Paraplegia caused by spinal cord injury is a serious neurological complication, for which surgery is currently the main treatment method. Due to different surgical approaches, patients are usually expected to maintain a passive prone position for a long time or switch between the supine and prone positions. Affected by multiple factors such as neurogenic sensory disorders, pathological changes in muscle tone and operative duration, the risk of intraoperative acquired pressure injury (IAPI) is significantly increased. Current clinical prevention strategies for IAPI in these patients predominantly focus on localized pressure relief during positioning, lacking systematic, standardized comprehensive prevention protocols or evidence-based guidelines. To address it, Department of Nursing, Orthopedics Branch, China International Exchange and Promotive Association for Medical and Health Care, Spinal Trauma Professional Committee, Orthopedics Branch, Chinese Medical Doctor Association, Nursing Group of Spine and Spinal Cord Professional Committee of Chinese Association of Rehabilitation Medicine organized experts in relevant fields to formulate Guideline for the prevention of intraoperative acquired pressure injury in paraplegic patients with spinal cord injury ( version 2025), based on evidence-based medical evidence and latest research results and clinical practice at home and abroad. Eleven recommendations were put forward from the aspects of preoperative risk assessment, intraoperative prevention strategies, postoperative handover and monitoring, and supportive mechanisms for IAPI prevention, aiming to standardize the prevention measures and management strategies of IAPI in paraplegic patients with spinal cord injury and accelerate the recovery of patients and improve the therapeutic effect.

Paraplegia caused by spinal cord injury is a serious neurological complication, for which surgery is currently the main treatment method. Due to different surgical approaches, patients are usually expected to maintain a passive prone position for a long time or switch between the supine and prone positions. Affected by multiple factors such as neurogenic sensory disorders, pathological changes in muscle tone and operative duration, the risk of intraoperative acquired pressure injury (IAPI) is significantly increased. Current clinical prevention strategies for IAPI in these patients predominantly focus on localized pressure relief during positioning, lacking systematic, standardized comprehensive prevention protocols or evidence-based guidelines. To address it, Department of Nursing, Orthopedics Branch, China International Exchange and Promotive Association for Medical and Health Care, Spinal Trauma Professional Committee, Orthopedics Branch, Chinese Medical Doctor Association, Nursing Group of Spine and Spinal Cord Professional Committee of Chinese Association of Rehabilitation Medicine organized experts in relevant fields to formulate Guideline for the prevention of intraoperative acquired pressure injury in paraplegic patients with spinal cord injury ( version 2025), based on evidence-based medical evidence and latest research results and clinical practice at home and abroad. Eleven recommendations were put forward from the aspects of preoperative risk assessment, intraoperative prevention strategies, postoperative handover and monitoring, and supportive mechanisms for IAPI prevention, aiming to standardize the prevention measures and management strategies of IAPI in paraplegic patients with spinal cord injury and accelerate the recovery of patients and improve the therapeutic effect.

Cytopharmaceutical based on macrophages is a breakthrough in the field of targeted drug delivery. However, it remains a challenge to localize and control drug release while retaining macrophage activity and exerting its immunotherapeutic effect. Herein, a localized light-triggered release macrophage cytopharmaceutical (USIP@M) was proposed, which could utilize the tumor targeting and immunotherapy effects of macrophages to reverse the immune suppression of tumor microenvironment (TME). Amphiphilic block copolymers with ultraviolet (UV)-responsive o-nitrobenzyl groups were synthesized and co-loaded with sorafenib (SF), IMD-0354 (IMD), and upconverting nanoparticles (UCNPs), which were then taken up by macrophages, and the targeted delivery of drugs was realized by using the tumor tropism of macrophages. UCNPs converted near-infrared light with strong penetrability and high safety into UV light, which promoted the photoresponsive depolymerization of block copolymers and production of exosomes from USIP@M, accelerated drug efflux and maintained the activity of macrophages. IMD simultaneously polarized carrier macrophages and tumor-associated macrophages to exert the antitumor effect of macrophages, enhance T cell immunity, and alleviate the immunosuppressive state of TME. Synergistically with the chemotherapeutic effect of SF, it could effectively kill tumors. In conclusion, based on the localized light-triggered release strategy, this study constructed a novel macrophage cytopharmaceutical that could localize and control drug release while retaining the activity of macrophages and exerting its immunotherapeutic effect, which could effectively treat solid tumors.

Objective To explore the clinical features,the risk factors of mortality and drug resistance of the isolates in patients with group B streptococcus (GBS) meningitis.Methods A retrospective analysis was performed in 96 children with GBS meningitis (46 males and 50 females) at Beijing Children's Hospital Affiliated to Capital Medical University from January 2013 to October 2017.The clinical characteristics,prognosis and drug resistance were reviewed and analyzed.According to the onset time,the patients were divided into early onset disease (EOD,0-6 days),late onset disease (LOD,7-89 days) and very late onset disease (VLOD,90 days-16 years),the clinical features were compared.According to the results of cranial imaging examination,the patients were divided into two groups:those with neurological complications and those without neurological complications.The influencing factors of neurological complications were analyzed.According to the outcome of 28 days after discharge,patients were divided into death group and survival group.The risk factors of mortality were analyzed by multivariate Logistic regression analysis.Non-numeric variables were analyzed with x2 test or Fisher's exact test.Numeric variable between groups were compared with nonparametric test.Results A total of 96 patients were enrolled,including 18 (19％) EOD,71 (74％) LOD and 7 (7％) VLOD cases.The median age of EOD cases was 2 days,with a range from 0 to 6 days.The median age of LOD cases was 31 days,with a range from 7 to 81 days.The median age of VLOD cases was 153 days,with a range from 95 to 214 days.Before the onset of the disease,the mother had mastitis in 6 cases and premature rupture of membranes in 6 cases.The common clinical manifestations of patients were fever (95％,91/96),anorexia (65％,62/96),seizure (56％,54/96),and consciousness changes (36％,35/96).The differences were statistically significant in gender (13/18 vs.28/71 vs.5/7,x2=7.705,P=0.024),the number of cases who was admitted to intensive care unit (ICU) (5/18 vs.31/71 vs.0,x2=6.065,P=0.042) and peripheral blood leukocyte (12(4,18)× 109/L vs.6(3,11)×109/L vs.13(6,17)× 109/L,H=9.885,P=0.007) in EOD group,LOD group and VLOD group.Cranial imaging was performed in 94 patients,60 patients (64％) developed neurological complications,including subdural effusion (31/94,33％),followed by intracranial hemorrhage (26/94,28％),cerebral softening (19/94,20％),cerebral atrophy (15/94,16％),ependinitis (8/94,9％) and hydrocephalus (4/94,4％).By univariate x2 test analysis,seizure (63％ (38/60) vs.41％ (14/34),x2=4.310,P=0.038) was a risk factor of neurological complications.Within 28 days after discharge,88 patients survived and 8 patients died,with a fatality rate of 8％.The independent risk factors for the death were septic shock (OR:9.548,95％ CI 1.439-63.356,P=0.019) and respiratory failure (OR:7.053,95％ CI 1.160-42.888,P=0.034).All of isolates were susceptible to penicillin (68/68),ceftriaxone (47/47),cefepime (50/50),vancomycin (60/60) and linezolid (54/54),while the rates of resistance to tetracycline,levofloxacin,clindamycin and erythromycin were 5/12,17/45,38/46 and 32/37,respectively.Conclusions The main type of GBS meningitis is late onset cases.The incidence of neurological complications was high.The independent risk factors for death were septic shock and respiratory failure.The strains were severely resistant to clindamycin and erythromycin.

Objective: To analyze the clinical characteristics of community-acquired pneumonia (CAP) in children under five years of age and analyze the safety and efficiency of nasal continuous positive airway pressure (NCPAP) ventilation for CAP in this population. Method: This was a prospective multicenter study. Children who were admitted to these six centers with CAP and met the NCPAP ventilation indications, aged from 29 d to 5 years, were continuously included during November 2013 to October 2015. The baseline data were collected and NCPAP ventilation were then followed up by operation standards, and the vital signs and arterial blood gas change at special time points were observed and recorded. Any side effect associated with NCPAP were recorded. For categorical variables, comparisons were performed using Fisher test. Rank-sum test and t test were performed respectively for abnormal and normal distribution continuous variables. The variables pre-NCPAP and post-NCPAP were analyzed by repeated measures ANOVA analysis. Result: Totally 145 children were included, and 13 children were excluded due to incomplete data. One hundred and two children(77.3%)were ≤12 months; 91 children (68.9%) were from rural area. NCPAP ventilation was effective in 123 children, with a response rate of 93.2%, were all discharged with a better condition; it was ineffective in 9 children(6.8%), and they were all intubated and went on mechanical ventilation, 5 were discharged with a better condition, and 4 died after gaving up treatment. The gender, age, body weight, residence, main symptoms, main signs, imaging diagnosis, medications, partial pressure of oxygen(PaO₂), breath and heart rate before NCPAP treatment of two groups had no significant differences(allP>0.05). The rates of combining underlying diseases, trouble with feeding and cyanosis, and the partial pressure of carbon dioxide(PaCO₂ ) before NCPAP ventilation were higher in NCPAP ineffective group ((59±11 )vs.( 49±11) mmHg, 1 mmHg=0.133 kPa, t=-2.597, P=0.028); while the PaO₂/fraction of inspiration O₂ (FiO₂ ) before NCPAP was lower((150±37) vs. (207±63) mmHg, t=2.697, P=0.008). The breathing, heart rate and PaCO₂ of NCPAP effective group decreased significantly, while the PaO₂ and PaO₂/FiO₂ increased significantly after 2, 8, 24 h of NCPAP ventilation(all P=0.000). PaCO₂ in children with hypercapnia before NCPAP ventilation in NCPAP effective group decreased significantly ((48±9), (47±12), (45±11)vs.(58±7)mmHg, all P=0.000). All children tolerated well to NCPAP ventilation, and there were no severe side effects or complications associated with NCPAP ventilation. Conclusion NCPAP ventilation is safe and effectively improved the oxygenation and hypercapnia in infants with CAP. But it may not work well in children with underlying diseases, manifest as difficulty in feeding/cyanosis and extremely high PaCO₂ or low PaO₂/FiO₂, and they may need early intubation.

Objective To establish a convenient ~(13)C-breath test system in live mice,and investigate the value of ~(13)C-methacetin breath test(~(13)C-MBT) in the diagnosis of acute liver damage of mice with domestically synthesized ~(13)C-methacetin. Methods Domestically synthesized ~(13)C.methacetin was prepared from aeamol by methylation. Abdominal injection of CCl_4 was adopted to duplicate acute liver damage of mice,then the mice were housed under normal laboratory condition for a whole month to gain recovery,which were indentified by hepatic pathological examinations and biochemical teats of liver function.After fasting, the mice were orally administered ~(13)C-methacetin,and the expired air was collected at various time points. Infrared spectrometer was employed, and delm over baseline(DOB) curves of ~(13)C-exhalation were drawn. Results Six to eight min after administration of ~(13)C-methacetin,the rate of ~(13)C-exhalation peaked in control group(51.9±2.04), and decreased thereafter. Sixteen min after administration of ~(13)C-methacetin,the rate of ~(13)JC-exhalation peaked in model group(26.37±5.74), and decreased thereafter.There were significant differences between these two groups(P<0.05).There was no significant difference in peak value and time to reach the peak on DOB curves of ~(13)C-methacetin breath test after the two groups of mice were housed under the same condition for a month(P>0.05).Conclution ~(13)C-MBT facilitates the collection and evaluation of ~(13)CO_2 in the expired air of live mice,and yields precise reflection of alterations of liver function in acute liver injury and functional recovery.

To evaluate the consistency of tongue manifestation and pulse condition observed by traditional Chinese medicine clinicians.

Objective　To study the causes of failure to IOL implantation during cataract surgery.Methods　We reviewed 540 eyes in which 23 eyes were failed to implant IOL during cataract surgery.Results　Detachment of suspended zonular ligament, rupture of posterior capsule and vitreous prolapse are the main factors influencing IOL implantation during cataract surgery.Conclusion　Improvement of surgical technique and reduction of complications are the key points for the IOL implantation successfully during cataract surgery.

AIM: To investigate the effects of ?-elemene,extracted from curcuma wenyujin,on proliferation, cell cycle and apoptosis of human multiple myeloma RPMI-8226 cells. METHODS: The effect of ?-elemene on the growth of human multiple myeloma RPMI-8226 cells was studied through MTT assay,cell cycle and apoptosis was studied by combined Annexin-V protein iodide staining,The morphological changes was studied by combining Hoechst33342-PI staining. RESULTS: ?-elemene inhibited the proliferation of RPMI-8226 cells in a time-and dose- dependent manner. Compared with the control cells,the proportions of the RPMI-8226 cells in the G0 /G1 phase rose,and the proportions of the RPMI-8226 cells in the S and G2 /M phases fell decreased. RPMI-8226 cells treated with ?-elemene for 48 h induced apoptosis in a dose-dependent manner. CONCLUSION: ?-elemene is able to inhibit the proliferation of RPMI-8226 cells by arresting the cell cycle and inducing the cell apoptosis.

In this article 108 human fetuses from 12 to 30 weeks of gestation, 3 neonates and a 1.5 years child were used for study of the histogenesis of the appendix.In 12 weeks old fetus, the appendix showed small lumen and thin wall. The mucosa presented intestinal villi and crypts. The endocrine and goblet cells could be found. The circular muscle and serous membrane had differentiated. In the specimens of 13 to 15 weeks, the lamina propria contained diffused lymphatic tissue and lymphatic follicles. On such sites, the intestinal villi were absent. The surface epithelium became attenuate and composed of cuboid or lower cuboid cells. The outer longitudinal muscle layer was evident. The scattered muscularis mucosa was found. At 16 weeks, the endocrine cells appeared and showed various forms. The open-type or closed-type endocrine cells could be distinguished easily. Under EM, based on the morphology of the basal granules, the endocrine cells might be divided into two types. The granules were cell enclosed in a limiting membrane. One type of the granules was round and various in size, and another type was irregular. In the surface epithelium covered on the lymphatic tissue, the microfold cells could be found. They showed irregular microvilli or mierofolds and numerous apical micropinocytotic vesicles. At 18.5 weeks, the villi tended to merge each other. At 20 weeks, the muscularis mucosa was formed and the 4 layers of appendix resembled those of the normal adult. We found endocrine cells aggregated into Segi's cap on the apex of the villi in 7 fetuses of 16-21 weeks. The T or B lymphocytes could be identified as early as 13.5 weeks by immunologic method. We found the percentage of the B lymphocytes decreased with the gestation age, and this fact suggested that the appendix might be a B lymphocyte pool during the fetal period.