ObjectiveTo investigate the effect of video-based educational intervention combined with maternal presence on perioperative adverse outcomes in preschool children undergoing general anesthesia， including cooperation in anesthesia induction， perioperative anxiety， pain and agitation during recovery. MethodsA total of 300 preschool children scheduled for general anesthesia in our hospital from June to December 2023 were randomly assigned to control group （n=150） and intervention group （n=150）. The control group received routine recovery care. For the intervention group， in addition to routine recovery care， a preoperative visit was scheduled one day before surgery. During this visit， mothers were guided to watch anesthesia videos with their children. During the waiting period in the operating room and 30 minutes after awakening， the mothers were guided to accompany the children for more than 30 minutes. Recovery conditions were recorded using the surgical anesthesia information system， and the children’s anesthetic induction compliance， perioperative anxiety， pain， and agitation were evaluated and recorded using the modified Yale Preoperative Anxiety Scale （m-YPAS）， the Induction Compliance Scale （ICC）， the Children’s Pain Behavior Scale （FLACC）， and the Pediatric Agitation and Emergence Delirium Scale （PAED）. ResultsOn the preoperative visit day， there were no statistically significant differences in baseline data between the two groups （P > 0.05）. For perioperative anxiety， the m-YPAS scores of the intervention group were significantly lower than those of the control group， both when entering the operating room waiting area （35.27±6.48 vs. 41.79±6.68， P < 0.05） and 30 minutes after postoperative recovery （20.13±7.05 vs. 35.75±9.51， P < 0.05）. In terms of anesthesia induction cooperation， the ICC scores of the intervention group were significantly lower than those of the control group （1.84±0.95 vs. 3.17±0.62， P < 0.05）， and the proportion of good induction cooperation was significantly higher than that of the control group （24.00% vs. 12.67%， P < 0.05）. There was no significant difference in awakening duration between the two groups， but the intervention group had a significantly shorter length of stay in the post-anesthesia care unit than the control group （0.90±0.29 hours vs. 1.29±0.42 hours， P < 0.001）. For perioperative agitation， the PAED scores of the intervention group were significantly lower than those of the control group （entering in the operating room waiting area： 8.5 vs. 9.2， P < 0.05； 30 minutes after postoperative recovery： 4.2 vs. 7.8， P < 0.05）. In terms of pain scores， the FLACC scores of the intervention group were also significantly lower than those of the control group， both when entering the operating room waiting area （ 5.3 vs. 6.7， P < 0.05； 30 minutes after postoperative recovery： 2.1 vs. 4.9， P < 0.05）. ConclusionsVideo-based educational intervention combined with maternal presence reduces the perioperative anxiety， pain and agitation of preschool children undergoing general anesthesia， and improved the compliance of anesthesia induction. It is recommended to promote this intervention measure in clinical practice.

The construction of a medication safety culture is important for medication safety management and rational drug use.The construction of medication safety culture standards is formulated based on relevant national policies and regulations,accreditation standards for hospitals,expert opinions,the current situation,and the development trend of the healthcare industry.With scientificity,general applicability,instructive guidance,and practicality,they standardized basic requirements,management processes,and improvement of the construction of medication safety culture.To facilitate understanding and the implementation of the standards,we describe the process of standards formulation and explain the key points of the standards.

Objective The objective of this study was to establish a mouse model of allergic rhinoconjunctivitis and investigate the role of the NLRP3 signaling pathway in allergic rhinoconjunctivitis.Methods Thirty-three female C57 mice(SPF)were randomLy divided into 3 groups:the control group,the experimental group,and the NLRP3-/-group.On days 0,4,7,14,and 21,the experimental group and NLRP3-/-group received a 0.2 mL intraperitoneal injection of medicine containing OVA(100 μg)and adjuvant Al(OH)3(4 mg),respectively.After an interval of 3 days,each eye and nose were dosed with 10 μL of 5%OVA for five consecutive days a week to induce allergic symptoms.During sensitization and excitation stages,the control group was replaced with an equiva-lent amount of PBS.Ocular and nasal symptoms were observed and scored.The levels of OVA-specific IgE,IL-4,IL-17,and IL-18 in serum were measured using ELISA,while changes in palpebral conjunctiva and nasal mucosa were assessed by hematoxylin-eosin staining.The expression of NLRP3 mRNA in conjunctival tissue and nasal mucosa was determined using real-time PCR analysis.Statistical analysis was performed using SPSS17.0 software with P<0.05 considered as statistically significant difference.Results The experimental group and NLRP3-/-group exhibited induced nasal and ocular allergic symptoms.In the experimental group,the duration of nasal allergy symptoms was(10.500±1.080)days,while the duration of eye allergy symptoms was(20.300±2.058)days.In the NLRP3-/-group,the duration of nasal allergy symptoms was(13.400±1.955)days,and for eye allergy symp-toms it was(20.900±2.132)days.The duration of nasal allergies in the NLRP3-/-group significantly exceeded that in the experimental group(P<0.05),whereas there were no significant differences observed in eye allergy durations between these two groups(P>0.05).Levels of OVA-specific IgE,IL-4,and IL-17 were significantly higher in both the experimental and NLRP3-/-groups compared to those in the control group(P<0.05).Additionally,serum IL-18 content increased significantly in the experimental group when compared with both control and NLRP3-/-groups(P<0.05).Conjunctival tissue lesions as well as nasal mucosa damage were evident in both experimental and NLRP3-/-groups.mRNA expression levels of NLRP3 within conjunctival tissue and nasal mucosa from the experimental group showed a significant increase when compared to those from both control and NLRP3-/-groups(P<0.05).Conclusion Allergic rhinoconjunctivitis pathogenesis is influenced by various factors;however,the involvement of NLPR3 signaling pathway promotes its development.

This paper summarises the experience in an emergency care of a patient who had a "silent lung" during ventilator-assisted ventilation while in the post-anaesthesia care unit (PACU) after a surgery of cavernous sinus fistula of internal carotid artery. By reviewing nursing records,the emergency nursing interventions were summed up,incluing immediate elimination of mechanical blockage,rapid identification and diagnosis of "silent lung",urgent application of manual balloon pressurisation ventilation to resolve ventilation difficulties and symptomatic medication to relieve airway spasm. A ventilator-assisted ventilation was reinitiated to ensure unobstructed breathing after the condition of patient had been stablised. Lungs were inflated when the condition of patient allowed together without a risk of airway spasm. Then the endotracheal catheter was removed under a deep anaesthesis. After 3 hours of emergency resuscitation,the patient became stable and safely returned to the ward. The patient was discharged 11 days later and was found in good condtion over the 3 months postoperative follow-up.

This paper summarises the experience in an emergency care of a patient who had a "silent lung" during ventilator-assisted ventilation while in the post-anaesthesia care unit (PACU) after a surgery of cavernous sinus fistula of internal carotid artery. By reviewing nursing records,the emergency nursing interventions were summed up,incluing immediate elimination of mechanical blockage,rapid identification and diagnosis of "silent lung",urgent application of manual balloon pressurisation ventilation to resolve ventilation difficulties and symptomatic medication to relieve airway spasm. A ventilator-assisted ventilation was reinitiated to ensure unobstructed breathing after the condition of patient had been stablised. Lungs were inflated when the condition of patient allowed together without a risk of airway spasm. Then the endotracheal catheter was removed under a deep anaesthesis. After 3 hours of emergency resuscitation,the patient became stable and safely returned to the ward. The patient was discharged 11 days later and was found in good condtion over the 3 months postoperative follow-up.

Objective:To evaluate the changes of peripapillary retinal and choroid thickness of tail-suspension rats in simulated weightless.Methods:Sixty rats were divided into 2 groups: control group (15 rats) and tail-suspension group (45 rats). The rats in tail-suspension group were tested by -30° tail suspension to simulate the effect of weightlessness for establishing model. The peripapillary retinal thickness of the rats were measured before and after 4- and 8-week tail suspension by enhanced depth imaging-optical coherence tomography (EDI-OCT). The choroid thickness of the rats were measured before and after 4-, 8-, 10-, and 12-week tail-suspension by EDI-OCT.Results:There was a significant difference in the peripapillary retinal thickness among the groups with different suspension time ( F=30.89, P<0.001), and the thickness showed a downward trend with the extension of the tail suspension time. After 8 weeks of tail-suspension, there was a significant difference in the peripapillary retinal thickness between the tail-suspension group and the control group ( t=5.73, P<0.001). After 4, 8, 10, and 12 weeks of tail-suspension, there were significant differences in the choroidal thickness of the rats between the tail-suspension group and the control group ( t=6.32, 12.78, 9.69, 6.39, all P<0.001); there was a significant difference in the choroidal thickness of the rats with different suspension time ( F=51.08, P<0.001). With the time of the tail suspension, the choroidal thickness and its changes compared with before tail suspension showed an upward trend, and reached peak after 8 weeks and then slightly decreased. Conclusions:With the extension of tail-suspension time, the changes of peripapillary retinal thickness of the tail-suspension rats generally show a downward trend, and the changes of choroidal thickness generally increased, and decreased slightly after reaching peak.

Objective:To investigate the preventive effect of postoperative pancreatic fistula by pedicled omentum wrapping pancreaticojejunostomy in pancreaticoduodenectomy.Methods:The clinical data of 78 patients who underwent pancreaticoduodenectomy in Songjiang Hospital Affiliated to Shanghai Jiao Tong University from September 2017 to August 2020 were retrospectively analyzed. Patients were divided into the modified pancreaticojejunostomy group (conventional approach group, n=43) and the pedicled omentum wrapping pancreaticojejunostomy group (omentum wrapping group, n=35) according to the surgical mode. Postoperative pancreatic fistula, postoperative abdominal bleeding, delayed gastric emptying and postoperative hospital stay were compared between the two groups. Results:Compared with the conventional approach group, the postoperative pancreatic fistula rate in omentum wrapping group was significantly reduced (2.9% vs 18.6%), and the difference was statistically different ( P=0.030); postoperative abdominal bleeding rate(0 vs 4.7%)and the delayed gastric emptying rate were significantly reduced (8.6% vs 25.6%), but both of them were not statistically different ( all P value>0.05); the length of postoperative hospital stay was significantly reduced [(11.3±2.9) days vs (12.8±3.5)days], and the difference was statistically different ( P=0.045). Conclusions:The pedicled omentum wrapping pancreaticojejunostomy was simple and convenient, which can significantly reduce the rate of postoperative pancreatic fistula. It can shorten the time of the length of hospital stay after surgery.

Objective:To evaluate the changes of peripapillary retinal and choroid thickness of tail-suspension rats in simulated weightless.Methods:Sixty rats were divided into 2 groups: control group (15 rats) and tail-suspension group (45 rats). The rats in tail-suspension group were tested by -30° tail suspension to simulate the effect of weightlessness for establishing model. The peripapillary retinal thickness of the rats were measured before and after 4- and 8-week tail suspension by enhanced depth imaging-optical coherence tomography (EDI-OCT). The choroid thickness of the rats were measured before and after 4-, 8-, 10-, and 12-week tail-suspension by EDI-OCT.Results:There was a significant difference in the peripapillary retinal thickness among the groups with different suspension time ( F=30.89, P<0.001), and the thickness showed a downward trend with the extension of the tail suspension time. After 8 weeks of tail-suspension, there was a significant difference in the peripapillary retinal thickness between the tail-suspension group and the control group ( t=5.73, P<0.001). After 4, 8, 10, and 12 weeks of tail-suspension, there were significant differences in the choroidal thickness of the rats between the tail-suspension group and the control group ( t=6.32, 12.78, 9.69, 6.39, all P<0.001); there was a significant difference in the choroidal thickness of the rats with different suspension time ( F=51.08, P<0.001). With the time of the tail suspension, the choroidal thickness and its changes compared with before tail suspension showed an upward trend, and reached peak after 8 weeks and then slightly decreased. Conclusions:With the extension of tail-suspension time, the changes of peripapillary retinal thickness of the tail-suspension rats generally show a downward trend, and the changes of choroidal thickness generally increased, and decreased slightly after reaching peak.

Aging is a major risk factor for diseases such as osteoarthritis (OA) and osteoporosis. However, they are not necessarily the results of aging, and the relationship between changes in bone and cartilage associated with aging and disease progression is still unclear. Studies have shown that the development and progression of OA is not a simple cartilage wear process, while its occurrence involves complex biological, chemical and mechanical changes in the tissues of the entire joint, especially the interaction of mechanics and biochemistry between cartilage and subchondral bone. Aging contributes to the occurrence and development of OA, but it is not the cause of OA. Changes associated with aging provide a foundation for OA to start, making joints more susceptible to other factors such as abnormal biomechanics and biochemistry, thereby promoting the development of OA. Therefore, understanding the basic mechanisms by which aging affects joint tissue may provide new targets for slowing or preventing the development of OA. In this paper, the related research progresses are reviewed from three aspects, i.e. age-related changes in cartilage and subchondral bone, mechanical conduction and angiogenesis.