OBJECTIVE To form an expert consensus on the clinical application of parenteral direct thrombin inhibitors （DTIs） in patients during the perioperative period. METHODS Led by Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital （the Affiliated Hospital of UESTC）， a multidisciplinary working group was established. Through literature review and the Delphi method， clinical questions related to the rational perioperative use of parenteral DTIs were identified. A structured design was adopted using the “Population-Intervention-Comparison-Outcome” framework； systematic searches were conducted in CNKI， Medline， Embase and other databases. Relevant evidence from randomized controlled trials and cohort studies was included and synthesized. Evidence quality was assessed using the Grades of Recommendations Assessment，Development and Evaluation （GRADE） approach， and recommendations were formulated through multiple rounds of Delphi surveys and expert consensus meetings. RESULTS &CONCLUSIONS Seven recommendations （each with an expert consensus rate exceeding 90%） on the use of parenteral DTIs in perioperative patients were developed. These recommendations specify drug selection， dosing ranges， key monitoring points， and safety management strategies for parenteral DTIs in various scenarios， including the perioperative period of ventricular assist device implantation， the perioperative period of cardiac surgery， perioperative patients with lower-extremity atherosclerotic disease， the perioperative period of percutaneous coronary intervention in patients with acute coronary syndrome， the perioperative period of carotid artery stenting in patients with carotid stenosis， the perioperative period of patients with right heart thrombosis， and patients who develop related thrombosis and dysfunction after a central venous catheter insertion. In addition， warning and management pathways for perioperative bleeding and thrombotic events were proposed. This expert consensus， which is formulated based on the best available evidence， provides evidence-based guidance for standardized and individualized use of parenteral DTIs in perioperative period.

Chang-Kang-Fang (CKF) formula, a Traditional Chinese Medicine (TCM) prescription, has been widely used for the treatment of irritable bowel syndrome (IBS). However, its potential material basis and underlying mechanism remain elusive. Therefore, this study employed an integrated approach that combined ultra-performance liquid chromatography-quadrupole time-of-flight mass spectrometry (UPLC-Q/TOF-MS) with network pharmacology to systematically characterize the phytochemical components and metabolites of CKF, as well as elucidating its underlying mechanism. Through this comprehensive analysis, a total of 150 components were identified or tentatively characterized within the CKF formula. Notably, six N-acetyldopamine oligomers from CicadaePeriostracum and eight resin glycosides from Cuscutae Semen were characterized in this formula for the first time. Meanwhile, 149 xenobiotics (58 prototypes and 91 metabolites) were detected in plasma, urine, feces, brain, and intestinal contents, and the in vivo metabolic pathways of resin glycosides were elaborated for the first time. Furthermore, network pharmacology and molecular docking analyses revealed that alkaloids, flavonoids, chromones, monoterpenes, N-acetyldopamine dimers, p-hydroxycinnamic acid, and Cus-3/isomer might be responsible for the beneficial effects of CKF in treating IBS, and CASP8, MARK14, PIK3C, PIK3R1, TLR4, and TNF may be its potential targets. These discoveries offer a comprehensive understanding of the potential material basis and clarify the underlying mechanism of the CKF formula in treating IBS, facilitating the broader application of CKF in the field of medicine.
Humans ; Tandem Mass Spectrometry/methods* ; Irritable Bowel Syndrome/drug therapy* ; Molecular Docking Simulation ; Drugs, Chinese Herbal/chemistry* ; Glycosides ; Chromatography, High Pressure Liquid/methods*

Objective:To explore the current situation, hotspots and trends of multi-sited license of nurses in China based on China National Knowledge Infrastructure (CNKI) , Wanfang and VIP database, so as to provide reference for the research of multi-sited license of nurses in China.Methods:CiteSpace 5.1.R6 was used to conduct a visual analysis of the research on the multi-sited license of nurses in databases from the following seven aspects, including the annual number of documents, authors, institutions, journal sources, high-frequency keywords, keyword clustering and keyword burst words. The retrieval time limit was from the establishment of the database to December 31, 2021.Results:A total of 100 articles were included. The annual number of documents issued was on the rise, but the total amount was low. Among the authors, Sun Hongyan published 11 articles, ranking first. There were 88 sending agencies, with little cooperation and communication among them. The sending agencies mainly relied on universities or their affiliated hospitals. The source of journals is mainly nursing journals. There were 125 key words in total. The cluster results showed that the multi-sited license research of nurses mainly included door-to-door service, practice registration, online appointment nurses, willingness, nursing quality and influencing factors. The results of keyword burst showed that the research on influencing factors, nursing quality, Internet +, and nursing services had continued since 2020, and might continue to become research hotspots in the next few years.Conclusions:The multi-sited license of nurses in China is still in the exploratory stage, and the research content remains at the theoretical level, lacking empirical research.

The central venous access device (CVAD) is widely used in infusion of intravenous high nutrient solution, chemotherapy drugs, rapid infusion, blood transfusion, etc. CVAD is left in the patient′s blood vessels for a long time, although it has certain advantages in intravenous therapy, but also risks associated with it. In the past 20 years, many studies have focused on the mechanism of CVAD on vascular injury, trying to explore its mechanism from a different perspective at the microscopic level of pathophysiology. This article will review the three aspects of acute damage to the blood vessel caused by CVAD catheterization and chronic changes caused by indwelling catheters, analysis of the causes of vascular injury caused by CVAD catheterization, and research on preventing vascular injury caused by CVAD catheterization, aiming at providing reference for clinical intravenous therapy.

Adipocytokines are polypeptides or proteins that are secreted by fat cells with a wide range of biological activities. Adiponectin is a fatty cytokine with insulin sensitization. It possesses the function of anti- diabetes, atherosclerosis and anti-inflammation. Adiponectin may participate in regulating the development of cognitive impairment, which is considered as a new regulatory factor for cognitive impairment.
Adiponectin ; Cognitive Dysfunction ; Diabetes Mellitus ; Humans ; Insulin ; Insulin Resistance

Postpartum depression(PPD)is one of the most common types of postpartum psychiatric syndromes. Because of the complex and changeable characteristics in PPD disease and the special period after childbirth, there are many clinical limitations in the study of this disease. Therefore,the preparation and establishment of a proper animal model closed to clinical and behavioral evaluation method plays an important role in study of its pathogenesis. This review mainly introduces the commonly used postpartum depression animal models and the behavioral evaluation method. It is hoped to provide a reference for further study of PPD pathogenesis and for the drug research and development.

Objective To integrate the "volunteer service" culture into standardized training nurses and to build the awareness of participation in volunteer service of a hospital. Methods A total of 75 new nurses in 2016 and 130 new nurses in 2017 were selected as control group and observation group respectively by cluster sampling. Two groups all included "volunteer service" in pre-job training advocating active participation in volunteer service in hospital. Observation group added "integration management" in volunteer service. The situation of volunteer service between two groups were compared after training. Results After training, the mean of integration of volunteer service was (2.23±0.21) in observation group and (1.14±0.16) in control group with a significant difference (t=2.87,P< 0.01). There were 36.15% of nurses participated in daily volunteer service, 11.54% of nurses donated blood voluntarily, 18.46% of nurses participated in volunteer service of public emergency events in observation group, which were better than those in control group with significant differences (χ2=6.95,4.31,5.43;P<0.05). Conclusions The application of "integration method" in hospital volunteer service management is in favor of improving nurses' enthusiasm for participating in volunteer service as well as establishing the spirits of "dedication, affection, cooperation and advancement".

Objective:On the basis of synthetic antigens on minoxidil ,we prepared its polyclonal antibody and established a ELISA method to detect minoxidil .Methods:We synthesized minoxidil artificial antigen with glutaraldehyde and identified by UV scan -ning.We had established a detection of minoxidil competition ELISA .Results: The UV scan showed that the minoxidil successfully coupled to a carrier protein.The conjugate of minoxidil-BSA was used to immunize BALB/c mice.And the produced antiserum showed high titer of 1:12 800 in the indirect ELISA.Its ELISA curve equation:y=-0.082 3 x+0.938 ( R2 =0.9811 ) , minoxidil mass concentration and the absorbance in 0.001-10 μg/ml showed a good linearity .Conclusion: This method has been successfully preparing minoxidil artificial antigen and polyclonal antibodies and established ELISA detection method for minoxidil ,which provides a basis for the practical application of minoxidil immunoassay method .

ObjectiveTo explore the damage of blood vessels in carbon monoxide poisoning patients by hyperbaric oxygen, especially for damage of vein, to understand the factors aggravating inflammatory response, thus work out the homologous protective measures.MethodsFrom January 2006 to January 2008, 80 patients of carbon monoxide poisoning were selected as the observation group. Another 80 patients with other diseases were set as the control group. Two groups both accepted hyperbaric oxygen treatment. The time of angioplerosis was compared between the two groups, besides, pain reaction of the observation group was also observed.ResultsThe time of angioplerosis was significantly different between the two groups, pain sensibility intensified in the observation group compared with that before treatment.ConclusionsHyperbaric therapy is closely related with vascular inflammatory reaction of carbon monoxide poisoning patients. Protective measures should be established in order to prevent further damage of vessel, relieve pain of patients and ensure smooth progress of the treatment.

Objective To explore the effect of cognitive-behavioral method on healthy behavior selection of in-patients with type 2 diabetes. Methods All patients with type 2 diabetes involved in this study were divided into the experimental group(99 patients) and the control group(96 patients). The experimental group was given health education with cognitive behavioral method, and the control group received only common health education. The comparison on the knowledge about diabetes mellitus and indicators of glucose metabolism on the first and 6th months between the two groups was performed. Results The knowledge about diabetes mellitus and indicators of glucose metabolism on the first and 6th months in the experimental group were better than those in the control group. Conclusions Cognitive-behavioral method can increase the treatment compliance of in-patients with type 2 diabetes and improve the glucose metabolism indicators, and created favorable condition for prevention of diabetes complications.