Objective To evaluate the efficacy and safety of a novel intravascular lithotripsy(IVL)balloon—Vesscrack shockwave balloon—for vascular preparation before stent implantation in patients with severe coronary artery calcification(CAC).Methods This was a prospective,single-arm,multicenter study conducted in China from June 2022 to October 2022.Patients with severe CAC were treated with the Vesscrack shockwave balloon for lesion preparation,followed by drug-eluting stent(DES)implantation.Of these,33 patients underwent optical coherence tomography(OCT).The primary endpoint was procedural success,defined as successful stent implantation with residual stenosis≤30％and the absence of in-hospital major adverse events,including cardiac death,target vessel-related myocardial infarction,or target lesion revascularization.Results A total of 170 patients[mean age:(65.9±7.9)years,116 males]were enrolled.After treatment with IVL and DES,the minimum lumen diameter increased significantly compared to baseline[(2.34±0.40)mm vs.(0.95±0.33)mm,P＜0.001],the degree of stenosis was significantly reduced[(13.24±6.60)％vs.(65.18±10.59)％,P＜0.001].Procedural success was achieved in 100％of cases,and device success was 98.8％.The 30-day patient-related cardiovascular clinical composite endpoint(POCE)rate was 0.0,with no target lesion failure,no confirmed or potential thrombotic events were observed.The shockwave energy generator demonstrated excellent stability and ease of use.Among the 33 patients assessed with OCT,after IVL intervention,the maximum calcified area of the lumen[(3.51±1.51)mm2 vs.(2.85±1.80)mm2,P＜0.001],and the minimum lumen area within the target lesion[(3.08±1.04)mm2 vs.(2.02±0.75)mm2,P＜0.001],and after DES intervention,the luminal area of the largest calcified site[(6.59±1.64)mm2 vs.(2.85±1.80)mm2,P＜0.001]and the minimum luminal area within the target lesion[(6.19±1.45)mm2 vs.(2.02±0.75)mm2,P＜0.001]were significantly increased,and the differences were statistically significant.Conclusions The Vesscrack shockwave balloon is effective and safe for vascular preparation in patients with severe CAC prior to stent implantation.It achieves significant calcified plaque modification,high procedural success rates,and minimal complications.

Objective To preliminarily explore the safety of collecting colostrum in the third trimester,and to evaluate postpartum breastfeeding in pregnant women with hyperglycemia during pregnancy.Methods Pregnant women with hyperglycemia during pregnancy who had prenatal examinations in Obstetrics and Gynecology Hospital,Fudan University from Jul to Nov 2022 were prospectively divided into the colostrum collection group(n=52)in the third trimester and the control group(n=55)by randomized controlled grouping method.The t-test,χ2 test,Fisher's exact probability method and rank sum test were used for statistical analysis of the data to compare the delivery outcomes,neonatal outcomes and postpartum breastfeeding status between the two groups.Results There were no significant differences in the gestational weeks at delivery,delivery methods,breastfeeding rates at 42 days postpartum and 4 months postpartum between the two groups of pregnant women with hyperglycemia during pregnancy.There were also no significant differences in the Apgar scores at 1 minute and 5 minutes after birth and the neonatal hospitalization rate.The proportion of formula milk as the first supplementary feeding after delivery and the delayed lactation rate at 3 days postpartum in the colostrum collection group were significantly lower than those in the control group(P<0.05).The exclusive breastfeeding rates at 24 hours postpartum and 3 days postpartum in the colostrum collection group were significantly higher than those in the control group(P<0.05).Conclusion Collecting colostrum in the third trimester among pregnant women with hyperglycemia during pregnancy is safe,and it can reduce the rate of supplementary feeding with formula milk after delivery,and increase the exclusive breastfeeding rates at 24 hours postpartum and 3 days postpartum.

This study analyzed the variations and evolution characteristics of influenza B Victoria(BV)virus in the Yellow River Delta region of China during 2021-2024.Throat swabs were collected from people with influenza-like illness(ILI)from 2021 to 2024 in Binzhou and Dongying,China.Viral isolation was performed,and 22 representative influenza BV isolates were selected for whole genome sequencing.Phylogenetic analysis of whole-genome sequences was performed in MegAlign and MEGA software.A total of 27 674 samples were obtained,and the overall positivity rate of influenza virus(A/H3N2,A/H1N1,BV)was 11.1％.Our surveillance data indicated that influenza B virus was detected in 2 years,which showed positivity rates of 28.2％and 1.7％,respectively.Statistically significant differences in the positivity rates of influenza BV viruses were observed(x2=3 641.791,P＜0.001).The median pairwise sequence identities ranged from 98.7％to 99.3％for eight segments of 22 viral sequences.The isolates for the monitoring years 2021-2024 were located in clades V1A.3a.1 and V1A.3a.2.Intra-lineage reassortments were discovered in B/shandongbincheng17/2022.The NA gene of one isolate exhibited an increase in the 488NLTV N-glycoproteome site.The K338R mutation occurred in the PA gene.Three locus deletion or insertion mutations occurred in the MP gene.The BV influenza epidemic was prevalent every other year;the intensity ranged from strong to weak;and the duration ranged from long to short in the Yellow River Delta region of China during 2021-2022.Influ-enza B virus formed intra-lineage reassortments,and showed significant mutations in NA gene,PA gene,and MP gene.

Objective:This study aimed to investigate the value of myocardial contrast echocardiography(MCE)in the prognostic assessment of patients undergoing revascularization for acute anterior ST-segment elevation myocar-dial infarction(STEMI).Methods:A total of 234 patients with acute anterior STEMI who underwent percutaneous coronary intervention(PCI)and completed MCE admitted in Dongguan People's Hospital between July 1st 2019 and October 1st 2021 were included.According to presence of major adverse cardiovascular events(MACE)during 6 months,patients were divided into no MACE group(n=188)and MACE group(n=46).General data and MCE indexes were compared between the two groups.Multivariate Logistic regression analysis was employed to analyze influencing factors for MACE in patients with acute anterior STEMI after PCI.Receiver operating characteristic(ROC)curve was applied to analyze predictive value of MCE indexes for MACE in patients with acute anterior STE-MI after PCI.Results:Compared with patients in no MACE group,those in MACE group had significant higher proportion of previous myocardial infarction,D-dimer,C reactive protein,B-type natriuretic peptide,creatine kinase isoenzyme MB(CK-MB),incidence of T-wave inversion and ST-segment resolution amplitude(P＜0.05 or＜0.01).MCE showed that compared with those in no MACE group,those in MACE group had significant lower left ventricular ejection fraction(LVEF)[(52.54±7.66)％ vs.(55.98±10.04)％],and significant higher wall motion score index(WMSI)[(1.22±0.13)vs.(1.17±0.15)]and contrast score index(CSI)[(1.54±0.32)％vs.(1.16±0.21)％](P＜0.05 or＜0.01).Multivariate Logistic regression analysis revealed that previous myocar-dial infarction,C-reactive protein,CSI and T-wave inversion were independent risk factors for MACE in patients with acute anterior STEMI after PCI(OR=13.790～6601.747,P＜0.05 or＜0.01).ROC curve indicated that CSI had good predictive value for MACE in patients with acute anterior STEMI after PCI,the area under curve(AUC)was 0.874(95％CI 0.825～0.914)and optimal cutoff point was 1.33％.Conclusion:Myocardial contrast echocardiography plays an important role in prognostic assessment of patients undergoing revascularization for acute anterior STEMI.

Objective:To observe the effects of auricular point compression and exercise therapy on glycolipid metabolism,oxidative stress and sleep quality in type 2 diabetes mellitus(T2DM)patients with poor glycemic control.Methods:This study was a single-center randomized controlled study,86 T2DM patients with poor glycemic control who were treated in our hospital from June 2022 to June 2024 were divided into control group(received conventional treatment,n=43)and observation group(received auricular point compression and exercise therapy,n=43)by using the random number table method.The clinical efficacy,blood lipid indexes,blood glucose indexes,oxidative stress indexes and sleep quality were compared between the two groups.Results:The total clinical effective rate,high-density lipoprotein cholesterol(HDL-C),superoxide dismutase(SOD)and Glutathione peroxidase(GSH-Px)of the observation group after treatment were higher than those of the control group,and the fasting blood glucose(FBG),glycated hemoglobin(HbA1c),Homeostatic Model Assessment of Insulin Resistance(HOMA-IR),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),triglycerides(TG),reactive oxygen species(ROS),malondialdehyde(MDA)and Pittsburgh sleep Quality Index(PSQI)score were lower than those of the control group(P＜0.05).Conclusion:Auricular point compression and exercise therapy can regulate glycolipid metabolism in T2DM patients with poor glycemic control,improve the degree of oxidative stress and sleep quality.

Objective:To summarize medication safety assessment tools for clinical nurses both domestically and internationally.Methods:Guided by the Joanna Briggs Institute (JBI) scoping review methodology, a systematic search was conducted across CINAHL, Embase, PubMed, Web of Science, SinoMed, China National Knowledge Infrastructure, and WanFang Data. The search period was from the establishment of database to January 1, 2025. Medication safety assessment tools for clinical nurses were extracted, relevant content was systematically analyzed, and the retrieval results were reported in a standardized manner.Results:A total of 28 studies were included, involving 15 medication safety assessment tools for clinical nurses. Assessment methods employed multidimensional and graded self-assessment formats. Based on evaluation perspectives, these tools were categorized into six types, including operational standardization monitoring, cognitive bias calibration, environmental stress testing, capability threshold identification, reporting barrier analysis, and medication information systems. The assessment tools had high reliability and validity, multiple types, and diverse evaluation perspectives.Conclusions:Researchers should carefully select and use assessment tools based on research characteristics. It is necessary to enhance the autonomy of nursing research on medication safety, develop comprehensive and accurate clinical nurse medication safety assessment tools that are adapted to China's clinical context, and promote the improvement of nurse medication safety.

Objective To develop a graded early mobility implementation pathway for critically ill adult patients in tertiary hospitals in Beijing and to preliminarily validate its feasibility and effectiveness.Methods Based on the"goal-directed"early mobility concept,a graded early mobility implementation pathway for critically ill patients was developed through evidence synthesis and the Delphi method,consisting of 3 components:patient inclusion,mobility implementation,and mobility evaluation.Using convenience sampling,patients meeting inclusion criteria in the general ICU of a tertiary hospital in Beijing from October 2024 to January 2025 were selected as participants.Among them,25 patients admitted from December 2024 to January 2025 were assigned to an experimental group and received early mobility interventions following the developed pathway.25 patients admitted from October to November 2024 served as a control group and received routine ICU mobility care.Outcomes including diaphragm excursion,muscle strength,ICU length of stay,and adverse events were compared between the 2 groups.Results The graded early mobility pathway achieved an implementation rate of 70.05％in the experimental group,significantly higher than it in the control group(P＜0.001),without increasing adverse events.Post-intervention diaphragm excursion in the experimental group was significantly greater than that in the control group(P=0.018).Conclusion The developed graded early mobility implementation pathway for ICU patients demonstrates scientific rigor and clinical practicality.It provides a reference for the widespread and effective implementation of early mobility in ICUs,standardizing its clinical application.

Objective:To observe the effects of auricular point compression and exercise therapy on glycolipid metabolism,oxidative stress and sleep quality in type 2 diabetes mellitus(T2DM)patients with poor glycemic control.Methods:This study was a single-center randomized controlled study,86 T2DM patients with poor glycemic control who were treated in our hospital from June 2022 to June 2024 were divided into control group(received conventional treatment,n=43)and observation group(received auricular point compression and exercise therapy,n=43)by using the random number table method.The clinical efficacy,blood lipid indexes,blood glucose indexes,oxidative stress indexes and sleep quality were compared between the two groups.Results:The total clinical effective rate,high-density lipoprotein cholesterol(HDL-C),superoxide dismutase(SOD)and Glutathione peroxidase(GSH-Px)of the observation group after treatment were higher than those of the control group,and the fasting blood glucose(FBG),glycated hemoglobin(HbA1c),Homeostatic Model Assessment of Insulin Resistance(HOMA-IR),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),triglycerides(TG),reactive oxygen species(ROS),malondialdehyde(MDA)and Pittsburgh sleep Quality Index(PSQI)score were lower than those of the control group(P＜0.05).Conclusion:Auricular point compression and exercise therapy can regulate glycolipid metabolism in T2DM patients with poor glycemic control,improve the degree of oxidative stress and sleep quality.

Peri-implant keratinized mucosa (PIKM) augmentation refers to surgical procedures aimed at increasing the width of PIKM. Consensus reports emphasize the necessity of maintaining a minimum width of PIKM to ensure long-term peri-implant health. Currently, several surgical techniques have been validated for their effectiveness in increasing PIKM. However, the selection and application of PIKM augmentation methods may present challenges for dental practitioners due to heterogeneity in surgical techniques, variations in clinical scenarios, and anatomical differences. Therefore, clear guidelines and considerations for PIKM augmentation are needed. This expert consensus focuses on the commonly employed surgical techniques for PIKM augmentation and the factors influencing their selection at second-stage surgery. It aims to establish a standardized framework for assessing, planning, and executing PIKM augmentation procedures, with the goal of offering evidence-based guidance to enhance the predictability and success of PIKM augmentation.
Humans ; Consensus ; Dental Implants ; Mouth Mucosa/surgery* ; Keratins

Avian influenza H10N3 is a type of avian influenza virus that can occasionally infect humans and cause severe pneumonia and acute respiratory distress syndrome (ARDS). On December 25, 2024, a 23-year-old obese female patient with H10N3 avian influenza complicated with severe ARDS was admitted to the Fourth People's Hospital of Nanning. The patient was transferred to our department due to "fever, cough, and shortness of breath for 13 days". Physical examination revealed moist rales in bilateral lungs. Chest imaging showed large areas of ground-glass opacity and consolidation in both lungs. Based on the patient's medical history, clinical manifestations, and laboratory findings, she was diagnosed with human infection of H10N3 avian influenza, severe pneumonia, and severe ARDS. Supported by mechanical ventilation and extracorporeal membrane oxygenation (ECMO), daily monitoring of airway peak pressure, plateau pressure (Pplat), driving pressure (ΔP), and lung compliance was performed to guide the adjustment of tidal volume (VT) and positive end-expiratory pressure (PEEP) during invasive mechanical ventilation. Medications including anti-avian influenza virus agents, antibacterial drugs, and antifungals were administered. Eventually, the patient's condition improved gradually, and she was successfully weaned from ECMO. No ventilator-induced lung injury (VILI) or multiple organ dysfunction syndrome (MODS) related to ARDS occurred during ECMO support. However, during the final stage of ventilator weaning after the restoration of spontaneous breathing, a right pneumothorax occurred. Closed thoracic drainage was performed, after which the ventilator was successfully discontinued. The patient was successfully transferred out of the intensive care unit (ICU), recovered fully, and was discharged from the hospital. In the invasive mechanical ventilation management of patients infected with H10N3 avian influenza complicated by ARDS, monitoring airway peak pressure, Pplat, ΔP, and assessing pulmonary compliance may facilitate more standardized management of such ARDS patients and help reduce VILI.
Humans ; Female ; Influenza, Human/complications* ; Respiratory Distress Syndrome/complications* ; Respiration, Artificial/methods* ; Obesity/complications* ; Young Adult ; Extracorporeal Membrane Oxygenation ; Influenza A virus