Objective:To comprehensively evaluate the clinical application status of oral movement intervention in preterm infants, analyze the obstacles in the process of clinical application of the best evidence and formulate countermeasures, so as to provide reference for clinical evidence transformation.Methods:Based on the theoretical guidance of the "Clinical Application Model of Evidence" of the Joanna Briggs Institute (JBI) Evidence-Based Health Care Center in Australia, 12 pieces of the best evidence for oral movement intervention in premature infants were included, and 13 review indicators were formulated. From May to July 2021, a status review was conducted in Department of Neonatology in Suzhou Hospital Affiliated to Nanjing Medical University. The Ottawa Model of Research Use (OMRU) was used to analyze the barriers and facilitators in the process of evidence application and formulate effective intervention strategies and action plans.Results:Among the 13 reviewed indicators, only 2 items had a compliance rate of 100%, 2 items had a compliance rate of more than 60%, 6 items had a compliance rate of less than 60%, and 3 items had a compliance rate of 0. The main obstacle factors were lack of standardized process and assessment tools, lack of oral motor intervention related knowledge and training for preterm infants, increased clinical workload due to evidence transformation and the low level of knowledge and action among medical staff. The main promoting factors were support from managers for the development and reform of evidence-based learning, good learning atmosphere for doctors and nurses, departments with material and hardware conditions for evidence transformation, effective evidence, and parents' willingness to accept the reform. Through analysis, countermeasures were drawn up to formulate feasible and suitable standardized procedures and introduce assessment tools. Managers formulated and implemented incentive policies, adopted various training methods, strengthened quality supervision in the process of evidence transformation, timely gave feedback of progress results and improved human resource allocation.Conclusions:There is a certain gap between the best evidence of oral movement intervention in premature infants and the current clinical nursing practice. It is necessary to formulate corresponding countermeasures according to the obstacle factors and promoting factors, promote the evidence transformation and constantly promote the evidence-based practice of oral movement intervention in premature infants.

Objective To investigate the neurodevelopmental characteristics of children with autism spectrum disorder(ASD),analyze the correlation between neurodevelopmental indicators and cerebral blood flow(CBF),and explore the potential mechanisms of neurodevelopment in ASD children.Methods A retrospective study was conducted on 145 children aged 2-6 years with newly-diagnosed ASD.Scores from the Gesell Developmental Diagnosis Scale and the Autism Behavior Checklist(ABC)and CBF results were collected to compare gender differences in the development of children with ASD and analyze the correlation between CBF and neurodevelopmental indicators.Results Fine motor and personal-social development quotient in boys with ASD were lower than those in girls with ASD(P<0.05).Gross motor development quotient in ASD children was negatively correlated with CBF in the left frontal lobe(r=-0.200,P=0.016),right frontal lobe(r=-0.279,P=0.001),left parietal lobe(r=-0.208,P=0.012),and right parietal lobe(r=-0.187,P=0.025).The total ABC score was positively correlated with CBF in the left amygdala(r=0.295,P<0.001).Conclusions Early intervention training should pay attention to gender and developmental structural characteristics for precise intervention in ASD children.CBF has the potential to become a biological marker for assessing the severity of ASD.

BACKGROUNDDecreases in the bioavailability of rifampicin (RFP) can lead to the development of drug resistance and treatment failure. Therefore, we investigated the relative bioavailability of RFP from one four-drug fixed-dose combination (FDC; formulation A) and three two-drug FDCs (formulations B, C, and D) used in China, compared with RFP in free combinations of these drugs (reference), in healthy volunteers.

METHODSEighteen and twenty healthy Chinese male volunteers participated in two open-label, randomized two-period crossover (formulations A and C) or one three-period crossover (formulations B and D) study, respectively. The washout period between treatments was 7 days. Bioequivalence was assessed based on 90% confidence intervals, according to two one-sided t-tests. All analyses were done with DAS 3.1.5 (Mathematical Pharmacology Professional Committee of China, Shanghai, China).

RESULTSMean pharmacokinetic parameter values of RFP obtained for formulations A, B, C, and D products were 11.42 ± 3.41 μg/ml, 7.86 ± 5.78 μg/ml, 13.05 ± 6.80 μg/ml, and 16.18 ± 3.87 μg/ml, respectively, for peak plasma concentration (C max ), 91.43 ± 30.82 μg·h-1·ml-1 , 55.49 ± 37.58 μg·h-1·ml-1 , 96.50 ± 47.24 μg·h-1·ml-1 , 101.47 ± 33.07 μg·h-1·ml-1 , respectively, for area under the concentration-time curve (AUC 0-24 h ).

CONCLUSIONSAlthough the concentrations of RFP for formulations A, C, and D were within the reported acceptable therapeutic range, only formulation A was bioequivalent to the reference product. The three two-drug FDCs (formulations B, C and D) displayed inferior RFP bioavailability compared with the reference (Chinese Clinical Trials registration number: ChiCTR-TTRCC-12002451).

Adult ; Asian Continental Ancestry Group ; Biological Availability ; Drug Combinations ; Humans ; Male ; Rifampin ; administration & dosage ; pharmacokinetics ; therapeutic use ; Tuberculosis ; drug therapy ; Young Adult

OBJECTIVE: To compare the therapeutic effect between distal acupoints along meridian plus exercising combined with penetration needling on meridians of back and simple penetration needling on meridians of back for mild to moderate lumbodorsal fascitis. METHODS: A total of 60 patients with mild to moderate lumbodorsal fascitis were randomized into an observation group and a control group, 30 cases in each one. In the control group, penetration needling on meridians of back was applied at acupoints of the Governor vessel (TL) and the first line of bladder meridian, penetration needling was performed from the top down along the governor vessel and the first line of bladder meridian of the lumbar back pain (from one acupoint down to another acupoint), until there was no pain. In the observation group, distal acupoints along meridian plus exercising were adopted on the base of treatment in the control group. The distal acupoints along meridian plus exercising was applied at Cuanzhu (BL 2) for 30 min, at the same time, lumbar back anteflexion, hypsokinesis and turning sides were used in combination for 10 min. And then penetration needling on meridians of back was performed. The treatments were given once a day, 5 consecutive treatments a week, 1 week as a course and 2 courses were required. The visual analogue scale (VAS) score and Oswestry disability index (ODI) before treatment, after treatment and 1month in followup were observed in the two groups, and the clinical effects were compared. RESULTS: Compared before treatment, the VAS score and ODI were reduced after treatment in the two groups (<0.01). The changes of the VAS score and ODI in the observation group were larger than those in the control group (<0.01, <0.05). In follow-up, the VAS score and ODI in the observation group were lower than those in the control group (<0.05). The total effective rate in the observation group was 90.0% (27/30), which was superior to 83.3% (25/30) in the control group (<0.05). CONCLUSION Distal acupoints along meridian plus exercising combined with penetration needling on meridians of back have a better therapeutic effect than simple penetration needling on meridians of back in the treatment of mild to moderate lumbodorsal fascitis.
Acupuncture Points ; Acupuncture Therapy ; Fasciitis ; therapy ; Humans ; Low Back Pain ; Meridians

Objective To investigate the causes of a cluster of suspected neonatal carbapenem-resistant Klebsiella pneumoniae(CRKP)bloodstream infection(BSI)in the neonatal department of a hospital,and provide references for the effective control of the occurrence of healthcare-associated infection(HAI).Methods Epidemiological in-vestigation on 3 neonates with CRKP BSI in the neonatal department from January 31 to February 6,2023 was per-formed.Specimens from environmental object surfaces were taken for environmental hygiene monitoring,and effec-tive control measures were taken according to the risk factors.Results From January 31 to February 6,2023,a to-tal of 60 neonates were admitted in the neonatal department,including 16 with peripherally inserted central venous catheter(PICC).Three neonates had CRKP BSI,with a incidence of 5.00％.There were 33 hospitalized neonates on the day(February 7)when the cluster of HAI was reported,with a prevalence rate of 9.09％(3/33).CRKP BSI rate in the neonatal department of this hospital from January 31 to February 6,2023 was higher than that in 2022(P＜0.001).The incubators of the 3 neonates with CRKP BSI were in the same ward and adjacent to each other.The first neonate with CRKP BSI(who developed BSI on January 31)underwent PICC maintenance on Feb-ruary 4,and the other 2 neonates with PICC maintenance immediately following the first one also developed CRKP BSI.CRKP were isolated from blood culture of all 3 neonates,and antimicrobial susceptibility testing results were consistent.Conclusion The occurrence of the cluster event of neonatal CRKP BSI may be related to the failure of strict implementation of aseptic procedures during PICC maintenance and cross contamination among items.

In recent years, deep learning has provided a new method for cancer prognosis analysis. The literatures related to the application of deep learning in the prognosis of cancer are summarized and their advantages and disadvantages are analyzed, which can be provided for in-depth research. Based on this, this paper systematically reviewed the latest research progress of deep learning in the construction of cancer prognosis model, and made an analysis on the strengths and weaknesses of relevant methods. Firstly, the construction idea and performance evaluation index of deep learning cancer prognosis model were clarified. Secondly, the basic network structure was introduced, and the data type, data amount, and specific network structures and their merits and demerits were discussed. Then, the mainstream method of establishing deep learning cancer prognosis model was verified and the experimental results were analyzed. Finally, the challenges and future research directions in this field were summarized and expected. Compared with the previous models, the deep learning cancer prognosis model can better improve the prognosis prediction ability of cancer patients. In the future, we should continue to explore the research of deep learning in cancer recurrence rate, cancer treatment program and drug efficacy evaluation, and fully explore the application value and potential of deep learning in cancer prognosis model, so as to establish an efficient and accurate cancer prognosis model and realize the goal of precision medicine.
Deep Learning ; Humans ; Neoplasms ; Precision Medicine ; Prognosis

Objective: To investigate hepatic perivascular epithelioid cell tumor (PEComa) diagnosis and treatment plan. Methods: 24 cases diagnosed with PEComa clinical manifestations, serum alpha fetoprotein (AFP), carcinoembryonic antigen (CEA), carbohydrate antigen 199 (CA199), imaging findings, surgical methods, postoperative hospital stay, pathological results and prognosis were analyzed retrospectively from September 2015 to September 2020. Results: Majority of patients were females (79.2%), aged 41.5±11.4 years. Tumors were predominantly located in the right liver (50.0%). 76.7% of the cases were mostly clinically asymptomatic. AFP, CEA and CA199 indices were all negative. CT mostly showed low density tumor in the plain scan phase, enhanced in the enhancement phase, and enhanced and weakened in portal venous and equilibrium phase (66.7%). MRI manifestations of most tumors were hypointense on T₁WI and hyperintense on T₂WI (72.7%). B-ultrasound mostly showed hyperechoic mass in the tumor area with punctate vascular shadow (52.9%). Postoperative hospital stay was 9.0±2.4 days for laparoscopic surgery patients (n=13), 13.4±6.3 days for traditional laparotomy (hereinafter referred to as laparotomy, n=10), and 3 days for 1 patient with microwave ablation. All postoperative pathological results were positive for HMB45 and Melan-A. Follow-up results: 21 cases survived normally, with no tumor recurrence in the recent physical examination; two cases had tumor recurrence and they died two and three years after surgery, and one case was lost to follow-up. Conclusion: Hepatic PEComa more commonly occurs in middle-aged women, with no specific features for tumor markers and clinical manifestations. Some imaging findings are specific, so its features can be combined as a basis for diagnosis. Postoperative pathological examination results can confirm the diagnosis. Therefore, surgery remains the initial treatment plan. Microwave ablation and laparoscopic surgery are recommended as the preferred option because of shorter hospital stays and less trauma than open surgery.
Adult ; Biomarkers, Tumor/analysis* ; Carbohydrates ; Carcinoembryonic Antigen ; Female ; Humans ; Liver/pathology* ; MART-1 Antigen ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Perivascular Epithelioid Cell Neoplasms/surgery* ; Retrospective Studies ; alpha-Fetoproteins