Objective To summarize the evaluation standard of cardiac death organ donation from Chinese first category donor heart application and experience of donor heart function maintenance.Method From Jan.2013 to Jan.2015,donor hearts for heart transplantation were obtained in 18 cases of Chinese first category cardiac death organ donors from 109 cases of organ donation donors through rigorous assessment and effective donor heart function maintenance.The diagnosis of brain death was based on the diagnosis of brain death criteria (adult) by the neurological department of internal medicine,department of neurosurgery,and intensive care unit with brain death qualification.Organ donation work followed the basic principles of voluntary,free,fair,equitable and technical access.Result Eighteen case of heart transplantations were all operated with double lumen venous anastornosis.The cold ischemia time was (125.5+ 18.7) min (61-60 min),and cardiopulmonary bypass time was (130.4+ 12.5) min (99-193 min).In 18 heart transplantations,16 cases survived,and 2 eases died of acute right heart failure.During the follow-u period,the quality of life in the survival recipients was satisfactory.Conclusion Using cardiac death organ donation from Chinese first category donor heart transplantation has achieved good results.The accurate assessment of donor hearts and effective donor heart function maintenance are the key factors to guarantee the success of heart transplantation.

Objective: To evaluate the dentinal tubular occlusion of nano-hydroxyapatite (nHAp) containing desensitizers and their influence on the dentin bonding performance of self-etch adhesive. Methods: Mid-coronal dentin specimens were prepared from 48 intact human third molars. They were immersed in 10 g/L of citric acid for 20 s to simulate sensitive teeth, and randomly divided into four groups. The control group received no desensitizing treatment. Three experimental groups were treated with two commercial nHAp containing desensitizing toothpastes (Biorepair and Dontodent) and an experimental pure nHAp paste, respectively. The effect of desensitizers on dentinal tubular occlusion was observed by the field-emission scanning electron microscope (FESEM). Each group was further bonded with Futurabond NR. The micro-tensile bond strength was tested and failure mode distribution was analyzed. Moreover, resin infiltration of the adhesive was evaluated under confocal laser scanning microscopy (CLSM). Results: FESEM revealed that all the desensitizers noticeably occluded the dentinal tubules. After application for 7 days, the penetration depth of desensitizing particles was obviously increased and the extent of occlusion was completer. The micro-tensile bond strength test showed no significant differences in bonding strength among the three desensitization groups and control group (P>0.05). CLSM demonstrated the similar morphology of resin tags was produced in the desensitized groups and control group. Conclusion: Nano-hydroxyapatite containing desensitizers could occlude dentinal tubules effectively. Meanwhile, the application of these nHAp desensitizers has no adverse effect on resin infiltration and dentin bond strength of Futurabond NR self-etch adhesive

OBJECTIVE:To study the improvement effects of citalopram combined with huperzine A in aged depression model rats. METHODS:Aged rats were randomly divided into blank control group,model group,huperzine A group(0.3 mg/kg),citalo-pram group(5 mg/kg),and combination group(huperzine A 0.3 mg/kg+citalopram 5 mg/kg),10 in each group. Except for blank control group,rats in other groups received chronic unpredictable mild stress to reduce depression model. After modeling,rats were intragastrically administrated relevant drugs once a day,for 2 weeks. The depression,learning and memory behavior changes of rats in each group were observed by using open-field test,sucrose consumption test,tail suspension test,forced swimming test and Morris water maze test. RESULTS:Compared with blank control group,the horizontal crossing number,uprightness number,su-crose preference rate,crossing number in platform,percentages of target quadrant distance and time of rats in model group were ob-viously decreased (P<0.05 or P<0.01);immobility time of tail suspension and swimming,escape latency were obviously pro-longed(P<0.05 or P<0.01). Compared with model group,the depression-related indexes of rats in citalopram group and combina-tion group were obviously improved(P<0.05 or P<0.01),and combination group had better effects;the learning and memory-re-lated indexes in combination group were obviously improved(P<0.05 or P<0.01),only crossing time in platform in huperzine A group and citalopram group were obviously increased (P<0.05 or P<0.01),and other learning and memory-related indexes had no obvious changes(P>0.05). CONCLUSIONS:Citalopram combined with huperzine A can obviously improve the depression be-havior,learning and memory ability of aged rats with depression,showing better effects than citalopram alone.

Objective To explore the current status of mental resilience and its influencing factors in caregivers of patients with mild Alzheimer's disease (AD), so as to provide evidence for improving the quality of life and care level of the caregivers.Methods A total of 208 mild AD patients' caregivers in the neurology department of a Class Ⅲ Grade A hospital in Beijing were investigated with general information questionnaire, the Chinese version of the Connor-Davidson Resilience Scale (CD-RISC) and the Caregivers Burden Inventory (CBI).The influencing factors were analyzed with single factor analysis, Pearson correlation analysis and multiple linear regression analysis.Results The total score of the mental resilience of the caregivers of patients with mild AD was lower than the domestic norm. The difference in the mental resilience of caregivers with different genders, ages, duration of care, caring burden and caring assistance was statistically significant (P<0.05). Pearson correlation analysis showed that there was no statistical significance of the correlations between the duration of care and the total score, the tenacity dimension, the self-development dimension, as well as the correlation between gender and the tenacity dimension, the self-development dimension (P>0.05). Otherwise, all of the other factors were correlated with the scores of CD-RISC and all dimensions of it (P<0.05). Regression analysis showed that the influencing factors of caregivers' burden on resilience could explain 54.5％ of the total variation of the resilience.Conclusions The mental resilience of the caregivers of the patients with mild AD is generally low. Nurses should give different interventions according to the different levels of resilience and related factors, especially, more technical guidance and psychological support should be given to the caregivers with heavier burden.

Electronic Health Records (EHRs) are digital health tools that support comprehensive care and digital services. This paper provides an overview of EHRs, summarizes their current applications in palliative care, and proposes solutions to address issues in the use of EHRs in this field. The aim is to offer reference points for promoting the application of EHRs in palliative care in China.

BACKGROUND: Degeneration of the annulus fibrosus (AF), an important structure of the intervertebral disc, is one of the main causes of degenerative disc disease. Fabrication of scaffolds replicating the stratified microstructure of the AF is critical for the successful regeneration of AF. METHODS: In this study, we cultured rabbit AF-derived stem cells (AFSCs) using fabricated electrospun fibrous poly-Llactic acid scaffolds with different diameters. We applied cyclic tensile strain (CTS) on the scaffolds to regulate the differentiation of AFSCs into specific cell types that resided at the inner, middle, and outer zones of the AF. RESULTS: We found that the morphologies of AFSCs on the smaller-fiber-diameter scaffolds were nearly round, whereas spindle-like cells morphologies were observed on large-diameter scaffolds. CTS enhanced these phenomena and made the cells slender. The expression levels of collagen-I in cells increased as a function of the fiber diameter, whereas collagen-II and aggrecan exhibited opposite trends. Moreover, the application of CTS upregulated the gene expressions of collagen-I, collagen-II, and aggrecan. CONCLUSION Overlaying the scaffolds with different CTS-stimulated cells could eventually lead to engineered AF tissues with hierarchical structures that approximated the native AF tissue. Thus, the proposed methodologies could be potentially applied for AF regeneration.

BACKGROUND: Degeneration of the annulus fibrosus (AF), an important structure of the intervertebral disc, is one of the main causes of degenerative disc disease. Fabrication of scaffolds replicating the stratified microstructure of the AF is critical for the successful regeneration of AF. METHODS: In this study, we cultured rabbit AF-derived stem cells (AFSCs) using fabricated electrospun fibrous poly-Llactic acid scaffolds with different diameters. We applied cyclic tensile strain (CTS) on the scaffolds to regulate the differentiation of AFSCs into specific cell types that resided at the inner, middle, and outer zones of the AF. RESULTS: We found that the morphologies of AFSCs on the smaller-fiber-diameter scaffolds were nearly round, whereas spindle-like cells morphologies were observed on large-diameter scaffolds. CTS enhanced these phenomena and made the cells slender. The expression levels of collagen-I in cells increased as a function of the fiber diameter, whereas collagen-II and aggrecan exhibited opposite trends. Moreover, the application of CTS upregulated the gene expressions of collagen-I, collagen-II, and aggrecan. CONCLUSION Overlaying the scaffolds with different CTS-stimulated cells could eventually lead to engineered AF tissues with hierarchical structures that approximated the native AF tissue. Thus, the proposed methodologies could be potentially applied for AF regeneration.

Objective:To systematically integrate the qualitative research on effective pain management disorders of cancer patients and caregivers, and to provide reference for patients and caregivers to safely and effectively implement cancer pain management.Methods:The qualitative studies on the experiences and obstacles of cancer patients and caregivers in cancer pain management were retrieved from electronic databases of PubMed, Web of Science, Cochrane Library, Embase, CINAHL, China National Knowledge Infrastructure, China Biology Medicine, VIP and Wanfang data from inception to September 2023. The quality of the literature was evaluated according to Joanna Briggs Institute Evidence Based Healthcare Center Critical Appraisal Tool for qualitative studies in Australia. Meta-synthesis was used to conduct the synthesis.Results:A total of 9 articles were included, and 46 research results were extracted, forming 14 categories, which were further summarized into 4 integrated results: patient-related pain management disorders, caregiver-related pain management disorders, medical staff-related pain management disorders, and health care system-related pain management disorders.Conclusions:Multiple factors cause obstacles for cancer patients and caregivers to participate in pain management. Medical staff should have a deep understanding of patients′pain problems and explore pain management plans and interventions suitable for cancer patients, so as to reduce the degree of cancer pain management obstacles.

Objective:To systematically evaluate the safety and effectiveness of sequential humidified high flow nasal cannula (HFNC) therapy in ICU patients after mechanical ventilation withdrawal.Methods:Cochrane Library, PubMed, Medline, Embase, Web of Science, Scopus, ProQuest, SinoMed, Chinese National Knowledge Infrastructure (CNKI) , Wanfang Data and VIP were searched by computer for randomized controlled trials (RCTs) or clinical controlled trials of HFNC in ICU patients after mechanical ventilation withdrawal. The retrieval time was from the establishment of the database to November 1, 2020, and the included references were tracked. Two researchers strictly evaluated the quality of literature and extracted data. RevMan 5.3 software and Stata 14.0 software were used for Meta-analysis.Results:A total of 14 articles were included. Meta-analysis showed that, compared with conventional oxygen therapy and noninvasive positive pressure ventilation, HFNC could reduce the partial pressure of carbon dioxide (PaCO 2) [combined SMD=-0.21, 95% CI (-0.32- -0.10) , P=0.000 3], reduce the incidence of respiratory failure [combined RR=0.72, 95% CI (0.61-0.85) , P=0.000 1], reduce the respiratory rate of patients while removing the source of heterogeneity [ SMD=-0.44, 95% CI (-0.86- -0.03) , P<0.05]and improve the oxygenation index of patients while removing the source of heterogeneity [ SMD=-0.34, 95% CI (-0.56- -0.12) , P<0.05]. Conclusions:HFNC can support the oxygenation demand of ICU patients after mechanical ventilation weaning, but it still needs higher treatment and nursing standards to promote its clinical application.

Diabetic foot has become one of the heavy burdens of global public health problems. As a revolutionary emerging technology, artificial intelligence has the advantages of accuracy, intelligence and efficiency, which can make up for the shortcomings of traditional risk assessment, monitoring and management of diabetic foot. This paper reviews the application of artificial intelligence in risk prediction model of diabetic foot, wound image analysis, and intelligent wearable devices, analyzes the challenges and suggestions faced in technical barriers, data quality, and talent shortage, so as to provide a reference for the clinical practice of artificial intelligence in the field of diabetic foot.