Objective To search,evaluate and synthesise the best available evidence on prevention strategies for unplanned extubation of nasogastric tube in adult inpatients and to offer a reference in management of safety and efficiency.Methods Literature on prevention strategies for unplanned extubation of nasogastric tube in adult inpatients was retrieved across BMJ Best Practice,UpToDate,JBI Center for Evidence Based Healthcare International Collaboration Library,Medlive,US National Guidelines Database,International Guidelines Collaboration Group,Scottish InterAcademy Guidelines Network,Ontario Registered Nurses Association of Canada,UK National Institute for Clinical Optimization,New Zealand Guidelines Research Group,PubMed,EMbase,Cochrane Library,Web of Science,EBSCO,CINAHL,CNKI,CBM Database,Wanfang Data and VIP Database,from the inception of databases to August 2024.Retrieved literature included guidelines,clinical decisions,recommended practices,evidence summaries,expert consensus and systematic reviews.Two researchers evaluated the literature methodologically and then summarised evidence from the included data.Results Fifteen publications(2 guidelines,1 clinical decision,3 recommended practices,7 evidences and 2 systematic reviews)were included.A total of 30 pieces of evidence were extracted and they were grouped into 7 themes:risk assessment,selection of nasogastric tube,depth of intubation,tube fixation,tube position,tube management and patient education.Conclusion Clinicians should integrate the best evidences into clinical practice and assess risk factors for unplanned extubation of nasogastric tube in adult inpatients.Personalised early intervention plans should be made to reduce or avoid the unplanned extubation.

Objective To search,evaluate and synthesise the best available evidence on prevention strategies for unplanned extubation of nasogastric tube in adult inpatients and to offer a reference in management of safety and efficiency.Methods Literature on prevention strategies for unplanned extubation of nasogastric tube in adult inpatients was retrieved across BMJ Best Practice,UpToDate,JBI Center for Evidence Based Healthcare International Collaboration Library,Medlive,US National Guidelines Database,International Guidelines Collaboration Group,Scottish InterAcademy Guidelines Network,Ontario Registered Nurses Association of Canada,UK National Institute for Clinical Optimization,New Zealand Guidelines Research Group,PubMed,EMbase,Cochrane Library,Web of Science,EBSCO,CINAHL,CNKI,CBM Database,Wanfang Data and VIP Database,from the inception of databases to August 2024.Retrieved literature included guidelines,clinical decisions,recommended practices,evidence summaries,expert consensus and systematic reviews.Two researchers evaluated the literature methodologically and then summarised evidence from the included data.Results Fifteen publications(2 guidelines,1 clinical decision,3 recommended practices,7 evidences and 2 systematic reviews)were included.A total of 30 pieces of evidence were extracted and they were grouped into 7 themes:risk assessment,selection of nasogastric tube,depth of intubation,tube fixation,tube position,tube management and patient education.Conclusion Clinicians should integrate the best evidences into clinical practice and assess risk factors for unplanned extubation of nasogastric tube in adult inpatients.Personalised early intervention plans should be made to reduce or avoid the unplanned extubation.

OBJECTIVE: To investigate the short-term effectiveness of uni-portal non-coaxial spinal endoscopic surgery (UNSES) via crossing midline approach (CMA) in the treatment of free lumbar disc herniation (FLDH). METHODS: Between March 2024 and June 2024, 16 patients with FLDH were admitted and treated with UNSES via CMA. There were 9 males and 7 females with an average age of 55.1 years (range, 47-62 years). The disease duration was 8-30 months (mean, 15.6 months). The pathological segments was L _{3, 4} in 4 cases, L _{4, 5} in 5 cases, and L ₅, S ₁ in 7 cases. The preoperative pain visual analogue scale (VAS) score was 6.9±0.9 and the Oswestry disability index (ODI) was 57.22%±4.16%. The operation time, intraoperative bleeding volume, postoperative hospital stay, and incidence of complications were recorded. The spinal pain and functional status were evaluated by VAS score and ODI, and effectiveness was evaluated according to the modified MacNab criteria. CT and MRI were used to evaluate the effect of nerve decompression. RESULTS: All 16 patients underwent operation successfully without any complications. The operation time was 63-81 minutes (mean, 71.0 minutes). The intraoperative bleeding volume was 47.3-59.0 mL (mean, 55.0 mL). The length of hospital stay after operation was 3-4 days (mean, 3.5 days). All patients were followed up 1-3 months, with 15 cases followed up for 2 months and 14 cases for 3 months. The VAS score and ODI gradually decreased over time after operation, and there were significant differences between different time points ( P<0.05). At 3 months after operation, the effectiveness was rated as excellent in 12 cases and good in 2 cases according to the modified MacNab criteria, with an excellent and good rate of 100%. CT and MRI during follow-up showed a significant increase in the diameter and cross-sectional area of the spinal canal, indicating effective decompression of the canal. CONCLUSION When using UNSES to treat FLDH, choosing CMA for nerve decompression has the advantages of wide decompression range, large operating space, and freedom of operation. It can maximize the preservation of the articular process, avoid fracture and breakage of the isthmus, clearly display the exiting and traversing nerve root, and achieve good short-term effectiveness.
Humans ; Male ; Intervertebral Disc Displacement/diagnostic imaging* ; Middle Aged ; Female ; Lumbar Vertebrae/surgery* ; Endoscopy/methods* ; Treatment Outcome ; Operative Time ; Pain Measurement ; Length of Stay

Purpose: Various types of trauma can cause retinal hemorrhages in children, including accidental and nonaccidental head trauma. We used animal eyes and a finite element model of the eye to examine stress patterns produced during purely linear and angular accelerations, along with stresses attained during simulated repetitive shaking of an infant. Methods: Using sheep and primate eyes, sclerotomy windows were created by removing the sclera, choroid, and retinal pigment epithelium to expose the retina. A nanofiber square was glued to a 5 mm2 area of retina. The square was pulled and separated from vitreous while force was measured. A finite element model of the pediatric eye was used to computationally measure tension stresses during shaking. Results: In both sheep and primate eyes, tension stress required for separation of retina from vitreous range from 1 to 5 kPa. Tension stress generated at the vitreoretinal interface predicted by the computer simulation ranged from 3 to 16 kPa during a cycle of shaking. Linear acceleration generated lower tension stress than angular acceleration. Angular acceleration generated maximal tension stress along the retinal vasculature. Linear acceleration produced more diffuse force distribution centered at the poster pole. Conclusions The finite element model predicted that tension stress attained at the retina during forcible shaking of an eye can exceed the minimum threshold needed to produce vitreoretinal separation as measured in animal eyes. Furthermore, the results show that movements that involve significant angular acceleration produce strong stresses localized along the vasculature, whereas linear acceleration produces weaker, more diffuse stress centered towards the posterior pole of the eye.

Objective To establish a pure planarian Dugesiaasexual strain in China.Methods The planarian worms were collected from a wild stream,and then made the worm grow after amputation in the lab.To establish an asexual strain through cutting and culturing for the single worms.Results After ten years and more than ten thousand experiments,an asexual pure planarian strain Dugesia ZB-1 originated from Shandong Zibo area was established.It grows stably under laboratory controlled conditions.Conclusions The establishment of DugesiaZB-1 Priovides a solid foundation for further experiments and promoting planarian research in our country and participation in the field of the international planarian research.

Objective To know the situation of time delay from the patients with ischemic stroke arrived the emergency to accepted the thrombolysis treatment, and analyze the related factors in order to put forward effective process optimization measures. Methods Totally 122 patients with acute ischemic stroke admitted into a Beijing grade A tertiary hospital who needed receive thrombolysis treatment from June 2014 to June 2015 were selected as the research object according to the purpose sampling method. Then we recorded the time in the whole process which were devided into 4 steps ( arrived at the emergency department- obtained consultation of stroke physicians;obtained consultation of stroke physicians- arrived in CT chamber; arrived in CT chamber- got CT scan results; got CT scan results- accepted thrombolysis therapy ) . Results The time delayed in hospital of intravenous thrombolysis group and artery thrombolysis group were (114.95±29.48)min and (171.22±50.10)min. The step of biggest delta-T between the actual time and standard time of two groups were both from getting a CT scan results to accepting thrombolysis therapy.Conclusions The delay after getting a CT scan results is the most important reason of delay in hospital. Shorten the time of blood test, optimize the hospital management and perfect the construction of the green channel, can promote the situation of the delay in hospital, and, improve the efficiency of thrombolysis treatment.

Objective To compare predicting validity of general movements (GMs) assessment for neurodevelopment outcome of high-risk premature infants in different gestational age. Methods 180 participants were divided into group A (28 to 31+6 gestational weeks), group B (32 to 33+6 gestational weeks) and group C (34 to 36+6 gestational weeks) according to gestational age, and evaluated by GMs assess-ments in the stage of writhing-movement and fidgety-movement respectively. They were evaluated with GMs assessment and Gesell devel-opmental scale, and cerebral palsy was diagnosed clinically. Results 133 infants were normal and 47 infants with developmental delay, in which 10 were with cerebral palsy. The sensitivity was 40.4%, the specificity was 90.2%, the positive predictive value was 59.4%, the nega-tive predictive value was 81.1% in the stage of writhing-movement; and it was 27.7%, 99.2%, 92.9% and 79.5% in the stage of fidg-ety-movement, respectively. There was no significantly difference in the detection rate among different age groups (P=0.610, P=0.765, P=0.290). Conclusion The absent fidgety-movement (F-) is the highest, and cramped-synchronized (CS) is the secondly to predict the motor de-velopmental outcome. There was no difference of GMs assessment to detect the neurodevelopmental outcome in premature infants of 28 to 36+6 gestational weeks.

Objective To explore the correlation between serum level of cystatin C and coronary slow flow (CSF).Methods Thirty-four patients with CSF were enrolled in CSF group and thirty-five patients with normal coronary flow and angiographically normal coronary arteries were enrolled in control group.Coronary flow patterns was assessed by corrected thrombolysis in myocardial infarction (TIMI) frame count.The change of serum high sensitivity C-reactive protein,uric acid,cystatin C were measured.Results There was no significant difference between two groups with respect to gender,age,history of smoking,prevalence of hypertension and diabetes mellitus,family history of coronary heart disease,low density lipoprotein,α-lipoprotein (P ＞0.05).Compared with control group,the level of serum high sensitivity C-reactive protein,cystatin C,uric acid in CSF group were obviously higher [(4.85 ± 6.39) mg/L vs.(2.55 ± 2.18) mg/L,(0.87 ± 0.22) mg/L vs.(0.75 ± 0.16) mg/L,(329.68 ± 85.46) μ mol/L vs.(278.97 ± 76.74) μ mol/L] (P ＜ 0.05 or ＜ 0.01).Logistic regression analysis showed that cystatin C increased as independent risk factors for CSF (P =0.002,OR =0.009).Conclusion High level of cystatin C may play an important role in the occurrence and development of CSF.

Objective To observe the effect of sensory integration training on motor function of cerebral palsy children.Methods 42 children with cerebral palsy were divided into two groups,with 22 cases in observation group,20 cases in control group.All children were treated with mainly Bobath technique based rehabilitation therapy,while those of observation group were added sensory integration training for 3 months.We used GMFM-88 to estimate the gross motor function of the two groups.Results After treatment,the scores of GMFM-88 significantly improved in both groups,GMFM scores of the observation group were more effective than thoes of the control group(t =2.481,P =0.018).Conclusion Sensory integration training based on tradition neural movement therapy can improve gross motor function in children with cerebral palsy,can significantly improve the curative effect of rehabilitation.

Objective To observe the effects of body weight support training on walking ability of children with cerebral palsy. Methods 40 cases were divided into observation group (n=20) and control group (n=20). All the children accepted rehabilitation therapy based on Bobath approach and biofeedback, while those of observation group accepted body weight support training in addition, for 2 months. They were assessed with Gross Motor Function Measure (GMFM) D and E dimension before and after treatment. Results Both the scores of D and E dimension significantly improved in both groups after treatment (P<0.05), and improved more in the observation group than in the control group (P<0.05). Conclusion Body weight support training can further improve the walking ability in children with cerebral palsy.