Objective:To investigate the cffect of Orem's self-care theory on mental health and cognitive function in patients with chronic heart failure(CHF).Methods:We retrospectively collected clinical data of 97 CHF patients treated in the First Affiliated Hospital of Xinjiang Medical University between February 2019 and August 2022.According to intervention way,they were divided into control group(n=45,routine intervention)and intervention group(n=52,Orem's self-care theory model intervention).Both groups were intervened for 6 months.Scores of Hamil-ton Anxiety scale(HAMA),Hamilton Depression scale(HAMD),Mini-Mental State Examination(MMSE),left ven-tricular ejection fraction(LVEF),resting heart rate(HR),scores of the Medical Outcomes Study 36-Item Short-Form Health Survey(SF-36)and Barthel index were compared between two groups.Kaplan-Meier survival curve was used to compare incidence of unfavorable outcome between two groups.Results:After 6-month intervention,compared with pa-tients in control group,those in intervention group had significant lower scores of HAMA[(12.50±4.89)points vs.(19.09±5.80)points],HAMD[(12.31±4.28)points vs.(19.56±5.79)points]and HR[(87.33±7.42)beats/min vs.(100.11±7.89)beats/min],and significant higher LVEF[(50.25±5.24)％vs.(42.11±4.51)％],scores of MMSE[(21.90±3.37)points vs.(18.27±3.50)points],SF-36[(63.65±10.43)points vs.(51.71±6.83)points]and Barthel index[(60.67±8.43)points vs.(45.00±9.56)points](P＜0.001 all).Kaplan-Meier survival analysis indicated that incidence of unfavorable outcome in intervention group was significantly lower than that of control group(5.77％vs.24.44％,P=0.035).Conclusion:Orem's self-care theory intervention could significantly improve negative emotions and cognitive ability,restore patients'cardiac function,improve the quality of life and self-care capacity,and re-duce risk of unfavorable outcome in CHF patients.

Objective To develop a single-person breast surgery teaching system to improve the teaching efficiency of breast surgery.Methods The single-person breast surgery teaching system consisted of a magnetic suspension and retraction device and a breast model.The magnetic suspension and retraction device was composed of a magnetic suspension component and a magnetic retraction component,of which,the magnetic suspension component included a bracket,an outer magnet and an inner magnet and the magnetic retraction component comprised a magnetic base and an elastic grasping forceps.The breast model was established with porcine abdominal tissue obtained from slaughterhouses.Twelve surgical trainees were randomized into an experimental group(n=6)and a control group(n=6),and the 2 groups performed flap release operations on the breast model with skin-preserving mastectomy as the target procedure.The operation was carried out with the developed system in the experimental group and with the traditional procedure in the control group.Results The two groups had the flap-free operation on the breast model finished successufully,which had no significant differences in the length of incision(P>0.05);the experimental group gained advantages over the control group in the number of assistants required,operation time,times of skin flap injuries,times of glandular injuries and effect of exposure,with the differences being statistically significant(all P<0.05).Conclusion The single-person breast surgery teaching system enhances the effect of exposure efficiently,meets the reequirements for single-person training and improves the teaching efficiency.[Chinese Medical Equipment Journal,2025,46(7):34-38]

Objective To explore the characteristics and influencing factors of complicated intra-abdominal infection in ICU patients after abdominal surgery.Methods A retrospective study was performed on ICU patients(n=92,observation group)developing complicated intra-abdominal infection after abdominal surgery versus patients(n=104,control group)without complicated intra-abdominal infection after abdominal surgery in our hospital from January 2020 to December 2023.The characteristics of patients who developed complicated intra-abdominal infections were analyzed and the relevant influencing factors were identified using multivariate Logistic regression analysis.Results A total of 124 strains of pathogenic bacteria were isolated and identified in 92 infected patients,with 64.52％(80/124)of Gram-negative strains comprising mainly 29.03％(36/124)of Escherichia coli,25.81％(32/124)of Gram-positive strains comprising mainly 12.90％(16/124)of Enterococcus faecalis,and 9.68％(12/124)of fungi comprising mainly 6.45％(8/124)of Candida albicans.Multivariate Logistic regression results showed that preoperative underlying disease,surgical methods,duration of surgery,invasive procedures,antibiotic use,and length of ICU stay,enteral nutrition were the influencing factors of complicated intra-abdominal infection in ICU patients after abdominal surgery(P＜0.0 5).Conclusion Patients with complicated intra-abdominal infection are infected with a variety of pathogenic bacteria,predominantly Gram-negative.The patient's preoperative underlying disease,surgical approach,duration of surgery,invasive procedures,use of antibiotics,length of ICU stay,and early enteral nutrition all affect the risk of complicated intra-abdominal infection in ICU patients after abdominal surgery.

Objective:To compare the effect of high frequency oscillatory ventilation (HFOV) and conventional mechanical ventilation (CMV) in the treatment of pediatric acute respiratory distress syndrome (ARDS).Methods:A prospective randomized controlled study was conducted on ARDS children treated with mechanical ventilation in the Intensive Care Unit (ICU) of Children′s Hospital, Capital Institute of Pediatric from January 2017 to December 2018.They were randomly (computer digital method) divided into HFOV group and CMV group.The basic data and clinical indicators, such as pediatric critical illness scores, oxygenation index (OI), blood gas, mechanical ventilation time, ventilator parameters, ICU hospitalization time, complications, prognosis, dynamic changes of inflammatory factors, use of sedative muscle relaxants and vasoactive drugs, were recorded.SPSS 22.0 software was used to analyze the data.The Mann Whitney U test was used for inter-group comparison.The χ2 test was adopted for the comparison of counting data. Results:A total of 45 children were included in the analysis.There were 21 cases in the HFOV group and 24 cases in the CMV group.Moderate and severe ARDS was detected in 34 cases, including 16 cases in the HFOV group and 18 cases in the CMV group.Compared with those in the CMV group, the levels of OI-24 h and OI-48 h in the HFOV group were significantly lower [7.4 (5.9, 8.6) vs.9.0 (6.7, 13.6), P=0.018] and [5.9 (5.2, 8.5) vs.9.2 (7.4, 12.4), P=0.001].The levels of OI-6 h [8.2(6.5, 10.0) vs.10.5(8.2, 13.0), P=0.037], OI-12 h[7.8(6.5, 9.0) vs.9.8(8.0, 12.8), P=0.009], OI-24 h [7.7(6.4, 8.6) vs.10.1(8.7, 15.5), P<0.001], OI-48 h [6.0(5.3, 8.6) vs.10.7(8.8, 13.1), P<0.001] and OI-72 h [5.8(5.0, 8.6) vs. 8.0(6.6, 10.6), P=0.031] in children with moderate to severe ARDS of the HFOV group were significantly lower than those of the CMV group.There were no significant differences in ICU hospitalization time, invasive mechanical ventilation time, total mechanical ventilation time, 28-day prognosis, vasoactive drugs, muscle relaxants, blood purification, fluid balance, inflammatory factors, intracranial hemorrhage and pneumothorax between the 2 groups. Conclusions:This study confirms that HFOV can improve the oxygenation level in pediatric patients with ARDS more rapidly than CMV.HFOV does not increase the incidence of complications such as pneumothorax and intracranial hemorrhage, and the use of vasoactive drugs and muscle relaxants, showing safety in clinical application.

Objective:To explore the experience of emotion management and program needs of patients with vasovagal syncope (VVS) from the doctor-nurse-patient perspective.Methods:This study was a phenomenological study in qualitative research. Using purposive sampling method, four medical specialists, four nursing specialists, and 10 patients with VVS from the Syncope Center of Shanghai East Hospital, Tongji University were selected from March to May 2024 for semi-structured interviews. Colaizzi's phenomenological data analysis was used to analyze the data.Results:Theme 1 was the initial perception and experience of emotion management, in which the doctor-nurse perspective included two sub-themes of emotion management met the actual needs of clinical patients and the management program was too specialized and unknown, and the patient perspective included three sub-themes of differences in the ability of individuals to recognize their own emotional state, lack of knowledge related to emotion management, and lack of social support. Theme 2 was the need for emotion management programs, in which the doctor-nurse perspective involved two sub-themes of multidisciplinary cooperation, suitable for clinical operation and follow-up, and the combination of online and offline, and in-hospital and out-of-hospital linkage, and the patient perspective involved two sub-themes of the need for healthcare guidance, easy to operate, and the diversification of forms, personalization, and meeting the needs of different populations.Conclusions:The content of emotion management is relatively unknown to doctors, nurses and patients, and even more so to patients. VVS emotion management work is still in its infancy, and emotion management as a branch of rehabilitation needs to be emphasized for its development, and psychological assessment and intervention work should be incorporated into the routine of syncope rehabilitation.

Objective:To identify the nucleotide sequence of a novel HLA-DRB1*12: 106 allele. Methods:A blood donor who was joined into the database for platelet matching transfusion at the Blood Center of Zhejiang Province in 2023 was selected as the study subject. HLA genotyping was carried out through next-generation sequencing based on AllType NGS 11 locus, AllType FASTPlex NGS reagents, and Sanger sequencing method. The HLA genotype of the donor by Sanger sequencing and next generation sequencing were assigned by using uTYPE 7.3 and TypeStream Visual 3.0 software, respectively. This study was approved by Medical Ethics Committee of the Zhejiang Blood Center (Ethics No. Provincial Blood Center Ethics Review 2022 Research No. 001). Results:A novel HLA-DRB1*12 allele has been identified, and the full coding sequence has been submitted to the GenBank database (No. OR101190), and the length of submitted sequence was 801 bp, which was officially named as HLA-DRB1*12: 106 by the WHO Nomenclature Committee for Factors of the HLA System (submission No. HWS10066755). Compared with the sequence of the highest homology ( HLA-DRB1*12: 01: 01: 01 allele), a single nucleotide change was identified at position 344 T>G in the exon 2 of the HLA-DRB1*12: 106, which has resulted in replacement of Valine by Glycine at residue 86. The HLA genotype of the proband was determined as HLA-A*02: 01, 11: 01; -B*13: 02, 40: 01; -C*01: 02, 03: 03; -DRB1*07: 01, 12: 106; -DRB3*01: 01; -DRB4*01: 03; -DQA1*02: 01, 04: 01; -DQB1*02: 02, 04: 02; -DPA1*01: 03, 01: 03; -DPB1*02: 01: 02G, 04: 01: 01G. Conclusion:A novel HLA-DRB1 allele has been identified in the Chinese population. The mutated amino acid, located in the peptide binding region of the β chain, may affect the binding characteristics of antigen peptides.

Objective:To retrospectively analyse the clinical data of patients after NUSS procedure for pectus excavatum, and summary of surgical techniques for NUSS bar removal.Methods:Retrospectively collected the clinical data of 276 patients undergoing NUSS bar removal from January 2024 to September 2024 in Beijing Children's Hospital affiliated to Capital Medical University. The age of the patients ranged from 6 to 20 years old, 211 males and 65 females. The average time the bar was in place in the body was 36 months.Results:All 276 patients successfully completed the NUSS bar removal. The average operative time was 22.6 min, with an average blood loss of 3.3 ml. 90 patients with bone scabs, 104 patients with wire breakage were successfully removed. 2 cases of postoperative wound infection, no other intraoperative and postoperative complications. The average hospitalization time after surgery was 1.2 days. Follow up for 3 months after surgery, and no abnormalities were found on the chest X-ray.Conclusion:Mastering the surgical techniques for pectus excavatum bar removal enhances the safety and efficiency of the procedure. It effectively reduces the incidence of intraoperative and postoperative complications, shortens operative time, and alleviates postoperative pain in patients.

Objective This review aims to investigate the application of eye tracking(ET)in patients with speech impairment in the ICU.The review summarizes the current status and prospects of ET technology applications.Methods Following the scoping reviews framework,a systematic search was conducted across Web of Science,PubMed,Cochrane Library,Embase,CINAHL,CNKI,Wanfang Data,Chinese Medical Database,and Chinese biomedical database.The search covered publications from the inception of each database to October 29th,2024.The included studies were comprehensively analyzed.Results A total of 12 pieces of the literature were included,including 4 prospective cohort studies,4 experimental studies,3 prospective observational studies,and 1 randomized controlled trial.The application population of ET in the ICU mainly includes patients on mechanical ventilation,those at high risk of delirium,patients with spinal cord injury,etc.The types of integrated ET system equipment are mainly head-mounted and fixed;the types of ET involve gaze,blinking,etc.;the functions include standardized scale assessment,free interaction,and eye-movement model recognition.The main outcome indicators of the research are feasibility,physical symptoms and social-psychological status.Conclusion ET is applicable to a specific group of ICU patients with aphasia,and has shown good feasibility and effectiveness in the expression of patients'basic needs,self-assessment of symptoms and improvement of psychosocial status.

This study aims to integrate data mining techniques of single cell transcriptomics and spatial transcriptomics, along with animal experiment validation, so as to systematically characterize the protective effects of Jianpi Tongluo Formula(JTF) on the cartilage in knee osteoarthritis(KOA) and elucidate the underlying molecular mechanisms. Single cell transcriptomics and spatial transcriptomics datasets(GSE254844 and GSE255460) of the cartilage tissue obtained from KOA patients were analyzed to map the single cell-spatial heterogeneity and identify key pathogenic factors. After that, a KOA rat model was established via knee joint injection of papain. The intervention effects of JTF on the expression features of these key factors were assessed through real-time quantitative polymerase chain reaction(PCR), Western blot, and immunohistochemical staining. As a result, the integrated single cell and spatial transcriptomics data identified distinct cell subsets with different pathological changes in different regions of the inflamed cartilage tissue in KOA, and their differentiation trajectories were closely related to the inflammatory fibrosis-like pathological changes of chondrocytes. Accordingly, the expression levels of the two key effect targets, namely nuclear receptor coactivator 4(NCOA4) and high mobility group box 1(HMGB1) were significantly reduced in the articular surface and superficial zone of the inflamed joints when JTF effectively alleviated various pathological changes in KOA rats, thus reversing the abnormal chondrocyte autophagy level, relieving the inflammatory responses and fibrosis-like pathological changes, and promoting the repair of chondrocyte function. Collectively, this study revealed the heterogeneous characteristics and dynamic changes of inflamed cartilage tissue in different regions and different cell subsets in KOA patients. It is worth noting that NCOA4 and HMGB1 were crucial in regulating chondrocyte autophagy and inflammatory reaction, while JTF could reverse the regulation of NCOA4 and HMGB1 and correct the abnormal molecular signal axis in the target cells of the inflamed joints. The research can provide a new research idea and scientific basis for developing a personalized therapeutic schedule targeting the spatiotemporal heterogeneity characteristics of KOA.
Animals ; Drugs, Chinese Herbal/administration & dosage* ; Rats ; Osteoarthritis, Knee/pathology* ; Humans ; Male ; Cartilage, Articular/metabolism* ; Chondrocytes/metabolism* ; Rats, Sprague-Dawley ; Female ; Protective Agents/administration & dosage* ; Single-Cell Analysis ; Middle Aged ; HMGB1 Protein/metabolism*