The Experience of Nurses’ Moral Dilemma in Intensive Care Unit: A Qualitative Study / 中国医学伦理学

【Objective:】 To understand the true experience and feelings of nurses in the intensive care unit on the clinical experience of moral dilemmas, and to provide strategies for reducing the impact of moral dilemmas. 【Methods:】 Thirteen nurses in the intensive care unit were interviewed face to face by descriptive nature research method. The traditional content analysis method were used to compute the data, and the coding, categorization and topic extraction were carried out cyclically until the data were saturated and the interview was stopped. 【Results:】 The moral dilemma experience of nurses in the intensive care unit had the following three themes: negative psychological experience, negative behavior experience, and life and death cognitive experience. 【Conclusion:】 Nurses in the intensive care unit will have complex negative experiences after experiencing moral dilemmas. This negative experience threatens nurses’ mental health. Nursing managers should pay attention to the impact of moral dilemmas on nurses and formulate effective measures, thereby ensure nursing safety and maintain the healthy development of the nursing team.

Effectiveness analysis of posterolateral approach lumbar interbody fusion assisted by one-hole split endoscope for L4, 5 degenerative lumbar spondylolisthesis / 中国修复重建外科杂志

OBJECTIVE@#To compare the effectiveness of posterolateral approach lumbar interbody fusion assisted by one-hole split endoscope (OSE) and traditional posterior lumbar interbody fusion (PLIF) in the treatment of L4, 5 degenerative lumbar spondylolisthesis (DLS).@*METHODS@#The clinical data of 58 patients with DLS who met the selection criteria admitted between February 2020 and March 2022 were retrospectively analyzed, of which 26 were treated with OSE-assisted posterolateral approach lumbar interbody fusion (OSE group) and 32 were treated with PLIF (PLIF group). There was no significant difference between the two groups in terms of gender, age, body mass index, Meyerding grade, lower limb symptom side, decompression side, stenosis type, and preoperative low back pain visual analogue scale (VAS) score, leg pain VAS score, Oswestry disability index (ODI), and the height of the anterior and posterior margins of the intervertebral space (P>0.05). The operation time, intraoperative blood loss, postoperative hospital stay, and complications were compared between the two groups. The low back pain and leg pain VAS scores and ODI before operation, at 1 month, 6 months after operation, and last follow-up, the height of anterior and posterior margins of the intervertebral space before operation, at 6 months after operation, and last follow-up, the modified MacNab criteria at last follow-up after operation were used to evaluate the effectiveness; and the Bridwell method at last follow-up was used to evaluate the interbody fusion.@*RESULTS@#Both groups successfully completed the operation. Compared with the PLIF group, the OSE group showed a decrease in intraoperative blood loss and postoperative hospital stay, but an increase in operation time, with significant differences (P<0.05). In the OSE group, no complication such as nerve root injury and thecal sac tear occurred; in the PLIF group, there were 1 case of thecal sac tear and 1 case of epidural hematoma, which were cured after conservative management. Both groups of patients were followed up 13-20 months with an average of 15.5 months. There was no complication such as loosening, sinking, or displacement of the fusion cage. The low back pain and leg pain VAS scores, ODI, and the height of anterior and posterior margins of the intervertebral space at each time point after operation in both groups were significantly improved when compared with those before operation (P<0.05). Except for the VAS score of lower back pain in the OSE group being significantly better than that in the PLIF group at 1 month after operation (P<0.05), there was no significant difference in all indicators between the two groups at all other time points (P>0.05). At last follow-up, both groups achieved bone fusion, and there was no significant difference in Bridwell interbody fusion and modified MacNab standard evaluation between the two groups (P>0.05).@*CONCLUSION@#OSE-assisted posterolateral approach lumbar interbody fusion for L4, 5 DLS, although the operation time is relatively long, but the postoperative hospitalization stay is short, the complications are few, the operation is safe and effective, and the early effectiveness is satisfactory.

Quality Control and Adulteration Detection of Cattle Bile Powder Based on Bile Acids / 中国药学杂志

OBJECTIVE: To establish a method for the quality control of cattle bile powder based on cholic acid components, evaluate the quality of commercially sold cattle bile powder, and analyze the possible adulteration. METHODS: A method was established for simultaneous determination of cholic acid content in bile powder of cattle, sheep, pig, chicken, duck and other animals. Self-made samples and samples collected by enterprises were studied respectively. Based on self-made samples, the differences and content rules of bile powder of cattle, pig, sheep and other animals were investigated, and the quality and possible adulteration of samples collected by enterprises were evaluated. RESULTS: An HPLC-ELSD method was established for simultaneous determination of 12 cholic acids in bile powder of cattle, sheep, pigs, chickens and ducks. By analyzing the determination results of 23 batches of self-made animal bile powder, the contents of cholic acid in cattle bile powder and other animal bile powder were determined. By analyzing the determination results of cattle bile powder samples collected from 23 enterprises, it was found that there were mainly two kinds of adulteration of cattle bile powder likely: sheep bile powder and cholic acid waste. Only 8 of the 23 batches of samples collected by enterprises met the requirements, and the qualified rate was only 34.8%. The quality of varieties needs to be improved and supervised urgently. CONCLUSION: The method established in this study can effectively control the quality of cattle bile powder, identify possible adulteration of cattle bile powder, and provide reference and basis for improving the quality standard of cattle bile powder and strengthening market supervision.

Preparation and antimicrobial assay of ceramic brackets coated with TiO2 thin films / 대한치과교정학회지

OBJECTIVE: Different methods have been utilized to prevent enamel demineralization and other complications during orthodontic treatment. However, none of these methods can offer long-lasting and effective prevention of orthodontic complications or interventions after complications occur. Considering the photocatalytic effect of TiO2 on organic compounds, we hoped to synthesize a novel bracket with a TiO2 thin film to develop a photocatalytic antimicrobial effect. METHODS: The sol-gel dip coating method was used to prepare TiO2 thin films on ceramic bracket surfaces. Twenty groups of samples were composed according to the experimental parameters. Crystalline structure and surface morphology were characterized by X-ray diffraction and scanning electron microscopy, respectively; film thickness was examined with a surface ellipsometer. The photocatalytic properties under ultraviolet (UV) light irradiation were analyzed by evaluating the degradation ratio of methylene blue (MB) at a certain time. Antibacterial activities of selected thin films were also tested against Lactobacillus acidophilus and Candida albicans. RESULTS: Films with 5 coating layers annealed at 700℃ showed the greatest photocatalytic activity in terms of MB decomposition under UV light irradiation. TiO2 thin films with 5 coating layers annealed at 700℃ exhibited the greatest antimicrobial activity under UV-A light irradiation. CONCLUSIONS: These results provide promising guidance in prevention of demineralization by increasing antimicrobial activities of film coated brackets.

Iincidence of postoperative delirium after hip surgery in elderly patients: a meta-analysis / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate incidence of postoperative delirium after hip surgery in elderly patients by meta-analysis.</p><p><b>METHODS</b>From January 1, 2014 to December 31, 2013, clinical literatures about postoperative delirium after hip surgery in elderly patients,were searched from the Pubmed. Literature extract table were formed according to inclusion and exclusion criteria. Stata-12.0 was applied for Meta-analysis. P was used to test heterogeneity of study, random-effect model was performed when I2 > 50%. Subgroup analysis was used according to stage of age, assessment scale of delirium and statistical area of literature. Begg test was used to test publication bias.</p><p><b>RESULTS</b>Twenty-one literatures were included. Incidence of postoperative delirium after hip surgery in elderly patients by weighted and combination was 17% [95% CI (16%, 18%)]. Incidence of postoperative delirium after optional hip surgery was decreased more than emergency operation in included 5 literatures [OR = 0.32, 95% CI (0.22, 0.45)]. Incidence of postoperative delirium in patients less than 80 years old was 21% [95% CI (19%, 23%)], while 21% [95% CI (19%, 24%)] in patients more than 80 years old. Incidence of postoperative delirium in CAM evaluation scale was 23% [95% CI (21%, 26%)], while 19% [95% CI (17%, 21%)] in other evaluation scales. Incidence of postoperative delirium in Asian area was 17% [95% CI (15%, 20%)], while 23% [95% CI (21%, 25%)] in European and American area. There was no publication bias tested by Begg test (P < 0.05).</p><p><b>CONCLUSION</b>Incidence of postoperative delirium after hip surgery in elderly patients increases higher, especially in emergency operation. A standardizing research method is benefit for evaluate incidence of postoperative delirium after hip surgery in elderly patients, decreasing heterogeneity and publication bias.</p>

Advances in cancer patients' supportive care needs / 中国实用护理杂志

This paper aimed to describe the concept of the cancerous person's supportive care needs and the current situation of the study on this issue abroad so that we can analyze the factors which influence the needs,and we also try to elaborate the shortcomings and study expectation on cancerous person's sup portive care study.

Portable instrument for arteriosclerosis assessment / 中国医疗器械杂志

A portable instrument for arteriosclerosis assessment containing sensor module, acquisition board and embedded module was developed for home care in this paper. The sensor module consists of one ECG module and three pulse wave extraction modules, synchronously acquiring human ECG and pulse wave signal of carotid, radial, and dorsal, respectively. The acquisition board converts the sensor module's analog output signals into digital signals and transmits them to the embedded module. The embedded module realizes the functions including signal display, storage and the calculation and output of pulse wave velocity. The structure of the proposed portable instrument is simple, easy to use, and easy to expand. Small size, low cost, and low power consumption are also the advantages of this device. Experimental results demonstrated that the proposed portable instrument for arteriosclerosis assessment has high accuracy, good repeatability and can assess the degree of atherosclerosis appropriately.

Expression of GDNF in rat Sertoli cells cultured in vitro at different temperatures / 中华男科学杂志

<p><b>OBJECTIVE</b>To explore the mechanism of hyperthermia inducing infertility by observing the expression of glial cell line-derived neurotrophic factor (GDNF) in rat Sertoli cells cultured in vitro at different temperatures.</p><p><b>METHODS</b>Using combination enzyme digestion and selective adhesion, we isolated Sertoli cells from male Wistar rats and cultured them in vitro at different temperatures, followed by observation of the changes in their adhesion and morphology and identification by FasL immunohistochemical staining. We divided the Sertoli cells into a control group (35 degrees C) and four experimental groups (36 degrees C, 37 degrees C, 38 degrees C, and 39 degrees C), measured their proliferation by CCK-8, observed their morphology and structure by HE staining, and determined the expression of GDNF by RT-PCR, immunofluorescence and Western blot.</p><p><b>RESULTS</b>Sertoli cells were successfully isolated and in vitro-cultured, with a purity of (95.30 +/- 2.15)% (n = 10). The CCK-8 assay showed that the proliferation of the Sertoli cells was the highest at 36 degrees C, gradually decreasing with the temperature above 36 degrees C, and significantly inhibited at 39 degrees C (P < 0.01). Immunofluorescence revealed the expression of GDNF in the cytoplasm, with the highest fluorescence intensity at 36 degrees C. RT-PCR and Western blot exhibited a decreasing trend of the GDNF expression with the increasing temperature above 36 degrees C. There were statistically significant differences in the expression of GDNF between the control group and the four experimental groups (P < 0.01).</p><p><b>CONCLUSION</b>The proliferation and GDNF expression of in vitro-cultured Sertoli cells differ significantly at different temperatures. At > 36 degrees C, the higher the temperature is, the lower the Sertoli cell proliferation and GDNF expression are. Our findings suggest that high temperature above 36 degrees C suppresses the function of Sertoli cells and may also damage spermatogenesis.</p>

Effect of high-pressure steam sterilization on two kinds of orthodontic distal end cutters / 中国组织工程研究

BACKGROUND:Steam sterilization is a commonly used oral clinical method of disinfection, but whether it would produce more significant impact on equipments waiting for sterilization has been controversial. OBJECTIVE:To investigate the effect of autoclave on two kinds of orthodontic distal end cutters by comparing shearing force and corrosion after sterilization. METHODS:Tiantian (n=15) and 3M (n=15) distal end cutters commonly used in orthodontic treatment were chosen for testing and divided into three groups, respectively. Three groups for each kind of cutter were treated with high-pressure steam sterilization, steam sterilization+extraoral shear, and steam sterilization+intraoral shear, respectively. The shearing force and metal ography of the distal end cutters were recorded after 0, 20, 40, and 60 cycles of sterilization. An energy dispersive spectrometer was used to scan the surfaces of the working edges of the distal end cutters after 60 cycles. RESULTS AND CONCLUSION:It was found that with an increase in the number of sterilization cycles, the shear force and extent of corrosion increased in al six groups of distal end cutters, but the situation was worse for Tiantian cutters than for 3M cutters. It was found that the difference of shear force between the Tiantian autoclave group and 3M autoclave group was statistical y significant (P<0.05) after 20, 40, and 60 sterilization cycles. Meanwhile, the metal ography showed that different degrees of discoloration and rust spots appeared on the work edges of the two brands of distal end cutters with an increase in the number of sterilization cycles, but the corrosion of the Tiantian distal-end cutter was more widespread, and even work-edge defects appeared. The carbon content of the Tiantian distal-end cutter was higher than that of the 3M cutter (P<0.05), but the chromium content was higher in the 3M cutter (P<0.05). In addition, aluminum and titanium elements only existed in the 3M cutter. The use of the autoclave affected the distal end cutters in terms of shearing force and corrosion, but the effect on 3M distal end cutters was obviously less than that on Tiantian cutters.

Icariin inhibits orthodontically induced inflammatory root resorption / 中国组织工程研究

BACKGROUND: Icari n as one of the main components of Epimedium has an inhibitory effect on osteoclasts.. OBJECTIVE: To further investigate the influence of icariin on the root absorption of the maxil ary first molar at mesial part during orthodontic treatment in rats. METHODS: Orthodontic root resorption models were established in the left maxil a of rats. Local injection of 200 mg/kg icari n (icari n group) or normal saline (positive control group) was administrated into the left first molar buccal periosteum. The right maxil a of rats served as negative control group that was treated with neither appliance nor drug injection. The mesial distance between bilateral first molars and the contralateral maxil ary incisor was measured before and after the appliance was placed. Mesial surface of the mesial root of bilateral maxil ary first molars was observed using scanning electron microscope. RESULTS AND CONCLUSION: Mesial movement of the maxil ary molars in the icari n group was significantly less than that in the positive control group (P < 0.05). Under the scanning electron microscope, smal absorption lacunae were scattered in the icari n group, while the positive control group showed a large amount of absorption lacunae and they were interconnected into a sheet, showing a stark contrast with the smooth root surface of the negative control group. It is indicated that icari n can inhibit root resorption caused by orthodontic treatment, while reducing the amount of mesial movement of the molar under corrective force.