This study summarizes the preoperative and intraoperative nursing experience in 5 cases of bridge-to-transplant heart transplantation with left ventricular assist device(LVAD)explant.Key points of nursing include:preoperative care and assessment of LVAD patients,preoperative discussion of the multidisciplinary team,safe transfer of patients to surgical rooms and other preoperative preparation,cardiomyocardial protection and multidisciplinary team cooperation during bridging transplantation,and intra-operative patient safety management.All 5 patients in this group successfully completed the surgery and were discharged.Pressure sores,wound infections,and other postoperative complications have not occurred.Postoperative cardiac function of 5 patients in this group were classified as New York Heart Association class Ⅰ～Ⅱ.The follow-up period for the 5 patients in this group ranged from 6 months to 6 years.The results of the most recent echocardiography follow-up showed that the left ventricular ejection fraction of all patients was all above 65％,with well prognosis.

Objective:To design a management system of internet of things(IoT)smart operation room based on business process reconstruction theory,and explore the application effect of that in improving management effectiveness for operation room.Methods:Aimed at the existing problems of key points in the management for operation room,the process was reconstructed on the basis of the original information system,relevant systems,workflows and standards of operation room of Fuwai Hospital of Medical Sciences and Peking Union Medical College.Then,a management system of IoT smart operation room based on business process reconstruction theory was designed.The surgical data of 13159 patients who underwent relevant operation of cardiovascular surgery from January to December 2022 were selected,and they were divided into"before-application"group(6 483 cases)and"after-application"group(6 676 cases)according to the point before and after the system was applied.Some indicators'data,which included scheduling management situation of picking up and dropping off patients by medical auxiliaries,duration of preparing anesthesia,duration of preoperative waiting,interval duration of continuous surgery and usage amount of surgical gowns under same amount of surgery,between two groups were compared.Results:The transportation efficiency of patients who underwent surgery after system was applied was(1.38±0.09)surgeries/h,which was higher than(0.99±0.09)surgeries/h before it was applied,and the difference was statistically significant(t=6.604,P<0.001).The satisfaction score of medical auxiliaries increased from 3.83(3.33,4.5)before application to 4.50(4.33,4.83)after application,and the difference was significant(Z=2.02,P<0.05).The duration of preparing anesthesia and duration of preoperative waiting after the system was applied were respectively(62.04±2.29)and(8.09±2.46)min,both of which were less than those before the system was applied,and the differences of them between two groups were statistically significant(t=2.309,2.280,P<0.05).The usage amount of surgical gowns under same amount of surgery after the system was applied was(4.11±0.57)gowns/surgery,which was less than(5.81±0.29)gowns/surgery before the system was applied,and the difference was statistically significant(t=6.489,P<0.05).Conclusion:The application of the management system of IoT smart operation room based on business process reconstruction theory can provide more safely,high-qualitatively and efficiently medical services for patients,and improve work efficiency and management effectiveness for operation room,and reduce resource consumption and operating cost.

Objective To investigate the sleep architecture of sleep related bruxism（SB）in adults and the sleep architecture of SB comorbid with obstructive sleep apnea hypopnea syndrome（OSAHS），as well as their correlation with age and other factors. Methods A total of 51 subjects with SB and 67 controls were included in this study to analyze the sleep architecture of SB and compare the sleep architecture of SB comorbid with different severities of OSAHS. Results Compared with the control group，the SB group had a younger age，increases in N1（%TST）and N2（%TST），a reduction in N3（%TST），and an increase in arousal index. The SB group was divided into non-OSAHS group（group 1），mild OSAHS group（group 2），and moderate-to-severe OSAHS group（group 3）. Group 1 had a younger age than group 2 and group 3，and group 3 had increases in body mass index（BMI），N1（%TST），oxygen desaturation index（ODI），and arousal index and a reduction in N3（%TST）. The Spearman's rank correlation analysis showed that BMI，N1（%TST），arousal index，and ODI increased with the increase in apnea-hypopnea index（AHI），while N3（%TST）decreased with the increase in AHI. The binary logistic regression analysis showed that SB was negatively correlated with age and was positively correlated with arousal index. Conclusion SB may affect sleep architecture by increasing light sleep，reducing deep sleep，and increasing the number of awakenings. There are changes in sleep architecture in case of SB comorbid with different severities of OSAHS. SB is negatively correlated with age and is positively correlated with arousal index.
Polysomnography

This study summarizes the preoperative and intraoperative nursing experience in 5 cases of bridge-to-transplant heart transplantation with left ventricular assist device(LVAD)explant.Key points of nursing include:preoperative care and assessment of LVAD patients,preoperative discussion of the multidisciplinary team,safe transfer of patients to surgical rooms and other preoperative preparation,cardiomyocardial protection and multidisciplinary team cooperation during bridging transplantation,and intra-operative patient safety management.All 5 patients in this group successfully completed the surgery and were discharged.Pressure sores,wound infections,and other postoperative complications have not occurred.Postoperative cardiac function of 5 patients in this group were classified as New York Heart Association class Ⅰ～Ⅱ.The follow-up period for the 5 patients in this group ranged from 6 months to 6 years.The results of the most recent echocardiography follow-up showed that the left ventricular ejection fraction of all patients was all above 65％,with well prognosis.

OBJECTIVE To detect the phenotypes and genotypes of carbapenem-resistant Enterobacteriaceae(CRE)strains and understand the drug resistance phenotypes and molecular characteristics of the CRE strains.METHODS Totally 85 strains of CRE were isolated and restored in microbiology lab of Affiliated Hospital of Inner Mongolia Medical University from Jan.2019 to Aug.2023.The phenotypes of carbapenemases were detected by means of carbapenemase inhibitor enhancement test,the genotypes of carbapenemases were detected by polymerase chain reaction(PCR),and the sequence type(ST)was further analyzed by multilocus sequence typing(MLST).RESULTS Among the 85 strains of CRE that were detected for phenotypes,54 strains carried serinase(type A carbapenemase),23 strains carried metalloenzyme(type B carbapenemase),5 strains produced both type A and type B carbapenemase,and 3 strains produced neither the type A and/or type B carbapenemase.Totally 5 common genotypes of carbapenemases were amplified for 73 strains of CRE,the detection rate of blaKPC was highest,fol-lowed by blaNDM;the drug resistance genes blaIMP,blaVIM and blaOXA-48 were not detected.The 51 strains of car-bapenem-resistant Klebsiella pneumoniae(CRKP)were classified into 7 types of ST in total,which were as fol-lows:ST1,ST11,ST15,ST23,ST34,ST690,ST4862.CONCLUSIONS The isolation rate of CRKP is highest among the CRE strains,and ST11 is the most prevalent strain.Serinase is the most common drug resistance phe-notype,and KPC type carbapenemase is the predominant drug resistance genotype.

OBJECTIVE To detect the phenotypes and genotypes of carbapenem-resistant Enterobacteriaceae(CRE)strains and understand the drug resistance phenotypes and molecular characteristics of the CRE strains.METHODS Totally 85 strains of CRE were isolated and restored in microbiology lab of Affiliated Hospital of Inner Mongolia Medical University from Jan.2019 to Aug.2023.The phenotypes of carbapenemases were detected by means of carbapenemase inhibitor enhancement test,the genotypes of carbapenemases were detected by polymerase chain reaction(PCR),and the sequence type(ST)was further analyzed by multilocus sequence typing(MLST).RESULTS Among the 85 strains of CRE that were detected for phenotypes,54 strains carried serinase(type A carbapenemase),23 strains carried metalloenzyme(type B carbapenemase),5 strains produced both type A and type B carbapenemase,and 3 strains produced neither the type A and/or type B carbapenemase.Totally 5 common genotypes of carbapenemases were amplified for 73 strains of CRE,the detection rate of blaKPC was highest,fol-lowed by blaNDM;the drug resistance genes blaIMP,blaVIM and blaOXA-48 were not detected.The 51 strains of car-bapenem-resistant Klebsiella pneumoniae(CRKP)were classified into 7 types of ST in total,which were as fol-lows:ST1,ST11,ST15,ST23,ST34,ST690,ST4862.CONCLUSIONS The isolation rate of CRKP is highest among the CRE strains,and ST11 is the most prevalent strain.Serinase is the most common drug resistance phe-notype,and KPC type carbapenemase is the predominant drug resistance genotype.

Objective:To design a management system of internet of things(IoT)smart operation room based on business process reconstruction theory,and explore the application effect of that in improving management effectiveness for operation room.Methods:Aimed at the existing problems of key points in the management for operation room,the process was reconstructed on the basis of the original information system,relevant systems,workflows and standards of operation room of Fuwai Hospital of Medical Sciences and Peking Union Medical College.Then,a management system of IoT smart operation room based on business process reconstruction theory was designed.The surgical data of 13159 patients who underwent relevant operation of cardiovascular surgery from January to December 2022 were selected,and they were divided into"before-application"group(6 483 cases)and"after-application"group(6 676 cases)according to the point before and after the system was applied.Some indicators'data,which included scheduling management situation of picking up and dropping off patients by medical auxiliaries,duration of preparing anesthesia,duration of preoperative waiting,interval duration of continuous surgery and usage amount of surgical gowns under same amount of surgery,between two groups were compared.Results:The transportation efficiency of patients who underwent surgery after system was applied was(1.38±0.09)surgeries/h,which was higher than(0.99±0.09)surgeries/h before it was applied,and the difference was statistically significant(t=6.604,P<0.001).The satisfaction score of medical auxiliaries increased from 3.83(3.33,4.5)before application to 4.50(4.33,4.83)after application,and the difference was significant(Z=2.02,P<0.05).The duration of preparing anesthesia and duration of preoperative waiting after the system was applied were respectively(62.04±2.29)and(8.09±2.46)min,both of which were less than those before the system was applied,and the differences of them between two groups were statistically significant(t=2.309,2.280,P<0.05).The usage amount of surgical gowns under same amount of surgery after the system was applied was(4.11±0.57)gowns/surgery,which was less than(5.81±0.29)gowns/surgery before the system was applied,and the difference was statistically significant(t=6.489,P<0.05).Conclusion:The application of the management system of IoT smart operation room based on business process reconstruction theory can provide more safely,high-qualitatively and efficiently medical services for patients,and improve work efficiency and management effectiveness for operation room,and reduce resource consumption and operating cost.

Objective To investigate the optimal blood concentration range of tacrolimus(TAC)for the treatment of nephrotic syndrome(NS)in children.Methods Children with NS admitted to the Department of Nephrology and Immunology of Hebei Children's Hospital from January 2021 to December 2023 were retrospectively selected as study subjects.They were divided into the effective group and the ineffective group according to whether the treatment was effective or not,and the TAC threshold for effective treatment was determined by using the receiver operator characteristic(ROC)curve.The children with NS were divided into a low concentration group(＜3 ng/mL),a medium concentration group(3-5 ng/mL)and a target concentration group(5-10 ng/mL)according to the TAC concentration,and the relationships between the TAC concentration and the clinical efficacy and adverse reactions was analyzed.Results A total of 160 children were enrolled in the study.The numbers of complete remission(CR),partial remission(PR),and null remission(NR)cases of NS children were 91,37,and 32,respectively,and the treatment was effective in 128 cases(80％).The ROC curve analysis results showed that the area under the ROC curve(95％CI),sensitivity,specificity,and threshold of the mean trough concentration of TAC for predicting the efficacy of the treatment were 0.779(0.704,0.853),62.5％,84.45％,and 3.33 ng/mL,respectively.In terms of clinical efficacy,CR and PR were lower and NR was higher in the low concentration group compared with the target concentration group(P＜0.05);whereas,CR was lower and PR was higher in the medium concentration group(P＜0.05),and the difference in NR was not statistically significant(P＞0.05).In terms of different hormone-responsive phenotypes of NS,the CR of the low concentration group was lower(P＜0.05),while there was no significant difference in CR and PR between the medium concentration group and the target concentration group(P＞0.05).As for the different pathological types of NS,CR was lower in the low concentration group when compared with the target concentration group or medium concentration group(P＜0.05);while the differences in CR and PR between the medium concentration group and the target concentration group were not statistically significant(P＞0.05).Regarding adverse reactions,the incidence of limb tremor and abnormal blood glucose was significantly higher in the target concentration group than in the other two groups(P＜0.05).In addition,the differences in serious infections and hypertension among the three groups were not statistically significant(P＞0.05).Conclusion When TAC is used to treat NS in children,the recommended TAC concentration range is 3-5 ng/mL.

Objective To investigate the association between sleep structure and respiratory events in patients with epilepsy. Methods A total of 95 patients with epilepsy and 66 control patients who attended our hospital from March 2018 to March 2022 were enrolled,and polysomnography was used to compare sleep structure and respiratory events between the epilepsy group and the control group. Results Compared with the control group,the epilepsy group had significant reductions in REM sleep duration and R%,a significant increase in the longest duration of hypoventilation,and a significant reduction in the lowest oxygen saturation. Conclusion Changes in sleep structure are observed in patients with epilepsy,and patients with epilepsy and obstructive sleep apnea-hypopnea syndrome tend to develop hypoxemia.

Objective:To observe the synaptic plasticity and characteristics of transmembrane calcium flux in the hippocampus of 3xTg-AD mice.Methods:According to different genotypes, 6-month-old mice were divided into two groups: APP/PS1/tau triple transgenic AD (3xTg-AD) model mice and wild type (WT) mice, with 13 mice in each group.Six mice were randomly selected from each group to do in vivo electrophysiological recording.Field excitatory postsynaptic potential (fEPSP) was evoked by test stimulation, paired-pulse facilitation (PPF) was induced by two stimuli, and long-term potentiation (LTP) was induced by high frequency stimulation (HFS) in the hippocampal CA1 region of mice.The remaining seven mice in each group were used to detect the transmembrane calcium influx and efflux in the slices of hippocampal CA1 region by using non-invasive micro-test technology (NMT). In the electrophysiological and NMT experiments, one mouse fell off respectively.Finally, five mice were enrolled in the electrophysiological experiment and six in the NMT experiment.SPSS 18.0 was used for statistical analysis of all data, and two independent sample t-test was used for comparison between the two groups. Results:(1) In the in vivo electrophysiological experiments, the fEPSP slopes of 3xTg-AD mice and WT mice evoked by test stimulation were stable within 30 min, and the average fEPSP slopes were ((97.8±2.3)%) and ((92.6±12.6)%), respectively.There was no statistical difference of the average fEPSP slopes between the two groups ( t=0.91, P>0.05). After paired-pulse stimulation, the PPF values of 3xTg-AD mice and WT mice were (1.58±0.69) and (1.74±0.17) respectively, and there was no statistical difference between the two groups ( t=0.50, P>0.05). At 30 min and 60 min post-HFS, the LTP values in 3xTg-AD mice were ((104.9±10.9)%) and ((98.0±10.8)%) respectively, which were significantly lower than those in WT mice((156.5±21.3)%, t=4.43, P<0.01; (162.5 ±19.7)%, t=5.92, P<0.01). (2) In NMT experiments, the standardized mean and peak velocities of glutamate-induced Ca 2+ influx in hippocampal CA1 region of 3xTg-AD mice were ((-2 166.0±425.0)%) and ((-3 539.6±1 270.9)%) respectively, which were significantly higher than those in WT mice((-735.3±262.9)%, t=6.81, P<0.01; (-917.3±271.7)%, t=4.89, P<0.01). The standardized average and peak velocities of low Ca 2+ solution-induced Ca 2+ efflux in 3xTg-AD mice were ((1 451.6±297.1)%) and ((1 968.7±227.3)%) respectively, which were significantly lower than those in WT mice((2 579.3±810.9)%, t=2.92, P<0.05; (3 420.4±954.8)%, t=3.31, P<0.01). Conclusion:The hippocampal synaptic plasticity impairment observed in 6-month-old 3xTg-AD may be closely related with the intracellular Ca 2+ overload caused by increased calcium influx and decreased calcium efflux.