Objective Feasibility application of microelectrode recording(MER)during sub thalamic nucleus deep brain stimulation(STN-DBS)implantation under desflurane general anesthesia(GA)in patients with Par-kinson's disease(PD).Methods A prospective cohort of 20 PD patients undergoing STN-DBS under desflurane general anesthesia were enrolled.Intraoperative MER quality,pos-operative acute pain,cognitive function,anxi-ety/depression status,quality of life,and clinical efficacy of DBS were evaluated.Results Among the patients,14 were male with average PD duration of(8.1±3.6)years.Hoehn-Yahr staging averaged 2.8±0.5 in"on"state and 2.3±0.5 in"off"state.The mean DBS surgery duration was 87.4 minutes.Highly normalized root-mean-square(NRMS)signals were successfully recorded in all cases,with remedial measures applied in 4 pa-tients to achieve satisfactory MER signals.Post-operative Visual Analogue Scale(VAS)pain scores on days 1,2,and 3 were 3.7±2.2,2.8±1.6,and 1.8±2.0,respectively.Montreal Cognitive Assessment(MoCA)scores showed no statistical difference during hospitalization as compared to pre-operative values,but significantly de-creased at 6-month follow-up(24.3±4.1 vs.21.5±3.5,P＜0.05).All patients demonstrated significant reduc-tion in Hamilton Anxiety Scale(HAMA),Hamilton Depression Rating Scale(HAMD),and Parkinson's disease Questionnaire-39(PDQ-39)scores at 6-month follow-up.The unified Parkinson's disease rating scale(UPDRS-Ⅲ)improvement rates were 51.4%±39.2%(medication-on)and 61.6%±26.8%(medication-off)respectively with Levodopa Equivalent Daily Dose(LEDD)improvement rate of 48.6%±23.0%.Conclusions Desflurane general anesthesia is safe and feasible for electrods implantation in STN-DBS of PD patients,without interfering with intra-operative MER or postoperative outcomes.

Objective:To explore the health education needs of patients undergoing fecal microbiota transplantation (FMT) at different stages of treatment.Methods:A qualitative research method was employed and an interview guide based on timing theory was developed. Semi-structured interviews were conducted with patients treated for colorectal conditions with FMT at Tenth People's Hospital of Tongji University from August to October 2022. Data from the interviews were analyzed using thematic analysis.Results:A total of 19 patients aged 20 to 65 were interviewed, including seven males and 12 females. A total of five main themes and 15 subthemes were identified: health education demands during the diagnosis phase (basic information about FMT; knowledge about donor screening), health education demands during the preparation phase (alleviating discomfort caused by nasoenteric tubes; interpretation of examination reports), health education demands during the execution phase (dietary guidance during FMT; exercise guidance during FMT; medication and supplementary training guidance; management of adverse reactions), health education demands during the adaptation phase (consolidating treatment effects; knowledge related to FMT capsules; post-discharge follow-up content and methods; post-discharge precautions), long-term health education demands (diverse health education tools; individualized health education approaches; alleviating psychological anxiety) .Conclusions:Patients undergoing FMT have numerous concerns, and diverse health education needs throughout the treatment process. Healthcare professionals should adopt various health education strategies to address these needs.

Objective To analyze the application effects of laryngeal mask airway(LMA)general anesthesia versus endotracheal intubation(ETI)general anesthesia in Parkinson's disease(PD)patients undergoing deep brain stimulation(DBS)implantable pulse generator(IPG)surgery.Methods A retrospective analysis was conducted on 164 PD patients who underwent IPG surgery at our hospital from August 2020 to February 2021.Patients were divided into two groups based on airway management:LMA group(n=61)and ETI group(n=103).Perioperative hemodynamic parameters,including mean arterial pressure(MAP)and heart rate(HR),were observed at five time points:pre-induction(T0),post-induction(T1),skin incision(T2),extubation(T3),and post-anesthesia care unit(PACU)admission(T4).Key outcomes,such as extubation time,intraoperative hypoxia events,LMA-to-ETI conversion rate,and postoperative complications(respiratory depression,pneumonia),were compared between the two groups.Results The LMA group had a significantly lower body mass index than the ETI group[(22.75±3.11)kg/m2 vs(23.85±3.49)kg/m2,P=0.039],while the other baseline characteristics were comparable.After induction,the LMA group exhibited a less decrease in MAP[(85.46±11.63)mmHg vs(74.13±11.78)mmHg in the ETI group,P<0.001].At extubation,the ETI group showed higher MAP[(98.27±13.78)mmHg vs(89.66±10.50)mmHg in the LMA group,P<0.001].The intraoperative use of vasoactive drugs was significantly lower in the LMA group(3.3%)than that in the ETI group(13.6%,P=0.032).The mean extubation time was shorter in the LMA group[(8.43±5.25)min vs(14.28±7.66)min in the ETI group,P<0.001].No intraoperative hypoxia or LMA-to-ETI conversion events occurred in either group.Postoperative respiratory depression and pneumonia rates showed no statistically significant differences between the groups.Conclusion LMA general anesthesia can be safely applied in PD patients undergoing DBS IPG implantation.It shortens extubation time,reduces the use of vasoactive drugs,and does not increase the risk of intubation-related complications.

Objective To analyze the application effects of laryngeal mask airway(LMA)general anesthesia versus endotracheal intubation(ETI)general anesthesia in Parkinson's disease(PD)patients undergoing deep brain stimulation(DBS)implantable pulse generator(IPG)surgery.Methods A retrospective analysis was conducted on 164 PD patients who underwent IPG surgery at our hospital from August 2020 to February 2021.Patients were divided into two groups based on airway management:LMA group(n=61)and ETI group(n=103).Perioperative hemodynamic parameters,including mean arterial pressure(MAP)and heart rate(HR),were observed at five time points:pre-induction(T0),post-induction(T1),skin incision(T2),extubation(T3),and post-anesthesia care unit(PACU)admission(T4).Key outcomes,such as extubation time,intraoperative hypoxia events,LMA-to-ETI conversion rate,and postoperative complications(respiratory depression,pneumonia),were compared between the two groups.Results The LMA group had a significantly lower body mass index than the ETI group[(22.75±3.11)kg/m2 vs(23.85±3.49)kg/m2,P=0.039],while the other baseline characteristics were comparable.After induction,the LMA group exhibited a less decrease in MAP[(85.46±11.63)mmHg vs(74.13±11.78)mmHg in the ETI group,P<0.001].At extubation,the ETI group showed higher MAP[(98.27±13.78)mmHg vs(89.66±10.50)mmHg in the LMA group,P<0.001].The intraoperative use of vasoactive drugs was significantly lower in the LMA group(3.3%)than that in the ETI group(13.6%,P=0.032).The mean extubation time was shorter in the LMA group[(8.43±5.25)min vs(14.28±7.66)min in the ETI group,P<0.001].No intraoperative hypoxia or LMA-to-ETI conversion events occurred in either group.Postoperative respiratory depression and pneumonia rates showed no statistically significant differences between the groups.Conclusion LMA general anesthesia can be safely applied in PD patients undergoing DBS IPG implantation.It shortens extubation time,reduces the use of vasoactive drugs,and does not increase the risk of intubation-related complications.

Objective:To explore the health education needs of patients undergoing fecal microbiota transplantation (FMT) at different stages of treatment.Methods:A qualitative research method was employed and an interview guide based on timing theory was developed. Semi-structured interviews were conducted with patients treated for colorectal conditions with FMT at Tenth People's Hospital of Tongji University from August to October 2022. Data from the interviews were analyzed using thematic analysis.Results:A total of 19 patients aged 20 to 65 were interviewed, including seven males and 12 females. A total of five main themes and 15 subthemes were identified: health education demands during the diagnosis phase (basic information about FMT; knowledge about donor screening), health education demands during the preparation phase (alleviating discomfort caused by nasoenteric tubes; interpretation of examination reports), health education demands during the execution phase (dietary guidance during FMT; exercise guidance during FMT; medication and supplementary training guidance; management of adverse reactions), health education demands during the adaptation phase (consolidating treatment effects; knowledge related to FMT capsules; post-discharge follow-up content and methods; post-discharge precautions), long-term health education demands (diverse health education tools; individualized health education approaches; alleviating psychological anxiety) .Conclusions:Patients undergoing FMT have numerous concerns, and diverse health education needs throughout the treatment process. Healthcare professionals should adopt various health education strategies to address these needs.

Conventional administration methods have problems including low bioavailability, complex operation process, and discomfort of patients with fear of needles. Transdermal delivery can avoid these problems, whereas most drugs are difficult to directly penetrate the skin cuticle and reach the diseased site. Microneedling is an emerging method of local drug delivery, enabling the drug penetration through the stratum corneum of the skin in a minimally invasive manner and delivering the drug directly to the diseased site, thereby improving the treatment effect. Stimuli-responsive microneedles have attracted much attention because of the spatiotemporal controllability, high drug delivery efficiency, and mild potential side effects. This review introduced the commonly used materials and various types of stimuli-responsive microneedles and the drug release mechanisms. In addition, this paper expounded the biomedical applications of stimuli-responsive microneedles as drug delivery systems in response to different stimuli and discusses the challenges and potential solutions for stimuli-responsive microneedles.
Needles ; Drug Delivery Systems/instrumentation* ; Microinjections/instrumentation* ; Humans ; Administration, Cutaneous

Objective:To explore the journey map of patients with chronic constipation during fecal microbiota transplantation.Methods:This study adopted phenomenological methods. From October to December 2023, purposive sampling was used to select chronic constipation follow-up patients who underwent fecal microbiota transplantation at the Intestinal Microecology Center of Shanghai Tenth People's Hospital as respondents for semi-structured interviews. Colaizzi 7-step analysis method and NVivo 11.0 software were used for data analysis.Results:A total of 15 interviewees were interviewed. During fecal microbiota transplantation, the journey map of constipation patients included stages, mood changes, touchpoints, themes, emotional experiences and opportunities. The patient's experience and needs were summarized into three themes and ten sub-themes, including pre-transplant adaptation disorders to new environments (unfamiliarity and confusion-admission coordination disorders, anxiety and expectations-diverse complex emotions, puzzle and helplessness-asymmetric doctor and patient information), effectiveness-related psychological and social experiences in transplantation (attention and expectations-longing for positive efficacy, perception of benefits and risk avoidance, shame and inferiority-treatment stigmatization experience, questioning and despair-unrealized expectations, treatment resistance-sensitive economic burden), post-transplant transition dilemmas (inaccessible medical services-lack of continuous treatment and nursing, disease recurrence troubles) .Conclusions:This study visualizes the experiences and needs of constipation patients during microbiota transplantation through a patient journey map and identifies multidimensional issues and needs of patients. Clinical medical and nursing staff should pay attention to the needs of patients at different stages of the treatment process when formulating intervention programs to improve the quality of fecal microbiota transplantation nursing.

Objective To explore the dilemmas faced by surrogate decision-makers of severe stroke patients in treatment decision-making,and to provide a basis for developing decision support strategies.Methods From April to December 2023,through phenomenological qualitative research with 16 surrogate decision-makers with severe stroke patients from ICU of the department of neurology in a tertiary hospital in Jing'an District,Shanghai.semi-structured in-depth interviews were used to examine the perceptions of decision-making on surrogate.Data were analyzed via Braun's style of thematic analysis.Results 4 themes and 10 sub-themes were identified.Theme 1:negative emotional dilemmas(urgent decision-making leads to anxiety,fear,and unknown stroke trajectory increases the sense of uncertainty).Theme 2:supportive environment dilemmas(lack of information support delays decision-making;lack of family support increases decision-making stress;insufficient economic support increases the burden of decision-making).Theme 3:the dilemma of weighing the pros and cons(difficult trade-offs between risk and reward,tough decisions between reality and ethics,conflicting choices of life and dignity).Theme 4:preference management dilemmas(practical difficulties in adhering to patient preferences,impediments to decision-making due to unknown patient preferences).Conclusion Surrogate decision-makers of severe stroke patients face multiple decision-making dilemmas.Healthcare professionals should provide emotional support in multiple ways and comprehensive support to reduce the decision-making dilemmas experienced by surrogate decision-makers,as well as implement death education for surrogate decision-makers and promote advance care planning to reduce their decision-making stress.

Objective:To explore the effects of quality control circle activity in the respiratory function exercise in patients with esophageal cancer.Methods:From June 2018 to June 2019, convenience sampling was used to select 96 patients with esophageal cancer admitted to the Cancer Hospital Affiliated to Zhengzhou University as the research object. According to the principle of computer randomization, patients were divided into experimental group and control group, with 48 cases in each group. Patients in control group were given nursing case based on enhanced recovery after surgery, and experimental group carried out quality control circle activity on the basis of the control group. The correct rate of breathing exercise and the ratio of forced expiratory volume in the first second to forced vital capacity (FEV 1/FVC) were compared between the two groups of patients. Results:After intervention, the correct rate of respiratory function exercise in experimental group was higher than that in control group, and the difference was statistically significant ( P<0.05) . The FEV 1/FVC of experimental group was higher than that of control group one day before discharge, and the difference was also statistically significant ( P<0.05) . Conclusions:Quality control circle activity applied to patients after esophageal cancer surgery can increase the correct rate of patients' respiratory function exercise and effectively improve the patient's lung function.

Objective: To investigate the protective effect of glucose regulatory protein 78 (GRP78) on cardiomyocytes in atrial fibrillation and its mechanism. Methods: HL-1 cardiomyocyte cell line was cultured from June 2016 to March 2017 at Harbin Medical University Central Laboratory.The cells were randomly divided into 4 groups: control group, pacing group, pacing+ GRP78cDNA group, pacing+ GRP78siRNA group.The following indicators were detected: (1)oxidative stress: flow cytometry was used to detect the content of reactive oxygen species (ROS) in each group; (2)Ca²⁺ overload and cell electrophysiology: flow cytometry was used to detect Ca²⁺ content in each group; (3)cell structure reconstruction: cell apoptosis was detected by flow cytometry. Results: The ROS production in the pacing group was significantly higher than that in the control group [(28.8±0.5)% vs.(4.5±0.8)%, F=27.91, P<0.01]. The number of ROS in the GRP78siRNA group was significantly higher than that in the pacing group [(71.1±0.3%) vs.(28.8±0.5)%, F=34.12, P<0.01]. The ROS content of the GRP78cDNA group was lower than that of the pacing group [(26.1±2.7)% vs.(28.8±0.5)%, F=26.60, P<0.01]. Pacing significantly increased Ca²⁺ concentration in HL-1 cells; GRP concentration in HL-1 cells in the GRP78siRNA group was significantly higher than that in the pacing group [(72.53±2.5)AM vs.(39.23±1.9)AM, F=19.50, P<0.05]. The intracellular Ca²⁺ concentration in the GRP78cDNA group was significantly lower than that in the pacing group [(31.23±0.57)AM vs.(39.23±1.9)AM, F=28.17, P<0.01]. The survival rate of the GRP78cDNA group was significantly higher than that of the pacing group [(87.9±0.4)% vs.(80.1±0.5)%, F=19, P<0.05]. Conclusion GRP78 protein reduces intracellular calcium overload by reducing ROS production in myocardial cells during atrial fibrillation.It can alleviate the oxidative stress of cardiomyocytes and improve the survival rate of cardiomyocytes, and has protective effect on cardiomyocytes.