1.Expert consensus on perioperative basic prevention for lower extremity deep venous thrombosis in elderly patients with hip fracture (version 2024)
Yun HAN ; Feifei JIA ; Qing LU ; Xingling XIAO ; Hua LIN ; Ying YING ; Junqin DING ; Min GUI ; Xiaojing SU ; Yaping CHEN ; Ping ZHANG ; Yun XU ; Tianwen HUANG ; Jiali CHEN ; Yi WANG ; Luo FAN ; Fanghui DONG ; Wenjuan ZHOU ; Wanxia LUO ; Xiaoyan XU ; Chunhua DENG ; Xiaohua CHEN ; Yuliu ZHENG ; Dekun YI ; Lin ZHANG ; Hanli PAN ; Jie CHEN ; Kaipeng ZHUANG ; Yang ZHOU ; Sui WENJIE ; Ning NING ; Songmei WU ; Jinli GUO ; Sanlian HU ; Lunlan LI ; Xiangyan KONG ; Hui YU ; Yifei ZHU ; Xifen YU ; Chen CHEN ; Shuixia LI ; Yuan GAO ; Xiuting LI ; Leling FENG
Chinese Journal of Trauma 2024;40(9):769-780
Hip fracture in the elderly is characterized by high incidence, high disability rate, and high mortality and has been recognized as a public health issue threatening their health. Surgery is the preferred choice for the treatment of elderly patients with hip fracture. However, lower extremity deep venous thrombosis (DVT) has an extremely high incidence rate during the perioperative period, and may significantly increase the risk of patients′ death once it progresses to pulmonary embolism. In response to this issue, the clinical guidelines and expert consensuses all emphasize active application of comprehensive preventive measures, including basic prevention, physical prevention, and pharmacological prevention. In this prevention system, basic prevention is the basis of physical and pharmacological prevention. However,there is a lack of unified and definite recommendations for basic preventive measures in clinical practice. To this end, the Orthopedic Nursing Professional Committee of the Chinese Nursing Association and Nursing Department of the Orthopedic Branch of the China International Exchange and Promotive Association for Medical and Health Care organized relevant nursing experts to formulate Expert consensus on perioperative basic prevention for lower extremity deep venous thrombosis in elderly patients with hip fracture ( version 2024) . A total of 10 recommendations were proposed, aiming to standardize the basic preventive measures for lower extremity DVT in elderly patients with hip fractures during the perioperative period and promote their subsequent rehabilitation.
2.Progress in research of cell-in-cell
Jinli FENG ; Qiang SUN ; Jiatang ZHANG
Chinese Journal of Pathophysiology 2024;40(8):1511-1519
Cell-in-cell(CIC)is a phenomenon described as the active infiltration of one or more living cells into another living cell,forming intracellular structures and producing biological effects.This phenomenon was first ob-served and detailed in the early 20th century.However,it has only become an active area of research in cell biology in the past decade.As research advanced,scientists gradually recognized that the phenomenon of CIC exists in many biological systems and diseases,and has important physiological and pathological significance in evolution,development,homeosta-sis,and diseases,especially in tumors,which has important clinical research value.Currently,five forms of CIC struc-tures have been identified:cell cannibalism,phagoptosis,enclysis,entosis,and emperipolesis.Each form represents a distinct interaction between cells,characterized by unique cell types,biological characteristics,molecular mechanisms,and implications in pathophysiology.This article aims to review the cell types involved in each CIC structure,their biologi-cal characteristics and the molecular mechanisms driving these interactions,and to explore the potential clinical signifi-cance in the diagnosis,treatment and prognosis of human diseases.
3.A multi-center performance evaluation of different hepatitis C virus core antigen assays for clinical infection screening
Ruifeng YANG ; Ning LIU ; Chengrong BIAN ; Juan LIU ; Yan LIU ; Shuping WU ; Bo FENG ; Huiying RAO ; Yanjiao LI ; Bo′an LI ; Jinli LOU ; Hongsong CHEN
Chinese Journal of Laboratory Medicine 2023;46(12):1305-1312
Objective:We conducted a real-world multi-center clinical study with a large sample size to comprehensively evaluate the performance of three commercial hepatitis C virus (HCV) core antigen assays. The study aimed to evaluate the performance for their use in HCV infection screening, and to provide clues for further improving the sensitivity and specificity of the assays.Methods:Key performance indicators including the lower limit of detection (LOD), diagnostic sensitivity, and specificity of three HCV antigen assays (the Architect, Laibo, and ChemClin HCV core antigen assays) were evaluated using commercial seroconversion panels reflecting early HCV infection and clinical routine serum samples of outpatients and inpatients from 3 tertiary hospitals from January 2018 to April 2022. Factors that affect the performance indicators were further investigated.Results:The window period for detecting HCV infection with the three antigen assays was equal to or slightly longer than that of the RNA assay, but all are shorter than that of the anti-HCV assay. There was a good linear positive correlation between HCV core antigen and HCV RNA levels in treatment naive patients with hepatitis C ( r=0.90, P<0.01). For the most common genotype 1b strain in China, the LOD of the three HCV assays were equivalent to 531 IU/ml (Architect), 3,698 IU/mL (Laibo), and 4,624 IU/mL (ChemClin) HCV RNA, respectively. Due to the skewed distribution of HCV RNA levels in treatment-naive hepatitis C patients, more than 95% of the patients had viral loads higher than 6 166 IU/ml. Therefore, the three HCV antigens assays still maintained a satisfactory diagnostic sensitivity (94.33%-99.40%). Among 54 immunodeficient patients (leukemia patients) with HCV infection, 9% (5/54) had negative anti-HCV results, while the HCV antigen assays found all these infectors. Through further experiments, we revealed the amino acid polymorphism in the core region of genotype 3 strain impaired the sensitivity of all three HCV antigen assays. In addition, the sensitivity of the two domestic assays was impaired by anti-HCV antibodies in the serum. The specificity of HCV antigen assays for diagnosing hepatitis C is 99.94% to 99.98%. The rheumatoid factors, autoantibodies, and other unknown interference substances can lead to a small number of low level, "false positive" antigen results. Conclusions:HCV core antigen assay may be used as a satisfactory approach of infection screening, especially for the immunodeficient patents. However, the sensitivity and specificity of the assays are influenced by multiple factors, which should be further improved.
4.Birth weight of infants born to pregnant women living with human immunodeficiency virus and its associated factors
Jinli LIU ; Songjie WU ; Shi ZOU ; Ling FENG ; Yajun YAN ; Yuting TAN ; Fangzhao MING ; Mingqi LUO ; Ke LIANG
Chinese Journal of Infectious Diseases 2023;41(6):401-406
Objective:To investigate the birth weight (BW) of infants born to pregnant women living with human immunodeficiency virus (HIV) and its associated factors, and to provide more evidence for the prevention of mother-to-child transmission (PMTCT) in China.Methods:This study was a retrospective cohort study. Between January 2004 and December 2021, pregnant women living with HIV and their infants in Hubei Province were recruited and followed up, and clinical data were collected through hospital medical records and HIV/acquired immunodeficiency syndrome comprehensive response information management system. The multivariable linear regression was performed on the collected data to investigate associated influencing factors of BW.Results:In total, 531 pregnant women living with HIV (581 pregnancies) and 581 infants were enrolled. Of the 581 infants, 36 were HIV-positive, with a PMTCT rate of 6.2%. The mean BW of the infants was (3 075.0±470.2) gram. Protease inhibitor (PI) based-anti-retroviral therapy (ART) ( β=-0.1, 95% confidence interval ( CI)-188.2 to -37.1, P=0.004), ART in the first trimester( β=-0.1, 95% CI -201.9 to -65.5, P<0.001), infant HIV infection ( β=-0.1, 95% CI -310.4 to -68.2, P=0.002), hepatitis C virus infection ( β=0.1, 95% CI 71.2 to 410.4, P=0.005) and gestational age ( β=0.6, 95% CI 155.9 to 191.5, P<0.001) were associated with decreased BW. Conclusions:While improving the effectiveness of PMTCT for HIV, more attention should be paid to pregnant women who received ART in the first trimester and PI-based ART for preventing lower BW and improving maternal and infantile health.
5.Expert consensus on clinical practice in perioperative nursing for elderly patients with hip fracture (version 2023)
Mi SONG ; Dan KONG ; Yuan GAO ; Yaping CHEN ; Xiaohua CHEN ; Yi CUI ; Junqin DING ; Leling FENG ; Lili FENG ; Jinli GUO ; Yun HAN ; Jing HU ; Sanlian HU ; Tianwen HUANG ; Yu JIA ; Yan JIN ; Xiangyan KONG ; Haiyan LI ; Hui LI ; Lunlan LI ; Shuixia LI ; Hua LIN ; Juan LIU ; Xuemei LU ; Ning NING ; Lingli PENG ; Lingyun SHI ; Changli WAN ; Jie WANG ; Qi WANG ; Yi WANG ; Ruifeng XU ; Ying YING ; Ping ZHANG ; Shijun ZHANG ; Wenjuan ZHOU
Chinese Journal of Trauma 2023;39(3):214-222
Hip fracture is considered as the most severe osteoporotic fracture characterized by high disability and mortality in the elderly. Improved surgical techniques and multidisciplinary team play an active role in alleviating prognosis, which places higher demands on perioperative nursing. Dysfunction, complications, and secondary impact of anaesthesia and surgery add more difficulties to clinical nursing. Besides, there still lack clinical practices in perioperative nursing for elderly patients with hip fracture in China. In this context, led by the Orthopedic Nursing Committee of Chinese Nursing Association, the Expert consensus on clinical practice in perioperative nursing for elderly patients with hip fracture ( version 2023) is developed based on the evidence-based medicine. This consensus provides 11 recommendations on elderly patients with hip fracture from aspects of perioperative health education, condition monitoring and inspection, complication risk assessment and prevention, and rehabilitation, in order to provide guiding advices for clinical practice, improve the quality of nursing and ameliorate the prognosis of elderly patients with hip fracture.
6.Expert consensus on perioperative nursing management of nutrition for elderly patients with hip fractures (version 2023)
Chunhua DENG ; Xiaohua CHEN ; Zhihua YIN ; Yao JIANG ; Xiaoju TAN ; Yaping CHEN ; Junqin DING ; Luo FAN ; Leling FENG ; Yuyun GAN ; Xiaoyan GAO ; Jinli GUO ; Jing HU ; Chen HUANG ; Guiling HUANG ; Tianwen HUANG ; Yingchun HUANG ; Hui JIN ; Yan JIN ; Fangfang LI ; Hui LI ; Hui LIU ; Ping LIU ; Ning NING ; Lingyun SHI ; Guomin SONG ; Yani SUN ; Guangling WANG ; Jie WANG ; Qi WANG ; Xia WANG ; Xiaoyun WANG ; Yi WANG ; Songmei WU ; Jian YANG ; Yumei ZHANG ; Yang ZHOU ; Xiaoyan WANG ; Yuan GAO
Chinese Journal of Trauma 2023;39(5):394-403
Hip fractures are among the most common fractures in the elderly, presenting to be a leading cause of disability and mortality. Surgical treatment is currently the main treatment method for hip fractures. The incidence of perioperative malnutrition is increased after hip fractures in the elderly due to the comorbidities, decreased basal metabolic rate, accelerated protein breakdown, weakened anabolism and surgical stress. However, malnutrition not only increases the incidence of postoperative complications, but also leads to increased mortality, indicating an important role of perioperative nursing management of nutrition for the elderly patients with hip fractures. At present, there still lacks scientific guidance and application standards on perioperative nursing management of nutrition for the elderly patients with hip fractures. Therefore, the Orthopedic Nursing Committee of Chinese Nursing Association and the Editorial Board of Chinese Journal of Trauma organized relevant experts to formulate the Expert consensus on perioperative nursing management of nutrition for elderly patients with hip fractures ( version 2023) according to evidence-based medical evidences and their clinical experiences. Fourteen recommendations were made from aspects of nutrition screening, nutrition assessment, nutrition diagnosis, nutrition intervention and nutrition monitoring to provide guidance for perioperative nursing management of nutrition in elderly patients with hip fractures.
7.Emergency laboratory construction and reflection in infectious hospital under the epidemic situation
Xia FENG ; Jinli LOU ; Ronghua JIN
Chinese Journal of Preventive Medicine 2020;54(12):1487-1490
Emerging infectious diseases are a common type of public health emergencies, which occur frequently around the world in recent years, seriously threatening the safety of human life and property. In the process of dealing with epidemic situation, medical laboratories have played an important role in disease diagnosis, treatment, efficacy evaluation and prognosis judgment and so on. Beijing Youan Hospital, as the designated hospital of the coronavirus disease 2019 (COVID-19), has set up an emergency laboratory in the capital for the prevention and control of the COVID-19 by carrying out routine tests and virus nucleic acid tests, it provides timely and effective evidence for clinical diagnosis and treatment. To provide ideas and references for the building of the Emergency Laboratory in infectious hospitals. This article discuss how to set up an independent emergency laboratory efficiently, strengthen the cooperation with the Center for Disease Control and Prevention, make the best use of all resources, and share the enlightenment gained in the process of construction.
8.Emergency laboratory construction and reflection in infectious hospital under the epidemic situation
Xia FENG ; Jinli LOU ; Ronghua JIN
Chinese Journal of Preventive Medicine 2020;54(12):1487-1490
Emerging infectious diseases are a common type of public health emergencies, which occur frequently around the world in recent years, seriously threatening the safety of human life and property. In the process of dealing with epidemic situation, medical laboratories have played an important role in disease diagnosis, treatment, efficacy evaluation and prognosis judgment and so on. Beijing Youan Hospital, as the designated hospital of the coronavirus disease 2019 (COVID-19), has set up an emergency laboratory in the capital for the prevention and control of the COVID-19 by carrying out routine tests and virus nucleic acid tests, it provides timely and effective evidence for clinical diagnosis and treatment. To provide ideas and references for the building of the Emergency Laboratory in infectious hospitals. This article discuss how to set up an independent emergency laboratory efficiently, strengthen the cooperation with the Center for Disease Control and Prevention, make the best use of all resources, and share the enlightenment gained in the process of construction.
9.A comparison study of DWI based on monoexponential and biexponential models in the staging of endometrial carcinoma
Journal of Practical Radiology 2018;34(3):401-404
Objective To compare the value of monoexponential and biexponential models in the preoperative evaluation of myometrial invasion in endometrial carcinoma.Methods 35 cases of endometrial carcinoma were examined by diffusion weighted imaging (DWI) with monoexponential model (b=0,800 s/mm2)and biexponential model (b=0,50,100,150,200,400,600,800,1 000,1 200,and 1 500 s/mm2),including 14 cases of deep myometrial invasion and 21 cases of non-deep myometrial invasion.The values of apparent diffusion coefficient (ADC),pure diffusion coefficient,perfusion related diffusion coefficient and the microvascular volume fraction were measured by the Matlab software.These parameters of two groups were compared and analyzed,respectively.Results The D value and the ADC value in the deep myometrial invasion group of endometrial carcinoma were lower than those in the non-deep myometrial invasion group,and the differences were statistically significant (both P<0.001).There was no significant difference between the two groups in the f value(P=0.600)and D?value(P=0.600).The AUC of ADC value and D value for the differential diagnosis of endometrial carcinoma with and without deep myometrial invasion were 0.9 1 3 and 0.9 6 9,respectively.Based on the Youden index and its corresponding optimal cut-point,the sensitivity of ADC value and D value were 90.48% and 100%,respectively,and the specificity of ADC value and D value were both 85.71% in differential diagnosis of endometrial carcinoma with and without deep myometrial invasion. Conclusion The ADC value in monoexponential model and the D value in biexponential model can be both used to evaluate deep myometrial invasion of endometrial carcinoma,among which D value is better.
10.Direct sampling introduction and atomic fluorescence spectrometry for determination of selenium content in mice liver and urine
Jinli CHEN ; Li FENG ; Cang QI ; Yongfang LI ; Da WANG ; Bing LI ; Guifan SUN
Chinese Journal of Endemiology 2018;37(2):149-151
Objective Through determination of selenium content in liver and urine of selenium-induced mice, direct sampling atomic fluorescence spectrometry was established to provide a more accurate and convenient determination method for detection of selenium-related biological samples. Methods Selenium in the sample was released by the electrically heated quartz tube,the selenium in the atomic state was captured by the quartz tube,and the selenium released by the heating quartz tube was carried by the argon-hydrogen mixed gas into the argon-argon flame atomic fluorescence detector for determination; standard curve was established based on selenium content and fluorescence area, and then the content of selenium in the sample was calculated. Results The detection limit of selenium in samples by direct sampling atomic fluorescence spectrometry was 0.28 μg/kg, the correlation coefficient of standard curve was 0.999 3, and the relative standard deviation range was 1.82% - 4.19%. The adding standard recovery of the liver in mice was 87.30%- 100.20%; meanwhile the adding standard recovery of the urine in mice was 93.10% - 96.60%. Conclusions Direct sampling atomic fluorescence method is simple and easy to operate, accuracy and precision are better, the linear range is wide. The samples need not be processed by complex pretreatment,such as acid,etc.,elements loss is avoided and efficiency of detection is improved.The method can be used in a variety of samples for rapid detection of trace selenium.

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