Objective To investigate the infection status after heart transplantation (HT) in a third-grade class-A hospital from 2018 to 2023, and explore its risk factors. Methods A retrospective analysis was conducted on the data of 314 patients who underwent HT surgery from January 2018 to July 2023, they were divided into infection group and control group according to postoperative infection situation, the possible influencing factors of HT postoperative infection were analyzed by univariate analysis, and the risk factors of HT postoperative infection were screened by multivariate Logistic regression analysis. Results A total of 91 patients(28.98%)developed postoperative infections, with infection sites of respiratory tract and blood. Logistic regression analysis showed that the main risk factors for postoperative infection in HT patients included complicating with chronic lung disease, surgical time ≥5 h, long retention time of postoperative thoracic drainage tube, long postoperative urinary tube retention time, long postoperative mechanical ventilation time, and preoperative Alb < 35 g/L. Conclusion Complicating chronic lung disease, surgical time ≥5 h, long postoperative thoracic drainage tube retention time, long postoperative urinary tube retention time, long postoperative mechanical ventilation time, preoperative Alb < 35 g/L are related to postoperative infection of HT. Therefore, active intervention should be carried out for the above factors in patients to reduce the risk of infection.

Objective To investigate the prevalence of hepatitis D virus (HDV) infection among patients with chronic hepatitis B virus (HBV) infection in some regions of China. Methods Serum samples were collected from 3 131 patients with chronic HBV infection in 10 provinces, cities, and autonomous regions of China from March 2021 to June 2022, and anti-HDV IgG ELISA was used for the detection of all serum samples. Nested reverse transcription-polymerase chain reaction (nRT-PCR) was used to detect HDV RNA in anti-HDV IgG-positive samples, and the nRT-PCR amplification products of HDV RNA-positive samples were sequenced and analyzed to determine HDV genotype. The clinical features of anti-HDV IgG-positive patients were analyzed. The Mann-Whitney U rank sum test was used for comparison of continuous data between two groups, and the chi-square test or the Fisher's exact test was used for comparison of categorical data between two groups. Results The positive rate of anti-HDV IgG in the 3 131 patients with chronic HBV infection was 0.70% (22/3 131), and that in the patients with chronic HBV infection in Inner Mongolia Autonomous Region, Xinjiang Uygur Autonomous Region, Beijing, and Hunan Province was 1.81% (16/886), 0.88% (2/226), 0.28% (2/708), and 1.00% (2/200), respectively; the patients with chronic HBV infection in Inner Mongolia Autonomous Region had a significantly higher positive rate of anti-HDV IgG than those in Beijing ( P =0.004), and there was no significant difference between the other regions ( P > 0.05). Clinical features of the patients with chronic HBV infection in Inner Mongolia Autonomous Region showed that compared with the anti-HDV IgG-negative group, the anti-HDV IgG-positive group had a significantly higher proportion of patients with Mongol nationality ( P =0.001), abnormal alanine aminotransferase ( P =0.007), or antiviral treatment ( P =0.029), as well as a significantly lower median HBV DNA level ( P =0.030). A total of 19 HDV RNA-positive samples were identified, all of which had HDV genotype 1. Conclusion The prevalence rate of HDV varies greatly across different regions of China, with a higher prevalence rate of HDV in patients with chronic HBV infection from Inner Mongolia Autonomous Region. HDV genotype 1 is the predominant genotype in some provinces and cities of northern China.

Central nervous system (CNS) injuries, including stroke, traumatic brain injury, and spinal cord injury, are essential causes of death and long-term disability and are difficult to cure, mainly due to the limited neuron regeneration and the glial scar formation. Herein, we apply extracellular vesicles (EVs) secreted by M2 microglia to improve the differentiation of neural stem cells (NSCs) at the injured site, and simultaneously modify them with the injured vascular targeting peptide (DA7R) and the stem cell recruiting factor (SDF-1) on their surface via copper-free click chemistry to recruit NSCs, inducing their neuronal differentiation, and serving as the nanocarriers at the injured site (Dual-EV). Results prove that the Dual-EV could target human umbilical vascular endothelial cells (HUVECs), recruit NSCs, and promote the neuronal differentiation of NSCs in vitro. Furthermore, 10 miRNAs are found to be upregulated in Dual-M2-EVs compared to Dual-M0-EVs via bioinformatic analysis, and further NSC differentiation experiment by flow cytometry reveals that among these miRNAs, miR30b-3p, miR-222-3p, miR-129-5p, and miR-155-5p may exert effect of inducing NSC to differentiate into neurons. In vivo experiments show that Dual-EV nanocarriers achieve improved accumulation in the ischemic area of stroke model mice, potentiate NSCs recruitment, and increase neurogenesis. This work provides new insights for the treatment of neuronal regeneration after CNS injuries as well as endogenous stem cells, and the click chemistry EV/peptide/chemokine and related nanocarriers for improving human health.

Sarcopenia, characterized as the progressive decrease in skeletal muscle mass, strength, and function, has been becoming one of chronic musculoskeletal diseases in aging people. In basic research studies, a reliable experimental model would be vital significance for deeply understanding pathophysiological mechanism of sarcopenia and developing novel drugs. This review provided a preliminary summary on the potential mechanisms involved in senescence-induced sarcopenia, followed by a discussion on research progress on pharmacology models based on molecular mechanism of senescence, especially from in vitro cell models and in vivo animal models.

Hyperphosphatemia is one of the common complications in maintenance hemodialysis patients and is closely related to cardiovascular disease and related death events. Therefore, the effective management of blood phosphorus is an important link to improve the prognosis of patients with maintenance hemodialysis. This study on maintenance hemodialysis patients with hyperphosphatemia 3Ds management including diet, along with the progress of dialysis and drug related nursing intervention were summarized, discuss how to reasonable dietary phosphorus limited, improve the efficiency of dialysis, and the correct use of problems still existing in phosphate binder, in order to reduce hyperphosphatemia to provide the reference for clinical nursing practice.

The epidemic of coronavirus disease 2019 (COVID-19) puts higher demands on critical care medicine. Lots of studies have been conducted to solve COVID-19-related problems. Therefore, we reviewed the annual progress for COVID-19-related issues including antivirals threapies, respiratory support and immunomodulatory therapies and other critical issues, including the effect of antibiotic on mitochondrial damage and its relationship with sepsis, the goal and direction of antimicrobial de-escalation, drug prophylaxis of constipation, bleeding in gastrointestinal disorders and management of critical illness in the informalization era and so on. We hope to provide reference for clinical and scientific research work of the intensivists.

Objective:To explore the mediating effect of empathy ability between personality characteristics and humanistic care ability of nursing undergraduates.Methods:The convenient sampling method was adopted to select 490 nursing undergraduates from the freshman to senior year of school of nursing in a medical university from June to July 2019 as the research objects. General information questionnaire, Caring Ability Inventory (CAI) , the Jefferson Scale of Physi-cian Empathy-Nursing Student (JSPE-NS) and Eysenck Personality Questionnaire-Revised Short Scale Chinese (EPQ-RSC) were used to conduct the questionnaire survey. A total of 490 questionnaires were issued and 435 valid questionnaires were recovered.Results:CAI score of 435 nursing undergraduates was (184.38±19.49) . The results of Sobel-test showed that the empathy ability of nursing students had a partial mediating effect between extroversion and neurotic personality characteristics and humanistic care ability, with effect values of 16.0% and 23.0%, respectively.Conclusions:The humanistic care ability of nursing students is at a low level, and the empathy ability plays a part of mediating role among the extroversion and neurotic personality characteristics and humanistic care ability of nursing undergraduates. Nursing educators can change the influence of extroversion and neurotic personality characteristics on the humanistic care ability by improving the empathy of nursing students, thereby improving the humanistic care ability of nursing undergraduates.

BACKGROUND: Epidemiological studies have suggested that noise exposure may increase the risk of type 2 diabetes mellitus (T2DM), and experimental studies have demonstrated that noise exposure can induce insulin resistance in rodents. The aim of the present study was to explore noise-induced processes underlying impaired insulin sensitivity in mice. METHODS: Male ICR mice were randomly divided into four groups: a control group without noise exposure and three noise groups exposed to white noise at a 95-dB sound pressure level for 4 h/day for 1, 10, or 20 days (N1D, N10D, and N20D, respectively). Systemic insulin sensitivity was evaluated at 1 day, 1 week, and 1 month post-noise exposure (1DPN, 1WPN, and 1MPN) via insulin tolerance tests (ITTs). Several insulin-related processes, including the phosphorylation of Akt, IRS1, and JNK in the animals' skeletal muscles, were examined using standard immunoblots. Biomarkers of inflammation (circulating levels of TNF-α and IL-6) and oxidative stress (SOD and CAT activities and MDA levels in skeletal muscles) were measured via chemical analyses. RESULTS: The data obtained in this study showed the following: (1) The impairment of systemic insulin sensitivity was transient in the N1D group but prolonged in the N10D and N20D groups. (2) Noise exposure led to enhanced JNK phosphorylation and IRS1 serine phosphorylation as well as reduced Akt phosphorylation in skeletal muscles in response to exogenous insulin stimulation. (3) Plasma levels of TNF-α and IL-6, CAT activity, and MDA concentrations in skeletal muscles were elevated after 20 days of noise exposure. CONCLUSIONS Impaired insulin sensitivity in noise-exposed mice might be mediated by an enhancement of the JNK/IRS1 pathway. Inflammation and oxidative stress might contribute to insulin resistance after chronic noise exposure.
Animals ; Biomarkers ; metabolism ; Inflammation ; physiopathology ; Insulin Receptor Substrate Proteins ; genetics ; metabolism ; Insulin Resistance ; genetics ; immunology ; MAP Kinase Signaling System ; physiology ; Male ; Mice ; Mice, Inbred ICR ; Mitogen-Activated Protein Kinase 8 ; genetics ; metabolism ; Noise ; adverse effects ; Oxidative Stress ; physiology ; Proto-Oncogene Proteins c-akt ; genetics ; metabolism ; Random Allocation ; Time Factors

Objective:To explore the therapeutic effect of psychological and drug intervention on anxiety and depres‐sion in patients after coronary artery bypass graft (CABG) .Methods :A total of 115 patients performed CABG were randomly divided into combined intervention group (n=60) and routine nursing group (n=55) .During peropera‐tive period ,combined intervention group received psychological intervention ,flupentixol and melitracen tablet and sertraline based on routine nursing .A total of 25 matching normal people were selected from community and regar‐ded as normal control group ,scores of Zung self‐rating anxiety scale (SAS) and self‐rating depression scale (SDS) were evaluated and compared among three groups before and after operation .Results :Before intervention ,there were no significant difference in standard scores of SAS and SDS between combined intervention group and routine nursing group ( P > 0.05) ,but they were all significantly higher than those of normal control group , P < 0.01 all . After operation ,standard scores of SAS and SDS in combined intervention group were significantly lower than be ‐ fore operation ( P < 0.01 both) ,and they were significantly lower than those of routine nursing group [SAS : (41.31 ± 6.13) scores vs .(51.35 ± 8.95) scores ,SDS : (40.20 ± 5.80) scores vs .(51.22 ± 8.78) scores , P < 0.01 both] . Conclusion :Psychological combined drug intervention could significantly relieve anxiety and depression in patients after coronary artery bypass graft ,which is helpful for improving postoperative prognosis .

Objective To analyze contrastly the effect of 89SrCl2 for bone metastasis in Uygur and Han patients with prostate cancer.Methods The curative effects in 75 Uygur and 82 Han patients with prostate cancer bone metastasis were investigated after intravenous injection with 89SrCl2,including palliation of pain.SPECT was used to detect the change of metastasis,level of prostate-specific antigen (PSA) and interleukin-6 (IL-6) were detected by electrochemiluminescence immunoassay.Results After treated with 89SrCl2,the palliation rate,the bone metastases and the level of IL-6 were higher in Uygur patients [82.67 ％ (62/75),75 ％ (56/75),(4.24±1.74) pg/ml] than those in Han patients [60.98 ％ (50/82),52.44 ％ (43/82),(2.81±2.38) pg/ml],and there were statistically significant (P ＜ 0.05).Conclusion 89SrCl2 is more effective for the Uygur patients with prostate cancer bone metastasis than the Han patients,clinical workers should pay more attention to this.