Urinary retention is a common complication of bedridden patients in traumatic orthopedics. The severe condition can even cause permanent bladder injury and renal failure, which brings great pain and psychological pressure to patients and seriously hinders their rehabilitation. The traditional Chinese medicine appropriate technologies have the characteristics of safety, effectiveness, low cost, simplicity and easy learning and achieve good clinical effects in the prevention and treatment of bedridden patients with urinary retention in traumatic orthopaedics, including Chinese herbal medicine, acupuncture and moxibustion, massage, etc. The authors summarize the research progress in appropriate technologies of traditional Chinese medicine in the prevention and treatment of bedridden patients with urinary retention in traumatic orthopedics from aspects of action principles, operation methods and effects of acupuncture points, moxibustion therapy, manipulation therapy, external treatment of traditional Chinese medicine and acupoint injection, so as to provide a reference for further nursing research and clinical application.

BACKGROUND:Numerous basic and clinical trials have confirmed that the low survival rate after bone marrow mesenchymal stem cell transplantation is a serious constraint on its long-term therapeutic effect.Previous studies have shown that apoptosis-related factors play an important role in the apoptosis of bone marrow mesenchymal stem cells,of which apoptosis-inducing factor may be a key factor. OBJECTIVE:Bone marrow mesenchymal stem cells,of which apoptosis-inducing factor was knocked down,were transplanted into infarcted myocardium of mice,aiming to certify the importance of apoptosis-inducing factor in the survival of bone marrow mesenchymal stem cells to further recover cardiac function after infarction. METHODS:Firstly,bone marrow mesenchymal stem cells were infected with LV-AIF-shRNA lentivirus to down-regulate the expression of apoptosis-inducing factor protein.Flow cytometry,western blot assay,and RT-qPCR were used to detect the infection efficiency of lentivirus.CCK-8 assay was used to detect the cell viability of bone marrow mesenchymal stem cells with apoptosis-inducing factor knockdown under hypoxic and ischemic conditions.Then,with the mouse model of acute myocardial infarction constructed,the normal bone marrow mesenchymal stem cells and bone marrow mesenchymal stem cells with apoptosis-inducing factor gene knockdown were transplanted into the model,respectively.The expression of apoptosis-inducing factor was examined by fluorescence immunoassay.Serum brain natriuretic peptide levels were detected by ELISA.Cardiac ultrasound was used to detect cardiac function.Myocardial fibrosis was observed by Masson staining.The expression of SRY gene was detected by RT-qPCR in apoptosis-inducing factor-knocked bone marrow mesenchymal stem cells after transplantation,reflecting cell survival. RESULTS AND CONCLUSION:(1)Bone marrow mesenchymal stem cells with apoptosis-inducing factor gene knockdown were successfully established by LV-AIF-shRNA lentivirus infection,following 97.7%of infection efficiency,and notably decline of the expression of apoptosis-inducing factor(P<0.001).(2)Under ischemia and hypoxia,the cell viability of apoptosis-inducing factor knockdown bone marrow mesenchymal stem cells was significantly increased compared with normal bone marrow mesenchymal stem cells.(3)Compared with normal bone marrow mesenchymal stem cells after transplantation,the survival number of bone marrow mesenchymal stem cells in the infarcted myocardium after apoptosis-inducing factor gene knockdown was significantly increased to 3.71 times(P<0.001),and the apoptosis-inducing factor protein expression and myocardial fibrosis degree in the infarcted area were significantly reduced.(4)Compared with normal bone marrow mesenchymal stem cells,the serum brain natriuretic peptide level of bone marrow stem cells with apoptosis-inducing factor gene knockdown after transplantation was significantly decreased(P<0.05),and left ventricular ejection fraction and left ventricular shortening fraction were significantly improved(P<0.05).(5)These findings confirm that apoptosis-inducing factor gene knockdown can reduce myocardial fibrosis and improve cardiac function after acute myocardial infarction via enhancing the bone marrow mesenchymal stem cell viability and increasing the bone marrow mesenchymal stem cell survival after transplantation in the donor.

Objective To compare the effects of losartan and irbesartan on blood pressure,blood uric acid,insulin sensitivity and insulin resistance in female hypertensive patients complicated with hyperuricemia.Methods From August 2015 to December 2017,100 females of hypertension complicated with hyperuricemia who hospitalized in the Third People's Hospital of Ningxia were enrolled in the study.All the patients were divided into two groups according to the random digital table,with 50 cases in each group.The observation group was treated with losartan,and the control group was treated with irbesartan for 8 weeks.The total effective rate and adverse reactions were compared between the two groups.Also the changes of blood pressure,serum uric acid,fasting glucose (FBG),fasting insulin (FINS),high sensitivity C-reactive protein (hs-CRP),insulin sensitivity index (ISI) and insulin resistance index (HOMA-IR) were compared between the two groups after treatment.Results There was no statistically significant difference in the total effective rate between the two groups [92.0％ (46/50) vs.90.0％ (45/50)] (P ＞ 0.05).Before treatment,there were no statistically significant differences in blood pressure,serum uric acid,FBG,FINS,hs-CRP,ISI and HOMA-IR between the two groups (all P ＞ 0.05).After treatment,the systolic blood pressure and diastolic blood pressure in the two groups were (133.09 ± 10.11) mmHg vs.(131.54 ± 11.01) mmHg and (82.76 ± 6.23) mmHg vs.(83.75 ± 6.88) mmHg,which were lower than those before treatment (observation group:t =19.742,10.606,control group:t =18.925,-9.956,all P ＜ 0.05).But there were no statistically significant differences between the two groups (all P ＞ 0.05).After treatment,the serum uric acid in the observation group was lower than that in the control group [(387.21 ± 25.56) μmol/L vs.(429.67 ± 27.44) μmol/L] (t =8.006,P ＜ 0.05).The hs-CRP,FINS,HOMA-IR,ISI in the observation group were (4.92 ± 1.02) rmg/L,(15.92 ± 3.01) mU/L,(1.71 ± 0.24),(1.047 ± 0.095),which in the control group were (4.54 ± 1.00) mg/L,(17.23 ± 3.20) mU/L,(1.65 ± 0.27),(1.140 ± 0.083).After treatment,the hs-CRP,FINS,HOMA-IR in the two groups were decreased (all P ＜ 0.05),while ISI was increased (P ＜ 0.05).Furthermore,the improvement of FINS,ISI and HOMA-IR in the observation group was better than those in the control group (t =2.109,-5.213,3.191,all P ＜ 0.05).Conclusion Both losartan and irbesartan can improve clinical symptoms,lower blood pressure and improve insulin resistance in female hypertension patients complicated with hyperuricemia,and losartan is more effective than irbesartan.

Objective To explore the feasibility of peritoneal dialysis catheter placement assisted by flexible ureteroscope.Methods A retrospective analysis was conducted on clinical data of 54 cases of end-stage renal disease receiving peritoneal dialysis catheter placement from May 2019 to March 2023.The placement method was chosen by the patient.In the conventional group,23 cases were guided by a metal guide wire for insertion of the peritoneal dialysis catheter,while in the flexible ureteroscope group,31 cases were guided by flexible ureteroscope instead of guide wire for insertion of the peritoneal dialysis catheter.The success rate of catheterization,surgical time,use of postoperative analgesic,complications related to peritoneal dialysis catheter,and postoperative creatinine decrease were compared between the two groups.Results The catheter placement was successfully performed in both groups.The total incidence of complications related to peritoneal dialysis catheter in the flexible ureteroscope group was lower than that in the conventional group[6.5%(2/31)vs.30.4%(7/23),χ2 =3.878,P =0.049].Between the conventional group and the flexible ureteroscope group,there were no statistically significant differences in the surgical time,postoperative analgesic usage,and the decrease of creatinine at 2 weeks after surgery(P>0.05).The median postoperative follow-up period was10 months(range,3-24 months)in the two groups,and there were no complications such as peritoneal leakage,intestinal perforation,or intraperitoneal bleeding.Conclusion The placement of peritoneal dialysis catheter guided by the flexible ureteroscope instead of metal guide wire is a safe,visible,and accurate method,which can reduce complications related to peritoneal dialysis catheter,and detect and manage comorbidities in the abdominal cavity.

Objective To investigate the clinical and epidemiological characteristics of osteosarcoma in China and analyze the incidence and clinical treatment of osteosarcoma.Methods The clinical data of 1 593 patients with osteosarcoma in 7 bone cancer treatment centers from January 2000 to February 2017 were analyzed.We retrieved large samples of documents in the database,extracted the relevant data and compared the data with this study.SPSS 13 software was used for statistical analysis and each factor was tested by x2.Results Of 1 593 patients,984 were males and 609 were females.The ratio of male to female was 1.62∶ 1.The average age was 23.2 years (range from 3-80 years).The peak age of onset was 11-20 years (52.4％).There were 217 elderly patients (＞ 40 years old).The tumors occurred in 1 524 limbs and 69 in axial bone.The most common sites of disease were distal femur 706 cases,proximal tibia 375 cases,distal humerus 117 cases and others 395 cases.There were 1 154 cases (71％) around the knee joint.The axial bone included 18 cases of spine,49 cases of pelvis and 2 cases of rib.Preoperative biopsy was performed in 1 111 cases and incisional biopsy in 280 cases.Preoperative diagnosis could be made in 1 345 cases (84.4％ of all patients,accounting for 96.7％ of biopsy patients).There were 79 cases with metastasis at first visit,accounting for 5％.Preoperative chemotherapy was performed in 1 185 cases (74.4％).With the DIA preoperative chemotherapy 271 cases,DIA+MTX 251 cases,AP 149 cases.220 cases of tumor cell necrosis rate was evaluated after operationaccording to the Huvos classification.There were78 cases of grade Ⅰ,105 cases of Ⅱ grade,35 cases of Ⅲ and 2 cases of grade Ⅳ.There were 1 299 cases undergoingpostoperative chemotherapy (81.5％),1 306 patients undergoinglimb salvage surgery (82％).Thespecific operation with prosthetic replacement is the most common (911 cases,69.8％).The postoperative chemotherapy included DIA+MTX regimen 471 cases,DIA regimen 266 cases and AP regimen 98 cases.Before and after the operation,379 cases were treated with the same chemotherapy regimen and 666 cases were changed.A total of 18 large sample documents were retrieved in Chinese data base (5 684 cases).The sex ratio,age range,peak incidence and location of the disease were similar to those of this study.The average age was 1-2 years old younger.The percentage of lung metastases associated with initial visits washigher.The rate of preoperative and postoperative chemotherapy and limb salvage waslowand the rate of tumor necrosis wasbetter after chemotherapy.A total of 22 large sample literatures were searched in foreign database (12 850 cases).The ratio of men and women is 1.30∶1 and the proportion of women is higher than the domestic data.The average age was 1-2 years older.The ratio of the knee joint was lower.The percentage of lung metastases associated with initial visits washigher.The rate of preoperative and postoperative chemotherapy and limb salvage were similar to that of this study and the rate of tumor necrosis was better after chemotherapy.Conclusion The general situation of the incidence of osteosarcoma (sex,age,location of the disease) is not significantly different from the previous reports both at home and abroad.In the treatment,preoperative and postoperative chemotherapy rate and limb salvage surgery rate have improved significantly compared with the past.The chemotherapy program from the coexistence of various programs,gradually to the DIA+MTX and DIA program as the mainstream program.

Objective To understand the characteristics of long-working hours exposure of medical staff,and analyze the impact of long-working hours exposure on mental health problems such as occupational stress,depression,fatigue accumulation,and insomnia.Methods The cluster random sampling method was used to select the medical staff of 12 tertiary general hospitals in Guangdong Province as the research subjects,and the"Core Scale of Occupational Stress Measurement"and other scales were used to evaluate their occupational mental health.Results The average working hours of medical staff per day were(8.99±2.18)h;2,094 people were exposed during long working hours,accounting for 78.96%.The results of binary logistics regression analysis showed that after excluding the influence of sociodemographic factors such as age,long working hours(weekly working hours greater than 40 h)were the risk factors for occupational stress,depressive symptoms and fatigue accumulation of medical staff(P<0.01),and the longer the working week,the higher the risk of occupational stress,depressive symptoms and fatigue accumulation.Weekly working hours greater than 48 hours are risk factors for insomnia(P<0.01).Conclusion Long working hours are common among delivery workers on food delivery platforms,and long working hours are a risk factor for occupational tension and fatigue.

Strain is the fundamental unit in microbial taxonomy. The functional diversity among strains has great influence on host phenotypes. With the development of microbiome research, knowing the composition and functional capacities of complex microbial communities at the strain level has become increasingly valuable in scientific research and clinical applications. This review introduces the principles of bioinformatics algorithms for strain analysis based on metagenomic data, the applications in microbiome research and directions of future development.
Algorithms ; Computational Biology ; Metagenome ; Metagenomics ; Microbiota/genetics*