BackgroundCompared with absenteeism， health-related productivity loss has a long-lasting negative effect， and poses a greater harm and loss. The health-related productivity loss is mediated by self-efficacy， and perceived social support has been shown to have an impact on health-related productivity loss， whereas the interaction mechanism among the three remains unclear. ObjectiveTo investigate the status of perceived social support， occupational coping self-efficacy and health-related productivity loss among ICU nurses， and to test the mediation role of perceived social support in the relationship between occupational coping self-efficacy and health-related productivity loss. MethodsFrom September to November， 2021， purposive sampling technique was adopted to select 468 ICU nurses in 8 tertiary hospitals in Sichuan Province. Subjects were assessed using self-made general information questionnaire， Perceived Social Support Scale （PSSS）， Occupational Coping Self Efficacy Scale for Nurses （OCSE-N） and Stanford Presenteeism Scale-6 （SPS-6）. Pearson correlation analysis was used to examine the correlation among variables. Amos 24.0 was utilized to test the mediation role of perceived social support in the relationship between occupational coping self-efficacy and health-related productivity loss. ResultsA total of 415 ICU nurses completed the valid questionnaire survey. ICU nurses scored （63.13±11.62） on PSSS， （22.24±6.15） on OCSE-N， and （16.83±4.24） on SPS-6. Health-related productivity loss was detected in 279 ICU nurses （67.23%）. Correlation analysis denoted that PSSS total score was positively correlated with OCSE-N total score （r=0.348， P<0.05）， and negatively correlated with SPS-6 total score （r=-0.274， P<0.05）. OCSE-N total score was negatively correlated with SPS-6 total score （r=-0.421， P<0.05）. The direct effect value of occupational coping self-efficacy on health-related productivity loss was -0.401， and perceived social support showed a mediation role in the relationship between occupational coping self-efficacy and health-related productivity loss （the indirect effect value was -0.052， accounting for 11.48% of the total effect）. ConclusionThe occupational coping self-efficacy of ICU nurses may affect the health-related productivity loss through the action path of perceived social support.［Funded by Scientific Research Project of Sichuan Provincial Health Commission （number， 19PJ042）］

Objective To retrieve and extract the best evidence for preventing intracranial infections related to ex-ternal cerebrospinal fluid(CSF)drainage,and provide evidence-based support for reducing the incidence of intracra-nial infection caused by external CSF drainage.Methods Evidence-based care issues were determined according to PIPOST,and the best evidence on intracranial infection related to external CSF drainage tube was retrieved from top to bottom.The literature retrieval period was 2013-2023.Quality control of the literatures,as well as extraction and summary of the evidence were carried out by 2 trained graduate students.Results A total of 17 literatures were included in the analysis,including 3 guidelines,5 expert consensus,8 systematic reviews,and 1 randomized con-trolled trial.Management strategies from 3 dimensions(pre-catheterization,in-catheterization and post-catheteriza-tion)were obtained,including 20 pieces of evidence for preventing intracranial infection,such as preparation for ex-ternal CSF drainage tube,precautions during catheterization,and post-catheterization disposal.Conclusion There are differences in the management of external CSF drainage tube in clinical practice.It is necessary to develop uni-fied,standardized,and rational bundle strategies to prevent intracranial infection,so as to reduce the incidence of catheter-related intracranial infection.

Objective To explore the clinical efficacy and safety of one-stage posterior lesion removal and internal spinal fixation in patients with lumbar Brucellosis spondylitis.Methods The clinical data of 24 patients admitted from October 2017 to October 2022 were retrospectively analyzed,2 patients were lost to follow-up at 10 months after surgery,at the final 22 cases were included in the study,including 13 males and 9 females with an average age of(52.00±6.89)years old,were treated with one-stage posterior lesion removal and internal spinal fixation.The operation time,intraoperative bleeding,follow-up time,ery-throcyte sedimentation rate(ESR)and C-reactive protein(CRP)before and after operation were recorded.The pain visual ana-logue scale(VAS),Oswestry disability index(ODI),the Japanese Orthopaedic Association(JOA)score for neurofunction,American Spinal Injury Association(ASIA)spinal cord injury grade and modified MacNab criteria were ussed to evaluate the efficacy.Results All patients were followed up from 12 to 30 months with an average of(17.41±4.45)months.The operation time was 70 to 155 min with an average of(1 16.59±24.32)min;the intraoperative bleeding volume was 120 to 520 ml with an average of(275.00±97.53)ml.CRP and ESR levels decreased more significantly at 1 week and at the final follow-up than pre-operative levels(P＜0.05).VAS,JOA score and ODI at 1 week and at the latest follow-up were more significantly improved than preoperative results(P＜0.05).There was no significant difference between ASIA preoperative and 1 week after operation(P＞0.05),and a significant difference between preoperative and last follow-up(P＜0.05).In the final follow-up,21 patients had ex-cellent efficacy,1 patient had fair,and there was no recurrence during the follow-up.Conclusion One-stage transpedicular le-sion removal and internal spinal fixation,with few incisions and short operation time,helps the recovery of neurological func-tion,and the prognosis meets the clinical requirements,which can effectively control Brucella spondylitis.

This study was aimed at understanding the etiological and genetic characteristics of Yersinia enterocolica isolated in Jiangsu Province between 2005 and 2019.All 110 identified strains of Y.enterocolica were from patients with foodborne diar-rhea in Jiangsu Province,or from pigs,dogs,cattle,sheep,poultry,flies,or food.Virulence genes,biological serotypes,drug resistance,multilocus sequence typing(MLST),and core genome multilocus sequence typing(cgMLST)based on whole-genome sequencing were performed.The strains included 27 pathogenic strains(24.5％)and 83 non-pathogenic strains(75.5％).Non-pathogenic strains accounted for a high proportion,particularly among strains from patients(15/16,93.8％).The biological serotypes of pathogenic strains were mainly type 3/O∶3(26/27,96.3％).Non-pathogenic strains included 1A/O∶8 type(23/83,27.7％),1 A/O∶5 type(14/83,16.9％),and the other four biological serotypes(excluding unknown se-rotypes).Pathogenic strains were dominated by type 3/O∶3(26/27,96.3％),and more than 80％of these strains were sensi-tive to 19 antibiotic types.Whole-genome sequencing indicated that the pathogenic strains were all ST135 type,whereas the non-pathogenic strains were more diverse and scattered.HierCC clustering analysis grouped all strains into three clus-ters:pathogenic strains were in one cluster,and strains from patients were found in all three clusters.In conclusion,the Y.enterocolica strains from patients were primarily non-patho-genic.Non-pathogenic strains showed richer epigenetic and ge-netic diversity than pathogenic strains.The monitoring of these strains should be strengthened to decrease the risk of human infection.

Tuberculosis(TB)is still a serious threat to global public health,causing millions of people infected ev-ery year.Mycobacterium tuberculosis(MTB)is the main pathogen causing TB.In recent years,MTB extracellular vesicles(MEVs)as important carriers for MTB-secreted Mycobacterium antigens have attracted the attention of re-searchers.MEVs enable MTB to secrete phospholipid,nucleic acid,lipopolysaccharide,and periplasmic component in a centralized protective mode,and interact with the host.Some progress has been made on the study of partial contents of MEVs,but the understanding of their biological mechanisms,functions,and roles in the immune re-sponses during MTB infection is still at its early stages.This article reviews the current progress in the biogenesis of MEVs,their roles in MTB infection and immune responses regulation,and discusses their applications in vaccine development and diagnostic techniques.

Objective To use mendelian randomization(MR)study to explore the causal relationship between cholelithiasis,cholecystectomy,and gastroesophageal reflux disease(GERD).Methods Based on large-scale genome-wide association studies(GW AS),genetic variants closely associated with cholelithiasis and cholecystectomy were selected as instrumental variables.Mendelian randomization pleiotropy residual sum and outlier(MR-PRESSO)was used to eliminate outliers.Inverse variance weighting(IVW)was used as the main analysis method and MR-Egger,Weighted median,Simple mode and Weighted mode were used as supplementary analysis methods for causal effect evaluation.Meanwhile,Cochran's Q was used for heterogeneity test.The MR Egger intercept test was used to analyze the level of horizontal pleiotropy,and the leave-one-out method was used to ensure the robustness of the results.Results Inverse variance weighted results showed that cholelithiasis(odds ratio:1.05,95％confidence interval:1.03-1.07,P＜0.01)and cholecystectomy(odds ratio:2.56,95％confidence interval:1.76-3.73,P＜0.01)were significantly associated with an increased risk of GERD.Cochran's Q test showed that there was heterogeneity in the genetic variants of cholelithiasis(P＜0.05),but no significant heterogeneity in the genetic variants of cholecystectomy(P＞0.05).MR-Egger intercept analysis did not detect potential horizontal pleiotropy(P＞0.05),and the leave-one-out analyses showed that the results were robust.Conclusion Genetically predicted cholelithiasis and cholecystectomy are causally associated with GERD,suggesting that the prevention of GERD should be strengthened in patients with cholelithiasis and after cholecystectomy.

This study was aimed at understanding the etiological and genetic characteristics of Yersinia enterocolica isolated in Jiangsu Province between 2005 and 2019.All 110 identified strains of Y.enterocolica were from patients with foodborne diar-rhea in Jiangsu Province,or from pigs,dogs,cattle,sheep,poultry,flies,or food.Virulence genes,biological serotypes,drug resistance,multilocus sequence typing(MLST),and core genome multilocus sequence typing(cgMLST)based on whole-genome sequencing were performed.The strains included 27 pathogenic strains(24.5％)and 83 non-pathogenic strains(75.5％).Non-pathogenic strains accounted for a high proportion,particularly among strains from patients(15/16,93.8％).The biological serotypes of pathogenic strains were mainly type 3/O∶3(26/27,96.3％).Non-pathogenic strains included 1A/O∶8 type(23/83,27.7％),1 A/O∶5 type(14/83,16.9％),and the other four biological serotypes(excluding unknown se-rotypes).Pathogenic strains were dominated by type 3/O∶3(26/27,96.3％),and more than 80％of these strains were sensi-tive to 19 antibiotic types.Whole-genome sequencing indicated that the pathogenic strains were all ST135 type,whereas the non-pathogenic strains were more diverse and scattered.HierCC clustering analysis grouped all strains into three clus-ters:pathogenic strains were in one cluster,and strains from patients were found in all three clusters.In conclusion,the Y.enterocolica strains from patients were primarily non-patho-genic.Non-pathogenic strains showed richer epigenetic and ge-netic diversity than pathogenic strains.The monitoring of these strains should be strengthened to decrease the risk of human infection.

Tuberculosis(TB)is still a serious threat to global public health,causing millions of people infected ev-ery year.Mycobacterium tuberculosis(MTB)is the main pathogen causing TB.In recent years,MTB extracellular vesicles(MEVs)as important carriers for MTB-secreted Mycobacterium antigens have attracted the attention of re-searchers.MEVs enable MTB to secrete phospholipid,nucleic acid,lipopolysaccharide,and periplasmic component in a centralized protective mode,and interact with the host.Some progress has been made on the study of partial contents of MEVs,but the understanding of their biological mechanisms,functions,and roles in the immune re-sponses during MTB infection is still at its early stages.This article reviews the current progress in the biogenesis of MEVs,their roles in MTB infection and immune responses regulation,and discusses their applications in vaccine development and diagnostic techniques.

Objective To use mendelian randomization(MR)study to explore the causal relationship between cholelithiasis,cholecystectomy,and gastroesophageal reflux disease(GERD).Methods Based on large-scale genome-wide association studies(GW AS),genetic variants closely associated with cholelithiasis and cholecystectomy were selected as instrumental variables.Mendelian randomization pleiotropy residual sum and outlier(MR-PRESSO)was used to eliminate outliers.Inverse variance weighting(IVW)was used as the main analysis method and MR-Egger,Weighted median,Simple mode and Weighted mode were used as supplementary analysis methods for causal effect evaluation.Meanwhile,Cochran's Q was used for heterogeneity test.The MR Egger intercept test was used to analyze the level of horizontal pleiotropy,and the leave-one-out method was used to ensure the robustness of the results.Results Inverse variance weighted results showed that cholelithiasis(odds ratio:1.05,95％confidence interval:1.03-1.07,P＜0.01)and cholecystectomy(odds ratio:2.56,95％confidence interval:1.76-3.73,P＜0.01)were significantly associated with an increased risk of GERD.Cochran's Q test showed that there was heterogeneity in the genetic variants of cholelithiasis(P＜0.05),but no significant heterogeneity in the genetic variants of cholecystectomy(P＞0.05).MR-Egger intercept analysis did not detect potential horizontal pleiotropy(P＞0.05),and the leave-one-out analyses showed that the results were robust.Conclusion Genetically predicted cholelithiasis and cholecystectomy are causally associated with GERD,suggesting that the prevention of GERD should be strengthened in patients with cholelithiasis and after cholecystectomy.

OBJECTIVE: To investigate the efficacy of posterior axillary approach internal fixation for Ideberg Ⅰa andⅡ glenoid fractures. METHODS: From December 2018 to September 2021, 9 patients with lower part of glenoid fractures were treated by posterior axillary approach, including 3 males and 6 females, aged from 50 to 78 years old. All the fractures were closed fractures. According to Ideberg type of scapular glenoid fracture was type Ⅰa in 6 cases and type Ⅱ in 3 cases. AP and lateral X-ray films of scapula were taken at 6, 12 weeks and 6 and 12 months postoperatively. Constant-Murley and disabilities of the arm shoulder and hand (DASH), and other complications were recorded at the latest follow-up. RESULTS: Nine patients were followed up, ranged from 6 to 15 months. And bone healing was achieved in all 9 patients at the final follow-up, the healing time 3 to 6 months, Constant-Murley score at the final follow-up ranged from 55 to 96, and DASH score ranged from 3.33 to 33.33. Both of them were better than preoperative. CONCLUSION The posterior axillary approach internal fixation for Ideberg Ⅰa and Ideberg Ⅱ Glenoid fractures scapular fracture is satisfactory and worthy of clinical application.
Male ; Female ; Humans ; Middle Aged ; Aged ; Fractures, Bone/surgery* ; Fracture Fixation, Internal ; Shoulder/surgery* ; Scapula/surgery* ; Shoulder Fractures ; Fractures, Closed ; Treatment Outcome ; Retrospective Studies