OBJECTIVE To study the role of ciliary neurotrophic factor(CNTF) in the generation of facial nerve.METHODS Twenty adult New Zealand rabbits' bilateral super buccals of facial nerves were transected and connected with silicone tube.CNTF was injected into a random side of silicone tube and normal saline in the other.At four and eight weeks after the operation, both the CNTF group and the SAL group underwent electrophysiology test and histopathology as well as quantity analysis.RESULTS Four weeks later, both CNTF and SAL group failed in eliciting muscular excitement upon stimulation; T-test showed a signifi-cant difference(P

Objective To analyze relation of comprehensive parameters of the dose-volume V5,V10 and V20 with radiation pneumonitis (RP) in patients with advanced stage non-small-cell lung cancer (NSCLC) treated with three-dimensional conformal (3DCRT) or intensity-modulated radiation therapy (IMRT).Methods Data of 90 patients with histologically proved NSCLC treated with 3DCRT or IMRT between November 2006 and July 2009 were collected.The median radiation dose of 70 Gy (range, 61 - 80 Gy) was delivered with late-course accelerated hyperfractionated radiotherapy (LAHRT).The V5 ,V10 ,V20,V30 and mean lung dose (MLD) were calculated from the dose-volume histogram system.The RP was evaluated according to the common toxicity criteria 3.0(CTC 3.0).Results The range of V5 ,V10 and V20 was 36% - 98%, 27% - 78% and 19% - 54%, respectively, with a median value of 66%, 48% and 31%, respectively.The RP of grade 1,2,3,4 and 5 was observed in 29,23,5,1 and 1 patients.The V5,V10 ,V20, contralateral V10, GTV,PTV, and numbers of fields were all significantly associated with RP of ≥grade 1 (χ2=2.04, 2.05, 2.01, 4.62, 6.50, 5.61, 5.61, and P= 0.044, 0.043, 0.047, 0.030,0.010,0.020,0.020).The V5, V10, V20, V30, and MLD were all significantly associated with RP of ≥ grade 2 (χ2= 2.05,2.20,2.96,4.96,5.20, and P = 0.040,0.030,0.000,0.030,0.020).In Logistic regression analysis, GTV was the only factor significantly associated with RP of ≥ grade 1 (χ2= 4.06, P =0.044).The V20 was the only factor significantly associated with RP of ≥grade 2(χ2=9.61,P=0.002).The RP of ≥grade 2 was significantly increased when V20 was more than 31%.The RP of ≥grade 2 was significantly increased when V20, V10 and V5 were more than 31%, 48% and 66%, respectively.The RP of ≥ grade 2 was significantly increased when V20 was more than 31% and V5 was more than 66%.Conclusions The comprehensive parameters combined with V5, V10 and V20 are effective in predicting RP.

Objective:To investigate the clinical application of salvianolate for injection in Tongde Hospital of Zhejiang Province and evaluate its rationality of injection.Methods:From March 2018 to November 2018, 560 patients treated with salvianolate for injection in Tongde Hospital of Zhejiang Province were selected by random sampling method.The indications, usage and dosage, route of administration, choice of vehicle, concentration of vehicle, course of treatment, compatibility, contraindications and adverse reactions of salvianolate for injection were analyzed retrospectively.Results:Totally 560 inpatients received salvianolate for injection were collected, about 26.96%(151/560) was consistent with the indication, 99.82%(559/560) with a correct administration dosage and frequency, 100.00%(560/560) with right administration route, 95.00%(532/560) with a right solvent selection, 67.86%(380/560) with correct solvent concentration, 61.07%(342/560) with a correct treatment course, 100.00%(560/560) with a right medicine combination, about 94.46%(529/560) was consistent with coagulation function contraindication, about 90.18%(505/560) was consistent with liver function contraindication.The incidence of adverse reactions was 1.61%(9/560).Conclusion:In the clinical application of salvianolate for injection, a high rate of unreasonable usage is found in indication, treatment course and solvent selection.Because of the serious problems in the use of salvianolate injection, it should be used strictly to ensure clinical medication safety.

Objective:To evaluate the prevalence and related risk factors of new onset diabetes after chronic pancreatitis by meta-analysis.Methods:Chronic pancreatitis, diabetes, post pancreatitis diabetes, type 2 diabetes, type 3c diabetes, endocrine dysfunction, chronic pancreatitis, diabetes mellitus, post pancreatitis diabetes mellitus, endocrine efficiency, risk factors were used as keywords, and the network database such as the CNKI database, Wanfang, Weipu, Chinese Medical Journal Full Text, PubMed, Embase, Cochrane Library, Web of Science, and so on from the database establishment to January 2023 were searched. The prospective and retrospective cohort studies on new diabetes after chronic pancreatitis published were searched and retrieved, and the papers were screened and the quality were evaluated according to preset inclusion and exclusion criteria; and the important data were extracted. Review Manager 5.4 was used for meta-analysis.Results:22 papers were finally included, including 13 785 patients with chronic pancreatitis, of which 4 233 were patients with new onset diabetes. Meta-analysis showed that the incidence of new diabetes after chronic pancreatitis was 29% ( RD=0.29, 95% CI 26%-32%, P<0.0001), which increased and tended to be stable along with the disease course. Alcohol drinking, smoking, alcoholic chronic pancreatitis, pancreatic calcification, biliary stricture, male, conservative treatment, pancreatic cyst and older onset age were considered as risk factors for new diabetes after chronic pancreatitis, and endoscopic treatment was considered as protective factors. Conclusions:The incidence of new diabetes after the diagnosis of chronic pancreatitis is relatively high. Clinically, we can identify high-risk groups exposed to risk factors, and early intervention can reduce the incidence rate of new diabetes after chronic pancreatitis and improve the prognosis of patients.

In order to understand the actual needs and influencing factors of cancer patients to participate in medical decision-making, 29 cancer patients were selected for semi-structured interviews by purpose sampling from September 2020 to February 2021, and the data were analyzed by substantive coding step by step according to interview method. The results showed that the quality of patient-clinician interaction was an important factor influencing the decision quality. The elements for cancer patients to participate in medical decision-making include: patients’ disease knowledge, awareness of choice, communication duration, support from family members and doctors, and mutual trust between doctors and patients. Medical staff should respect patients’ preference to participate in medical decision-making, break the medical-centered system arrangement, help patients obtain services matching their preferences for participating in decision-making, and achieve a pattern that is beneficial to both patients and the medical system.

Objective:To investigate the standardization of implementing enteral nutrition in patients with stroke among nurses in Guangdong province.Methods:The results of 175 valid questionnaires submitted by 175 nurses from 60 hospitals in Guangdong province from June to July 2022 were analyzed. Contents of the questionnaires included status of enteral nutrition management of stroke patients (facility, staffing, risk screening, and formulation, implementation and quality control of the plans), nurses' knowledge of enteral nutrition monitoring and complication prevention, follow-up status of enteral nutrition in stroke patients, and nurses' willingness in participating in special training of enteral nutrition.Results:(1) In terms of enteral nutrition facilities and staffing, only 76% and 36% used enteral infusion pumps and heating infusion devices, and only 3% had multidisciplinary team configuration; in terms of risk screening, only 63% had all-patient-screen for enteral nutrition risk; in terms of plan formulation, the proportion of no enteral nutrition process reached to 44%; in terms of plan implementation, the implementation rate of enteral nutrition≤48 h and gastrointestinal function evaluation using gastrointestinal function evaluation scale was less than 50%; in terms of plan quality control, less than 50% Departments had sensitive indexes of enteral nutrition nursing. (2) Among 14 risk management problems of enteral nutrition monitoring and complication prevention, only 3 had accuracy rate higher than 70%. (3) 78% nurses mentioned that patients had experienced enteral nutrition complications, and 77% nurses mentioned that patients/family members had consulted about enteral nutrition related issues; 81% nurses wanted to participate in training or refresher courses related to enteral nutrition, and 88% nurses wanted to join the enteral nutrition Nursing Alliance for stroke patients to serve patients after referral and discharge.Conclusion:The current situation of enteral nutrition management of stroke patients in Guangdong province is not optimistic; nurses lack knowledge of enteral nutrition monitoring and complication prevention, but are strongly willing to participate in the special training of enteral nutrition; relevant measures to further improve the standardized management of enteral nutrition of stroke patients is suggested.

Objective:To retrieve, evaluate, and integrate the best practice evidence for targeted temperature management in neurocritically ill patients.Methods:PIPOST tool was used to identify evidence-based issues; the Chinese and English terms were chosen as "Traumatic brain injuries", "Craniocerebral trauma/Cerebral hemorrhage/Stroke/Subarachnoid hemorrhage/Cerebral vascular disease", and "Mild hypothermia therapy/Target body temperature/Cyotherapy". According to top-down design of the "6S" evidence model, databases such as French guideline network, US guideline network, UpToDate, Chinese Biomedical Literature Database, China Yimaitong Guide network, CNKI, and Wanfang Medical Network were searched. Two researchers independently evaluated the quality of the included literature, and extracted and summarized the evidences of the literature that met the quality standards.Results:A total of 10 articles were included, including 1 clinical decision, 4 guidelines, 1 evidence summary, and 4 expert consensuses. Finally, 27 pieces of best evidences were summarized, including 6 aspects as evaluation, preparation before implementation, targeted body temperature selection, intervention duration, chill management, and other complication prevention.Conclusion:Best evidence for temperature management in neurocritically ill patients can provide evidence-based evidence for healthcare professionals.

ObjectiveTo analyze the distribution, drug resistance characteristics, and changing trends of Acinetobacter baumannii (AB) isolated from environmental surfaces and healthcare workers’ hands in a grade Ⅱ level A general hospital in Xuhui District of Shanghai from 2018 to 2023, and to provide reference for infection control in the hospital. MethodsEnvironmental samples were collected quarterly from critical surfaces and healthcare workers’ hands in the intensive care unit (ICU), geriatrics, and respiratory departments from 2018 to 2023. Clinical isolates were obtained from all patients with AB infections in ICU, geriatrics, respiratory department, rehabilitation department, infectious diseases department, emergency department, cardiology department, and orthopedics of the hospital from 2018 to 2023. Retrospective analyses were performed on AB detection rates, strain origins, resistance rates to commonly used antimicrobial agents, and resistance gene features, comparing the antimicrobial resistance between clinically isolated strains and environmentally isolated strains. ResultsFrom 2018 to 2023, a total of 1 416 samples were collected from the hospital and a total of 272 strains of AB were detected, with a positive detection rate of 19.21%. The detection rate gradually decreased year-on-year (χ²_trend=45.290, P<0.001). The majority of samples originated from patient-contacted items (34.56%, 94/272), followed by shared items (26.84%, 73/272) and healthcare worker-contacted items (15.07%, 41/272). From 2018 to 2023, the resistance rate of AB on environmental surfaces and healthcare workers’ hands to commonly tested antibiotics in the hospital ranged from 10% to 40%. The resistance rates to cefotaxime (42.52%) and piperacillin (38.58%) were relative high, while the resistance to polymyxin E (1.57%), polymyxin B (2.36%), and doxycycline (3.94%) maintained low. The annual fluctuations in resistance to cefotaxime, piperacillin, ceftriaxone, tobramycin, doxycycline, minocycline and cotrimoxazole were statistically significant (all P<0.05). There were statistically significant differences in the resistance of clinical and environmental isolates to ampicillin/sulbactam, cefepime, ceftazidime, subamphetamine, meropenem, piperacillin, aztreonam, gentamicin, tobramycin, minocycline, ciprofloxacin, levofloxacin, and cotrimoxazole in the hospital from 2018 to 2023 (all P<0.05). The resistance rate of clinical isolates was generally high, especially to β-lactam and quinolone drugs, which were mostly above 80% [such as cefepime (93.86%), cefotaxime (97.37%), imipenem (98.25%), and ciprofloxacin (99.12%)]. The resistance rate of environmental isolated strains to similar antibiotics was relatively lower, mostly concentrated at 10%‒30%. The whole-genome sequencing of 34 carbapenem-resistant Acinetobacter baumannii (CRAB) strains isolated from the hospital environment in 2023 revealed that the main resistance mechanism was overexpression of efflux pumps (51.97%), followed by changes in target sites (32.46%). Among the 34 CRAB strains, carbapenem resistance genes OXA-23 and OXA-51 were detected in 6 strains (17.65%), while genes such as KPC, IMP, VIM, and SIM were not detected. ConclusionFrom 2018 to 2023, AB in the hospital environment exhibited high resistance rates to certain antimicrobial agents and carried multiple resistance genes, indicating a potential transmission risk. It is necessary to further strengthen bacterial resistance monitoring and hospital infection control, and use antibiotics reasonably.