Objective To explore the effect of sitting and lateral sputum aspiration on the retention time of tracheal cannula in patients with neurosurgical tracheotomy. Methods Totally 120 cases of neurosurgery tracheotomy in hospitalized patients complicated with pulmonary infection by random number table method, 58 cases were divided into experimental group and control group 62 examples, two groups of patients with sputum top all joint taps to the back of the chest, the experimental group after taps take seat effectively causes cough; In the control group, the lateral position was used to effectively cough or induce cough, and the daily sputum volume of the two groups of patients was observed. To observe the time when the body temperature was restored to normal after the phlegm of the two groups of patients, the time of the lung auscultation, and the time of the tracheal tube retention. Results Implementing position row of phlegm daily sputum volume within a week the experimental group were (44.84±6.85) ml, (44.60±6.80) ml, (43.79±5.98) ml, (44.38±5.42) ml, (42.22±5.45) ml, (38.12±4.77) ml, (36.88±4.57) ml and control group were(36.13±7.34) ml, (35.15±7.34) ml, (36.13±7.34) ml, (37.13±7.34) ml, (37.13±7.34) ml, (32.97±7.17) ml, (31.35±4.36) ml, the difference had statistical significance (t=4.30-7.31, P<0.01);In the two groups, the time of normal body temperature recovery, the time of hearing and the time of the lung and the time spent in the tracheal tube were compared, and the experimental group were respectively (9.93±2.02) d, (32.33±1.50) d, (37.33±1.50) d, while control group were(15.77±1.05) d, (37.63 ± 2.33) d, (42.63 ± 2.33) d, the difference had statistical significance (t=20.04, 14.71, P<0.01). Conclusions It is better to reduce the retention time of tracheal tube in patients with neurosurgical patients than the lateral position.

Objective:To discuss the effect of lumbar disc herniation of motility kinesiophobia during convalescence which intervened by Chinese medicine nursing.Methods:A total of 172 patients with lumbar disc herniation treated at TCM Rehabitation Department at Three Gorges Hospital Affiliated to Chongqing University from May 1, 2017 to January 30, 2019 were selected and divided into control group and intervention group by random digits table method with 86 cases each. The control group was given routine psychological nursing, and the intervention group was given emotional nursing of traditional Chinese medicine combined with cognitive behavior intervention. The scores of anxiety, depression and kinesiophobia, the quality of life, the completion and accuracy of rehabilitation training before and after intervention were compared between the two groups.Results:There was no significant difference in the scores of anxiety, depression and kinesiophobia, the quality of life, the completion and accuracy of rehabilitation training before intervention between the two groups( P>0.05). The scores of anxiety, depression at 1,2,3 weeks after intervention was (54.61±7.23), (49.98±6.55), (45.03±6.21) and (55.16±7.53), (50.96±6.45), (46.31±5.72) in the intervention group, (59.69±7.52), (56.92±6.79), (53.62±7.28) and (60.65±7.96), (56.87±6.80), (52.80±5.92) in the control group, the differences were significant( Fgroup values were 10.157, 9.138, P<0.05). The scores of kinesiophobia, the quality of life at 1,2,3 weeks after intervention was (39.66±4.02), (30.58±4.02), (24.38±3.87) and (43.83±2.74), (56.72±3.81), (75.27±5.83)in the intervention group, (43.71±6.87), (37.83±6.81), (33.95±2.86) and (42.50±3.92), (46.05±3.95), (51.62±4.64) in the control group, the differences were significant( Fgroup values were 30.718, 30.938, P<0.01). The completion and accuracy of rehabilitation training at 1, 2, 3 weeks after intervention was (69.08±1.83), (77.05±2.04), (87.34±3.16) and (60.32±2.19), (70.42±3.22), (83.93±2.74) in the intervention group, (54.23±4.22), (62.72±2.65), (73.51±5.41) and (48.24±5.07), (59.77±4.13), (75.64±3.33) in the control group, the differences were significant( Fgroup values were 28.471, 25.139, P<0.01). Conclusions:Emotion nursing of traditional Chinese medicine combined with cognitive behavioral intervention is helpful to relieve the anxiety and depression of patients with lumbar disc herniation, effectively reduce the kinesiophobia of patients during rehabilitation, improve the quality of life of patients, improve the completion and accuracy of rehabilitation training of patients, and contribute to the improvement of rehabilitation effect and the realization of good treatment outcome.

Objective To retrospectively compare the efficacy of Serva NB1 collagenase with Vitacyte GOLD collagenase on islet isolation of pancreas.Methods All the human pancreata were obtained from Chinese organ donors.In GMP laboratory,the pancreata were trimmed and distended with Serva NB1 collagenase (Serva NB1,n =12) or Vitacyte GOLD collagenase (Vitacyte GOLD,n =5) and digested according to a modified Ricordi semi-automatic protocol,and the digestion duration was recorded.The digested islets were then collected and washed,followed by the continuous density purification in a Cobe 2991 cell separator.The islet yield,purity,viability and glucose-stimulated insulin release (GSI) were determined each time after purification.Quantity and quality of isolated islets were determined by digestion efficacy.Results The digestion duration in Vitacyte GOLD collagenase group was significantly shorter than in Serva NB1 collagenase group to achieve the same digestion endpoint (P＜ 0.05).The islets yields of different sizes were variable between the two groups.The Vitacyte GOLD collagenase digestion produced more islets with a diameter range of 50-100 μm than the ServaNB1 collagenase digestion (P＜0.05),but the latter yielded more islets with a diameter range of 251-300 μm and 301-350μm (P＜0.05).There was no significant difference in total islets yields,viability,and GSI between two collagenase digestions (P＞0.05).Conclusion Both Vitacyte GOLD collagenase and Serva NB1 collagenase can be used for the clinical islet isolation in China.

Objective: To investigate the effect factors of liver enzymes elevation by monitoring the liver function changes before and after intraportal islet transplantation. Methods: 16 diabetic patients who received intraportal islet transplantation in our hospital were analyzed. The levels of aspartic aminotransferase (AST), alanine aminotransferase (ALT)and total bilirubin (TBil)were monitored after islet transplantation. Results: Among those 16 diabetic patients who received intraportal islet transplantation, 11 patients showed an increased AST and 8 patients showed an increased ALT, among which a 2.5-fold increase in AST was observed in 4 patients and over 1.5-fold elevation of ALT was observed in 3 patients. The level of TBil were in the normal range before and after transplantation in all patients. Transplanted tissue volume of islet was the main factor for significantly increased AST (P<0.05) in this study. It is also shown that the change in portal pressure is related to the AST elevation after islet transplantation. Conclusions The amount of transplanted islet tissue volume is related to the liver enzymes elevation after intraportal islet transplantation. Therefore, the improvement of the purity of islet to reduce the amount of transplanted tissue could be benefit to prevent the liver injury after islet transplantation. Meanwhile, the purified islets should be injected as slowly as possible to maintain a stable portal pressure.

Background and Objectives: Adipose tissue-derived mesenchymal stem cells (ASCs) are recognized as an advantaged source for the prevention and treatment of diverse diseases including type 2 diabetes mellitus (T2DM). However, alterations in characteristics of ASCs from the aforementioned T2DM patients are still obscure, which also hinder the rigorous and systematic illumination of progression and pathogenesis. Methods: and Results: In this study, we originally isolated peripancreatic adipose tissue-derived mesenchymal stem cells from both human type 2 diabetic and non-diabetic donors (T2DM-ASCs, ND-ASCs) with the parental consent, respectively. We noticed that T2DM-ASCs exhibited indistinguishable immunophenotype, cell vitality, chondrogenic differentiation and stemness as ND-ASCs. Simultaneously, there’s merely alterations in migration and immunoregulatory capacities in T2DM-ASCs. However, differing from ND-ASCs, T2DM-ASCs exhibited deficiency in adipogenic and osteogenic differentiation, and in particular, the delayed cell cycle and different cytokine expression spectrum. Conclusions The conservative alterations of T2DM-ASCs in multifaceted characteristics indicated the possibility of autologous application of ASCs for cell-based T2DM treatment in the future.

Objective:To investigate the correlations of β cell dedifferentiation in non-diabetic subjects with risk factors for type 2 diabetes mellitus(T2DM).Methods:Immunofluorescence staining with insulin and β cell dedifferentiated marker ALDH1A3 was used to evaluate the β cell dedifferentiation levels in 38 non-diabetic and 23 T2DM. Correlation analyses were performed between β cell dedifferentiation levels and available clinical parameters including age, body mass index, HbA 1C level, triglycerides, and cholesterol levels in non-diabetic subjects. Results:β cell dedifferentiation level defined by the positive expression of ALDH1A3 in β cells(ALDH1A3 + INS + cell proportion) was significantly elevated in T2DM subjects( P<0.001). In PreD subjects, ALDH1A3 + INS + cells proportion were decreased( P=0.050) and negatively correlated with HbA 1C( r=-0.44, P=0.006), but not with age and body mass index. The analysis of correlation with lipidemic parameters showed that ALDH1A3 + INS + cells proportion was positively correlated with plasma total cholesterol level( r=0.39, P=0.045), but not plasma total triglyceride. Conclusion:ALDH1A3 + INS + cells were found to be decreased in prediabetes, suggesting that there may be enhanced β-cell identity in prediabetes to compensate for insulin secretion requirements; ALDH1A3 + INS + cells were elevated in people with high plasma total cholesterol levels, suggesting that total cholesterol may be one of the factors that induce β-cell dedifferentiation.

Objective:To evaluate the laparoscopic sleeve gastrectomy combined with hiatal hernia repair surgery for weight loss and antireflux.Methods:This study included 21 obese patients with gastroesophageal reflux who underwent laparoscopic sleeve gastrectomy at the Weight Loss Metabolism Center of the Department of Hepatobiliary and Pancreatic Surgery of Zhejiang Provincial People's Hospital from Dec 2019 to Dec 2020. Patients were divided into simple bariatric surgery group (9 cases) and simultaneous combined surgery group (12 cases).Results:In the combined surgery group, 1 case had postoperative gastric leakage. The postoperative body weight, waist circumference, and BMI indexes of the two groups showed a downward trend ( F=5.154, P=0.013; F=14.319, P<0.001; F=6.725, P=0.004). There was a statistically significant difference in the excess weight loss in both the two groups at 6 months after the operation compared to 1 month after the operation ( t=8.927, P<0.001; t=8.926, P<0.001). There was no statistically significant difference in postoperative lower esophageal sphincter resting pressure and Gerd symptom score in the bariatric surgery group compared with preoperative ( t=-0.891, P=0.507; t=0.629, P=0.298). The postoperative Gerd symptom score of the patients in the combined surgery group was significantly lower than that before the operation, and the resting pressure of the lower esophageal sphincter was significantly higher than that before the operation, ( t=-10.539, P<0.001; t=5.066, P=0.038). Conclusion:Combined surgery have the same weight loss effect as in simple bariatric surgery in obese patients with gastroesophageal reflux, in addition to stronger anti-reflux effect.

Objective:To evaluate the application status of wearable smart devices in domestic and foreign medical fields through visual analysis.Method:With “smart wearable device” “wearable smart device” “Smart wearable device” and “wearable smart devices” as search terms, literatures on the application status of wearable intelligent devices in the medical field at home and abroad in the core collection of CNKI, Wanfang, VIP, PubMed and Web of Science databases were retrieved from the establishment of the databases to April 30, 2023. The software CiteSpace was used for bibliometric analysis, including publication trend, institutional cooperation network, publication journal distribution analysis, keyword co-occurrence, clustering and emergence analysis, as well as publication journal and literature co-citation analysis.Results:A total of 121 valid Chinese literatures and 289 English literatures were obtained. Domestic and foreign research began in 2013 and 2004, respectively, and the overall number of published papers showed an upward trend. The top 3 institutions of publication in China were Chinese Academy of Sciences (13 articles), Union Hospital Affiliated to Huazhong University of Science and Technology (11 articles), and West China Nursing College of Sichuan University (10 articles). The top 3 institutions in the number of foreign publications were Harvard University (13 articles), the University of California (14 articles), and the University of London (5 articles). The top 3 Chinese journals in terms of publication volume were Nursing Research, Journal of Nursing Science and Chinese Journal of Nursing, with 38 publications, accounted for 31.4% of the total publications. The top 3 foreign journals in terms of publication volume are Sensors, IEEE Access and Applied Sciences-Basel, with a total of 39 publications, accounted for 13.5% of the total publications. A total of 8 Chinese keyword clusters and 10 English keyword clusters were formed. The top 5 categories were “senior citizens” “artificial intelligence” “mobile medical” “extended care” “nursing” and “wearable electronics” “sensor” “deep learning” “mobile health” and “big data”; there were 9 emergent words in Chinese and 10 emergent words in English. The top 5 were “wearable” “internet of things” “review literature” “big data” “smart watch” and “care” “activity recognition” “wearable sensors” “system” and “accelerometer”. The journal with the highest total citation frequency was Sensors, and the journal with the highest total citation center was Biosens. Bioelectron.. There were 2 literatures with a total citation frequency of 11-20 times, and 10 literatures with a frequency of 5-10 times. Conclusions:The research popularity of wearable smart devices in the medical field is generally increasing, and the quantity and quality of English papers are higher than those of Chinese. At present, mobile health is mainly used in the fields of physical signs monitoring, pain assessment, rehabilitation and exercise. Mobile health is a common research hotspot at home and abroad.

OBJECTIVE To investigate the working pressure of return-working postpartum hospital pharmacists， analyze the influential factors， and find the suitable strategy to relieve the working pressure of postpartum pharmacists. METHODS By the means of general information questionnaire， working pressure questionnaire and self-rating depression scale， the data of postpartum pharmacists were surveyed with sampling survey to investigate the working-pressure situation. The main influential factors of the postpartum working pressure were analyzed by multiple linear stepwise regression analysis. RESULTS A total of 281 valid questionnaires were collected from 84 different hospitals， with effective rate of 88.64%. The total score of working pressure for 281 postpartum pharmacists who were back to position was （79.80±23.06） （total score of 155）. However， 51.60% of return-working postpartum pharmacists showed depressive state （≥53）. The depression status was positively correlated with working pressure. Family support， frequency of physical exercise， and ideal personnel care were all negatively associated with working pressure. CONCLUSIONS The working pressure of return-working postpartum pharmacists is at a moderate level. Depression， family support， ideal personnel care， and frequency of physical exercise are the main influential factors.

OBJECTIVE To quantitatively and qualitatively analyze the progress of potentially inappropriate medication （PIM） research by means of bibliometrics， and to predict the hotspots and trends of PIM， so as to provide reference for PIM research in China. METHODS The research literature related to PIM were searched from Web of Science core database， and the publication trend of the literature was analyzed on the bibliometric online analysis platform and CiteSpace 5.8.R3 software. The research results were visualized and analyzed， and the research hotspots of PIM were summarized through gCLUTO. RESULTS About PIM research， the annual number of the literature issued from 2012 to 2021 showed a continuous growth trend totally； the United States had the largest number of literature （241 pieces）； the University of Sydney in Australia was the research institution with the largest number of literature （59 pieces）； O’Mahony D from University College Cork， Ireland， published the most literature （23 pieces）； the research of PIM involved 57 disciplines， among which there was the largest number of literature about gerontology （384 pieces）； International Journal of Clinical Pharmacy was the journal with the largest number of literature （61 pieces）； Journal of the American Geriatrics Society was cited most frequently （1 197 times）. The hotspots of PIM research mainly focused on seven aspects： the standard of PIM， the safety and economy research of PIM， the risk factors research of PIM， the PIM research of chronic patients， the PIM research of antipsychotics， the research of pharmacists’ participation in PIM management， and the PIM research about palliative care of tumor patients. CONCLUSIONS The heat of research on PIM has been on the rise， and there is little cooperation between countries and institutions， and more cooperation is needed. In the future， the focus of Chinese pharmacists’ research on PIM may be on the deep localization of PIM standards， PIM intervention and precise medication guidance， and PIM management of specific diseases and drugs.