Paraplegia caused by spinal cord injury is a serious neurological complication, for which surgery is currently the main treatment method. Due to different surgical approaches, patients are usually expected to maintain a passive prone position for a long time or switch between the supine and prone positions. Affected by multiple factors such as neurogenic sensory disorders, pathological changes in muscle tone and operative duration, the risk of intraoperative acquired pressure injury (IAPI) is significantly increased. Current clinical prevention strategies for IAPI in these patients predominantly focus on localized pressure relief during positioning, lacking systematic, standardized comprehensive prevention protocols or evidence-based guidelines. To address it, Department of Nursing, Orthopedics Branch, China International Exchange and Promotive Association for Medical and Health Care, Spinal Trauma Professional Committee, Orthopedics Branch, Chinese Medical Doctor Association, Nursing Group of Spine and Spinal Cord Professional Committee of Chinese Association of Rehabilitation Medicine organized experts in relevant fields to formulate Guideline for the prevention of intraoperative acquired pressure injury in paraplegic patients with spinal cord injury ( version 2025), based on evidence-based medical evidence and latest research results and clinical practice at home and abroad. Eleven recommendations were put forward from the aspects of preoperative risk assessment, intraoperative prevention strategies, postoperative handover and monitoring, and supportive mechanisms for IAPI prevention, aiming to standardize the prevention measures and management strategies of IAPI in paraplegic patients with spinal cord injury and accelerate the recovery of patients and improve the therapeutic effect.

Paraplegia caused by spinal cord injury is a serious neurological complication, for which surgery is currently the main treatment method. Due to different surgical approaches, patients are usually expected to maintain a passive prone position for a long time or switch between the supine and prone positions. Affected by multiple factors such as neurogenic sensory disorders, pathological changes in muscle tone and operative duration, the risk of intraoperative acquired pressure injury (IAPI) is significantly increased. Current clinical prevention strategies for IAPI in these patients predominantly focus on localized pressure relief during positioning, lacking systematic, standardized comprehensive prevention protocols or evidence-based guidelines. To address it, Department of Nursing, Orthopedics Branch, China International Exchange and Promotive Association for Medical and Health Care, Spinal Trauma Professional Committee, Orthopedics Branch, Chinese Medical Doctor Association, Nursing Group of Spine and Spinal Cord Professional Committee of Chinese Association of Rehabilitation Medicine organized experts in relevant fields to formulate Guideline for the prevention of intraoperative acquired pressure injury in paraplegic patients with spinal cord injury ( version 2025), based on evidence-based medical evidence and latest research results and clinical practice at home and abroad. Eleven recommendations were put forward from the aspects of preoperative risk assessment, intraoperative prevention strategies, postoperative handover and monitoring, and supportive mechanisms for IAPI prevention, aiming to standardize the prevention measures and management strategies of IAPI in paraplegic patients with spinal cord injury and accelerate the recovery of patients and improve the therapeutic effect.

Objective:To study the effects of diphenhydramine and caffeine compound on motion sickness.Methods:Sixty Sprague Dawley (SD) rats were randomly divided into six groups with ten rats in each group, namely, blank control group, model control group, diphenhydramine group (2.25 mg/kg), compound (diphenhydramine and caffeine) low-dose group [(1.13+ 2.70) mg/kg], compound medium-dose group [(2.25+ 5.40) mg/kg], and compound high-dose group [(4.50+ 10.80) mg/kg]. The mental states of rats were observed. The motion sickness (MS) scores and saccharin water intake were evaluated. Thirty Beagle dogs were randomly divided into five groups with six dogs in each group, namely, model control group, diphenhydramine group (0.67 mg/kg), compound (diphenhydramine and caffeine) low-dose group [(0.33+ 0.80) mg/kg], compound medium-dose group [(0.67+ 1.60) mg/kg], and compound high-dose group [(1.34+ 3.20) mg/kg]. The latent periods of salivation and vomiting after rotational stimulation were observed and recorded.Results:The rats in the compound medium-dose group and the compound high-dose group did not manifest somnolence while the rats in other groups receiving diphenhydramine did. After rotational stimulation, the MS scores of the rats in the model group were higher than those of the rats in the compound groups, and the MS scores in the compound groups showed a dose-dependent decreasing trend. Before rotational stimulation, there were no significant difference in the saccharin water intake among the rats of all the groups. After rotational stimulation, the saccharin water intake in the model group was more significantly reduced than that of the blank control group ( P<0.01). Compared with the model group, the saccharin water intakes in diphenhydramine group and compound groups were significantly increased ( P<0.05), and the increase were dose-dependent. Before drug administration, all the Beagle dogs were susceptible to rotational stimulation with early salivation and vomiting. After drug administration, the latent periods of salivation and vomiting were all considerably extended ( P<0.05), and the extension of the latent periods in the compound groups was dose-dependent. Conclusion:The diphenhydramine and caffeine compound has protective effects against motion sickness, and the adverse reactions of inhibition in central nervous system are mild.

Objective:To study the effects of diphenhydramine and caffeine compound on motion sickness.Methods:Sixty Sprague Dawley (SD) rats were randomly divided into six groups with ten rats in each group, namely, blank control group, model control group, diphenhydramine group (2.25 mg/kg), compound (diphenhydramine and caffeine) low-dose group [(1.13+ 2.70) mg/kg], compound medium-dose group [(2.25+ 5.40) mg/kg], and compound high-dose group [(4.50+ 10.80) mg/kg]. The mental states of rats were observed. The motion sickness (MS) scores and saccharin water intake were evaluated. Thirty Beagle dogs were randomly divided into five groups with six dogs in each group, namely, model control group, diphenhydramine group (0.67 mg/kg), compound (diphenhydramine and caffeine) low-dose group [(0.33+ 0.80) mg/kg], compound medium-dose group [(0.67+ 1.60) mg/kg], and compound high-dose group [(1.34+ 3.20) mg/kg]. The latent periods of salivation and vomiting after rotational stimulation were observed and recorded.Results:The rats in the compound medium-dose group and the compound high-dose group did not manifest somnolence while the rats in other groups receiving diphenhydramine did. After rotational stimulation, the MS scores of the rats in the model group were higher than those of the rats in the compound groups, and the MS scores in the compound groups showed a dose-dependent decreasing trend. Before rotational stimulation, there were no significant difference in the saccharin water intake among the rats of all the groups. After rotational stimulation, the saccharin water intake in the model group was more significantly reduced than that of the blank control group ( P<0.01). Compared with the model group, the saccharin water intakes in diphenhydramine group and compound groups were significantly increased ( P<0.05), and the increase were dose-dependent. Before drug administration, all the Beagle dogs were susceptible to rotational stimulation with early salivation and vomiting. After drug administration, the latent periods of salivation and vomiting were all considerably extended ( P<0.05), and the extension of the latent periods in the compound groups was dose-dependent. Conclusion:The diphenhydramine and caffeine compound has protective effects against motion sickness, and the adverse reactions of inhibition in central nervous system are mild.

The corona virus disease 2019 (COVID-19) has recently become pandemic and is still spreading. Many severe or critical COVID-19 cases meet the diagnostic criteria of sepsis and septic shock in the clinical manifestations. It is important to study the pathogenesis and treatment strategy of COVID-19 for the disease prevention and control. This article reviews the clinical features and treatment progress of COVID-19 viral sepsis.