Pressure ulcer is a common complication of long-term bed rest in intensive care unit(ICU)patients,which can increase the risk of infection and prolong ICU hospitalization.They are an important indicator of patient safety and nursing quality in medical institutions.Early prevention of pressure ulcer is an important means of controlling their development.At present,the prevention of pressure ulcer mainly involves timed flipping and the use of pressure reducing devices.However,during the flipping process,it often requires two or more nursing staff to complete,which increases the workload and also exacerbates the occurrence of occupational lower back pain among nursing staff.In addition,existing pressure reducing devices still have certain limitations in use,and their functions are single,often requiring the combination of multiple tools to increase material and financial resources.Based on this,the research team from the department of critical care medicine of Hospital of Chengdu University of Traditional Chinese Medicine,has designed a nursing device for preventing pressure ulcer in critically ill patients,and has obtained a National Utility Model Patent of China(Patent Number:ZL 202320609787.6).It has several inflation components and connecting structures.The inflation components are equipped with a connected air inlet,a connected air outlet,and a discharge port on the side;the inflatable components are fitted together and can be detachably connected through a connecting structure.The connected air inlet of one inflatable component corresponds to the connected air outlet of adjacent inflatable components.This device is connected by multiple inflation components,which lower or raise the height of the airbag through inflation and deflation,adjust the pressure on various parts of the patient's body,and solve the problem of labor-intensive and heavy workload in nursing work;In addition,multiple inflatable components can be detachably connected to form an inflatable mattress.When in use,the number of inflatable component connections can be selected according to the specific needs of different patients or nursing areas.The device is easy to operate,flexible in combination,and suitable for timed flipping pressure reduction regulation in pressure ulcer high-risk areas under various postures.It has good clinical application value.

This article systematically reviews the regulatory mechanism of SIRT3,an important mitochondrial deacetylase,in the pathogenesis of Alzheimer disease(AD).As a major mitochondrial deacetylase,SIRT3 participates in cerebral energy metabolism,neuroinflammation,and mitochondrial quality control by regulating mitochondrial protein functions.During the pathological process of AD,the downregulated expression of SIRT3 can induce hyperacetylation of mitochondrial proteins.This not only leads to mitochondrial dysfunction(such as impaired ATP synthesis and excessive reactive oxygen species production)but also impairs mitochondrial quality control mechanisms such as mitophagy and fusion/fission balance,thereby promoting mitochondrial damage.In addition,SIRT3 deficiency can activate neuroinflammatory pathways,prompting the release of inflammatory factors and further exacerbating neuronal damage.Future research will aim to undercover the detailed protective mechanisms of SIRT3 in AD,validate its feasibility as a therapeutic target for AD,and develop specific agonists,providing a theoretical basis for the intervention strategies of AD.

This article systematically reviews the regulatory mechanism of SIRT3,an important mitochondrial deacetylase,in the pathogenesis of Alzheimer disease(AD).As a major mitochondrial deacetylase,SIRT3 participates in cerebral energy metabolism,neuroinflammation,and mitochondrial quality control by regulating mitochondrial protein functions.During the pathological process of AD,the downregulated expression of SIRT3 can induce hyperacetylation of mitochondrial proteins.This not only leads to mitochondrial dysfunction(such as impaired ATP synthesis and excessive reactive oxygen species production)but also impairs mitochondrial quality control mechanisms such as mitophagy and fusion/fission balance,thereby promoting mitochondrial damage.In addition,SIRT3 deficiency can activate neuroinflammatory pathways,prompting the release of inflammatory factors and further exacerbating neuronal damage.Future research will aim to undercover the detailed protective mechanisms of SIRT3 in AD,validate its feasibility as a therapeutic target for AD,and develop specific agonists,providing a theoretical basis for the intervention strategies of AD.

Pressure ulcer is a common complication of long-term bed rest in intensive care unit(ICU)patients,which can increase the risk of infection and prolong ICU hospitalization.They are an important indicator of patient safety and nursing quality in medical institutions.Early prevention of pressure ulcer is an important means of controlling their development.At present,the prevention of pressure ulcer mainly involves timed flipping and the use of pressure reducing devices.However,during the flipping process,it often requires two or more nursing staff to complete,which increases the workload and also exacerbates the occurrence of occupational lower back pain among nursing staff.In addition,existing pressure reducing devices still have certain limitations in use,and their functions are single,often requiring the combination of multiple tools to increase material and financial resources.Based on this,the research team from the department of critical care medicine of Hospital of Chengdu University of Traditional Chinese Medicine,has designed a nursing device for preventing pressure ulcer in critically ill patients,and has obtained a National Utility Model Patent of China(Patent Number:ZL 202320609787.6).It has several inflation components and connecting structures.The inflation components are equipped with a connected air inlet,a connected air outlet,and a discharge port on the side;the inflatable components are fitted together and can be detachably connected through a connecting structure.The connected air inlet of one inflatable component corresponds to the connected air outlet of adjacent inflatable components.This device is connected by multiple inflation components,which lower or raise the height of the airbag through inflation and deflation,adjust the pressure on various parts of the patient's body,and solve the problem of labor-intensive and heavy workload in nursing work;In addition,multiple inflatable components can be detachably connected to form an inflatable mattress.When in use,the number of inflatable component connections can be selected according to the specific needs of different patients or nursing areas.The device is easy to operate,flexible in combination,and suitable for timed flipping pressure reduction regulation in pressure ulcer high-risk areas under various postures.It has good clinical application value.

Objective:To study the trinucleotide repeats of GCN (GCA, GCT, GCC, GCG) encoding Alanine in exon 3 of the PHOX2B gene among healthy individuals from southwest China and two patients with Congenital central hypoventilation syndrome (CCHS). Methods:The number and sequence of the GCN repeats of the PHOX2B gene were analyzed by capillary electrophoresis, Sanger sequencing and cloning sequencing of 518 healthy individuals and two newborns with CCHS, respectively. Results:Among the 1036 alleles of the 518 healthy individuals, five alleles were identified, including (GCN) 7, (GCN) 13, (GCN) 14, (GCN) 15 and (GCN) 20. The frequency of the (GCN) 20 allele was the highest (94.79%). And five genotypes were identified, which included (GCN) 7/(GCN) 20, (GCN) 13/(GCN) 20, (GCN) 14/(GCN) 20, (GCN) 15/(GCN) 20, (GCN) 20/(GCN) 20. The homozygous genotypes were all (GCN) 20/(GCN) 20, and the carrier rate was 89.58%. Four GCN sequences of the (GCN) 20 homozygous genotypes were identified among the 464 healthy individuals. The GCN repeat numbers in the exon 3 of the PHOX2B gene showed no significant difference between the expected and observed values, and had fulfilled the, Hardy-Weinberg equilibrium. The genotypes of the two CCHS patients were (GCN) 20/(GCN) 25 and (GCN) 20/(GCN) 30, respectively. Conclusion:It is important to determine the GCN repeats and genotypic data of the exon 3 of the PHOX2B gene among the healthy individuals. The number of GCN repeats in 518 healthy individuals was all below 20. The selection of appropriate methods can accurately detect the polyalanine repeat mutations (PARMs) of the PHOX2B gene, which is conducive to the early diagnosis, intervention and treatment of CCHS.

Objective To observe the effect of Baduanjin exercise on depression,sleep quality and life quality of patients with breast cancer in the rehabilitation period.Methods A total of 76 breast can-cer patients in postoperative rehabilitation were randomly divided into an intervention group of 38 with 2 dropping out,and a control group of 38 with 3 dropouts.Both groups received routine nursing and rehabilitation after breast cancer surgery,while the intervention group additionally practised Baduanjin for 6 weeks.The Beck Depression Inventory-Ⅱ(BDI-Ⅱ-C),Pittsburgh Sleep Quality Index(PSQI)and Quality of Life Questionnaire Core 30(EORTC QLQ-C30)were used to evaluate both groups be-fore,as well as 3 and 6 weeks after intervention.Results After 3-week intervention,the average BDI-Ⅱ-C score,the total PSQI score and the scores of all dimensions except for the hypnotic drug dimen-sion of the intervention group was significantly lower than before treatment(P<0.05),and the control group at the same time point(P<0.05),while the scores of physical,emotional,cognitive,social and role function in EORTC QLQ-C30 were significantly higher than the latter(P<0.05).Three weeks lat-er,the average BDI-Ⅱ-C score,the total PSQI score and the scores of all dimensions except for the hypnotic drug dimension of the intervention group was significantly lower than before treatment(P<0.05),and the control group at the same time point(P<0.05),while the various scores of EORTC QLQ-C30 were significantly higher than the latter(P<0.05).Compared with after 3-week intervention,after 6-week intervention,the average BDI-Ⅱ-C score,the total PSQI score and the scores of its all dimensions except for the sleep disorder dimension of the intervention group decreased significantly,while all dimension scores of EORTC QLQ-C30 except the cognitive function dimension increased sig-nificantly(P<0.05 for all).Conclusion Baduanjin is feasible in improving the sleep and life quality of patients in the rehabilitation period after breast cancer surgery,and relieving their depression.

Background: To enhance perioperative outcomes, a perioperative registry that integrates high-quality real-world data throughout the perioperative period is essential. Singapore General Hospital established the Perioperative and Anesthesia Subject Area Registry (PASAR) to unify data from the preoperative, intraoperative, and postoperative stages. This study presents the methodology employed to create this database. Methods: Since 2016, data from surgical patients have been collected from the hospital electronic medical record systems, de-identified, and stored securely in compliance with privacy and data protection laws. As a representative sample, data from initiation in 2016 to December 2022 were collected. Results: As of December 2022, PASAR data comprise 26 tables, encompassing 153,312 patient admissions and 168,977 operation sessions. For this period, the median age of the patients was 60.0 years, sex distribution was balanced, and the majority were Chinese. Hypertension and cardiovascular comorbidities were also prevalent. Information including operation type and time, intensive care unit (ICU) length of stay, and 30-day and 1-year mortality rates were collected. Emergency surgeries resulted in longer ICU stays, but shorter operation times than elective surgeries. Conclusions The PASAR provides a comprehensive and automated approach to gathering high-quality perioperative patient data.

AIM: Lipopolysaccharide (LPS) on the cell membrane of gram negative bacteria is closely related to the occurrence and development of severe acute pancreatitis (SAP). Local and systemic monocyte / macrophages play an important role in the inflammatory process of SAP. Artesunate (AS) was reported to protect rats with severe acute pancreatitis by reducing the release of proinflammatory cytokines. This study further explored the molecular mechanism of anti-inflammatory effect of AS. METHODS: The release of proinflammatory cytokines in the supernatant were studied by enzyme-linked immunosorbent assay. Then, the mRNA expressions of PI3K-III and its key molecules in signaling pathway were detected by real-time quantitative PCR. Finally, the phosphorylation levels of PI3KIII were detected by Western blot. RESULTS: AS could significantly inhibit the release of proinflammatory cytokines from mouse macrophage induced by LPS. Autophagy inhibitor 3-methyladenine (3-MA) could significantly inhibit the release of TNF-α from mouse macrophages induced by LPS; LPS significantly increased the mRNA expression of PI3KIII and its key molecules in mouse peritoneal macrophages (PMs). Finally, AS could significantly inhibit the increase of PI3K-III phosphorylation induced by LPS in PMs. CONCLUSION: The anti-inflammatory mechanism of AS is closely related to the inhibition of PI3K-III phosphorylation.

Objective To explore the effect of paraquat (PQ) on autophagy in human embryonic neural progenitor cells.Methods Using ReNcell CX cell model.After treatment with various concentration (0.00,1.00,10.00 and 100.00 μmol/L) of PQ,CCK8 assay was used to detect the cell viability,the transmission electron microscope was used to observe the the cell ultrastructure,the real-time polymerase chain reaction (RTPCR) was adopted to detect mRNA expression of autophagy related genes which including LC3,Atg12,Atg5,beclinl,Atg7 and mTOR and apoptosis related genes Bax and Bcl-2.Results The cell viability was significantly inhibited after administered with 100.00 μmol/L of PQ (P＜0.01).The mRNA expression of Beclin1 was significantly up-regulated and the emergency of autophagosome were observed at the concentration of 1.00 μ mol/L group,while mild cell apoptosis,significantly up-regulated Atg5,Atg8,Atg7 and Atg12 mRNA expression as well as down-regulated expression of mTOR and Bax were detected at the 10.00 μmol/L of PQ group,howere,the obvious apoptosis and the up-regulated mRNA expression of mTOR and Bax were observed at the 100.00 μmol/L of PQ group,the mRNA expression of Bcl-2 were all down-regulated after administered with 1.00,10.00 and 100.00 μmol/L of PQ and reached the lowest level at the concentration of 10.00 μmol/L.Conclusion PQ can induced autophagy at the low concentration in ReNcell CX cell and autophagy might serve as a protective mechanism to ameliorate PQ-induced cytotoxic effects but apoptosis will be induced at the 100 μmol/L concentration.

Objective To explore the effect of paraquat (PQ) on autophagy in human embryonic neural progenitor cells.Methods Using ReNcell CX cell model.After treatment with various concentration (0.00,1.00,10.00 and 100.00 μmol/L) of PQ,CCK8 assay was used to detect the cell viability,the transmission electron microscope was used to observe the the cell ultrastructure,the real-time polymerase chain reaction (RTPCR) was adopted to detect mRNA expression of autophagy related genes which including LC3,Atg12,Atg5,beclinl,Atg7 and mTOR and apoptosis related genes Bax and Bcl-2.Results The cell viability was significantly inhibited after administered with 100.00 μmol/L of PQ (P＜0.01).The mRNA expression of Beclin1 was significantly up-regulated and the emergency of autophagosome were observed at the concentration of 1.00 μ mol/L group,while mild cell apoptosis,significantly up-regulated Atg5,Atg8,Atg7 and Atg12 mRNA expression as well as down-regulated expression of mTOR and Bax were detected at the 10.00 μmol/L of PQ group,howere,the obvious apoptosis and the up-regulated mRNA expression of mTOR and Bax were observed at the 100.00 μmol/L of PQ group,the mRNA expression of Bcl-2 were all down-regulated after administered with 1.00,10.00 and 100.00 μmol/L of PQ and reached the lowest level at the concentration of 10.00 μmol/L.Conclusion PQ can induced autophagy at the low concentration in ReNcell CX cell and autophagy might serve as a protective mechanism to ameliorate PQ-induced cytotoxic effects but apoptosis will be induced at the 100 μmol/L concentration.