The Prevalence and Risk Factors for Postoperative Thirst: A Systematic Review and Meta-analysis.

PURPOSE: Thirst is a symptom of dehydration and one of the main complications affecting postoperative outcomes and comfort. Persistent water scarcity can have a detrimental effect on the cognitive function and psychology of patients. However, the current evidence about the prevalence and risk factors for postoperative thirst is not fully understood. Therefore, this study aims to investigate the prevalence and risk factors of postoperative thirst and provide guidance for clinical practice. DESIGN: Systematic review and meta-analysis. METHODS: We searched PubMed, Cochrane Library, Web of Science, Embase, Clinicaltrials.gov, China National Knowledge Infrastructure, and Wanfang Database. Eligible studies were evaluated using the Agency for Healthcare Research and Quality. The collected data were pooled and analyzed using Stata15.0. FINDINGS: A total of 11 cross-sectional studies were included involving 20,612 patients. Eight studies reported prevalence and the pooled prevalence of postoperative thirst was 76.8% (95% confidence interval [CI]: 0.664 to 0.858). Five studies contributed to meta-syntheses of risk factors for postoperative thirst. The results indicated that sex (odds ratio [OR] = 1.44, 95% CI = 1.13 to 1.84, I2 = 80.2%, P = .006), anesthesia drug (OR = 1.48, 95% CI = 1.06 to 2.06, I2 = 94.8%, P < .001), surgical type (OR = 0.66, 95% CI = 0.49 to 0.9, I2 = 77.9%, P = .004) were statistically associated with postoperative thirst. CONCLUSIONS: Our study shows a high prevalence of postoperative thirst. Sex, anesthesia drug, and surgical type are risk factors that influence postoperative thirst. Nurses and other health care professionals should routinely assess the postoperative thirst of patients and perform targeted interventions to alleviate their distressing symptoms and improve the quality of care.

Does Prior Respiratory Viral Infection Provide Cross-Protection Against Subsequent Respiratory Viral Infections? A Systematic Review and Meta-Analysis.

The epidemiology of different respiratory viral infections is believed to be affected by prior viral infections in addition to seasonal effects. This PROSPERO-registered systematic review identified 7388 studies, of which six met our criteria to answer the question specifically. The purpose of this review was to compare the prevalence of sequential viral infections in those with previously documented positive versus negative swabs. The pooled prevalence of sequential viral infections over varying periods from 30-1000 days of follow-up was higher following a negative respiratory viral swab at 0.15 than following a positive swab at 0.08, indicating the potential protective effects of prior respiratory viral infections. However, significant heterogeneity and publication biases were noted. There is some evidence, albeit of low quality, of a possible protective effect of an initial viral infection against subsequent infections by a different virus, which is possibly due to broad, nonspecific innate immunity. Future prospective studies are needed to validate our findings.

Tumour response following preoperative chemotherapy is affected by body mass index in patients with colorectal liver metastases.

BACKGROUND: Colorectal cancer is the third most prevalent malignancy globally and ranks second in cancer-related mortality, with the liver being the primary organ of metastasis. Preoperative chemotherapy is widely recommended for initially or potentially resectable colorectal liver metastases (CRLMs). Tumour pathological response serves as the most important and intuitive indicator for assessing the efficacy of chemotherapy. However, the postoperative pathological results reveal that a considerable number of patients exhibit a poor response to preoperative chemotherapy. Body mass index (BMI) is one of the factors affecting the tumorigenesis and progression of colorectal cancer as well as prognosis after various antitumour therapies. Several studies have indicated that overweight and obese patients with metastatic colorectal cancer experience worse prognoses than those with normal weight, particularly when receiving first-line chemotherapy regimens in combination with bevacizumab. AIM: To explore the predictive value of BMI regarding the pathologic response following preoperative chemotherapy for CRLMs. METHODS: A retrospective analysis was performed in 126 consecutive patients with CRLM who underwent hepatectomy following preoperative chemotherapy at four different hospitals from October 2019 to July 2023. Univariate and multivariate logistic regression models were applied to analyse potential predictors of tumour pathological response. The Kaplan-Meier method with log rank test was used to compare progression-free survival (PFS) between patients with high and low BMI. BMI < 24.0 kg/m2 was defined as low BMI, and tumour regression grade 1-2 was defined as complete tumour response. RESULTS: Low BMI was observed in 74 (58.7%) patients and complete tumour response was found in 27 (21.4%) patients. The rate of complete tumour response was significantly higher in patients with low BMI (29.7% vs 9.6%, P = 0.007). Multivariate analysis revealed that low BMI [odds ratio (OR) = 4.56, 95% confidence interval (CI): 1.42-14.63, P = 0.011], targeted therapy with bevacizumab (OR = 3.02, 95%CI: 1.10-8.33, P = 0.033), preoperative carcinoembryonic antigen level < 10 ng/mL (OR = 3.84, 95%CI: 1.19-12.44, P = 0.025) and severe sinusoidal dilatation (OR = 0.17, 95%CI: 0.03-0.90, P = 0.037) were independent predictive factors for complete tumour response. The low BMI group exhibited a significantly longer median PFS than the high BMI group (10.7 mo vs 4.7 mo, P = 0.011). CONCLUSION: In CRLM patients receiving preoperative chemotherapy, a low BMI may be associated with better tumour response and longer PFS.

Milk fat globule epidermal growth factor 8 alleviates liver injury in severe acute pancreatitis by restoring autophagy flux and inhibiting ferroptosis in hepatocytes.

BACKGROUND: Liver injury is common in severe acute pancreatitis (SAP). Excessive autophagy often leads to an imbalance of homeostasis in hepatocytes, which induces lipid peroxidation and mitochondrial iron deposition and ultimately leads to ferroptosis. Our previous study found that milk fat globule epidermal growth factor 8 (MFG-E8) alleviates acinar cell damage during SAP via binding to αvß3/5 integrins. MFG-E8 also seems to mitigate pancreatic fibrosis via inhibiting chaperone-mediated autophagy. AIM: To speculate whether MFG-E8 could also alleviate SAP induced liver injury by restoring the abnormal autophagy flux. METHODS: SAP was induced in mice by 2 hly intraperitoneal injections of 4.0 g/kg L-arginine or 7 hly injections of 50 µg/kg cerulein plus lipopolysaccharide. mfge8-knockout mice were used to study the effect of MFG-E8 deficiency on SAP-induced liver injury. Cilengitide, a specific αvß3/5 integrin inhibitor, was used to investigate the possible mechanism of MFG-E8. RESULTS: The results showed that MFG-E8 deficiency aggravated SAP-induced liver injury in mice, enhanced autophagy flux in hepatocyte, and worsened the degree of ferroptosis. Exogenous MFG-E8 reduced SAP-induced liver injury in a dose-dependent manner. Mechanistically, MFG-E8 mitigated excessive autophagy and inhibited ferroptosis in liver cells. Cilengitide abolished MFG-E8's beneficial effects in SAP-induced liver injury. CONCLUSION: MFG-E8 acts as an endogenous protective mediator in SAP-induced liver injury. MFG-E8 alleviates the excessive autophagy and inhibits ferroptosis in hepatocytes by binding to integrin αVß3/5.

Lithium chloride induces apoptosis by activating endoplasmic reticulum stress in pancreatic cancer.

Lithium compounds, a classic class of metal complex medicine that target GSK 3ß and are widely known as mood-stabilizer, have recently been reported as potential anti-tumor drugs. The objective of this investigation was to explore the anticancer potential of lithium chloride (LiCl) and elucidate its mode of action in pancreatic cancer cells. The MTT, colony formation, and Edu assay were used to evaluate the impact of LiCl on pancreatic cancer cell proliferation. Various methods were employed to investigate the anti-tumor activity of LiCl and its underlying mechanisms. Cell cycle analysis and apoptosis detection assays were utilized for in vitro experiments, while the orthotopic pancreatic cancer mouse model was employed to evaluate the effectiveness of LiCl treatment in vivo. Furthermore, the impact of LiCl on the proliferation of patient-derived organoids was also studied. The results demonstrated that LiCl inhibited the proliferation of pancreatic cancer (PC) cells, induced G2/M phase arrest, and activated apoptosis. Notably, the triggering of endoplasmic reticulum (ER) stress by LiCl was observed, leading to the activation of the PERK/CHOP/GADD34 pathway, which subsequently promoted apoptosis in PC cells. In the future, Lithium compounds could become an essential adjunct in the treatment of human pancreatic cancer.

Effect of Individualized Cardiac Rehabilitation on Cardiac Function, Time Consumption, and Quality of Life in Patients After CABG.

BACKGROUND: To investigate the effect of individualized cardiac rehabilitation (CR) on cardiac function, time consumption, and quality of life (QoL) in post-CABG patients. METHODS: Two different CR strategy: basic rehabilitation and individualized rehabilitation was designed. The patients were screened and randomized into the two groups: the basic rehabilitation group (BRG) and individualized rehabilitation group (IRG). Data, such as clinical characteristics, LVEF, 6MWD (6-min walk distance), BNP, LVEDD (left ventricular end diastolic dimension), SF-36 score, and time consumption were collected and recorded. RESULTS: There was no difference between the IRG and BRG patients in the clinical characteristics. The 6MWD and LVEF on post-op significantly were higher, while BNP and LVEDD significantly was lower in the IRG than in BRG. The time to first out-of-bed activity, ICU stay time, and post-op hospital stay time of the IRG in post-op was significantly shorter than BRG. The IRG patients scored significantly higher on the SF-36. CONCLUSION: Individualized CR is safe and can reduce the time consumption and improve the cardiac function and QoL of patients undergoing CABG.

Genomic structure of varicella-zoster virus and its vaccine application status / 中华预防医学杂志

With the determination of the whole genome sequence of varicella-zoster virus (VZV) virus, the successful breakthrough of infectious cloning technology of VZV, and the emergence of effective preventive vaccines, which have been proven to be effective and safe, varicella has become a disease preventable by specific immunity. This article will review the genomic structure, epidemiological characteristics, and research application progress of varicella vaccine and herpes zoster vaccine of varicella zoster virus to provide reference for primary prevention of the disease.

Heterologous boost with mRNA vaccines against SARS-CoV-2 Delta/Omicron variants following an inactivated whole-virus vaccine

The coronavirus SARS-CoV-2 has mutated quickly and caused significant global damage. This study characterizes two mRNA vaccines ZSVG-02 (Delta) and ZSVG-02-O (Omicron BA.1), and associating heterologous prime-boost strategy following the prime of a most widely administrated inactivated whole-virus vaccine (BBIBP-CorV). The ZSVG-02-O induces neutralizing antibodies that effectively cross-react with Omicron subvariants following an order of BA.1>BA.2>BA.4/5. In naive animals, ZSVG-02 or ZSVG-02-O induce humoral responses skewed to the vaccines targeting strains, but cellular immune responses cross-react to all variants of concern (VOCs) tested. Following heterologous prime-boost regimes, animals present comparable neutralizing antibody levels and superior protection across all VOCs. Single-boost only generated ancestral and omicron dual-responsive antibodies, probably by "recall" and "reshape" the prime immunity. New Omicron-specific antibody populations, however, appeared only following the second boost with ZSVG-02-O. Overall, our results support a heterologous boost with ZSVG-02-O, providing the best protection against current VOCs in inactivated virus vaccine- primed populations.

Accessory Climbing Routes Associated With More Rescue Operations Than the Main Climbing Route: A Retrospective 12-Year Report of Yushan National Park.

INTRODUCTION: This study compared the casualties and types of rescues conducted on the main climbing route (MCR) and accessory climbing routes (ACRs) in Yushan National Park (YSNP) between 2008 and 2019. METHODS: We collected the following information for all documented mountain rescue operations conducted on the MCRs and ACRs in YSNP between 2008 and 2019: accident location, casualty type, victim number, and type of rescue. The victims were categorized as to injury, illness, mortality, or no medical problem (NMP) groups according to their condition at the time of rescue. RESULTS: Two-hundred forty-four rescue operations involving 329 victims were conducted during the 12-y study period. Among them, 105 (32%) did not require medical treatment, 102 (31%) were injured, 82 (25%) were ill, and 40 (12%) were deceased. Of the 82 individuals with illness, 69 (84%) had acute altitude sickness. The accident and mortality rates on the ACRs were significantly higher than those on the MCR (P<0.001; χ2). The ACR incidents involved significantly higher percentages of helicopter-based rescues and victims in the NMP group (P<0.001). CONCLUSIONS: Acute altitude sickness accounted for most of the rescues. ACRs had higher injury and mortality rates and required more helicopter-based rescues for patients who did not have medical problems. This study may serve as a reference to reduce casualties and overuse of helicopters by educating tourists on the appropriate use of maps and the evaluation of trails in relation to weather conditions.

Optimal indicator for changing the filter during the continuous renal replacement therapy in intensive care unit patients with acute kidney injury: A crossover randomized trial.

BACKGROUND: The study aims to investigate an optimal indicator for changing the filter during the continuous renal replacement therapy (CRRT) in intensive care unit (ICU) patients with acute kidney injury (AKI). METHODS: Patients with AKI requiring CRRT in an ICU were randomly divided into two groups for crossover trial, i.e., groups A and B. Patients in the group A were firstly treated with continuous veno-venous hemofiltration (CVVH), followed by continuous veno-venous hemodiafiltration (CVVHDF). Patients in the group B were firstly treated with CVVHDF followed by CVVH. Delivered doses of solutes with different molecular weights at the indicated time points between groups were compared. A correlation analysis between the delivered dose and pre-filter pressure (PPRE) and transmembrane pressure (PTM) was performed. Receiver operating characteristic (ROC) curves were constructed to evaluate the accuracy of PTM as an indicator for filter replacement. RESULTS: A total of 50 cases were analyzed, 27 in the group A and 23 in the group B. Delivered doses of different molecular-weight solutes significantly decreased before changing the filter in both modalities, compared with those at the initiation of treatment (all P<0.05). In the late stage of CRRT, the possible rebound of serum medium-molecular-weight solute concentration was observed. PTM was negatively correlated with the delivered dose of medium-molecular-weight solute in both modalities. The threshold for predicting the rebound of serum concentration of medium-molecular-weight solute by PTM was 146.5 mmHg (1 mmHg=0.133 kPa). CONCLUSIONS: The filter can be used as long as possible within the manufacturer's safe use time limits to remove small-molecular-weight solutes. PTM of 146.5 mmHg may be an optimal indicator for changing the filter in CRRT therapies to remove medium-molecular-weight solutes.

ß2-adrenergic receptor drives the metastasis and invasion of pancreatic ductal adenocarcinoma through activating Cdc42 signaling pathway.

Recent investigations indicate that ß2-adrenergic receptor (ß2-AR) signaling may facilitate the progression of various tumors, whose underlying mechanisms remain largely elusive. In the present study, we showed that ß2-AR recruited Cdc42 in response to isoproterenol (ISO, a ß-AR selective agonist) exposure in pancreatic ductal adenocarcinoma (PDAC) cells. The association of ß2-AR and Cdc42 promoted the activation of Cdc42, as revealed by increased levels of Cdc42-GTP, and co-incubation with ß2-AR antagonist abrogated ISO-induced activation of Cdc42. ß2-AR-mediated Cdc42 activation further led to the phosphorylation of downstream PAK1, LIMK1 and Merlin. Furthermore, we showed that the activation of ß2-AR/Cdc42 signaling facilitated the migration and invasion of PDAC cells. In addition, ß2-AR and Cdc42 were overexpressed in PDAC specimens, compared with adjacent non-tumor tissues. High expression of ß2-AR and Cdc42 were correlated with lymph node metastasis and TNM stage in PDAC patients. Finally, we showed that overexpression of ß2-AR and Cdc42 were indicative of unfavorable prognosis in PDAC patients. Taken together, our findings suggested that ß2-AR might facilitate Cdc42 signaling to drive the migration and invasion of PDAC cells, consequently resulting in the metastasis and dismal prognosis of PDAC. These studies highlight targeting ß2-AR/Cdc42 signaling as a therapeutic strategy against PDAC.

Study of the Behavior of Square Concrete-Filled CFRP Steel Tubular under a Bending-Torsion Load.

To study the behavior of square concrete-filled CFRP (carbon fiber polymer) steel tubular under bending-torsional load, nine square section concrete-filled CFRP steel tubular specimens are designed. The T-θ curve and failure mode of square concrete-filled CFRP steel tubular are studied under a bending-torsional load. Based on the test results, a finite element modeling method is proposed by using the finite element software ABAQUS, and the simulation results are compared with the experimental results. The results show that the simulation is in good agreement with the experimental results. On the basis of verifying the reliability of the model, the whole stress process and parameter analysis of the component are studied, and the calculation expression of bearing capacity of square concrete-filled CFRP steel tubular under bending-torsion load is proposed. The predicted specimen-bearing capacity of the proposed calculation expression of the bearing capacity of square concrete-filled CFRP steel tubular under bending-torsion load is basically consistent with the test results.

Creatine Supplementation for Muscle Growth: A Scoping Review of Randomized Clinical Trials from 2012 to 2021.

Creatine supplementation is the most popular ergonomic aid for athletes in recent years and is used for improving sport performance and muscle growth. However, creatine supplementation is not always effective in all populations. To address these discrepancies, numerous studies have examined the use of creatine supplementation for muscle growth. This scoping review aimed to investigate the effects of creatine supplementation for muscle growth in various populations, in which Arksey and O'Malley's scoping review framework is used to present the findings. For this study, we performed a systematic search of the PubMed, Embase, and Web of Science databases for theses and articles published between 2012 and 2021. A manual search of the reference lists of the uncovered studies was conducted and an expert panel was consulted. Two reviewers screened the articles for eligibility according to the inclusion criteria. Methodological quality was assessed using the National Heart, Lung and Blood Institute's (NHLBI's) quality assessment tool. A total of 16 randomized controlled trials (RCTs) were finally included. All the authors extracted key data and descriptively analyzed the data. Thematic analysis was used to categorize the results into themes. Three major themes related to muscle growth were generated: (i) subjects of creatine supplementation-muscle growth is more effective in healthy young subjects than others; (ii) training of subjects-sufficient training is important in all populations; (iii) future direction and recommendation of creatine supplementation for muscle growth-injury prevention and utilization in medical practice. Overall, creatine is an efficient form of supplementation for muscle growth in the healthy young population with adequate training in a variety of dosage strategies and athletic activities. However, more well-designed, long-term RCTs with larger sample sizes are needed in older and muscular disease-related populations to definitively determine the effects of creatine supplementation on muscle growth in these other populations.

Investigation of stretchable strain sensor based on CNT/AgNW applied in smart wearable devices.

Stretchable strain sensor, an important paradigm of wearable sensor which can be attached onto clothing or even human skin, is widely used in healthcare, human motion monitoring and human-machine interaction. Pattern-available and facile manufacturing process for strain sensor is pursued all the time. A carbon nanotube (CNT)/silver nanowire (AgNW)-based stretchable strain sensor fabricated by a facile process is reported here. The strain sensor exhibits a considerable Gauge factor of 6.7, long-term durability (>1000 stretching cycles), fast response and recovery (420 ms and 600 ms, respectively), hence the sensor can fulfill the measurement of finger movement. Accordingly, a smart glove comprising a sensor array and a flexible printed circuit board is assembled to detect the bending movement of five fingers simultaneously. Moreover, the glove is wireless and basically fully flexible, it can detect the finger bending of wearer and display the responses distinctly on an APP of a smart phone or a host computer. Our strain senor and smart glove will broaden the materials and applications of wearable sensors.

Dosimetric comparison between conventional IMRT and EBCRT combined with IMRT for post-mastectomy left-sided breast cancer patients / 中华放射医学与防护杂志

Objective:To investigate the dosimetric differences between conventional IMRT and electron beam conformal radiotherapy (EBCRT) combined with IMRT for post-mastectomy left-sided breast cancer patients.Methods:A total of 20 post-mastectomy left-sided breast cancer patients who were treated in the Ningbo First Hospital from June 2018 to October 2021 were retrospectively studied. The planning target volume (PTV) included the supra-and infra-clavicular regions(PTV sc)and the ipsilateral chest wall (PTV cw), and the prescribed dose was 50 Gy/25 f. All radiotherapy plans were designed using the Varian Eclipse treatment planning system (TPS). After that, the dose distribution of the target volume and the dose exposure of organs at risk (OARs) were compared and analyzed. Results:All the IMRT plans met the clinical requirements, yet 2/20 of the EBCRT combined with IMRT plans were not clinically accepted. For these two patients, the maximum chest wall thickness was 3.7 cm and 4.4 cm each, and the designed electron beam energy was 12 MeV and 15 MeV, respectively. The dose to the ipsilateral lung of these two patients exceeded the institution-specific dose limit standard. For the remaining 18 patients whose chest wall thickness was 3 cm or less, the designed electron beams were 9 MeV or less. All the EBCRT combined with IMRT plans were clinically accepted. The target dose distribution of the conventional IMRT was better than that of the EBCRT combined with IMRT (uniformity index (HI): PTV sc: t = -10.20, P<0.05; PTV cw: t = -9.24, P<0.05; conformal index (CI): PTV all: t = 10.39, P <0.05). For OARs, the V5 Gy, V20 Gy, and Dmean of the ipsilateral lung of EBCRT combined with IMRT were lower than those of IMRT ( t = 5.98, 6.30, 11.30, P <0.05). Specifically, the V25 Gy and Dmean of heart decreased by 8.3% and 4.79 Gy, respectively ( t = 15.23, 15.76, P<0.05), the Dmean of the left anterior descending coronary artery (LADCA) decreased by 44.03% ( t = 11.69, P <0.05), and the V5 Gy and Dmean of the contralateral breast decreased by 7.9% and 0.8 Gy, respectively ( t = 3.66, 4.93, P<0.05). The dosimetric differences of other OARs were not statistically significant ( P > 0.05). Conclusions:For post-mastectomy left-sided breast cancer patients with a chest wall thickness of less than 3 cm, EBCRT combined IMRT can significantly reduce the exposure dose to the heart, the ipsilateral lung, and the contralateral breast, which is beneficial to reducing the potential risk of long-term complications after radiotherapy and can further improve the long-term overall survival rate of patients. For patients with thick chest wall, IMRT plans are more technologically ideal.

Propagation of a hospital-associated cluster of COVID-19 in Malaysia.

BACKGROUND: Hospitals are vulnerable to COVID-19 outbreaks. Intrahospital transmission of the disease is a threat to the healthcare systems as it increases morbidity and mortality among patients. It is imperative to deepen our understanding of transmission events in hospital-associated cases of COVID-19 for timely implementation of infection prevention and control measures in the hospital in avoiding future outbreaks. We examined the use of epidemiological case investigation combined with whole genome sequencing of cases to investigate and manage a hospital-associated cluster of COVID-19 cases. METHODS: An epidemiological investigation was conducted in a University Hospital in Malaysia from 23 March to 22 April 2020. Contact tracing, risk assessment, testing, symptom surveillance, and outbreak management were conducted following the diagnosis of a healthcare worker with SARS-CoV-2 by real-time PCR. These findings were complemented by whole genome sequencing analysis of a subset of positive cases. RESULTS: The index case was symptomatic but did not fulfill the initial epidemiological criteria for routine screening. Contact tracing suggested epidemiological linkages of 38 cases with COVID-19. Phylogenetic analysis excluded four of these cases. This cluster included 34 cases comprising ten healthcare worker-cases, nine patient-cases, and 15 community-cases. The epidemic curve demonstrated initial intrahospital transmission that propagated into the community. The estimated median incubation period was 4.7 days (95% CI: 3.5-6.4), and the serial interval was 5.3 days (95% CI: 4.3-6.5). CONCLUSION: The study demonstrated the contribution of integrating epidemiological investigation and whole genome sequencing in understanding disease transmission in the hospital setting. Contact tracing, risk assessment, testing, and symptom surveillance remain imperative in resource-limited settings to identify and isolate cases, thereby controlling COVID-19 outbreaks. The use of whole genome sequencing complements field investigation findings in clarifying transmission networks. The safety of a hospital population during this COVID-19 pandemic may be secured with a multidisciplinary approach, good infection control measures, effective preparedness and response plan, and individual-level compliance among the hospital population.

Knowledge, attitudes, and practices regarding venous thromboembolism prophylaxis: A survey of medical staff at a tertiary hospital in China.

ABSTRACT: To assess the knowledge, attitudes, and practices regarding venous thromboembolism (VTE) prophylaxis among medical staff at a tertiary hospital in China.A self-administered web-based survey was completed by medical staff, and data about respondent knowledge, attitudes, and practices regarding VTE prophylaxis were gathered and analyzed with chi-square tests, using a 95% significance level.Of the 2079 medical staff invited to participate in the survey, a total of 2042 (including 921 clinicians and 1121 nurses) responded. The overall rate of correct responses to knowledge items was 57.6%; the rate was 60.1% for clinicians and 55.4% for nurses (P < .001). The median affirmative ("strongly agree"/"agree") rate for attitude items was 99.0% (range, 83.2%-99.4%). Medical staff members were most commonly concerned about the possibility of a financial penalty when a patient could not be treated with VTE prophylaxis (49.4%). Low levels of knowledge and participation of medical staff were identified most commonly as difficulties involved in VTE prophylaxis (48.5%). The median affirmative response rate for practice items was 58.2% (range, 51.1%-68.3%). All affirmative response rates for practice items were significantly higher for nurses than for clinicians (all P < .001).Although the overall attitude toward VTE prophylaxis was positive, the knowledge level was poor, especially among nurses, and the rate of affirmative responses regarding practices was low, especially among clinicians. Medical institutions should improve staff training regarding VTE prophylaxis, and medical staff should be encouraged to actively engage in VTE prophylaxis.

A positive COX-2/IL-1ß loop promotes decidualization by upregulating CD82.

A successful pregnancy requires sufficient decidualization of endometrial stromal cells (ESCs). CD82, a metastasis suppressor, is a critical regulator for trophoblast invasion but the effect in decidualization was largely unknown. Here we reported that there was a high level of CD82 in DSC by the immunohistochemistry staining and flow cytometer analysis. Stimulation with prostaglandin E2 (PGE2) elevated the expression of CD82 in ESCs. In contrast, celecoxib, a selective COX-2 inhibitor, significantly downregulated the expression of CD82 in decidual stromal cells (DSCs). Bioinformatics analysis and further research showed that recombinant human interleukin (IL)-1ß protein (rhIL-1ß) upregulated CD82 in ESCs. Of note, blocking IL-1ß signaling with anti-human IL-1ß neutralizing antibody could reverse the stimulatory effect of PGE2 on CD82 in ESCs. Silencing CD82 resulted in the decease of the decidualization markers PRL and IGFBP1 mRNA levels in DSCs. More importantly, we observed rhIL-1ß also upregulated the expression of COX-2, and the upregulation of PRL and IGFBP1 induced by rhIL-1ß could be abolished by celecoxib in ESCs or CD82 deficiency in DSCs. This study suggests that CD82 should be a novel promotor for decidualization under a positive regulation of the COX-2/PGE2/IL-1ß positive feedback loop.

Case report : Actinomyces naeslundii complicating preterm labour in a trisomy-21 pregnancy.

Preterm birth is a global concern with considerable morbidity and mortality. Intrapartum infection is a known cause of preterm birth and Actinomyces infection is one of the infections contributing to preterm birth. We report a case of preterm birth of a trisomy-21 neonate to a mother with positive Actinomyces naeslundii from an intra-operative placental swab sample and discussed the relationship of this bacteria and preterm delivery, and the role of postpartum antibiotics use in this case.

Emergency craniotomy in patient with intracranial metastatic choriocarcinoma: a case report.

Choriocarcinoma is a highly malignant gynaecological tumour. This disease becomes life-threatening once brain haemorrhage or brain herniation occurs. Timely and accurate brain surgery can gain treatment time for patients that have a large number of cerebral haemorrhages and/or brain herniation. This current report describes a case of choriocarcinoma secondary to a hydatidiform mole in a 55-year-old woman that presented with neurological symptoms. Following admission to hospital, computed tomography examination found that lung and brain metastases were accompanied by cerebral haemorrhage. Cerebral hernia occurred during induction chemotherapy treatment and emergency surgery was performed. The patient recovered after individual chemotherapy and rehabilitation treatment. Patients with a very high risk of choriocarcinoma with brain metastasis should be referred to a comprehensive medical centre. Necessary surgical treatment and individualized chemotherapy can reduce the mortality of patients with choriocarcinoma brain metastasis.