Objective To explore the clinical effect of personalized pars plana vitrectomy(PPV)for proliferative di-abetic retinopathy(PDR).Methods In this retrospective case study,76 patients(86 eyes)diagnosed with PDR and re-ceiving PPV in the Department of Ophthalmology of Songjiang Hospital affiliated to Shanghai Jiao Tong University School of Medicine,from October 2019 to November 2022,were divided into the observation group(40 patients,46 eyes)and the control group(36 patients,40 eyes).Patients in the obseration group were treated with personalized PPV,while patients in the control group were treated with conventional PPV,After treatment,all patients were followed up for 12 months.The operation time,intraoperative use of heavy water and silicone oil,incidence of iatrogenic retinal tears and heavy water resi-dues,proportion of scleral buckling,preoperative and postoperative best corrected visual acuity(BCVA)and intraocular pressure(IOP),retinal reattachment rate at 12 months after surgery,and the incidence of post-vitrectomy vitreous hemor-rhage(PVH),diabetic macular edema(DME)and neovascular glaucoma(NVG)were compared between the two groups.Results The operation time of patients in the observation group was shorter than that in the control group(P＜0.05).Intraoperative use of heavy water and silicone oil in the observation group was lower than that in the control group(both P＜0.05).The incidence of iatrogenic retinal tears and heavy water residues and the proportion of scleral buckling showed no statistically significant difference between the two groups(all P＞0.05).There was no statistically significant difference between the two groups in BCVA preoperatively,3,6 and 12 months postoperatively(all P＞0.05).BCVA in the observa-tion group was better than that in the control group at 1 day,1 week and 1 month after surgery(all P＜0.05).Compared with the preoperative value,BCVA increased in the observation group at 1 day,1 week,1 month,3 months,6 months,and 12 months after surgery(all P＜0.05);in the control group,BCVA increased slightly at 1 day and 1 week(both P＞0.05)and then increased significantly at 1 month,3 months,6 months,and 12 months after surgery(all P＜0.05).The two groups showed no statistically significant difference in IOP at 1 day,1 week,1 month,3 months,6 months,and 12 months postoperatively(all P＞0.05).There was no statistically significant difference in the retinal reattachment rate and the inci-dence of complications such as PVH,DME,and NVG between the two groups at 12 months postoperatively(all P＞0.05).Conclusion Personalized PPV can shorten the operation time,reduce the intraoperative use of heavy water and silicone oil,enhance the efficiency of the operation,and rapidly improve the visual acuity of PDR patients.

The construction of a medication safety culture is important for medication safety management and rational drug use.The construction of medication safety culture standards is formulated based on relevant national policies and regulations,accreditation standards for hospitals,expert opinions,the current situation,and the development trend of the healthcare industry.With scientificity,general applicability,instructive guidance,and practicality,they standardized basic requirements,management processes,and improvement of the construction of medication safety culture.To facilitate understanding and the implementation of the standards,we describe the process of standards formulation and explain the key points of the standards.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Most drugs taste bitter and irritating, resulting in poor compliance of patients, and the bad odor affects the therapeutic effect. The successful research and development of a drug should not only conform to the five quality characteristics of effectiveness, stability, safety, uniformity and economy, but also the compliance of patients to drugs with bad odor. The development of taste masking techniques is critical for bitter drugs.This review describes the principles, advantages and drawbacks of traditional taste masking techniques, and introduces the mechanism and application of novel taste masking techniques, such as melt granulation, hot melt extrusion, 3D printing, drug complex preparation, and bitter taste inhibitors. The in vitro evaluation methods of drug taste masking effect, such as functional magnetic resonance imaging, in vitro dissolution, and electronic tongue technology, are described. And introduce in vivo evaluation methods, such as animal and human taste, in the field of taste masking effect. A new strategy of BP neural network prediction model for drug taste evaluation is proposed, with a view to providing theoretical reference for the future research on drug taste masking.

Objective:To retrieve, evaluate, and summarize the best evidence for the assessment of gastrointestinal function in critically ill patients by bedside ultrasound.Methods:Guidelines, evidence summaries, group standards, expert consensus, systematic reviews, and randomized controlled trials on the assessment of gastrointestinal function in critically ill patients by bedside ultrasound were retrieved by computer on domestic and foreign guideline websites, society websites and databases based on evidence-based nursing. The search period was from January 1, 2010 to April 30, 2021. The quality of the article was independently assessed by two researchers using the Appraisal of Guidelines for Research and Evaluation Ⅱ and the critical appraisal tool of the Joanna Briggs Institute (JBI) in Australia (2016) . Combined with the judgment of the research team, the data from the article that met the criteria were extracted and the evidence was graded and recommended according to the JBI quality level of evidence system (2014 Edition) .Results:A total of 22 articles were included, involving 5 guidelines, 1 evidence summary, 1 group standard, 6 expert consensuses, 4 systematic reviews, and 5 randomized controlled trials. A total of 33 pieces of evidence were summarized from 6 aspects, namely, the feasibility of nurses applying bedside ultrasound, fundamentals of ultrasound assessment of gastrointestinal tract, ultrasound assessment of gastric contents, ultrasound assessment of gastric motility, ultrasound assessment of bowel, ultrasound guided enteral nutrition program.Conclusions:Nurses who have been systematically trained can use ultrasound to assess gastrointestinal function in critically ill patients in real time. Ultrasound-guided enteral nutrition for critically ill patients needs to be standardized and improved, and many studies need to be carried out.

Animals ; COVID-19/virology* ; Disease Models, Animal ; Evolution, Molecular ; Humans ; Polymorphism, Single Nucleotide ; SARS-CoV-2/metabolism* ; Spike Glycoprotein, Coronavirus/genetics*

Purpose: Reduced quality of life after cystectomy has made bladder preservation a popular research topic for muscle-invasive bladder cancer (MIBC). Previous research has indicated significant tumor downstaging after neoadjuvant chemotherapy (NAC). However, maximal transurethral resection of bladder tumor (TURBT) was performed before NAC to define the pathology, impacting the real evaluation of NAC. This research aimed to assess real NAC efficacy without interference from TURBT and apply combined modality therapies guided by NAC efficacy. Materials and Methods: Patients with cT2-4aN0M0 MIBC were confirmed by cystoscopic biopsy and imaging. NAC efficacy was assessed by imaging, urine cytology, and cystoscopy with multidisciplinary team discussion. Definite responders (≤ T1) underwent TURBT plus concurrent chemoradiotherapy. Incomplete responders underwent radical cystectomy or partial cystectomy if feasible. The primary endpoint was the bladder preservation rate. Results: Fifty-nine patients were enrolled, and the median age was 63 years. Patients with cT3-4 accounted for 75%. The median number of NAC cycles was three. Definite responders were 52.5%. The complete response (CR) was 10.2%, and 59.3% of patients received bladder-sparing treatments. With a median follow-up of 44.6 months, the 3-year overall survival (OS) was 72.8%. Three-year OS and relapse-free survival were 88.4% and 60.0% in the bladder-sparing group but only 74.3% and 37.5% in the cystectomy group. The evaluations of preserved bladder function were satisfactory. Conclusion After stratifying MIBC patients by NAC efficacy, definite responders achieved a satisfactory bladder-sparing rate, prognosis, and bladder function. The CR rate reflected the real NAC efficacy for MIBC. This therapy is worth verifying through multicenter research.

【Objective】 To discuss the prevention and control strategies of physical examination and health consultation for apheresis donation during the COVID-19 outbreak, and to verify its necessity and efficiency. 【Methods】 A three-stage (Hubei import period, Jan 23 to 31; local(Zhejiang) epidemic period( Feb 1 to Mar 1); overseas import period, Mar 2 to 22) prevention and control strategy for physical examination and health consultation during the COVID-19 outbreak from January 23 to March 22, 2020 was adopted by our center, and the consultation of residence history, contact history, and the investigation of related symptoms were added to health consultation.The deferral rates of health consultation and physical examination during the COVID-19 outbreak were compared with the same period in 2019. The deferral rates in each stage were compared, containing those contributed by first-time and regular apheresis donors. 【Results】 The deferral rates of health consultation during the epidemic period and the same period in 2019 were 2.31%(100/4 371) vs 1.62%(78/4 740) (P<0.05), the physical examination 3.75%(160/4 264) vs 1.07%(50/4 655) (P<0.01). The deferral rates of health consultation during the three stages were 2.32%(9/388) vs 3.49%(68/1 947)vs 1.13%(23/2 036) respectively(P<0.01), physical examination 2.12%(8/378)vs 3.68%(69/1 877)vs 4.13%(83/2 009)(P>0.05) The deferral rate of travel contact history was the highest at 2.05%(40/1947)during local epidemic period, and respiratory symptoms at 1.29%(5/388)during Hubei import period. The deferral rates of blood pressure during the three stages were1.85%(7/378)vs 3.57%(67/1877)vs 4.08(82/2009)(P>0.05). The deferral rate of health consultation and physical examination in first-time and regular apheresis donors were 5.86%(38/649)vs 1.65%(61/3 696)and 5.79%(35/604)vs 3.41%(124/3 635)(P<0.01). 【Conclusion】 The deferral rates of health consultation and physical examination increased significantly during the COVID-19 epidemic. Therefore, it is necessary to formulate and adopt a targeted consultation strategy during the epidemic period to block COVID-19 transmission to the greatest extent.

Objective:To provide evidence for guiding enteral nutrition programs for critically ill patients by evaluating the application effect of ultrasonic monitoring gastric residual volume.Methods:CNKI, China Biology Medicine disc, Wanfang, VIP, Chinese Clinical Trial Registry, PubMed, Embase, Cochrane Library, ClinicalTrials.gov and other databases were systematically searched to collect randomized controlled trails (RCTs) of application of ultrasonic monitoring of gastric residual volume in enteral nutrition of critically ill patients. The search time limit was from the establishment of the database to December 31, 2019. Two researchers independently searched literature, screened literature, extracted data and evaluated the quality of the literature. RevMan 5.3 software was used for Meta-analysis.Results:A total of 10 articles were included, involving 897 patients. Compared with the syringe withdrawal method, ultrasonic monitoring of gastric residual volume could reduce the incidence of reflux or vomiting [ RR=0.53, 95% CI (0.38-0.75) ] and the incidence of aspiration [ RR=0.48, 95% CI (0.30-0.77) ], increase albumin level [ MD=1.53, 95% CI (0.71-2.35) ] and reduce operating time of nurses [ MD=-5.62, 95% CI (-7.59--3.65) ], and the combined effects were statistically significant ( P<0.05) . However, the incidence of diarrhea [ RR=0.77, 95% CI (0.53-1.11) ] and in-hospital mortality [ RR=0.73, 95% CI (0.41-1.28) ] were not changed, and the combined effects were not statistically significant ( P>0.05) . Conclusions:Ultrasonic monitoring of gastric residual volume in enteral nutrition of critically ill patients may be helpful to reduce the incidence of complications and improve the nutritional status of patients.

Recently, the 2019 novel coronavirus has rapidly spread throughout China. The medical staff at dermatology departments of some hospitals in Hubei province also participated in the fight against coronavirus disease 2019. However, many problems emerged during this period. Some medical staff at dermatology departments lacked abilities to deal with emergencies, self-protect, and to conduct surveys on skin diseases occurring in this period. In this article, the authors highlight common problems in and give advice on dermatology teaching about national public health emergencies to healthcare workers, undergraduate students, graduate students and senior residents, hoping that healthcare workers at dermatology departments will calmly deal with public health emergencies in the future.