Advanced atherosclerosis is the major global cause of death, as featured by the aggregation of apoptotic cells (ACs) in necrotic cores. The defective efferocytosis and dysfunctional cholesterol efflux of macrophages are the main reasons for forming necrotic cores in advanced atherosclerosis. In this study, we constructed self-assembled procyanidins (PC) NPs for loading pitavastatin (Pita). The designed HA@PC@Pita NPs with hyaluronic acid (HA) modification combined the advantages of efferocytosis restoration of Pita and cholesterol efflux enhancement of PC. In vitro assay indicated that HA@PC@Pita NPs could induce M1/M2 repolarization and upregulate ERK5/Mertk expression to restore efferocytosis of macrophages. Simultaneously, HA@PC@Pita NPs notably promoted cholesterol efflux by promoting macrophage lipophagy, a selective autophagy of lipid droplets. In vivo study showed that HA@PC@Pita NPs cleared necrotic core and enhanced plaque stability in the ApoE ^-/- mice model with advanced atherosclerosis. Taken together, this study demonstrated the potential of HA@PC@Pita NPs for the treatment of advanced atherosclerosis.

Surgical operation is the main treatment of oral and maxillofacial tumors.Dysphagia is a common postoperative complication.Swal-lowing disorder can not only lead to mis-aspiration,malnutrition,aspiration pneumonia and other serious consequences,but also may cause psychological problems and social communication barriers,affecting the quality of life of the patients.At present,there is no systematic evalua-tion and rehabilitation management plan for the problem of swallowing disorder after oral and maxillofacial tumor surgery in China.Combining the characteristics of postoperative swallowing disorder in patients with oral and maxillofacial tumors,summarizing the clinical experience of ex-perts in the field of tumor and rehabilitation,reviewing and summarizing relevant literature at home and abroad,and through joint discussion and modification,a group of national experts reached this consensus including the core contents of the screening of swallowing disorders,the phased assessment of prognosis and complications,and the implementation plan of comprehensive management such as nutrition management,respiratory management,swallowing function recovery,psychology and nursing during rehabilitation treatment,in order to improve the evalua-tion and rehabilitation of swallowing disorder after oral and maxillofacial tumor surgery in clinic.

ObjectiveTo use the maternal morbidity WOICE Tool（Chinese version）to investigate the maternal morbidity in Shanghai， and to examine the current situation and associated factors of adverse symptoms and impaired functioning in the third trimester and postpartum period. MethodsPregnant women who made their initial visit and established a medical record at a tertiary obstetrics and gynecology hospital in Shanghai from March to August 2021 were recruited and a baseline survey was completed. The prevalence of maternal morbidity was surveyed in the third trimester and first 6 weeks postpartum. ResultsSelf-reported adverse physical symptoms were observed in 89.8% of women in the third trimester and 86.1% in first 6 weeks postpartum. The prevalence rates of anxiety and depression were 4.1% and 6.2% in the third trimester， and 6.2% and 7.5% in first 6 weeks postpartum， respectively. The proportions of women reporting impaired functioning were 80.3% in the third trimester and 64.1% in first 6 weeks postpartum， respectively. Physical symptoms were associated with parity， education， the newborn’s health status， and risk of experiencing violence. Psychological symptoms were associated with age， household responsibilities， employment status， the newborn’s health status， pre-pregnancy body mass index （BMI）， and risk of experiencing violence. Functionality was associated with the type of registered residence， education level， household responsibilities， and risk of experiencing violence. ConclusionThe physical health status of pregnant and postpartum women in Shanghai is better than that in the middle-income regions abroad， with anxiety and depression at average levels compared to national statistics in China. Physical， psychological， and functional status are affected by multiple factors including personal， health， family， and work conditions. Preventive measures should be taken from various perspectives to mitigate adverse symptoms and impaired functioning， and to improve the positive experience of pregnancy and childbirth.

Objective:To establish the post competency evaluation index system for extracorporeal membrane oxygenation (ECMO) nurses.Methods:Based on semi-structured interviews, a preliminary post competency evaluation index system for ECMO nurses was developed. From May to June 2022, the Delphi method was used to conduct two rounds of consultation with 19 experts in critical illness field from 15 ClassⅢGrade A hospitals in 6 provinces and municipalities across the country to determine the evaluation index system. The analytic hierarchy process was used to determine the weights and consistency coefficients of indexes at all levels. The positivity of experts was expressed by the effective response rate of the questionnaire, the coordination degree of expert opinions was expressed by Kendall's W and coefficient of variation, the authority of experts was expressed by the authority coefficient of experts, and the concentration of expert opinion was expressed by the mean importance assignment and the perfect score rate. Results:In two rounds of expert consultations, the effective response rates of the questionnaires well all 100.00% (19/19), with expert authority coefficients of 0.834 and 0.879. The Kendall's W for the overall indicator in the second round of expert correspondence was 0.281 ( P<0.01), and the coefficient of variation of the indicators at all levels was 0.05 to 0.17. In the second round of consultation, the mean importance scores assigned to indicators at all levels was 4.05 to 4.95, with a perfect score of 21.05% to 94.74%. The final constructed post competency evaluation index system for ECMO nurses included 4 first-level indicators, 28 second-level indicators, and 59 third-level indicators. Conclusions:The post competency evaluation index system for ECMO nurses is scientific, reliable, and reasonable, which can provide reference for optimizing the ECMO nurse training system and improving evaluation standards.

Extracorporeal membrane oxygenation is an extracorporeal life support technique used to rescue patients with respiratory and (or) heart failure. Infection is one of the most serious complications of extracorporeal membrane oxygenation, which can affect patients' clinical outcomes. This article reviews the definition, diagnosis, incidence, site of infection, pathogenic bacteria, risk factors, prevention and treatment measures of extracorporeal membrane oxygenation associated nosocomial infection, so as to provide reference for the prevention and treatment of extracorporeal membrane oxygenation associated nosocomial infection.

Objective:To study the effect of thermal effect on the filling effect of bioceramic paste combined with thermal gel gutta-percha vertical obturation method in different parts of root canal.Methods:Forty single-root canal teeth samples were randomly and randomized divided into the control group, the iRoot SP group, the 10 s group and the 20 s group. All tooth samples were root canal prepared to 0.04 taper after crown removal. The control group received AH-plus paste combined with thermal gel gutta-percha vertical obturation. The iRoot SP group received iRoot SP single-point filling. The 10 s group and 20 s group received iRoot SP single-point filling combined with thermal gel gutta-percha vertical obturation, in which the root canal of the two groups were heated at 180 °C for 10 s and 20 s, respectively, before using the thermosetting gutta-percha. Methylene blue staining, scanning electron microscope (SEM) observation and dental microscope observation were used to analyze the occurrence of gaps in the middle and upper segment of the root canal and the apical 1/3 of the root canal after filling.Results:For the filling in the apical 1/3 of the root canal, no obvious gap appeared in the 10 s group and the 20 s group, and there was no significant difference between the dye infection depth and the control group (all P>0.05). For the filling of the middle and upper segment of the root canal, the probability of porosity is higher when using iRoot SP combined with single-point filling. Conclusions:Short-term high temperature heating will not affect the sealing effect of iRoot SP on the apical 1/3 of the root canal. For the middle and upper segment of the root canal, the filling effect of iRoot SP single-point filling combined with thermal gel gutta-percha vertical obturation method is better than that of iRoot SP single-point filling.

This paper reviews the research status of the training and certification of extracorporeal membrane oxygenation nurses at home and abroad and their job competencies, and analyzes its limitations, so as to provide a reference for the training of extracorporeal membrane oxygenation nurses in my country.

BACKGROUND: The fetal growth charts in widest use in China were published by Hadlock >35 years ago and were established on data from several hundred of American pregnant women. After that, >100 fetal growth charts were published around the world. We attempted to assess the impact of applying the long-standing Hadlock charts and other charts in a Chinese population and to compare their ability to predict newborn small for gestational age (SGA). METHODS: For this retrospective observational study, we reviewed all pregnant women ( n  = 106,455) who booked prenatal care with ultrasound measurements for fetal biometry at the Shenzhen Maternity and Child Healthcare Hospital between 2012 and 2019. A fractional polynomial regression model was applied to generate Shenzhen fetal growth chart ranges for head circumference (HC), biparietal diameter (BPD), abdominal circumference (AC), and femur length (FL). The differences between Shenzhen charts and published charts were quantified by calculating the Z -score. The impact of applying these published charts was quantified by calculating the proportions of fetuses with biometric measurements below the 3rd centile of these charts. The sensitivity and area under the receiver operating characteristic curves of published charts to predict neonatal SGA (birthweight <10th centile) were assessed. RESULTS: Following selection, 169,980 scans of fetal biometry contributed by 41,032 pregnancies with reliable gestational age were analyzed. When using Hadlock references (<3rd centile), the proportions of small heads and short femurs were as high as 8.9% and 6.6% in late gestation, respectively. The INTERGROWTH-21st standards matched those of our observed curves better than other charts, in particular for fat-free biometry (HC and FL). When using AC<10th centile, all of these references were poor at predicting neonatal SGA. CONCLUSIONS Applying long-standing Hadlock references could misclassify a large proportion of fetuses as SGA. INTERGROWTH-21st standard appears to be a safe option in China. For fat-based biometry, AC, a reference based on the Chinese population is needed. In addition, when applying published charts, particular care should be taken due to the discrepancy of measurement methods.
Infant, Newborn ; Child ; Female ; Pregnancy ; Humans ; Growth Charts ; Prenatal Care ; Ultrasonography, Prenatal/methods* ; Fetal Development ; Fetal Growth Retardation ; Gestational Age ; Fetus ; China ; Infant, Newborn, Diseases ; Observational Studies as Topic

Animals ; Antlers ; Exosomes ; Mesenchymal Stem Cells ; Osteoarthritis/therapy*