Nocardia is a Gram-positive pathogen responsible for causing dairy mastitis,which leads to purulent granulomatous lesions in mammary tissue and can significantly impact the dairy indus-try,resulting in substantial economic losses.To develop a rapid and accurate diagnostic method for detecting Nocardia of bovine origin,a conserved sequence of the 16S rRNA gene from Nocardia was selected from the NCBI database.Based on this sequence,a pair of primers and a TaqMan fluo-rescent quantitative probe were designed.The validation of the TaqMan fluorescence quantitative PCR(qPCR)method found in this study showed that the Ctvalue had a good linear relationship with recombinant plasmid concentrations ranging from 1×1010 to 1×102 copies/μL,with a regres-sion equation of y=-3.536x+43.78,a correlation coefficient(R2)of 0.997 5,a slope of-3.536,and an amplification efficiency(E)of 91％(where 90％＜E＜110％).The specificity was strong,with no cross-reactions with other pathogens.The standard curve had a high sensitivity with a low-er detection limit of 1 × 102 copies/μL,it was 100-fold higher than conventional PCR.The repeatability of the standard curve was also good.Both intra-and inter-group coefficients of varia-tion were below 2％.Using this method,234 milk samples and 80 environmental samples were tested using this method,respectively,with a positive detection rate of 27.07％,whereas conven-tional PCR had a positive detection rate of 19.43％,indicating that this method was more sensitive compared to conventional PCR.The fluorescent quantitative PCR detection method established in this study provides an effective means for the clinical detection of Nocardia in dairy cows.

Triglyceride(TG)is transported in the blood as specific triglyceride-rich lipoprotein(TRL).When TRL is overproduced or the catabolism is not timely,cholesterol ester-rich residues is formed.Both TRL and its residues contribute to the development of atherosclerosis(As)through various direct and indirect mechanisms.Currently,the combination of lifestyle interventions and Western medicines is considered the preferred treatment strategy for As.Howev-er,lipid-lowering therapy alone cannot fully eliminate the residual risk of As.In contrast,traditional Chinese medicine emphasizes the holistic regulation of bodily functions to prevent and treat As.This paper will begin by examining the met-abolic mechanisms of TRL,elucidate the role of TRL and its residues in the risk of As occurrence,and summarize current strategies targeting the TRL metabolic pathway to reduce the incidence of As.

Triglyceride(TG)is transported in the blood as specific triglyceride-rich lipoprotein(TRL).When TRL is overproduced or the catabolism is not timely,cholesterol ester-rich residues is formed.Both TRL and its residues contribute to the development of atherosclerosis(As)through various direct and indirect mechanisms.Currently,the combination of lifestyle interventions and Western medicines is considered the preferred treatment strategy for As.Howev-er,lipid-lowering therapy alone cannot fully eliminate the residual risk of As.In contrast,traditional Chinese medicine emphasizes the holistic regulation of bodily functions to prevent and treat As.This paper will begin by examining the met-abolic mechanisms of TRL,elucidate the role of TRL and its residues in the risk of As occurrence,and summarize current strategies targeting the TRL metabolic pathway to reduce the incidence of As.

Nocardia is a Gram-positive pathogen responsible for causing dairy mastitis,which leads to purulent granulomatous lesions in mammary tissue and can significantly impact the dairy indus-try,resulting in substantial economic losses.To develop a rapid and accurate diagnostic method for detecting Nocardia of bovine origin,a conserved sequence of the 16S rRNA gene from Nocardia was selected from the NCBI database.Based on this sequence,a pair of primers and a TaqMan fluo-rescent quantitative probe were designed.The validation of the TaqMan fluorescence quantitative PCR(qPCR)method found in this study showed that the Ctvalue had a good linear relationship with recombinant plasmid concentrations ranging from 1×1010 to 1×102 copies/μL,with a regres-sion equation of y=-3.536x+43.78,a correlation coefficient(R2)of 0.997 5,a slope of-3.536,and an amplification efficiency(E)of 91％(where 90％＜E＜110％).The specificity was strong,with no cross-reactions with other pathogens.The standard curve had a high sensitivity with a low-er detection limit of 1 × 102 copies/μL,it was 100-fold higher than conventional PCR.The repeatability of the standard curve was also good.Both intra-and inter-group coefficients of varia-tion were below 2％.Using this method,234 milk samples and 80 environmental samples were tested using this method,respectively,with a positive detection rate of 27.07％,whereas conven-tional PCR had a positive detection rate of 19.43％,indicating that this method was more sensitive compared to conventional PCR.The fluorescent quantitative PCR detection method established in this study provides an effective means for the clinical detection of Nocardia in dairy cows.

Objective:To investigate the incidence and risk factors of deep vein thrombosis(DVT)in patients with rheumatoid arthritis(RA).Methods:The clinical data of RA patients who were hospi-talized in the Department of Rheumatology and Immunology of Aerospace Center Hospital from May 2015 to September 2021 was retrospectively analyzed,including demographic characteristics,concomitant diseases,laboratory examinations(blood routine,biochemistry,coagulation,inflammatory markers,rheumatoid factor,antiphospholipid antibodies and lupus anticoagulant,etc.)and treatment regimens.The patients were compared according to the presence or absence of DVT,and the t test,Mann-Whitney U test or Chi-square test were applied to screen for relevant factors for DVT,followed by Logistic regres-sion analysis to determine risk factors for DVT in patients with RA.Results:The incidence of DVT in the RA patients was 9.6％(31/322);the median age of RA in DVT group was significantly older than that in non-DVT group[64(54,71)years vs.50(25,75)years,P＜0.001];the level of disease activity score using 28 joints(DAS28)-erythrocyte sedimentation rate(ESR)in DVT group was higher than that in non-DVT group[5.2(4.5,6.7)vs.4.5(4.5,5.0),P＜0.001];the incidence of hypertension,chronic kidney disease,fracture or surgery history within 3 months,and varicose veins of the lower ex-tremities in DVT group was higher than that in non-DVT group(P＜0.001).The levels of hemoglobin and albumin in DVT group were significantly lower than that in non-DVT group(P=0.009,P=0.004),while the D-dimer level and rheumatoid factor positive rate in DVT group were significantly higher than that in non-DVT group(P＜0.001).The use rate of glucocorticoid in DVT group was higher than that in non-DVT group(P=0.009).Logistic regression analysis showed that the age(OR=1.093,P＜0.001),chronic kidney disease(OR=7.955,P=0.005),fracture or surgery history with-in 3 months(OR=34.658,P=0.002),DAS28-ESR(OR=1.475,P=0.009),and the use of glu-cocorticoid(OR=5.916,P=0.003)were independent risk factors for DVT in RA patients.Conclu-sion:The incidence of DVT in hospitalized RA patients was significantly increased,in addition to tradi-tional factors,such as age and chronic kidney disease,increased DAS28-ESR level and the use of glu-cocorticoid were also independent risk factors for DVT.

Objective:To investigate the risk factors affecting the delay of recovery in patients under general anesthesia.Methods:Patients who underwent radical mastectomy for breast cancer in our hospital from Jul. 2020 to Aug. 2022 were selected as the research objects, and the effective data of 80 patients were obtained after screening. The patients were divided into the non-delayed recovery group (54 cases) and the delayed recovery group (26 cases). The general conditions and perioperative data of the two groups were compared, and the high-risk factors affecting delayed recovery from anesthesia were analyzed using the Logistic hazard proportional regression model. Results:In general, there were no significant differences in body mass index, hypertension, diabetes, tumor size, tumor subtype, tumor location, or tumor stage between the non-delayed awakening group and the delayed awakening group (all P>0.05). The average age of patients in the wake-up delay group was (53.28±11.01), the proportion of anemia was 42.30% (11/26), and the proportion of ASA Ⅱ patients was 76.92% (20/26) compared with the average age of the non-wake-up delay group (46.89±6.91) ( t=3.17, P=0.002), the proportion of anemia was 20.37% (11/54) ( χ2=3.17, P=0.040), the proportion of ASA Ⅱ patients was 27.78% (15/54) ( χ2=17.22, P<0.001), which was significantly increased. In the perioperative data, there was no statistical significance in the intraoperative combined epidural anesthesia between the non-delayed recovery group and the delayed recovery group (all P>0.05). The data of the patients in the delayed recovery group, including average intraoperative blood loss (234.14±32.28), operation time (229.47±29.84), anesthesia time (246.14±35.64) and intraoperative compound sevoflurane inhalation accounted for 69.23% (18/26) ,which were significantly increased compared with the data of non-delayed recovery group following, including the average intraoperative blood loss (215.48±29.54) ( t=2.57, P=0.012), operation time (206.35±27.41) ( t=3.43, P=0.001), anesthesia time (215.61±28.54) ( t=4.13, P<0.001), intraoperative compound sevoflurane inhalation (44.44%, 24/54). Through Logistic hazard ratio regression analysis, it was found that age ( OR=1.15, 95% CI: 1.05-1.30, P=0.008), ASA Ⅱ grade ( OR=9.49, 95% CI: 2.05-60.94, P=0.008), intraoperative bleeding volume ( OR=1.04, 95% CI: 1.01-1.08, P=0.012), operation time ( OR=1.05, 95% CI: 1.01-1.08, P=0.009), and anesthesia time ( OR=1.04, 95% CI: 1.02-1.07, P=0.004) were high-risk factors affecting the delayed recovery from anesthesia. Conclusion:Increasing age, high grade of ASA, heavy intraoperative blood loss, long operation time and anesthesia time are independent risk factors affecting delayed recovery from anesthesia.

Objective:To review the scope of related factors that affect the elderly′s participation in digital health intervention, and to provide a certain reference for the application and development of smart elderly technology.Methods:Based on the scope review guidelines issued by the Joanna Briggs Institute in Australia in 2019, the inclusion and exclusion criteria were determined according to the PCCS principles. Chinese and English literatures were searched in PubMed, Cochrane Library, JBI, CINAHL, Web of Science, Scopus, CNKI, Wanfang database and Chinese biomedical literature database. The search time limit was from the establishment of the database to November 30, 2021. Two researchers independently read, and used EndNoteX9 and Excel tables to extract relevant data from the literature for summary and analysis.Results:Totally 20 articles were selected, including 2 mixed studies, 10 cross-sectional studies, 6 qualitative studies, and 2 quasi-experimental studies. Relevant factors affecting the participation of the elderly in digital health interventions involved the developers, users and the user himself of digital health intervention systems, including the degree of system integration of system development, the degree of autonomy of the elderly, the credibility and accessibility of system equipment and ease of use; the degree of compatibility of equipment in the process of use, the degree of digital infrastructure configuration, the degree of Internet penetration, the availability and reliability of health information resources, the degree of training and education, the degree of communication with the elderly in the process of participation, financial payment, etc.; the four inherent factors of the elderly included the cost of technology use, technical anxiety, privacy and safety, and health needs.Conclusions:The elderly, medical staff, developers and other stakeholders should jointly participate in decision-making on the development and management of the digital health intervention system for the elderly, especially by inviting and empowering the elderly , and improve the training and feedback of the system application and use process, accelerate the popularization and promotion of technical resources, and increase social capital and financial payment incentives to reduce the burden on the elderly and the medical system.

Objective:To evaluate the efficacy of ultrasound-guided adductor canal approach to nerve block using one-puncture four-point technique for analgesia after total knee arthroplasty (TKA).Methods:Sixty patients of both sexes, aged 65-80 yr, with body mass index of 18-27 kg/m 2, of American Society of Anesthesiologists physical status Ⅱor Ⅲ, scheduled for elective unilateral TKA under general anesthesia, were enrolled in this study.Peripheral nerve block was performed for postoperative analgesia under ultrasound guidance.All the patients were allocated into 2 groups ( n=30 each) using a random number table method: adductor canal block combined with posterior approach to sciatic nerve block group (group ASB) and adductor canal approach to nerve block using one-puncture four-point technique including sciatic nerve, medial vastus muscle nerve, saphenous nerve, anterior femoral cutaneous nerve at adductor canal level group (group ANSB). When visual analogue scale score ≥4 during postoperative movement, ketorolac tromethamine 0.6 mg/kg was intravenously injected as rescue analgesic. The muscle strength of quadriceps on the affected side, range of knee joint motion and rate of the ability to walk for 10 m using the walker were recorded at 2, 8, 24 and 48 h after surgery.The consumption of analgesics for rescue analgesia, manipulation completion time, length of hospital stay and patients′ satisfaction score were recorded within 48 h after surgery. Results:Compared with group ASB, the consumption of ketorolac tromethamine was significantly reduced, manipulation completion time and length of hospital stay were shortened, patients′ satisfaction scores were increased, and the range of knee joint motion and rate of the ability to walk for 10 m using the walker were increased at 2, 8, 24 and 48 h after surgery in group ANSB ( P<0.05). There was no significant difference in muscle strength of quadriceps between two groups ( P>0.05). Conclusion:Ultrasound-guided adductor canal approach to nerve block using one-puncture four-point technique provides better efficacy than adductor canal block combined with posterior approach to sciatic nerve block when used for analgesia after TKA.

Objective:To explore the effect of smoking on the wound healing of stage 4 pressure ulcers in rats.Methods:Fifty male Sprague-Dawley rats aged 6-8 weeks were divided into simple pressure ulcer group and smoking+ pressure ulcer group according to the random number table, with 25 rats in each group. After the rats in the smoking+ pressure ulcer group received passive smoking intervention for 12 weeks, an iron plate was placed in the back muscle of each rat in 2 groups, and a magnet was placed outside the skin at the corresponding position of the iron plate for 2 h at each time, with 5 times a day and continuously for 6 days to reproduce stage 4 pressure ulcer model. Immediately after establishing the model, 3 rats in each group were sacrificed and wound tissue was collected, and hematoxylin-eosin staining was applied to observe the pathological changes of the wounds. On 1, 3, 7, and 14 day (s) after establishing the model, 3 rats in each group were collected to measure the pressure ulcer wound area by the paper jam method. After measurement of the wound area, the rats were sacrificed and the wound tissue was collected, and the protein expression levels of matrix metalloproteinases 9 (MMP-9) and tissue inhibitor of metalloproteinase 1 (TIMP-1) in wound tissue were detected by immunohistochemical method, and the ratio of MMP-9/TIMP-1 was calculated.The wound healing time of the remaining 10 rats in each group was recorded. Data were statistically analyzed with analysis of variance for factorial design, two independent sample t test, and Bonferroni correction. Results:(1) Immediately after establishing the model, muscle fiber necrosis and dissolution with large areas were seen on the wound, the myofibrils arranged loosely, and more lymphocytes and monocytes infiltration were seen around the wound of rats in simple pressure ulcer group. A large number of necrotic myofibers were dissolved and gradually disappeared, the myofibrils arranged loosely, and the number of diffuse lymphocytes and monocyte infiltration in wound of rats in smoking+ pressure ulcer group were significantly higher than those in simple pressure ulcer group. (2) The wound areas of rats in smoking+ pressure ulcer group were significantly larger than those in simple pressure ulcer group on 1, 3, 7, and 14 day (s) after establishing the model ( t=3.019, 2.549, 2.181, 3.674, P<0.05 or P<0.01). (3) On 1 to 14 days after establishing the model, the protein expression levels of MMP-9 and TIMP-1 in the wound tissue and the ratio of MMP-9/TIMP-1 of rats in the two groups increased first and then decreased. On 1, 3, 7, and 14 day (s) after establishing the model, the protein expression levels of MMP-9 in the wound tissue and the ratio of MMP-9/TIMP-1 of rats in smoking+ pressure ulcer group were significantly higher than those in simple pressure ulcer group ( t=4.783, 4.508, 6.325, 7.204, 3.078, 2.989, 4.081, 4.696, P<0.05 or P<0.01), and the protein expression levels of TIMP-1 in wound tissue of rats in the two groups were similar. (4) The wound healing time of rats in smoking+ pressure ulcer group was (48.9±2.6) d, which was significantly longer than (35.2±2.3) d of simple pressure ulcer group ( t=12.477, P<0.05). Conclusions:Smoking can up-regulate the expression of MMP-9 in pressure ulcer wound and result in an imbalance of MMP-9/TIMP-1, thereby affecting the wound healing of stage 4 pressure ulcers in rats.

Objective To compare of the application of tracheal intubation guided by Lightwand,Shikani optical stylet,or Macintosh. Methods Ninety ASA Ⅰ~Ⅱ patients undergoing elective general anesthesia were randomly divided into three groups(n = 30):Macintosh group(group M),Lightwand group(group L)and Shi-kani optical stylet group(group S). MAP and HR were recorded at the time of entering the operating room(T1), before intubation(T2),at the immediate time of intubation(T3),3 mins(T4)and 5 mins after intubation(T5). The intubation duration,the first intubation success rate,the number of intubation,and the incidence of complications including sore throat were observed. Results As compared with T1,MAP and HR decreased significantly at T2in the three groups(P<0.05). As compared with T2,HR increased in group L and MAP and HR increased in group S at T3(P<0.05). As compared with group M,MAP and HR at T4and T5were lower in groups L and S(P<0.05). The first intubation time was obviously shorter in group L than in other groups(P<0.05). The incidence of compli-cations was lower in group S(P < 0.05). The first success rate of intubation,the intubation times and the inci-dence of airway complications did not differ significantly among the three groups.(P > 0.05). Conclusions As compared with Macintosh,Lightwand and Shikani optical stylet have less influence on hemodynamic parameters. Lightwand needs shorter intubation time,Shikani optical stylet has the lowest rate of sore throat.