Objective To explore the applicability and optimal cut-off of the revised Cubbin & Jackson scale in the diagnosis of pressure injury in ICU patients in China.Methods From April 2021 to October 2022,6 203 ICU patients from 35 tertiary hospitals in Gansu Province were included in the study by convenience sampling method.The standardized trained ICU nurses examined the skin and collected relevant data,determined whether or not there was pressure injury and its stage,and simultaneously used the revised Cubbin & Jackson scale for pressure injury risk assessment.The software was used to statistically analyze the area under the receive operating characteristic curve(AUC),Yoden index,sensitivity,specificity and other indexes of the revised Cubbin & Jackson scale in the diagnosis of pressure injury in ICU patients.Results A total of 79 cases of pressure injury occurred during hospitalization in 6 203 ICU patients,with an incidence of 1.27％.Hierarchical analysis showed that the AUC of the revised Cubbin & Jackson scale in the prediction and diagnosis of pressure injury ranged from 0.74 to 0.92 in ICU patients with different sex,age,length of ICU stay,whether or not mechanically ventilated,and whether or not surgical.The Yoden index,sensitivity and specificity were 0.40-0.74,77.27％-94.44％and 62.44％-82.63％,respectively.When the total score was ≤28 points,the revised Cubbin & Jackson scale obtained the highest AUC(0.86),and the Yoden index,sensitivity,specificity,positive predictive value,negative predictive value,positive likelihood ratio,and negative likelihood ratio were 0.60,92.41％,67.26％,3.50％,99.86％,2.82 and 0.11,respectively.Conclusion The revised Cubbin & Jackson scale can be used as a suitable tool to effectively predict and diagnose pressure injury in ICU patients in China,and the optimal cut-off of ≤28 points is appropriate.

Objective To develop"a guideline for pressure injury risk assessment and prevention of neonates in NICU",and to provide guidance and references for clinical staff in the implementation of pressure injury assessment and prevention for neonates in NICU.Methods Based on the World Health 0rganization Guideline Development Manual and the results of systematic search for identified clinical problems,the GRADE method was used to evaluate the evidence and grade the recommendations,and the RIGHT report specifications were referred to for writing,and the guideline was developed and revised according to the results and recommendations of the expert review,so as to form the official guideline.Results The guideline included 2 aspects of pressure injury risk assessment and prevention,resulting in 12 clinical questions and 19 recommendations.Conclusion The guideline for risk assessment and prevention of pressure injury of neonates in NICU is an evidence-based guideline based on the best available evidence,clinical practice,and professional judgment,and it can provide a practical basis for scientific decision-making by clinical staff and managers.

In the context of the new era of metaverse, this article summarizes and analyzes the rapid development of medical education in the new situation and the current research status of new teaching model for medical imaging. Moreover, this article focuses on how to build a metaverse medical imaging teaching resource library, construct a virtual environment for metaverse medical imaging teaching, and create a learning platform for metaverse medical imaging teaching. The article also describes the logic and plan of a course for practicing the new teaching model for medical imaging in the context of metaverse. Virtual teaching was carried out for the specific theme course "Head MRI", and the teaching experience for medical imaging in the context of metaverse was explored and summarized, which provides a reference for achieving diversified teaching.

Objective To investigate and validate the expression profiles of Ppp3cb and Ppm1g through differential proteomic analysis of hippocampal tissue in NHE1 gene knockout mice with proteomic analysis.Method ① Six 2-week-old NHE1 knockout mice were selected as the model group,and 6 wild-type mice of the same age served as the control group,and their genotypes were detected by agar-gel electrophoresis.Open field test and forced swimming test were used to evaluate the behaviors of mice in the model group and control group,and epileptic seizure was graded according to Racine scoring.② Tandem mass spectrometry was employed to screen the differential proteins in the hippocampus tissues from the model group and the control group.Then the obtained differential proteins were annotated and enriched in the Gene Ontology(GO)database.Search tool for the retrieval of interesting genes(STRING)database was used to analyze protein-protein interaction(PPI)among different proteins.③ The transcriptional and translational levels of Ppp3cb and Ppm1g were detected by qPCR and Western blotting,respectively,and their expression levels in the tissues were observed with immunohistochemistry.Results ① NHE1 was not expressed in the model group.The mice of the model group had shorter total movement distance(P=0.007 3)and less crossing cells(P＜0.000 1)in open field test,and longer period of immobility in forced swimming test(P＜0.000 1)when compared with those from the control group.② When fold change ≥1.2 times and P＜0.05 were set as the significant threshold for differential expression,845 differentially expressed protein sites were detected in the hippocampus,among which 9 proteins(including Ppm1g)were up-regulated and 7 ones(including Ppp3cb)were down-regulated.Gene Ontology(GO)functional analysis showed that after NHE1 knockout,the most significant differences were observed in the concentration of molecular function(MF)related to protein serine/threonine phosphatase activity,concentration of cellular component(CC)related to the plasma membrane,and concentration of biological process(BP)related to negative regulation of biological processes and immune system processes.STRING analysis indicated that the differential proteins Ppp3cb and Slc9a1 directly acted,Ppm1g indirectly acted through Ppp3cb and Slc9a1,and Ppp3cb and Ppm1g interacted.③The transcriptional and translational levels of Ppp3cb were decreased,and its expression level was reduced in the tissues,while those of Ppm1g were increased,and its expression was elevated in the tissues(P＜0.05).Conclusion In the hippocampus of NHE1 gene knockout mice,the expression of differential protein Ppp3cb is down-regulated and that of Ppm1g is up-regulated,which provide a basis for further study on their involvement in the pathogenesis of epilepsy.

Objective:To analyze the application value of noninvasive prenatal testing (NIPT) in screening fetal chromosome aneuploidy in cautious population.Methods:The data of 19 590 pregnant women who voluntarily received NIPT in the Department of Gynecology and Obstetrics, General Hospital of Tianjin Medical University from October 2016 to June 2020 were retrospectively analyzed. The patients were divided into groups according to age, type of pregnancy and number of fetuses. The screening efficiency of NIPT was compared among different groups. Meanwhile, the screening efficacy of second trimester serum screening (STSS), STSS combined with NIPT and direct NIPT screening was compared and analyzed.Results:The positive predictive values of NIPT for trisomy 21, trisomy 18 and trisomy 13 were 87.18%, 54.84% and 41.18%, respectively. In pregnant women with advanced age (≥35 years old), in vitro fertilization and embryo transfer (IVF-ET) and twin pregnancy, NIPT sensitivity was all 100%, specificity was 99.79%, 99.82% and 100%, positive predictive value was 85.25%, 50.00% and 100%, respectively. The positive predictive value of ≥35 years old patients was significantly higher than that of <35 years old patients (61.54%, P=0.003), and the other indicators were similar to those of the young (<35 years old), conceived naturally and singleton group (all P>0.05). Compared with STSS, combined screening and direct NIPT screening had higher positive predictive value (1.20%, 68.75%, 73.74%; all P<0.001) and lower false positive rate (27.83%, 0.19%, 0.17%; all P<0.001). Conclusion:NIPT has high sensitivity, specificity and positive predictive value for fetal chromosome aneuploidy screening in pregnant women with advanced age, STSS high risk, IVF-ET and twin pregnancy, which greatly relieves the pressure of prenatal diagnosis and reduces the birth rates of children with chromosome disease.

Objective:To analyze the application value of noninvasive prenatal testing (NIPT) in screening fetal chromosome aneuploidy in cautious population.Methods:The data of 19 590 pregnant women who voluntarily received NIPT in the Department of Gynecology and Obstetrics, General Hospital of Tianjin Medical University from October 2016 to June 2020 were retrospectively analyzed. The patients were divided into groups according to age, type of pregnancy and number of fetuses. The screening efficiency of NIPT was compared among different groups. Meanwhile, the screening efficacy of second trimester serum screening (STSS), STSS combined with NIPT and direct NIPT screening was compared and analyzed.Results:The positive predictive values of NIPT for trisomy 21, trisomy 18 and trisomy 13 were 87.18%, 54.84% and 41.18%, respectively. In pregnant women with advanced age (≥35 years old), in vitro fertilization and embryo transfer (IVF-ET) and twin pregnancy, NIPT sensitivity was all 100%, specificity was 99.79%, 99.82% and 100%, positive predictive value was 85.25%, 50.00% and 100%, respectively. The positive predictive value of ≥35 years old patients was significantly higher than that of <35 years old patients (61.54%, P=0.003), and the other indicators were similar to those of the young (<35 years old), conceived naturally and singleton group (all P>0.05). Compared with STSS, combined screening and direct NIPT screening had higher positive predictive value (1.20%, 68.75%, 73.74%; all P<0.001) and lower false positive rate (27.83%, 0.19%, 0.17%; all P<0.001). Conclusion:NIPT has high sensitivity, specificity and positive predictive value for fetal chromosome aneuploidy screening in pregnant women with advanced age, STSS high risk, IVF-ET and twin pregnancy, which greatly relieves the pressure of prenatal diagnosis and reduces the birth rates of children with chromosome disease.

Objective By analyzing the incidence, prevalence, mortality, Disability Adjusted of Life Years (DALY) situations and trends of AIDS in China from 1990 to 2019, this paper provides scientific basis for the preventions and controls of AIDS in China. Methods The incidence, prevalence, mortality and DALY rate of AIDS from 1990 to 2019 are obtained from GBD 2019 data. The standardardized rate of four indicators are used to compare and analyze the AIDS changes in China, the United States, Japan and the global with the development of years. Results The four indicators of AIDS in China present increasing trends, with male higher than female. The incidence rate increased from 0.82/100 000 in 1990 to 2.24/100 000 in 2019, the prevalence increased from 5.63/100 000 to 38.77/100 000, and the mortality increased from 0.23/100 000 to 2.23/100 000. The DALY rate increased from 13.18/100 000 to 98.15/100 000. Compared with the global and the United States, the standardized rate of four indicators of AIDS in China in 2019 showed a trend of low level, but it was higher than that in Japan. Conclusion In recent years, some progress has been made in AIDS preventions and controls in China, but the disease burden of AIDS is still on the rise. The situation of AIDS preventions and controls is still serious and unremitting efforts should be made to reduce the burden of AIDS.

Objective:To explore effects of multidisciplinary team cooperation combined with continuous nursing on postoperative functional recovery of patients with high cervical spinal cord tumors.Methods:Using the convenient sampling method, a total of 60 patients with high cervical spinal cord tumors who were hospitalized in Department of Orthopedics of the First Affiliated Hospital of Xinjiang Medical University were selected from January 2012 to December 2019. According to the time of admission, they were divided into the control group and the observation group, with 30 cases in each group. The observation group adopted multidisciplinary team cooperation combined with continuous nursing model, while the control group adopted conventional nursing. Function recovery, muscle strength and complications were compared between the two groups at 3 months after operation.Results:There were 18 cases with good function recovery in the observation group and 10 cases with good function recovery in the control group, and the difference was statistically significant (χ 2=4.268, P<0.05) . The muscle tension was improved in 17 cases of observation group and 6 cases of control group, and the difference was statistically significant (χ 2=8.684, P<0.05) . Complications occurred in 2 patients in the observation group and 9 patients in the control group, the difference was statistically significant (χ 2=5.455, P<0.05) . Conclusions:Multidisciplinary team cooperation combined with continuous nursing can promote postoperative rehabilitation of patients with high cervical spinal cord tumors, and reduce complications.

Chlamydia psittaci is a causative agent of psittacosis,which can infect a wide range of hosts including birds and humans.However,information regarding C.psittaci infection in pigeons is scarce.In the present study,a total of 399 fecal samples from pigeons were collected from Jilin Province,northeastern China,between March and May 2015,and examined by nested PCR amplification of outer membrane protein A (ompA) gene.The overall Chlamydiosis prevalence was 5.01％ (21/399),with 3.19％ in Changchun City and 9.40％ in Jilin City.Furthermore,breed was the major risk factor associated with Chlamydia infection in pigeon,boiler pigeons had a prevalence of 7.49％,whereas no C.psittaci was detected in racing pigeons.Sequence analysis of the ompA gene revealed that all the identified isolates represented C.psittaci genotype B.Our results firstly indicated the presence of zoonotic C.psittaci in boiler pigeons in Jilin Province,northeastern China,and effective measures should be implemented to reduce the risk of C.psittaci transmission from pigeons to humans.

Objective To evaluate the image quality and the diagnostic value of low radiation,low dose and isotonic low concentration iodine contrast pulmonary computed tomography angiography (CTPA) protocol in pulmonary embolism.Methods Eighty patients with clinic ally suspected pulmonary embolism and BMI＜28 kg/m2 underwent pulmonary CTA on a 64-MDCT scanner (GE Discovery CT750 HD).Eighty patients were divided into two groups (group A:n=40,80 kV,Auto mA,20 ml 270 mg I/ml,60％FBP+40％ ASIR; group B:n=40,120 kV,Auto mA,40 ml 370 mg I/ml,100％FBP).Image quality was assessed,using a five-point scoring scale.Intraarterial density was measured in the common pulmonary artery trunk,the main right and left pulmonary arteries,lobar arteries,and then the average CT value was calculated.Image quality score,Average CT value,noise,SNR,CNR,CTDIvol and DLP were compared between the two groups using t-test.The occurrence rate of the superior vena cava iodine contrast agent sclerosis artifacts and the positive rate of pulmonary embolism were compared between the two groups,using Chi-square test.Results PE was found in 33 patients (14 in group A,19 in group B),and there was no difference of the positive rate of PE between two groups (35.0％ vs 47.5％,x2=1.289,P＞0.05).Overall 4-6 pulmonary artery branches were clearly displayed in all the cases.The image quality scores for two groups were 3.9±0.6 and 4.0 ± 0.7,respectively.There was no statistical difference between two groups (t=0.632,P＞0.05).The superior vena cava iodine contrast agent sclerosis artifacts were reduced in group A (28 cases vs.36 cases,x 2=10.362,P＜0.01).The average CT value and noise in group A [(426.8 ± 84.8),(14.9 ± 1.5)HU,respectively] was higher than those in group B [(359.4±75.3),(7.4± 1.4)HU,respectively],which was statistically significant(t=3.758,22.848,respectively; P＜0.01).However,the SNR (28.8 ±6.3)and CNR (24.5±6.1) in group A were lower than those in group B(SNR 50.4± 14.7,CNR 42.9± 13.8).There was statistically significant difference between two groups (t=8.522,7.669,respectively; P＜0.01 both).The CTDIvol[(3.3±0.3)mGy]and DLP[(101.4± 11.9)mGy· cm] in group A were significantly lower than those in group B [CTDI vol (9.6±0.6)mGy,DLP (328.5 ± 37.3)mGy· cm].The difference between two groups was statistically significant(t=56.393,36.675,respectively,P＜0.01 both).Conclusions The low radiation,low dose and isotonic low concentration iodine contrast CTPA protocol shows pulmonary artery branches of 4-6 levels,reduces radiation exposure and contrast media volume compared with the conventional pulmonary CTA,and achieves the same positive rate of PE in comparison of the conventional CTPA.It can meet the clinical needs.