Objective To evaluate clinical application effects of evidence-based practice for proper limb positioning management in stroke patients with hemiplegia.Methods An evidence-based practice was conducted following the"evidence-based continuous quality improvement model"research framework,which included four stages:evidence acquisition,current situation review,evidence intro-duction,and effect evaluation.Convenience sampling was used to select 39 nurses and 86 stroke pa-tients with hemiplegia from the First Affiliated Hospital of Xi'an Jiaotong University as research sub-jects.Among them,43 patients from July to August 2023 did not undergo evidence-based practice,and 43 patients from December 2023 to January 2024 received evidence-based practice.The imple-mentation rates of review indicators,nurses'knowledge,attitude,and practice(KAP)scores for prop-er limb positioning management,and patients'activities of daily living index,motor function,and proper limb positioning qualification rates were compared before and after evidence-based practice.Results A total of 24 pieces of best evidence were finally included in this study,and 28 quality re-view indicators were formulated.After evidence-based practice,nurses'KAP scores for proper limb positioning management increased from(119.95±17.61)to(148.87±8.46).The patients Barthel index score significantly improved from(71.51±9.36)before evidence-based practice to(81.28±7.87)after evidence-based practice(P＜0.05).The patients'motor function scores were(77.21±7.79)before evidence-based practice and(84.14±6.11)after evidence-based practice,with a statistically significant difference(P＜0.05).The proper limb positioning qualification rate was 95.35％(41/43)after evidence-based practice,which was higher than 81.39％(35/43)before evidence-based practice,with a statistically significant difference(P＜0.05).Conclusion Evi-dence-based practice for proper limb positioning management in stroke patients with hemiplegia based on evidence-based evidence can effectively improve nurses'implementation rates of review in-dicators,enhance their KAP levels for proper limb positioning management,and improve patients'clinical outcomes.

In order to understand the prevalence of Akabane disease(AKAD)in Guizhou Province and the molecular characteristics of the isolates,the whole-genome sequence of a strain of Akabane virus(AKAV)from a bovine AKAD-positive sample was determined and analyzed.The genotype and genetic variation of the strain were also explored.Based on the conserved S sequence,a fluores-cence quantitative PCR(qPCR)detection method was established and applied for the investigation of AKAV infection status in four large-scale beef cattle farms of Guizhou.Results showed that the S,M and L fragments of the bovine strain were highly homologous to the Tianjin strain(TJ2016/China/2016)and the Australian strain(JaLAB39/Australia/1959),where they were in the same evolutionary branch and belonged to genotype Ⅱ.Sensitivity assay found that the lowest detection limit was 2.5 X 101 copies/μL.Specificity assay showed the established method detected only AKAV with no amplification on bovine bluetongue virus(BLUV),Pasteurella multocida(PM),bovine infectious rhinotracheitis virus(IBRV)and bovine Mycoplasma bovis.The variation coefficients of inter-and intra batches in the repeatability test were both lower than 2.26％.These findings illus-trated that the established qPCR method had high sensitivity,good specificity and repeatability.A total of 298 serum samples from 4 large-scale beef cattle farms in Qianxi City and Huangping County of Guizhou Province were collected and tested for AKAV by the method.Out of 298 sam-ples,25 positive samples(25/298)were detected as positive with a positive rate of 8.39％.In sum-mary,this work provided the reference data for a deep understanding of the molecular prevalence of AKAV in Guizhou Province and laid foundation for the prevention and control of AKAD.

Antibody-drug conjugates(ADCs)are a new type of targeting antibodies that conjugate with highly toxic anticancer drugs via chemical linkers to exert high specificity and efficient killing of tumor cells,thereby attracting considerable attention in precise oncology therapy.Cetuximab(Cet)is a typical antibody that offers the benefits of good targeting and safety for individuals with advanced and inoperable cutaneous squamous cell carcinoma(cSCC);however,its anti-tumor activity is limited to a single use.Cisplatin(CisPt)shows good curative effects;however,its adverse effects and non-tumor-targeting ability are major drawbacks.In this study,we designed and developed a new ADC based on a new cytotoxic platinum(Ⅳ)prodrug(C8Pt(Ⅳ))and Cet.The so-called antibody-platinum(Ⅳ)prodrugs conjugates,named Cet-C8Pt(Ⅳ),showed excellent tumor targeting in cSCC.Specifically,it accurately delivered C8Pt(Ⅳ)into tumor cells to exert the combined anti-tumor effect of Cet and CisPt.Herein,metabolomic analysis showed that Cet-C8Pt(Ⅳ)promoted cellular apoptosis and increased DNA damage in cSCC cells by affecting the vitamin B6 metabolic pathway in tumor cells,thereby further enhancing the tumor-killing ability and providing a new strategy for clinical cancer treatment using antibody-platinum(Ⅳ)prodrugs conjugates.

OBJECTIVE: Hypertrophic scars (HS) are a variety of skin tissue fibrosis disease that occurs in human skin, the effective therapeutic method of which is still inaccessible up to now. As a bioactive constituent of a well-known medical plant, Salvia miltiorrhiza (Danshen in Chinese), tanshinone II_A (TSA) is reported to inhibit cell proliferation in HS. Therefore, the aim of this study was to prepare TSA self-soluble microneedles to strengthen its dermal retention and break through the difficulty of significantly thickening epidermal connective tissue and stratum corneum at the HS site. The possible mechanism of action in suppressing HS was studied using human skin fibroblasts (HSF). METHODS: Tanshinone II_A self-dissolving microneedles (TSA-MN) was prepared using a negative mold casting method. The prescription process of microneedle was optimized by Box-Behnken effect surface method. Different media were selected to investigate the ability of transdermal absorption and in vitro release. Furthermore, according to Cell Counting Kit-8 (CCK8) method as well as the Western blot method, the effect of TSA-MN on the biological characteristics of HSF was investigated. RESULTS: With remarkable slow release effect and dermal retention, the release and transdermal properties of TSA-MN in vitro were better than both TSA and ordinary dosage forms. Its effect of HSF confirmed the essential decrease in cell motility during cell proliferation and cell migration in vitro, which plays a significant role in down-regulating the secretion of transforming growth factor-β₁ (TGF-β₁) in HSF and increasing the expression level of Smad7. CONCLUSION The prepared TSA self-soluble microneedles is helpful in solving the problem of hypertrophic scars, with a stable dermal retention effect after process optimization.

Objective:To explore the association between hair trace element and all-cause death in the elderly in Hainan Province.Methods:The subjects of the study were elderly people from China Hainan Centenarian Cohort Study, a total of 163 elderly were included. The association between hair trace element level and all-cause death was analyzed by using Cox proportional risk regression model.Results:After fully adjusting the covariates, the multiple Cox proportional hazards regression analyses showed that selenium (Se), manganese (Mn), strontium (Sr) concentrations in hair were significantly associated with all-cause mortality, the hazard ratio ( HR) were 0.72 (95% CI: 0.54-0.98, P=0.035), 1.50 (95% CI: 1.07-2.11, P=0.020) and 0.54 (95% CI: 0.37-0.79, P=0.001), respectively. Subgroup and cross analysis showed that hair copper (Cu) were significant association with death in the people with anemia, the HR were 1.81 (95% CI: 1.13-2.88, P=0.013). And, hair Mn interacted with anemia, the HR was 0.46 (95% CI: 0.22-0.94, P=0.033). Conclusions:Se, Mn and Sr concentrations in hair were associated with the elevated risk for all-cause death in the elderly in Hainan. Se, Mn and Sr concentrations in hair can be used as a reference index for the prediction of the death risk of long-lived elderly in community, suggesting that the daily diet of elderly people are rich and diverse, in order to maintain normal and balanced trace element content in the body.

We conducted a randomized, open-label, parallel-controlled, multicenter trial on the use of Shuanghuanglian (SHL), a traditional Chinese patent medicine, in treating cases of COVID-19. A total of 176 patients received SHL by three doses (56 in low dose, 61 in middle dose, and 59 in high dose) in addition to standard care. The control group was composed of 59 patients who received standard therapy alone. Treatment with SHL was not associated with a difference from standard care in the time to disease recovery. Patients with 14-day SHL treatment had significantly higher rate in negative conversion of SARS-CoV-2 in nucleic acid swab tests than the patients from the control group (93.4% vs. 73.9%, P = 0.006). Analysis of chest computed tomography images showed that treatment with high-dose SHL significantly promoted absorption of inflammatory focus of pneumonia, which was evaluated by density reduction of inflammatory focus from baseline, at day 7 (mean difference (95% CI), -46.39 (-86.83 to -5.94) HU; P = 0.025) and day 14 (mean difference (95% CI), -74.21 (-133.35 to -15.08) HU; P = 0.014). No serious adverse events occurred in the SHL groups. This study illustrated that SHL in combination with standard care was safe and partially effective for the treatment of COVID-19.
COVID-19 ; Humans ; Medicine, Chinese Traditional ; Research ; SARS-CoV-2 ; Treatment Outcome

Objective:To observe the clinical effects of hot-wet compression with Xiaohua ointment for acne mastitis in mass stage and its impacts on humoral immune function and inflammation.Methods:85 cases of patients with acne mastitis in mass stage treated in our hospital from January 2018 to January 2019 were selected as the research objects and randomly divided into control group (42 cases) and observation group (43 cases). The control group taken Tuoli xiaodu powder and external use of purple detumescence cream, and the observation group received hot-wet compression with Xiaohua ointment additionally. All treated for 30 days. The clinical efficacy, symptom scores, breast mass size, humoral immune indexes, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were compared, and the adverse reactions were recorded.Results:After treatment, the humoral immune indexes of the two groups had no significant change ( P>0.05), but the pain score, breast tumor size, mass score, CRP and ESR were significantly decreased than those before treatment ( P<0.05); compared with the control group, the pain score, breast tumor size and mass score in the observation group were significantly lower than those in the control group ( P<0.05). The total effective rate of the observation group was 83.7%, which was significantly higher than 59.5% of the control group ( P<0.05). There were no obvious adverse reactions in both groups. Conclusions:Hot-wet compression with Xiaohua ointment is effective and safe for patients with acne mastitis in mass stage, and could improve their inflammation.

Objective: To identify confounding factors associated with dental caries prevention, as the basis for the development of subsequent health management plan for dental caries prevention in young children. Methods: From June to September 2019, a questionnaire survey was conducted among parents of young children enrolled in five kindergartens in the district of Shanggang Steel Community, Pudong New District, Shanghai, using the convenience sampling method. The survey included basic demographic characteristics on parents and children, as well as information factor, motivation factor, behavioral skills, and caries prevention behavior. Results: Among 718 parents surveyed, the median information factor score was 8 (7, 9), the median personal motivation factor score was 20 (19, 20), the median social motivation factor score was 9 (8, 10), the median behavioral skills score was 25 (24, 25), and the median caries prevention behavior score was 7 (5, 8). Motivation factor was positively associated with behavioral skills, both information factor and behavioral skills were positively associated with dental caries prevention (P<0.05). Personal motivation factor had a direct influence factor of 0.80 on behavioral skills and an indirect influence factor of 0.15 on dental caries prevention behavior; behavioral skills and information factor had a direct influence factor of 0.19 and 0.26 respectively on dental caries prevention. Conclusion The finding suggest that in addition to oral hygiene information and education for parents of young children, mental support should be a key component of any community-based dental caries prevention program.

Objective:To explore the morphology and vessel distribution of the scapholunate interosseous ligament and anatomical basis for the clinical reconstruction of scapholunate interosseous ligament.Methods:From October, 2018 to December, 2018, 12 fresh wrist joint specimens were perfused with gelatin-lead oxide solution from ulnar or radial artery and scanned under micro-CT. The morphology of scapholunate interosseous ligament in neutral position and the distribution of nutrient vessels in the ligament were observed on reconstructed 3D images by Mimics. The width, length and thickness of palmar, dorsal and proximal ligaments were measured. The anatomical parameters at the entrance of nutrient vessels in the scapholunate interosseous ligament were taken and their relationship with the blood supply to the scapholunate was analyzed.Results:①For scapholunate interosseous ligament, it was found that the average length of the proximal sub-region was the longest, the length of palmar and dorsal sides was similar to each other and the widest and thinnest was in palmar side, while the thickness and width of dorsal and proximal were similar. ②There was no nutrient vessel in the proximal part of the scapholunate interosseous ligament. But there were abundant nutrient vessels in the palmar and dorsal scapholunate interosseous ligament, and there was no significant difference in blood supply to palmar and dorsal scapholunate interosseous ligament ( P>0.05). ③The palmar and dorsal medial nutrient vessels that supply to the scapholunate interosseous ligament enter the scapholunate from the attachment of ligament of scapholunate interosseous joint. Conclusion:The palmar side of the scapholunate interosseous ligament is wider and thinner than that of the other subareas, which makes it more vulnerable to injury from an anatomical point of view. There is abundant blood supply to the palmar and dorsal subareas of the scapholunate interosseous ligament and the supplying vessels anastomose inside the scapholunate bone. There is no distribution of blood vessel at the proximal part of scapholunate interosseous ligament, hence is difficult to heal. An injury of palmar and dorsal ligaments may affect the blood supply of scapholunate.

Objective To explore the efficiency of the ABC-HOME in the rapid identification and assessment of potential donors.Methods We developed a submit system and a rapid assessment method of ABC-HOME for potential donors at 2013.They were on trial in service area hospitals of Guangzou General Hospital Organ Procurement Organization (GHOPO) from February,2015.We reviewed medical records of potential donors occurring in the intensive unit at 2014,from February to December 2015 and 2016,respectively.We examined data on the number of potential donors,actual donors and beds of ICU,and calculated the number of potential donors and actual donors per bed per year.The reasons for donation failure were analyzed.Results 19,38 and 50 organ donations were realized in 243,474 and 513 potential donors in 2014,from February 2015 to December 2015 and 2016,respectively.The growth rate of organ donation and the number of actual donors per bed per year was 95.0%,8.2% and 0.45,0.89 and 0.96,respectively.The conversion rate in these potential donors was 8.92% from February 2015 to December 2016.The reasons for donation failure included the family and social factors,doctor-patient relationship and communication factor and illness condition of donors' factors.Conclusion ABC-HOME is a convenient assessment method for potential donors,which can help to promote the identification of potential donors and to increase the number of potential donor information.