Anesthesiologists′ proficiency and training needs in flexible bronchoscope-guided awake fiberoptic intubation in China: a nationwide prevalence survey / 中华麻醉学杂志

Objective:To investigate the Chinese anesthesiologist′s proficiency, training experience and needs of flexible bronchoscope-guided awake flexible bronchoscopy intubation (AFBI) using a questionnaire method.Methods:The cluster sampling was used, and self-designed questionnaires that addressed 54 questions in 5 categories were distributed through WeChat and online platforms. The survey took one month, and the answers were automatically recorded by the WeChat server.Results:A total of 1 250 anesthesiologists participated in the survey in 30 provinces of China, 9 of them were not anesthesiologists, and 1 241 (99.28%) questionnaires were validated. In the valid questionnaires, 52.70% (654) of the anesthesiologists were from tertiary hospitals, and 74.78% (928) of the anesthesiologists were attending physicians or above, only 7.57% (94) of the anesthesiologists had sufficient confidence in AFBI. Twenty-five point two two percent (313) of the anesthesiologists preferred fiberoptic intubation as the first tool when dealing with the anticipated difficult airway. Forty-eight point one one percent (597) of the anesthesiologists had implemented AFBI. Among them, 80.74% (482) had experienced unsuccessful AFBI practices. Eight hundred and ninety-four anesthesiologists had received AFBI training, and the most common AFBI training strategy was theoretical lectures. In addition, the degree of satisfaction regarding the theoretical lectures quality, technical training, clinical practice relativity and non-technical skills training was 21.47% (192), 14.32% (128), 12.3% (110) and 17.90% (160), respectively. The degree of satisfaction with all the 4 training elements mentioned above was 7.27% (65).Conclusions:The awareness and practice of Chinese anesthesiologists in terms of clinical application of AFBI to treat difficult airways need to be strengthened at present, and the lack of high-quality AFBI training may be the key.

Expert consensus on clinical practice in perioperative nursing for elderly patients with hip fracture (version 2023) / 中华创伤杂志

Hip fracture is considered as the most severe osteoporotic fracture characterized by high disability and mortality in the elderly. Improved surgical techniques and multidisciplinary team play an active role in alleviating prognosis, which places higher demands on perioperative nursing. Dysfunction, complications, and secondary impact of anaesthesia and surgery add more difficulties to clinical nursing. Besides, there still lack clinical practices in perioperative nursing for elderly patients with hip fracture in China. In this context, led by the Orthopedic Nursing Committee of Chinese Nursing Association, the Expert consensus on clinical practice in perioperative nursing for elderly patients with hip fracture ( version 2023) is developed based on the evidence-based medicine. This consensus provides 11 recommendations on elderly patients with hip fracture from aspects of perioperative health education, condition monitoring and inspection, complication risk assessment and prevention, and rehabilitation, in order to provide guiding advices for clinical practice, improve the quality of nursing and ameliorate the prognosis of elderly patients with hip fracture.

Supplementary immunization among children attending kindergarten and primary school in Pudong New Area of Shanghai from 2018 to 2021 / 上海预防医学

ObjectiveTo determine the situation of vaccination certificate inspection and supplementary immunization among children attending kindergarten and primary school in Pudong New Area. MethodsThe study was conducted based on the annual report form“vaccination record inspection summary” of all community health service centers in Pudong New Area， Shanghai. Data related to vaccination certificate inspection and supplementary immunization among children attending kindergarten and primary school were retrieved in Pudong New Area from 2018 to 2021 and statistically analyzed. ResultsFrom 2018 to 2021， a total of 1 850 kindergartens and 887 primary schools in Pudong New Area inspected the vaccination certificates of children attending kindergarten and school，with a coverage rate of 100.00%. There were 375 407 children enrolled in kindergarten and primary school.A total of 373 820 children were inspected with an examination rate of 99.58%. The average certificate holding rate among children was 99.48%．The full-course immunization rate of eight national immunization programs vaccines was 94.95%. Furthermore， a total of 73 407 doses of eight national immunization vaccines were supplemented，with an average supplementary rate of 92.95%. The supplement rate increased annually．In terms of supplemented doses，the top three vaccines were meningococcal vaccine， measles vaccine and polio vaccine. As a vaccine of local immunization program in Shanghai， a total of 14 143 doses of varicella vaccine were supplemented with a supplementary rate of 86.99%. ConclusionIn Pudong New Area， vaccination certificate inspection of children attending kindergarten and primary school has been strictly performed . Inspection rate in the kindergartens and primary schools， children's certificate holding rate， full-course immunization rate and supplementary immunization rate remain high.

Optimization of detection conditions of pre-donation ABO blood type screening by sliding methods in fixed blood donation sites / 中国输血杂志

【Objective】 To explore the quantitative value of key points for ABO blood group initial screening in fixed blood donation sites, so as to provide reference for standardized testing process of sliding method. 【Methods】 Several groups of experiments were carried out to illustrate the optimal conditions, including the serum dosage of monoclonal reagent, red blood cell dosage of blood sample, and reaction time in ABO blood group initial screening, by sliding method, and the quantitative value of key points of sliding method was preliminarily determined. Blood typing tests of 310 blood donor samples including type A, B, O, AB, subtype A and subtype AB were conducted to evaluate the effects of quantitative value of key points in the initial screening procedure. The test tube method would be conducted if the results are inconsistent with the fully automated blood grouping analyzer. The ABO subtypes suspected are identified by serological and molecular biological methods. 【Results】 The quantitative value of key points in initial screening procedure of sliding methods was as follows: 2 drops of reagent serum, 5-10 μL of whole blood and 3 minutes of reaction time. The concordance rate of ABO blood type screening comparison experiment in 310 blood donors was 100%. 【Conclusion】 ABO blood group initial screening by sliding method with quantitative value can effectively standardize the pre-donation blood type screening in fixed blood donation sites, and can meet the requirements of ABO blood group initial screening.

Development of morphology engineering for production of bio-based chemicals / 生物工程学报

Synthetic biology and metabolic engineering have been widely used to construct microbial cell factories for efficient production of bio-based chemicals, which mainly focus on the modification and regulation of metabolic pathways. The characteristics of microorganisms themselves, e.g. morphology, have rarely been taken into consideration in the biotechnological production processes. Morphology engineering aims to control cell shapes and cell division patterns by manipulating the genes related to cell morphology, providing a new strategy for developing efficient microbial cell factories. This review summarized the proteins related to cell morphology, followed by illustrating a few examples of using morphology engineering strategies for improving production of bio-based chemicals. This includes increasing intracellular product accumulation by regulating cell size, enhancing extracellular secretion of target products by improving cell permeability, reducing production cost by achieving high cell density, and improving product performance by controlling the degree of product hydrolysis. Finally, challenges and perspectives for the development of morphology engineering were discussed.

Identifications and characteristics of organic ultraviolet filters in indoor air / 环境与职业医学

Background Organic ultraviolet (UV) filters are widely used in personal care products. So far, relevant studies on organic UV filters in indoor dust have been reported. Objective This study aims to establish a thermal desorption combined with gas chromatography-mass spectrometry (TD-GCMS) method to identify organic UV filters in indoor air collected from different indoor environments, so as to reveal the pollution levels and characteristics of organic UV filters in indoor environment. Methods Based on the standard indoor air sampling protocol, a total of 60 samples were collected from eight different kinds of indoor environments (male and female dormitory rooms, offices, labs, barber shops, printing shops, hotels, and private cars) on and nearby Minhang Campus of Shanghai Jiao Tong University from August to November, 2020. The concentrations of six common organic UV filters, including homosalate (HMS), 2-ethylhexyl salicylate (EHS), 3-(4-methylbenzylidene)-camphor (4-MBC), isoamyl 4-methoxycinnamate (IMC), octocrylene (OC), and octyl 4-methoxycinnamate (EHMC), in the air of different indoor environments were detected by TD-GCMS. Furthermore, the correlations of individual organic UV filters in different indoor environments were analysed. Results Under optimized detection conditions, the correlation coefficients of the quantitative standard curves of selected six organic UV filters were all at or above 0.997. The relative standard deviations of 1 mg·L−3 samples ranged from 1.74% to 7.11%, and the recoveries ranged from 67.17% to 106.5%. The relative standard deviations of 10 mg·L−3 samples ranged from 3.59% to 8.76%, and the recoveries ranged from 78.80% to 126.60%. The detection rates of the other five organic UV filters except IMC were all at or more than 92% in eight different kinds of indoor air. The median concentration of total organic UV filters was 75.17 ng·m−3, and EHS presented the highest median concentration of 28.55 ng·m−3. Regarding different indoor environments, the highest concentration of total organic UV filters was found in the female dormitory samples, 154.98 ng·m−3. The respective pair-analysis among HMS, EHMC, OC, and EHS of all indoor air samples reached a significant level of correlation (r=0.40-0.61, P<0.01). Conclusion The TD-GCMS method is satisfactory for the determination of organic UV filters in indoor air. EHS, EHMC, HMS, OC, and 4-MBC are identified in selected eight indoor environments, and they may have similar sources of pollution.

Primary retroperitoneal liposarcoma surgery in combination of bowel resection, a report of 24 cases / 中华普通外科杂志

Objective:To evaluate primary retroperitoneal liposarcoma surgeries in combination with involved bowel resection .Methods:Clinical data of primary retroperitoneal liposarcoma patients admitted for surgery at Peking University International Hospital from Jan 2015 to July 2019 were retrospectively reviewed.Results:Twenty-four patients undergoing resectional surgeries combining with bowel resection were included for the study, of which 6 cases underwent right hemicolectomy, 8 did left hemicolectomy, 6 did sigmoidectomy, 2 did proctectomy and 8 did small bowel resection. The post operative morbidity was 38%. 2 of 24 had anastomotic fistula. There was no mortality. Final pathology disclosed well differentiated liposarcoma in 13 and dedifferentiated liposarcoma in 11 cases. 18 cases were confirmed with bowel infiltration pathologically. All patients were followed up after the surgery. After a median of 25 months following up, 8 cases developed recurrences and 3 deceased. Two-year overall survival and progression free survival probability were 91% and 71% respectively. Dedifferentiated liposarcoma as a pathological type was found as the only risk factor associated to poor progression free survival ( Z=2.02, P=0.042). Conclusion:Combining resection of primary retroperitoneal liposarcoma with involved bowel was relatively safe, with low morbidity, increasing tumor clearance. Dedifferentiated liposarcoma is associated wth poor prognosis.

Diagnostic value of different puncture needles in endoscopic ultrasonography guided aspiration for pancreatic solid masses / 中华胰腺病杂志

Objective To compare the diagnostic value of two different types of puncture needles guided by endoscopic ultrasonography for pancreatic solid masses.Methods The clinical data of 176 pancreatic solid tumor patients who received endoscopic fine needle aspiration (EUS-FNA) in Shanghai Changhai Hospital from January 2018 to December 2018 was retrospectively analyzed.The acquired specimens were analyzed by cytology and histology.The patients were divided into 25G acupuncture needle group (25G group,63 cases) and 22G acupuncture needle group (22G group,113 cases) according to the type of acupuncture needle.The satisfaction score of specimen,the positive rate of puncture and diagnostic accuracy of malignant masses were compared between the two groups.Results The satisfaction of specimen in 25G group (44.6 ± 18.8) was higher than 22G group (20.5 ± 18.1),and the differences were statistically significant (P =0.047).The positive rates of puncture were 79.3％ and 85.8％,respectively,and the differences were not statistically significant (P =0.267).Thirty nine of 176 patients underwent surgical resection.Thirty three cases of malignant were diagnosed pathologically.The accuracy of 25G and 22G group was 81.3％ and 86.9％,respectively,and the differences were not statistically significant.Conclusions The accuracy and positive rate of 25G and 22G needle in the diagnosis of pancreatic solid masses are comparable,but compared with 25G needle,22G needle can obtain more tissue specimen.

Application of inteins in building protein affinity purification system / 生物工程学报

Intein is a part of polypeptide in the premature protein with the capability of self-splicing, which is widely applied in protein purification, protein conjuction, cyclopeptide preparation, protein labeling and biosensor. In this review, we summarized the development of intein used in protein purification, discussed intein-mediated chromatographic and non-chromatographic purification systems, and summarized the researches in manipulating intein cleavage reaction. This work is to provide clues for improvement of intein-mediated protein purification.

Study on Quality Standard for Compound Jieyu Granules / 中国药师

Objective:To establish the quality control method for compound Jieyu granules. Methods:Liquorice was identified by TLC. saikosaponin a, Saikosaponin d and rutin were determined by HPLC. Results:The spots on TLC plates were clear without any in-terference. The linearity was achieved within the range of 0. 508-16. 200 μg (r=0. 999 8) for saikosaponin a, 0. 503-16. 100 μg(r=0.999 7) for saikosaponin d, and 0.130-4.250 μg(r =0.999 9) for rutin. The average recovery was 99.7%(RSD =2.03%), 99. 8%(RSD=1. 44%) and 102. 6%(RSD=1. 40%), respectively. Conclusion:The method is simple, reliable and accurate, and can be applied as the quality control method for compound Jieyu granules.

Fluid distribution abnormalities and influence of hemodialysis on fluid distribution in patients on maintenance hemodialysis / 北京大学学报(医学版)

Objective: To study the fluid distribution abnormalities in patients on hemodialysis and fluid shift between intracellular and extracellular compartment during hemodialysis (HD).Methods: Eighty stable end stage renal disease patients on maintenance hemodialysis were selected. Conventional low flux dialyses at dialysate sodium concentration of 138 mmoL/L were performed for all of the patients. Fresenius polysulphons or Gambro hemophon dialyzers were used. All of the patients showed no clinical signs of over ultrafiltration during HD sessions and dry body weights were considered adequate. Intracellular water (ICW), extracellular water (ECW) and total body water (TBW) were measured and standardized by body weight (nICW, nECW, nTBW) before and after HD sessions. Sixty-seven cases of sex, age and body weight matched normal individuals were used as controls. Bio-impedance spectrum (BIS) analysis (Xitron, Technolo gies, San Diego, CA, USA) was used in body fluid measurement. Pre and post HD nICW, nECW, and nTBW were compared with these of the controls.Results: There were no differences in age, post-dialysis body weight and body mass index between patients on hemodialysis and the controls. Patients on hemodialysis had less nICW [male (0.28?0.05) vs (0.33?0.04), P

Assessment of total body water of patients on hemodialysis with urea kinetic model / 北京大学学报(医学版)

Objective:To propose a method to evaluate the total body water (TBW) of patients on hemodialysis with urea kinetic model (UKM), and compare it with body surface bio-impedance spectrum (BIS) analysis. Methods:We enrolled 24 adult patients with end stage renal disease (ESRD) without hyper-catabolism in our dialysis center. All of them had been on hemodialysis for more than 3 months. TBW was measured with BIS analysis immediately before and after dialysis session, and one hour after hemodialysis session. Spent dialysate was collected; blood samples were taken before and one hour after hemodialysis session, TBW before hemodialysis session were calculated by UKM. Results:Patients were 6 men and 18 women, the average age was (51.2?13.5) years and the average time on dialysis was (33.2?36.7) months. Causes of ESRD included chronic glomerulonephritis (8 patients), diabetic nephropathy (1 patients), hypertensive renal damage (1 patients), interstitial nephritis(two patients), chronic pyelonephritis (two patients). The average ultrafiltration volume was (2.7?1.0) L (0.5-4.4 L) . Plasma urea concentrations were (23.06?5.76) mmol/L and (8.15?2.06) mmol/L before and one hour after hemodialysis session, respectively. There was no significant difference between TBW measured immediately after and one hour after hemodialysis session with BIS analysis [(29.9?8.8) L and (29.8?8.6) L, respectively; average difference was (0.1?0.9)L, P=0.70]. These two measurements correlated very well (Pearson r=0.99, P

Change of the plasma ghrelin level in patients with severe sepsis and its clinical significance / 中国实用内科杂志

Objective To observe the changes of plasma ghrelin in patients with severe sepsis and to explore the correlation of the plasma ghrelin and cytokines with sepsis.Methods Choose the healthy volunteer(n=10)as control group,and measure the plasma ghrelin(by ELISA),TNF-?,IL-1?,PCT(procalcitonin)and CRP at the 1st day,3rd day and 10th day in sepsis group(n=26).Results The plasma ghrelin level in sepsis group increased significantly compared with control group(P