The gut microbiota is generally thought in regulating the body's metabolism and immune function.The imbalance of gut microbiota is related to the occurrence and development mechanisms of acute and chronic lung dis-eases,resulting from lung injury.The"gut-lung axis"pays a main role in various ways in the occurrence of lung injury,including intestinal barrier dysfunction,reduced diversity of gut microbiota,decreased secretion of beneficial metabolites,translocation of gut microbiota and metabolites to the lungs,immune damage to the body and lungs,increased inflammatory response in the lungs.

Objective To evaluate the high-risk factors for venous thromboembolism(venous throm-boembolism,VTE)during the perioperative period in gynecology and analyze the rationality of anticoagulant drug use.Methods Clinical data of 183 gynecological surgical patients treated at Kunming Maternal and Child Health Hospital from January 2023 to December 2024 were collected.Among them,29 diagnosed with postoperative VTE were classified as the VTE group and 154 diagnosed with no postoperative VTE during the same period were classified as the non-thrombosis group.Independent sample t-test,Mann-Whitney U test,or χ2 test were used to analyze high-risk factors for VTE during the perioperative period.Logistic regression analysis was employed to identify risk factors for VTE after the gynecological surgery and a predictive regression model was established.The ROC curve was plotted to evaluate the model's validity.Results Elevated D-dimer levels,open abdominal surgery,and history of thrombosis were independent risk factors for VTE in postoperative gynecological patients(OR>1,P<0.05).The AUC of the regression-based predictive model was higher than that of the Caprini and G-Caprini scores,indicating that this model had the good discriminatory ability its resolution was better than G-Caprini and Caprini risk assessment tools.The identified issues in VTE prophylaxis at the hospital included the insufficient mechanical prevention time limit and delayed initiation of anticoagulant therapy in patients at moderate risk of bleeding.Conclusion This predictive model has certain clinical value for broader application.For issues related to drug therapy such as delayed use of anticoagulant drugs,clinical pharmacists should collaborate with physicians to assess patients'bleeding and thrombosis risks,jointly develop precise anticoagulation regimens.

Objective:The aim of this study is to develop a comprehensive index system for assessing the key first aid skills required for aeromedical evacuation of infected patients, with the goal of enhancing our army's medical support capabilities.Methods:This study combined literature review and two rounds of Delphi expert correspondence to construct the key first aid skills index system of aeromedical evacuation for infected patients. 19 experts from relevant disciplines were selected purposively to conduct Delphi expert consultation.Results:Both rounds of Delphi expert correspondence achieved a 100% response rate, indicating high effectiveness. The degree of authority among the experts was determined to be 0.87. In the first round, there was a Kendall coordination coefficient value of 0.184 for assessing the importance of primary indicators, while secondary indicators showed coefficients of 0.289 and 0.380 for importance and feasibility respectively. In the second round, these values increased slightly to 0.263, 0.304 (importance) and 0.398 (feasibility), respectively. The final evaluation index system of key first aid skills applied to the aeromedical evacuation of infected patients was constructed, including 3 primary indicators of life support technology, intensive care technology and isolation protection technology, and 40 secondary indicators.Conclusion:The evaluation index system of key first aid skills applied to the aeromedical evacuation of infected patients constructed through two rounds of Delphi expert correspondence is scientific and reasonable, which can provide reference for the training and assessment of key first aid skills applied to the aeromedical evacuation of infected patients, so as to promote the development of aeromedical evacuation for infectious patients in China.

Objective To develop an expert consensus on subcutaneous injection nursing for allergic asthma in children,standardize nursing practice to reduce the occurrence of related adverse reactions.Methods The clinical guideline,expert consensus,systematic review,evidence summary and original research on subcutaneous injection of monoclonal antibody drug for children with allergic asthma were comprehensively searched in domestic and foreign databases.The time limit for retrieval was from the establishment of databases until August 2023.Combined with clinical practice experience,the first draft of the consensus was formed.From December 2023 to February 2024,27 experts were invited to conduct 2 rounds of expert letter consultation,revise and improve the contents of the first draft,and expert demonstration was conducted,and finally a consensus final draft was formed.Results The effective recovery rate of the 2 rounds of letter consultation questionnaires was 100％;the authority coefficient of experts was 0.88;the judging basis coefficient was 0.93;the familiarity coefficient was 0.83.In the 2 rounds of correspondence,the Kendall concordant coefficients of expert opinions were 0.241 and 0.252,respectively(P＜0.001 for both).The consensus includes 6 parts,including personnel management,environmental layout,indications and contraindications,subcutaneous injection operation norms,identification and treatment of adverse reactions,and health education.Conclusion The consensus is strongly scientific and practical,and can provide guidance for nursing practice of subcutaneous injection of monoclonal antibodies in children with allergic asthma.

Objective:To compare the clinicopathological differences between elderly and non-elderly patients with idiopathic membranous nephropathy(IMN).Methods:Patients diagnosed with IMN via renal biopsy at Beijing Huairou Hospital, Beijing Changping Hospital of Traditional Chinese Medicine, and Beijing Hospital of Traditional Chinese Medicine from January 2017 to August 2021 were retrospectively enrolled.They were classified into the elderly group(≥65 years)and the non-elderly group(<65 years), and the clinicopathological differences between the two groups were compared.Results:A total of 207 IMN patients were included in the study, with a male to female ratio of 1.7∶1.0.There were 56 patients in the elderly group, aged(68.2±3.1)years, and 151 patients in the non-elderly group, aged(48.2±6.2)years.Compared with the non-elderly group, the elderly group had a longer time from onset to renal biopsy and a higher proportion of patients with renal insufficiency and hypertension( P<0.05). The elderly group had a lower eGFR, lower serum albumin, higher serum cholesterol, and higher low-density lipoprotein than the non-elderly group( P<0.05). The proportions of patients with glomerulosclerosis, renal tubular atrophy, and interstitial fibrosis in the elderly group were higher than in the non-elderly group( P<0.05). The positive rates of glomerular PLA2R antigen staining in the two groups were 90.6%(29/32)and 91.0%(111/122), respectively, and there was no statistically significant difference between the two groups.IgG4 deposition represented the most common IgG subtype, with 93.8%(30/32)in the elderly group and 94.3%(115/122)in the non-elderly group.There was no statistical significance between the two groups( P>0.05). Conclusions:Compared with non-elderly IMN patients, a higher proportion of elderly IMN patients has renal insufficiency, hypertension and chronic renal pathology.The glomerular deposition of pathogenic antigens in elderly IMN patients was similar to that in non-elderly IMN patients, suggesting no difference in pathogenesis between the two groups.The clinicopathological differences between the two groups may be related to age and complications.

Objective To analyze the frail status and influencing factors of inpatients in geriatrics department.Methods A total of 170 patients aged ≥ 65 years in Geriatrics Department in our hospital were selected.Frailty was defined according to the Clinical Frailty Scale (CFS),and patients were divided into non-frail group and frail group.The differences in comorbidity,physical function,nutrition,cognitive,psychological,geriatrics syndromes,medication,social support and other aspects were analyzed between the two groups by using Comprehensive Geriatrics Assessment(CGA),and correlationof the factors with frailty was evaluated.Results There were 83 (49.0％)patients in frail group and 87 (51.0％)in non-frail group.In frail group versus non-frail group,Charlson comorbidity index was(2.7±2.0)vs.(1.9±1.1),and cumulative illness rating scale was(10.8±3.7) vs.(8.0±2.6) (all P＜0.05);mini-nutrition assessment was(11.2±2.3)vs.(13.0±1.3),and simple cognitive score was(2.7±1.3)vs.(4.1±0.9)(all P＜0.05).Grip,five chair rising,timed get-up and go test,walking speed,SPPB showed statistically significant differences (all P＜ 0.05) between frail group and non-frail group:(20.7±6.6)kg vs.(27.96.7)kg,(30.4±17.5)vs.(12.9±4.1),(23.7± 9.9)vs.(11.7± 3.3),(0.5 ± 0.2)m/s vs.(0.9± 0.2)m/s,(5.6 ± 2.3) vs.(10.3±1.8)respectively.The incidences of incontinence,visual impairment,hearing impairment,sleeping disorder,oral problems,chronic pain,anxiety or depression and fall history were higher in frail patients than in non-frail patients.Living alone,the widowed,nursing staff employment proportion were higher in frail group than in non-frail group.Level of education was lower in frail group than non-frail group.Logistic regression analysis showed that BMI,the walking speed and the number of geriatrics syndromes had a significant impact on frailty(OR=0.789,0.000,2.745,all P＜0.05).Conclusions Incidence rate of frailty in elderly hospitalized patients is high.To identify frailty of hospitalized patients,comprehensive geriatric assessment can be used for understanding frail characteristics and its influencing factors for hospitalized old patients,so as to provide evidence for the reasonable treatment programs.

Objective To observe the effects of dietary nursing based on macroscopic and microscopic syndrome differentiation on the compliance, clinical efficacy and quality of life (QOL) of ulcerative colitis patients with damp-heat in large intestine. Methods One hundred and ten cases meeting the diagnostic criteria of ulcerative colitis patients with damp-heat in large intestine were divided into routine group and observation group, 55 cases in each group. Both groups were given oral use of Sulfasalazine Tablets, and routine health education and dietary nursing for ulcerative colitis patients with damp-heat in large intestine. Additionally, the observation group was given dietary nursing based on macroscopic syndrome differentiation and colonoscopic microscopic syndrome differentiation. One month constituted a treatment course. After 6 courses of treatment, the compliance, clinical efficacy and QOL of the two groups were compared. Results (1) The incidence of medication missing or suspension in the routine group was 14.55%, while the incidence of diet missing or suspension in the observation group was 1.82%, the difference between the two groups being statistically significant (P < 0.01). (2) In the routine group, the cure rate was 5.5% and the total effective rate was 81.8%; in the observation group, the cure rate was 12.7% and the total effective rate was 92.7%. The differences between the two groups were statistically significant(P<0.05).(3) The scores of each dimension of QOL scale in the observation group were higher than those of the routine group (P < 0.05) , indicating that the improvement of QOL in the observation group was superior to that of the routine group. Conclusion The compliance, clinical efficacy and QOL of ulcerative colitis patients with damp-heat in large intestine are enhanced after treatment with dietary nursing based onmacroscopic and microscopic syndrome differentiation.

Objective To systematically review the efficacy of hypotensive resuscitation for traumatic-hemorrhagic shock.Methods Randomized controlled trails (RCTs) or quasi-Randomized controlled trails (qRCTs) were searched in Pubmed,Embase and the Corchrane Library from inception to August 2015.Two reviewers respectively picked out the useful data and performed quality evaluation.Metaanalysis was carried out with RevMan 5.3 software,risk ratio (RR) and its 95％ confidence interval (CI) were pooled to estimate the enumeration data,and GRADE 3.6.1 software was used to rate the level of evidence.Results The results of meta-analysis and GRADE rating system which included 4 studies showed that:compared with conventional resuscitation,hypotensive resuscitation was associated with lower total mortality [RR =0.77,95％ CI:0.62-0.95,P =0.01;n =984,GRADE rating:moderate],and 24-hour mortality [RR =0.47,95％ CI:0.24-0.91,P =0.03;n =281,GRADE rating:moderate],but the subgroup analysis of total mortality showed that there were no significant differences in mortality between the subgroup of blunt or penetrating trauma and the subgroup of penetrating trauma.Conclusions Hypotensive resuscitation reduced total mortality and 24-hour mortality,and the quality of the evidence was moderate.The future studies should do further research to explore the efficacy of hypotensive resuscitation for different types of trauma.

Objective To comparative evaluation of root canal filling paste AH-plus and zinc oxide root canal of clove oil seal performance. Methods By computer, we retrieved PubMed, CNKI and controlled clinical trial databases to find out the standard randomised controlled trial, and literature retrieval time from building library until October 20, 2014. According to the Cochrane literature quality evaluation method of system for the evaluating methodlogical quality of the study, and then we extracted the relevant data and analyzed by Rev Man 5. 1 software for Meta analysis. Results Eventually the study included in 23 articles of randomized controlled trials, and a total of 4104 teeth. The results showed the pain occurred after plus treatment of AH paste group which was lower than that in the control group [OR=0. 32, 95%CI(0. 26,0. 26), P<0. 01);AH plus paste group cure rate was higher than that of the control group after intervened 1 -2 years [ OR=2. 61, 95%CI(2. 03, 2. 03), P<0. 01];the paste resin class root filling AH plus length of root tip leakage was better than that of the control group, and nail polish and wax experiment method of measuring the penetration length of the tooth had statistical significance [MD=1. 28,95%CI( -1. 48,-1. 08), P<0. 01]; India ink staining solution to measure the penetration length of the tooth had statistical significance [MD=0. 82, 95% CI(-0. 90,-0. 74),P<0. 01]. Conclusions AH plus paste in root canal therapy can significantly alleviate pain, and the long-term curative effect is good, and better than biological intermiscibility, which is an ideal root canal filling material. Due to large incorporated in the analysis of the research and the quality difference, it is necessary for large sample, multicenter, randomized, double-blind, placebo-controlled trails to further confirm the clinical curative effect.

Objective To explore the relationship of insulin resistance with serum 25-hydroxyvitamin D levels and arterial stiffness in elderly patients.Methods A total of 162 elderly inpatients (aged 60 years or over) were recruited from 2012 to 2014.Levels of fasting serum insulin,fasting serum glucose,creatinine and vitamin D were determined.Insulin resistance (IR) was evaluated by the homeostasis model assessment of insulin resistance (HOMA-IR).The patients were divided into the following three groups according to HOMA-IR:the low IR group with HOMA-IR less than 2 (n=78),the median IR group with HOMA-IR between 2 and 6 (n=43),and the high IR group with HOMA-IR greater than 6 (n=41).Arterial stiffness was assessed by carotid-femoral pulse wave velocity (cfPWV).Arterial stiffness and serum vitamin D levels were compared among the three groups.Results cfPWV was increased and the serum 25-hydroxyvitamin D level was decreased in the high insulin resistance group compared with the low insulin resistance group[(13.2± 5.7) μg/L vs.(17.8±6.2) μg/L,(14.3±5.2) m/s vs.(11.9±3.0) m/s].Multiple liner regression analysis showed that IR was negatively correlated with the serum 25 hydroxyvitamin D level (r=-0.63,P＜0.05) and positively correlated with arterial stiffness (r=0.45,P＜0.05) after adjustment for age,sex and other confounders.Conclusions Elderly patients with high insulin resistance may have lower levels of serum vitamin D and higher arterial stiffness.