos que avaliaram diferentes agentes tópicos para prevenir a radiodermatite, a saber: corticosteroides, de ação antioxidante e fitoterápicos. A qualidade metodológica de cada estudo foi apropriada, mas a qualidade da evidência gerada pela reunião deles foi baixa, independentemente do tipo de agente tópico empregado, sugerindo que a confiança no seu efeito é limitada e tornando a força de recomendação fraca. Conclusão: Alguns agentes tópicos mostraram-se promissores para a prevenção de radiodermatite, mas as evidências aqui reunidas sobre a eficácia deles não permitem indicar seu uso para a prevenção de radiodermatite em pacientes com câncer. (AU)

Objective: To analyze the evidence on the effect of topical agents to prevent radiodermatitis in cancer patients. Methods: Systematic review of double-blind randomized clinical studies built according to JBI recommendations and search in the databases MEDLINE/PubMed, CINAHL, LILACS, Web of Science, Embase and Scopus, in addition to the Gray Literature. The JBI critical assessment tool for randomized clinical trials was used to assess the possibility of bias, GRADE for the quality of evidence, and Gradepro® to recommend them. Results: Thirteen studies were selected that evaluated different topical agents to prevent radiodermatitis, namely: corticosteroids, with antioxidant action and herbal medicines. The methodological quality of each study was appropriate. Still, the quality of evidence generated by pooling them was low, regardless of the type of topical agent employed, suggesting that confidence in its effect is limited and weakening the strength of the recommendation. Conclusions: Some topical agents have shown promise for the prevention of radiodermatitis, but the evidence gathered here about their effectiveness does not indicate their use for the prevention of radiodermatitis in cancer patients. (AU)

Objetivo: Analizar la evidencia sobre el efecto de los agentes tópicos utilizados para la prevención de la radiodermatitis en pacientes con cáncer. Método: Revisión sistemática de estudios clínicos aleatorizados, doble ciego, elaborados según las recomendaciones del JBI y buscados en MEDLINE/PubMed, CINAHL, LILACS, Web of Science, Embase y Scopus, además de literatura gris. Se utilizó la herramienta de evaluación crítica JBI para ensayos clínicos aleatorios para evaluar la posibilidad de sesgo, GRADE para la calidad de la evidencia y Gradepro® para recomendarla. Resultados: Se seleccionaron trece estudios que evaluaron diferentes agentes tópicos para prevenir la radiodermatitis, a saber: corticosteroides, con acción antioxidante y fitoterapia. La calidad metodológica de cada estudio fue apropiada, pero la calidad de la evidencia generada al combinarlos fue baja, independientemente del tipo de agente tópico empleado, lo que sugiere que la confianza en su efecto es limitada y debilita la fuerza de la recomendación. Conclusión: Algunos agentes tópicos se han mostrado prometedores para la prevención de la radiodermatitis, pero la evidencia aquí reunida sobre su eficacia no nos permite indicar su uso para la prevención de la radiodermatitis en pacientes con cáncer. (AU)

Educación sexual, conocimiento de ITS y conductas protectoras/de riesgo en personas entre 18 y 30 años / Sex education, knowledge of STIs and protective/risk behaviors in people between 18 and 30 years of age

Introducción: Las infecciones de transmisión sexual (ITS) se adquieren principalmente por el contacto sexual y pueden afectar a personas de cualquier edad, sin embargo los adolescentes son el grupo etario más afectado, por tanto es probable que sus conductas sean más de riesgo que protectoras. Objetivo: El objetivo de la investigación es determinar la relación entre el nivel de educación sexual y el conocimiento sobre ITS y las conductas de riesgo y protectoras en los jóvenes. Método: Investigación de diseño analítico, estudio de tipo descriptivo, transversal con datos de tipo cuantitativos, con una muestra de 130 hombres y mujeres, considerando 10 personas por edad desde los 18 a los 30 años. Resultados: No existe relación estadísticamente significativa entre la educación sexual y las conductas de riesgo y/o protectores (p > 0,05), ni tampoco entre la educación sexual y el uso del preservativo, tanto interno como externo (p > 0,05). Conclusión: A pesar de tener educación sexual, no todas las personas utilizan de forma frecuente los anticonceptivos de barrera y principalmente es sorprendente el poco uso del condón de vagina en la población en general, siendo las personas de orientación heterosexual las que lo utilizan menos.

Introduction: Sexually transmitted infections (STIs) are mainly acquired through sexual contact and can affect people of any age; however, adolescents are the most affected age group, therefore, it is likely that their behaviors are more risky than protective. Objective: The objective of the research is to determine the relationship between the level of sexual education and knowledge about STIs and risk and protective behaviors in young people. Method: Analytical design research, descriptive, cross-sectional study with quantitative data, with a sample of 130 men and women, considering 10 people by age from 18 to 30 years. Results: There is no statistically significant relationship between sexual education and risk and/or protective behaviors (p > 0.05) nor between sexual education and condom use, both internal and external (p > 0.05). Conclusion: Despite having sexual education, not all people use frequently barrier contraceptives and, mainly, the little use of the vaginal condom in the general population is surprising, with people of heterosexual orientation being those that use it less.

Equipos de protección personal en odontología antes y después de la COVID-19

El uso de equipamientos de protección personal durante los tratamientos odontológicos garantiza la salud de profesionales y pacientes. Este trabajo tiene como propósito analizar, en la literatura científica, el conocimiento de estudiantes y profesionales de odontología sobre el uso de equipos de protección personal, antes y después de la pandemia COVID-19. Para ello se realizó una revisión integrativa en las bases de datos: Scielo, Pubmed, BVS y Web of Science, incluyendo artículos publicados entre agosto del 2010 y agosto del 2022. Fueron seleccionados 14 artículos, disponibles íntegramente en las bases de datos seleccionadas. Se excluyeron tesis, artículos de revisión, duplicados y aquellos donde la metodología no respondía al objetivo propuesto. En los 14 artículos seleccionados, el método para obtención de datos fue el cuestionario. Los estudios fueron realizados en Brasil, Yemen, Cuba, México, Líbano, Turquía, India, Londres, y Colombia. Seis estudios se realizaron antes de la pandemia y 8 de ellos después de su inicio. Todas las investigaciones evaluaban conocimientos, actitudes, prácticas y factores relacionados con el uso de equipos de protección personal. Se concluye que el uso de equipos de protección personal antes de la pandemia ya era una práctica esencial para garantizar la seguridad de profesionales, estudiantes y pacientes durante los procedimientos odontológicos; con la pandemia de COVID-19 nuevos protocolos fueron establecidos y con ellos nuevos equipamientos como el uso del protector facial y la mascarilla N95.

The use of personal protective equipment during dental treatments guarantees the professionals and patients' health. This researcher's purpose is to analyze in scientific literature the dental students and professionals' knowledge regarding the use of personal protective equipment, before and after the COVID-19 pandemic. An integrative review was carried out in the databases: Scielo, Pubmed, BVS and Web of Science, including articles published between August 2010 and August 2022. 14 articles were selected, available in full in the selected databases. Theses, review articles, duplicates and those where the methodology did not respond to the proposed objective were excluded. In the 14 selected articles, the method for obtaining data was the questionnaire. The studies were carried out in Brazil, Yemen, Cuba, Mexico, Lebanon, Turkey, India, London, and Colombia. Six studies were carried out before the pandemic and 8 of them after its start. All researches evaluated knowledge, attitudes, practices and factors related to the use of personal protective equipment. It is concluded that the use of personal protective equipment before the pandemic was already an essential practice to guarantee the safety of professionals, students and patients during dental procedures; with the COVID-19 pandemic, new protocols were established and with them new equipment such as the use of the face shield and the N95 mask.

Analysis of the shielding effect of protective door of an 18 MV linear accelerator debugging room and its influencing factors / 中国辐射卫生

Objective To study the shielding effect of the protective door of a maze-free debugging room for an 18 MV medical linear accelerator and its influencing factors, and to provide guidance for protection of debugging personal against radioactive occupational disease hazards. Methods The investigation focused on the protective door of a newly constructed maze-free debugging room for an 18 MV medical linear accelerator. The protective door was made of the following shielding materials from inside to outside: 2.5 cm steel plate + 20 cm lead + 41 cm polyethylene containing 5% boron + 6 cm lead + 2.5 cm steel plate. The right side of the protective door was provided with a groove (commonly known as “door pocket”) lap. With different lap widths, irradiation directions, and installation positions of the accelerator base, FLUKE451P and WENDI II neutron detectors were used to measure the ambient dose equivalent rate of the points of interest outside the protective door. The shielding effect and influencing factors were analyzed. Results When the lap width at both sides of the protective door was 300 mm, the ambient dose equivalent rates outside the protective door were (1.37 ± 0.05) μSv/h on the side with “door pocket” and (4.71 ± 0.11) and (4.19 ± 0.11) μSv/h on the side without “door pocket”. When the primary beam of the accelerator was directed towards the east, the ambient dose equivalent rates at the points of interest outside the protective door were higher than those of the corresponding points of interest when the primary beam was directed towards other directions. When the accelerator base was located on the south side of the machine room, the ambient dose equivalent rates of the points of interest outside the protective door under the same irradiation conditions were lower than those when the accelerator base was located on the north side of the machine room. Conclusion The study of an 18 MV accelerator and its maze-free debugging room showed that the radiation of photons and neutrons should be taken into consideration when designing the protective door at the entrance. The protective door with shiplaps on both sides of the wall has improved shielding effect outside the door.

The protective effectiveness of hearing protectors for noise-exposed workers and its influencing factors / 中国职业医学

ObjectiveTo explore the protective effect of hearing protectors worn by noise-exposed workers and its influencing factors. Methods A total of 329 occupational noise-exposed workers were selected as the research subjects by judgment sampling method. A questionnaire survey on the use of ear protectors and individual suitability tests was conducted. Intervention was carried out for those whose personal attenuation rating (PAR) did not pass the baseline standard. Results The median (M) and the 25th and 75th percentiles of baseline PAR were 17.0 (5.0, 22.5) dB. The baseline PAR of the workers who were male, aged 25-<35 years, with a working experience of 5-<15 years, with a college degree or above, wearing ear protectors for 5-<15 years, knowing the right way to wear ear protectors, and workers who wore ear protectors correctly during work was relatively high (all P<0.01). The unqualified rate of baseline PAR of the study subjects was 32.8%. The unqualified rate of baseline PAR of workers in automobile manufacturing enterprises was lower than that of workers in plastic enterprises and textile enterprises (9.2% vs 43.6%, and 9.2% vs 50.0%, both P<0.01). The M of the 108 unqualified worker on baseline PAR was improved after intervention (22.0 vs 1.0 dB, P<0.01). The rates of knowing the right way to wear ear protectors, wearing ear protectors correctly during work, and receiving training on wearing ear protectors correctly for the research subjects were 88.1%, 84.8%, and 86.6%, respectively. Workers in automobile manufacturing enterprises and plastic enterprises had higher rates of knowing the right way to wear ear protectors, wearing ear protectors correctly during work, and receiving training on wearing ear protectors correctly than those in textile enterprises (all P<0.01). Conclusion Gender, age, working experience, education level, duration of wearing ear protectors, knowledge and use of ear protectors correctly are influencing factors of the protective effect of ear protectors for noise-exposed workers.

Influencing factors for intestinal colonization and secondary infection of CRKP in neonates / 中国感染控制杂志

Objective To analyze the influencing factors for intestinal colonization and secondary infection of car-bapenem-resistant Klebsiella pneumoniae(CRKP)in neonates,and provide a basis for formulating prevention and control strategies for CRKP infection.Methods Neonates who were admitted to the neonatal ward of a hospital from January 2021 to October 2022 were selected as the study subjects,and the first screening of CRKP was con-ducted within 48 hours after admission.In addition,active anal swab screening for carbapenem-resistant Ente-robacterales(CRE)was performed weekly during hospitalization,and the infection status of CRKP strains was mo-nitored.Clinical data of neonates in the colonization group,non-colonization group,and infection group were ana-lyzed.Intestinal colonized strains and the non-repetitive CRKP strains isolated from clinical specimens of neonates with secondary infection after colonization were performed carbapenemase gene detection,multilocus sequence ty-ping(MLST)and pulsed-field gel electrophoresis(PFGE)analysis.Results A total of 1 438 neonates were active-ly screened for CRE,174 were CRKP positive,CRKP colonization rate was 12.1％.Among 174 neonates,35 were with secondary infection,with the incidence of 20.1％.The independent risk factors for neonatal CRKP intestinal colonization were cesarean section(OR=2.050,95％CI:1.200-3.504,P=0.009),use of cephalosporins(OR=1.889,95％CI:1.086-3.288,P=0.024),nasogastric tube feeding(OR=2.317,95％CI:1.155-4.647,P=0.018).Protective factors were breast-feeding(OR=0.506,95％CI:0.284-0.901,P=0.021),oral probiotics(OR=0.307,95％CI:0.147-0.643,P=0.002),and enema(OR=0.334,95％CI:0.171-0.656,P=0.001).Independent risk factors for secondary infection after intestinal colonization of neonatal CRKP were carbapenem anti-biotic use(OR=19.869,95％CI:1.778-222.029,P=0.015)and prolonged hospital stay(OR=1.118,95％CI:1.082-1.157,P＜0.001).The detection results of drug resistance genes showed that carbapenemase-producing genes of CRKP strains were all blaKPC-2,all belonged to type ST11.Homologous analysis showed that intestinal CRKP colonization was highly homologous with the secondary infection strains after colonization.Conclusion CRKP intestinal colonization during neonatal hospitalization may increase the risk of CRKP infection.Risk and pro-tective factors of neonatal intestinal colonization and secondary infections after colonization should be paid attention,and corresponding preventive and control measures should be taken,so as to reduce the occurrence and transmission CRKP healthcare-associated infection.

Protective effect and mechanism of TLR4/NF-κB pathway regulated by miR-146a in intracerebral hemorrhage model rats / 中国免疫学杂志

Objective:To explore role of miR-146a in regulating TLR4/NF-κB pathway on inflammatory injury and neuropro-tection in intracerebral hemorrhage model rats and its possible mechanism.Methods:A total of 40 rats were selected and randomly divided into sham,model,over-expressing miR-146a adenovirus and negative virus injection groups,with 10 rats in each group.Garcia score was used for neurological function;HE staining was used to observe changes of brain tissues.ELISA was used to detect inflammatory factors levels.TLR4,NF-κB protein and gene expressions in brain tissues were detected by Western blot and RT-PCR.Results:Compared with model group,neural function score of overexpressed miR-146a adenovirus injection group was increased(P<0.05).Model group had abnormal cell morphology,edema and inflammation.Cell morphology,edema and inflammation were alleviated in overexpressed miR-146a adenovirus injection group.Inflammatory factors levels in model group were higher than sham group(P<0.05).Inflammatory factors levels in overexpressed miR-146a adenovirus injection group were lower than model group(P<0.05).TLR4,NF-κB protein and mRNA expressions in model group were increased than sham group(P<0.05).TLR4,NF-κB protein and mRNA expressions in overexpressed miR-146a adenovirus injection group were decreased than model group(P<0.05).Conclusion:miR-146a can improve neural function and reduce inflammatory injury in rats with intracerebral hemorrhage,possibly by inhibiting activation of TLR4/NF-κB signaling pathway and reducing inflammatory factors levels of brain tissues.

Screening and identification of human monoclonal antibodies against low-calcium response V antigen of Yersinia pestis / 中国人兽共患病学报

To characterize human antibodies against low-calcium response V(LcrV)antigen of Yersinia pestis,the mono-clonal antibodies were screened and assayed.Antibody gene was derived from peripheral blood mononuclear cells of the vaccin-ees immunized by plague subunit vaccine in phase Ⅱb clinical trial.Human ScFv antibody library was constructed by phage dis-play.After panning library by using recombinant LcrV antigen,antibody variable genes were sequenced and converted into IgG1 format to evaluate its binding specificity and relevant parameters.An anti-plague human ScFv antibody library was estab-lished contained 7.54× 108 independent clones.After panning by LcrV antigen,3 human antibodies named as RV-B4,RV-D1 and RV-E8,respectively,were identified.Using indirect enzyme-linked immunosorbent assay(ELISA)and Western blot(WB),the specific bindings of the mAbs to LcrV antigen were confirmed.The dissociation constant(KD)of them to LcrV is 2.1 nmol/L,1.24 nmol/L and 42 nmol/L,respectively.Minor protective efficacy was found among 3 human antibodies in Y.pestis 141-infected mice.Three anti-LcrV monoclonal antibodies generated from immunized vaccinees were binding specific antibod-ies and could not block plague infection in mice.These antibodies are the potential candidate reagents for basic research of plague immunity and the application of plague diagnosis.

Protective effect of Xiebaisan on allergic asthma in rats based on non-targeted metabolomics and intestinal bacterial flora / 中国实验动物学报

Objective To explore the possible mechanism of Xiebaisan in protecting against allergic asthma in rats from the perspective of host intestinal flora metabolism.Methods SPF SD rats were divided into normal group(NC group),model group(M group),and Xiebaisan group.The allergic asthma rat model was established by ovalbumin.Changes in lung histopathology were observed by HE staining.Colon contents were harvested for 16S rDNA high-throughput sequencing to assess changes in the intestinal flora structure and function.Serum and lung tissue samples were collected for non-targeted metabolomics by Ultra-high performance liquid-time-of-flight mass spectrometer.Results HE staining showed some improvement of lung histomorphology in asthmatic rats in the Xiebaisan group compared with that in the M group.16S rDNA high-throughput sequencing showed that the diversity of intestinal flora was decreased in the M group and increased in the Xiebaisan group compared with the M group,the microecosystem of intestinal was improved.Non-targeted metabolomics of serum showed regulation of amino acid metabolism and the mTOR pathway in the Xiebaisan group,and partially reversed differential metabolite expression in the M group.Non-targeted metabonomics of lung tissue samples showed regulation of carbon metabolism,vascular smooth muscle and cAMP signaling pathways in the Xiebaisan group,and partially reversed differential metabolite expression in the M group.Conclusions The protective effects of Xiebaisan on allergic asthma in rats may be related to improvement of the morphological structure of lung tissue,the diversity of intestinal flora,and regulation of mTOR,vascular smooth muscle contraction,and cAMP pathways,which affect amino acid and carbon metabolism.

Driving pressure-guided PEEP titration for intraoperative mechanical ventilation:a meta-analysis / 重庆医学

Objective To systematic evaluate the effectiveness and safety of driving pressure-guided fixed positive end-expiratory pressure(PEEP)titration in intraoperative mechanical ventilation.Methods PubMed,Web of Science,the Cochrane Library,Embase,CNKI,Wanfang and VIP databases were searched for collect randomized controlled trials(RCTs)of PEEP titration guided by driving pressure in intraoperative mechanical ventilation from inception to November 8,2023.After two researchers independently screened the literature,extracted data,and evaluated the risk of bias of the included studies,the meta-analysis was conducted by Rev-Man 5.4 software.Results Nineteen studies with a total of 2 906 patients were included.There were 1 440 patients in the study group with the lung protective ventilation strategy guided by PEEP titration,and 1 466 patients in the control group with the traditional lung protective ventilation strategy.Compared with the con-trol group,the incidence of postoperative pulmonary complications(PPCs)in the study group was lower in the non-thoracic surgery(RR=0.53,95%CI:0.43-0.65,P<0.001),but there was no statistical difference in the incidence of PPCS in the thoracic surgery(RR=0.89,95%CI:0.78-1.02,P=0.09).Compared with the control group,the intraoperative lung compliance was increased(MD= 6.90 L/cmH2O,95%CI:5.80-7.99,P<0.001),and the length of hospital stay was shortened in the study group(MD=-0.27 d,95%CI:-0.43 to-0.12,P<0.001),while there was no significant difference in intraoperative mean arterial pres-sure(MAP)between the two groups(MD=0.36 mmHg,95%CI:-1.30 to 2.01,P=0.67).Conclusion Com-pared with the traditional lung protective ventilation,driving pressure-guided PEEP titration ventilation can im-prove intraoperative lung compliance,reduce the incidence of PPCs in non-thoracic surgery,shorten the length of hospital stay,and does not increase the risk of hemodynamic disturbances in patients undergoing surgery.

Protective effects of cinnamaldehyde on benzene-induced immune and oxidative stress injury in mice / 军事医学

Objective To investigate the effects of cinnamaldehyde,the main active component of cinnamon,on benzene-induced immune injury in mice and the related mechanism.Methods Forty male BALB/c mice were randomly divided into the control group,model group(benzene 500 mg/kg),cinnamaldehyde low,medium and high dose groups(5,25,50 mg/kg),with 8 mice in each group.Except the control group,mice in each group were treated with benzene by intragastric administration daily to induce immune and oxidative stress damage,but the intervention group was treated with cinnamaldehyde 5 times/week for 3 weeks.After medication,peripheral blood was collected 24 h after the last gavage for blood cell count,and the changes in body weight of mice in each group were observed.The pathological structure of the spleen and thymus was observed via hematoxylin-eosin(HE)staining.Peripheral blood mononuclear cells(PBMCs)of mice were extracted and the amounts of reactive oxygen species(ROS)and ATP in mitochondria were measured.Plasma levels of malondialdehyde(MDA)were measured using the barbituric acid method,the activity of glutathione peroxidase(GSH-PX)in plasmawith the dithiodinitrobenzoic acid methodand the activity of total superoxide dismutase(SOD)in plasma using the hydroxylamine method.Results After exposure to benzene,the body weight of the model group became lower(P<0.05).The spleen and thymus were damaged,and the indexes of the spleen and thymus were decreased(P<0.05).Counts of peripheral white blood cells and lymphocyteswere decreased(P<0.05).The activities of GSH and SOD in plasma were decreased(P<0.05),but the content of MDA was increased(P<0.05).The amount of mitochondrial ROS in PBMC was increased,while the ATP content was decreased(P<0.05).The weight of mice increased after treatment with cinnamaldehyde.The spleen and thymus tissues recovered well,and the indexes of the spleen and thymus were increased(P<0.05).Counts of peripheral white blood cells and lymphocytesin the high dose cinnamaldehyde group were increased(P<0.05).The activities of GSH and SOD in plasma were increased,while the content of MDA was decreased(P<0.05).The amount of mitochondrial ROS in PBMC was decreased,but the ATP content was increased(P<0.05).Treatment with cinnamaldehyde could alleviate the damage to the mitochondrial function of PBMC induced by benzene in mice,and 50 mg/kg was the best dose(P<0.05).The therapeutic effect of cinnamaldehyde had a dose-response relationship.Conclusion Cinnamaldehyde can inhibit benzene-induced immune injury and oxidative stress injury in mice by delivering an antioxidant effect and improving mitochondrial enhancement of PBMC.

Effect of dynamic lung compliance-guided individual positive end-expiratory pressure titration on pulmonary function in elderly patients undergoing laparoscopic colorectal cancer surgery / 临床麻醉学杂志

Objective To investigate the effects of dynamic lung compliance(Cdyn)-guided indi-vidual positive end-expiratory pressure(PEEP)titration on pulmonary function in elderly patients undergoing laparoscopic colorectal cancer surgery.Methods Sixty-eight elderly patients were selected for laparoscopic radical resection of colorectal cancer,37 males and 31 females,aged 65-79 years,BMI<30 kg/m2,ASA physical status Ⅱ or Ⅲ.The patients were divided into two groups using the random number table method:individualized PEEP group(group P)and control group(group C),34 patients in each group.In group P,the patients received recruitment maneuvers and PEEP titration test at immediately after intubation,immediately after establishing pneumoperitoneum-Trendelenburg position and immediately after pneumoperitoneum.The patients in group C received PEEP 5 cmH2 O during procedure.The three best titra-tion PEEP and the actual tidal volume(VT)in group P were also recorded.PaO2,PaCO2,PETCO2 10 mi-nutes after the tracheal intubation(T1),10 minutes(T2)and 1 hour(T3)after establishing pneumoperito-neum-Trendelenburg position,at the end of the surgery but before extubation(T4)were recorded,and the oxygenation index(OI),physiological dead space to tidal volume(Vd/VT),alveolar arterial oxygen differ-ence(A-aDO2),driving pressure,and Cdyn were calculated.Concentrations of interleukin-8(IL-8),tumor necrosis factor-α(TNF-α),Clara cell secretoyr protein(CC16)and lung alveolar surface active sub-stances-D(SP-D)in the serum samples were determined by ELISA before anesthesia induction(T0)and 10 minutes after extubation(T5).Postoperative pulmonary complications(PPCs)were also recordrd.Results The individualized PEEP of Cdyn?guided PEEP titration was 4 cmH2O. Compared with group C, the PaO2 and OI in group C were significantly increased at T4, the Cdyn was significantly increased at T1,T3, and T4, the driving pressure was significantly decreased at T1 -T4, the serum concentration of CC16 was significantly decreased at T5 ( P < 0. 05). There were no significant differences in PaCO2, PET CO2,A?aDO2, and Vd/ VT between the two groups. There was no severe PPCs in the two groups. Conclusion Pressure?controlled ventilation modes combined with Cdyn?guide PEEP titration can increase the Cdyn, reduce thedriving pressure, and improve OI at the end of the operation, reduce the concentrations of CC16 at postop?eration, improve pulmonary function in elderly patients undergoing laparoscopic colorectal cancer surgery.

Protective effect of C2 ceramide on dopaminergic neurons in a mouse model of Parkinson's disease / 中国组织工程研究

BACKGROUND:C2 ceramide reduces the formation of Alpha-Synuclein(α-Syn)oligomers as the protein phosphatase 2A agonist,which has an important regulatory effect on cell aging in the central nervous system. OBJECTIVE:To investigate the protective mechanism of C2 ceramide on dopaminergic neurons. METHODS:Twenty-five C57BL/6 mice were randomly divided into control group,model group,C2 ceramide low-,medium-and high-dose groups(n=5 per group).Except for the control group,a mouse model of Parkinson's disease was established by injecting mutant A53T α-Syn oligomers into the left striatum in the other groups.On the 30th day after the striatal injection,three C2 ceramide groups were intragastrically administered with C2 ceramide(1,5,10 μg/g)dissolved in saline at one time,while the control and model groups were administered with the same amount of saline within 30-90 days after modeling,for a total of 60 days.Behavioral changes in each group of mice were observed during this period.On the 90th day after striatal injection,mouse brain tissue was extracted by perfusion under anesthesia,and the changes of dopaminergic neurons in the midbrain substantia nigra were analyzed by immunohistochemical staining.The levels of α-Syn oligomerization and phosphorylation in the midbrain of mice were detected by ELISA,and the changes of enzyme activities related to α-Syn phosphorylation were analyzed. RESULTS AND CONCLUSION:C2 ceramide had an ameliorating effect on Parkinson's disease-like dyskinesia in mice caused by the striatal injection of mutant A53T α-Syn oligomers.High-dose C2 ceramide showed better effects on dyskinesia in mice with Parkinson's disease(P<0.01).The mutant A53T α-Syn oligomers significantly reduced the number of dopaminergic neurons in the substantia nigra of mice(P<0.01),while the number of dopaminergic neurons in the substantia nigra increased significantly in the C2 ceramide high-dose group(P<0.01).The levels of α-Syn oligomers and phosphorylated α-Syn in the brain were significantly reduced in the C2 ceramide high-dose group compared with the model group(P<0.01),while the level of ceramide was increased(P<0.05)and the activity of protein phosphatase 2A was significantly upregulated(P<0.01).To conclude,C2 ceramide can attenuate the neurotoxic effects induced by oligomerized α-Syn by the phosphorylation modification environment of α-Syn in mouse midbrain tissue and protect against the reduction in the number of nigrostriatal dopaminergic neurons in mice,thereby reducing the degree of dyskinesia in Parkinson's disease.

Meta-analysis of safety and immunogenicity of DTaP-IPV-Hib-HepB hexavaccine / 中国生物制品学杂志

@#Objective To compare the differences of safety and immunogenicity of DTaP-IPV-Hib-HepB hexavaccine,DTaPIPV-Hib pentavaccine plus HepB single vaccine or DTaP-IPV-HepB pentavaccine plus Hib single vaccine,so as to provide a reference for the marketing and use of hexavaccine in China.Methods Randomized controlled trials(RCTs)of DTaP-IPVHib-HepB hexavaccine,DTaP triple vaccine,Hib,IPV and HepB vaccines published at home and abroad were searched.The safety and immunogenicity of the hexavaccine were evaluated by Meta-analysis using Revman 5.4.1 software.Results A total of 7 articles,8 RCTs and 3 429 subjects were included. Meta-analysis of safety showed that there was no significant difference in the incidence of injection site and systemic adverse reactions after vaccination with hexavaccine and pentavaccine plus single vaccine(P > 0. 05)except for induration at the inoculation site and crying. Meta-analysis of immunogenicity showed no significant difference in antibody indexes after vaccination with hexavaccine and pentavaccine plus single vaccine(P > 0. 05).Conclusion The safety and immunogenicity of DTaP-IPV-Hib-HepB hexavaccine in basic immunity was comparable to that of the control vaccine,and might be applied to infants and young children to prevent related diseases. However,due to the limitations of the quantity and quality of included studies,the above conclusions still depend on the further development of larger sample,multicenter and high-quality

Working Hours and Personal Protective Equipment Effect on Blood Cholinesterase Levels of Tobacco Plantation Workers

@#Introduction: Tobacco production is increasing in certain regions of Indonesia due to its high economic value. Tobacco and its products can have harmful effects on the health of consumers, producers and processing workers. Analysis of blood samples has shown that tobacco farmers are at risk of developing occupational diseases related to pesticide exposure and nicotine absorption through the epidermis of wet tobacco leaves. The aim of this study was to compare blood cholinesterase levels in tobacco plantation workers in relation to their working hours and use of personal protective equipment (PPE). Methods: This cross-sectional observational study was conducted in ten subdistricts in Jember district, Indonesia, and included 50 participants selected using proportional sampling. Spearman’s test was used to analyse the relationship between variables. Results: The significance value of the relationship based on Spearman’s test between working hours and blood cholinesterase levels of tobacco farmers in Jember was 0.058 > α (0.05). Meanwhile, the significance value of the relationship between working hours and complete blood count, specifically mean corpuscular haemoglobin concentration (MCHC), was 0.00 < α (0.05), and between PPE use and blood cholinesterase levels was 0.035 < α (0.05). Conclusion: Working hours were not associated with blood cholinesterase levels, but were associated with blood MCHC levels. Meanwhile, the use of PPE was found to be associated with cholinesterase levels in tobacco farmers.

Construction and reliability and validity of a scale for assessing psychiatric nurses' knowledge， attitude and practice towards the use of protective restraint / 四川精神卫生

BackgroundThe existing tools in China for assessing psychiatric nurses' knowledge， attitude and practice towards the use of protective restraint do not sufficiently consider the specialty in psychiatric practice， and the scale items are somewhat cumbersome to use， which together restrict their further promotion and application. Accordingly， there is an urgent need for developing a more scientific assessment tool. ObjectiveTo construct a scale for assessing psychiatric nurses' knowledge， attitude and practice towards the use of protective restraint and to verify its reliability and validity， so as to provide a generic tool for the assessment. MethodsBased on the theoretical framework of the knowledge-attitude-practice model， the preliminary scale was formed through systematic literature review， qualitative interview and Delphi method. From July to December 2021， a stratified sampling was utilized to select 729 psychiatric nurses from tertiary， secondary and primary （including unclassified medical institutions and grassroots hospitals） psychiatric hospitals in Guangdong Province. The formal scale was developed through item analysis， exploratory factor analysis and confirmatory factor analysis. The validity of the scale was evaluated by content validity and structure validity， and the reliability was verified by procedures including Cronbach's α coefficient， test-retest reliability， and split-half reliability. ResultsA total of 12 items of three dimensions （knowledge， attitude， practice） were included in the scale for assessing psychiatric nurses' knowledge， attitude and practice towards the use of protective restraint. The scale-level content validity index （S-CVI） was 0.941， and the item-level content validity index （I-CVI） ranged from 0.812 to 1.000. Exploratory factor analysis extracted three common factors， and the cumulative variance contribution rate was 62.948%. The confirmatory factor yielded adequate fit. Cronbach's α coefficient was found to be 0.887 for the scale， 0.819 for knowledge dimension， 0.842 for attitude dimension， and 0.831 for practice dimension. The split-half reliability and test-retest reliability for the scale were 0.712 and 0.922， respectively. ConclusionThe scale shows satisfactory reliability and validity， which can be used to assess psychiatric nurses' knowledge， attitude and practice towards the use of protective restraint. ［Funded by Guangdong Clinical Teaching Base Teaching Reform Research Project （number， 2021JD119）］

Prevalence and influencing factors of work-related knee pain among workers in shoemaking industry / 环境与职业医学

Background Shoemaking industry workers are prone to work-related musculoskeletal disorders (WMSDs) due to long-term awkward postures during the work process. There is little research on the prevalence and influencing factors of WMSDs in the knee region of this industry, and it should be taken seriously. Objective To estimate the prevalence of work-related knee pain among shoemaking workers and analyze the related influencing factors. Methods A total of 6982 shoemaking workers were selected from 26 shoemaking factories in Guangdong, Hubei, Fujian, Chongqing, Shandong, Zhejiang, and Jingxi by convenience sampling. Prevalence of work-related knee pain in past year, demographic characteristics, occupational related factors, and work posture were collected by a cross-sectional survey using the electronic version of Musculoskeletal Disorder Questionnaire. Logistic regression analysis was used to analyze the influencing factors that may lead to work-related knee pain. Results This survey collected 6982 valid questionnaires with a recovery rate of 98.3%. The prevalence of work-related knee pain of shoemaking workers in the past 12 months was 13.0% (908/6982). According to the results of logistic regression analysis, compared with workers with less than 5 years of service, workers with 5-10 years of service (OR=1.21, 95%CI: 1.02, 1.45) and more than 10 years (1.53, 95%CI: 1.27, 1.83) showed a higher risk of knee WMSDs; sometimes, often and very frequent (reference : rarely or never) long-term standing (OR=1.33, 95%CI: 1.08, 1.64; OR=2.67, 95%CI: 2.10, 3.39; OR=2.75, 95%CI: 2.08, 3.63) and sometimes, often and very frequent (reference: rarely or never) long-term squatting or kneeling (OR=1.80, 95%CI: 1.47, 2.21; OR=2.43, 95%CI: 1.58, 3.75; OR=3.22, 95%CI: 1.66, 6.24) increased the risk of knee pain: long-term bending (OR=1.59, 95%CI: 1.34, 1.89) and often repeated movement of lower limbs and ankles (OR=1.48, 95%CI: 1.25, 1.75) were also risk factors for knee WMSDs among shoemaking industry workers (P<0.05). Adequate rest time (OR=0.58, 95%CI: 0.49, 0.68) and able to stretch or change leg posture (OR=0.75, 95%CI: 0.64, 0.88) reduced the risk of knee WMSDs (P<0.05). Conclusion In the shoemaking industry, length of service and awkward postures are risk factors for knee pain. The shoemaking enterprises should ensure that workers have sufficient rest time, reduce long-term standing, squatting, kneeling, and bending postures, as well as lower limbs repetition in order to reduce the occurrence of knee WMSDs of workers.

The impact of lung protective ventilation strategy on elderly emergency surgical patients / 中国现代医生

Objective To observe the effects of implementing lung protective ventilation strategies on lung dynamic compliance and oxygenation function in elderly emergency surgery patients.Methods A total of 126 elderly patients undergoing emergency surgery admitted to Northern Jiangsu People's Hospital from December 2021 to December 2022 were selected.They were randomly divided into an observation group and a control group,with 63 patients in each group,using a random number table method.All selected cases underwent general anesthesia mechanical ventilation during surgery.The control group chose conventional ventilation mode,while the observation group adopted lung protective ventilation.The lung dynamic compliance,oxygenation function,inflammatory indicators,and complications of the two groups of patients were compared.Results Within 30 minutes of surgery,the mean airway pressure(Pmean)and peak airway pressure(Ppeak)levels of both groups of patients increased compared to preoperative levels.The observation group had a smaller increase than the control group(P<0.05),and the pulmonary dynamic compliance(Cdyn)levels were lower than preoperative levels.The observation group had a lower increase than the control group(P<0.05).After 2 hours of surgery,the levels of Pmean and Ppeak in both groups of patients decreased compared to 30 minutes during surgery,and the decrease in the observation group was smaller than that in the control group(P<0.05).The levels of Cdyn in both groups decreased compared to before surgery,and the observation group was lower than that in the control group(P<0.05).24 hours after surgery,the blood oxygen saturation(SpO2)and arterialpartial pressure of oxygen(PaO2)levels in both groups of patients decreased compared to before surgery,and the observation group was lower than the control group(P<0.05).The alveolar-arterial oxygen partial pressure difference[P(A-a)DO2]levels between the two groups increased compared to preoperative levels,and the observation group was higher than the control group(P<0.05).48 hours after surgery,the SpO2 and PaO2 levels in the observation group were higher than those in the control group,and the P(A-a)DO2 levels were lower than those in the control group(P<0.05).24 hours after surgery,the serum C-reactive protein(CRP)and white blood cell(WBC)levels in both groups were significantly increased compared to preoperative levels,and the observation group was higher than those in the control group(P<0.05).48 hours after surgery,the serum CRP and WBC levels of both groups of patients decreased compared to 24 hours after surgery,and the observation group was lower than the control group(P<0.05).The incidence of complications in the observation group was lower than that in the control group(7.94％vs.25.40％)(P<0.05).Conclusion Implementing lung protective ventilation strategies for elderly emergency surgical patients is beneficial for improving lung dynamic compliance and oxygenation function,inhibiting the release of inflammatory cytokines,reducing the incidence of postoperative pulmonary complications,and effectively exerting lung protective effects.

Comparison of the inward leakage rate between N95 filtering facepiece respirators and modified surgical masks during the COVID-19 pandemic

BACKGROUND@#Owing to shortage of surgical and N95 filtering facepiece respirators (FFRs) during the COVID-2019 pandemic, various masks were developed to prevent infection. This study aimed to examine the inward leakage rate (ILR) of sealed face masks and modified surgical masks using a quantitative fit test and compared it with the ILR of unmodified N95 FFRs.@*METHODS@#We conducted paired comparisons of ILRs of bent nose-fit wire masks, double masks, and N95 FFRs from October to December 2021. To measure the protective effectiveness of masks, participants wore masks, and the number of particles outside and inside the mask were measured. The ILR was based on the percentage of particles entering the mask using a fit tester.@*RESULTS@#We enrolled 54 participants (20 men and 34 women) in this study. The median ILR for surgical masks without and with a W-shaped bend in the nose-fit wire were 96.44% and 50.82%, respectively. The nose-fit wire adjustment reduced the ILR of surgical masks by a mean of 28.57%, which was significantly lower than the ILR without adjustment (P < 0.001). For double masks, with surgical or polyurethane masks on top of the W-shaped mask, the ILR did not differ significantly from that of N95. Although the filtration performance of double surgical masks matched that of N95 masks, their ILR was notably higher, indicating that double masks do not provide equivalent protection.@*CONCLUSIONS@#Wearing N95 masks alone is effective in many cases. However, surgical mask modifications do not guarantee consistent effectiveness. Properly selected, sealed masks with a good fit overcome leakage, emphasizing their crucial role. Without evidence, mask-wearing may lead to unexpected infections. Education based on quantitative data is crucial for preventing adverse outcomes.

Covid-19: fatores associados ao uso e adesão de equipamentos de proteção individual entre residentes no Brasil / Covid-19: factors associated with the use and adherence of personal protective equipment in Brazil among residents / Covid-19: factores asociados al uso y adherencia de equipos de protección personal entre los residentes en Brasil

Objetivo: analisar os fatores associados ao uso e a adesão aos equipamentos de proteção individual pelos profissionais pós-graduandos vinculados a programas de residência em saúde. Método: transversal com 227 residentes. Avaliadas variáveis relacionadas à adesão e uso adequado de equipamentos de proteção individual por meio de instrumento validado "E.P.I. covid-19 Brasil-versão adaptada para residentes". Realizou-se análise bivariada, teste qui-quadrado/exato de Fisher e cálculo da razão de prevalência. Pesquisa foi aprovada pelo Comitê de Ética em Pesquisa com Seres Humanos. Resultados: realizaram atividades de capacitação sobre EPIs (59,9%).Associação entre uso de máscara cirúrgica(p≤0,01) e idade; área de concentração do programa e uso de gorro (p≤0,01) e máscara cirúrgica (p=0,04); realização de atividades de capacitação e uso de máscara cirúrgica (p=0,02) e N95 (p≤0,01). A adesão variou de 0% a 67%. Conclusão: fatores associados ao uso adequado, idade, área de concentração do programa e realização de atividades de capacitação. Houve fragilidades na adesão. Sugere-se o fortalecimento do tema biossegurança na residência.

Objective: to analyze the factors associated with the use and adherence to personal protective equipment by graduate professionals linked to residency programs in health. Method: cross-sectional study with 227 residents. E.P.I.covid-19 Brasil-adapted version for residents". Bivariate analysis, Fisher chi-square/exact test and calculation of the prevalence ratio were performed. Research was approved by the Ethics Committee for Research with Human Beings. Results: they carried out training activities on PPE (59.9%). Association between use of surgical mask (p≤0.01) and age; program concentration area and use of cap (p≤0.01) and surgical mask (p=0.04); performance of training activities and use of surgical mask (p=0.02) and N95 (p≤0.01). Adherence to PPE ranged from 0% to 67%. Conclusion: factors associated with the proper use of personal protective equipment were age, area of program concentration, and performance of training activities. There were weaknesses in adherence. It is suggested to strengthen the theme of biosafety in the residence.

Objetivos:analizar los factores asociados al uso y la adherencia a los equipos de protección personal (EPP) por parte de profesionales graduados vinculados a programas de residencia en salud. Método: estudio transversal con 227 residentes. Se utilizó la versión adaptada para residentes del «Cuestionario sobre EPI en la atención primaria de salud (EPS-APS) en el contexto de la COVID-19 en Brasil. Se realizaron análisis bivariados, prueba chi-cuadrado de Fisher/prueba exacta y cálculo de la razón de prevalencia. La investigación fue aprobada por el Comité de Ética para la Investigación con Seres Humanos. Resultados: se realizaron actividades de capacitación sobre EPI (59,9%). Se observó asociación entre el uso de mascarilla quirúrgica (p≤0,01) y la edad; área de concentración del programa y uso de cofia (p≤0,01) y mascarilla quirúrgica (p=0,04); realización de actividades de capacitación y uso de mascarilla quirúrgica (p=0,02) y N95 (p≤0,01). La adherencia a los EPI osciló entre el 0% y el 67%. Conclusión: los factores asociados al uso correcto de los EPI fueron la edad, el área de concentración del programa y la realización de actividades de capacitación. Se observaron debilidades en la adherencia. Se sugiere fortalecer el tema de la bioseguridad en la residencia.