Multi-rehabilitation treatment and early nutritional support are closely related to the recovery of critical ill patients.At present,a number of nutritional and rehabilitation interventions have been applied to critically ill patients to aid in their treatment and improve their nutritional status and motor dysfunction..In recent years,certain progress has been made in related research.This paper aims to summarize the latest literature on the application of multidisciplinary rehabilitation therapy in patients with CI under early nutritional support,provide comprehensive,systematic and practically valuable reference for clinical medical staff when formulating comprehensive treatment plans for CI patients under early nutritional support,and improve the treatment effect and quality of life of CI patients.

Objective:To observe the incidence of early blood eosinophils (Eos) elevation in patients with peritoneal dialysis (PD), analyze its related factors, and its relationship with early-onset peritonitis in PD patients.Methods:This study was a retrospective observational cohort study. Patients who underwent PD catheterization in Peking University People's Hospital from January 2012 to December 2022 were included. After surgery, PD treatment was started immediately and followed up regularly ≥12 months. The general information and laboratory indexes collected 1 week before catheterization, and at 1, 3, 6 and 12 months after catheterization were recorded. The occurrence of elevated blood Eos (≥0.5×10 9/L) during the early stage of PD, the related factors of Eos elevation (≥0.5×10 9/L) and the relationship with early-onset peritonitis (within 12 months after PD initiation) were analyzed. Results:(1) A total of 235 patients were enrolled, with an age of (57.9.±13.9) years, including 136 males (57.9%). The primary diseases were predominantly chronic glomerulonephritis (111/235, 42.7%) and diabetic nephropathy (83/235, 35.3%). During the 12-month follow-up period, 73 patients had elevated blood Eos (31.1%), of which 37 cases (50.7%) occurred within 1 month after PD catheterization, 21 cases (28.7%) occurred 2-3 months after PD catheterization, 12 cases (16.4%) occurred 4-6 months after PD catheterization, and 3 cases (4.1%) occurred 7-12 months after PD catheterization. In 73 patients with elevated Eos, 69 cases (94.5%) were mildly elevated, 4 cases (5.5%) were moderately elevated. As for the duration of elevated blood Eos, 28 cases (38.4%) lasted less than 1 month, 27 cases (37.0%) lasted 1-3 months, and 18 cases (24.7%) lasted more than 3 months. (2) In patients with elevated blood Eos, the proportion of male patients (71.4% vs. 52.1%, χ 2=7.515, P=0.006), the proportion of diabetes mellitus (55.7% vs. 41.2%, χ 2=4.168, P=0.046), and the proportion of combined vascular disease (32.9% vs. 18.2%, χ 2=6.060, P=0.017) were significantly higher than those patients in normal blood Eos group. (3) Multivariate Logistic regression analysis showed that male was an independent related factor for elevated blood Eos (≥0.5×10 9/L) in the early stages of PD ( OR=2.044, 95% CI 1.101- 3.794, P=0.023). (4) Diabetes mellitus ( OR=3.363, 95% CI 1.087-10.405, P=0.035), lower baseline hemoglobin level ( OR=0.941, 95% CI 0.903-0.980, P=0.004) and elevated blood Eos (with serum Eos<0.5×10 9/L as reference, OR=2.917, 95% CI 1.022-8.326, P=0.045) were the independent related factors of early-onset peritonitis. Conclusion:Blood Eos elevations are common in early stage of PD patients , mainly occuring within 6 months after PD catheterization, and most of them are slightly increased and last less than 3 months. Male sex is an independent related factor for the elevation of blood Eos in the early stage of PD. Elevated blood Eos is an independent related factor for early-onset peritonitis.

Objective Network pharmacology and molecular docking techniques were used to predict the potential mechanisms by which the active components of Piper nigrum(PN)regulate depressive-like behaviors in chronic restraint stress(CRS)mice.Methods The major chemical components and targets of PN were screened using the Traditional Chinese Medicine Systems Pharmacology database.Targets related to ferroptosis and depression were obtained from the Online Mendelian Inheritance in Man,GeneCards,and FerrDB databases.The intersecting targets were then subjected to Gene Ontology and Kyoto Encyclopedia of Genes and Gnomes(KEGG)pathway enrichment analyses,and molecular docking was performed to validate the binding capacities between the core targets and their corresponding active components.Finally,we established a CRS mouse model.Mice were treated with PN 75,150,and 300 mg/kg for 4 weeks,followed by behavioral assessments and reverse transcription-quantitative polymerase chain reaction(RT-qPCR)to verify the expression of core genes.Results Nine active components were screened from PN,corresponding to 27 targets,and 8377 targets related to depression and 547 targets associated with ferroptosis were screened from the databases.The intersection of these three sets resulted in 25 target genes.KEGG enrichment analysis revealed that these core targets were predominantly enriched in signaling pathways,including cholinergic synapses,serotonergic synapses,and neuroactive ligand-receptor interactions.Molecular docking result showed that the main active components of PN had strong binding affinities for the targets CHRM2,SLC6A4,PTGS2,and SLC6A2.Behavioral assessments demonstrated that PN significantly increased the sucrose preference index(P＜0.01,P＜0.001),reduced immobility time in the tail suspension and forced swimming tests(P＜0.01,P＜0.001),and enhanced exploratory behavior in the open field test(P＜0.05.P＜0.01,P＜0.001).PN significantly reduced the serum levels of inflammation markers(P＜0.05.P＜0.01,P＜0.001),as shown by enzyme-linked immunosorbent assay,and neurotransmitter analysis revealed that PN significantly increased the levels of serotonin and acetylcholine in the mouse hippocampus(P＜0.05).RT-qPCR showed that PN demonstrated the mRNA expression of SLC6A4(P＜0.05.P＜0.01,P＜0.001).Conclusions PN may improve depressive-like behavior in mice by modulating serotonin and acetylcholine levels,inhibiting inflammatory responses,participating in immune regulation,and exerting neuroprotective effects.

Objective Network pharmacology and molecular docking techniques were used to predict the potential mechanisms by which the active components of Piper nigrum(PN)regulate depressive-like behaviors in chronic restraint stress(CRS)mice.Methods The major chemical components and targets of PN were screened using the Traditional Chinese Medicine Systems Pharmacology database.Targets related to ferroptosis and depression were obtained from the Online Mendelian Inheritance in Man,GeneCards,and FerrDB databases.The intersecting targets were then subjected to Gene Ontology and Kyoto Encyclopedia of Genes and Gnomes(KEGG)pathway enrichment analyses,and molecular docking was performed to validate the binding capacities between the core targets and their corresponding active components.Finally,we established a CRS mouse model.Mice were treated with PN 75,150,and 300 mg/kg for 4 weeks,followed by behavioral assessments and reverse transcription-quantitative polymerase chain reaction(RT-qPCR)to verify the expression of core genes.Results Nine active components were screened from PN,corresponding to 27 targets,and 8377 targets related to depression and 547 targets associated with ferroptosis were screened from the databases.The intersection of these three sets resulted in 25 target genes.KEGG enrichment analysis revealed that these core targets were predominantly enriched in signaling pathways,including cholinergic synapses,serotonergic synapses,and neuroactive ligand-receptor interactions.Molecular docking result showed that the main active components of PN had strong binding affinities for the targets CHRM2,SLC6A4,PTGS2,and SLC6A2.Behavioral assessments demonstrated that PN significantly increased the sucrose preference index(P＜0.01,P＜0.001),reduced immobility time in the tail suspension and forced swimming tests(P＜0.01,P＜0.001),and enhanced exploratory behavior in the open field test(P＜0.05.P＜0.01,P＜0.001).PN significantly reduced the serum levels of inflammation markers(P＜0.05.P＜0.01,P＜0.001),as shown by enzyme-linked immunosorbent assay,and neurotransmitter analysis revealed that PN significantly increased the levels of serotonin and acetylcholine in the mouse hippocampus(P＜0.05).RT-qPCR showed that PN demonstrated the mRNA expression of SLC6A4(P＜0.05.P＜0.01,P＜0.001).Conclusions PN may improve depressive-like behavior in mice by modulating serotonin and acetylcholine levels,inhibiting inflammatory responses,participating in immune regulation,and exerting neuroprotective effects.

Objective To compare the application effects of bronchial blocker(BB)and double-lumen endotracheal tube(DLT)in pediatric thoracoscopic lobectomy.Methods A total of 80 pediatric patients who underwent thoracoscopic lobectomy at Xuzhou Children's Hospital from February 2020 to February 2023 were randomly divided into the DLT group(n=40)and the BB group(n=40)by envelope drawing.The DLT group received treatment with double-lumen endotracheal tubes,while the BB group was treated with bronchial blockers.Perioperative indicators,mean arterial pressure(MAP),heart rate(HR)at different times,airway pressure,pre-and post-operative recovery quality scores(QoR-15),intraoperative lung collapse(LCS)scores,modified Aldrete recovery scores,and adverse reactions were compared between the two groups.Results The comparison of single-lung ventilation time,intubation positioning time,and anesthesia time between the two groups showed no statistically significant differences(P＞0.05);however,the operation time of the BB group was(68.37±6.28)minutes and the hospital stay was(4.56±0.35)days,while those of the DLT group were(76.87±8.34)minutes and(5.97±0.70)days,respectively.There was a statistically significant difference between the two groups(P＜0.05).There were no significant differences in the mean arterial pressure(MAP)and heart rate(HR)before induction(T0)between the two groups(P＞0.05).The MAP of the BB group immediately after intubation(T1),2 minutes after intubation(T2),immediately after extubation(T3),and 2 minutes after extubation(T4)was(91.53±8.28)mmHg,(89.58±8.72)mmHg,(89.33±8.97)mmHg,and(95.40±9.86)mmHg,respectively.The HRS were(72.74±6.35)times/minute,(72.83±6.82)times/minute,(71.19±6.57)times/minute,and(73.63±7.46)times/minute respectively.The MAP in the DLT group was(83.88±7.29)mmHg,(83.40±7.66)mmHg,(85.17±7.91)mmHg,and(89.42±9.15)mmHg,respectively.HR was(66.68±6.17)times/minute,(64.27±6.19)times/minute,(65.97±6.28)times/minute,and(68.80±6.27)times/minute,respectively.There was a statistically significant difference between the two groups(P＜0.05).The airway pressures of the BB group at 5 minutes of bilateral lung ventilation(T5),5 minutes of unilateral lung ventilation(T6),and 5 minutes of recovery of bilateral lung ventilation(T7)were(14.36±2.46)cmH2O,(17.34±2.75)cmH2O,and(15.30±2.32)emH2O,respectively.The values in the DLT group were(17.77±2.85)cmH2O,(21.35±3.17)cmH2O,and(18.49±2.99)cmH2O,respectively.There was a statistically significant difference between the two groups(P＜0.05).There was no statistically significant difference in QOR-15 score and modified Aldrete recovery score one day before the operation between the two groups(P＞0.05).One day after surgery,the QOR-15 score of the BB group was(119.33±12.20)points,and the intraoperative LCS score was(7.70±0.61)points,while those of the DLT group were(107.60±10.10)and(6.31±0.57)points,respectively.There was a statistically significant difference between the two groups(P＜0.05).The incidence of adverse reactions was 10.0％in the BB group and 27.5％in the DLT group.There was a statistically significant difference between the two groups(P＜0.05).Conclusion The application of bronchial blockers in pediatric thoracoscopic lobectomy shows better results compared to double-lumen endotracheal tubes.

Objective:To summarize the key points of perioperative anesthesia management of infants undergoing endoscopic endonasal resection of craniopharyngioma.Methods:The medical records of infants, aged 1-3 yr, undergoing endoscopic endonasal resection of craniopharyngioma at Beijing Tiantan Hospital affiliated to Capital Medical University from January 1, 2023 to December 31, 2023, were retrospectively analyzed. The demographic and perioperative information was collected.Results:Six pediatric patients were included, with 5 males and 1 female, with height of (103±6) cm and weight of (16±3) kg. Five cases had abnormal anterior pituitary hormones before surgery. All the children with abnormal hormone levels were given hormone supplementation during surgery, except for those with elevated free thyroxine. None of the 6 children showed significant electrolyte abnormalities or diabetes insipidus. Five children received blood transfusion treatment, with an allogeneic red blood cell volume of (114±79) ml. Among them, 4 children received allogeneic plasma transfusion, with a volume of (75±69) ml. All the 6 pediatric patients were conscious with tracheal tubes removed after surgery. Three pediatric patients had hyponatremia, and 2 pediatric patients still had hypothyroidism. All the pediatric patients did not experience postoperative diabetes insipidus, cerebrospinal fluid rhinorrhea or epileptic seizures.Conclusions:Adequate preoperative assessments should be conducted, and detection of anterior pituitary hormone levels should be improved, with hormone replacement therapy administered when necessary in the perioperative anesthesia management for endoscopic endonasal resection of craniopharyngioma in infants. Vital signs should be closely monitored, and prompt treatment should be administered when diabetes insipidus and electrolyte disorders are found during surgery. Attention should be given to airway management to avoid airway spasms after surgery.

A method was developed for determination of dilauryl thiodipropionate(DLTDP)in fried foods by coupling solid-phase extraction(SPE)pretreatment with reverse-phase liquid chromatography-tandem mass spectrometry(RPLC-MS/MS)detection.Samples were extracted with n-hexane as the solvent,purified using a neutral alumina SPE cartridge,and finally analyzed by RPLC-MS/MS.Quantitative analysis was performed using matrix-matched calibration curves combined with an external standard method under optimal experimental conditions.The results showed that DLTDP exhibited good linearity in the range of 2.0-50.0 μg/L,with a correlation coefficient(R2)≥0.999.The limit of detection(LOD)and the limit of quantification(LOQ)of the method were 0.15 mg/kg and 0.5 mg/kg,respectively.The mean recoveries at three fortification levels(0.5,1.0,and 200 mg/kg)in different samples ranged from 84.8%to 96.8%,with the relative standard deviations(RSDs)all less than 8.0%.The developed method was highly sensitive,accurate and reliable,and easy to operate,making it well suited for the routine quantitative analysis of DLTDP in fried foods.

This paper focuses on extreme environments and systematically analyzes sleep disorders caused by multiple pathogenesis,including circadian rhythm disorder,yin-yang imbalance and qi-blood disorder under weightlessness,emotional depression due to environmental changes,abnormal diet and excretion,and six excesses pathogenic factors,in accordance with the theory of correspondence between nature and human.It proposes harmonizing yin and yang as the core therapeutic principle and guiding framework,with specific methods including calming rebellious qi-blood,regulating qi movement,harmonizing heart and kidney,and dredging and regulating blood vessels,thus forming the"one guiding principle and four specific methods"treatment strategy.Additionally,by integrating the modified application of classic formulas,a diagnostic and therapeutic approach targeting multi-dimensional pathogenesis is established.This study aims to promote the in-depth integration of Traditional Chinese Medicine(TCM)in extreme environmental medicine through TCM theories and innovative application of prescriptions,provide TCM-characterized solutions for health management of workers in extreme environments,and facilitate the transformation of extreme environmental medicine toward the modern medical model of"prevention-treatment integration".

Objective:To observe the incidence of early blood eosinophils (Eos) elevation in patients with peritoneal dialysis (PD), analyze its related factors, and its relationship with early-onset peritonitis in PD patients.Methods:This study was a retrospective observational cohort study. Patients who underwent PD catheterization in Peking University People's Hospital from January 2012 to December 2022 were included. After surgery, PD treatment was started immediately and followed up regularly ≥12 months. The general information and laboratory indexes collected 1 week before catheterization, and at 1, 3, 6 and 12 months after catheterization were recorded. The occurrence of elevated blood Eos (≥0.5×10 9/L) during the early stage of PD, the related factors of Eos elevation (≥0.5×10 9/L) and the relationship with early-onset peritonitis (within 12 months after PD initiation) were analyzed. Results:(1) A total of 235 patients were enrolled, with an age of (57.9.±13.9) years, including 136 males (57.9%). The primary diseases were predominantly chronic glomerulonephritis (111/235, 42.7%) and diabetic nephropathy (83/235, 35.3%). During the 12-month follow-up period, 73 patients had elevated blood Eos (31.1%), of which 37 cases (50.7%) occurred within 1 month after PD catheterization, 21 cases (28.7%) occurred 2-3 months after PD catheterization, 12 cases (16.4%) occurred 4-6 months after PD catheterization, and 3 cases (4.1%) occurred 7-12 months after PD catheterization. In 73 patients with elevated Eos, 69 cases (94.5%) were mildly elevated, 4 cases (5.5%) were moderately elevated. As for the duration of elevated blood Eos, 28 cases (38.4%) lasted less than 1 month, 27 cases (37.0%) lasted 1-3 months, and 18 cases (24.7%) lasted more than 3 months. (2) In patients with elevated blood Eos, the proportion of male patients (71.4% vs. 52.1%, χ 2=7.515, P=0.006), the proportion of diabetes mellitus (55.7% vs. 41.2%, χ 2=4.168, P=0.046), and the proportion of combined vascular disease (32.9% vs. 18.2%, χ 2=6.060, P=0.017) were significantly higher than those patients in normal blood Eos group. (3) Multivariate Logistic regression analysis showed that male was an independent related factor for elevated blood Eos (≥0.5×10 9/L) in the early stages of PD ( OR=2.044, 95% CI 1.101- 3.794, P=0.023). (4) Diabetes mellitus ( OR=3.363, 95% CI 1.087-10.405, P=0.035), lower baseline hemoglobin level ( OR=0.941, 95% CI 0.903-0.980, P=0.004) and elevated blood Eos (with serum Eos<0.5×10 9/L as reference, OR=2.917, 95% CI 1.022-8.326, P=0.045) were the independent related factors of early-onset peritonitis. Conclusion:Blood Eos elevations are common in early stage of PD patients , mainly occuring within 6 months after PD catheterization, and most of them are slightly increased and last less than 3 months. Male sex is an independent related factor for the elevation of blood Eos in the early stage of PD. Elevated blood Eos is an independent related factor for early-onset peritonitis.

Objective:To summarize the key points of perioperative anesthesia management of infants undergoing endoscopic endonasal resection of craniopharyngioma.Methods:The medical records of infants, aged 1-3 yr, undergoing endoscopic endonasal resection of craniopharyngioma at Beijing Tiantan Hospital affiliated to Capital Medical University from January 1, 2023 to December 31, 2023, were retrospectively analyzed. The demographic and perioperative information was collected.Results:Six pediatric patients were included, with 5 males and 1 female, with height of (103±6) cm and weight of (16±3) kg. Five cases had abnormal anterior pituitary hormones before surgery. All the children with abnormal hormone levels were given hormone supplementation during surgery, except for those with elevated free thyroxine. None of the 6 children showed significant electrolyte abnormalities or diabetes insipidus. Five children received blood transfusion treatment, with an allogeneic red blood cell volume of (114±79) ml. Among them, 4 children received allogeneic plasma transfusion, with a volume of (75±69) ml. All the 6 pediatric patients were conscious with tracheal tubes removed after surgery. Three pediatric patients had hyponatremia, and 2 pediatric patients still had hypothyroidism. All the pediatric patients did not experience postoperative diabetes insipidus, cerebrospinal fluid rhinorrhea or epileptic seizures.Conclusions:Adequate preoperative assessments should be conducted, and detection of anterior pituitary hormone levels should be improved, with hormone replacement therapy administered when necessary in the perioperative anesthesia management for endoscopic endonasal resection of craniopharyngioma in infants. Vital signs should be closely monitored, and prompt treatment should be administered when diabetes insipidus and electrolyte disorders are found during surgery. Attention should be given to airway management to avoid airway spasms after surgery.