Objective The filum terminale(FT)plays an important role in the pathophysiology of tethered cord syndrome(TCS).The study on morphology and structure of fetus FF can provide reference standard for diagnosis of TCS.Methods Ten fresh human aborted fetuses had their fila measured and removed.Transversal and longitudi nal sections of the middle,and distal thirds of FF were submitted to light microscopy analysis with four different techniques.Results The bulk of the Frr is composed of 1～5μm thick spring like longitudinal bundles of colla gen separated by 5～30μm layer intervals and 1～5μm intervals in the layer,although a small quantity of eapillar ies and other elements may be present.Collagen bundles can also be found between layers and bundles.Abundant longitudinally oriented elastic fibers ale found inside or between collagen bundles.Conclusion A complex tridi mensional structure composed by ordered arrangement of spring like fibers and small quantity of capillaries should e licit considerable elastic properties to the FI".Tts alternation of structure and element maybe involved in TCS closely.

Objective:To evaluate and summarize the best evidence of health workers respiratory protection during aerosol-generating procedures in patients with acute respiratory infectious diseases.Methods:We searched EBM Guidelines, Essential Evidence Plus, Dynamed, UpToDate, JBI, BMJ, Clinical Key, Cochrane Library, NICE, AARC, PubMed, EMbase, CKNI, Wanfang to collect related literature including guidelines,evidence summary, recommended practices, standards, consensus and systematic reviews.Results:A total of 20 articles were included, including 10 guidelines, 1 consensus, 2 standards, 2 evidence summaries, and 5 systematic reviews. 24 best evidences including aerosol-generating procedures, training of protective equipment using, principles of protective equipment using, protective equipment using, aerosol operating environment control and medical staff self-monitoring were summarized.Conclusion:The study integrated the best evidence of healthcare workers respiratory protection during aerosol-generating procedures in patients with acute respiratory infectious disease. It is recommended to combine the current status of institutional protection resources and clinical practice experience to promote the conversion of the best evidence to clinical practice.

Objective To investigate the effect and mechanism of S100A16 in the course of 3T3-L1 preadipocytes differentiation.MethodsA recombinant virus vector overexpressing S100A16 ( PLJM1-S100A16-GFP) was constructed and transfected into 3T3-L1 preadipocytes.The expression of S100A16 in the course of 3T3-L1 preadipocytes differentiated into adipocytes was detected by Western blot.The lipid droplets were observed by oil-red O staining and triglycercide (TG) content was measured by the TG measure kit.Levels of adipogenesis-associated genes such as PPARγ,CCAAT/enhancer binding protein ( C/EBP-α),lipoprotein lipase ( LPL),fatty acid synthase ( FAS),adipocyte fatty acid binding protein( aP2 ) were measured by realtime PCR and Western blot.The interaction between S100A16 and p53 was detected by immunoprecipitation.Results3T3-L1 cell line overexpressing S100A16was successfully contructed.It was found that the expression of S100A16 was increased during 3T3-L1 adipocytes differentiation.Overexpression of S100A16 stimulated 3T3-L1 preadipocytes differentiation and increased the accumulation of triglycerides in adipocytes (P＜ 0.01 ),along with the up-regulation of adipocyte differentiationassociated gene expressions including PPARγ,C/EBP-α,LPL,aP2,and FAS ( P ＜ 0.05 or P ＜ 0.01 ).Immunoprecipitation analysis revealed that S100A16 interacted with tumor suppressor protein p53,also a known inhibitor of adipogenesis.ConclusionS100A16 stimulates 3T3-LI preadipocytes differentiation via inhibiting p53activity.

Aim To develop LC-MS/MS method to de-termine rasagiline mesylate in human plasma and its application in a pharmacokinetics study .Methods Plasma samples were extracted using liquid-liquid ex-traction with clopidogrel as internal standard .The con-tent of rasagiline mesylate in human plasma was detec-ted by selectivelypositive ion reaction monitoring on a triple quadrupoles tandem mass spectrometer .The de-tected ions were m/z 172.3→117.1 ( rasagiline ) , m/z 322.3 →184.0 ( clopidogrel ) .The linear calibration curve was obtained in the concentration range of 0.1047~20.93 μg · L-1 .The lower limit of quantifi-cation was 0.1047 μg · L-1 .Indicators of the method validation were in line with requirements .The method was used to determine the concentration of rasagiline in human plasma after oral administration of rasagiline mesylate capsule to 24 healthy Chinese volunteers ( with half males and females ) and the results were compared statistically .Results The single oral dose of 0.5 ,1.0 and 2.0 mg presented linear pharmacokinetics in the health volunteers .No accumulation was observed with multiple doses .Meanwhile , no significant difference was identified between the gender groups . High fat postprandial has obvious effects on the peak serum con-centration of rasagiline , but there was no effect on the absorption amount and cumulative excretion .Conclu-sion The LC-MS/MS method is specific and sensi-tive, and can be successfully applied to the pharmaco-kinetic study of Rasagiline mesylate tablets in healthy Chinese volunteers .

Objective To preliminarily identify the nursing interventions and activities for inpatients with pulmonary ventilation dysfunction in different levels based on Nursing Interventions Classification (NIC). Methods Evidence-based clinical practices and literatures about nursing activities of patients with ventilation dysfunction were reviewed, and took full advantage of their function with clinical follow-up. Firstly, 6 clinical nursing specialists were consulted by a questionnaire survey, which was based on the initial screened nursing interventions and activities from NIC. Then, 22 experts were consulted twice. Results The expert authority coefficient was 0. 80 on average and the positive coefficient of experts were 95. 83% and 100. 00%. The established nursing programs related to function included 31 interventions and 258 activities which ranging from extremely severe to mild was 30 ( 252 ) , 20 ( 143 ) , 19 ( 103 ) , 6 ( 25 ) , 5 ( 19 ) , respectively. The nursing specialists consistency of selected interventions was 90. 9% to 100%. The selected activities scored 4. 00 to 5. 00 in average, with the coefficient of variations ranging from 0 to 0. 25. Conclusions The preliminarily established nursing interventions and activities are easy to communicate and can guide the clinical nursing practice.

At present, researches on self-management of patients with multiple chronic conditions (MCC) are increasing in foreign countries, but there are still few reports about it in China. This paper introduces research progress on self-management of MCC patients from three aspects including self-management status of MCC patients, influencing factors and measurement tools so as to provide ideas for researches on the self-management of MCC patients in China.

Objective? To investigate the training, operation and examination of nursing care for lymphedema in Jiangsu Province. Methods? We selected 99 nurses provided nursing care for lymphedema at 13 class Ⅲ hospitals of prefecture-level city in Jiangsu Province as subjects by purposive sampling. All of nurses were investigated with the self-designed questionnaire involving general information, application and training of nursing care for lymphedema, nursing operation and examination of lymphedema. Results? Among 99 nurses, 68 (68.69%) nurses could carry out training regularly, and 59 (59.60%) nurses participated in training on nursing care for lymphedema. The main causes failing to could carry out training regularly included the teaching staff and lack of related content. Conclusions? At present, the training of nursing care for lymphedema needs to be strengthened. There is a pressing need to formulate the unified standardized operation and examination standards so as to improve the quality of work and professional connotation of nursing care for lymphedema.

Objective To analyze the correlation between cumulative fluid balance volume and increasing plasma volume and aggravated clinical congestion symptoms in patients with heart failure on admission for 1～7 d,and to explore the application value of cumulative fluid balance volume in predicting volume overload.Methods Using the convenience sampling method,235 heart failure patients hospitalized from October 2022 to February 2023 in a total of 3 tertiary hospitals in Nanjing,Lianyungang,Jiangsu Province,and Zhumadian,Henan Province,were selected and classified into an increasing/decreasing plasma volume group and an aggravated/alleviated clinical congestion symptoms group.General information,clinical characteristics,and 1～7 d cumulative fluid balance volume of the study subjects were collected to compare the differences in cumulative fluid balance volume between the 2 groups.Logistic regression was used to analyze the effect of cumulative fluid balance volume on plasma volume and clinical congestion symptoms.Receiver operating characteristic curves were used to analyze the optimal cutoff value of cumulative fluid balance volume for predicting increasing plasma volume and aggravated clinical congestion symptoms.Results Excluding 15 pat ients who were discharged early and 3 patients with inaccurate records of fluid intake and excretion,a total of 217 patients were included.The incidence of positive fluid balance was lowest on day 1,at 65.90%,with the smallest cumulative volume of(0.235±0.983)L;the highest incidence of positive balance occurred on day 6,at 75.58%,with the largest cumulative volume of(2.444±5.445)L.The cumulative fluid balance at 4～7 d in the increasing plasma volume group was higher than that in the decreasing plasma volume group,and the difference was statistically significant(P<0.05);the cumulative fluid balance at 4～7 d was an independent risk factor for plasma volume elevation,and a cumulative fluid balance of 2.308,3.361,3.518,and 3.702 L at 4～7 d was predictive of a plasma volume elevation,and areas under receiver operating characteristic curve were 0.686,0.721,0.647,and 0.766,respectively.The cumulative fluid balance for 4～7 d in the aggravated clinical congestion symptoms group was higher than that in the alleviated clinical congestion symptoms group,and the difference was statistically significant(P<0.05);the cumulative fluid balance for 4～7 d was an independent risk factor for the aggravated clinical congestion symptoms,and a cumulative fluid balance for 4～7 d of 2.574,3.383,4.995,and 4.235 L predicted aggravated clinical congestion symptoms,and area under receiver operating characteristic curve was 0.640,0.693,0.654,and 0.720,respectively.Conclusion The incidence of cumulative positive fluid balance in heart failure patients is high,and the amount of cumulative fluid balance can better predict the occurrence of volume overload,and the increase of plasma volume precedes the appearance of clinical congestion symptoms.It is suggested that heart failure patients with more than 3 d of cumulative positive balance should be closely monitored,and when the cumulative positive balance exceeds 2.308 L,measures should be taken in time to drain excessive fluid,so as to avoid the incidence of volume overload.

Objective:To systematically review the effects of limited fluid intake on the prognosis of patients with heart failure.Methods:RCTs about the effects of limited fluid intake on the prognosis of patients with heart failure published up to March 31, 2021 were retrieved from PubMed, The Cochrane Library, CINAHL, Embase, Web of Science, CNKI, Wanfang, VIP, and SinoMed. Two independent researchers were employed to extract data and evaluate the quality of included literature. Rev Man 5.3 was used for Meta-analysis, sequential analysis to evaluate the reliability and authenticity of the research results, and the Egger's test for publication bias.Results:A total of 7 articles were included, with a sample size of 867 cases. Meta-analysis showed that the body weight [ MD=-3.04, 95% CI (-4.70, -1.38) , P<0.001], B-type natriuretic peptide [ MD=-249.32, 95% CI (-305.00, -193.63) , P<0.001], blood creatinine [ MD=-22.03, 95% CI (-24.98, -19.09) , P<0.001], readmission rate [ OR=0.30, 95% CI (0.20, 0.45) , P<0.001] of the limited fluid intake group in the chronic phase of heart failure were lower than those in the control group; the body weight [ MD=1.41, 95% CI (-3.73, 6.55) , P=0.59], B-type natriuretic peptide [ MD=64.52, 95% CI (-50.01, 179.06) , P=0.27], serum creatinine [ MD=3.83, 95% CI (-9.69, 17.36) , P=0.58], readmission rate [ OR=1.21, 95% CI (0.65, 2.27) , P=0.55] of the acute fluid intake group were not statistically different from those in the control group. Conclusions:Limiting fluid intake in the chronic phase of heart failure can effectively improve the patients' heart and kidney function and the prognosis of the disease. In the acute phase of heart failure, it may be necessary to combine multiple treatments to keep the patients at the best volume state.