Objective:To explore the ventilation strategy of using pressure controlled ventilation-volume guaranteed (PCV-VG) mode combined with personalized positive end expiratory pressure (PEEP) during surgery, and its impact on oxygenation function and incidence of postoperative pulmonary complications (PPCs) in patients undergoing brain tumor surgery.Methods:Sixty patients who underwent elective brain tumor surgery at the Linyi People′s Hospital from January 2023 to June 2023 were selected. The patients were randomly divided into PCV-VG ventilation mode group (T group) and volume controlled ventilation (VCV) mode group (C group) using a random number table method, with 30 patients in each group. One patient was excluded from group T due to changes in the condition, and 29 patients were actually included. Group T adopted PCV-VG ventilation mode and searched for the maximum dynamic lung compliance (Cdyn) by titrating PEEP. The PEEP corresponding to the maximum Cdyn value was the optimal PEEP, which was maintained until the end of mechanical ventilation. Group C adopted a ventilation mode of VCV plus 5 cmH 2O fixed value PEEP. All patients underwent arterial blood gas analysis before anesthesia induction (T 1), 15 minutes after setting ventilation mode (T 2), and 15 minutes after extubation (T 3), recording arterial oxygen partial pressure (PaO 2), carbon dioxide partial pressure (PaCO 2), lactate (Lac), and blood glucose (Glu), and calculating oxygenation index (PaO 2/FiO 2). The levels of white blood cells (WBC), C-reactive protein (CRP), and procalcitonin (PCT) were recorded before and 72 hours after surgery. The incidence of postoperative PPCs at 72 hours was observed. Results:There was a statistically significant difference in the grouping effect and time effect of PaO 2 and PaCO 2 between group C and group T (all P<0.05), while there was no statistically significant difference in the interaction effect (all P>0.05); The differences in grouping effects, time effects, and interaction effects of PaO 2/FiO 2 between group C and group T were statistically significant (all P<0.05); The average value of the optimized PEEP obtained by T-group titration was 7.48 cmH 2O, corresponding to an average platform pressure (Pplat) of 14.90 cmH 2O, and an average value of 53.37 ml/cmH 2O corresponding to the maximum Cdyn value. Compared with the Pplat and Cdyn corresponding to the fixed value of 5 cmH 2O PEEP in Group C, the Pplat corresponding to the optimized PEEP in Group T was lower than that in Group C ( P<0.05), and the Cdyn was higher than that in group C ( P<0.05). The CRP level and incidence of PPCs in group T after 72 hours of surgery were significantly lower than those in group C (all P<0.05). Conclusions:Compared with VCV, the ventilation mode of PCV-VG combined with personalized PEEP can improve intraoperative lung ventilation and oxygenation function in patients with brain tumors, reduce the occurrence of pulmonary inflammation 72 hours after surgery, and lower the incidence of PPCs.

Purpose/Significance To analyze the influencing factors of user satisfaction on mobile medical platform,and to put for-ward suggestions to improve the quality of medical service and user satisfaction.Method/Process Taking the evaluation texts of users from eight tertiary hospitals in Guangxi in the online mobile medical service platform of haodf.com as the research object,the paper uses the software of ROST content mining system to filter meaningless words,carries out emotional analysis,word frequency statistical analysis and co-occurrence matrix semantic network analysis.Result/Conclusion The degree of satisfaction and recognition of users to the mo-bile medical service platform is high.From the perspective of influencing factors and departments,it puts forward some suggestions on how to improve the satisfaction of mobile medical service users.

Objective:To review the scope of related factors that affect the elderly′s participation in digital health intervention, and to provide a certain reference for the application and development of smart elderly technology.Methods:Based on the scope review guidelines issued by the Joanna Briggs Institute in Australia in 2019, the inclusion and exclusion criteria were determined according to the PCCS principles. Chinese and English literatures were searched in PubMed, Cochrane Library, JBI, CINAHL, Web of Science, Scopus, CNKI, Wanfang database and Chinese biomedical literature database. The search time limit was from the establishment of the database to November 30, 2021. Two researchers independently read, and used EndNoteX9 and Excel tables to extract relevant data from the literature for summary and analysis.Results:Totally 20 articles were selected, including 2 mixed studies, 10 cross-sectional studies, 6 qualitative studies, and 2 quasi-experimental studies. Relevant factors affecting the participation of the elderly in digital health interventions involved the developers, users and the user himself of digital health intervention systems, including the degree of system integration of system development, the degree of autonomy of the elderly, the credibility and accessibility of system equipment and ease of use; the degree of compatibility of equipment in the process of use, the degree of digital infrastructure configuration, the degree of Internet penetration, the availability and reliability of health information resources, the degree of training and education, the degree of communication with the elderly in the process of participation, financial payment, etc.; the four inherent factors of the elderly included the cost of technology use, technical anxiety, privacy and safety, and health needs.Conclusions:The elderly, medical staff, developers and other stakeholders should jointly participate in decision-making on the development and management of the digital health intervention system for the elderly, especially by inviting and empowering the elderly , and improve the training and feedback of the system application and use process, accelerate the popularization and promotion of technical resources, and increase social capital and financial payment incentives to reduce the burden on the elderly and the medical system.

Objective:To explore the application of laparoscopic training in the standardized residency training of pediatric general surgery.Methods:A total of 36 rotating residents who received the standardized residency training in the department of pediatric general surgery of Shenzhen Children's Hospital from January 2017 to December 2019 were selected for laparoscopic training. The training content includes the study and training of laparoscopic theory knowledge, laparoscopic surgery video, skills operation of simulated operating system. Assessment was conducted before and after the training, and statistical analysis was performed to compare the difference of scores before and after the training. The self-evaluation of resident's learning efficiency and the satisfaction with teachers were investigated by questionnaires. SPSS 20.0 was used for paired t-test. Results:After receiving the standardized residency training of pediatric general surgery, the theoretical knowledge and cognition of the application on pediatric general laparoscopic surgery were significantly improved among the 36 residents. The time that the skills spent in vitro simulation box during the simulated operation training was significantly reduced after training, with a statistically significant difference ( P < 0.05). According to the questionnaire survey, resident's satisfaction with self-evaluation of learning efficiency was 97.22% (35/36), their satisfaction with teachers was 94.44% (34/36), and their satisfaction with teaching curriculum was 100.00% (36/36). Conclusion:Laparoscopic training can effectively improve the clinical practice ability of pediatric general surgery residents, which is worthy of promotion.

Objective:To compare the clinical characteristics and prognosis of bacterial liver abscess in patients with or without diabetes mellitus (DM), to provide a reference for clinical diagnosis and treatment.Methods:Patients with bacterial liver abscesses hospitalized in Tongren Hospital, Shanghai Jiao Tong University School of Medicine from January 2016 to August 2021 were enrolled, and their clinical data were collected. The patients were divided into diabetic and non-diabetic groups for comparison according to whether they had comorbid DM. Statistical analysis was performed by chi-square test or Fisher′s exact test, and multivariate logistic regression analysis.Results:A total of 131 patients with bacterial liver abscesses were included, including 47 cases in the diabetic group and 84 cases in the non-diabetic group. The percentages of platelet count <100×10 9/L, C-reactive protein>10 mg/L, and total bilirubin>17.5 μmol/L were lower in the diabetic group than that in the non-diabetic group, and the differences were all statistically significant ( χ2=3.90, 6.44 and 5.56, respectively, all P<0.05). The percentage of multiple abscesses in the diabetic group was 10.6%(5/47), which was lower than 29.8%(25/84) in the non-diabetic group, and the difference was statistically significant ( χ2=6.24, P=0.012). The positive rate of pus culture for Klebsiella pneumoniae was 64.9%(24/37) in the diabetic group, which was higher than 41.5%(27/65) in the non-diabetic group, with a statistically significant difference ( χ2=5.13, P=0.023). The incidences of pleural effusion and abscesses at other sites in the diabetic group were 29.8%(14/47) and 10.6%(5/47), respectively, which were both higher than 14.3%(12/84) and 1.2%(1/84) in the non-diabetic group, respectively, and the differences were statistically significant ( χ2=4.55, Fisher′s exact test, both P<0.05). The proportion of hospital stays>21 d was 34.0%(16/47) in the diabetic group, which was higher than 16.7%(14/84) in the non-diabetic group, with a statistically significant difference ( χ2=5.15, P=0.023). DM (odds ratio ( OR)=2.654, 95% confidence interval ( CI) 1.020 to 6.907, P=0.046) and abscess maximum diameter>10 cm ( OR=11.045, 95% CI 4.493 to 27.154, P<0.001) were significant risk factors for hospital stay>21 d. Conclusions:Bacterial liver abscesses combined with DM are more common with single abscess, a higher rate of Klebsiella pneumoniae infection, and more likely to develop pleural effusions and abscesses at other sites. Liver abscesses>10 cm in maximum diameter and comorbid DM would prolong hospital stay.

Objective:To explore whether or not radioactive wastewater leakage or overflow exists in the nuclear medicine decay pool after the 7·20 extraordinary rainstorm disaster and to analyze its causes, so as to provide scientific basis for the design, construction and maintenance of the nuclear medicine decay pool and the radiation protection management of nuclear medicine in the future.Methods:Three hospitals A, B and C where 131I therapy are being performed were selected in Zhengzhou city, Henan province. Sampling points were set based on the monitoring result of the environmental radiation level around the nuclear medical decay pool in line with the relevent standard method. Soil samples were collected at different depths. The 131I radioactivity level in the soil was measured using HPGe gamma spectrometer, with the measured result being processed and analyzed. Results:Except for Hospital B where no 131I was detected, different 131I activity concentrations were detected in the soil samples collected around the nuclear medicine decay pool at Hospitals A and C. The 131I activity concentrations ranged from 16.4 to 98 111.8 Bq/kg at Hospital A and from 10.6 to 7 176.6 Bq/kg at Hospital C. After a time period of decay, the repeated detection has shown that the 131I activity concentrations ranged from 1.3 to 17.0 Bq/kg at Hospital A and from 3.9 to 7.1 Bq/kg at Hospital C. The 131I activity concentration in the soil at the depth of 0-5 cm was higher than that at the depth of 5-10 cm soil at the same sampling point. The ratios of activity concentration of 131I between different depths ranged from 1.3 to 13.1, with the median value of 5.9. Conclusions:After the 7·20 extraordinary rainstorm disaster, the surrounding environment of nuclear medicine decay pools at a few hospitals was contamminated by 131I to some extent. To prevent the risk of leakage of radioactive wastewater, the safety evaluation and management of radiation protection should be made better with increased awareness during the design, evaluation, construction and use of nuclear medicine decay pools.

Nearly a quarter of the world's population is infected with Mycobacterium tuberculosis and remains long-term asymptomatic infection. Rv2626c is a latent infection-related protein regulated by DosR of M. tuberculosis. In this study, the Rv2626c protein was prokaryotically expressed and purified, and its immunobiological characteristics were analyzed using RAW264.7 cells and mice as infection models. SDS-PAGE and Western blotting analysis showed that the Rv2626c-His fusion protein was mainly expressed in soluble form and specifically reacted with the rabbit anti-H37RV polyclonal serum. In addition, we found that the Rv2626c protein bound to the surface of RAW264.7 macrophages and up-regulated the production of NO. Moreover, the Rv2626c protein significantly induced the production of pro-inflammatory cytokines IFN-γ, TNF-α, IL-6 and MCP-1, and induced strong Th1-tendency immune response. These results may help to reveal the pathogenic mechanism of M. tuberculosis and facilitate the development of new tuberculosis vaccine.
Animals ; Mice ; Rabbits ; Mycobacterium tuberculosis/genetics* ; Tuberculosis ; Antigens, Bacterial ; Cytokines ; Immunity, Cellular

Objective:To explore the therapeutic characteristics of population with gout achieving treat-to-target (T2T) indicators through real-world research and evaluate their safety.Methods:A total of 3 287 patients diagnosed with gout by rheumatologists in 21 first-class tertiary hospitals in 10 provinces, municipalities, and autonomous regions in China from January 2015 to December 2021 were included in this polycentric cross-sectional study. The database included patients′ general information, disease characteristics, and clinical application of traditional Chinese and Western medicine treatment measures. SPSS and Excel software were used for data analysis. Frequency analysis, cluster analysis, and factor analysis were used to summarize the characteristics and rules of treatment measures for patients with gout who achieved the target after treatment. The occurrence of adverse events (AE) was recorded during treatment.Results:After treatment, 691 visits (7%) achieved the serum urate (SUA) target, and the most frequent use of urate-lowering therapy (ULT) was febuxostat, followed by benzbromarone. The most common treatment options were following: GroupⅠ: traditional Chinese medicine (TCM) decoction-TCM external treatment-physical exercise-proprietary Chinese medicine; GroupⅡ: ferulic acid-nonsteroidal anti-inflammatory drugs (NSAIDs); Group Ⅲ: allopurinol-sodium bicarbonate-benzbromarone; Group Ⅳ: glucocorticoid-colchicine; Group Ⅴ: febuxostat. A total of 5 898 visits (60%) chieved manifestations of joint pain VAS scores target, and the most frequently used drug to control joint symptoms was NSAIDs. The frequency of use of drugs to control joint symptoms were 2 118 times (usage rate reached 35.9%), while the frequency of ULT were 2 504 times (usage rate reached 42.5%), which was higher than the joint symptom control drug. The most common treatment options were following: Group Ⅰ: proprietary Chinese medicine-TCM decoction-TCM external treatment-physical exercise; Group Ⅱ: NSAIDs-colchicine hormones; Group Ⅲ: allopurinol, Group Ⅳ: benzbromarone; Group Ⅴ: febuxostat. A total of 59 adverse events occurred during treatment.Conclusion:The proportions of gout patients who reach target serum urate level & good control of joint symptoms are both very low, and ULT and anti-inflammatory prescription patterns are very different from international guidelines, so it is necessary to strengthen the standardized management of gout patients. At the same time, life intervention measures account for a certain proportion of the treatment plans for the T2T population, and further exploration is needed.

Objective:To establish an evaluation index system of home care quality for caregivers of children aged ≤3 years with burns.Methods:The combined approach of qualitative and quantitative research was used, and the fundamental principles of constructing an index system was followed. From January to February 2022, through literature analysis, conducting a semi-structured interview on 6 female nurses aged 31 to 51 years who worked for more than 10 years in the Department of Burns, Plastic Surgery, and Aesthetic Medicine of General Hospital of Ningxia Medical University, as well as 15 caregivers (11 females and 4 males) of hospitalized children with burns aged 28 to 54 years who received professional training from nursing staff, a preliminary evaluation index system of home care quality for caregivers of children ≤3 years old with burns was established using Maslow's hierarchy of needs as theoretical guidance. From March to June 2022, the Delphi method was applied to conduct inquiry by correspondence with 15 experts in relevant fields who met the inclusion criteria and were employed in general hospitals, specialized hospitals, and universities in the Ningxia Hui Autonomous Region (with their general information being recorded), and the evaluation index system was established and the weights of indicators at all levels were determined by the analytic hierarchy process. The effective recovery ratio of the inquiry form was calculated to determine the level of enthusiasm of experts, the average authority coefficient of all indicators was calculated to determine the level of expert authority, the average importance assignment and full score ratio of all indicators were calculated to determine the concentration of expert opinions, and the average Kendall's harmony coefficients and mean coefficient of variation for all indicators were calculated to determine the degree of coordination of expert opinions. The Kendall's harmony coefficients for the first level indicators, the total second level indicators, and the total third level indicators in each round of correspondence inquiry were statistically analyzed with chi-square test.Results:The preliminary evaluation index system of home care quality for caregivers of children ≤3 years old with burns included 5 first level indicators, 13 second level indicators, and 55 third level indicators. The majority of the 15 experts were women, aged 32-56 years, all with a bachelor's degree or above education background, intermediate or above professional titles, and worked for 14-31 years. The effective recovery ratios of the first and second rounds of inquiry forms were 1 (15/15) and 0.93 (14/15), respectively. The average authority coefficients of all indicators in the first and second rounds of correspondence inquiries were 0.87 and 0.90, respectively. The average importance assignment and average full score ratio of all indicators were 4.25 and 0.68 respectively in the first round of inquiry, and 4.39 and 0.70 respectively in the second round of inquiry. In the first and second rounds of inquiries, the average Kendall's harmony coefficients for all indicators were 0.50 and 0.62, respectively, and the average coefficients of variation for all indicators were 0.15 and 0.14, respectively. The Kendall's harmony coefficients of the five first level indicators (physiological needs, safety needs, needs for love and belonging, needs for respect, and needs for self-realization), the total second level indicators, and the total third level indicators in the first and second rounds of correspondence inquiries were statistically significant (with χ2 values of 22.18, 20.36, 23.42, 25.81, 21.44, 124.73, 524.05 and 24.27, 19.85, 22.39, 27.52, 20.83, 102.38, 503.27, respectively, P<0.05). The final evaluation index system of home care quality for caregivers of children ≤3 years old with burns included 5 first level indicators, 13 second level indicators, and 56 third level indicators. The weights of the first level indicators for physiological needs, safety needs, needs for love and belonging, needs for respect, and needs for self-realization were 0.343, 0.371, 0.091, 0.076, and 0.127, respectively. The weights of the second level indicators were 0.024 to 0.192, and the weights of the third level indicators were 0.001 to 0.089. Conclusions:The evaluation index system of home care quality for caregivers of children ≤3 years old with burns established on the basis of Maslow's hierarchy of needs theory is scientific and reliable, and can serve as a reference for home care of children with burns in this age group.

Objective: To evaluate the therapeutic efficacy of acupuncture plus Dang Gui Bu Xue Qu Feng Tang for benign essential blepharospasm (BEB). Methods: A prospective randomized controlled trial was performed. A total of 105 participants were randomized 1:1:1 into an acupuncture group, a herbal medicine group and an acupuncture plus herbal medicine group. Participants in the acupuncture group received manual acupuncture treatment, twice a week. Participants in the herbal medicine group received Dang Gui Bu Xue Qu Feng Tang, oral administration, once a day. Participants in the acupuncture plus herbal medicine group received both treatments. The therapeutic effects of the three groups were evaluated after four weeks of treatment. The primary outcome was the Jankovic rating scale (JRS) score, and the secondary outcome was the blepharospasm disability index (BSDI) score. Results: After four weeks of treatment, the JRS total scores significantly decreased in all three groups versus baseline (P<0.05). A greater reduction in the JRS total score was reported in participants in the acupuncture plus herbal medicine group (P<0.05), but there was no significant difference between the acupuncture group and the herbal medicine group (P>0.05). The acupuncture plus herbal medicine group had a greater decrease in the JRS severity score than the herbal medicine group (P<0.05). The reduction in the JRS frequency score was not significantly different among the three groups (P>0.05). The BSDI scores significantly decreased in all three groups versus baseline (P<0.05), but the reduction in the BSDI score was insignificantly different among the three groups (P>0.05). Conclusion: It is effective in the treatment of BEB either to use acupuncture and Dang Gui Bu Xue Qu Feng Tang alone or in combination. The combination therapy shows a more significant effect than either of the treatment alone.