Objective To review the research of safe injection protocols for peripheral norepinephrine(pNE),to make clear the main contents of safe injection protocols and the compliance of clinical implementation protocols,and to provide reference for clinical nurses to use drugs safely.Methods Systematic searches were conducted in the PubMed database,the Embase database from the Netherlands,the Web of Science,the Cochrane library,CNKI,Wanfang database,VIP,and the China biomedical literature database for studies related to safe injection protocols for pNE.The search period extended from the establishment of the databases to April 30,2024.Two researchers conducted data extraction and summary analysis of the included literature.Results A total of 10 articles were incorporated,including 2 guidelines,4 observational retrospective cohort studies,2 observational prospective cohort studies,2 ambispective cohort study.All documents provide a complete safe injection scheme of pNE,and its main contents were as follows:the drug concentration should be diluted to 8～64 mg/L;the injection dose should be small,and the maximum dose should not exceed 0.5 μg·kg-1·min-1 or 25 μg/min;a short infusion time was appropriate,among which 4 schemes require≤24 hours;intravenous catheters should be large-bore models,mainly 16,18 and 20 G;selection of infusion sites with favorable venous conditions of upper limb should be selected for injection;during infusion,regular and effective monitoring was required,and the frequency of monitoring should be once an hour,not exceeding a maximum of 2 hours;observation of the puncture site,and must assess whether there was blood return to the venous pathway,develop an emergency plan for drug extravasation.Several studies provided the compliance analysis of the protocol.The items with the highest compliance were using the drug concentration specified in the protocol,with the highest implementation rate of 100.0%.The items with low compliance were:using ultrasonic catheterization or evaluation,with minimum 26.6%;monitor according to the specified time frequency,with a minimum of 36.0%;selection of infusion sites,with a minimum of 65.0%.Conclusion The pNE is safe and feasible in emergency situations,but it comes with numerous risks and limitations.Norepinephrine(NE)should be administered at low concentrations and small doses,using large-caliber venous indwelling needles,and choosing optimal injection sites.Ultrasound assessment and localization can be used if conditions permit.Short-term infusion is preferred,and effective monitoring should be conducted at regular intervals during the infusion.Emergency plans for drug extravasation should be established.Developing safe injection protocols can reduce the incidence of adverse events such as extravasation.

Objective To review the research of safe injection protocols for peripheral norepinephrine(pNE),to make clear the main contents of safe injection protocols and the compliance of clinical implementation protocols,and to provide reference for clinical nurses to use drugs safely.Methods Systematic searches were conducted in the PubMed database,the Embase database from the Netherlands,the Web of Science,the Cochrane library,CNKI,Wanfang database,VIP,and the China biomedical literature database for studies related to safe injection protocols for pNE.The search period extended from the establishment of the databases to April 30,2024.Two researchers conducted data extraction and summary analysis of the included literature.Results A total of 10 articles were incorporated,including 2 guidelines,4 observational retrospective cohort studies,2 observational prospective cohort studies,2 ambispective cohort study.All documents provide a complete safe injection scheme of pNE,and its main contents were as follows:the drug concentration should be diluted to 8～64 mg/L;the injection dose should be small,and the maximum dose should not exceed 0.5 μg·kg-1·min-1 or 25 μg/min;a short infusion time was appropriate,among which 4 schemes require≤24 hours;intravenous catheters should be large-bore models,mainly 16,18 and 20 G;selection of infusion sites with favorable venous conditions of upper limb should be selected for injection;during infusion,regular and effective monitoring was required,and the frequency of monitoring should be once an hour,not exceeding a maximum of 2 hours;observation of the puncture site,and must assess whether there was blood return to the venous pathway,develop an emergency plan for drug extravasation.Several studies provided the compliance analysis of the protocol.The items with the highest compliance were using the drug concentration specified in the protocol,with the highest implementation rate of 100.0%.The items with low compliance were:using ultrasonic catheterization or evaluation,with minimum 26.6%;monitor according to the specified time frequency,with a minimum of 36.0%;selection of infusion sites,with a minimum of 65.0%.Conclusion The pNE is safe and feasible in emergency situations,but it comes with numerous risks and limitations.Norepinephrine(NE)should be administered at low concentrations and small doses,using large-caliber venous indwelling needles,and choosing optimal injection sites.Ultrasound assessment and localization can be used if conditions permit.Short-term infusion is preferred,and effective monitoring should be conducted at regular intervals during the infusion.Emergency plans for drug extravasation should be established.Developing safe injection protocols can reduce the incidence of adverse events such as extravasation.

Objective To investigate the expression of miR-27a in colorectal cancer cell,and to analyze the effect of its targeted regulation of(Secreted Frizzled-Related Protein,SFRP1)on the biological behavior of colorectal cancer cells.Methods Real-time fluorescent quantitative PCR(qRT-PCR)was employed to examine the expres-sion of miR-27a and SFRP1 mRNA in colorectal cancer tissues and adjacent normal tissues.Western blot was used to detect the expression of SFRP1 protein in colorectal cancer tissues and adjacent normal tissues.TargetScan soft-ware and dual luciferase reporter gene test were used to detect the targeted regulation of miR-27a on SFRP1.HCT116 cells were transfected with miR-27a mimic,miR-27a inhibitor and negtive control(NC).The expression of miR-27a and SFRP1 mRNA in each group was determined by qRT-PCR.MTT colorimetry was performed to eval-uate the proliferation of each group cells.Transwell assay was used to evaluate the cell invasion and migration abili-ty.Meanwhile,the protein expression levels of SFRP1,key factors Wnt4 and β-catenin in the Wnt/β-catenin sig-naling pathway were determined by Western blot.Results Compared with adjacent normal tissues,miR-27a was highly expressed in colorectal cancer tissues,while SFRP1 was low expressed in colorectal cancer tissues(P<0.05).TargetScan software and dual luciferase reporter gene test showed that miR-27a targeted SFRP1.Compared with NC group,the expression of miR-27a of miR-27a mimic group increased,the proliferation,invasion and mi-gration ability enhanced,the expression of SFRP1 protein decreased,while Wnt4 and β-catenin protein expression increased(P<0.05).Compared with miR-27a mimic group,the expression of miR-27a of miR-27a inhibitor group decreased,the proliferation,invasion and migration ability reduced,the expression of SFRP1 protein in-creased,while Wnt4 and β-catenin protein expression decreased(P<0.05).Conclusion miR-27a can target SFRP1,inhibit the proliferation,invasion and migration of colorectal cancer cells,mainly by up-regulating SFRP1 and blocking the downstream Wnt/β-catenin signaling pathway,which provides a new direction for clinical treat-ment.

Female ; Humans ; Hypoglycemic Agents/therapeutic use* ; Insulin Resistance ; Metformin/therapeutic use* ; Phosphatidate Phosphatase ; Pioglitazone/therapeutic use* ; Polycystic Ovary Syndrome/genetics*

Objective:To understand the knowledge, attitude and practice of edema in patients with critically illness of ICU nurses, and to analyze its influencing factors.Methods:After developing the Knowledge-Attitude-Practice Scale of Edema Status in Critically Ill Patients for ICU nurses by Delphi expert consultation method, the level of knowledge, attitude and practice of edema status of ICU nurses in six tertiary hospitals in Shanghai City was investigated by using convenience sampling method.Results:A total of 292 ICU nurses were investigated by questionnaire. The total scores of knowledge dimension, attitude dimension and practice dimension of critical patients with edema in ICU nurses were 38.27 ± 5.52, 58.33 ± 8.34 and 43.04 ± 8.05, respectively. Multiple stepwise regression analysis showed that age ( β=0.28, P<0.05) was the main factor affecting ICU nurses′ knowledge about edema state of critically ill patients; age( β=0.20, P<0.05) and education ( β=0.28, P<0.05) were the factors affecting ICU nurses' attitude towards edema state of critically ill patients; and years of nursing work ( β=0.28, P<0.05) was the factor affecting the practice of critically ill patients of ICU nurses. Conclusions:The level of knowledge and attitude towards edema in critically ill patients of ICU nurses is good, but the level of behavior is general. Nursing managers should strengthen the training related to edema for ICU nurses, further to form a standardized prevent-treatment plan and nursing process in order to actively improve the nursing practice of edema in critically ill patients.

Objective To evaluate the efficacy and safety of Willis covered stent in the treatment of traumatic carotid cavernous fistulae (tCCF).Methods The imaging and clinical data of 7 patients with tCCF treated with Willis covered stent in Shanghai Punan Hospital from November 2015 to June 2018 were analyzed retrospectively.Results Seven Willis covered stent were used in 7 patients.Immediately after stent release,angiography showed that the fistulae completely disappeared in 6 cases.One patient had a small amount of endoleak,and there was still a small amount of endoleaks after balloon dilatation.It was not further treated.There were no operative complications.During 3-12 months follow-up,no new neurological deficits were found in all patients.Angiographic follow-up of 2 patients showed that the fistulae completely disappeared without recurrence.The internal carotid arteries were patent,no in-stent stenosis and stent displacement.Conclusions Wills covered stent can be used as a treatment for tCCF.Its efficacy is satisfactory and the safety is good.

CRISPR-Cas Systems ; Embryo, Mammalian ; Gene Editing ; methods ; HEK293 Cells ; Humans ; Polycomb Repressive Complex 1 ; genetics ; Zygote

Melkersson-Rosenthal syndrome (MRS) is an uncommon granulomatous disease characterized by the triad of relapsing facial paralysis, orofacial swelling, and fissured tongue. Genital swelling in MRS is rarely reported. We presented the first case of complete MRS with genital swelling in a child. Biopsy examinations of both the child's lower lip and penis showed noncaseating granuloma and intralymphatic granuloma infiltration. No symptoms or signs of other systemic disease (Crohn's disease or sarcoidosis) were observed after 2 years of follow-up. Genetic screening for CARD15/NOD2 in this patient showed negative, which further confirmed the diagnosis of MRS. Eleven other cases of suspected complete or incomplete MRS with genitalia involved were reviewed. Our case emphasizes the specific clinical feature of MRS with genitalia involved, which was genetically different from Crohn's disease and could be an independent entity. Lymphatic obstruction is responsible for localized edema in MRS.
Biopsy ; Child* ; Crohn Disease ; Diagnosis ; Edema ; Facial Paralysis ; Follow-Up Studies ; Genetic Testing ; Genitalia* ; Granuloma ; Humans ; Lip ; Lymphatic Vessels ; Male* ; Melkersson-Rosenthal Syndrome* ; Penis ; Tongue, Fissured

Melkersson-Rosenthal syndrome (MRS) is an uncommon granulomatous disease characterized by the triad of relapsing facial paralysis, orofacial swelling, and fissured tongue. Genital swelling in MRS is rarely reported. We presented the first case of complete MRS with genital swelling in a child. Biopsy examinations of both the child's lower lip and penis showed noncaseating granuloma and intralymphatic granuloma infiltration. No symptoms or signs of other systemic disease (Crohn's disease or sarcoidosis) were observed after 2 years of follow-up. Genetic screening for CARD15/NOD2 in this patient showed negative, which further confirmed the diagnosis of MRS. Eleven other cases of suspected complete or incomplete MRS with genitalia involved were reviewed. Our case emphasizes the specific clinical feature of MRS with genitalia involved, which was genetically different from Crohn's disease and could be an independent entity. Lymphatic obstruction is responsible for localized edema in MRS.
Biopsy ; Child* ; Crohn Disease ; Diagnosis ; Edema ; Facial Paralysis ; Follow-Up Studies ; Genetic Testing ; Genitalia* ; Granuloma ; Humans ; Lip ; Lymphatic Vessels ; Male* ; Melkersson-Rosenthal Syndrome* ; Penis ; Tongue, Fissured

Objective Screening the immune polypeptide sequence of toxoplasma (Tg) CDPK5 gene ,which were synthesized and then immunized the New Zealand white rabbit to prepare antiserum ,and identification its function .Methods Bioinformatics a‐nalysis was used to determine the immune peptide of Tg CDPK5 sequence ,which were artificially synthesized to immune white rab‐bit to prepare antiserum .The titers of antibodies were determined by ELISA and the polyclonal antibodies were verified with CD‐KP5 antigen by Western blot .The sub‐cellular localization of Tg CDPK 5 were obtained by immunofluorescence assay .Results 17 bp peptide sequence from the Tg CDPK5 N‐terminal were chosen as immune polypeptide by bioinformatics analysis .Synthetic pep‐tide were used to immune rabbit to obtain polyclonal antiserum .The result showed that the titer of the obtained ployantibody were 1∶640 000 ;Western blot demonstrated that the antiserum could specifically recognize Tg CDPK 5(75 .4 × 103 );Immunofluores‐cence assay revealed this antibody could specifically recognize the endogenous Tg CDPK 5 of Toxoplasma gondii .Conclusion Ac‐cording to the analysis of Tg CDPK5 sequence information ,this study successful obtained Tg CDPK5 polyclonal antibody .