Objective:To investigate the short-term efficacy and safety of rituximab (RTX) in children with calcineurin inhibitor (CNI) resistant steroid resistant nephrotic syndrome (SRNS).Methods:A retrospective case analysis was conducted. Thirteen children with CNI resistant SRNS who were regularly treated with RTX (375 mg/m 2 per dose (maximum dose 500 mg), 1 dose per week, a total of 4 doses) in Department of Nephrology, Children′s Hospital of Fudan University from January 2016 to December 2023 were enrolled. The general data, disease related information, urinary protein/creatinine, serum albumin, blood creatinine before RTX treatment, immunosuppressants, adverse events, and monthly urinary protein/creatinine, serum albumin, and blood creatinine indexes within 6 months after RTX treatment were collected. The changes of urinary protein/creatinine, serum albumin and estimated glomerular filtration rate (eGFR) before and after RTX at 3 and 6 months were analyzed by using paired sample t test and Wilcoxon signed-rank test. Results:Among the 13 patients, 8 were male and 5 were female. The age of disease onset was 4.0 (2.9, 6.8) years and the age of RTX treatment was 9.8 (5.9, 13.6) years. There were 8 cases of focal segmental glomerulosclerosis, 3 cases of minimal change disease and 2 cases of mesangial proliferative glomerulonephritis. No clinically significant gene variation was detected in 12 cases and the other one did not receive gene test. Before RTX treatment, 11 cases were in chronic kidney disease stage G1, and 1 case each was in stage G2 and stage G3. Ten children completed 4 doses of RTX treatment, 1 patient completed 3 doses, and 2 patients completed 2 doses. Urinary protein/creatinine in 13 children at 3 and 6 months after RTX treatment was significantly lower than baseline (0.60 (0.13, 2.04), 0.49 (0.28, 1.10) vs. 1.44 (0.76, 4.11) mg/mg, Z=-2.34, -2.34, both P<0.05), and serum albumin was significantly higher than baseline ((35±8), (34±7) vs. (30±6) g/L, t=2.30, 2.60, both P<0.05). The eGFR at 6 months after RTX treatment was not significantly different from the baseline ((110±32) vs. (113±35) ml/(min·1.73 m 2), t=-0.76, P>0.05)). No serious adverse reactions occurred in this study. Conclusion:RTX could reduce urinary protein and increase serum albumin in short-term treatment in children with CNI resistant SRNS without significant side effects.

Objective To analyze the research status,hotspots,and trends of wearable devices in nursing applications both domestically and internationally.Methods Using China National Knowledge Infrastructure,Wanfang Data Knowledge Service Platform,and Embase core databases as data sources,VOSviewer was used to visualize and analyze the publication time,keywords,and other relevant literature.Results Total of 428 articles were included,including 196 Chinese articles and 232 English articles.The overall publication volume showed an upward trend.Domestic research focuses on chronic diseases,artificial intelligence,and nursing,with the main research subjects being the elderly;Foreign research focuses on smart devices,self-monitoring,and quality of life,with the main research subjects being adults.Conclusion Currently,the number of publications on the application of wearable devices in nursing is relatively small,but the overall research heat is on the rise,mainly used for chronic diseases and self-monitoring.In the future,the application scope of wearable devices should be expanded and their potential value should be explored to promote the innovation and progress of nursing models.

Spine fracture and dislocation are common traumatic spinal conditions that often require surgical intervention due to compromised spinal stability. Surgical approaches include anterior, posterior, and combined anterior-posterior spinal procedures. According to the specific surgical requirements, patients may be placed in the prone position or repositioned between prone and supine positions during surgery. Intraoperative repositioning has become an essential step in patient positioning. However, during repositioning, patients with spinal fracture and dislocation are at increased risk for complications such as hemodynamic instability, nerve injury, and pressure injuries to the skin and soft tissue. Notably, due to the instability of the spinal cord, even minor manipulations can further exacerbate the damage, potentially leading to severe outcomes like paraplegia. Although the current clinical guidelines provide instructive recommendations for standard position, there remains no specific protocols for intraoperative repositioning in patients with spine fracture and dislocation. With a concern for the lack of clinical studies on positioning techniques, risk prevention, and operational norms for special patients, no applicable guidelines or standards are available. A consensus was required to provide clinical reference, meet the requirements of surgical treatment, and minimize the safety risks of patients caused by improper placement of positions. Professional Committee of Operating Room Nursing of Shaanxi Nursing Association organized experts in nursing management and operating room nursing from major hospitals across China to formulate Expert consensus on intraoperative repositioning for patients with spinal fracture and dislocation ( version 2025). The consensus provides 11 recommendations covering pre-repositioning preparation, intraoperative maneuvers, and post-repositioning observation, aiming to provide references for clinical standardization of the intraoperative repositioning process and protection of patients′ safety.

BACKGROUND: The effect of the interval between previous Helicobacter pylori (H. pylori) eradication and rescue treatment on therapeutic outcomes remains unknown. The aim of this study was to investigate the association between eradication rates and treatment interval durations in H. pylori infections. METHODS: This prospective observational study was conducted from December 2021 to February 2023 at six tertiary hospitals in Shandong, China. We recruited patients who were positive for H. pylori infection and required rescue treatment. Demographic information, previous times of eradication therapy, last eradication therapy date, and history of antibiotic use data were collected. The patients were divided into four groups based on the rescue treatment interval length: Group A, ≥4 weeks and ≤3 months; Group B, >3 and ≤6 months; Group C, >6 and ≤12 months; and Group D, >12 months. The primary outcome was the eradication rate of H. pylori . Drug compliance and adverse events (AEs) were also assessed. Pearson's χ2 test or Fisher's exact test was used to compare eradication rates between groups. RESULTS: A total of 670 patients were enrolled in this study. The intention-to-treat (ITT) eradication rates were 88.3% (158/179) in Group A, 89.6% (120/134) in Group B, 89.1% (123/138) in Group C, and 87.7% (192/219) in Group D. The per-protocol (PP) eradication rates were 92.9% (156/168) in Group A, 94.5% (120/127) in Group B, 94.5% (121/128) in Group C, and 93.6% (190/203) in Group D. There was no statistically significant difference in the eradication rates between groups in either the ITT ( P = 0.949) or PP analysis ( P = 0.921). No significant differences were observed in the incidence of AEs ( P = 0.934) or drug compliance ( P = 0.849) between groups. CONCLUSION: The interval duration of rescue treatment had no significant effect on H. pylori eradication rates or the incidence of AEs. REGISTRATION ClinicalTrials.gov , NCT05173493.
Humans ; Helicobacter Infections/drug therapy* ; Helicobacter pylori/pathogenicity* ; Male ; Female ; Prospective Studies ; Middle Aged ; Anti-Bacterial Agents/adverse effects* ; Adult ; Aged ; Treatment Outcome ; Proton Pump Inhibitors/therapeutic use*

Objective To compare the fifth-generation total-etch adhesive system,the sixth-generation self-etching adhesive system and the eighth-generation universal adhesive system in terms of the bonding effectiveness for sclerotic dentin.Methods A total of 150 patients with caries in the occlusal surface of the mandibular right first molar who were examined between January 2022 and June 2022 at the dental department of some hospital were selected prospectively,and then enrolled into an ASB group,a SEB group and a SBU group and underwent Class Ⅰ cavity restorations on the mandibular right first molar,with 50 affected teeth in each group.The adhesives involved in included 3MTM AdperTM Single Bond 2(the fifth-generation total-etch adhesive system)for the ASB group,ClearfilTM SE Bond(the sixth-generation self-etching adhesive system)for the SEB group and 3MTM Single Bond Universal(the eighth-generation universal adhesive system)for the SBU group.Postoperative sensitivity was evaluated using a visual analog scale(VAS)1 week,6 months,1 year and 2 years after the operation in the three groups,and clinical performance—including color match,anatomic form,surface texture,marginal adaptation,marginal discoloration and secondary caries—was assessed based on the modified United States Public Health Service(USPHS)criteria at the same follow-up intervals.SPSS 27.0 software was used for data analysis.Results All the three groups showed a 100％restoration retention rate over the 2-year follow-up period.At 1 week postoperatively,2 cases of mild allergic reactions occurred in both the ASB group and the SEB group;these reactions resolved by 6 months postoperatively.No allergic reactions were observed in the SBU group.The three groups showed no statistically significant differences in sensitivity(P>0.05)and color match,anatomic form,surface texture,marginal adaptation,marginal discoloration and secondary caries(P>0.05).Conclusion The eighth-generation universal adhesive 3MTM Single Bond Universal demonstrates comparable clinical effectiveness to the fifth-and sixth-generation adhesives in Class Ⅰ cavity restorations,and can be used for dental restorations with high requirements for operational efficiency and universal adaptability.[Chinese Medical Equipment Journal,2025,46(8):72-78]

Objective To compare the fifth-generation total-etch adhesive system,the sixth-generation self-etching adhesive system and the eighth-generation universal adhesive system in terms of the bonding effectiveness for sclerotic dentin.Methods A total of 150 patients with caries in the occlusal surface of the mandibular right first molar who were examined between January 2022 and June 2022 at the dental department of some hospital were selected prospectively,and then enrolled into an ASB group,a SEB group and a SBU group and underwent Class Ⅰ cavity restorations on the mandibular right first molar,with 50 affected teeth in each group.The adhesives involved in included 3MTM AdperTM Single Bond 2(the fifth-generation total-etch adhesive system)for the ASB group,ClearfilTM SE Bond(the sixth-generation self-etching adhesive system)for the SEB group and 3MTM Single Bond Universal(the eighth-generation universal adhesive system)for the SBU group.Postoperative sensitivity was evaluated using a visual analog scale(VAS)1 week,6 months,1 year and 2 years after the operation in the three groups,and clinical performance—including color match,anatomic form,surface texture,marginal adaptation,marginal discoloration and secondary caries—was assessed based on the modified United States Public Health Service(USPHS)criteria at the same follow-up intervals.SPSS 27.0 software was used for data analysis.Results All the three groups showed a 100％restoration retention rate over the 2-year follow-up period.At 1 week postoperatively,2 cases of mild allergic reactions occurred in both the ASB group and the SEB group;these reactions resolved by 6 months postoperatively.No allergic reactions were observed in the SBU group.The three groups showed no statistically significant differences in sensitivity(P>0.05)and color match,anatomic form,surface texture,marginal adaptation,marginal discoloration and secondary caries(P>0.05).Conclusion The eighth-generation universal adhesive 3MTM Single Bond Universal demonstrates comparable clinical effectiveness to the fifth-and sixth-generation adhesives in Class Ⅰ cavity restorations,and can be used for dental restorations with high requirements for operational efficiency and universal adaptability.[Chinese Medical Equipment Journal,2025,46(8):72-78]

Objective To analyze the research status,hotspots,and trends of wearable devices in nursing applications both domestically and internationally.Methods Using China National Knowledge Infrastructure,Wanfang Data Knowledge Service Platform,and Embase core databases as data sources,VOSviewer was used to visualize and analyze the publication time,keywords,and other relevant literature.Results Total of 428 articles were included,including 196 Chinese articles and 232 English articles.The overall publication volume showed an upward trend.Domestic research focuses on chronic diseases,artificial intelligence,and nursing,with the main research subjects being the elderly;Foreign research focuses on smart devices,self-monitoring,and quality of life,with the main research subjects being adults.Conclusion Currently,the number of publications on the application of wearable devices in nursing is relatively small,but the overall research heat is on the rise,mainly used for chronic diseases and self-monitoring.In the future,the application scope of wearable devices should be expanded and their potential value should be explored to promote the innovation and progress of nursing models.

Objective:To investigate the short-term efficacy and safety of rituximab (RTX) in children with calcineurin inhibitor (CNI) resistant steroid resistant nephrotic syndrome (SRNS).Methods:A retrospective case analysis was conducted. Thirteen children with CNI resistant SRNS who were regularly treated with RTX (375 mg/m 2 per dose (maximum dose 500 mg), 1 dose per week, a total of 4 doses) in Department of Nephrology, Children′s Hospital of Fudan University from January 2016 to December 2023 were enrolled. The general data, disease related information, urinary protein/creatinine, serum albumin, blood creatinine before RTX treatment, immunosuppressants, adverse events, and monthly urinary protein/creatinine, serum albumin, and blood creatinine indexes within 6 months after RTX treatment were collected. The changes of urinary protein/creatinine, serum albumin and estimated glomerular filtration rate (eGFR) before and after RTX at 3 and 6 months were analyzed by using paired sample t test and Wilcoxon signed-rank test. Results:Among the 13 patients, 8 were male and 5 were female. The age of disease onset was 4.0 (2.9, 6.8) years and the age of RTX treatment was 9.8 (5.9, 13.6) years. There were 8 cases of focal segmental glomerulosclerosis, 3 cases of minimal change disease and 2 cases of mesangial proliferative glomerulonephritis. No clinically significant gene variation was detected in 12 cases and the other one did not receive gene test. Before RTX treatment, 11 cases were in chronic kidney disease stage G1, and 1 case each was in stage G2 and stage G3. Ten children completed 4 doses of RTX treatment, 1 patient completed 3 doses, and 2 patients completed 2 doses. Urinary protein/creatinine in 13 children at 3 and 6 months after RTX treatment was significantly lower than baseline (0.60 (0.13, 2.04), 0.49 (0.28, 1.10) vs. 1.44 (0.76, 4.11) mg/mg, Z=-2.34, -2.34, both P<0.05), and serum albumin was significantly higher than baseline ((35±8), (34±7) vs. (30±6) g/L, t=2.30, 2.60, both P<0.05). The eGFR at 6 months after RTX treatment was not significantly different from the baseline ((110±32) vs. (113±35) ml/(min·1.73 m 2), t=-0.76, P>0.05)). No serious adverse reactions occurred in this study. Conclusion:RTX could reduce urinary protein and increase serum albumin in short-term treatment in children with CNI resistant SRNS without significant side effects.

Spine fracture and dislocation are common traumatic spinal conditions that often require surgical intervention due to compromised spinal stability. Surgical approaches include anterior, posterior, and combined anterior-posterior spinal procedures. According to the specific surgical requirements, patients may be placed in the prone position or repositioned between prone and supine positions during surgery. Intraoperative repositioning has become an essential step in patient positioning. However, during repositioning, patients with spinal fracture and dislocation are at increased risk for complications such as hemodynamic instability, nerve injury, and pressure injuries to the skin and soft tissue. Notably, due to the instability of the spinal cord, even minor manipulations can further exacerbate the damage, potentially leading to severe outcomes like paraplegia. Although the current clinical guidelines provide instructive recommendations for standard position, there remains no specific protocols for intraoperative repositioning in patients with spine fracture and dislocation. With a concern for the lack of clinical studies on positioning techniques, risk prevention, and operational norms for special patients, no applicable guidelines or standards are available. A consensus was required to provide clinical reference, meet the requirements of surgical treatment, and minimize the safety risks of patients caused by improper placement of positions. Professional Committee of Operating Room Nursing of Shaanxi Nursing Association organized experts in nursing management and operating room nursing from major hospitals across China to formulate Expert consensus on intraoperative repositioning for patients with spinal fracture and dislocation ( version 2025). The consensus provides 11 recommendations covering pre-repositioning preparation, intraoperative maneuvers, and post-repositioning observation, aiming to provide references for clinical standardization of the intraoperative repositioning process and protection of patients′ safety.

Objective:Clot waveform analysis (CWA) of activated partial thromboplastin time (APTT) was used to rapidly identify patients with hemophilia A (HA) and lupus anticoagulant (LA) positive, and to explore the diagnostic efficacy of APTT-CWA in HA and LA-positive patients.Methods:From July 25, 2022, to December 28, 2023, 145 patients with APTT prolongation were admitted to the First Hospital of Jilin University. This group comprised 106 males and 39 females, with an average age of (29.3±15.8) years, among whom there were 94 clinically confirmed HA cases and 51 LA-positive cases. The retrospective analysis employed the Mann-Whitney U test to compare APTT results and CWA parameters between HA patients and LA-positive individuals.CWA parameters including the first derivative of maximum reaction velocity (|min1|), the second derivative of maximum acceleration (|min2|), and maximum deceleration (|max2|) were investigated. Patients were classified based on the duration of APTT prolongation into mild (33 s53 s) groups. A comparison of APTT seconds and CWA parameters |min1|, |min2|, and |max2| was conducted for HA and LA-positive patients between each group. Furthermore, receiver operating characteristic (ROC) curves and area under the curve (AUC) were utilized to assess the diagnostic efficacy of CWA parameters and determine cut-off values. Results:The APTT results for HA and LA-positive patients were 70.2 s and 41.5 s, respectively, exhibiting a statistically significant difference ( P<0.001). CWA parameters |min1| were 1.459 %/s vs 3.868 %/s, |min2| were 0.124 %/s2 vs 0.502 %/s2, and |max2| were 0.054 %/s2 vs 0.388 %/s2in HA and LA patients, respectively ( P<0.001). In all APTT prolongation groups, the CWA parameters |min1|, |min2|and |max2| for HA were significantly lower than those for LA-positive patients ( P<0.05). CWA graph analysis revealed that the peak heights of |min1|, |min2|, and |max2| in HA were lower compared to LA patients. In the severe extension group, HA displayed significantly decreased peak values and a flatter, incomplete curve. ROC curve analysis indicated AUC values were greater than 0.8 ( P<0.01) for |min1|, |min2|, and |max2| in all APTT prolongation groups. Cut-off values for |min1|, |min2|, and |max2| were established for each prolongation group: mild (3.205 %/s, 0.423 %/s2, and 0.300 %/s2), moderate (2.884 %/s, 0.340 %/s2, 0.231 %/s2), and severe (2.209 %/s, 0.190 %/s2, 0.095 %/s2). Conclusion:When APTT was extended within the same range, there were significant differences in CWA parameters between HA patients and LA patients, ROC curve analysis demonstrated the effectiveness of CWA parameters in distinguishing HA from LA-positive patients,APTT-CWA can serve as a low-cost, efficient, and specific method for the rapid identification of hemophilia and lupus anticoagulant-positive patients.