ABSTRACT
OBJECTIVE: Prognostic nutritional index (PNI) is an indicator to evaluate the nutritional immune status of patients. This study aimed to assess whether preoperative PNI could predict the occurrence of postoperative POD in aged patients undergoing non-neurosurgery and non-cardiac surgery. METHOD: The aged patients undergoing non-neurosurgery and non-cardiac surgery between January 2014 and August 2019 were included in the retrospective cohort study. The correlation between POD and PNI was investigated by univariate and multivariable logistic regression analysis, propensity score matching (PSM), inverse probability of treatment weighting (IPTW), and subgroup analysis. RESULTS: In the cohort (n = 29,814), the cutoff value of PNI was 46.01 determined by the receiver operating characteristic (ROC) curve. In univariate and three multivariable regression analysis, the ORs of PNI ≤ 46.01 was 2.573(95% CI:2.261-2.929, P < 0.001),1.802 (95% CI:1.567-2.071, P < 0.001),1.463(95% CI:1.246-1.718, P < 0.001),1.370(95% CI:1.165-1.611, P < 0.001). In the PSM model and IPTW model, the ORs of PNI ≤ 46.01 were 1.424(95% CI:1.172-1.734, P < 0.001) and 1.356(95% CI:1.223-1.505, P < 0.001). CONCLUSION: The PNI was found to have a predictive value for POD in patients undergoing non-neurosurgery and non-cardiac surgery. Improving preoperative nutritional status may be beneficial in preventing POD for aged patients.
Subject(s)
Emergence Delirium , Nutrition Assessment , Humans , Aged , Retrospective Studies , Prognosis , Cohort Studies , Nutritional StatusABSTRACT
Based on stimulus-organism-response (SOR) paradigm, this study proposes a conceptual framework of immersive virtual reality (IVR) learning model. To investigate the effect of IVR on learning process, this study has designed and implemented an educational application of appendectomy using IVR. The results indicate that IVR-based cognitive response, emotional response and learning results are significantly better than traditional learning. IVR learning model has a high level of immersion and user acceptance, and is expected to be employed to influence the learning satisfaction by the mediating effect of IVR presence in the future.
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Firstly, this paper introduces the classification of holographic projection by its concept and characteristics. Secondly, this paper investigates the present application status in medical fields like virtual surgery, medical diagnosis, telemedicine, doctor-patient communication, etc. It also analyzes the feasibility of applying this technology into medical education from three aspects of basic medicine, clinical medicine, and remote instruction.
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Smart classroom as the basis support of classroom teaching, should set the function of smart teaching, real-time interaction, environmental control, video monitoring and remote control, teaching reform, evaluation feedback and other functions into an organic whole, and by using new technology integration and development, to achieve the optimization of the teaching effect. In view of the characteristics of practice and complexity of medical teaching, The spatial structure of smart class-room should provide long-distance education, remote operation, live classroom group discussion, group exhibition, HD recording, classroom attendance voting and other functions, and by choosing the appro-priate teaching mode in teaching to promote the innovation and development of medical teaching.
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Tomato yellow leaf curl virus (TYLCV) belongs to the genus Begomovirus, family Geminiviridae. It is transmitted by the whitefly Bemisia tabaci. A pair of primers was designed according to the specific sequence of the TYLCV gene and used in the PCR detection of the virus in the infected tissues of tomato grown in the Shanghai area of China. DNA was extracted from leaves, fruits, seeds, and roots of infected tomato plants separately. The results showed that the target fragment of about 570 bp could be isolated from the leaves, fruits, roots of infected tomato plants, but not from the seeds. Thus, the PCR-based detection technology for the Shanghai TYLCV (TYLCV-Sh10) has been established. Primers were then designed based on the sequence of the 570 bp fragment to obtain the complete DNA-A sequence of TYLCV-Sh10 by genome walking. Sequencing results indicated that the DNA-A sequence of TYLCV-Sh10 contained 2781 nt that included six ORFs. BLAST results showed that DNA-A of TYLCV-Sh10 had low homology with the characterized TYLCV in China (TYLCCNV) except TYLCV-ZJ8 (TYLCV isolated from Zhejiang China). But it was most closely related to TYLCV-USA (99.28% sequence identity). TYLCV-Sh10, TYLCV-ZJ8, TYLCV-USA, TYLCV-Mex, and TYLCV-Eg formed an independent branch by pairwise comparison and phylogenetic analysis. All these results strongly suggested that Sh10 was an isolate of America or Africa TYLCV.
