Objective To develop the Expert Consensus on Sensitive Indicators for Assessment of the Quality of Nursing in Operating Theatre and provide a scientific and practical guidance for improving the quality of nursing in operating theatre.Methods The writing team established by the Operating Room Nursing Professional Committee of Guangdong Nursing Association conducted systematic literature retrieval and screening,and used the updated clinical Guidelines for Research and Evaluation Ⅱ in UK 2017.AGREE Ⅱ and the evidence evaluation system of the Australian JBI(Joanna Briggs Institute,JBI)Evidence-Based Health Care Center evidence level system(2016 Edition)comprehensively analyzed the evidence related to the sensitive indicators for evaluating the quality of operating room nursing and the suggestions of the writing group members.The first draft was formed based on the three-dimensional quality evaluation theoretical framework of"structure-process-result".Through the Delphi method,after two rounds of expert consultations and members'votes,the first draft was deeply revised and improved.Results Based on the three-dimensional quality evaluation theoretical framework of"structure-process-outcome"proposed by American scholar Donabedian,the expert consensus finally included five primary indicators:basic nursing quality,quality indicators of patient safety,quality indicators of hospital infection control,quality indicators of medication and safety management,and quality indicators of specialised nursing in operating theatre.The secondary indicators consisted of one structural indicator(management of commonly used instrument and equipment in operating theatre)and 17 process indicators(e.g.,infusion and blood transfusion management,body temperature management,etc.).The tertiary indicators included 26 process indicators and 11 outcome indicators(e.g.,incidence of adverse reactions of infusion during surgery,incidence of intra-operative hypothermia,etc.).Conclusion The evidence-and guideline-based Expert Consensus on Sensitive Indicators for Assessment of the Quality of Nursing in Operating Theatre based on eviclence and guidelines was established through rigorous evidence-based methods.It is operational and practical,and offers theoretical support and practical guidance for the managers of operating theatre to improve the quality of nursing.

This study aimed to investigate the association between secondhand smoke exposure in different places and overweight/obesity among children and adolescents. Children and adolescents aged 7 to 18 years old in Hunan Province were recruited for questionnaire surveys and physical examinations using a multi-stage stratified cluster sampling method. Secondhand smoke exposure was evaluated according to the answer to the question, "Has someone smoked in front of you in the last 7 days?". Overweight and obesity were determined using BMI-for-age and BMI-for-sex according to the national standard WS/T586-2018. Multivariate logistic regression was used to explore the association between secondhand smoke exposure in different places and overweight/obesity among children and adolescents. A total of 187 863 participants were included in this study, with a prevalence of overweight and obesity of 28.4%. The prevalence of secondhand smoke exposure at home, school and other public places was 25.5%, 12.6% and 32.3%, respectively. Children and adolescents with secondhand smoke exposure at home, school and other public places had a higher prevalence of overweight and obesity than those without exposure. After adjusting for confounding factors, secondhand smoke exposure was positively associated with overweight and obesity among children and adolescents, and exposure at home showed the closest association ( OR=1.091; 95% CI: 1.066-1.117). In conclusion, secondhand smoke exposure, especially at home, significantly increases the risk of overweight and obesity among children and adolescents. Comprehensive strategies should be implemented to avoid secondhand smoke exposure and protect children and adolescents from overweight and obesity.

For middle-aged and elderly patients with conditions such as spinal fractures and degenerative spinal diseases, spinal internal fixation is a core surgical procedure for reconstructing spinal stability, heavily relying on the biomechanical stability provided by pedicle screw systems. Whereas, these patients are often complicated by osteoporosis that can significantly compromise the stability of the bone-pedicle screw interface, leading to a marked increase in pedicle screw loosening and surgical failure rates. The bone cement-augmented pedicle screw technique, which involves injecting bone cement into the vertebral body or screw trajectory to optimize the mechanical properties of the bone-pedicle screw composite, has been proven to significantly enhance fixation strength and effectively prevent screw-related failures, thereby reducing the incidence of internal fixation failure in high-risk populations undergoing spinal fusion. However, the widespread clinical application of this technique has faced challenges such as inaccurate clinical decision-making (indication and contraindication selection), non-standardized operative practices, and insufficient awareness of complication prevention, resulting in considerable variability in clinical outcomes and even severe complications. To address this, Prof. Luo Fei from First Affiliated Hospital of Army Medical University initiated the project and the Chinese Association Orthopaedic Surgeons organized relevant experts to develop the Evidence-based clinical practice guideline for bone cement-augmented pedicle screw technique ( version 2025), based on current evidence. The guidelines put forward 8 recommendations regarding the clinical value, scope of application, and operational standards of the technique, aiming to provide evidence-based medical support and technical standardization for clinical decision-making.

Objective:To evaluate the efficacy of eculizumab in treating hematopoietic stem cell transplantation-associated thrombotic microangiopathy (TA-TMA) .Methods:This retrospective study included 11 patients who developed TA-TMA after allogeneic hematopoietic stem cell transplantation and subsequently received eculizumab treatment at Peking University People′s Hospital between June 2018 and May 2024. The incidence of TA-TMA, treatment details, and clinical outcomes were analyzed.Results:Among the 11 included patients [4 males, 7 females; median age: 29 years (range: 9-56) ], underlying diseases were severe aplastic anemia (SAA) in 5 patients, acute lymphoblastic leukemia (ALL) in 3 patients, and acute myeloid leukemia (AML) in 3 patients. The median time to TA-TMA diagnosis was 48 days post-transplantation (range: 4-213 days), and all patients met the diagnostic criteria for high-risk TA-TMA. The median interval from TA-TMA diagnosis to the initiation of eculizumab treatment was 12 days (range: 1-56 days). Patients received a median of 3 doses of eculizumab (range: 1-14). Ten of the 11 patients were assessed as having no response (NR) to eculizumab at the end of treatment or at death. One patient achieved a partial response (PR) but subsequently died after TA-TMA relapsed due to infection. At the last follow-up, all patients were either lost to follow-up or had died. The median follow-up duration was 88 days (range: 33-326 days), and the median time from TA-TMA diagnosis to the last follow-up was 31 days (range: 21-113 days) .Conclusion:Eculizumab demonstrated poor efficacy in this TA-TMA cohort. This might be attributable to the critical and complex condition of the patients, delayed initiation of eculizumab treatment, and insufficient dosage.

Objective:To evaluate the diagnostic value of targeted next-generation sequencing (tNGS) of throat swab samples for detecting community-acquired respiratory viruses (CARV) in patients with hematological diseases.Methods:Clinical and laboratory data from 64 episodes involving patients with hematological diseases and suspected infections—who underwent both pharyngeal swab tNGS and CARV polymerase chain reaction (PCR) testing concurrently—were retrospectively analyzed. The cases were drawn from the Department of Hematology, Peking University People’s Hospital, between September 2023 and April 2024. Concordance between tNGS and CARV PCR results, as well as the diagnostic performance of tNGS in detecting CARV, were evaluated.Results:Among the 64 episodes, 29 were clinically diagnosed with respiratory tract infections, including one case of cytomegalovirus pneumonia and 28 CARV-positive cases. The remaining 35 episodes involved patients with fever or respiratory symptoms attributed to other causes, including 14 with extrapulmonary infections and 21 with noninfectious etiologies. The median follow-up duration was 215.5 days (range: 7-271 days). PCR detected 24 strains of seven CARV types, whereas tNGS detected 25 strains of eight CARV types. Using PCR results as the reference standard, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of tNGS were 85.0%, 88.6%, 77.3%, 92.9%, and 87.5%, respectively. The two methods showed good concordance (Kappa=0.717, P<0.001) . Conclusion:Pharyngeal swab tNGS may serve as a viable alternative to PCR for diagnosing CARV infections in patients with hematological diseases.

Objective:To analyze the patterns of change of brain function among civil pilots in prospective memory tasks by using task-state functional magnetic resonance imaging (fMRI) and a cue-based repetitive search task.Methods:A total of 85 subjects were enrolled, including 47 civil pilots (pilot group) and 38 ordinary workers (control group). The task-state fMRI data during the execution of the prospective memory task was analyzed using a general linear model to find out about the activation patterns of brain functions in the 2 groups in the 3 phases of encoding, maintenance, and retrieval of the prospective memory task. The differences in activation patterns between the 2 groups and correlations between regions of interest and the rate of accuracy, reaction time and flying hours were analyzed.Results:The repeated measurement analysis of variance showed that there were no interactions of reaction time or of the rate of accuracy between the task and grouping ( P>0.05), and that the difference in the main effect of grouping was significant ( F=5.67, 15.46, P=0.020, <0.001). The difference in the main effect of grouping on the rate of accuracy was significant ( F=5.42, P=0.022), and the rate of accuracy in the pilot group was higher than in the control group ( P=0.048). In the phase of encoding, the activation in the bilateral cerebellum, bilateral superior frontal gyrus, bilateral fusiform gyrus, and temporal lobe regions decreased in the pilot group compared with the control group ( t=2.68-4.13, all P<0.05), while the activation in the fusiform gyrus and the right parietal superior gyrus increased, and the differences were statistically significant ( t=3.28, 3.35, 3.02, P=0.038, 0.024, 0.042). During the phase of maintenance, the pilot group showed significantly reduced activation in the bilateral cerebellum, bilateral medial superior frontal gyrus, bilateral middle occipital gyri, and the right middle temporal gyrus compared with the control group ( t=2.24-3.36, P<0.05 or 0.01). In the retrieval phase, activation in the right peri-calcarine cortex, bilateral caudate nuclei, and bilateral precentral and postcentral gyri was enhanced in the pilot group compared with the control group ( t=2.57-3.35, all P<0.05), especially in the right middle frontal gyrus ( t=3.12, P=0.007). In the encoding phase, activation was increased in the left fusiform gyrus and right parietal superior gyrus of the pilot group, which was positively correlated with flying hours in the last 3 months ( r=0.347, 0.418, P=0.020, 0.005). Conclusions:Due to long-term flights, the way in which such regions as the frontal lobe, cerebellum, and default mode network are activated in civil pilots is likely to undergo some changes during prospective memory activities, which is why they have higher processing efficiency when performing prospective memory tasks.

Anxiety disorder is a major symptom of autism spectrum disorder (ASD) with a comorbidity rate of ~40%. However, the neural mechanisms of the emergence of anxiety in ASD remain unclear. In our study, we found that hyperactivity of basolateral amygdala (BLA) pyramidal neurons (PNs) in Shank3 InsG3680 knock-in (InsG3680^+/+) mice is involved in the development of anxiety. Electrophysiological results also showed increased excitatory input and decreased inhibitory input in BLA PNs. Chemogenetic inhibition of the excitability of PNs in the BLA rescued the anxiety phenotype of InsG3680^+/+ mice. Further study found that the diminished control of the BLA by medial prefrontal cortex (mPFC) and optogenetic activation of the mPFC-BLA pathway also had a rescue effect, which increased the feedforward inhibition of the BLA. Taken together, our results suggest that hyperactivity of the BLA and alteration of the mPFC-BLA circuitry are involved in anxiety in InsG3680^+/+ mice.
Animals ; Prefrontal Cortex/metabolism* ; Basolateral Nuclear Complex/metabolism* ; Mice ; Anxiety/metabolism* ; Nerve Tissue Proteins/genetics* ; Male ; Gene Knock-In Techniques ; Pyramidal Cells/physiology* ; Mice, Transgenic ; Neural Pathways/physiopathology* ; Mice, Inbred C57BL ; Microfilament Proteins

Objective To investigate the effect of 9S management combined with plan-do-check-adjust(PDCA)cycle on the incidence of nonstandard surgical instrument handover in urological endoscopic surgery in operating room and supply room.Methods A total of 760 instruments of urological endoscopic surgery used from June 2022 to December 2022 were selected as control group and received routine management.A total of 920 instruments of urological endoscopic surgery used from January 2023 to June 2023 were selected as observation group,and 9S management and PDCA cycle management mode were administrated in instrument handover.The management performance and the satisfaction of surgeons to the instrument nursing staff were compared between the two groups.Results The accuracy of instrument identification and master rate of assembly and disassembly of instruments in the observation group were significantly higher than those in the control group(P<0.05).The incidence of instrument cleaning and packaging errors in the observation group was significantly lower than that in the control group(P<0.05).The satisfaction of surgeons to the instrument nursing staff in the observation group was higher than that in the control group,but no significant difference was found(P>0.05).Conclusion The 9S management combined with PDCA cycle management solves the problem of transport and handover of urological instruments between operating room and supply room,decreases the error rates of disassembly,cleaning,assembly and packaging of instruments,improves work efficiency,reduces the probability of instrument damage,and saves costs.

Glucose oxidase (GOD) is an oxygen-consuming dehydrogenase that can catalyze the production of gluconic acid hydrogen peroxide from glucose, and its specific mechanism of action makes it promising for applications, while the low catalytic activity and poor thermostability have become the main factors limiting the industrial application of this enzyme. In this study, we used the glucose oxidase AtGOD reported with the best thermostability as the source sequence for phylogenetic analysis to obtain the GOD with excellent performance. Six genes were screened and successfully synthesized for functional validation. Among them, the glucose oxidase AhGODB derived from Aspergillus heteromorphus was expressed in Pichia pastoris and showed better thermostability and catalytic activity, with an optimal temperature of 40 ℃, a specific activity of 112.2 U/mg, and a relative activity of 47% after 5 min of treatment at 70 ℃. To improve its activity and thermal stability, we constructed several mutants by directed evolution combined with rational design. Compared with the original enzyme, the mutant T72R/A153P showcased the optimum temperature increasing from 40 to 50 ℃, the specific activity increasing from 112.2 U/mg to 166.1 U/mg, and the relative activity after treatment at 70 ℃ for 30 min increasing from 0% to 33%. In conclusion, the glucose oxidase mutants obtained in this study have improved catalytic activity and thermostability, and have potential for application.
Glucose Oxidase/chemistry* ; Enzyme Stability ; Aspergillus/genetics* ; Pichia/metabolism* ; Temperature ; Catalysis ; Fungal Proteins/metabolism* ; Hot Temperature