Objective To investigate the correlation between early clinical outcomes following endoscopic surgery for unilateral lumbar disc herniation and variations in the cross-sectional area of the sciatic nerve.Methods Fifty-two patients(n=52)with unilateral lumbar disc herniation were recruited from June 2023 to June 2024 at the Pain Department of the First Affiliated Hospital of Nanchang University.The cross-sectional area(CSA)values of bilateral sciatic nerves were measured at the gluteal sciatic tuberosity-great femoral rotor level using ultrasound before and on the 4th day after surgery.The change in nerve cross-sectional area ΔCSA and sciatic nerve swelling rate(SR-SN)were calculated.Patient BMI(Body Mass Index),visual analog scale(VAS),Japanese Orthopaedic Association score(JOA),Oswestry Disability Index(ODI),and Treatment Improvement Rate(TIR)were collected preoperatively and on postoperative day 4.Changes in sciatic nerve cross-sectional area in unilateral lumbar disc herniation and its relationship to clinical outcomes were analyzed using the scoring scales as controls.Results Compared to the preoperative period,there was a significant decrease in VAS and ODI scores,as well as an increase in JOA score on the 4th postoperative day(P<0.01).Furthermore,surgical intervention led to substantial improve-ment in clinical outcomes for the patients.Prior to surgery,the CSA value of the affected side of the sciatic nerve was greater than that of the healthy side(P<0.01).Although CSA value decreased on the affected side after surgery,it remained higher than that of the healthy side(P<0.01).Additionally,there was a significant difference between SR-SN values on both sides with higher values observed on the affected side(P<0.01).Notably,△CSA on the affected side exhibited a negative correlation with postoperative VAS score,JOA score,and treatment improvement rate(P<0.05);The SR-SN on the affected side exhibited a positive correlation with BMI and negative correlations with postoperative VAS score,JOA score,and treatment improvement rate(P<0.05).However,no significant correlations were observed between △CSA,SR-SN,and ODI score on the affected side.(P>0.05).Conclusions In patients undergoing endoscopic surgery for lumbar disc herniation,a greater change in the cross-sectional area of the affected sciatic nerve before and after the operation is associated with more pronounced improvement in early symptoms.However,further investigation is required to explore the relationship between this change and recovery of both lumbar spine and lower limb function.

Objective:To assess the level of moral distress among pediatric nurses in China and explore its influencing factors, providing a reference for future interventions.Methods:A cross-sectional survey was conducted using a convenience sampling method from May 2022 to March 2023. Pediatric nurses meeting the inclusion and exclusion criteria were selected from children′s specialized hospitals, general hospitals, and maternal and child health hospitals across 16 provinces in China. Moral distress was assessed using the Chinese version of the Moral Distress Scale-Revised (MDS-R). Data analysis included descriptive statistics, non-parametric analysis, and multiple linear regression.Results:A total of 509 pediatric nurses participated in the survey, including 10 males and 499 females. Among them, 45 were aged ≤25 years, 268 were aged 26-35 years, 172 were aged 36-45 years, and 24 were aged >45 years.The median moral distress score was 58.00 (26.00, 77.50). Factors independently associated with higher levels of moral distress included having a master′s degree ( t = 2.33), working in a ward with more than 40 beds ( t = 3.38), working in a ward without parental accompaniment ( t = 2.60), being passively assigned to the nursing profession ( t = 2.63), and considering resignation but not leaving the job ( t = 3.85) (all P<0.05). Conclusions:Pediatric nurses in China experience a moderate level of moral distress. Further research is needed to understand its underlying causes and to develop preventive and intervention strategies.

Objective To investigate the correlation between early clinical outcomes following endoscopic surgery for unilateral lumbar disc herniation and variations in the cross-sectional area of the sciatic nerve.Methods Fifty-two patients(n=52)with unilateral lumbar disc herniation were recruited from June 2023 to June 2024 at the Pain Department of the First Affiliated Hospital of Nanchang University.The cross-sectional area(CSA)values of bilateral sciatic nerves were measured at the gluteal sciatic tuberosity-great femoral rotor level using ultrasound before and on the 4th day after surgery.The change in nerve cross-sectional area ΔCSA and sciatic nerve swelling rate(SR-SN)were calculated.Patient BMI(Body Mass Index),visual analog scale(VAS),Japanese Orthopaedic Association score(JOA),Oswestry Disability Index(ODI),and Treatment Improvement Rate(TIR)were collected preoperatively and on postoperative day 4.Changes in sciatic nerve cross-sectional area in unilateral lumbar disc herniation and its relationship to clinical outcomes were analyzed using the scoring scales as controls.Results Compared to the preoperative period,there was a significant decrease in VAS and ODI scores,as well as an increase in JOA score on the 4th postoperative day(P<0.01).Furthermore,surgical intervention led to substantial improve-ment in clinical outcomes for the patients.Prior to surgery,the CSA value of the affected side of the sciatic nerve was greater than that of the healthy side(P<0.01).Although CSA value decreased on the affected side after surgery,it remained higher than that of the healthy side(P<0.01).Additionally,there was a significant difference between SR-SN values on both sides with higher values observed on the affected side(P<0.01).Notably,△CSA on the affected side exhibited a negative correlation with postoperative VAS score,JOA score,and treatment improvement rate(P<0.05);The SR-SN on the affected side exhibited a positive correlation with BMI and negative correlations with postoperative VAS score,JOA score,and treatment improvement rate(P<0.05).However,no significant correlations were observed between △CSA,SR-SN,and ODI score on the affected side.(P>0.05).Conclusions In patients undergoing endoscopic surgery for lumbar disc herniation,a greater change in the cross-sectional area of the affected sciatic nerve before and after the operation is associated with more pronounced improvement in early symptoms.However,further investigation is required to explore the relationship between this change and recovery of both lumbar spine and lower limb function.

Objective:To assess the level of moral distress among pediatric nurses in China and explore its influencing factors, providing a reference for future interventions.Methods:A cross-sectional survey was conducted using a convenience sampling method from May 2022 to March 2023. Pediatric nurses meeting the inclusion and exclusion criteria were selected from children′s specialized hospitals, general hospitals, and maternal and child health hospitals across 16 provinces in China. Moral distress was assessed using the Chinese version of the Moral Distress Scale-Revised (MDS-R). Data analysis included descriptive statistics, non-parametric analysis, and multiple linear regression.Results:A total of 509 pediatric nurses participated in the survey, including 10 males and 499 females. Among them, 45 were aged ≤25 years, 268 were aged 26-35 years, 172 were aged 36-45 years, and 24 were aged >45 years.The median moral distress score was 58.00 (26.00, 77.50). Factors independently associated with higher levels of moral distress included having a master′s degree ( t = 2.33), working in a ward with more than 40 beds ( t = 3.38), working in a ward without parental accompaniment ( t = 2.60), being passively assigned to the nursing profession ( t = 2.63), and considering resignation but not leaving the job ( t = 3.85) (all P<0.05). Conclusions:Pediatric nurses in China experience a moderate level of moral distress. Further research is needed to understand its underlying causes and to develop preventive and intervention strategies.

Abstract The COVID-19 pandemic has posed a series of complex challenges. COVID-19 in children and adolescents is generally less severe than in adults and the elderly; however, some children and adolescents may experience severe complications and adverse health effects even after mild or asymptomatic COVID-19 infections. The article focuses on gathering the epidemic characteristics, health impact, risk factors, prevention and control measures, and vaccination status of children and adolescents with COVID-19 infection to provide recommendations for protecting children and adolescents in the post COVID-19 era.

AIM:To investigate the role of renal denervation(RDN)in treatment of obesity-related atrial fi-brillation(AF)in rats.METHODS:A high-fat diet AF-susceptible rat model was constructed.The rats in control group was fed with a standard diet,while those in RDN group was subjected to RDN via surgical and chemical ablation.The re-nal tyrosine hydroxylase expression level was detected by Western blot.An in vivo electrophysiological instrument was used to detect the cardiac electrophysiological parameters of rats,including atrial effective refractory period(AERP),AF induction rate,and AF duration.Alterations in cardiac structure and function of the rats were assessed using echocar-diography.PowerLab bioinformatics acquisition system was used to analyze alterations in the tension of the rat cardiac au-tonomic nervous system.Transmission electron microscopy was used to further observe structural changes in the rat atrial mitochondria.The protein levels of mammalian target of rapamycin(mTOR)and phosphorylated mTOR(p-mTOR)were detected by Western blot.Masson staining and HE staining were used to detect the extent of structural changes in the left atrium.RESULTS:(1)Compared with standard diet group,the AF induction rate and duration of the rats fed with a high-fat diet were significantly increased;however,the AERP significantly decreased.RDN reduced the increases in AF induction rate and duration in the rats fed with a high-fat diet,and even restored the AERP.(2)Cardiac low frequency significantly increased whereas cardiac high frequency decreased in heart autonomic nerves of the rats fed with a high-fat diet.After RDN,low frequency was significantly restored,suggesting that RDN could reverse the cardiac autonomic ner-vous system disorder induced by a high-fat diet.(3)Ultrasound results showed that compared with standard diet group,the left atrial diameter and left ventricular end-systolic diameter(LVESD)of the rats fed with high-fat diet were increased,whereas the left ventricular ejection fraction(LVEF)and left ventricular fractional shortening(LVFS)were decreased.Af-ter RDN,the LVEF and LVFS of high-fat diet-fed rats increased,whereas the LVESD decreased.Ultrasound results showed that RDN could attenuate the cardiac functional and structural damage induced by a high-fat diet.Masson and HE staining results showed that compared with standard diet group,atrial fibrosis and atrial cardiomyocyte hypertrophy in-creased in high-fat diet-fed rats,while atrial fibrosis was significantly attenuated after RDN.(4)Transmission electron mi-croscopy showed that the functional structure of atrial mitochondria in high-fat diet-fed rats was damaged,with disordered arrangement and increased number of vacuoles.Western blot results showed that mTOR and p-mTOR protein levels in-creased in the left atrium of high-fat diet-fed rats.Mitochondrial autophagy and structural damage were attenuated after RDN.CONCLUSION:Renal denervation may reduce high-fat diet-induced AF susceptibility via alleviating autonomic nervous system disorders and cardiac structural and functional remodeling.

AIM:To investigate the role of renal denervation(RDN)in treatment of obesity-related atrial fi-brillation(AF)in rats.METHODS:A high-fat diet AF-susceptible rat model was constructed.The rats in control group was fed with a standard diet,while those in RDN group was subjected to RDN via surgical and chemical ablation.The re-nal tyrosine hydroxylase expression level was detected by Western blot.An in vivo electrophysiological instrument was used to detect the cardiac electrophysiological parameters of rats,including atrial effective refractory period(AERP),AF induction rate,and AF duration.Alterations in cardiac structure and function of the rats were assessed using echocar-diography.PowerLab bioinformatics acquisition system was used to analyze alterations in the tension of the rat cardiac au-tonomic nervous system.Transmission electron microscopy was used to further observe structural changes in the rat atrial mitochondria.The protein levels of mammalian target of rapamycin(mTOR)and phosphorylated mTOR(p-mTOR)were detected by Western blot.Masson staining and HE staining were used to detect the extent of structural changes in the left atrium.RESULTS:(1)Compared with standard diet group,the AF induction rate and duration of the rats fed with a high-fat diet were significantly increased;however,the AERP significantly decreased.RDN reduced the increases in AF induction rate and duration in the rats fed with a high-fat diet,and even restored the AERP.(2)Cardiac low frequency significantly increased whereas cardiac high frequency decreased in heart autonomic nerves of the rats fed with a high-fat diet.After RDN,low frequency was significantly restored,suggesting that RDN could reverse the cardiac autonomic ner-vous system disorder induced by a high-fat diet.(3)Ultrasound results showed that compared with standard diet group,the left atrial diameter and left ventricular end-systolic diameter(LVESD)of the rats fed with high-fat diet were increased,whereas the left ventricular ejection fraction(LVEF)and left ventricular fractional shortening(LVFS)were decreased.Af-ter RDN,the LVEF and LVFS of high-fat diet-fed rats increased,whereas the LVESD decreased.Ultrasound results showed that RDN could attenuate the cardiac functional and structural damage induced by a high-fat diet.Masson and HE staining results showed that compared with standard diet group,atrial fibrosis and atrial cardiomyocyte hypertrophy in-creased in high-fat diet-fed rats,while atrial fibrosis was significantly attenuated after RDN.(4)Transmission electron mi-croscopy showed that the functional structure of atrial mitochondria in high-fat diet-fed rats was damaged,with disordered arrangement and increased number of vacuoles.Western blot results showed that mTOR and p-mTOR protein levels in-creased in the left atrium of high-fat diet-fed rats.Mitochondrial autophagy and structural damage were attenuated after RDN.CONCLUSION:Renal denervation may reduce high-fat diet-induced AF susceptibility via alleviating autonomic nervous system disorders and cardiac structural and functional remodeling.

Reducing lactate accumulation has always been a goal of the mammalian cell biotechnology industry. When animal cells are cultured in vitro, the accumulation of lactate is mainly the combined result of two metabolic pathways. On one hand, glucose generates lactate under the function of lactate dehydrogenase A (LDHA); on the other hand, lactate can be oxidized to pyruvate by LDHB or LDHC and re-enter the TCA cycle. This study comprehensively evaluated the effects of LDH manipulation on the growth, metabolism and human adenovirus (HAdV) production of human embryonic kidney 293 (HEK-293) cells, providing a theoretical basis for engineering the lactate metabolism in mammalian cells. By knocking out ldha gene and overexpression of ldhb and ldhc genes, the metabolic efficiency of HEK-293 cells was effectively improved, and HAdV production was significantly increased. Compared with the control cell, LDH manipulation promoted cell growth, reduced the accumulation of lactate and ammonia, significantly enhanced the efficiency of substrate and energy metabolism of cells, and significantly increased the HAdV production capacity of HEK-293 cells. Among these LDH manipulation measures, ldhc gene overexpression performed the best, with the maximum cell density increased by about 38.7%. The yield of lactate to glucose and ammonia to glutamine decreased by 33.8% and 63.3%, respectively; and HAdV titer increased by at least 16 times. In addition, the ATP production rate, ATP/O₂ ratio, ATP/ADP ratio and NADH content of the modified cell lines were increased to varying degrees, and the energy metabolic efficiency was significantly improved.
Animals ; Humans ; L-Lactate Dehydrogenase/genetics* ; Lactic Acid ; Adenoviruses, Human ; Ammonia ; HEK293 Cells ; Glucose/metabolism* ; Adenosine Triphosphate/metabolism* ; Kidney/metabolism* ; Mammals/metabolism*

Objective:To explore the changes of the auditory event-related potentials P300 and the Montreal Cognitive Assessment (MoCA) in the chronic mild lead poisoning in order to find out the impairment of cognitive function and intervene early.Methods:In February 2020, 50 patients with chronic mild lead poisoning in Wuhan Center for Prevention and Treatment of Occupational Diseases from June 2011 to June 2015 were selected as the case group, and 50 healthy people were selected as the control group. The changes of auditory event-related potential P300 and MOCA of the two groups were analyzed.Results:Compared with the control group, the latency of P300 of auditory event-related potential in the case group was prolonged and the amplitude was decreased ( P<0.05) . Compared with the control group, the total score of MoCA in the case group was decreased, the mean score of language, abstract and delayed memory items decreased, and the differences were statistically significant ( P<0.05) . Conclusion:The combination of auditory event-related potential P300 and MOCA is helpful to detect the early cognitive impairment in chronic lead poisoning population, and auditory event-related potential P300 is an objective and effective early detection method.

Objective:To explore the changes of the auditory event-related potentials P300 and the Montreal Cognitive Assessment (MoCA) in the chronic mild lead poisoning in order to find out the impairment of cognitive function and intervene early.Methods:In February 2020, 50 patients with chronic mild lead poisoning in Wuhan Center for Prevention and Treatment of Occupational Diseases from June 2011 to June 2015 were selected as the case group, and 50 healthy people were selected as the control group. The changes of auditory event-related potential P300 and MOCA of the two groups were analyzed.Results:Compared with the control group, the latency of P300 of auditory event-related potential in the case group was prolonged and the amplitude was decreased ( P<0.05) . Compared with the control group, the total score of MoCA in the case group was decreased, the mean score of language, abstract and delayed memory items decreased, and the differences were statistically significant ( P<0.05) . Conclusion:The combination of auditory event-related potential P300 and MOCA is helpful to detect the early cognitive impairment in chronic lead poisoning population, and auditory event-related potential P300 is an objective and effective early detection method.