Objective To retrieve,analyse and integrate the best evidences in perioperative fluid management for elderly patients with hip fracture,therefore to provide references for patient care.Methods Following the 6S evidence model,databases and websites were searched to collect the evidences on perioperative fluid management of elderly patients with hip fracture.The searched databases including BMJ Best Practice,UpToDate,AAOS Clinical Practice Guidelines,ASBMR,ANZHFR,ESTES,NICE,SIGN,JBI,Cochrane Library,CINAHL,Embase,PubMed,Web of Science,CNKI,Wanfang Data,VIP database,CEBM Database,Medive,China Science and Technology Journal Database,SinoMed,and other websites about orthopaedics.The searched literatures included guidelines,clinical decision-making,best practices,expert consensus and systematic reviews.The time span for the published literatures was from the inception of the databases and websites to August 2022.Two researchers independently completed quality evaluations of the retrieved literatures,as well as extraction,assessment and integration of the abstracted evidences.Results A total of 15 articles were included,they were 2 guidelines,3 clinical decision-makings,1 best practice,7 expert consensus,and 2 systematic reviews.Thirty pieces of evidence were summarised from 7 aspects,covering multidisciplinary team collaboration,dynamic assessment and monitoring of fluid status,fluid resuscitation,fluid management before and after the surgery and health education.Conclusions This study summarised the best evidences in perioperative fluid management for elderly patients with hip fracture.The evidences provide an evidence-based solution which will enable the healthcare workers to fully combine the clinical scenarios,evaluate changes in fluid volume status dynamically,develope personalised fluid management strategies and improve patient outcomes.

Objective:To explore the changes in topological attributes of structural covariance network based on cortical thickness and the brain functional activities in patients with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis by graph theory and functional connectivity (FC) analyses, and to investigate whether these changes were correlated to cognitive impairment.Methods:A total of 33 patients with anti-NMDAR encephalitis from Department of Neurology of the First Affiliated Hospital of Guangxi Medical University(patient group) and 35 healthy controls(control group) with matched gender, age, and education were included from July 2018 to November 2021.All subjects received cognitive function assessments, structural and functional magnetic resonance imaging scans.Structural covariance networks were constructed in the two groups based on cortical thickness values and topological characteristics of networks were computed.A non-parametric permutation test which repeated 1 000 times was used to compare the characteristics of the networks between the two groups.Brain regions with abnormal topology were defined as region of interest(ROI), and FC values in global brain level were calculated.SPM 12 and RESTplus were used to identify the brain regions with significant differences in FC values between the two groups.Finally, Spearman correlation analysis between FC values of significant brain regions and cognitive scores were performed by SPSS 24.0.Results:The cognitive score of patients with anti-NMDAR encephalitis (27.0(23.5, 28.0)) was lower than that in control group(29.0(27.0, 30.0)) ( Z=-3.029, P=0.002). Graph theory analysis found that the patients showed significantly increased clustering coefficients ( P=0.004) and decreased global efficiency ( P=0.004) compared with healthy controls.Moreover, the nodal efficiency of left ventral posterior cingulate cortex (vPCC) and right dorsal posterior cingulate cortex (dPCC), as well as the nodal degree centrality of left vPCC and left polar planum of superior temporal gyrus (ppSTG) in patient group were significantly decreased ( P<0.05, FDR corrected) compared with control group.FC analysis showed the increased FC values between left vPCC and posterior cerebellum (MNI: x=6, y=-66, z=-21), as well as between left ppSTG and anterior cerebellum (MNI: x=6, y=-54, z=-12) (GRF corrected, voxel level P<0.001, cluster level P<0.05) in patient grooup.The FC values between left vPCC and posterior cerebellum were negatively correlated with the cognitive scores ( r=-0.403, P=0.020). Conclusion:Patients with anti-NMDAR encephalitis show abnormal topology of structural covariance network based on cortical thickness and altered FC values, some of which are correlated to cognition and may be the underlying neural mechanism of cognitive impairment in patients with anti-NMDAR encephalitis.

Epilepsy is a disorder of the brain charac-terized by abnormal neuron excitability.However,the underlying molecular mechanism of neuron excitability modulation remains elusive.With the help of bioinformatic methods,we have identified receptor-type tyrosine-pro-tein phosphatase-like N(PTPRN)as a critical gene dur-ing epileptogenesis.PTPRN recruits NEDD4L ubiquitin E3 ligase to NaV1.2 sodium channels,facilitating NEDD4L-mediated ubiquitination and endocytosis.Knockout of PTPRN endows hippocampal granule cells with augmented depolarization currents and higher intrinsic excitability,which is reflected by increased seizure susceptibility of transgenic mice.On the contrary,reduced neuron excit-ability and decreased seizure susceptibility are observed after PTPRN overexpression.Meanwhile,we find that a 133 aa fragment recaptures modulation effect of PTPRN full-length,and this fragment shows therapeutic potential towards epilepsy caused by NaV1.2 gain of function vari-ants.In brief,our results demonstrate PTPRN playsa criti-calroleinregulatingneuronexcitability,providing a poten-tial therapeutic approach for epilepsy.

Objective:To investigate the application values of bone marrow morphology, bone marrow immunohistochemistry, flow cytometry, fluorescence in situ hybridization (FISH) and cytogenetic testing in newly diagnosed multiple myeloma.Methods:A total of 280 patients with multiple myeloma who were newly diagnosed in Tianjin KingMed Diagnosis Center from September 2018 to August 2019 were collected. The bone marrow biopsy was carried out according to the routine method, and bone marrow morphology, bone marrow immunohistochemistry, flow cytometry immunophenotyping, FISH and cytogenetic testing were performed. The detection results of each method were compared.Results:In 280 patients, the bone marrow immunohistochemistry results showed that the median ratio of plasma cells was higher than those of bone marrow morphology (20 cases, 0.675 vs. 0.300) and flow cytometry (47 cases, 0.650 vs. 0.147), and the differences were statistically significant ( Z = -3.883, P < 0.01; Z = -5.947, P < 0.01). Flow cytometry results showed that the positive rates of CD38, CD138, κ, λ, CD56 and CD19 were 100.0% (280/280), 100.0% (280/280), 57.5% (161/280), 42.5% (119/280), 62.1% (174/280) and 19.3% (54/280); bone marrow immunohistochemistry results showed that the positive rates of CD38, CD138, κ, λ and CD56 were 98.9% (277/280), 98.2% (275/280), 57.5% (161/280), 42.5% (119/280) and 62.1% (174/280); there was no statistical difference between the two detection methods in the detection coincidence rate of the same detection index (all P > 0.05). Among patients who underwent FISH detection, the detection rate of gene abnormalities was 69.9% (93/133); the detection rate of abnormalities by direct fluorescence in situ hybridization (D-FISH) was 42.9% (57/133); the detection rate of abnormalities by CD138 immunomagnetic sorting myeloma cells (MACS)-FISH was 82.7% (110/133). Among patients who underwent G-band karyotyping, the detection rate of abnormal karyotype was 38.5% (85/221). FSIH, especially MACS-FISH, had a higher detection rate of cytogenetic abnormalities than G-band karyotyping, and the difference was statistically significant ( χ2 = 65.697, P < 0.05). Conclusion:The comprehensive application of bone marrow morphology, bone marrow immunohistochemistry, flow cytometry, FISH (especially MACS-FISH), cytogenetic testing and other detection methods is more helpful for the diagnosis of multiple myeloma, and may be useful for prognostic judgment.

Objective:To conduct periodic revalidation of the 15 items and 43 terms autoverification rules of blood analysis after 1 year of application, analyze the application suitability and make the rules improved.Methods:Track the results of 528 010 blood analysis samples of our hospital from August 1, 2019 to January 31, 2020, and analyze the pass rate and interception rate of autoverification; 600 specimens in total were selected randomly for microscope examination, including 300 specimens which touched autoverification rules (1 012 items of autoverification rules) and were intercepted by autoverification and 300 specimens which untouched autoverification rules and were released by autoverification. The abnormal characteristics and unacceptable Delta check of the specimens also need to be concerned at the same time.The false negative rate and false positive rate, true negative rate, true positive rate and pass correct rate of autoverification were verified and compared with the rate of the second phase verification when the autoverification rule was established. The false negative rate, false positive rate, true negative rate and true positive rate of the Delta check rule which 54 716 specimens touched were calculated and compared with the second phase verification rate when the autoverification rule was established.The results of microscopic examination were used as the gold standard for the calculation of the rates, and P<0.05 was considered as a significant difference. The false positive and true positive of 1 012 autoverification rules were analyzed item by item.The false positive and true positive of 108 specimens which touched blast cell autoverification rule were analyzed terms by terms. The mean TAT and median TAT of 528 010 specimens and 193 750 outpatient specimens were calculated respectively, and the report percentages of 528 010 samples that TAT<30, 30-60　and>60 min were calculated respectively. Analyze and evaluate the application suitability of autoverification rules to juge whether they meet the needs of doctors and laboratory. The design process and the rules and application process of autoverification were optimized and improved.Results:The autoverification pass rate was 63.06% (332 971/528 010), the interception rate was 36.94% (195 039/528 010). The false negative rate was 1.00% (1/600), the false positive rate was 12.67% (76/600), the true negative rate was 49% (294/600), the true positive rate was 37.33% (224/600), and the correct rate was 98% (294/300). The pass rate, true negative rate, true positive rate and correct rate of the periodic reverification group were higher than the second phase verification group, the false negative rate and false positive rate were lower than that the second phase verification group. The false negative rate and true positive rate of the Delta check of periodic verification group were lower than that the second phase verification group, the false positive rate and true negative rate were higher than the second phase verification group, there were significant differences in the comparition results. The mean TAT of 528 010 specimens was25 min, and the median TAT was 22 min. The mean TAT of 193 750 outpatient specimens was 23 min, and the median TAT was 20 min. The report percentages of 528 010 samples that TAT<30 min, 30 min-60 min and>60 min were 83.30% (439 819/528 010), 8.00% (42 250/528 010) and 8.70% (45 941/528 010), respectively.Conclusion:The results of periodic revalidation of autoverification after 1 years application show that the 15 items and 43 terms autoverification rules of blood analysis could meet requirements about the accuracy and efficiency of the laboratory, and have a good suitability for application.

Objective:To analyze the effect of implementing information-motivation-behavior skill model (IMB) home care in elderly patients with chronic obstructive pulmonary disease (COPD).Methods:From October 2017 to October 2018, patients with COPD who were discharged after treatment in Wuxi Fifth People′s Hospital were included and divided into control group and observation group by block randomization method. The control group was given routine health education, discharge guidance and follow-up guidance after discharge. The observation group received the information-motivation-behavior home care based on IMB. The general information before intervention, the level of disease cognition, quality of life before and after the intervention and the health behavior after the intervention were compared between the two groups.Results:The Bristol COPD Knowledge Questionnaire (BCKQ) score in the observation group was higher than that in the control group [(58.36±6.68) vs. (52.14±5.80) points] ( P<0.05). The scores of physical activity, health responsibility, stress management, nutrition, and spiritual growth in the Health Promoting Lifestyle Profile-Ⅱ (HPLR-Ⅱ) after the intervention in the observation group were higher than those in the control group [(26.01±3.95) vs. (23.25±3.48) points, (38.65±4.33) vs. (34.64±4.05) points, (16.98±2.51) vs. (14.20±1.80) points, (19.87±2.20) vs. (15.65±3.51) points, (20.32±2.85) vs. (17.35±2.89) points] ( P<0.05). The symptoms, mobility, and disease impact scores of the St George′s Respiratory Questionnaire (SGRQ) in the observation group were lower than those in the control group [(40.32±4.30) vs. (45.36±4.50) points, (43.21±4.87) vs.(45.33±4.25) points, (38.41±4.37) vs. (42.35±4.01) points] (all P<0.05). Conclusion:Implementing the home care model based on IMB in elderly patients with COPD can improve patients′ disease awareness and improve their health behaviors and quality of life.

Objective To explore the effect of drug injection under bronchoscopy on the retreatment of smear positive cavitary pulmonary tuberculosis. Methods From June 2016 to December 2017,164 cases of pul-monary tuberculosis with smear Yang cavity type were selected,which were divided into 2 groups according to the random digital table method,each groups has 82 cases.The control group received routine treatment,the observa-tion group underwent bronchoscopy with Kangfuxin Liquid combined with drug injection therapy.The clinical effect of the two groups,the changes of lung function before and after treatment and the improvement of clinical symp-toms were compared.Results The clinical curative effect of the treatment group was better than the control group, which difference was statistically significant(P < 0.05). FEV1,FEV1/FVC,PEF index in the observation group were better than the control group,which difference was statistically significant(P<0.05).The complication rate of observation group was lower than the control group,which difference was statistically significant(P < 0.05). Conclusion Drug injection under bronchoscopy can significantly improve the clinical efficacy and lung function and promote clinical symptoms in patients with retreated smear positive pulmonary tuberculosis.It is worthy of popu-larization and application.

Objective To understanding the real experience in the marriage life of the MSM/HIV young patients,so as to provide reference for conducting the humanization concern to the MSM/HIV young patients. Methods By phenomenological research method of the qualitative study, a total of 12 MSM/HIV young patients were interviewed for marriage cognition, life after married, and education and rearing of children. Results Throughout interview, there were four topics extracted from the true feelings of their marriage, including passive marriage, marriage choice was not helped, marriage was not happiness, love their children. Conclusions Medical staff should ask the parents of the MSM/HIV patients not to force them to get married, and tell the MSM/HIV patients who are in marriage should take family responsibility and practice safe-sex to prevent the spread of HIV.

Objective To design a vision-based detection method for rotated human bodies to fulfill unmanned wounded search in the rescue operation.Methods HOG (histogram of oriented gradient) which was the most successful visual feature in pedestrian detection was involved in,and the human detection in the wounded search task was realized by multi-directional detection.Furthermore,two human bodies datasets were established by imitating the views of unmanned ground vehicle (UGV)and unmanned aerial vehicle (UAV).Results The application to the two datasets proved the method's feasibility in UGV and UAV.Conclusion The method is robust to the in-plane rotations and out-plane rotations of human bodies,which is of vital significance to promote the efficiency of the wounded searching and rescuing.

Objective To realize SLAM and path planning of mobile robot to solve the problem of real-time data association in the process of moving and to update the computational complexity of the state covariance matrix.Methods The mathematical model of SLAM was built,and FastSlam algorithm based on particle filter,A* and dynamic window approach (DWA) were used to prepare gmapping function package in the ROS framework.Results The motion simulation,path planning and dynamic obstacle avoidance of mobile robot in the ROS framework were realized.Conclusion By using ROS platform,mobile robots can execute path planning efficiently while completing self-localization and map building.