To further standardize the management of postoperative nausea and vomiting in China, the Chinese Society of Anesthesiology initiated the development of Clinical practice guidelines on postoperative nausea and vomiting(2024 edition). The guideline development strictly adhered to internationally recognized principles. This protocol primarily described the methodology and process of guideline formulation, including essential information, background, objectives, development principles, task force and responsibilities, selection of clinical question, evidence acquisition, evidence evaluation, and expert consensus formulation.

Objective:To construct a quality indicator system for pain nursing process in adult inpatients and to provide a scientific, objective and practical basis for the evaluation and management of pain nursing quality in clinical nursing.Methods:Based on the guidance framework of nursing procedures, a quality index system for pain nursing process in adult inpatients was preliminarily developed. Two rounds of expert questionnaires were conducted using the Delphi method, the analytic hierarchy process was used to analyze the weight of the indicators, and the semantic analysis of the indicator system was carried out with the nurses, and finally the quality indicator system for the pain nursing process in adult inpatients was constructed.Results:Both Delphi rounds attained 100% response rates, and the expert authority coefficients were 0.96 and 0.98 respectively, the familiarity coefficients were 0.95 and 0.98 respectively, both judgment basis coefficients were 0.98, and the Kendall′s coefficient of concordance were 0.187 and 0.451 respectively. The mean values of each indicator in semantic analysis ranged from 4.30 to 5.00, and the standard deviation was 0-1.06. The final constructed quality indicator system for the pain nursing process in adult inpatients included 5 primary-level indicators (pain assessment, pain nursing diagnosis, pain nursing plan, pain nursing measures, and pain nursing evaluation) and 28 secondary-level indicators.Conclusions:The quality indicator system for the pain nursing process is successfully constructed in adult inpatients, the method is scientific and reasonable, and the content is practical and reliable. It has guiding significance for evaluating the quality of pain nursing process for inpatients.

Objective To explore the effect of influenza vaccination on the prevention of respiratory tract infection in preschool children. Methods The clinical data of 400 preschool children (1-6 years old) who were diagnosed with respiratory tract infection for the first time in department of pediatrics of Xi'an Third Hospital and second department of respiratory medicine of Xi'an Children's Hospital were retrospectively analyzed from January 2023 to December 2023, including acute bronchitis, upper respiratory tract infection and pneumonia. According to the actual influenza vaccination status, the patients were divided into vaccination group (n=210) and non-vaccination group (n=190). The incidence of respiratory tract infection was compared between both groups. The fever duration, average course of disease, hospitalization rate, clinical symptoms scores (fever, cough, nasal congestion, sore throat), inflammation indicators [C-reactive protein (CRP), white blood cell count (WBC), neutrophil percentage (NE%)] and recurrence rate after 6 months of follow-up were compared. Results The incidence of respiratory tract infection in the vaccination group was significantly lower than that in the non-vaccination group (21.43% vs 43.16%, P<0.05), and the hospitalization rate was significantly lower compared with that in the non-vaccination group (P<0.05). The scores of fever, cough, nasal congestion and sore throat were lower in the vaccination group than those in the non-vaccination group (P<0.05), and the CRP, WBC and NE% were significantly lower compared to the non-vaccination group (P<0.05). After 6 months of follow-up, the recurrence rate in the vaccination group was 11.11% (5/45), which was significantly lower than 26.83% (22/82) in the non-vaccination group (χ²=0.038, P=4.288<0.05). Conclusion Influenza vaccination can effectively reduce the incidence of respiratory tract infection in preschool children, relieve the symptoms and shorten the disease course after infection. Its preventive effect on influenza is particularly significant, suggesting the importance of strengthening influenza vaccination in preschool children.

Objective: To investigate treatment strategies for chronic periapical periodontitis in prematurely erupted premolars and provide guidance for managing pulp and periapical diseases in young permanent teeth with immature roots. Methods: A regenerative endodontic procedure (REP) was performed on a prematurely erupted maxillary left first premolar (tooth 24) at Nolla stage Ⅶ with chronic apical periodontitis, following standardized protocols including root canal irrigation, disinfection, and coronal sealing. The case was followed up, and a literature review was conducted. Results: Clinical resolution of symptoms was observed on tooth 24, with sustained root development. After a 20-month follow-up, the tooth had restored biological function. Literature synthesis revealed that periapical infections in prematurely erupted permanent teeth predominently arise from pulp exposure and bacterial infection, with retrograde infection being rare. For young permanent teeth with necrotic pulp, regenerative endodontic procedures has been established as the treatment of choice to promote apical closure and root maturation. The critical steps of regenerative endodontic procedures include thorough disinfection, induced bleeding to form a fibrin scaffold, and coronal sealing to facilitate stem cell recruitment and differentiation. Conclusion Regenerative endodontic procedures represents an effective and viable treatment option for prematurely erupted young permanent teeth with chronic periapical periodontitis.

Objective:This study aims to investigate the differences in emotional status and cognitive function among patients with vestibular migraine (VM), Meniere′s disease (MD), and their comorbidity (VMMD), and to analyze key factors influencing cognitive function.Methods:This cross-sectional study included 96 outpatients (32 males, 64 females, aged 21-73 years) from the Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, between December 2022 and December 2023. The study population consisted of 31 VM patients (VM group), 36 MD patients (MD group), and 29 VMMD patients (VMMD group), along with 32 healthy controls (16 males, 16 females, aged 19-74 years). Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), while emotional status and somatization symptoms were evaluated through the Generalized Anxiety Disorder scale, Patient Health Questionnaire Depression scale, Symptom Checklist-90, and the Self-rating Somatization Symptom scale. Multiple linear regression analysis was conducted to explore the influence of different variables on cognitive function.Results:The total MoCA score in the VMMD group (26.0 [24.5, 28.0]) was significantly lower than that in the control group (28.0 [27.0, 29.0]) and the MD group (28.0 [26.0, 30.0]) ( P=0.006). VMMD patients exhibited significant impairments in specific cognitive domains, including visuospatial/executive function, delayed recall, and orientation ( P<0.05). Patients with VM, MD, and VMMD showed higher rates of anxiety, depression, and somatization symptoms compared to the control group ( P<0.05), with the VMMD group experiencing the most severe emotional distress. Multiple linear regression analysis identified education level and vestibular disease type as key factors affecting cognitive function, with a university-level education predicting higher MoCA scores ( P<0.001), while VMMD was associated with cognitive decline ( P<0.01). Conclusions:Patients with VM and MD, particularly those with comorbid VMMD, exhibit significant emotional distress. Cognitive impairments are present in VM and VMMD patients, affecting different cognitive domains. These factors should be comprehensively considered in clinical assessments to develop more effective treatment strategies.

Anxiety disorder is a highly prevalent psychological illness, and research has shown that obesity is a significant risk factor for its development. This study explored the ameliorative effects and mechanisms of saponins from Panax japonicus(SPJ) on anxiety disorder in mice fed a high-fat diet(HFD). Fifty C57BL/6J mice were randomly divided into normal control diet(NCD) group, HFD group, and low-and high-dose SPJ groups. At week 12, six mice from the HFD group were further divided into a control group(treated with DMSO) and an exogenous fibroblast growth factor 21(FGF21) group(administered rFGF21). The anxiety-like behavior of the mice was assessed using the open field test and elevated plus maze test. Hematoxylin-eosin(HE) staining and oil red O staining were performed to observe pathological changes in the liver and adipose tissue. Glucose metabolism was evaluated through the glucose tolerance test(GTT) and insulin tolerance test(ITT). Western blot analysis was performed to detect the expression of FGF21 and its downstream-related proteins in the liver and cortex, along with the expression of brain-derived neurotrophic factor(BDNF), disks large homolog 4(DLG4), and synaptophysin(SYP) in the cortex. Real-time quantitative fluorescent PCR(qPCR) was used to detect the expression of FGF21 and its receptor genes in the liver and cortex. Immunofluorescence staining was employed to examine the expression of neuronal activator c-Fos, FGF21, and the FGF21 co-receptor β-klotho in the cerebral cortex. The results showed that SPJ significantly improved the frequency of activity in the open arms of the elevated plus maze and the central area of the open field in HFD mice, up-regulated the expression of BDNF, DLG4, and SYP, and effectively alleviated anxiety-like behaviors in HFD mice. Compared with the NCD group, HFD mice exhibited up-regulated expression of FGF21 in the liver and cerebral cortex, while the expression of fibroblast growth factor receptor 1(FGFR1) and β-klotho was significantly down-regulated, suggesting that HFD mice exhibited FGF21 resistance. SPJ markedly up-regulated the β-klotho levels in HFD mice, reversing FGF21 resistance. Further comparison with exogenously administered FGF21 revealed that SPJ activates brain cortical regions in a consistent manner, and additionally, SPJ promotes the number and colocalization of c-Fos and β-klotho positive cells in the brain cortex. In summary, SPJ effectively alleviates anxiety-like behaviors in HFD mice. Its mechanism is associated with up-regulation of β-klotho expression in the brain, reversal of FGF21 resistance, and subsequent activation of neurons in the cerebral cortex and amygdala.
Animals ; Diet, High-Fat/adverse effects* ; Fibroblast Growth Factors/genetics* ; Mice ; Male ; Panax/chemistry* ; Mice, Inbred C57BL ; Anxiety/etiology* ; Saponins/administration & dosage* ; Brain-Derived Neurotrophic Factor/genetics* ; Humans ; Liver/metabolism* ; Drugs, Chinese Herbal/administration & dosage*

In order to clarify the effects of drought stress training on the quality and drought resistance of Codonopsis pilosula, this study used PEG to simulate drought stress and employed potting with water control for the drought stress training of C. pilosula plants. The polysaccharide content, secondary metabolites, antioxidant system, and photosynthetic pigment system of C. pilosula after drought stress training were analyzed. The results showed that the content of fructans in the root of C. pilosula increased after two rounds of drought stress treatment, and it was significantly higher than that of the control group. The accumulation of fructans in the root of C. pilosula showed an upward trend during the rehydration treatment. The content of lobetyolin and tangshenoside Ⅰ increased after drought stress treatment compared with that of the control group. The rehydration treatment caused first increasing and then decreasing in the content of lobetyolin, while it had no significant effect on the tangshenoside Ⅰcontent. The content of photosynthetic pigments decreased after drought stress treatment, and it gradually increased during the first round of rehydration and the second round of rehydration. Moreover, the increase was faster in the second round of rehydration than in the first round of rehydration. The content of the peroxidation product malondialdehyde(MDA) and the activities of superoxide dismutase(SOD), peroxidase(POD), and catalase(CAT) increased after drought stress treatment compared with those of the control group, and they showed a tendency of decreasing during rehydration. Moreover, the decrease was faster in the second round of rehydration than in the first round of rehydration. When the plants of C. pilosula after drought stress training were again subjected to severe drought stress, the wilting rate decreased significantly, and the biomass increases significantly. This study showed that the drought stress training could promote the accumulation of polysaccharides and secondary metabolites in the root of C. pilosula. When encountering drought stress again, C. pilosula plants could quickly regulate the antioxidant system and delay the decomposition of chlorophyll to respond to drought stress. The findings provide a theoretical basis for the ecological cultivation of C. pilosula in arid and semi-arid areas.
Codonopsis/growth & development* ; Droughts ; Polysaccharides/metabolism* ; Stress, Physiological ; Water/metabolism* ; Antioxidants/metabolism* ; Photosynthesis ; Drought Resistance

Objective:This study aimed to explore the molecular mechanisms of the maladaptation of H3N2 influenza virus in chicken embryos, provide a theoretical basis for the restoration of H3N2 influenza vaccine production in chicken embryos.Methods:Samples of respiratory secretions from patients with influenza-like symptoms (Influenza-like Illness, ILI) caused by H3N2 influenza virus were inoculated into chicken embryos and Madin-Darby Canine Kidney cells (MDCK), respectively. After isolating the virus, hemagglutination experiments were conducted to detect hemagglutination titers and hemagglutination inhibition experiments were used to compare antigenic differences; further, whole-genome sequencing of H3N2 influenza virus was performed using second-generation high-throughput gene sequencing (Next Generation High-Throughput Gene Sequencing, NGS), and key amino acid sites of mutations were identified through sequence alignment; combined with sialic acid receptor binding experiments, the differences in the binding of wild-type and mutant receptor binding sites (RBS) to sialic acid receptors were compared; finally, molecular docking and molecular dynamics simulation method were used to explore the specific molecular mechanisms of how mutation sites affect the differences in the affinity of the RBS pocket for sialic acid receptors.Results:The hemagglutination assay result indicated that both chicken embryos and MDCK cells could isolate the influenza virus, and the hemagglutination inhibition test showed that no antigenic differences were produced in the isolated strains. NGS analysis revealed that the H3N2 virus underwent an F195Y mutation in the (RBS) region of the hemagglutinin (HA) protein after adaptation through chicken embryo passages. Receptor-binding experiments demonstrated that the F195Y mutation enhanced the virus′s binding ability to α2, 3-linked sialic acid glycan (Neu5Acα2-3Galβ1-4GlcNAcβ-PAA, 3′SLN), while the mutation did not affect the affinity of the RBS pocket for α2, 6-linked sialic acid glycan (Neu5Acα2-6Galβ1-4GlcNAcβ-PAA, 6′SLN). Molecular docking and molecular dynamics simulation result indicate that the F195Y mutation, by replacing a hydrophobic amino acid with a hydrophilic one, leads to a significant decrease in the structure of the RBS pocket, enhancing the binding stability of the H3N2 influenza virus with α2, 3-sln. This is specifically manifested by an increase in binding time and an increase in the number of hydrogen bonds at the RBS site with the receptor. Furthermore, the F195Y mutation does not alter the binding of the virus to other receptors.Conclusions:The F195Y mutation in the RBS pocket of H3N2 influenza virus is a key site affecting the viral chicken embryo inadaptability.

To further standardize the management of postoperative nausea and vomiting in China, the Chinese Society of Anesthesiology initiated the development of Clinical practice guidelines on postoperative nausea and vomiting(2024 edition). The guideline development strictly adhered to internationally recognized principles. This protocol primarily described the methodology and process of guideline formulation, including essential information, background, objectives, development principles, task force and responsibilities, selection of clinical question, evidence acquisition, evidence evaluation, and expert consensus formulation.

Objective:To construct a quality indicator system for pain nursing process in adult inpatients and to provide a scientific, objective and practical basis for the evaluation and management of pain nursing quality in clinical nursing.Methods:Based on the guidance framework of nursing procedures, a quality index system for pain nursing process in adult inpatients was preliminarily developed. Two rounds of expert questionnaires were conducted using the Delphi method, the analytic hierarchy process was used to analyze the weight of the indicators, and the semantic analysis of the indicator system was carried out with the nurses, and finally the quality indicator system for the pain nursing process in adult inpatients was constructed.Results:Both Delphi rounds attained 100% response rates, and the expert authority coefficients were 0.96 and 0.98 respectively, the familiarity coefficients were 0.95 and 0.98 respectively, both judgment basis coefficients were 0.98, and the Kendall′s coefficient of concordance were 0.187 and 0.451 respectively. The mean values of each indicator in semantic analysis ranged from 4.30 to 5.00, and the standard deviation was 0-1.06. The final constructed quality indicator system for the pain nursing process in adult inpatients included 5 primary-level indicators (pain assessment, pain nursing diagnosis, pain nursing plan, pain nursing measures, and pain nursing evaluation) and 28 secondary-level indicators.Conclusions:The quality indicator system for the pain nursing process is successfully constructed in adult inpatients, the method is scientific and reasonable, and the content is practical and reliable. It has guiding significance for evaluating the quality of pain nursing process for inpatients.