Objective:To evaluate the clinical application of water-filling with "four-eyes" sign under the guidance of ultrasound in nasal-jejunum intubation for critical patients.Methods:This study was a randomized controlled trial. Eighty patients who needed indwelling nasobenteric tube were selected from June 2021 to April 2022 in the Department of Critical Care Medicine, Xiangya Hospital, Central South University. They were divided into control group ( n=40) and experimental group ( n=40) by systemic randomization. For the patients in the experimental group, the intubation was performed by water-filling with "four-eyes" sign under the guidance of ultrasound. For the control group, the traditional method was applicated under the guidance of ultrasound. Using abdominal X-ray as the gold standard of successful pylorus posterior catheterization, the result of catheterization, time of operation, efficiency of positioning in the two groups were analyzed and compared. Results:In the experimental group, 38 cases were successfully intubated, 2 were failed; in the control group, 27 cases were successfully intubated, 13 were failed, and all the failed cases in the control group were then successfully intubated again by using method of the experimental group. The success rate of tube placement in the experimental group was 95.0% (38/40), which was higher than 67.5% (27/40) in the control group ( χ2 = 9.93, P<0.05). The average time of operation in the experimental group was (45.2 ± 14.2) min, which was significantly lower than (70.2 ± 17.7) min in the control group, the difference was significantly different ( t=-5.51, P<0.05). The specificity, sensitivity, positive predictive value, negative predictive value and diagnostic rate of nasal-jejunum intubation positioning in the experimental group were 100.0% respectively, higher than 38.4%, 77.7%, 72.4%, 45.4%, 65.0% in the control group; the false positive rate, false negative rate in the experimental group were both 0, lower than 22.2%, 61.5% in the control group, with statistically significant differences( χ2 values were 4.69- 16.97, all P<0.05). Conclusions:Water-filling with "four-eyes" sign under the guidance of ultrasound in nasal-jejunum intubation was a new method which can shorten the operation time and increase the success rate for intubation. It has relatively high positioning accuracy and possess valuable clinical application.

Objective:To conduct a Meta-analysis on the application effect of information management on safe in-hospital transfer of patients in China.Methods:Using computers to search for randomized controlled trials and quasi experimental studies on the effect of information management on safe in-hospital transfer of patients in China from China National Knowledge Infrastructure, VIP, Wanfang Database, China Biomedical Mediline disc, PubMed, Embase, Web of Science, CINAHL and Cochrane Library. The search period was from establishment of databases to May 17, 2022. Literature screening, quality evaluation and data extraction were conducted independently by two trained researchers. Stata 15.1 software was used for Meta-analysis.Results:A total of 14 articles were included, involving a total of 130 670 patients. The results of Meta-analysis showed that the incidence of adverse event in in-hospital transfer of patients in the information management group was shorter than that in the control group ( OR=0.24, 95% CI: 0.17-0.35, P<0.01), duration of in-hospital tranfer was longer than that in the control group ( WMD=-5.76, 95% CI: -8.30-3.22, P<0.01), and patients' satisfaction ( OR=1.11, 95% CI: 1.05-1.17, P<0.01) and satisfaction of medical personnel responsible for transfer ( OR=1.37, 95% CI: 1.13-1.66, P<0.01) were higher than those of the control group. Conclusions:Information management can effectively control the incidence of adverse events in in-hospital transfer of patients in China, shorten the time required for hospital transfers and improve the satisfaction of patients and medical staff in hospital transfers.

Objective: To explore the association between self-reported gingival bleeding and prevalent hypertension among adults in Zhejiang with a cross-sectional study. Methods: After excluding participants with self-reported, physician-diagnosed heart diseases, stroke, diabetes, cancer, and those who never or rarely brush their teeth at baseline study, 48 625 participants aged 30-79 in the China Kadoorie Biobank (CKB) study from Tongxiang, Zhejiang were included for the final analysis. Three multivariable logistic regression models were used to estimate the odds ratios (ORs) for the associations of self-reported gingival bleeding with prevalent hypertension. Results: The mean age of women was (51.2±9.2) years, and 42.9% of participants had prevalent hypertension. The percentage of self-reported frequent gingival bleeding was 6.56% (95%CI: 6.38%-6.75%), significantly higher among women (8.08%, 95%CI: 7.82%-8.35%) than among men (4.36%, 95%CI: 4.12%-4.60%) (P<0.001). After adjusting for socio-demographic factors, behavioral lifestyle, sleep duration, BMI, waist circumference, snoring, in comparison with men whose gingivae never or rarely bleed while brushing teeth, the odds ratio (95%CI) of hypertension for those with occasional, and frequent gingival bleeding were 1.04 (0.96-1.12) and 1.18 (1.02-1.37), respectively (trend P =0.038). The corresponding figures for women were 0.96 (0.91-1.02) and 0.95 (0.86-1.05), respectively (trend P=0.344). Conclusion: Frequent gingival bleeding was positively associated with prevalent hypertension among men.
Adult ; China/epidemiology* ; Cross-Sectional Studies ; Female ; Gingival Hemorrhage ; Humans ; Hypertension/epidemiology* ; Male ; Middle Aged ; Risk Factors ; Self Report

Cardiac Rehabilitation ; Exercise Therapy ; Heart Failure/surgery* ; Heart Transplantation ; Humans

Objective: To explore the association between chronic hepatitis B virus infection and diabetes among adults. Methods: The baseline data of China Kadoorie Biobank ( CKB ) study from Tongxiang of Zhejiang Province was used for analysis. Community residents were investigated in the study from August 2004 to May 2008, including questionnaire survey, physical measurement and biological sample test. Univariate and multivariate logistic regression models were used to estimate the association of chronic hepatitis B virus infection with diabetes. Results: Totally 52 888 participants were included in the final analysis. The overall prevalence of HBsAg-positive was 3.55% ( N=1 877 ). The overall prevalence of diabetes was 5.17% ( N=2 733 ). The prevalence of HBsAg-positive in diabetic patients was 3.51% ( N=96 ). Both univariate and multivariate logistic regression models indicated that there was no association between chronic hepatitis B virus infection and diabetes（ P>0.05 ）. Conclusion No significant association has been found between chronic hepatitis B virus infection and diabetes among adults.

Objectives:To study the feasibility of using ultrasound to evaluate diaphragm function in patients with invasive mechanical ventilation.Methods:From March to December 2017, 40 adult patients with acute respiratory distress syndrome who were admitted to the Department of Critical Care Medicine, Xiangya Hospital, Central South University for more than 48 hours were included. Diaphragmatic excursion and thickness of bilateral anterior, middle and posterior parts were measured by ultrasound for 5 consecutive days.Results:(1) Compared with the diaphragmatic excursion of the right [anterior: (11.05±3.04) mm; middle: (12.08±2.71) mm; posterior: (11.51±3.33) mm] and left [anterior: (13.63±7.52) mm; middle: (15.44±7.52) mm; posterior: (14.76±6.93) mm] sides on day 1, the diaphragmatic excursion of the right [anterior: (8.90±3.65) mm; middle: (10.02±4.24) mm; posterior: (10.25±4.38) mm] and left [anterior: (9.82±1.96) mm; middle: (11.60±1.13) mm; posterior: (11.52±1.98) mm] sides decreased significantly on day 3 ( P<0.05). Bilateral anterior, middle and posterior diaphragmatic excursion recovered on day 5, and was higher than the baseline levels on day 1, with the left middle and posterior diaphragmatic excursion changing most significantly. (2) Compared with day 1, 2, 3, the thickening fraction of bilateral anterior, middle and posterior diaphragm were significantly decreased on day 4, with the left middle part [day 1: (33.87±14.34)%; day 2: (37.26±13.91)%; day 3: (30.56±14.27)%; day 4: (15.53±5.68)%] and the left posterior part [day 1: (35.50±15.69)%; day 2: (39.84±15.32)%; day 3: (29.06±14.96)%; day 4: (13.30±5.79)%] changing most significantly ( P<0.05). The thickening fractions of left anterior, middle and posterior diaphragm recovered on day 5 compared with that on day 4, but still lower than those on day 1 ( P<0.05). Conclusions:It is feasible to evaluate the diaphragm function in patients with invasive mechanical ventilation by ultrasound, which can provide guidance for preventing diaphragmatic atrophy and withdrawing from mechanical ventilation.

Objective:To explore the association between snoring and prevalent hypertension among adults in Zhejiang with a cross-sectional study.Methods:After excluding participants with self-reported, physician-diagnosed heart diseases, stroke and cancer at baseline study, 56 728 participants aged 30-79 in the China Kadoorie Biobank study from Tongxiang, Zhejiang were included for the final analysis. Three multivariable logistic regression models were used to estimate the ORs for the associations of snoring with prevalent hypertension. Results:The proportion of participants who snored frequently, snored sometimes, and never snored were 24.55%, 23.94%, and 51.51%, respectively. The corresponding figures of males were 32.40%, 26.55%, and 41.05%, respectively. The corresponding figures of females were 19.00%, 22.08%, and 58.92%, respectively ( P<0.001). After adjusted socio-demographic factors, behavioral lifestyle, BMI, waist circumference, and sleep duration etc., in comparison with participants who never snored, the odds ratios (95% CI) of hypertension for those who snored frequently and snored sometimes were 1.17 (1.12-1.23) and 1.12 (1.07-1.18), respectively. The effects of snoring on hypertension were statistically significantly different between women and men, participants who were central obese and those who were not, and between premenopausal and post-menopausal women. Conclusion:Snoring was associated positively with hypertension among adults. The effect of snoring on prevalent hypertension were obvious, especially among people, being female, being central obese, and being premenopausal.

With the development of critical care ultrasound technology, clinics begins to pay attention to the role of critical care ultrasound in nursing of critically ill patients. The increasingly extensive application of ultrasound in the field of critical care provides a visual tool for clinical nursing work, which can qualitatively and quantitatively evaluate nursing indicators, help to solve the existing nursing problems and nursing difficulties and promote the improvement of critical care quality and the development of nursing academics. To this end, experts formulates this consensus based on years of experience and application of intensive care ultrasound practice.

The drug delivery system with "gatekeeper" is designed to achieve a stable entrapment state of the payload under normal physiological conditions through the gatekeepers. With tumor microenvironment or stimulation of exogenous factors, the gatekeeper is detached or altered to promote the responsive release of the drug. In this paper, we focus on applications of stimuli-responsive linkages and stimuli-responsive groups, and review research progresses of drug delivery system with "gatekeeper" developed over the past 10 years.

Objective:To explore the clinicaleffect of radial arterial puncture cannulationunder ultrasonic guidance in patients with critical diseases.Methods:From December 2016 to May 2017,120 patients under critical conditions in Department of Intensive Care Unit,Xiangya Hospital,Central South University,who received arterial cannulation,were randomly divided into 2 groups:a control group (traditional blind puncture method) and an observation group (ultrasound-guided radial arterial cannulation) (60 cases in each group).The success ratio of radial arterial puncture cannulation by one time,total success ratio of radial arterial puncture cannulation,numbers of puncture,the rate of complications and the time of consumption were compared between the 2 groups.Results:There was no statistically significant difference in the total success ratio of radial arterial puncture cannulationin the 2 groups (P＞0.05).The success ratio radial arterial puncture cannulation by one time was significantly greater in the observation group than that in the control group (P＜0.05);the numbers of puncture,the rate of complications and the time of consumption in the observation group were lower than those in the control group,with statistically significant (all P＜0.05).Conclusion:The application of ultrasound-guided radial arterial puncturecannulation can improve the success ratio of radial arterial puncturecannulation by one time,decrease the numbers of puncture,reduce the incidence of complications and save operation time.