Nasal drug delivery efficiency is highly dependent on the position in which the drug is deposited in the nasal cavity. However, no reliable method is currently available to assess its impact on delivery performance. In this study, a biomimetic nasal model based on three-dimensional (3D) reconstruction and three-dimensional printing (3DP) technology was developed for visualizing the deposition of drug powders in the nasal cavity. The results showed significant differences in cavity area and volume and powder distribution in the anterior part of the biomimetic nasal model of Chinese males and females. The nasal cavity model was modified with dimethicone and validated to be suitable for the deposition test. The experimental device produced the most satisfactory results with five spray times. Furthermore, particle sizes and spray angles were found to significantly affect the experimental device's performance and alter drug distribution, respectively. Additionally, mometasone furoate (MF) nasal spray (NS) distribution patterns were investigated in a goat nasal cavity model and three male goat noses, confirming the in vitro and in vivo correlation. In conclusion, the developed human nasal structure biomimetic device has the potential to be a valuable tool for assessing nasal drug delivery system deposition and distribution.

Objective:To investigate the application effect of problem-based learning (PBL) combined with scenario simulation in nursing teaching of needlestick injuries.Methods:A total of 123 undergraduates majoring in nursing were selected as research subjects from the classes of 2020 and 2021 in a medical university. The 60 undergraduates in the class of 2020 were established as control group and were given PBL teaching, and the 63 undergraduates in the class of 2021 were established as experimental group and were given PBL combined with scenario simulation. The two groups were compared in terms of theoretical score, skill examination score, and knowledge-attitude-practice (KAP) score of needlestick injury knowledge. SPSS 25.0 was used to perform the t-test, the chi-square test, and the rank sum test. Results:Compared with the control group, the experimental group had significantly higher scores of theoretical examination [(84.43±5.03) vs. (80.30±4.81), P<0.001] and skill examination [(88.40±4.26) vs. (83.55±5.84), P<0.001], as well as significantly higher scores of knowledge [(14.46±1.03) vs. (13.18±1.23), P<0.001], attitude [(52.59±3.09) vs. (48.05±3.06), P<0.001], and practice [(67.37±4.28) vs. (62.17±3.92), P<0.001] in KAP questionnaire. Conclusions:PBL combined with scenario simulation teaching can effectively improve the knowledge of protection against needlestick injuries and related skills in nursing students, enhance their awareness of needlestick injuries, and promote the protective behavior against needlestick injuries.

Humans ; RNA, Long Noncoding/genetics* ; MicroRNAs/genetics* ; Cell Line, Tumor ; Inflammation/genetics* ; Apolipoproteins E ; Apoptosis

Objective:To investigate the application value of single-port laparoscopic left lateral donor liver acquisition in pediatric living donor liver transplantation (PLDLT).Methods:The retrospective and descriptive study was conducted. The clinical data of the donor and recipient who were admitted to Beijing Friendship Hospital of Capital Medical University for PLDLT in January 2020 were collected. The donor was a male, aged 28 years with body mass as 62 kg, height as 174 cm and body mass index (BMI) as 20.5 kg/m 2. The recipient was the daughter of the donor, aged 1 year with body mass as 9 kg, height as 75 cm and BMI as 16.0 kg/m 2. The donor underwent single-port laparoscopic left lateral donor liver acquisition. The recipient underwent living donor liver trans-plantation by the same operation team. Observation indicators: (1) intraoperative conditions; (2) postoperative conditions; (3) follow-up. Results:(1) Intraoperative conditions. The donor under-went single-port laparoscopic left lateral donor liver acquisition successfully, with the single-port access system being placed through a transumbilical incision. The operation time, the warm ischemia time of the donor liver and volume of intraoperative blood loss were 240 minutes, 3 minutes and 40 mL, respectively, of the donor. The weight of the donor liver was 233.6 g, and the corrected graft-to-recipient body weight ratio was 2.60%. The recipient underwent living donor liver transplantation successfully. (2) Postoperative conditions. The donor began to take liquid diet at postoperative day 1, and results of laboratory examination showed that the alanine aminotransferase (ALT), aspartate aminotransferase (AST), glutamyltransferase (GGT) and total bilirubin (TBil) of the donor was 239 U/L, 116 U/L, 53 U/L and 22.57 μmol/L. The donor began to take diet with high quality proteins at postoperative day 2, and to get for out-of-bed activities moderately. The donor′s peritoneal drainage fluid was light red at postoperative day 3, and no fluid accumulation was found in the operation area after abdominal B-ultrasound examination, so the peritoneal drainage tube was removed. The donor was discharged at postoperative day 4. The liver function of the recipient recovered to normal level 2 weeks after the operation. (3) Follow-up. The donor was followed up by outpatient examination 2 weeks after discharged, and results of laboratory examination showed that the ALT, AST, GGT and TBil was 44 U/L, 25 U/L, 53 U/L and 9.22 μmol/L, respectively. Neither the donor nor the recipient had complication ≥Ⅱ grade of the Clavien-Dino classification, such as biliary fistula and vascular complication during the 6 months after operation.Conclusion:Single-port laparoscopic left lateral donor liver acquisition can be used into the PLDLT.

Objective To evaluate the clinical efficacy of liver transplantation in children with Alagille syndrome (ALGS). Methods Clinical data of 12 children with ALGS were collected and retrospectively analyzed. Clinical characteristics of children with ALGS, pathological characteristics of liver tissues, characteristics of liver transplantation, postoperative complications and follow-up of children with ALGS were analyzed. Results JAG1 gene mutation and typical facial features was present in all 12 children. Jaundice was the most common initial symptom, which occurred at 7 (3, 40) d after birth. Upon liver transplantation, the Z scores of height and body weight were calculated as -2.14 (-3.11, -1.83) and -2.32 (-3.12, -1.12). Five children developed severe growth retardation and 4 children with severe malnutrition. Eight of 12 children were diagnosed with cardiovascular abnormalities. Pathological examination showed that the lobular structure of the diseased livers of 4 children was basically maintained, and 8 cases of nodular liver cirrhosis in different sizes including 1 case of single early moderately-differentiated hepatocellular carcinoma. Three children were misdiagnosed with biliary atresia and underwent Kasai portoenterostomy. Eight children underwent living donor liver transplantation, three children underwent cadaveric donor liver transplantation (two cases of split liver transplantation and one case of cadaveric total liver transplantation), and one child underwent domino liver transplantation (donor liver was derived from a patient with maple syrup urine disease). during the follow-up of 30.0(24.5, 41.7) months, the survival rates of the children and liver grafts were both 100%. During postoperative follow-up, the Z scores of height and body weight were calculated as -1.24 (-2.11, 0.60) and -0.83 (-1.65, -0.43), indicating that the growth and development of the children were significantly improved after operation. Conclusions Liver transplantation is an efficacious treatment for children with ALGS complicated with decompensated cirrhosis, severe itching and poor quality of life. For children with ALGS complicated with cardiovascular abnormalities, explicit preoperative evaluation should be delivered, and consultation with pediatric cardiologists should be performed if necessary.

Objective:To review our experience in the use of "Full right-Full left" split liver transplantation in adult-to adult or adult-to adult-size child.Methods:The clinical data of liver donors to 4 recipients of full right-full left split liver transplantation performed at Beijing Friendship Hospital of Capital Medical University from January to December 2019 were reviewed. The surgical methods of split liver transplantation, cold ischemia time, operation time, intraoperative blood transfusion, and postoperative complications and prognosis were analyzed.Results:The 4 recipients of complete right hepatic-left hepatic split liver transplantation included 3 adults and 1 heavy child (45 kg). Their ages ranged from 14 to 48 years, and body weight ranged from 45 to 61 kg. The end-stage liver disease model score were 21, 12, 41, and 30 points. The ratios of graft mass to recipient's body mass ranged from 0.85% to 1.35%. The cold ischemia time was 457-650 min, and the operation time was 460-575 min. Early liver function recovered smoothly in all the 4 patients after transplantation, and no small liver syndrome occurred. Patients were followed up to 6 months after operation. One patient developed anastomotic biliary leak, which was cured by endoscopic retrograde cholangiopancreatographic treatment. Another patient developed biliary stricture presenting with repeated biliary tract infection despite percutaneous transhepatic puncture biliary drainage. A third patient died six months from lung infection.Conclusion:In properly selected patients, using full right-full left hemiliver by split liver transplantation increased organ utilization and provided patients with increased treatment opportunities.

Objective:To explore the clinical efficacy of venovenous extracorporeal membrane oxygenation(V-V ECMO)in patients with severe acute respiratory distress syndrome(ARDS)caused by Pneumocystis pneumonitis(PJP)after kidney transplantation(KT).Methods:Cal data of 9 KT recipients on V-V ECMO were retrospectively analyzed. Timing of V-V ECMO support, complications during treatment and V-V ECMO performance were summarized.Results:All 9 patients with confirmed PJP adopted V-V ECMO with oxygenation index of 25~92 prior to V-V ECMO and average time from admission to initiating V-V ECMO was 5.56(1~17)days. Except for one death from hemorrhagic shock due to abdominal hemorrhage, the remainders were successfully weaned. Another recipient died from sepsis after weaning and there were 7 survivors. V-V ECMO support time was 215.5 h among 8 successfully weaned recipients. Among 7 survivors, 1 had premorbid deterioration of graft function and no fatal complications occurred.Conclusions:V-V ECMO is an effective treatment for severe ARDS caused by P. pneumoniae post-KT. And its early application is recommended for reducing complications and improving patient prognosis.

Objective:To analyze the results of external quality assessment (EQA) of different levels laboratories of iodine deficiency disorders (IDD) in Inner Mongolia in 2018, and to understand the detection ability of these laboratories.Methods:In 2018, the Inner Mongolia region level laboratories and all 12 league and municipal level laboratories were assessed for salt iodine, urinary iodine and water iodine (74 banner, county and district level laboratories participated in the urinary iodine assessment, and 100 banner, county and district level laboratories participated in the salt iodine assessment). As 3+-Ce 4+ catalytic spectrophotometry (WS/T 107.1-2006) was used to measure the iodine in urine, direct titrimetric method (GB/T 13025.7.1-2012) was used to measure the salt iodine, and water iodine was determined based on "Determination of Iodine in Drinking Water by As 3+-Ce 4+ Catalytic Spectrophotometry" in the range of 0 - 100 μg/L. The examination results of EQA of different levels of IDD laboratories in Inner Mongolia were statistically analyzed. Results:Regional level leboratory passed all the 3 assessments, qualified rates of salt iodine, urinary iodine and water iodine were 83.3% (10/12), 91.7% (11/12), and 100.0% (12/12), respectively, at league and municipal level; qualified rates of salt iodine and urinary iodine were 95.0% (95/100), and 90.5% (67/74), respectively, at banner, county and district level in 2018.Conclusions:The detection ability of IDD laboratories at all levels in the whole region has been stabilized, but there are still fluctuations in some laboratories. It is suggested that the technical and responsibility training, instrument verification, experimental environment control and quality control of laboratories at all levels should be continued.

Objective To investigate the effect of Xinmailong injection on patients with heart failure after emergency PCI and its effect on cardiac function. Methods 80 patients with heart failure after PCI in our hospital from December2015 to December 2016 were enrolled. All patients were divided into Xinmailong treatment group and conventional treatment group according to the random number table method, with 40 cases in each group. After emergency PCI, both groups were given conventional anti-platelet aggregation therapy, oral statin lipid-lowering drugs, ACEI, β-receptor antagonists, nitrates, etc. The Xinmailong treatment group was given 0.9％ sodium chloride injection 100 mL+Xinmailong injection 6 m L (ivgtt, 2 times/d). And the conventional treatment group was given 0.9％ sodium chloride injection 100 mL (ivgtt, 2 times/day). The two groups were treated continuously for 4 weeks. The clinical efficacy after treatment, as well as the changes of serum NT-proBNP levels before and after 1 week and 1 month of treatment, the LVEF and LVEDd before and after treatment of the two groups. Results The total effective rate of the patients in Xinmailong treatment group was 95.00％, which was significantly higher than that of the conventional treatment group, and the difference was significant (P<0.05). After treatment, serum NT-proBNP levels in the Xinmailong treatment group were significantly lower than those in the conventional treatment group at 1 week and 1 month after treatment, respectively, and the difference was significant (P<0.05). After treatment, the LVEF of the Xinmailong treatment group was significantly higher than that of the conventional treatment group, and the LVEDd of the Xinmailong treatment group was significantly lower than that of the conventional treatment group, and the difference was significant (P<0.05). Conclusion Xinmailong injection on the basis of routine treatment has exact curative effect on patients with heart failure after emergency PCI, which can significantly improve the heart function and improve the prognosis of patients. It is worthy of clinical promotion and application.