Objective:To retrieve, evaluate, and integrate the best evidence for the management of skin complications in children with percutaneous endoscopic gastrostomy (PEG) .Methods:Evidence on skin complications in children with PEG was systematically searched on BMJ Best Practice, UpToDate, CINAHL, Cochrane Library, Embase, Medline, National Institute for Health and Clinical Excellence (NICE), PubMed, Web of Science, Joanna Briggs Institute Evidence-Based Health Care Center Database in Australia, China Biology Medicine disc, China National Knowledge Infrastructure, WanFang Data, Chinese Medical Journal Full-text Database, Medlive and other domestic and foreign databases. The search period was from database establishment to August 31, 2023. Three evidence-based nursing professionals conducted quality evaluation, evidence extraction, and summarization of retrieved literature.Results:A total of six articles were included, including three guidelines, one clinical decision and two expert consensus. Eighteen pieces of evidence were formed from four aspects of perioperative nursing, ostomy tube nursing, complication management, and health education.Conclusions:The best evidence for management of skin complications in children with PEG summarized is of high quality and strong authority, which can provide evidence-based support for medical and nursing staff, aiming to reduce the incidence of skin complications in children with PEG and ensure patient safety.

Objective To investigate the effects of MCSO on physiological behavior and antioxidant index in D.melanogaster.Methods One-day-old wild type D.melanogaster was divided into control group,0.25％,0.5％,1％,2％and 4％dose groups,as well as male and female groups.The control group was exposed to the base medium,and each dose group was exposed to the MCSO medium added with 0.25％,0.5％,1％,2％and 4％concentrations,respectively.The optimal dosage concentration and time of administration were investigated by climbing experiment.Then the flies were divided into control group,model group and MCSO group.The model group was established by depriving the flies of sleep through repeated nocturnal light stimulation.Period of drug treatment,appetite test,negative geotaxis ability test,stress test,olfactory memory test,and sleep-wake rhythm detection were used to explore the effects of MCSO on their physiological behavior.The activities of super oxidase dismutase(SOD),catalase(CAT),and malondialdehyde(MDA)were detected by enzyme-linked immunosorbent assay.Results MCSO enhanced the locomotory ability of 30-day-old D.melanogaster(P＜0.01),increased the activity of SOD and CAT(P＜0.01),and decreased the concentration of MDA(P＜0.01).Improve olfactory memory of senile fruit flies.After sleep deprivation,the night sleep time of female Drosophila model group was reduced(P＜0.05),and that of male Drosophila model group was reduced(P＜0.01).After feeding MCSO,the night sleep time of female drosophila model group was extended(P＜0.05),and that of male drosophila model group was extended(P＜0.01).Conclusions MCSO had a certain antioxidant effect,prolonging the sleep time and improving the olfactory memory of sleep-deprived Drosophila.

Objective:To investigate the feasibility, clinical efficacy and donor site impact of the deep inferior epigastric artery perforator flap (DIEPF) with transverse symmetrical design in reconstruction of soft tissue defects in limbs.Methods:From September 2020 to August 2023, 12 patients with soft tissue defects of limbs who agreed to flap donor site in the lower abdominal wall were treated in the Department of Hand Surgery and Microsurgery, Sichuan Modern Hospital. There were 10 females and 2 males with an average age of 58.42 years old. Defect sites: 3 in upper limbs and 9 in lower limbs. Sizes of the soft tissue defect were 8.0 cm×15.0 cm-13.0 cm×40.0 cm. CTA or CDU was used to detect the perforators of deep inferior epigastric artery and appropriate perforators were selected. The width and length of redundant skin and subcutaneous tissues in the lower abdomen were evaluated according to the "pinch and lift test". Taking into account the requirements of abdominoplasty, symmetrical bilateral DIEPFs were designed in the transverse direction on the lower abdominal wall. The sizes of the flaps were 7.5 cm×24.0 cm-13.0 cm ×42.0 cm. The harvested flaps were firstly thinned under the microscope, trimmed and shaped properly to match the profile of the wounds. Blood circulation was reconstructed with various forms of vascular anastomoses, such as internal pressurisation, connection in series and Flow-through, etc. Lower abdominal wall wound should be gradually reduced in tension according to the requirements of abdominal wall plastic surgery, and cosmetic suturing should be performed.Results:All 12 DIEPFs survived. The lower abdominal donor site healed primarily. All patients were included in postoperative follow-up for 6 to 42 (average 18.31) months. All flaps were normal in colour and soft in texture. The appearance of abdominal walls were improved, and the function was not affected, except 1 patient who underwent debulking procedure 3 months after the surgery.Conclusion:The transverse symmetrical design of a DIEPF is an ideal method for reconstruction of soft tissue defects in limbs after appropriate flap modification. It is a win-win solution for an aesthetic appearance of donor and recipient sites of the flap.

Colorectal cancer is one of the most common malignant tumors of digestive tract. In 2020， 1.93 million new cases of colorectal cancer were diagnosed globally， ranking third in the global incidence spectrum， and 930 000 new deaths were reported， ranking second in the global cause of death spectrum. Meanwhile， the medical cost of metastatic colorectal cancer is the highest among all stages. A large number of studies have demonstrated that traditional Chinese medicine（TCM） treatment can bring clinical benefits to patients with metastatic colorectal cancer with unique efficacy. In order to further standardize the TCM diagnosis and treatment for metastatic colorectal cancer and improve the level of TCM diagnosis and treatment， Xiyuan Hospital， China Academy of Chinese Medical Sciences， together with other relevant units in China， according to the guideline development process of the World Health Organization Handbook for Guideline Development and the relevant requirements of the Clinical Evidence Grading Criteria on TCM Based on Evidence Body， the Regulations for Group Standards of China Association of Chinese Medicine and others， combined with the characteristics of TCM diagnosis and treatment and the actual situation in China， the Guidelines for TCM Diagnosis and Treatment of Metastatic Colorectal Cancer was developed in accordance with the Catalogue of TCM Diagnosis and Treatment Plans for 105 Diseases in 24 Specialties issued by Department of Medical Administration of National Administration of TCM.

Porcine deltacoronavirus (PDCoV) is a newly emerging enteropathogenic swine coronavirus causing acute diarrhea and vomiting in pigs. The apoptosis of ST cells induced by PDCoV infection was studied in this research. In ST cells, caspase activity assay showed that the activity of caspase 3, caspase 8 and caspase 9 increased significantly with the infection of PDCoV, but not observed in UV irradiated PDCoV-infected cells, indicating that PDCoV infection activated both endogenous and exogenous apoptotic pathways in ST cells, and the induction of apoptosis depended on viral replication. To further investigate the endogenous apoptosis induced by PDCoV, cytochrome C and apoptosis-inducing factors in cytoplasm and mitochondria were detected. Compared with normal cells, the amount of cytochrome C released from mitochondria to cytoplasm increased significantly in PDCoV-infected cells, and the release increased with the prolongation of infection, while the apoptosis-inducing factor was always localized to mitochondria, suggesting that PDCoV induced apoptosis was initiated through caspase-dependent mitochondrial apoptosis pathway by promoting cytochrome C in the mitochondrial membrane gap into the cytosol. In conclusion, this study reveals the mechanism of PDCoV inducing apoptosis.
Animals ; Apoptosis ; Coronavirus ; Coronavirus Infections ; Mitochondria ; Swine ; Swine Diseases

Objective To investigate the risk factors for postoperative deep wound infection after open reduction and internal fixation for closed calcaneal fractures.Methods From January 2014 to January 2017,190 patients with closed calcaneal fracture were treated at Department of Traumatic Orthopaedics,Taihe Hospital.They were 118 males and 72 females with an average of 39.8 years (range,from 18 to 73 years).They were divided into a deep infection group and a non deep infection group according to the presence or absence of deep wound infection in the follow-up period.The 2 groups were compared in the general clinical data.In statistical analysis,the related risk factors were first screened by single factor analysis and followed by multivariate logistic regression analysis to identify the independent risk factors associated with the postoperative deep wound infection in patients with closed calcaneal fracture.Results The 190 patients were followed up for an average of 21.3 months(range,from 13 to 31 months).Postoperative deep wound infection occurred in 11 patients,giving an overall incidence of 5.7％ (11 / 190).The single factor analysis showed that the deep infection group incurred significantly longer time for tourniquet and used significantly more conventional extensile lateral approach than the non deep infection group (P ＜ 0.05).There were no significant differences between the 2 groups in general data,injury cause,fracture type,drainage,or incision closure technique (P ＞ 0.05).The multivariate logistic regression analysis revealed that tourniquet time ＞ 80 min (OR=5.949,95％ CI:1.216～ 29.108,P=0.028) and conventional extensile lateral approach (OR =5.414,95％ CI:1.507 ～ 19.452,P =0.01) were independent risk factors fo r the postoperative deep wound infection in patients with closed calcaneal fracture after open reduction and internal fixation.Conclusions Tourniquet time and conventional extensile lateral approach may be the independent risk factors for postoperative deep wound infection in patients with closed calcaneal fracture after open reduction and internal fixation.Therefore,it is important to adopt the sinus tarsi approach and control tourniquet time within 80 minutes for prevention of deep wound infection as long as the surgical quality is ensured.

Objective To explore the correlation study of cerebral vascular hemo -dynamic index(CVHI) with blood pressure,body mass index (BMI)etc.in outpatients.Methods Participants were outpatients with non -invasive CVHI test,who were selected as study subjects.Height,weight,blood pressure and other general information were investigated and the distribution characteristics of blood pressure,BMI and CVHI were compared in different age and gender groups.Results A total of 28 616 subjects were included in the study.The age range was 11 -99 years. Means of CVHI integral score in males and females were (77.78 ±28.44)points and (79.18 ±27.8)points(t =4.275,P <0.01),and abnormality rates of the score(<75 points)were 30.1% and 28.1%(χ2 =13.444,P <0.01),the differences were statistically significant.CVHI score was decreased and the abnormal rate was increased with aging.Systolic blood pressure was elevated with aging and diastolic blood pressure was higher in middle age subjects (40 -65 years).The proportions of over weighted and obesity in male were 37.5% and 15.4%,which in female were 33.2% and 14.9%(χ2 =70.661,P <0.01).It was especially higher in middle age subjects.Conclusion Degree of injury of cerebrovascular function and level of systolic blood pressure are along with aging.Means of BMI and diastolic blood pressure is higher in middle age population.The rate of high risk individuals in outpatients is about 30%.

Objective To investigate the impact flat deformity of the cerebral cortex induced by congenital hydrocephalus on motor functioning and cognition.Methods Tomography was used to confirm the presence of flat cortex deformity in three congenital hydrocephalus patients ranging in age from 20 to 33.Their motor control,balance,cognition and ability in the activities of daily living (ADL) were evaluated using the Fugl-Meyer assessment (FMA),the Berg balance scale (BBS),the mini-mental state examination (MMSE) and the modified Barthel index (MBI).Speech dysfunction was judged on the basis of clinical communication.The patients were scanned using a 64-slice spiral CT and size-of-ventricle indices were calculated.Results All 3 patients underwent ventrideperitoneal shunt.Their FMA scores were 75.5,83 and 100,with BBS scores of 4,24 and 56,MMSE scores of 14,23 and 26,and the MBIs of 40,90 and 100.CT images showed obvious ventricle enlargement and a thinner cortex layer in all three,with the thinnest part 0.18 cm,0.22 cm and 0.57 cm.Their ventricle indexes were 303％,288％ and 192％,respectively.Conclusion Although there is no systematic rehabilitation therapy for such patients,their motor,cognition and speech functioning were good,indicating the great potential for plasticity of the human brain.

Objective To investigate the effect of cyclic tensile stress (CTS) on the metabolism inand apoptosis of rat chondrocytes.Methods Primary rat chondrocytes were cultured on a Bioflex plate for one day and then stretched cyclically for 24 hours at a frequency of 0.5 Hz using a Flexcell-5000T apparatus.The cells were divided into 5 groups according to their stretching ratio:0％ (the control group),2％,6％,10％ and 14％.After the stretching,Col Ⅱ,Aggrecan,MMP-13 and ADAMTS-5 mRNA were measured using qPCRs,and the NO and PGE2 levels were measured using ELISA kits.Moreover,TUNEL staining and Annexin V-FITC/PI were used to analyze the apoptosis of chondrocytes.Results Compared with the control group,the average levels of Col Ⅱ and Aggrecan mRNAdecreasedin 10％ and 14％ groups [(0.738±0.11) and (0.58±0.13),(0.75±0.11) and (0.55±0.09)].In those groups,the MMP-13 [(2.47±0.47) and (2.88±0.36)] and ADAMTS-5 mRNA level [(2.39±0.33) and (2.75±0.49)],the NO [(6.96±0.96) and (8.28±0.82)] and PGE2 level [(6.83±0.66) and (7.15±0.71)] had increased significantly.In the 6％ group the average levels of Col Ⅱ(1.76±0.30) and Aggrecan mRNA (1.93±0.14)of 6％ group were significantly higher than the control group,but the NO level of the former (3.07±0.20) was significantly lower than the control group (3.89 ± 0.33).The apoptosis rate of chondrocytesin 2％ and 6％ groups were (0.065±0.013) and (0.063 ± 0.147),without significant differences to that of the control group (0.045 ± 0.008).However,compared with the control group,apoptosis in the 10％ and 14％ groups [(0.135 ±0.026) and (0.184±0.020)] increased significantly.Conclusion The effect of cyclic tensile stress on chondrocyte metabolism and apoptosis was magnitude-dependent.Ten percent and 14％ CTS can increase the catabolism and apoptosis of chondrocytes.Ten percent and 14％ strain can increase the catabolism and apoptosis of chondrocytes.Cyclic 6％ strain can increase the anabolism of chondrocytes,but 2％ strain has no impact on metabolism or apoptosis.

Objective To evaluate the prophylatic effect of recombinant human erythropoietin (rhEPO) on bronchopulmonary dysplasia (BPD) of preterm infants. Methods One hundred and fifty-five infants who were born at 26-29+6 weeks of gestation in Department of Neonatology, Guangdong Women and Children Hospital from January 1, 2009 to December 31, 2010 were randomly assigned to rhEPO-treated group (n=78) and control group (n=77) on admission. Randomization was stratified according to gestational age (26 or 27 weeks and 28 or 29 weeks). rhEPO-treated group was given the rhEPO at 300 U/kg, but none for the control group. Forty-eight hours after birth, rhEPO was injected subcutaneously every other day, three times a week for 4 weeks. The supportive care was same in the two groups. The outcomes at 36 weeks gestation included:(1) mortality of the infants;(2) incidence and severity of BPD;(3) rates of the complications, such as pneumonia, sepsis, necrotizing enterocolitis (NEC), intraventricular hemorrhage (IVH), patent ductus arteriosus (PDA), and retinopathy of prematurity (ROP) ; and (4) duration of oxygen and ventilation support. Mann-Whitney U, χ2, Fisher's exact or t test were used for statistical analysis. Results The incidence of BPD in rhEPO-treated group was lower than in the control group [18.6%(11/59) vs 36.8%(25/68),χ2=5.107,P=0.030), but there was no difference in the severity of BPD (P>0.05). There was no significant difference in the mortality rate between the two groups [12.8%(10/78)vs 7.8%(6/77), P>0.05]. The duration of the mechanical ventilation and oxygen therapy was shorter in rhEPO-treated group than in the control group [oxygen therapy:166.4(138.9-198.1) h vs 288.9(287.4-312.9)h, U=361.000;mechanical ventilation:80.5(67.7-95.1) h vs 150.4(148.9-151.9) h, U=88.000;both P<0.05]. There were no significant differences between the two groups in the rates of the complications, including pneumonia, sepsis, NEC, IVH, PDA and ROP, in preterm infants during hospitalization (all P>0.05). Conclusion Prophylatic treatment of rhEPO in preterm infants could decrease the incidence of BPD, and reduce the duration of the mechanical ventilation and oxygen therapy, but without increasing any side effects.