Objective:To establish a chain management model for blood glucose in critically ill patients after cardiac surgery and analyze its clinical effectiveness, and to provide a reference for related clinical nursing practices.Methods:A quasi-experimental study design was adopted. Using convenience sampling, 120 critically ill patients after cardiac surgery admitted to Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine were selected as study subjects. They were divided into groups based on the time of admission to the intensive care unit after surgery. Sixty patients admitted from March to May 2024 were assigned to the control group and received conventional blood glucose management. Another 60 patients admitted from June to August 2024 were assigned to the observation group and received the chain management model for blood glucose control in addition to the conventional approach. Blood glucose levels and quality indicators of blood glucose management (including maximum blood glucose fluctuation, time in target glucose range, duration of insulin use, incidence of hypoglycemia, etc.) were compared between the two groups.Results:The control group included 27 males and 33 females, with an age of 63.00(59.00, 69.25) years; the observation group included 28 males and 32 females, with an age of 66.00(60.00, 70.00) years. The blood glucose levels of the observation group on postoperative days 2, 3, 4 were 9.10(8.68, 9.90), 8.90(8.40, 10.00), 8.75(7.38, 9.03) mmol/L, respectively, which were lower than those of the control group [10.30(9.80, 11.00), 9.95(9.40, 11.05), 9.30(8.10, 10.02) mmol/L], with a statistically significant difference ( Z=-5.85, -4.95, -3.50, all P<0.05). The maximum blood glucose fluctuation in the observation group was (4.09 ± 2.45) mmol/L, lower than that of the control group [(5.19 ± 2.47) mmol/L], with a statistically significant difference ( t=2.46, P<0.05). The time in the target glucose range was 67.00(60.00, 75.00)% in the observation group, higher than that of the control group 52.00(45.00, 60.00)%, with a statistically significant difference ( Z=-6.57, P<0.05). The duration of insulin use was 6.00(5.00, 7.00) h in the observation group, shorter than that of the control group [13.00(9.75, 15.32) h], with a statistically significant difference ( Z=-8.68, P<0.05). The incidence of hypoglycemia was 3.33%(2/60) in the observation group and 15.00%(9/60) in the control group, with a statistically significant difference ( χ2=4.90, P<0.05). The mechanical ventilation time, ICU stay, and total hospital stay in the observation group were 42.00(37.00, 89.25) h, 6.00(5.00, 7.00) d, and 12.00(11.75, 13.00) d, respectively, which were shorter than those of the control group [96.00(86.25, 98.00) h, 7.00(7.00, 10.00) d, and 13.00(11.75, 15.00) d], with a statistically significant difference ( Z=8.67, 17.57, 4.73, all P<0.05). Conclusions:The implemented chain management model for blood glucose control meets the comprehensive requirements of blood glucose management. It not only reduces blood glucose fluctuations and decreases the incidence of hypoglycemia but also effectively improves the quality of blood glucose management in critically ill patients after cardiac surgery, enhances the safety of blood glucose control, and promotes patient recovery.

Objective:To establish a chain management model for blood glucose in critically ill patients after cardiac surgery and analyze its clinical effectiveness, and to provide a reference for related clinical nursing practices.Methods:A quasi-experimental study design was adopted. Using convenience sampling, 120 critically ill patients after cardiac surgery admitted to Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine were selected as study subjects. They were divided into groups based on the time of admission to the intensive care unit after surgery. Sixty patients admitted from March to May 2024 were assigned to the control group and received conventional blood glucose management. Another 60 patients admitted from June to August 2024 were assigned to the observation group and received the chain management model for blood glucose control in addition to the conventional approach. Blood glucose levels and quality indicators of blood glucose management (including maximum blood glucose fluctuation, time in target glucose range, duration of insulin use, incidence of hypoglycemia, etc.) were compared between the two groups.Results:The control group included 27 males and 33 females, with an age of 63.00(59.00, 69.25) years; the observation group included 28 males and 32 females, with an age of 66.00(60.00, 70.00) years. The blood glucose levels of the observation group on postoperative days 2, 3, 4 were 9.10(8.68, 9.90), 8.90(8.40, 10.00), 8.75(7.38, 9.03) mmol/L, respectively, which were lower than those of the control group [10.30(9.80, 11.00), 9.95(9.40, 11.05), 9.30(8.10, 10.02) mmol/L], with a statistically significant difference ( Z=-5.85, -4.95, -3.50, all P<0.05). The maximum blood glucose fluctuation in the observation group was (4.09 ± 2.45) mmol/L, lower than that of the control group [(5.19 ± 2.47) mmol/L], with a statistically significant difference ( t=2.46, P<0.05). The time in the target glucose range was 67.00(60.00, 75.00)% in the observation group, higher than that of the control group 52.00(45.00, 60.00)%, with a statistically significant difference ( Z=-6.57, P<0.05). The duration of insulin use was 6.00(5.00, 7.00) h in the observation group, shorter than that of the control group [13.00(9.75, 15.32) h], with a statistically significant difference ( Z=-8.68, P<0.05). The incidence of hypoglycemia was 3.33%(2/60) in the observation group and 15.00%(9/60) in the control group, with a statistically significant difference ( χ2=4.90, P<0.05). The mechanical ventilation time, ICU stay, and total hospital stay in the observation group were 42.00(37.00, 89.25) h, 6.00(5.00, 7.00) d, and 12.00(11.75, 13.00) d, respectively, which were shorter than those of the control group [96.00(86.25, 98.00) h, 7.00(7.00, 10.00) d, and 13.00(11.75, 15.00) d], with a statistically significant difference ( Z=8.67, 17.57, 4.73, all P<0.05). Conclusions:The implemented chain management model for blood glucose control meets the comprehensive requirements of blood glucose management. It not only reduces blood glucose fluctuations and decreases the incidence of hypoglycemia but also effectively improves the quality of blood glucose management in critically ill patients after cardiac surgery, enhances the safety of blood glucose control, and promotes patient recovery.

Objective Based on network pharmacology,protein mechanism,and experimental validation,this study aims to explore the role of Ganmai Dazao Tang in treating intestinal inflammation in children with attention deficit hyperactivity disorder(ADHD)model rats.Methods Screening the relevant targets and pathways for the effect of Ganmai Dazhao Tang on intestinal inflammation in ADHD model rats using network pharmacology methods,and verifying the affinity of the main components and targets through molecular docking.Forty spontaneously hypertensive rats(SHR)were randomly divided into model group,methylphenidate group,and low,medium,and high dose groups of Ganmai Dazao Tang,with 8 rats in each group.Additionally,8 Wistar Kyoto rats(WKY)were set as the normal group.Rats in each group were treated daily by gavage for 3 weeks.Observing the pathological condition of the small intestine using HE staining technology,and detecting interleukin-1 using enzyme-linked immunosorbent assay(ELISA)and Western blot methods β(IL-1β),tumor necrosis factor α(TNF-α),Expression of the oncogene Fos(FOS).Results Network pharmacology screened 117 chemical components and predicted 248 effective targets.Molecular docking results showed that Isovitexin β-Ingredients such as beta carotene,kaempferol,luteolin,and naringenin have strong affinity with targets such as AKT1,FOS,VEGFA,and TNF.Animal test results show that Ganmai Dazhao Tang can improve the core symptoms of ADHD,protect normal intestinal function and status,and downregulate related IL-1 β,TNF-α,FOS factor content.Conclusion Ganmai Dazao Tang can alleviate the core symptoms of ADHD in SHR rats by protecting normal intestinal function and downregulating inflammatory factors.

Objectives:To investigate the incidence and risk factors of perioperative complications after en bloc resection for thoracic and lumbar spinal tumors.Methods:The data of patients with thoracic and lumbar spinal tumors treated in our department with en bloc resection and anterior column reconstruction were retro-spectively analyzed.Between May 2016 and October 2022,90 consecutive patients underwent en bloc resec-tion on the basis of Weinstein-Boriani-Biagini surgical staging system,and anterior reconstruction was per-formed using 3D-printed artificial vertebral bodies.The demographic,oncological,and operative data of the patients were collected prospectively,and the intraoperative and postoperative complications occurring within three months were categorized into major and minor complications according to their impacts on the recovery process(Major complications were considered as any complication that appeared to substantially alter an other-wise full and expected course of recovery,and other complications were regarded as minor).All the patients were divided into the primary group(n=67)and revision group(n=23)based on their previous surgical history.Differences between the two groups in terms of age,gender,pathological type,tumor-involved segments,oper-ative time,intraoperative blood loss,and perioperative complications were compared.The predictive factors for major and minor complications were explored.Results:En bloc resection was achieved in all the patients,in-cluding total en bloc spondylectomy in 77 cases,sagittal resection in 12 cases,and vertebrectomy in one case.The mean operative time was 553.4min(210-1208min),and the mean intraoperative blood loss was 1534.1mL(260-5500mL).A total of 129 complications were observed in 65(72.2%)patients,including 29 ma-jor complications in 21(23.3%)patients.Two patients(2.2%)died as a result of complications.The revision group was more than primary group in tumor-involved segments(P=0.000)and incidence rate of major compli-cations(P=0.038).In univariate regression analysis,the combined approach[odds ratio(OR)=14.778,P=0.001],total blood loss(OR=1.004,P=0.004),staged surgery(OR=5.250,P=0.008),previous surgical history(OR=2.946,P=0.043),number of tumor-involved vertebrae(OR=1.607,P=0.023)and lumbar tumor(OR=3.509,P=0.015)were statistically significant risk factors for major complication occurrence,while the combined approach(OR= 6.375,P=0.036)was the independent risk factor.Conclusions:En bloc resection and anterior column recon-struction is associated with high risks of complications,especially when a combined approach is needed.

Objective To investigate the bacterial community diversity in human Demodex mites, so as to provide insights into unraveling the role of human Demodex mites in them caused infectious diseases. Methods From June to July 2023, Demodex mites were collected from the faces of college students in a university in Wuhu City using the adhesive tape method, and the V4 region of 16S ribosomal RNA (16S rRNA) gene and the internal transcribed spacer (ITS) gene of nuclear ribosomal DNA were amplified on an Illumina PE250 high-throughput sequencing platform. Sequencing data were spliced according to the overlapping relations and filtered to yield effective sequences, and operational taxonomic units (OTUs) was clustered. The diversity index of obtained OUTs was analyzed, and the structure of the bacterial community was analyzed at various taxonomic levels. Results A total of 57 483 valid sequences were obtained using 16S rRNA gene sequencing, and 159 OUTs were classified according to similarity. Then, OUTs at a 97% similarity were included for taxonomic analyses, and the bacteria in Demodex mites belonged to 14 phyla, 20 classes, 51 orders, 72 families, and 94 genera. Proteobacteria was the dominant phylum, and Vibrio, Bradyrhizobium and Variovorax were dominant genera. A total of 56 362 valid sequences were obtained using ITS gene sequencing, and 147 OTUs were obtained, which belonged to 5 phyla, 17 classes, 34 orders, 68 families, and 93 genera and were annotated to Ascomycota, Basidiomycota and Chytridiomycota, with Ascomycota as the dominant phylum, and Alternaria alternata, Epicoccum, Penicillium, and Sarocladium as dominant genera. Conclusions There is a high diversity in the composition of bacterial communities in human Demodex mites, with multiple types of microorganisms and high species abundance.

Objective Based on network pharmacology,protein mechanism,and experimental validation,this study aims to explore the role of Ganmai Dazao Tang in treating intestinal inflammation in children with attention deficit hyperactivity disorder(ADHD)model rats.Methods Screening the relevant targets and pathways for the effect of Ganmai Dazhao Tang on intestinal inflammation in ADHD model rats using network pharmacology methods,and verifying the affinity of the main components and targets through molecular docking.Forty spontaneously hypertensive rats(SHR)were randomly divided into model group,methylphenidate group,and low,medium,and high dose groups of Ganmai Dazao Tang,with 8 rats in each group.Additionally,8 Wistar Kyoto rats(WKY)were set as the normal group.Rats in each group were treated daily by gavage for 3 weeks.Observing the pathological condition of the small intestine using HE staining technology,and detecting interleukin-1 using enzyme-linked immunosorbent assay(ELISA)and Western blot methods β(IL-1β),tumor necrosis factor α(TNF-α),Expression of the oncogene Fos(FOS).Results Network pharmacology screened 117 chemical components and predicted 248 effective targets.Molecular docking results showed that Isovitexin β-Ingredients such as beta carotene,kaempferol,luteolin,and naringenin have strong affinity with targets such as AKT1,FOS,VEGFA,and TNF.Animal test results show that Ganmai Dazhao Tang can improve the core symptoms of ADHD,protect normal intestinal function and status,and downregulate related IL-1 β,TNF-α,FOS factor content.Conclusion Ganmai Dazao Tang can alleviate the core symptoms of ADHD in SHR rats by protecting normal intestinal function and downregulating inflammatory factors.

ObjectiveTo understand the current situation and influencing factors of health service demands of new residents in Shanghai. MethodsFrom July to August 2020， a questionnaire survey was conducted in 1 358 new residents from 36 survey points in 7 districts of the city. The questionnaire included the basic medical insurance coverage in the inflow area， the current situation of medical demand and related influencing factors， and the demands for other health services. Results47.1%（562/1 194）of new residents did not choose to seek timely medical treatment when they were not feeling well. The main reason was that the working hours occupied the medical treatment time. Logistic regression analysis showed that the main factors affecting the medical needs in new residents were the average daily working hours， living area and type of residence， health status， physical examination and physical exercise， and the type of basic medical insurance. The demands of new residents for "health consultation of common diseases and frequently occurring diseases"， "health behavior intervention （such as smoking cessation and alcohol restriction）"， "medical guidance and publicity"， "accidental injury prevention （traffic， work， falling， etc.）" and "maintenance of legitimate rights and interests of health" were 57.1%（682/1 194）、41.3%（493/1 194）、34.9%（417/1 194）、32.2%（385/1 194） and 31.9%（381/1 194）， respectively. ConclusionNew residents demands for medical services cannot be met. We should actively improve the working and living conditions of new residents， improve the construction of new residents' health service system， and improve the utilization level of health services.

Objective: To explore the cause and preventive measures of floor-of-mouth hematoma after dental implant placement. Methods: The prevention of hematoma of the floor of the mouth in a case of lower anterior teeth implant placement was analyzed, and the literature was reviewed. Results: Four mandibular vascular canals were found on the lingual side of the anterior mandible before dental surgery in the reported case. Two of them were quite thick (1.4 mm and 1.0 mm, respectively) and were located adjacent to the crest of the alveolar bone and superior to the mental spine. These two thick endosseous branches from the sublingual artery were dissected and ligated , and there was no obvious hematoma in the patients immediately after the operation and at the postoperative 3 d review. The results of the literature review show that the incidence of endosseous branches from the lingual vascular canal of the mandible is 90%-100%. The distribution of the vessels on the lingual side of the mandible is highly variable and adjacent to the lingual cortical plate. Accidental injury of the lingual cortical plate during implant surgery would probably lead to bleeding or hematoma on the floor of the mouth. Conclusion Mastering the anatomy of blood vessels on the floor of the mouth, elaboratively examining preoperative three-dimensional radiographic imaging, and cautiously exploring the lower jaw bone morphology after flap elevation are preventive measures to avoid damage to the arterial supply on the lingual side of the anterior lower jaw and to prevent complications of hematoma in the floor of the mouth.

Objective To observe the changes and significance of the protein expression levels of nuclear factor-κB p65 (NF-κB p65), transforming long factor-β1 (TGF-β1) and apoptosis-related factors Bcl-2 and Bax in myocardial tissue of Bama miniature pig model of diabetic cardiomyopathy (DCM). Methods Ten healthy male Guangxi Bama miniature pigs, aged 4 to 5 months old, were selected and divided into control group and model group according to the random number table method, with 5 pigs in each group. After 12 hours of fasting in the two groups, the DCM model was replicated by intravenous injection of streptozotocin (STZ) 150 mg/kg; for the Bama miniature pigs in the control group, citric acid-sodium citrate buffer 150 mg/kg was injected intravenously. After 10 months of modeling, the basic conditions of the two groups of animals were observed and their fasting blood glucose (FPG) levels were detected. The protein expression levels of NF-κB p65, TGF-β1, Bcl-2 and Bax in myocardial tissue of two groups were detected by Western Blot and the pathological changes of myocardial tissue were observed under electron microscope. Results In the model group, 4 models were successfully established, and 1 died. The model pigs had symptoms such as polydipsia, polyphagia, polyuria and decreased body weight. The FPG level in the model group was significantly higher than that in the control group (mmol/L: 25.53±3.75 vs. 4.68±0.77, P < 0.01). Compared with the control group, the protein expression levels of NF-κB p65, Bax and TGF-β1 in the myocardial tissue of model group were significantly increased (NF-κB p65/GAPDH: 0.46±0.05 vs. 0.38±0.02, Bax/GAPDH: 0.46±0.01 vs. 0.35±0.01, TGF-β1/GAPDH: 0.39±0.01 vs. 0.33±0.01, all P < 0.05) and the expression level of Bcl-2 protein was significantly decreased (Bcl-2/GAPDH: 0.33±0.01 vs. 0.42±0.01, P < 0.01). Electron microscopy results showed that the myofibrils of myocardial tissue in the DCM model group were disordered, and the number of mitochondria in the gap was significantly reduced. A large number of mitochondria with vacuolar degeneration were observed. Conclusions The DCM model of Bama miniature pigs can be successfully replicated after 10 months of high-dose STZ disposable ear vein injection. The DCM model miniature pigs have obvious glucose metabolism disorder, and their myocardial tissue has inflammatory reaction, cardiomyocyte apoptosis and fibrosis.