Objective:To assess the effects of recognition function of four-lead electrocardiogram(ECG)synchronization technique and multi-parameter fusion technique in reducing the number of false alarms and improving the quality of alarms in intensive care units(ICU).Methods:Four-lead ECG synchronization technique and multi-parameter fusion technique were used to strengthen the monitoring and assessment for the alarm of clinical monitors,and reduce the false alarm rate of monitors.The clinical alarm data of bed units corresponding to 48 monitors in clinical use of ICU,cardiovascular intensive care unit(CCU)and neurosurgery intensive care unit(NICU)of Hainan General Hospital from October 14 to December 27,2024 were selected.According to the opening and close of the four-lead ECG synchronization and multi-parameter fusion technique algorithm of the monitors,they were divided into group A(opened four-lead ECG synchronization and multi-parameter fusion),group B(opened four-lead ECG synchronization,but closed multi-parameter fusion),group C(closed four-lead ECG synchronization,but opened multi-parameter fusion)and group D(closed four-lead ECG synchronization and multi-parameter fusion),with 12 units in each group.The numbers of total alarms and false alarms generated by monitor of each bed unit among different optimization strategies were compared.Results:The numbers of average daily alarm of the monitors in groups A,B and C were respectively(134.2±32.4)cases,(392.5±68.2)cases and(583.4±126.5)cases,which were lower than those in group D(1 073.2±168.6),with statistically significant differences(Z=3.45,2.94,2.52,P<0.05).The optimization rates of the alarm numbers in groups A,B and C were increased by 87.51%,63.47%and 45.67%,respectively.The rates of average false alarm of the monitors in groups A,B and C were respectively(1.04±0.15)%,(1.73±0.12)%and(2.07±0.08)%,which were lower than(3.76±0.2)%in group D,with statistically significant differences(Z=3.45,2.94,2.52,P<0.05).Conclusion:Four-lead ECG synchronization technique and multi-parameter fusion technique can effectively optimize the number of alarms in ICU,and reduce the proportion of false alarms of monitors in department,and decrease fatigue of medical staffs for alarm.

Objective To investigate the clinical efficacy of Guhong Injection for the treatment of patients with coronary microvascular dysfunction(CMD)of qi stagnation and blood stasis syndrome.Methods Sixty cases of patients with CMD of qi stagnation and blood stasis syndrome who were admitted to Guangdong Provincial Hospital of Chinese Medicine from June 2021 to August 2022 were randomly divided into the control group and the trial group according to the random number table method,with 30 cases in each group.The control group was treated with conventional western medicine,and the trial group was treated with Guhong Injection on the basis of treatment for the control group.The course of treatment for the two groups covered 10 days.The changes in traditional Chinese medicine(TCM)syndrome scores,and levels of lipid indicators,serum inflammatory factors and endothelial factors in the two groups were observed before and after treatment.After treatment,the clinical efficacy of the two groups was evaluated.Results(1)During the trial,three cases in the control group and two cases in the trial group fell off and a total of 55 cases were finally included in the statistical analysis of efficacy,including 27 cases in the control group and 28 cases in the trial group.(2)After 10 days of treatment,the total effective rate of the trial group was 89.29%(25/28),and that of the control group was 40.74%(11/27),and the intergroup comparison(tested by chi-square test)showed that the therapeutic efficacy of the trial group was significantly superior to that of the control group(P<0.01).(3)After treatment,the TCM syndrome scores of patients in both groups were decreased compared with those before treatment(P<0.05),and the decrease in the trial group was significantly superior to that in the control group(P<0.01).(4)After treatment,the levels of lipid indicators triglyceride(TG),total cholesterol(TC),and low-density lipoprotein cholesterol(LDL-C)in the two groups of patients were decreased compared with those before treatment(P<0.05),and the level of high-density lipoprotein cholesterol(HDL-C)was increased compared with that before treatment(P<0.05).The intergroup comparison showed that the decrease of TG,TC,and LDL-C levels as well as the increase of HDL-C level in the trial group was significantly superior to that in the control group(P<0.05 or P<0.01).(5)After treatment,the serum levels of inflammatory factors high-sensitivity C-reactive protein(hs-CRP),interleukin 6(IL-6)and tumor necrosis factor α(TNF-α)in the two groups of patients were decreased compared with those before treatment(P<0.05),and the decrease in the trial group was significantly superior to that in the control group(P<0.01).(6)After treatment,the serum level of endothelial factor nitric oxide(NO)in the two groups of patients was increased(P<0.05)and the serum endothelin 1(ET-1)level was decreased compared with that before treatment(P<0.05),and the increase of serum NO level,as well as the decrease of serum ET-1 level in the trial group was significantly superior to that in the control group(P<0.05 or P<0.01).Conclusion Based on the conventional treatment in western medicine,the application of Guhong Injection in the treatment of patients with CMD of qi stagnation and blood stasis syndrome exerts remarkable efficacy,which can effectively alleviate the symptoms,regulate the levels of blood lipids,reduce the inflammatory response,and improve the endothelial function.

AIM:This study aims to investigate the role of dynamin-related protein 1(Drp1)in the A1 type activation of astrocytes and elucidate the underlying mechanism of abnormal astrocyte activation.METHODS:Rat astro-cyte line CTX-TNA2 was divided into control group,astrocyte-conditioned medium(ACM)group,and 5,10 and 25 μmol/L mitochondrial division inhibitor-1(Mdivi-1;a selective inhibitor of Drp1)+ACM group.The cells in ACM group were exposed to ACM containing interleukin-1α(IL-1α),tumor necrosis factor-α(TNF-α)and complement 1q(C1q)for 24 h to induce type A1 activation,while those in Mdivi-1+ACM group were pre-treated with various concentrations of Mdi-vi-1 for 2 h before stimulation with ACM for 24 h.RT-qPCR was used to detect the expression levels of A1 type activation-related indicators IL-1β,TNF-α and IL-10 mRNA in each group.Immunofluorescence was utilized to assess the expres-sion levels of A1 type activation marker molecules C3,inducible nitric oxide synthase(iNOS)and S100 calcium binding protein A10(S100A10).The level of mitochondrial reactive oxygen species(ROS)was measured using MitoSOX Red staining and flow cytometry analysis.The mitochondrial morphology was observed using the MICA full-field imaging analy-sis platform.Lastly,the expression level of mitochondrial fission protein 1(FIS1)and the activation level of Drp1 in each group were evaluated through immunoblotting analysis.RESULTS:The RT-qPCR and immunofluorescence results indi-cated that the ACM group exhibited significantly elevated levels of IL-1β and TNF-α mRNA,and C3 protein expression compared with control group,along with increased iNOS protein expression and reduced IL-10 mRNA and S100A10 pro-tein expression(P＜0.05).Interventions with 10 and 25 μmol/L Mdivi-1 effectively inhibited the rise in IL-1β and TNF-α mRNA,and C3 and iNOS protein expression induced by ACM,while promoting S100A10 expression.MitoSOX Red staining revealed a significant increase in mitochondrial ROS levels in astrocytes stimulated by ACM,which was effectively re-versed by Mdivi-1 intervention.The MICA full-field imaging analysis platform demonstrated that ACM induced the forma-tion of round-shaped mitochondria in astrocytes,while 10 and 25 μmol/L Mdivi-1 interventions facilitated the restoration of their tubular shape.Additionally,Western blot results confirmed that Mdivi-1 intervention effectively reversed the acti-vation of Drp1 and FIS1.CONCLUSION:The Drp1-mediated mitochondrial fission represents one of the intrinsic molecu-lar mechanisms underlying A1 type activation of astrocytes,and Mdivi-1,as a selective inhibitor of Drp1,can effectively inhibit abnormal astrocyte activation.

Hemophilia is a hereditary coagulation disorder, in which patients often suffer from joint dysfunction due to recurrent joint bleeding, with the knee joint being particularly susceptible to involvement, thereby significantly impairing their ability to walk.Gait analysis, as an objective, quantitative, and comprehensive assessment tool, can be employed to accurately evaluate the walking function of patients and provide a scientific basis for the rehabilitation management of individuals with hemophilia.With the deepening of medical research, the role of gait analysis in the rehabilitation management of hemophilia is increasingly being recognized.This review article summarizes the application of gait analysis in the rehabilitation management of hemophilia, including changes in gait parameters, kinematic and kinetic characteristics of joints in patients with hemophilia, as well as the relationships between these parameters and the severity of the disease and treatment outcomes in hemophilia patients, exploring the role of gait analysis in the rehabilitation management of hemophilia to better apply it in clinical practice.

AIM:This study aims to investigate the role of dynamin-related protein 1(Drp1)in the A1 type activation of astrocytes and elucidate the underlying mechanism of abnormal astrocyte activation.METHODS:Rat astro-cyte line CTX-TNA2 was divided into control group,astrocyte-conditioned medium(ACM)group,and 5,10 and 25 μmol/L mitochondrial division inhibitor-1(Mdivi-1;a selective inhibitor of Drp1)+ACM group.The cells in ACM group were exposed to ACM containing interleukin-1α(IL-1α),tumor necrosis factor-α(TNF-α)and complement 1q(C1q)for 24 h to induce type A1 activation,while those in Mdivi-1+ACM group were pre-treated with various concentrations of Mdi-vi-1 for 2 h before stimulation with ACM for 24 h.RT-qPCR was used to detect the expression levels of A1 type activation-related indicators IL-1β,TNF-α and IL-10 mRNA in each group.Immunofluorescence was utilized to assess the expres-sion levels of A1 type activation marker molecules C3,inducible nitric oxide synthase(iNOS)and S100 calcium binding protein A10(S100A10).The level of mitochondrial reactive oxygen species(ROS)was measured using MitoSOX Red staining and flow cytometry analysis.The mitochondrial morphology was observed using the MICA full-field imaging analy-sis platform.Lastly,the expression level of mitochondrial fission protein 1(FIS1)and the activation level of Drp1 in each group were evaluated through immunoblotting analysis.RESULTS:The RT-qPCR and immunofluorescence results indi-cated that the ACM group exhibited significantly elevated levels of IL-1β and TNF-α mRNA,and C3 protein expression compared with control group,along with increased iNOS protein expression and reduced IL-10 mRNA and S100A10 pro-tein expression(P＜0.05).Interventions with 10 and 25 μmol/L Mdivi-1 effectively inhibited the rise in IL-1β and TNF-α mRNA,and C3 and iNOS protein expression induced by ACM,while promoting S100A10 expression.MitoSOX Red staining revealed a significant increase in mitochondrial ROS levels in astrocytes stimulated by ACM,which was effectively re-versed by Mdivi-1 intervention.The MICA full-field imaging analysis platform demonstrated that ACM induced the forma-tion of round-shaped mitochondria in astrocytes,while 10 and 25 μmol/L Mdivi-1 interventions facilitated the restoration of their tubular shape.Additionally,Western blot results confirmed that Mdivi-1 intervention effectively reversed the acti-vation of Drp1 and FIS1.CONCLUSION:The Drp1-mediated mitochondrial fission represents one of the intrinsic molecu-lar mechanisms underlying A1 type activation of astrocytes,and Mdivi-1,as a selective inhibitor of Drp1,can effectively inhibit abnormal astrocyte activation.

Objective:To assess the effects of recognition function of four-lead electrocardiogram(ECG)synchronization technique and multi-parameter fusion technique in reducing the number of false alarms and improving the quality of alarms in intensive care units(ICU).Methods:Four-lead ECG synchronization technique and multi-parameter fusion technique were used to strengthen the monitoring and assessment for the alarm of clinical monitors,and reduce the false alarm rate of monitors.The clinical alarm data of bed units corresponding to 48 monitors in clinical use of ICU,cardiovascular intensive care unit(CCU)and neurosurgery intensive care unit(NICU)of Hainan General Hospital from October 14 to December 27,2024 were selected.According to the opening and close of the four-lead ECG synchronization and multi-parameter fusion technique algorithm of the monitors,they were divided into group A(opened four-lead ECG synchronization and multi-parameter fusion),group B(opened four-lead ECG synchronization,but closed multi-parameter fusion),group C(closed four-lead ECG synchronization,but opened multi-parameter fusion)and group D(closed four-lead ECG synchronization and multi-parameter fusion),with 12 units in each group.The numbers of total alarms and false alarms generated by monitor of each bed unit among different optimization strategies were compared.Results:The numbers of average daily alarm of the monitors in groups A,B and C were respectively(134.2±32.4)cases,(392.5±68.2)cases and(583.4±126.5)cases,which were lower than those in group D(1 073.2±168.6),with statistically significant differences(Z=3.45,2.94,2.52,P<0.05).The optimization rates of the alarm numbers in groups A,B and C were increased by 87.51%,63.47%and 45.67%,respectively.The rates of average false alarm of the monitors in groups A,B and C were respectively(1.04±0.15)%,(1.73±0.12)%and(2.07±0.08)%,which were lower than(3.76±0.2)%in group D,with statistically significant differences(Z=3.45,2.94,2.52,P<0.05).Conclusion:Four-lead ECG synchronization technique and multi-parameter fusion technique can effectively optimize the number of alarms in ICU,and reduce the proportion of false alarms of monitors in department,and decrease fatigue of medical staffs for alarm.

To investigate the influencing factors of postoperative complications following thoracoscopic lung resection in elderly patients and to provide a scientific basis for developing preoperative prehabilitation strategies for high-risk elderly populations.

Objective:To study the current status of longitudinal extrauterine growth restriction (EUGR) in extremely preterm infants (EPIs) and to develop a prediction model based on clinical data from multiple NICUs.Methods:From January 2017 to December 2018, EPIs admitted to 32 NICUs in North China were retrospectively studied. Their general conditions, nutritional support, complications during hospitalization and weight changes were reviewed. Weight loss between birth and discharge > 1SD was defined as longitudinal EUGR. The EPIs were assigned into longitudinal EUGR group and non-EUGR group and their nutritional support and weight changes were compared. The EPIs were randomly assigned into the training dataset and the validation dataset with a ratio of 7∶3. Univariate Cox regression analysis and multiple regression analysis were used in the training dataset to select the independent predictive factors. The best-fitting Nomogram model predicting longitudinal EUGR was established based on Akaike Information Criterion. The model was evaluated for discrimination efficacy, calibration and clinical decision curve analysis.Results:A total of 436 EPIs were included in this study, with a mean gestational age of (26.9±0.9) weeks and a birth weight of (989±171) g. The incidence of longitudinal EUGR was 82.3%(359/436). Seven variables (birth weight Z-score, weight loss, weight growth velocity, the proportion of breast milk ≥75% within 3 d before discharge, invasive mechanical ventilation ≥7 d, maternal antenatal corticosteroids use and bronchopulmonary dysplasia) were selected to establish the prediction model. The area under the receiver operating characteristic curve of the training dataset and the validation dataset were 0.870 (95% CI 0.820-0.920) and 0.879 (95% CI 0.815-0.942), suggesting good discrimination efficacy. The calibration curve indicated a good fit of the model ( P>0.05). The decision curve analysis showed positive net benefits at all thresholds. Conclusions:Currently, EPIs have a high incidence of longitudinal EUGR. The prediction model is helpful for early identification and intervention for EPIs with higher risks of longitudinal EUGR. It is necessary to expand the sample size and conduct prospective studies to optimize and validate the prediction model in the future.

Adult-onset leukoencephalopathy with axonal spheroids and pigmented glia(ALSP)is a clinically rare autosomal dominant genetic disease,and its specific pathogenesis is not yet clear.The colony-stimulating factor 1 receptor(CSF1R)is a transmembrane tyrosine kinase receptor on the cell surface and mutations in the gene encoding it have been identified as potential pathogenic factors for ALSP.However,the specific mechanisms by which CSF1R gene mutations lead to the onset of ALSP are still unclear.After reviewing the mutation sites and pathogenic mechanisms of CSF1R in the pathogenesis of ALSP,CSF1R mutations have been shown to cause microglial dysfunction through mechanisms such as dominant-negative effects,loss of function,haploinsufficiency,and gain of function,thereby leading to the onset of ALSP.A deeper understanding of the causes of ALSP will help in exploring potential treatment methods.

Objective To investigate the effectiveness of team-based learning(TBL)combined with research-based learning(RBL)in enhancing evidence-based nursing practice skills of undergraduate nursing interns.Methods A total of 114 undergraduate nursing students who interned in the operating room of a ⅢA hospital in Guangzhou from July 2021 to April 2022 were selected as study subjects.A randomized cluster sampling method based on a random number table was used to divide the students into a control group and a trial group.The control group received traditional teaching methods,while the trial group was taught using a combination of TBL and RBL.The two groups were compared in terms of evidence-based practice skills,critical thinking abilities,and their evaluations on the teaching methods.Results The differences in evidence-based practice skills and critical thinking abilities before and after the internship were significantly higher in the observation group compared to the control group(t=35.108,35.897;both P<0.05).Additionally,post-internship evaluation scores for the teaching methods in the trial group were significantly higher than those in the control group(t=-17.580,P<0.05).Conclusion TBL combined with RBL effectively enhances the evidence-based nursing practice skills and critical thinking abilities of undergraduate nursing interns.This approach also improves students'evaluations on the teaching methods and fosters the cultivation of excellent clinical evidence-based nursing professionals.