Amide proton transfer-weighted (APTw) imaging is a kind of new magnetic resonance molecular imaging that rapidly developed in recent years. APTw imaging reflects the protein concentration and acid-base changes in tissues by detecting amide protons in free proteins and peptides in tissues. APTw imaging is a complementary technique to the existing magnetic resonance techniques, which can provide new molecular biological information for central nervous system diseases. In this article, the basic principle of APTw imaging and its application in common central nervous system diseases such as brain tumor, ischemic stroke, and neurodegenerative diseases are reviewed to provide new methods for promoting the transformation of APTw imaging from the research stage to routine clinical application, and facilitating the precise diagnosis and treatment of central nervous system diseases.

Objective:To revise the quality standards of purified siliceous earth in the Chinese Pharmacopoeia 2020 Vol Ⅳ.Methods:Referring to USP2024 and GB 14936-2012 food additive purified siliceous earth and related ref-erences,the current quality standards for pharmaceutical excipient purified siliceous earth were revised,including description,dissolved substances in water,dissolved substances in acid,and content determination.The soluble a-luminum content was also investigated.Results:Revised the description of characteristic items,methods for deter-mining dissolved substances in water and acid,and limits for content determination;Through the investigation of soluble aluminum before and after filtration of human serum albumin(HSA)samples using purified siliceous earth as a filter aid,it is shown that purified siliceous earth has a certain degree of adsorption effect on aluminum ele-ment.At present,the use of low-temperature ethanol ultrafiltration process does not increase the residual aluminum content in biological products,so an aluminum element determination item is not added to the standard.Conclusion:The comprehensive quality standards for purified siliceous earth will be included in the Chinese Phar-macopoeia 2025 edition,providing strong technical support for the quality and safety supervision of this product.

Objective:To revise the quality standards of purified siliceous earth in the Chinese Pharmacopoeia 2020 Vol Ⅳ.Methods:Referring to USP2024 and GB 14936-2012 food additive purified siliceous earth and related ref-erences,the current quality standards for pharmaceutical excipient purified siliceous earth were revised,including description,dissolved substances in water,dissolved substances in acid,and content determination.The soluble a-luminum content was also investigated.Results:Revised the description of characteristic items,methods for deter-mining dissolved substances in water and acid,and limits for content determination;Through the investigation of soluble aluminum before and after filtration of human serum albumin(HSA)samples using purified siliceous earth as a filter aid,it is shown that purified siliceous earth has a certain degree of adsorption effect on aluminum ele-ment.At present,the use of low-temperature ethanol ultrafiltration process does not increase the residual aluminum content in biological products,so an aluminum element determination item is not added to the standard.Conclusion:The comprehensive quality standards for purified siliceous earth will be included in the Chinese Phar-macopoeia 2025 edition,providing strong technical support for the quality and safety supervision of this product.

Amide proton transfer-weighted (APTw) imaging is a kind of new magnetic resonance molecular imaging that rapidly developed in recent years. APTw imaging reflects the protein concentration and acid-base changes in tissues by detecting amide protons in free proteins and peptides in tissues. APTw imaging is a complementary technique to the existing magnetic resonance techniques, which can provide new molecular biological information for central nervous system diseases. In this article, the basic principle of APTw imaging and its application in common central nervous system diseases such as brain tumor, ischemic stroke, and neurodegenerative diseases are reviewed to provide new methods for promoting the transformation of APTw imaging from the research stage to routine clinical application, and facilitating the precise diagnosis and treatment of central nervous system diseases.

Objective:The incidence of occupational burnout among emergency department healthcare workers is high,and their occupational health deserves attention.Establishing a comprehensive occupational health system in medical institutions is crucial.This study aims to understand the current status of occupational burnout among emergency department healthcare workers,analyze its influencing factors,and provide references for preventing burnout in this population. Methods:A cross-sectional survey was conducted using convenience sampling through the Questionnaire Star platform from December 2022 to January 2023 among emergency department healthcare workers.The Maslach Burnout Inventory-General Survey(MBI-GS)scale was used to assess the level of occupational burnout,and univariate analysis and binary Logistic regression analysis were employed to explore the influencing factors of burnout. Results:A total of 1 173 valid questionnaires were collected,with 946(80.65％)respondents experiencing occupational burnout.The proportions of mild-to-moderate and severe burnout were 73.57％and 7.08％,respectively.The scores for the three dimensions of burnout among emergency department healthcare workers were as follows:emotional exhaustion(EE)2.33±0.31;depersonalization(DP)1.88±0.28;low personal accomplishment(LPA)3.20±0.39.The overall score was 2.46±0.22.Factors associated with occupational burnout included being an only child(OR=1.362,95％CI-0.707 to-0.058),the average number of night shifts per month(OR=1.167,95％CI 0.091 to 0.272),and personal experience of workplace violence(OR=1.094,95％CI 0.027 to 0.195)(all P＜0.05). Conclusion:The incidence of occupational burnout is high among emergency department healthcare workers.Effective measures should be taken by management to promptly intervene,reduce burnout,and ensure the smooth functioning of emergency medical services.

Although multifarious tumor-targeting modifications of nanoparticulate systems have been attempted in joint efforts by our predecessors, it remains challenging for nanomedicine to traverse physiological barriers involving blood vessels, tissues, and cell barriers to thereafter demonstrate excellent antitumor effects. To further overcome these inherent obstacles, we designed and prepared mycoplasma membrane (MM)-fused liposomes (LPs) with the goal of employing circulating neutrophils with the advantage of inflammatory cytokine-guided autonomous tumor localization to transport nanoparticles. We also utilized in vivo neutrophil activation induced by the liposomal form of the immune activator resiquimod (LPs-R848). Fused LPs preparations retained mycoplasma pathogen characteristics and achieved rapid recognition and endocytosis by activated neutrophils stimulated by LPs-R848. The enhanced neutrophil infiltration in homing of the inflammatory tumor microenvironment allowed more nanoparticles to be delivered into solid tumors. Facilitated by the formation of neutrophil extracellular traps (NETs), podophyllotoxin (POD)-loaded MM-fused LPs (MM-LPs-POD) were concomitantly released from neutrophils and subsequently engulfed by tumor cells during inflammation. MM-LPs-POD displayed superior suppression efficacy of tumor growth and lung metastasis in a 4T1 breast tumor model. Overall, such a strategy of pathogen-mimicking nanoparticles hijacking neutrophils in situ combined with enhanced neutrophil infiltration indeed elevates the potential of chemotherapeutics for tumor targeting therapy.

Background: Cardiopulmonary resuscitation (CPR) strategies in COVID-19 patients differ from those in patients suffering from cardiogenic cardiac arrest. During CPR, both healthcare and non-healthcare workers who provide resuscitation are at risk of infection. The Working Group for Expert Consensus on Prevention and Cardiopulmonary Resuscitation for Cardiac Arrest in COVID-19 has developed this Chinese Expert Consensus to guide clinical practice of CPR in COVID-19 patients. Main recommendations: 1) A medical team should be assigned to evaluate severe and critical COVID-19 for early monitoring of cardiac-arrest warning signs. 2) Psychological counseling and treatment are highly recommended, since sympathetic and vagal abnormalities induced by psychological stress from the COVID-19 pandemic can induce cardiac arrest. 3) Healthcare workers should wear personal protective equipment (PPE). 4) Mouth-to-mouth ventilation should be avoided on patients suspected of having or diagnosed with COVID-19. 5) Hands-only chest compression and mechanical chest compression are recommended. 6) Tracheal-intubation procedures should be optimized and tracheal-intubation strategies should be implemented early. 7) CPR should be provided for 20-30 min. 8) Various factors should be taken into consideration such as the interests of patients and family members, ethics, transmission risks, and laws and regulations governing infectious disease control. Changes in management: The following changes or modifications to CPR strategy in COVID-19 patients are proposed: 1) Healthcare workers should wear PPE. 2) Hands-only chest compression and mechanical chest compression can be implemented to reduce or avoid the spread of viruses by aerosols. 3) Both the benefits to patients and the risk of infection should be considered. 4) Hhealthcare workers should be fully aware of and trained in CPR strategies and procedures specifically for patients with COVID-19.

Objective To explore the effect of head nurses′tutoring and commenting on nursing ward round. Methods The nursing ward rounds performed during August 2013 to July 2014 were assigned as the control group and those nursing ward rounds during August 2014 to August 2015 as observation group: in the former group routine nursing ward rounds were done once a week and in the latter the rounds were performed by head nurses′tutoring and commenting once every week. The two groups were compared in terms of examination performances of nursing ward rounds, doctors′ and nurses′ satisfaction degree, nurses′ and student nurses′evaluation on the ward rounds and their critical thinking ability. Results The examination performances and the satisfaction degree in the observation group were significantly higher than those of the control group (P<0.05). The nurses in the observation group thought the head nurse′s commenting at ward rounds could be more effective than those from the control group in their improvement of theoretical knowledge and clinical ability (P<0.05). In terms of critical thinking by California Critical Thinking Disposition Inventory-Chinese Version), the total score and the scores on its dimensions in the observation group were significantly higher than those of the control group. Conclusion The nursing ward rounds by head nurses′tutoring and commenting can help the nurses to strengthen their ability in nursing ward rounds and improve their theory and clinical practice so that the nursing quality is improved.

Objective To explore the nursing effect of home care in patients with minimally invasive total hip arthroplasty (THA) in patients with minimally invasive surgery,and to provide comprehensive and seamless care for patients.Methods A total of 79 patients with THA were divided into observation group (38 cases)and control group(41 cases).The observation group received home care,including health education,telephone follow-up,home visits and other nursing measures.Control group followed the routine nursing education.Activity of Daily Living Scale(ADL),Functional Independence Measure(FIM) and Harris scores were compared between the two groups of patients when discharged and three months after discharge.Results In the observation group and the control group,the ADL,FIM and Harris scores were gradually increased at 3 months after discharge which had no difference when discharge (P ＞ 0.05).The ADL,FIM and Harris scores of the observation group were significantly higher than that in the control group at 3 months after discharge (P ＜ 0.01).Conclusions Implementation of home care can improve patients' ability of daily life,the whole hip joint function recovery and hip function independence,thus it makes their quality of life better,achieving the goal of comprehensive rehabilitation.

Objective To investigate the relationship between the gene polymorphism of TLR3c.1377,TLR9-1486,and TLR9 2848 and susceptibility to multiple sclerosis(MS)in Han people of south China. Methods A total of 123 unrelated MS patients from South China with a clinical or laboratory definition MS according to 2005 Revisions to the McDonald Criteria were studied. Another 126 controls were randomly selected from hospital staff of non-autoimmune diseases and healthy individuals. Toll like receptor (TLR) 3 and TLR 9 genotypes were determined by PCR and digested by specific restriction enzymes.Results There was significant difference in genotype and allele distribution of TLR3c.1377 polymorphism between the MS patients and the controls (P<0.05), and the MS patients with T allele had a lower risk (OR=0.532, P=0.014). There was no significant difference in genotypes and allele distribution of TLR9-1486 polymorphism between the MS patients and the controls. There was higher TLR9 2848 A allele frequency in the MS patients than in the controls ((39.8%) vs. 30.6%;P=0.037), and higher risk in MS patients with A allele than those without ((OR=)(1.837), P=0.020). There was no significant interaction among the TLR3c.1377, TLR9-1486 and TLR9 2848 allele. Strong linkage disequilibrium was found between TLR9-1486 and TLR9 2848, but there was no significant interaction between the polymorphism of TLR9-1486 and TLR9 2848 in the MS patients.Conclusion TLR3c.1377 and TLR9 2848 polymorphisms may be related to MS in Han people in south China. TLR3c.1377 and TLR9 2848 may be linked with susceptibility genes.