The peripheral pulmonary lesions are located far from the central airway and close to the pleura, so it is a challenge for clinical diagnosis of their nature through biopsy. Therefore, the Ion robot-assisted bronchoscopy system which has started its commercialization in China is proposed to diagnose and treat peripheral pulmonary lesions. The Ion system can be used for navigation, registration, biopsy and treatment. In this paper, the structural principle of the Ion system is expounded, and its technical advantages such as shape perception, slender catheter and flexible operation are summarized. It represents the latest development direction of the diagnosis and treatment of peripheral pulmonary lesions. Then, the clinical application and development status of the Ion system are analyzed and discussed in detail. Finally, the development trend of the robot-assisted bronchoscopy system is prospected, which provides new ideas for realizing the "integrated and one-stop" diagnosis and treatment services for peripheral pulmonary lesions based on this system.
Bronchoscopy/instrumentation* ; Humans ; Robotics ; Robotic Surgical Procedures

Objective To investigate the prevalence and molecular characteristics of Anaplasma infections in sheep and goats in Anhui Province in 2020, so as to provide insights into ovine anaplasmosis prevention and control. Methods A total of 355 fresh blood samples were collected from 7 sheep and goat farms in Linquan County of Fuyang City, Lixin County of Bozhou City, Yu'an District of Lu'an City, Wangjiang County of Anqing City, Nanling County of Wuhu City, and Tianchang City and Fengyang County of Chuzhou City in Anhui Province from June to December 2020. A. bovis and A. phagocytophilum 16S ribosomal RNA (16S rRNA) gene, A. ovis major surface protein 4 (MSP4) gene and A. capra citric acid synthase (gltA) gene were amplified using PCR assay in all blood samples, and the prevalence of A. bovis, A. phagocytophilum, A. ovis and A. capra infections was calculated in sheep and goats. In addition, the positive amplification products were sequenced and subjected to genetic evolutionary analysis. Results The overall prevalence of Anaplasma infections was 17.5% (62/355) in sheep and goats in Anhui Province, and the prevalence of A. bovis, A. phagocytophilum, A. ovis and A. capra infections was 2.8% (10/355), 2.5% (9/355), 2.5% (9/355), and 7.0% (25/355), while the prevalence of A. bovis and A. phagocytophilum, A. phagocytophilum and A. ovis, A. phagocytophilum and A. capra and A. bovis, A. phagocytophilum and A. ovis co-infections was 0.8% (3/355), 1.1% (4/355), 0.3% (1/355) and 0.3% (1/355), respectively. No Anaplasma was detected in the sheep and goat farms in Fengyang County, while at least three Anaplasma species were detected in other sheep and goat farms, with co-infections of multiple Anaplasma species identified. The prevalence of Anaplasma infections was 14.7% (24/163) in goats and 19.8% (38/192) in sheep, and the prevalence of Anaplasma infections was 31.0% (31/100) in goats and sheep under 6 months of age, and 12.2% (31/255) in goats and sheep at ages of 6 months and older, respectively. A. bovis, A. phagocytophilum, A. ovis and A. capra were identified in sheep and goats of different breeds and ages. Conclusions Multiple Anaplasma species infections were commonly prevalent in goats and sheep in Anhui Province in 2020, notably A. phagocytophilum, A. ovis and A. capra, which have zoonotic risks. Improved surveillance and prevention and control of Anaplasma infections are required in sheep and goats in Anhui Province.

Objective:To analyze the status quo, hotspots and fronts of emergency nursing training research at home and abroad in the past ten years, and to provide reference and ideas for the efficient development of emergency nursing training in China.Methods:CiteSpace 6.2.R2 software was used to visually analyze the Chinese and English literatures on emergency nursing training included in CNKI and Web of Science core databases from January 1, 2013 to June 1, 2023.Results:A total of 1 177 Chinese literatures and 1 163 English literatures were included. The number of foreign articles in this field increased year by year, while the number of domestic articles showed a downward trend since 2018. There were many stable core author groups and core institution groups in foreign countries, while there was less cooperation among domestic authors and institutions. The common research hotspots and frontiers at home and abroad focused on broadening the training audience of emergency nursing, innovating the training methods of emergency nursing, strengthening the evaluation of the effect of emergency nursing training, and paying attention to the training experience and needs of nurses. Foreign researches also focused on specialized nurses, interprofessional education and nurses′mental health, etc, and the research direction was diversified.Conclusions:The development stages of emergency nursing training researches at home and abroad are different, and the research hotspots are different. In the future, we should learn from foreign research, strengthen interdisciplinary cooperation, improve the depth and breadth of research, and strengthen the cooperation between authors, institutions and countries to promote the high-quality development of emergency nursing training research in China.

Extracellular vesicles(EVs)are nano-sized bilayer vesicles that are shed or secreted by virtually every cell type.A variety of biomolecules,including proteins,lipids,coding and non-coding RNAs,and mitochondrial DNA,can be selectively encapsulated into EVs and delivered to nearby and distant recipient cells,leading to alterations in the recipient cells,suggesting that EVs play an important role in intercellular communication.EVs play effective roles in physiology and pathology and could be used as diagnostic and therapeutic tools.At present,although the mechanisms of exosome biogenesis and secretion in donor cells are well understood,the molecular mechanism of EV recognition and uptake by recipient cells is still unclear.This review summarizes the current understanding of the molecular mechanisms of EVs'biological journey in recipient cells,from recognition to uptake and cargo release.Furthermore,we highlight how EVs escape endolysosomal degradation after uptake and thus release cargo,which is crucial for studies applying EVs as drug-targeted delivery vehicles.Knowledge of the cellular processes that govern EV uptake is important to shed light on the functions of EVs as well as on related clinical applications.

Objective To investigate the current postoperative physical activity levels of lung cancer patients after a month and to analyze the influencing factors.Methods From January to December 2023,a total of 1,195 lung cancer patients from 16 hospitals in eastem,central and westem China were selected as the survey subjects by the convenient sampling method.A cross-sectional survey was conducted by General Information Questionnaires,Health-Related Physical Fitness Surveys,MD Anderson Symptom Inventory,Hospital Anxiety and Depression Scale,Social Support Rating Scale,Self-Rated Abilities for Health Practices Scale,and the International Physical Activity Questionnaire.Results 36 questionnaires with missing data exceeding 10％and 13 duplicate questionnaires were excluded,resulting in the analysis of 1,146 questionnaires.After a month postoperatively,lung cancer patients with moderate and low levels of physical activity were 732(63.9％)and 204(17.8％),respectively.Multivariate regression analysis showed that the influencing factors included residence,average monthly family income,regional lymph node staging,family history of lung cancer,grip strength,hemoglobin,and depression score(P＜0.05).Conclusion The physical activity level of lung cancer patients a month after surgery is influenced by a combination of sociodemographic,disease-related,health-related physical fitness,and psychological factors.Clinical healthcare professionals should accurately assess the physical activity levels of lung cancer patients,identify those with insufficient physical activity,and develop and implement personalized intervention strategies based on their physical condition and potential influencing factors to enhance their physical activity levels and improve their quality of life.

Deep venipuncture catheterization is a routine and basic operation in the treatment of critically ill patients, and it is the most effective way to quickly correct the shock. Clinical B-ultrasound guided deep vein catheters can improve the success rate of puncture, but in the process of operation, the short axis needs to be replaced by the long axis. In the replacement process, the stability of the novice is insufficient, the positioning is difficult, and the operation time is too long. If only short axis puncture is used, it is impossible to know whether the current position of the puncture needle, and the puncture may be too deep and stray into the artery. The accuracy of the 45 degree angle of the injection point requires a very experienced operator. In view of the above shortcomings, doctors in the department of critical care medicine of Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine designed a B-ultrasound puncture equipment, which has obtained the National Invention Patent of China (ZL 2016 1 0571557.X). The device is composed of B-ultrasound probe fixing frame, sliding scale plate, simulation slide rule, puncture needle, sliding device. By sliding device the angle of the pinhole channel, it is conducive to the accurate positioning of the puncture target, optimizing the operation procedure, improving the puncture speed and accuracy, effectively reducing the occurrence of puncture complications, ensuring patient safety, reducing unnecessary waste of human and material resources. It can reduce the workload of medical staff and is worthy of clinical practice.
Humans ; Catheterization, Central Venous/methods* ; Ultrasonography, Interventional/methods* ; Ultrasonography ; Punctures/methods* ; Needles

Objective : To investigate the status and influencing factors of self-management behaviors among pregnant women with gestational diabetes mellitus (GDM), so as to provide insights into health management of GDM. Methods: GDM patients admitted to Medical Community General Hospital of Shaoxing Second Hospital were sampled from January to June 2023, and basic characteristics were collected using questionnaire surveys, including age, parity, education level and gestational age. The self-management behaviors were evaluated among GDM patients using the self-management behavior scale, and the social support level was evaluated using the social support scale, while the modes of coping with diseases were identified using the medical coping modes questionnaire (MCMQ). Factors affecting the self-management behaviors were identified among GDM patients using a multiple linear regression model. Results: A total of 120 GDM patients were enrolled, with a mean age of (27.58±3.73) years and gestational age of (22.16±5.82) weeks. The score for self-management behaviors was (118.19±24.86) points among GDM patients, including 15 cases with good self-management behaviors (12.50%), 61 cases with moderate behaviors (50.83%) and 44 cases with poor behaviors (36.67%). Multiple linear regression analysis showed that educational level (high school: β'=0.168; junior college and above: β'=0.187), per capita monthly household income (≥5 000 Yuan, β'=0.305), health education for GDM (β'=0.087), coping mode (avoidance: β'=0.168; acceptance: β'=0.375) and social support level (general: β'=0.184; high: β'=0.429) were factors affecting self-management behaviors among GDM patients. Conclusion The self-management behaviors of GDM patients are associated with educational level, per capita monthly household income, health education for GDM, coping mode and social support level.

Objective : To study the association between single nucleotide polymorphism (SNP) in transcriptional coactivator containing PDZ binding motif (TAZ) gene and the risk of non⁃cardia gastric cancer. Methods : Among 460 patients with non⁃cardia gastric cancer and 470 normal controls , TAZ rs16861985 , rs1055153 , rs6783790, rs12490239 were genotyped by polymerase chain reaction⁃restriction fragment length polymorphism (PCR⁃RFLP) . Unconditional Logistic regression was used to evaluate the association of studied SNPs with the risk of non⁃cardia gastric cancer. Results : TAZ rs16861985 was associated with the risk of non⁃cardia gastric cancer, compared with the CC genotype carriers , the carriers of GC genotype had an increased risk of noncardia gastric cancer ( OR =1. 547 , 95% CI: 1. 145 - 2. 089) . TAZ rs1055153 was associated with the risk of non-cardia gastric cancer, compared with the GG genotype carriers , the carriers of GT + TT genotypes had a decreased risk of non-cardia gastric cancer ( OR = 0. 570 , 95% CI: 0. 400 - 0. 814) . TAZ rs6783790 and rs12490239 were not associated with the risk of non⁃cardia gastric cancer. Among the haplotypes constructed by TAZ rs16861985 , rs1055153 , rs6783790 and s12490239 , C ⁃G ⁃A ⁃A haplotype had a decreased risk of non⁃cardia gastric cancer ( OR = 0. 761 , 95% CI: 0. 612- 0. 945) , while G ⁃G ⁃A ⁃G haplotype had an increased risk of non⁃cardia gastric cancer ( OR = 1. 894 , 95% CI:1. 314 - 2. 730) . The fourth⁃order interaction of TAZ rs16861985 , rs1055153 , rs6783790 and rs12490239 was associated with non⁃cardia gastric cancer risk(P < 0. 05) . Conclusion TAZ rs16861985 and rs1055153 may play a role in the risk of non⁃cardia gastric cancer. The C ⁃G ⁃A ⁃A haplotype constructed by TAZ rs16861985 , rs1055153, rs6783790 and rs12490239 can reduce the risk of non⁃cardia gastric cancer, and G ⁃G ⁃A ⁃G haplotype can increase the risk of non⁃cardia gastric cancer. The interaction of TAZ rs16861985 , rs1055153 , rs6783790 and rs12490239 has a synergistic effect innon⁃cardia gastric cancer.

Objective:To investigate Helicobactor pylori (H. pylori) infection status and interfamilial transmission pattern in Zhengzhou area. Methods:A cross-sectional study was conducted from September 2020 to march 2021, among 731 individual from 266 families randomly selected from 9 communities of Zhengzhou area. H. pylori infection status was determined by serum antibody tests, and 13C-urea breath test was performed in the previously eradicated population to clarify the current infection status. The individual and familial infection rate, infection status for couples and children and adolescent were analyzed. Results:Among 731 individuals from 266 families, 397 of them were H. pylori positive. The individual infection rate was 54.31% (397/731); among infected individuals 77.83% (307/397) were infected with type Ⅰ strain, 22.67% (90/397) were infected by type Ⅱ strain. Annual household income ( χ2=0.419, 0.410, 0.213, all P>0.05), smoking history (χ 2=0.071, P>0.05), drinking history ( χ2=0.071, P>0.05), dining place ( χ2=0.009, P>0.05), gastrointestinal symptoms ( χ2=0.047, P>0.05), family history of gastric disease ( χ2=0.069, P>0.05), and history of gastric cancer ( χ2=0.004, P>0.05) had no significant differences between H. pylori-positive and -negative groups, but the infection rate in individuals with higher education level was lower ( χ2=4.449, P<0.05). The infection rate was significantly higher in≥18 age groups compared with<18 age groups ( χ2=6.531, 23.362, 20.671, 24.244, 37.948, 14.597 and 5.170, all P<0.05). The familial H. pylori infection rate was 87.59% (233/266), and in 61 families all member were infected (26.18%, 61/233). The positive rate was 23.08% (6/26) in 50 families with children under 18 years when both parents were infected. Among 231 coupled families, both couples were infected in 78 families (33.76%), one couple was infected in 113 families (48.92%), and both couples were not infected in 40 (17.32%). With the increase of marriage time, the infection rate of both spouses increased significantly ( χ2=7.775, 12.662, 15.487, all P<0.05). Conclusions:The distribution of H. pylori infection presents a family cluster pattern, and intrafamilial infection is an important transmission rout of H. pylori. The type I strain of H. pylori is the dominate strain in this area.

Objective:To observe the clinical characteristics and optical coherence tomography (OCT) features of pseudopapilledema (PPE) combined with peripapillary hyper-reflective ovoid mass-like structures (PHOMS) in children.Methods:A retrospective observational study. From October 2019 to May 2021, total 22 eyes from 12 children diagnosed as PPE combined with PHOMS in the Neuro-ophthalmology Department of The First Hospital of Xi’an (Affiliated of The First Hospital of Northwest University) were recruited. Among the children, 6 were male and 6 were female. The average age was (10.6±2.7) years. The average course from disease onset to diagnosis of PPE combined with PHOMS was (8.0±7.5) months. All patients underwent best corrected visual acuity (BCVA), relative afferent papillary defect (RAPD), Ishihara's test, fundus photography, OCT, fundus autofluorescence (FAF), ocular B-mode ultrasound, visual field and patternvisual evoked potential (P-VEP). The clinical and OCT characteristics of the patients were observed.Results:The anterior segments of the patients were normal. The intraocular pressures and Ishihara's test were all normal. All RAPD were negative. Total 22 eyes, BCVA was 1.0 in 21 eyes and one eye was 0.12. The fundus photography revealed blurred optic discs margin, showing mild to moderate edema-like elevation with more prominent in the nasal parts, presenting as a "C" shape halo. No obvious abnormal fluorescence was observed in FAF. The OCT scan of involvement eyes showed an elevated appearance in vary degrees, and the sharply marginated ovoid hyper-reflective mass-like structures which laterally herniated into the peripapillary region under retinal nerve fiber layer and above the Bruch membrane were detected with consecutive nasal enlargement scanning, corresponding to the nasal parts in the fundus photography. The higher degree of elevation, the larger the volume. Macular retina pigment epithelium layer and ganglion cell thickness were normal. Ocular B-mode ultrasound showed that the head of the optic nerve in the posterior wall of the eyeball (in front of the optic disc) was elevated in all affected eyes, and there was no strong signal echo in it. Visual field examination showed physical blind spot enlargement in 3 eyes and visual field defect in 2 eyes. P-VEP examination showed that the peak was slightly delayed in 3 eyes and the amplitude was slightly reduced in 3 eyes.Conclusions:Enlarged nasal optic disc OCT scan can improve the detection rate of PHOMS. PHOMS were detected bilaterally in the cases with binocular PPE while only in the effected eye in the cases of monocular PPE; the higher degree of PPE, the lager volume of PHOMS. PHOMS were could contribute to the diagnosis of PPE in children.