When bacteria inhabit an unfavorable environment, they adapt by forming small colony variants (SCVs) under selective pressure, resulting in a slow-growing subpopulation with distinct phenotypic and pathogenic characteristics. Phenotypically, SCVs exhibit a slow growth rate, atypical colony morphology, and unusual biochemical traits. Clinically, SCVs demonstrate reduced susceptibility to antibiotics and can persistently proliferate within the host environment as potential pathogens, posing a significant challenge for the treatment of associated infections. This paper analyzes the phenotypic, genetic, and clinical characteristics of SCVs to provide a reference for the clinical diagnosis and treatment of SCV infections.

Objective To construct a human resource allocation model for the Experimental Medicine Department through the measurment of working hour load,in order to achieve accurate and efficient allocation of human resources in the Experimental Medicine Department under the background of medical insurance payment reform.Methods The Department of Experimental Medicine,a 1 100-beds tertiary general hospital in Chengdu,was selected as the research object.The task list method and expert consultation method were used to analyze the work connotation,business process and specific operation of technicians in detail,and the business of laboratory medicine was divided into three dimensions:inspection operation,transactional task and management responsibility.The business operation time of all in-service technicians in the department was measured by stopwatch timing,work sampling,self-recording and back-up interviews,the average value method was used to describe the time consumption of each work step,and the working hours of the work items were counted according to the task list.Combined with the DORATASK model and the standard time concept,a manpower allocation model of the experimental medicine department was established.Results The total time spent of the inspection work was 1 320.82h,the total time of the whole process of the measured transactional work was multiplied by the operation frequency,and the total time spent of the monthly average transactional work was 523.38h,and the average monthly total time spent of the management work was 168 hours by multiplying the number of management positions by the standard working hours.Substituting the data into the model,the average monthly workload of technicians in the hospital was 2 012.2h,and the number of technicians in non-night shift,on-duty or compensatory leave positions was 14 to 15.The measurement results were basically consistent with the number of manpower allocated recommended by experts from multiple departments of the hospital.From 2021 to 2023,the model measurements were continuously tracked,which were consistent with the staffing of the department.Conclusion The human resource allocation model for work hour load adopts quantitative methods,combined with standard time and physiological slack rate,to provide a scientific and flexible path for human resource allocation decision-making.Based on this,the management can gain insight into work intensity and efficiency bottlenecks,implement targeted cost control and manpower optimization,ensure efficient resource utilization and cost control,and promote continuous optimization and upgrading of hospital operation management.

Objective To construct a human resource allocation model for the Experimental Medicine Department through the measurment of working hour load,in order to achieve accurate and efficient allocation of human resources in the Experimental Medicine Department under the background of medical insurance payment reform.Methods The Department of Experimental Medicine,a 1 100-beds tertiary general hospital in Chengdu,was selected as the research object.The task list method and expert consultation method were used to analyze the work connotation,business process and specific operation of technicians in detail,and the business of laboratory medicine was divided into three dimensions:inspection operation,transactional task and management responsibility.The business operation time of all in-service technicians in the department was measured by stopwatch timing,work sampling,self-recording and back-up interviews,the average value method was used to describe the time consumption of each work step,and the working hours of the work items were counted according to the task list.Combined with the DORATASK model and the standard time concept,a manpower allocation model of the experimental medicine department was established.Results The total time spent of the inspection work was 1 320.82h,the total time of the whole process of the measured transactional work was multiplied by the operation frequency,and the total time spent of the monthly average transactional work was 523.38h,and the average monthly total time spent of the management work was 168 hours by multiplying the number of management positions by the standard working hours.Substituting the data into the model,the average monthly workload of technicians in the hospital was 2 012.2h,and the number of technicians in non-night shift,on-duty or compensatory leave positions was 14 to 15.The measurement results were basically consistent with the number of manpower allocated recommended by experts from multiple departments of the hospital.From 2021 to 2023,the model measurements were continuously tracked,which were consistent with the staffing of the department.Conclusion The human resource allocation model for work hour load adopts quantitative methods,combined with standard time and physiological slack rate,to provide a scientific and flexible path for human resource allocation decision-making.Based on this,the management can gain insight into work intensity and efficiency bottlenecks,implement targeted cost control and manpower optimization,ensure efficient resource utilization and cost control,and promote continuous optimization and upgrading of hospital operation management.

When bacteria inhabit an unfavorable environment, they adapt by forming small colony variants (SCVs) under selective pressure, resulting in a slow-growing subpopulation with distinct phenotypic and pathogenic characteristics. Phenotypically, SCVs exhibit a slow growth rate, atypical colony morphology, and unusual biochemical traits. Clinically, SCVs demonstrate reduced susceptibility to antibiotics and can persistently proliferate within the host environment as potential pathogens, posing a significant challenge for the treatment of associated infections. This paper analyzes the phenotypic, genetic, and clinical characteristics of SCVs to provide a reference for the clinical diagnosis and treatment of SCV infections.

The comparison between traditional Chinese medicine Jinzhen oral liquid (JZOL) and Western medicine in treating children with acute bronchitis (AB) showed encouraging outcomes. This trial evaluated the efficacy and safety of the JZOL for improving cough and expectoration in children with AB. 480 children were randomly assigned to take JZOL or ambroxol hydrochloride and clenbuterol hydrochloride oral solution for 7 days. The primary outcome was time-to-cough resolution. The median time-to-cough resolution in both groups was 5.0 days and the antitussive onset median time was only 1 day. This randomized controlled trial showed that JZOL was not inferior to cough suppressant and phlegm resolving western medicine in treating cough and sputum and could comprehensively treat respiratory and systemic discomfort symptoms. Combined with clinical trials, the mechanism of JZOL against AB was uncovered by network target analysis, it was found that the pathways in TRP channels like IL-1β/IL1R/TRPV1/TRPA1, NGF/TrkA/TRPV1/TRPA1, and PGE2/EP/PKA/TRPV1/TRPA1 might play important roles. Animal experiments further confirmed that inflammation and the immune regulatory effect of JZOL in the treatment of AB were of vital importance and TRP channels were the key mechanism of action.

Objective To explore the clinical characteristics of patients with drug-induced liver injury(DILI),so as to provide references for its diagnosis and treatment.Methods The clinical data of inpatients diagnosed as DILI in The Third Affiliated Hospital of Naval Medical University(Second Military Medical University),from Jan.2017 to Dec.2021 were retrospectively analyzed,including basic information,underlying diseases,drug use history,clinical manifestations,laboratory indexes,severity and prognosis of DILI.Results Among 145 patients with DILI,112 cases(77.24％)were hepatocellular type,25 cases(17.24％)were cholestatic type,and 8 cases(5.52％)were mixed type.The types of drugs causing DILI mainly included traditional Chinese medicine,proprietary Chinese medicine and anti-infective drugs,and the proportions were 48.72％(76/156),16.03％(25/156),and 10.26％(16/156),respectively.The common clinical manifestations of DILI patients were jaundice(76.55％),poor appetite(52.41％),and fatigue(49.66％).The levels of alanine transaminase(ALT),aspartate transaminase,alkaline phosphatase(ALP),total bilirubin(TBil),γ-glutamyl transferase and albumin(ALB),as well as the length of hospital stay and severity distribution were significantly different among different types of liver injury(all P＜0.05).The levels of ALT and ALB in the good prognosis group were significantly higher than those in the poor prognosis group,while the levels of TBil and international normalized ratio in the good prognosis group were significantly lower than those in the poor prognosis group(all P＜0.05).Multivariate analysis showed that INR was an independent predictor of the prognosis of DILI(P＜0.05).Conclusion Serum biochemistry indicators can help to identify the clinical classification and prognosis of DILI.Traditional Chinese medicine,proprietary Chinese medicine and other drugs can cause DILI.Medical staff should pay attention to it and strengthen public health education.

Transradial access(TRA)for performing interventional diagnosis and treatment can reduce access site complications.However,TRA can still cause complications in the operated limb,including radial artery spasm,radial artery perforation,hemorrhage,hematoma,radial artery dissection,osteofascial compartment syndrome,nerve injury,pseudoaneurysm,arteriovenous fistula,and radial artery occlusion,among which radial artery spasm is the most commonly seen.At present,the clinical recognition,prevention and treatment of complications of surgical limbs are still insufficient.Therefore,this consensus aims to make a detailed introduction about the identification,prevention and nursing of nine major types of complications of the surgical limb in interventional diagnosis and treatment procedures via radial artery access,to propose 24 recommendations which may provide a reference for medical institutions in carrying out the nursing care for complications of the surgical limb in interventional diagnosis and treatment procedures via radial artery access,and to reduce the occurrence of complications in patients.(J Intervent Radiol,2024,33:465-471)

Objective: To investigate the clinical effects of sinus elevation surgery and implant restorationdue to insufficient bone massafter tooth extraction in patients with odontogenic maxillary sinusitis (OMS) and to provide a reference for use in clinical practice. Methods: This study was reviewed and approved by the Ethics Committee, and informed consent was obtained from the patients. Forty-five teeth were extracted from patients with OMS in the maxillary posterior area (the study group). Sinus elevation and implantation were performed due to insufficient bone height in the implant area 6-8 months after tooth extraction in the study group. Forty-eight teeth were extracted from patients without "OMS" in the maxillary posterior area (the control group), and sinus elevation and implantation were performed due to insufficient bone height in the implant area 6-8 months after tooth extraction inthe control group. In the study group, 13 cases of discontinuous maxillary sinus floor bone and residual alveolar bone height of the maxillary sinus floor less than 4 mm were addressed with lateral wall sinus elevation, and the other 32 cases were addressed with crest-approach sinus elevation. In the control group, 8 cases of residual alveolar bone height less than 4 mm in the maxillary sinus floor were addressed with lateral wall sinus,and the other 40 cases were addressed with crest approach sinus elevation. Restorations were placed 6 to 8 months after surgery. The patients were followed up 21 days, 3 months, and 8 months after implantation and every 6 months after the placement of the restorations. The sinus bone gain (SBG), apical bone height (ABL) and marginal bone loss (MBL) were statistically analyzed 24 months after the restoration. Results: The average preoperative mucosal thickness in the 45 patients in the study group was (1.556 ± 0.693) mm, which was significantly larger than that in the control group (1.229 ± 0.425) mm (P<0.001). There were no perforations in either group. Twenty-four months after restoration, there was no significant difference in the SBG, ABH or MBL between the two groups (P>0.05). Conclusion After the extraction of teeth from patients with OMS, the inflammation of the maxillary sinus decreased, and the bone height and density in the edentulous area were restored to a certain degree. The effects of sinus floor lifting surgery and implant restoration do not differ between patients with and without OMS.

The organization of the brain follows a topological hierarchy that changes dynamically during development. However, it remains unknown whether and how cognitive training administered over multiple years during development can modify this hierarchical topology. By measuring the brain and behavior of school children who had carried out abacus-based mental calculation (AMC) training for five years (starting from 7 years to 12 years old) in pre-training and post-training, we revealed the reshaping effect of long-term AMC intervention during development on the brain hierarchical topology. We observed the development-induced emergence of the default network, AMC training-promoted shifting, and regional changes in cortical gradients. Moreover, the training-induced gradient changes were located in visual and somatomotor areas in association with the visuospatial/motor-imagery strategy. We found that gradient-based features can predict the math ability within groups. Our findings provide novel insights into the dynamic nature of network recruitment impacted by long-term cognitive training during development.
Child ; Humans ; Cognitive Training ; Magnetic Resonance Imaging ; Brain ; Brain Mapping ; Motor Cortex

ObjectiveTo explore the possible mechanism of Bimin Formula （鼻敏方） in treating lung-spleen qi deficiency syndrome of allergic rhinitis （AR） with high mucin secretion. MethodsThirty-four SD rats were randomly divided into a blank group （8 rats）， a model group （8 rats）， a low-dose Bimin Formula group （8 rats）， and a high-dose Bimin Formula group （10 rats）. Except for the blank group， the other groups were subjected to AR lung-spleen qi deficiency rat models induced by smoking， gavage of Ginkgo biloba leaf extract， and ovalbumin. After modeling， rats in the low- and high-dose Bimin Formula groups were given Bimin Formula concentrate （concentration of 2.16 g/ml） by gavage at doses of 1.08 g/100 g and 2.16 g/100 g， respectively， while rats in the model group were given 0.5 ml/100 g of normal saline by gavage， once daily for 28 days； the blank group was not intervened. Behavioral assessments were performed after intervention. ELISA was used to detect the levels of peripheral blood total immunoglobulin E （IgE）. HE staining was used to observe the pathological changes of nasal mucosa epithelium in rats， while immunohistochemistry was used to detect the expression of transmembrane protein 16A （TMEM16A） and mucin 5AC （MUC5AC） protein in nasal mucosa. Western Blot was used to detect the expression of nuclear factor kappa B （NF-κB） protein， and RT-PCR was used to detect the expression of TMEM16A， MUC5AC， and NF-κB mRNA in nasal mucosa. ResultsHE staining showed that the nasal mucosa epithelial cell structure in the blank group was intact without shedding， swelling， or necrosis； the nasal mucosa epithelial tissue of rats in the model group was thickened and partially shed， with infiltration of eosinophils and lymphocytes visible； the pathological changes in nasal mucosa tissue of rats in the high- and low-dose Bimin Formulagroups were improved， and more improvement was showen in the high-dose group. Compared with those in the blank group， the behavioral scores and peripheral blood total IgE levels of rats in the model group significantly increased， as well as the expression of TMEM16A， MUC5AC， and NF-κB proteins and mRNA in nasal mucosa （P＜0.05 or P＜0.01）. Compared with those in the model group， the behavioral scores and peripheral blood total IgE levels of rats in the high-dose Bimin Formula group decreased， and the expression of TMEM16A， MUC5AC， and NF-κB proteins and mRNA in nasal mucosaalso decreased （P＜0.05 or P＜0.01）； the behavioral scores and peripheral blood total IgE levels of rats in the low-dose Bimin Formula group were reduced， and the expression of TMEM16A and MUC5AC proteins and mRNA in nasal mucosa， as well as the expression of NF-κB protein decreased （P＜0.05 or P＜0.01）， but the difference in NF-κB mRNA expression was not statistically significant （P＞0.05）. Compared with the low-dose Bimin Formula group， the expression of NF-κB protein in the high-dose group decreased （P＜0.01）. ConclusionBimin Formula may improve the symptoms and high mucus secretion of AR lung-spleen qi deficiency by regulating the TMEM16A/NF-κB/MUC5AC signaling pathway in nasalmucosa.