Objective To explore the application value of preoperative nebulized inhalation of esket-amine in pediatric snoring surgery under general anesthesia.Methods A total of 145 children who were sched-uled to undergo elective pediatric snoring surgery in this hospital from January to December 2023 were select-ed and divided into the control group,the NC group and the ES group by random number table method,with 48,49,48 cases in each group,respectively.The control group was given routine preoperative preparations,the NC group was nebulized and inhaled normal saline before the operation,and the ES group was nebulized and inhaled esketamine solution before the operation.The awakening time,extubation time,post-anesthesia care u-nit(PACU)stay time,direct care time,choking cough score after awakening,visual analogue scale(VAS)for pain,restlessness score,incidence of restlessness and occurrence of adverse reactions were compared among the three groups of children.Results Compared with the control group and the NC group,the recovery time,ex-tubation time,PACU stay time,direct care time,choking cough score after awaking,VAS,restlessness score and the incidence of restlessness in the ES group were significantly decreased(P＜0.05).There was no statis-tically significant difference in the above indicators between the NC group and the control group(P＞0.05).No adverse reactions occurred in any of the three groups of children during the recovery period from general anesthesia.Conclusion Preoperative nebulized inhalation of esketamine can effectively accelerate the recovery and extubation time of children undergoing general anesthesia for snoring surgery,alleviate choking,pain and restlessness reactions,and reduce direct care time.

Objective:To express NY-ESO-1 epitopes using circular RNA (circRNA) and construct circRNA cancer vaccines using a novel lipid-like material C1, and to evaluate the transfection efficiency and T cell activation potential at cellular level.Methods:In vitro transcription was used to synthesize mRNA and circRNA expressing EGFP and NY-ESO-1 epitopes. Then, they were transfected into COS7 cells and the expression of target proteins were detected in vitro. Lipid-like material C1 and commercial transfection agent TransIT-mRNA were used as delivery systems for mRNA NY-ESO-1 and circRNA NY-ESO-1, and their delivery efficiency was compared. Results:The expression of EGFP was observed under fluorescence microscopy after transfection of mRNA EGFP and circRNA EGFP into COS7 cells for 24 h. The secretion of IFN-γ by T cell receptor-engineered T (TCR-T) cells targeting NY-ESO-1/HLA-A2 was stimulated by COS7-A*02: 01 cells transfected with mRNA NY-ESO-1 and circRNA NY-ESO-1. Compared with mRNA NY-ESO-1, circRNA NY-ESO-1 was able to express the target antigen and stimulate the target cells to release IFN-γ more persistently. The delivery efficiency of C1 material was better than that of commercial transfection reagents when COS7 cells were transfected in vitro. Conclusions:Compared with the linear mRNA, transfection of COS7-A*02: 01 cells with circRNA can lead to more efficient and durable activation of T cells, suggesting that it could be a more suitable candidate for clinical treatment of tumors in the future. The lipid-like material C1 can effectively deliver linear mRNA and circular RNA molecules. This study provides reference for further research on circRNA tumor vaccines.

Objective:To investigate the safety of early antiplatelet therapy for non-cardioembolic mild stroke patients with thrombocytopenia.Methods:Data of acute ischemic stroke patients with baseline National Institutes of Health Stroke Scale(NIHSS)score≤3 and a platelet count<100×109/L were obtained from a multicenter register.Those who required anticoagulation or had other contraindications to antiplatelet therapy were excluded.Short-term safety outcomes were in-hospital bleeding events,while the long-term safety outcome was a 1-year all-cause death.The short-term neurological outcomes were evaluated by modified Rankin scale(mRS)score at discharge.Results:A total of 1868 non-cardioembolic mild stroke patients with thrombocytopenia were enrolled.Multivariate regression analyses showed that mono-antiplatelet therapy significantly increased the proportion of mRS score of 0-1 at discharge(OR=1.657,95%CI:1.253-2.192,P<0.01)and did not increase the risk of intracranial hemorrhage(OR=2.359,95%CI:0.301-18.503,P>0.05),compared with those without antiplatelet therapy.However,dual-antiplatelet therapy did not bring more neurological benefits(OR=0.923,95%CI:0.690-1.234,P>0.05),but increased the risk of gastrointestinal bleeding(OR= 2.837,95%CI:1.311-6.136,P<0.01)compared with those with mono-antiplatelet therapy.For patients with platelet counts≤75×109/L and>90×109/L,antiplatelet therapy significantly improved neurological functional outcomes(both P<0.05).For those with platelet counts(>75-90)×109/L,antiplatelet therapy resulted in a significant improvement of 1-year survival(P<0.05).For patients even with concurrent coagulation abnormalities,mono-antiplatelet therapy did not increase the risk of various types of bleeding(all P>0.05)but improved neurological functional outcomes(all P<0.01).There was no significant difference in the occurrence of bleeding events,1-year all-cause mortality risk,and neurological functional outcomes between aspirin and clopidogrel(all P>0.05).Conclusions:For non-cardioembolic mild stroke patients with thrombocytopenia,antiplatelet therapy remains a reasonable choice.Mono-antiplatelet therapy has the same efficiency as dual-antiplatelet therapy in neurological outcome improvement with lower risk of gastrointestinal bleeding.

The complexity of oral ulcerations poses considerable diagnostic and therapeutic challenges to oral specialists. The expert consensus was conducted to summarize the diagnostic work-up for difficult and complicated oral ulcers, based on factors such as detailed clinical medical history inquiry, histopathological examination, and ulceration-related systemic diseases screening. Not only it can provide a standardized procedure of oral ulceration, but also it can improve the diagnostic efficiency, in order to avoid misdiagnosis and missed diagnosis.
Consensus ; Humans ; Oral Ulcer/therapy*

Objective: To explore the effects of application of Plato analysis combined with plan-do-check-action (PDCA) cycle in scientific research management of nurses with primary position title. Methods: Twenty-six nurses with primary position title were recruited in this self pre- and post-control study. From January 2012 to December 2013, they were guided by normal scientific research management. In January 2014, the factors which hinder these nurses from writing papers were investigated by the questionnaire titled " the impediments that hinder nurses with primary position title from writing papers" . Based on " twenty-eighty percent laws" of Plato analysis method, the main influencing factors which hinder nurses with primary position title from writing papers were " had no idea" and " did not know how to write although with ideas" . From January 2014 to December 2015, based on the results of the survey and combined with PDCA cycle method, interventions were planned, carried out, analyzed by stage, and then improved continuously. Impediments which hinder writing papers of 26 nurses in January 2014 and December 2015, specific scientific research achievement, total scientific research achievement, and average scientific research achievement of these 26 nurses before intervention (from January 2012 to December 2013) and after intervention (from January 2014 to December 2015) were analyzed. Data were processed with McNemar exact probability test, Wilcoxon signed rank sum test. Results: (1) The cumulative percentages of main impediments " had no idea" and " did not know how to write although with ideas" were decreased from 76.93% in January 2014 to 23.07% in December 2015. The number of nurses who " had no idea" was significantly reduced from 14 in January 2014 to 4 in December 2015 (P<0.01). The total number of nurses who had impediments which hinder writing papers was significantly reduced from 26 in January 2014 to 10 in December 2015 (P<0.01). (2) The total scientific research achievement and average scientific research achievement of the 26 nurses were significantly increased from 5 before intervention to 32 after intervention and 0.19 before intervention to 1.23 after intervention, respectively (Z=-4.838, -3.703, P<0.01). Among which, numbers of specific scientific research achievement of papers published in Journals of Statistic Source, papers published in other journals, science and technology awards, fund projects, national utility model patents, and patents for invention after intervention were all increased than those before intervention (P<0.05 or P<0.01). Conclusions Plato analysis can accurately analyze the main impediments that hinder nurses with primary position title from writing papers. Plato analysis combined with PDCA cycle can improve the overall ability of scientific research of nurses with primary position title and affect the achievements in nursing scientific research, which is worthy of promotion.

A 67-year-old female patient with incontinent dermatitis complicated with sacrococcygeal pressure ulcer was admitted to our unit in November 2017. The wound was treated with a new dressing based on the concept of wet healing, management of exudation, prevention of infection to promote wound healing. Meanwhile, the fecal incontinence was properly treated with colostomy bag combined with disposable negative pressure drainage device to avoid fecal contamination and aggravation of pressure ulcer. Incontinent dermatitis was treated with wound protective powder and wound protective film. After 14 days of treatment, the wound of pressure ulcer was reduced and the incontinent dermatitis was cured.

In order to investigate the effects of HA whisker and carboxymethyl chitosan-gelatin(CMC-Gel) on the mechanical properties of porous calcium phosphate cement, a series of alpha-tricalcium phosphate (alpha-TCP), HA whisker and L-sodium glutamate porogen with different mass fractions were mixed, and setting liquid was added to them to prepare alpha-TCP/HA whisker composite porous bone cement. Then, the cement was immersed in a series of CMC-Gel solutions which had different weight ratios of CMC to Gel to prepare alpha-TCP/HA whisker/CMC-Gel composite porous bone cement. The compressive strengths and microstructure of cement were characterized by mechanical testing machine and SEM. The results showed that when the mass fraction of HA whisker is 4%, the compressive strength of alpha-TCP/HA whisker composite porous bone cement reaches 2.57MPa, which is 1.81 times that of alpha-TCP bone cement. When the weight ratio of CMC to Gel is 50:50, the compressive strength of alpha-TCP/HA whisker/CMC-Gel composite porous bone cement is 3. 34MPa, which is 2.35 times that of alpha-TCP bone cement, and the toughness of the composite cement is greatly improved as well.
Biocompatible Materials ; chemistry ; pharmacology ; Bone Cements ; chemical synthesis ; Calcium Phosphates ; chemistry ; Chitosan ; analogs & derivatives ; chemical synthesis ; chemistry ; Compressive Strength ; Gelatin ; chemistry ; Hydroxyapatites ; chemical synthesis ; chemistry ; Porosity