ObjectiveTo investigate the effect of video-based educational intervention combined with maternal presence on perioperative adverse outcomes in preschool children undergoing general anesthesia， including cooperation in anesthesia induction， perioperative anxiety， pain and agitation during recovery. MethodsA total of 300 preschool children scheduled for general anesthesia in our hospital from June to December 2023 were randomly assigned to control group （n=150） and intervention group （n=150）. The control group received routine recovery care. For the intervention group， in addition to routine recovery care， a preoperative visit was scheduled one day before surgery. During this visit， mothers were guided to watch anesthesia videos with their children. During the waiting period in the operating room and 30 minutes after awakening， the mothers were guided to accompany the children for more than 30 minutes. Recovery conditions were recorded using the surgical anesthesia information system， and the children’s anesthetic induction compliance， perioperative anxiety， pain， and agitation were evaluated and recorded using the modified Yale Preoperative Anxiety Scale （m-YPAS）， the Induction Compliance Scale （ICC）， the Children’s Pain Behavior Scale （FLACC）， and the Pediatric Agitation and Emergence Delirium Scale （PAED）. ResultsOn the preoperative visit day， there were no statistically significant differences in baseline data between the two groups （P > 0.05）. For perioperative anxiety， the m-YPAS scores of the intervention group were significantly lower than those of the control group， both when entering the operating room waiting area （35.27±6.48 vs. 41.79±6.68， P < 0.05） and 30 minutes after postoperative recovery （20.13±7.05 vs. 35.75±9.51， P < 0.05）. In terms of anesthesia induction cooperation， the ICC scores of the intervention group were significantly lower than those of the control group （1.84±0.95 vs. 3.17±0.62， P < 0.05）， and the proportion of good induction cooperation was significantly higher than that of the control group （24.00% vs. 12.67%， P < 0.05）. There was no significant difference in awakening duration between the two groups， but the intervention group had a significantly shorter length of stay in the post-anesthesia care unit than the control group （0.90±0.29 hours vs. 1.29±0.42 hours， P < 0.001）. For perioperative agitation， the PAED scores of the intervention group were significantly lower than those of the control group （entering in the operating room waiting area： 8.5 vs. 9.2， P < 0.05； 30 minutes after postoperative recovery： 4.2 vs. 7.8， P < 0.05）. In terms of pain scores， the FLACC scores of the intervention group were also significantly lower than those of the control group， both when entering the operating room waiting area （ 5.3 vs. 6.7， P < 0.05； 30 minutes after postoperative recovery： 2.1 vs. 4.9， P < 0.05）. ConclusionsVideo-based educational intervention combined with maternal presence reduces the perioperative anxiety， pain and agitation of preschool children undergoing general anesthesia， and improved the compliance of anesthesia induction. It is recommended to promote this intervention measure in clinical practice.

Objective To explore the feasibility and safety of ultrasound-guided percutaneous microwave ablation for unresectable pancreatic cancer.Methods Totally 84 patients who underwent ultrasound-guided percutaneous microwave ablation for unresectable pancreatic cancer were enrolled,and the technical success rate,complete ablation rate,complication rate,pain relief rate and survival time,etc.were observed.Results The median age of 84 cases was 61.5 years.Totally 86 tumors,including 44.19％(38/86)at the head/neck and 55.81％(48/86)at the body/tail of pancreas were detected,and a total of 85 ablation sessions were performed with the median ablation energy applied per tumor of 9.90(1.08,21.60)kJ and the complete ablation rate of 42.86％(36/84).The technical success rate was 100％(85/85).Thirty-nine complication events occurred in 25 cases,no ablation-related death.Among 34 patients underwent ablation mainly for pain symptoms,the pain score decreased from(6.22±1.12)points before treatment to(1.94±1.64)points after treatment(P＜0.001).During 6.8(3.3,12.9)months' follow-up,the mean survival time was(8.5±6.7)months,and all 47 patients died due to tumor progression.Conclusion Ultrasound-guided percutaneous microwave ablation was safe and feasible for unresectable pancreatic cancer.

Objective To explore changes of blood cell counts and hepatic and splenic fibrosis rates in rat models of liver cirrhosis and portal hypertension after partial splenic artery embolization(PSE).Methods Fifteen rat models of liver cirrhosis and portal hypertension were successfully established.Red blood cell(RBC),white blood cell(WBC)and platelet(PLT)counts were measured.Splenic artery angiography and PSE were performed in 10 rats(PSE group),while only splenic artery angiography was performed in the rest 5 rats(control group).1 week after interventions,RBC,WBC and PLT counts were remeasured,and then the rats were euthanized to obtain liver and spleen specimens for pathological examination and evaluation of fibrosis rate.The changes of blood cell count within 1 week and the hepatic and splenic fibrosis rates 1 week after intervention were compared between groups.Results Rats in both groups exhibited good general condition within 1 week after intervention.One week after intervention,RBC,WBC and PLT counts in PSE group were all significantly higher than those before intervention(all P＜0.05),and the increasing rate of RBC,WBC and PLT counts in PSE group were larger than those in control group(all P＜0.05).WBC and PLT counts in PSE group 1 week after intervention were all higher than those in control group(both P＜0.05),but no significant difference of RBC count was observed between groups(P＞0.05).One week after intervention,hepatic fibrosis rate was higher,while splenic fibrosis rate was lower in PSE group than that in control group(both P＜0.05).Conclusion PSE might be used to improve decrease of blood cell count caused by hypersplenism in rat with liver cirrhosis and portal hypertension,hence reverse or slow down progression of splenic fibrosis.

Objective To explore changes of blood cell counts and hepatic and splenic fibrosis rates in rat models of liver cirrhosis and portal hypertension after partial splenic artery embolization(PSE).Methods Fifteen rat models of liver cirrhosis and portal hypertension were successfully established.Red blood cell(RBC),white blood cell(WBC)and platelet(PLT)counts were measured.Splenic artery angiography and PSE were performed in 10 rats(PSE group),while only splenic artery angiography was performed in the rest 5 rats(control group).1 week after interventions,RBC,WBC and PLT counts were remeasured,and then the rats were euthanized to obtain liver and spleen specimens for pathological examination and evaluation of fibrosis rate.The changes of blood cell count within 1 week and the hepatic and splenic fibrosis rates 1 week after intervention were compared between groups.Results Rats in both groups exhibited good general condition within 1 week after intervention.One week after intervention,RBC,WBC and PLT counts in PSE group were all significantly higher than those before intervention(all P＜0.05),and the increasing rate of RBC,WBC and PLT counts in PSE group were larger than those in control group(all P＜0.05).WBC and PLT counts in PSE group 1 week after intervention were all higher than those in control group(both P＜0.05),but no significant difference of RBC count was observed between groups(P＞0.05).One week after intervention,hepatic fibrosis rate was higher,while splenic fibrosis rate was lower in PSE group than that in control group(both P＜0.05).Conclusion PSE might be used to improve decrease of blood cell count caused by hypersplenism in rat with liver cirrhosis and portal hypertension,hence reverse or slow down progression of splenic fibrosis.

Objective To explore the feasibility and safety of ultrasound-guided percutaneous microwave ablation for unresectable pancreatic cancer.Methods Totally 84 patients who underwent ultrasound-guided percutaneous microwave ablation for unresectable pancreatic cancer were enrolled,and the technical success rate,complete ablation rate,complication rate,pain relief rate and survival time,etc.were observed.Results The median age of 84 cases was 61.5 years.Totally 86 tumors,including 44.19％(38/86)at the head/neck and 55.81％(48/86)at the body/tail of pancreas were detected,and a total of 85 ablation sessions were performed with the median ablation energy applied per tumor of 9.90(1.08,21.60)kJ and the complete ablation rate of 42.86％(36/84).The technical success rate was 100％(85/85).Thirty-nine complication events occurred in 25 cases,no ablation-related death.Among 34 patients underwent ablation mainly for pain symptoms,the pain score decreased from(6.22±1.12)points before treatment to(1.94±1.64)points after treatment(P＜0.001).During 6.8(3.3,12.9)months' follow-up,the mean survival time was(8.5±6.7)months,and all 47 patients died due to tumor progression.Conclusion Ultrasound-guided percutaneous microwave ablation was safe and feasible for unresectable pancreatic cancer.

The construction of a medication safety culture is important for medication safety management and rational drug use.The construction of medication safety culture standards is formulated based on relevant national policies and regulations,accreditation standards for hospitals,expert opinions,the current situation,and the development trend of the healthcare industry.With scientificity,general applicability,instructive guidance,and practicality,they standardized basic requirements,management processes,and improvement of the construction of medication safety culture.To facilitate understanding and the implementation of the standards,we describe the process of standards formulation and explain the key points of the standards.

BACKGROUND:With the increase of the incidence of cervical spondylosis,it is particularly important to control the postoperative bleeding and related inflammatory reaction of cervical vertebra. OBJECTIVE:A prospective study was conducted to investigate the combined effect of intravenous and topical tranexamic acid of different concentrations on postoperative blood loss and inflammatory response during posterior cervical decompressive laminectomy combined with lateral mass screw internal fixation and bone graft fusion. METHODS:From January 2020 to December 2022,150 patients who were scheduled to undergo posterior cervical decompressive laminectomy combined with lateral mass screw internal fixation and bone graft fusion for cervical spondylotic myelopathy in Tianjin People's Hospital were enrolled in the study.Patients were divided into A,B,and C groups(n=50)by randomized double-blind lottery.The patients in the A,B,and C groups were treated with 1%,3%,and 5%intravenous and topical tranexamic acid solution,respectively.Postoperative blood loss and inflammation-related indicators were compared among three groups.The occurrence of venous thromboembolism and hematoma was observed after operation. RESULTS AND CONCLUSION:(1)There were significant differences in blood loss-related indexes,such as intraoperative blood loss,overall blood loss,and occult blood loss among the three groups(P<0.01).The above indexes were significantly lower in groups B and C than that in group A.There was no significant difference between groups B and C(P>0.05).(2)On days 1 and 3 after surgery,the levels of inflammatory indicators including serum C-reactive protein and interleukin-6 were increased to varying degrees in the three groups compared to before surgery(P<0.05).As the drug concentration increased,its expression decreased,and there was a significant difference among the three groups(P<0.001).(3)Two cases of intramuscular venous thrombosis appeared in each of the three groups after surgery.No hematoma or pulmonary embolism occurred in all three groups.(4)It is concluded that in posterior cervical decompressive laminectomy combined with lateral mass screw internal fixation and bone graft fusion,intravenous combined with topical application of different concentrations of tranexamic acid is effective in reducing perioperative blood loss and inflammatory response.3%tranexamic acid achieves the same effect without significantly increasing the risk of postoperative venous thromboembolism.

This paper summarises the experience in an emergency care of a patient who had a "silent lung" during ventilator-assisted ventilation while in the post-anaesthesia care unit (PACU) after a surgery of cavernous sinus fistula of internal carotid artery. By reviewing nursing records,the emergency nursing interventions were summed up,incluing immediate elimination of mechanical blockage,rapid identification and diagnosis of "silent lung",urgent application of manual balloon pressurisation ventilation to resolve ventilation difficulties and symptomatic medication to relieve airway spasm. A ventilator-assisted ventilation was reinitiated to ensure unobstructed breathing after the condition of patient had been stablised. Lungs were inflated when the condition of patient allowed together without a risk of airway spasm. Then the endotracheal catheter was removed under a deep anaesthesis. After 3 hours of emergency resuscitation,the patient became stable and safely returned to the ward. The patient was discharged 11 days later and was found in good condtion over the 3 months postoperative follow-up.

This paper summarises the experience in an emergency care of a patient who had a "silent lung" during ventilator-assisted ventilation while in the post-anaesthesia care unit (PACU) after a surgery of cavernous sinus fistula of internal carotid artery. By reviewing nursing records,the emergency nursing interventions were summed up,incluing immediate elimination of mechanical blockage,rapid identification and diagnosis of "silent lung",urgent application of manual balloon pressurisation ventilation to resolve ventilation difficulties and symptomatic medication to relieve airway spasm. A ventilator-assisted ventilation was reinitiated to ensure unobstructed breathing after the condition of patient had been stablised. Lungs were inflated when the condition of patient allowed together without a risk of airway spasm. Then the endotracheal catheter was removed under a deep anaesthesis. After 3 hours of emergency resuscitation,the patient became stable and safely returned to the ward. The patient was discharged 11 days later and was found in good condtion over the 3 months postoperative follow-up.

A15, a DNA aptamer with binding specificity for U87 glioma cells stably overexpressing the epidermal growth factor receptor variant III (U87-EGFRvIII), was generated by cell systematic evolution of ligands by exponential enrichment (cell-SELEX) using a random nucleotide library. Subsequently, we established a cell enzyme-linked assay (cell-ELA) to detect the affinity of A15 compared to an EGFR antibody. We used A15 as a detection probe and cultured U87-EGFRvIII cells as targets. Our data indicate that the equilibrium dissociation constants (K(d)) for A15 were below 100 nmol/L and had similar affinity compared to an EGFR antibody for U87-EGFRvIII. We demonstrated that the cell-ELA was a useful method to determine the equilibrium dissociation constants (K(d)) of aptamers generated by cell-SELEX.
Aptamers, Nucleotide ; metabolism ; Brain Neoplasms ; metabolism ; Cell Line, Tumor ; Glioma ; metabolism ; pathology ; Humans ; Mutation ; Protein Binding ; Receptor, Epidermal Growth Factor ; genetics ; metabolism ; SELEX Aptamer Technique ; methods