The latest research findings on bidirectional regulation of neuro-immunity through traditional neural circuits shed new light on the theoretical basis of the role of vidian neurectomy (VN). This article aims to provide a comprehensive understanding of VN, including the history of VN, the principle of neuroimmuno-interaction, the applied anatomy of VN as well as the methods of transnasal endoscopic surgery. Additionally, we introduce the concept of the nose-brain axis, which was proposed based on the advancement in the area of neuro-immune interactions.

Organic acids are organic compounds that can be synthesized using biological systems. They often contain one or more low molecular weight acidic groups, such as carboxyl group and sulphonic group. Organic acids are widely used in food, agriculture, medicine, bio-based materials industry and other fields. Yeast has unique advantages of biosafety, strong stress resistance, wide substrate spectrum, convenient genetic transformation, and mature large-scale culture technology. Therefore, it is appealing to produce organic acids by yeast. However, challenges such as low concentration, many by-products and low fermentation efficiency still exist. With the development of yeast metabolic engineering and synthetic biology technology, rapid progress has been made in this field recently. Here we summarize the progress of biosynthesis of 11 organic acids by yeast. These organic acids include bulk carboxylic acids and high-value organic acids that can be produced naturally or heterologously. Finally, future prospects in this field were proposed.
Saccharomyces cerevisiae/metabolism* ; Organic Chemicals ; Carboxylic Acids/metabolism* ; Metabolic Engineering ; Fermentation ; Acids

Objective:To explore the main management points and ethical considerations of diabetic subjects involved in hypoglycemic drug clinical trials.Methods:Taking the subject management of a hypoglycemic drug clinical trial in Yuncheng Central Hospital as an example, the problems and measures in the subject management of diabetic patients were systematically discussed.Results:In hypoglycemic drug clinical trial that involving diabetic patients, ethical considerations regarding to the subjects' rights, safety and health should take into account in the whole process of subjects' recruitment, screening, enrollment and follow-up.Conclusions:Subject management taking into account of ethical consideration can better protect the safety and rights of subjects, enhance the compliance of subjects and improve the quality of drug clinical trials.

Secondary traumatic stress refers to the natural, consequent emotions and behaviors that arise from knowledge of traumatic events experienced by others. It is the stress of helping or wanting to help a traumatized person and is considered one of the occupational injuries for nurses. Because of the unpredictable working environment, nurses in Emergency Department often experience patient death, suicide, traumatic events, and participate in emergency first aid and nursing of a large number of trauma patients, and they are at increased risk of secondary traumatic stress. This article mainly reviews the concept, symptoms, current situation, measurement tools and influencing factors of secondary traumatic stress of nurses in Emergency Department, so as to provide a basis for further identification and intervention in clinical practice.

SARS-CoV-2 infection causes complicated clinical manifestations with variable multi-organ injuries, however, the underlying mechanism, in particular immune responses in different organs, remains elusive. In this study, comprehensive transcriptomic alterations of 14 tissues from rhesus macaque infected with SARS-CoV-2 were analyzed. Compared to normal controls, SARS-CoV-2 infection resulted in dysregulation of genes involving diverse functions in various examined tissues/organs, with drastic transcriptomic changes in cerebral cortex and right ventricle. Intriguingly, cerebral cortex exhibited a hyperinflammatory state evidenced by significant upregulation of inflammation response-related genes. Meanwhile, expressions of coagulation, angiogenesis and fibrosis factors were also up-regulated in cerebral cortex. Based on our findings, neuropilin 1 (NRP1), a receptor of SARS-CoV-2, was significantly elevated in cerebral cortex post infection, accompanied by active immune response releasing inflammatory factors and signal transmission among tissues, which enhanced infection of the central nervous system (CNS) in a positive feedback way, leading to viral encephalitis. Overall, our study depicts a multi-tissue/organ transcriptomic landscapes of rhesus macaque with early infection of SARS-CoV-2, and provides important insights into the mechanistic basis for COVID-19-associated clinical complications.
Animals ; COVID-19/genetics* ; Macaca mulatta ; SARS-CoV-2/genetics* ; Transcriptome

Objective:To explore the current situation of evidence-based practice competence of masters of nursing specialist at Class Ⅲ hospitals and its influencing factors so as to provide decision-making basis for optimizing the construction and educational management of clinical teaching base for masters of nursing specialist.Methods:From July to October 2021, 141 masters of nursing specialist of Class Ⅲ hospitals in Tianjin were selected as subjects by purposive sampling. All students were investigated with the Chinese version of Evidence Based Practice Evaluation Competence Questionnaire (EBP-COQ) and the Barriers to Research Utilization Scale. Multiple linear regression was used to analyze the influencing factors.Results:Among 141 masters of nursing specialist, the total scores of the EBP-COQ and the Barriers to Research Utilization Scale were 95.35 ± 11.90 and 72.52 ± 26.28 respectively. Multiple linear regression analysis showed that the influencing factors of evidence based practice competence of masters of nursing specialist included the results of availability and the awareness of evidence-based nursing ( r = -2.85, -2.41, both P<0.05). Conclusions:Masters of nursing specialist have the intermediate level of evidence-based practice competence and positive attitudes to evidence based practice, but their evidence-based knowledge and skills need to be improved. Clinical teaching base managers should pay attention to the training of evidence-based nursing practice ability of professional nursing master students, provide more supportive resources and environment, and promote the development of specialty nursing practice.

Objective:To investigate the abnormal patterns of spontaneous neural activity of patients with type 2 diabetes comorbid depression (T2DD) by using resting-state functional magnetic resonance imaging (rs-fMRI) fractional amplitude of low-frequency (fALFF) analysis, and determine the neuroimaging features of brain damage in T2DD patients.Methods:A perspective study was performed. Fifty-nine type 2 diabetes mellitus (T2DM) patients and 52 T2DD patients, admitted to and accepted treatment in Department of Endocrinology of our hospital from November 2017 to November 2020, were chosen; another 57 healthy controls matched with gender, age and education level, admitted to our hospital at the same time period were enrolled. Their clinical data, neuropsychological test and rs-fMRI data were collected; whole brain fALFF values were calculated, and fALFF values of different brain regions were compared in subjects of the 3 groups. Pearson correlation analysis was used to verify the correlations of fALFF values with clinical variables and neuropsychological scale scores.Results:The fALFF values in bilateral precuneus showed significant difference among the three groups ( P<0.05). The fALFF values in bilateral precuneus of the T2DD and T2DM groups were significantly lower than those in heathy control group ( P<0.05), and those in the T2DD group were lower than those in the T2DM group without significant difference ( P>0.05). Pearson correlation analysis showed that there were no correlations of fALFF values with clinical data and psychometric scale scores in T2DD group and T2DM group ( P>0.05). Conclusion:The abnormal patterns of spontaneous brain activity in the bilateral precuneus may be the neuroimaging markers of brain damage in T2DD patients.

Objective:To systematically evaluate the effect of couple-centered psychological intervention on breast cancer patients.Methods:Randomized controlled trials published in PubMed, Embase, Web of Science, Scopus, CINAHL, Cochrane Library, JBI, CNKI, Wanfang, Vip and CBM database on the effect of psychological intervention on breast cancer patients with husband and wife as the center were searched by computer. The retrieval time was from the establishment of the database to September 2020. Two reviewer independently conducted literature screening, data extraction and literature quality evaluation according to the inclusion and exclusion criteria, and Meta analysis was carried out using RevMan 5.3 software.Results:A total of 879 patients were included in 11 articles. Meta analysis results showed that the couple-centered psychological intervention not only improved the quality of life, but also improved the anxiety of breast cancer patients ( SMD=1.54, 95% CI 0.22-2.86, P=0.02) and depression ( SMD=1.22, 95% CI 0.12-2.33, P=0.03). Conclusions:After psychological intervention, the anxiety and depression of breast cancer patients were improved and the quality of life was also improved. Due to the inconsistency in the mode, frequency and evaluation index of psychological intervention, more large samples and high-quality studies are needed to further verify the effect of couple-centered psychological intervention on breast cancer patients and spouses centered on husband and wife.

Objective:To explore the current status of deep vein thrombosis (DVT) prevention and nursing in Department of Orthopedics of China hospitals, and provide a basis for hospitals and related departments to promote systematic DVT prevention and nursing management.Methods:This study was a cross-sectional study, and convenience sampling method was used. In September 2019, the self-designed Domestic Orthopedic Deep Vein Thrombosis Prevention and Nursing Questionnaire was used to investigate the members of the Orthopedic Nursing Professional Committee who signed up for the China Health Promotion Foundation Orthopedic Venous Thromboembolism (VTE) Prevention and Nursing Management Forum. The survey subject came from 125 hospitals in 29 provinces, municipalities and autonomous regions across the country. Respondents completed the electronic questionnaire survey by scanning the quick response code, and 118 valid questionnaires were finally recovered.Results:The proportion of 118 hospitals carrying out in-hospital DVT special training was 82.2% (97/118) . Among the ways for nurses to acquire knowledge, the exchanges outside the hospital, literature review, and international exchange accounted for 70.3% (83/118) , 60.2% (71/118) and 14.4% (17/118) respectively. The proportion of establishing hospital DVT risk early warning information system was 57.6% (68/118) . The hospital-level professional group formulated a complete DVT prevention and nursing system process accounting for 44.1% (52/118) , and the department-level professional group formulated a complete DVT prevention and nursing system process accounting for 36.4% (43/118) . In the comprehensive evaluation of DVT prevention and nursing management, 65.3% (77/118) of hospitals rated it as excellent, and 34.7% (41/118) of hospitals rated it as fair and lacking.Conclusions:The Department of Orthopedics of China hospitals attaches great importance to DVT prevention, but in the construction of DVT prevention and nursing management system for orthopedic patients, the popularization of DVT risk early warning information system, the application of DVT preventive equipment measures, the improvement of DVT prevention and nursing related systems, and the implementation of professional management specifications needs to be further strengthened.

Objective: To evaluate the effect of dexmedetomidine on postoperative cognitive function in the patients with mild hyperbilirubinemia caused by choledocholithiasis. Methods: One hundred and twenty patients of both sexes with mild hyperbilirubinemia (serum total bilirubin levels 21-170 μmol/L) caused by choledocholithiasis, aged 51-63 yr, with body mass index of 20-28 kg/m², of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, with preoperative Mini-Mental State Examination (MMSE) scores≥20, scheduled for elective cholecystectomy and choledocholithotomy, were divided into 3 groups (n=40 each) using a random number table method: control group (C group) and dexmedetomindine 0.4 μg·kg^-1·h^-1 group (D1 group) and dexmedetomindine 0.6 μg·kg^-1·h^-1 group (D2 group). After induction of anesthesia, dexmedetomidine was intravenously infused for 10 min in a loading dose of 0.5 μg/kg, followed by an infusion of 0.4 and 0.6 μg·kg^-1·h^-1 until the end of operation in D1 and D2 groups, respectively.The equal volume of normal saline was given instead in group C. with preoperative scores≥20, MMSE and Montreal Cognitive Assessment (MoCA) were used to assess the cognitive function at 1 day before operation (T₀) and 1, 3, 5 and 7 days after operation (T_1-4). The occurrence of cognitive dysfunction within 7 days after operation was recorded.Venous blood samples were collected at the time points mentioned above, and the plasma concentrations of β-amyloid (Aβ) 42 were determined by enzyme-linked immunosorbent assay. Results: Compared with group C, MoCA scores were significantly increased at T₁ in group D₁, and MMSE scores at T₁ and MoCA scores at T₁ and T₂ were significantly increased, and the plasma concentrations of Aβ42 were decreased at T_2-4 in group D2, and the incidence of cognitive dysfunction was significantly decreased in D1 and D2 groups (P<0.05). Compared with group D1, MoCA scores were significantly increased at T₁, and the plasma concentrations of Aβ42 were decreased at T_2-4 in group D2 (P<0.05). Conclusion Dexmedetomidine can improve postoperative cognitive function, and intravenous infusion at a rate of 0.6 μg·kg^-1 · h^-1 provides better efficacy for the patients with mild hyperbilirubinemia caused by choledocholithiasis.