Objective To establish a rat model of acclimatization to motion sickness(MS)induced by rotational stimulation.Methods To determine the stimulation conditions of MS,SD rats were divided into a static control group(SCG)and a single rotation stimulation group(SRG)before being subjected to the motion sickness index(MSI)measurement,open-field experiment and Morris water maze experiment after rotational stimulation to verify the feasibility of MS being induced in rats.Morris water maze experiments were performed to find out whether rotational stimulation could be used to induce MS in rats.During experiments on acclimatization,the SD rats were divided into the control group(Ctrl),one day of rotational stimulation group(Day1),three days of continuous rotational stimulation group(Day3),and seven days of continuous rotational stimulation group(Day7)before the changes in the MSI and behavior of these rats were recorded so as to explore the relationship between continuous stimulation and MS acclimatization in rats.Results After rotational stimulation,the rats showed a significant increase in the number of fecal pellets(P<0.0001)and in the MSI(P<0.0001)compared with the SCG.In the open field experiment,the rats showed a significant decrease in the spontaneous activity time(AT)(P<0.0001),total spontaneous activity distance(TD)(P<0.001)and distance moved by the center point per second(DMCPS)(P<0.001).The time taken to climb onto the platform(latency to find the platform,LP)(P<0.0001)and the total distance to the platform(distance to the platform,DP)(P<0.001)were significantly increased during the Morris water maze experiment.Acclimatization experiments revealed a significant increase in MSI and in the number of fecal pellets in the Day1 and Day3 groups of rotational stimulation compared to the Ctrl group(P<0.0001).AT(P<0.01),TD(P<0.05)and DMCPS(P<0.01)were significantly decreased,while LP and DP were significantly increased(P<0.0001),but there was no statistically significant difference in indices compared with the Day7 group(P>0.05).Conclusion Sinusoidal stimulation can induce MS in rats,and twice-a-day,continuous rotational stimulation for seven days can lead to acclimatization.The rat MS model can be assessed via behavioral experiments.

Background::Hepatitis B poses a heavy burden for children in China, however, the national studies on the distributional characteristics and health care costs of children with severe hepatitis B is still lacking. This study aimed to analyze the disease characteristics, health economic effects, and medical cost for children with severe hepatitis B in China.Methods::Based on patient information in the Hospital Quality Monitoring System, cases with severe hepatitis B were divided into four groups according to age, and the etiology and symptoms of each group were quantified. The cost of hospitalization was calculated for cases with different disease processes, and severity of disease. The spatial aggregation of cases and the relationship with health economic factors were analyzed by Moran’s I analysis. Results::The total number of children discharged with hepatitis B from January 2016 to April 2022 was 1603, with an average age of 10.5 years. Liver failure cases accounted for 43.48% (697/1603) of total cases and cirrhosis cases accounted for 11.23% (180/1603). According to the grouping of disease progression, there were 1292 cases without associated complications, and the median hospitalization cost was $818.12. According to the spatial analysis, the aggregation of cases was statistically significant at the prefectural and provincial levels in 2019, 2020, and 2021 (all P <0.05). The number of severe cases was negatively correlated with gross domestic product (Moran’s I <0) and percentage of urban population (Moran’s I <0), and positively correlated with the number of pediatric beds per million population (Moran’s I >0). Conclusion::The number of severe hepatitis B cases is low in areas with high gross domestic product levels and high urban population ratios, and health care costs have been declining over the years.

Electroencephalography (EEG) is a powerful tool for investigating brain electrophysiology with high temporal resolution. In recent years, advancements in EEG signal analyses have expanded our research capabilities. Among these, microstate analysis has emerged as a promising approach, providing insights into the topographical distribution of EEG signals and capturing millisecond-scale brain network dynamics. This technique offers a window into the intrinsic activity of large-scale neural networks. A hallmark of disorders of consciousness (DoC) is the disruption of brain activity dynamics. Research shows that EEG microstate analysis can deeply assess the consciousness level and neural mechanism during recovery process in DoC patients, demonstrating significant value in diagnosis and prognosis evaluation of DoC. This article reviews the principles and parameters of microstate analysis, the correlation between microstates and brain networks, and the parameter changes under different states of consciousness, and explores its application value in the diagnosis, classification and prognosis assessment of DoC, with the aim of providing new ideas for DoC precise diagnosis and treatment.

Background::Hepatitis B poses a heavy burden for children in China, however, the national studies on the distributional characteristics and health care costs of children with severe hepatitis B is still lacking. This study aimed to analyze the disease characteristics, health economic effects, and medical cost for children with severe hepatitis B in China.Methods::Based on patient information in the Hospital Quality Monitoring System, cases with severe hepatitis B were divided into four groups according to age, and the etiology and symptoms of each group were quantified. The cost of hospitalization was calculated for cases with different disease processes, and severity of disease. The spatial aggregation of cases and the relationship with health economic factors were analyzed by Moran’s I analysis. Results::The total number of children discharged with hepatitis B from January 2016 to April 2022 was 1603, with an average age of 10.5 years. Liver failure cases accounted for 43.48% (697/1603) of total cases and cirrhosis cases accounted for 11.23% (180/1603). According to the grouping of disease progression, there were 1292 cases without associated complications, and the median hospitalization cost was $818.12. According to the spatial analysis, the aggregation of cases was statistically significant at the prefectural and provincial levels in 2019, 2020, and 2021 (all P <0.05). The number of severe cases was negatively correlated with gross domestic product (Moran’s I <0) and percentage of urban population (Moran’s I <0), and positively correlated with the number of pediatric beds per million population (Moran’s I >0). Conclusion::The number of severe hepatitis B cases is low in areas with high gross domestic product levels and high urban population ratios, and health care costs have been declining over the years.

Electroencephalography (EEG) is a powerful tool for investigating brain electrophysiology with high temporal resolution. In recent years, advancements in EEG signal analyses have expanded our research capabilities. Among these, microstate analysis has emerged as a promising approach, providing insights into the topographical distribution of EEG signals and capturing millisecond-scale brain network dynamics. This technique offers a window into the intrinsic activity of large-scale neural networks. A hallmark of disorders of consciousness (DoC) is the disruption of brain activity dynamics. Research shows that EEG microstate analysis can deeply assess the consciousness level and neural mechanism during recovery process in DoC patients, demonstrating significant value in diagnosis and prognosis evaluation of DoC. This article reviews the principles and parameters of microstate analysis, the correlation between microstates and brain networks, and the parameter changes under different states of consciousness, and explores its application value in the diagnosis, classification and prognosis assessment of DoC, with the aim of providing new ideas for DoC precise diagnosis and treatment.

Objective:To investigate the effect of bupivacaine liposome for erector spinae plane block on the quality of postoperative recovery in patients undergoing thoracoscopic lung resection.Methods:From July 2023 to January 2024, 128 American Society of Anesthesiologists Physical Status classification ⅠorⅡ patients of either sex, aged 18-75 yr, with body mass index of 18-32 kg/m 2, scheduled for elective thoracoscopic lung resection at the First Affiliated Hospital of Soochow University, were assigned to either bupivacaine liposome group (BL group) or bupivacaine hydrochloride group (BH group) using a random number table method, with 64 patients in each group. Patients received an ultrasound-guided erector spinae plane block following anesthesia induction. BL group received an injection of bupivacaine liposome 20 ml (266 mg) plus normal saline 10 ml, while BH group received an injection of bupivacaine hydrochloride 20 ml (100 mg) plus normal saline 10 ml. The primary outcome was the Quality of Recovery-15 (QoR-15) score at 24 h postoperatively. Secondary outcomes included the QoR-15 score at 3 days postoperatively, time to first patient-controlled analgesia press, and total opioid consumption within the first 3 days postoperatively. Other outcomes assessed were the time to ambulation, duration of chest tube placement, length of hospital stay, patient satisfaction scores at discharge, and development of adverse reactions during hospitalization. Results:Compared to BH group, QoR-15 scores were significantly increased at 24 h and 3 days postoperatively, the time to first patient-controlled analgesia press was significantly prolonged, the consumption of opioid was reduced within the first 3 days postoperatively, the time to ambulation was shortened, and patient satisfaction scores at discharge were increased in BL group ( P<0.05). There were no statistically significant differences between the two groups in terms of the chest tube duration, length of hospital stay, and incidence of adverse reactions during hospitalization ( P>0.05). Conclusions:Bupivacaine liposome for erector spinae plane block can improve the quality of postoperative recovery in patients undergoing thoracoscopic lung resection.

This study aimed to explore key quality control factors that affected the prognosis of intensive care unit (ICU) patients in Chinese mainland over six years (2015-2020). The data for this study were from 31 provincial and municipal hospitals (3425 hospital ICUs) and included 2 110 685 ICU patients, for a total of 27 607 376 ICU hospitalization days. We found that 15 initially established quality control indicators were good predictors of patient prognosis, including percentage of ICU patients out of all inpatients (%), percentage of ICU bed occupancy of total inpatient bed occupancy (%), percentage of all ICU inpatients with an APACHE II score ⩾15 (%), three-hour (surviving sepsis campaign) SSC bundle compliance (%), six-hour SSC bundle compliance (%), rate of microbe detection before antibiotics (%), percentage of drug deep venous thrombosis (DVT) prophylaxis (%), percentage of unplanned endotracheal extubations (%), percentage of patients reintubated within 48 hours (%), unplanned transfers to the ICU (%), 48-h ICU readmission rate (%), ventilator associated pneumonia (VAP) (per 1000 ventilator days), catheter related blood stream infection (CRBSI) (per 1000 catheter days), catheter-associated urinary tract infections (CAUTI) (per 1000 catheter days), in-hospital mortality (%). When exploratory factor analysis was applied, the 15 indicators were divided into 6 core elements that varied in weight regarding quality evaluation: nosocomial infection management (21.35%), compliance with the Surviving Sepsis Campaign guidelines (17.97%), ICU resources (17.46%), airway management (15.53%), prevention of deep-vein thrombosis (14.07%), and severity of patient condition (13.61%). Based on the different weights of the core elements associated with the 15 indicators, we developed an integrated quality scoring system defined as F score=21.35%xnosocomial infection management + 17.97%xcompliance with SSC guidelines + 17.46%×ICU resources + 15.53%×airway management + 14.07%×DVT prevention + 13.61%×severity of patient condition. This evidence-based quality scoring system will help in assessing the key elements of quality management and establish a foundation for further optimization of the quality control indicator system.
Humans ; China/epidemiology* ; Cross Infection/epidemiology* ; Intensive Care Units/statistics & numerical data* ; Quality Control ; Quality Indicators, Health Care/statistics & numerical data* ; Sepsis/therapy* ; East Asian People/statistics & numerical data*

Background::It is crucial to improve the quality of care provided to ICU patient, therefore a national survey of the medical quality of intensive care units (ICUs) was conducted to analyze adherence to quality metrics and outcomes among critically ill patients in China from 2015 to 2019.Methods::This was an ICU-level study based on a 15-indicator online survey conducted in China. Considering that ICU care quality may vary between secondary and tertiary hospitals, direct standardization was adopted to compare the rates of ICU quality indicators among provinces/regions. Multivariate analysis was performed to identify potential factors for in-hospital mortality and factors related to ventilator-associated pneumonia (VAP), catheter-related bloodstream infections (CRBSIs), and catheter-associated urinary tract infections (CAUTIs).Results::From the survey, the proportions of structural indicators were 1.83% for the number of ICU inpatients relative to the total number of inpatients, 1.44% for ICU bed occupancy relative to the total inpatient bed occupancy, and 51.08% for inpatients with Acute Physiology and Chronic Health Evaluation II scores ≥15. The proportions of procedural indicators were 74.37% and 76.60% for 3-hour and 6-hour surviving sepsis campaign bundle compliance, respectively, 62.93% for microbiology detection, 58.24% for deep vein thrombosis prophylaxis, 1.49% for unplanned endotracheal extubations, 1.99% for extubated inpatients reintubated within 48 hours, 6.38% for unplanned transfer to the ICU, and 1.20% for 48-hour ICU readmission. The proportions of outcome indicators were 1.28‰ for VAP, 3.06‰ for CRBSI, 3.65‰ for CAUTI, and 10.19% for in-hospital mortality. Although the indicators varied greatly across provinces and regions, the treatment level of ICUs in China has been stable and improved based on various quality control indicators in the past 5 years. The overall mortality rate has dropped from 10.19% to approximately 8%.Conclusions::The quality indicators of medical care in China’s ICUs are heterogeneous, which is reflected in geographic disparities and grades of hospitals. This study is of great significance for improving the homogeneity of ICUs in China.

Objective:To study the illumination for distance vision evaluation of the pilots wearing night vision goggles (NVGs).Methods:The distance vision was tested by circular visual acuity chart for flying personnel 5 m apart from subjects. The Illuminance on the surface of chart was set 300 lx for naked eye and 1×10 -1 lx and 1×10 -3 lx for NVG aided eyes. The naked and NVG distance visions of 15 healthy male volunteers were tested under all illuminations. The differences of NVG distance vision were compared between the illuminations of 1×10 -1 lx and 1×10 -3 lx to determine the proper level for evaluation. The naked and NVG distance visions of 20 male pilots were tested to verify the feasibility and necessity of the test, but NVG tests were only at 1×10 -1 lx level. Results:Volunteers′ left distance vision was 0.67±0.39, the right was 0.67±0.38 and the binocular was 0.80±0.40. Their NVG distance vision under 1×10 -1 lx was 0.53±0.22, 0.59±0.25 and 0.63±0.24 respectively, comparing with the vision of 0.30±0.11, 0.34±0.11 and 0.36±0.11 under 1×10 -3 lx. The difference showed statistical significance ( P<0.05). In verification test, the left, right and binocular NVG distance vision of 20 pilots under 1×10 -1 lx was 0.63±0.16, 0.64±0.14 and 0.73±0.12 respectively, comparing with their left, right and binocular naked vision of 1.12±0.32, 1.08±0.37, and 1.37±0.37 respectively. Conclusions:The tests indicated that 1×10 -1 lx would be the appropriate illumination level for pilot′s NVG distance vision evaluation. And it is necessary to evaluate pilot′s NVG distance vision before night flight mission.

Objective:To study the illumination for distance vision evaluation of the pilots wearing night vision goggles (NVGs).Methods:The distance vision was tested by circular visual acuity chart for flying personnel 5 m apart from subjects. The Illuminance on the surface of chart was set 300 lx for naked eye and 1×10 -1 lx and 1×10 -3 lx for NVG aided eyes. The naked and NVG distance visions of 15 healthy male volunteers were tested under all illuminations. The differences of NVG distance vision were compared between the illuminations of 1×10 -1 lx and 1×10 -3 lx to determine the proper level for evaluation. The naked and NVG distance visions of 20 male pilots were tested to verify the feasibility and necessity of the test, but NVG tests were only at 1×10 -1 lx level. Results:Volunteers′ left distance vision was 0.67±0.39, the right was 0.67±0.38 and the binocular was 0.80±0.40. Their NVG distance vision under 1×10 -1 lx was 0.53±0.22, 0.59±0.25 and 0.63±0.24 respectively, comparing with the vision of 0.30±0.11, 0.34±0.11 and 0.36±0.11 under 1×10 -3 lx. The difference showed statistical significance ( P<0.05). In verification test, the left, right and binocular NVG distance vision of 20 pilots under 1×10 -1 lx was 0.63±0.16, 0.64±0.14 and 0.73±0.12 respectively, comparing with their left, right and binocular naked vision of 1.12±0.32, 1.08±0.37, and 1.37±0.37 respectively. Conclusions:The tests indicated that 1×10 -1 lx would be the appropriate illumination level for pilot′s NVG distance vision evaluation. And it is necessary to evaluate pilot′s NVG distance vision before night flight mission.