Objective To explore the application effect of the multidisciplinary team collaboration model in vascular access management for patients with maintenance hemodialysis.Methods A total of 102 patients with maintenance hemodialysis in the hospital from October 2023 to October 2024 were selected as the research subjects,and they were randomly divided into observation group and control group by the random number table method,with 51 cases in each group.The observation group re-ceived routine nursing combined with the multidisciplinary team collaboration model,while the control group received routine nursing.The multidisciplinary team collaboration model involved professionals from multiple disciplines,including nephrologists,vascular surgeons,interventional radiologists,B-ultrasound doctors,clinical pharmacists,nutritionists,psychological counselors,the head nurse of the blood purification center,and blood purification specialist nurses.The intervention duration was 6 months.The related indicators of dialysis adequacy[urea reduction ratio(URR),equilibrium urea clearance rate(eKt/V)],psychological burden[the Self-rating Anxiety Scale(SAS)and the Self-rating Depression Scale(SDS)],vascular access satisfaction degree[the Simple Version of Vascular Access Questionnaire(VAQ)],quality of life[the Kidney Disease-Targeted Areas Scale(KDTA)and the 36-item Short-form Health Survey(SF-36)],and complications were compared between the two groups before and after the intervention.Results After the intervention,the levels of URR and eKt/V and the score of each dimension of quality of life in the observation group were signifi-cantly higher than those in the control group,while the SAS and SDS scores were significantly lower than those in the control group(P＜0.05).After the intervention,the satisfaction rate of vascular access in the observation group was 96.08％(49/51),which was significantly higher than 80.39％(41/51)in the control group(x2=6.044,P=0.014).The total complication rate in the observa-tion group was 1.96％(1/51),which was significantly lower than 13.73％(7/51)in the control group(P＜0.05).Conclusion The adoption of the multidisciplinary team collaboration model for patients with maintenance hemodialysis is beneficial for improving the adequacy of hemodialysis,re-ducing psychological burden,enhancing vascular access satisfaction and quality of life,and preven-ting complications.

Abstract In order to enhance the visual working memory abilities of children with autism spectrum disorders (ASD) and to promote future exploration and practice in related fields, the study systematically sorts out and summarizes the relevant research at home and abroad, and points out that the performance of children with ASD in various visual working memory tasks is generally lower than that of normal children, especially in the function of refreshing, transforming and suppressing visual information, which reflect that children with ASD have difficulties in processing visual information. Neuroimaging and electrophysiological studies further reveal the abnormal activation of ASD children in related brain regions, especially the dysfunction in key areas such as prefrontal cortex and contralateral delayed activity. In addition, the abnormal oscillation of α, θ and β bands also shows that children with ASD are deficient in visual attention control and information processing, which affects the overall performance of their visual working memory.

Objective: To investigate the effect and mechanism of α-lipoic acid(ALA) on the formation of hypertrophic scar(HTS) in rabbit ears. Methods: Eighteen New Zealand white rabbits were randomly divided into normal group, model group and 4%ALA group. After 28 days of treatment, the changes of scar related indexes were evaluated by hematoxylin-eosin(HE) staining, Masson pine(Masson) staining and immunohistochemical staining, the changes of oxidative stress related indexes were evaluated, and the expression of antioxidant pathway related proteins was detected by Western blotting. Results: The color, texture and volume of scar in 4%ALA group were lighter and softer than those in model group. The results of HE, Masson staining and immunohistochemical staining showed that the number of fibrous cells and the degree of fibrosis in the 4%ALA group were less than those in the model group. In the 4%ALA group, the content of malondialdehyde(MDA) was lower than that of the model group(P<0.001), the content of hydroxyproline(Hyp) was lower than that of the model group(P<0.01), the level of glutathione(GSH) was higher than that of the model group(P<0.01), the activity of T-SOD was higher than that of the model group(P<0.001). Western blotting showed that the content of NRF2 and the expression level of downstream antioxidant proteins in the 4%ALA group were higher than those in the model group. Conclusion ALA up-regulates NRF2 signal pathway to reduce the level of oxidative stress in HTS and inhibit scar proliferation in rabbit ears.