The rupture of carotid vulnerable plaques is the core pathological basis for major cardiovascular and cerebrovascular events. However， the insufficient alignment between existing animal models and the clinical disease and syndrome characteristics of traditional Chinese and western medicine has limited research progress. In this study， biomedical databases in China and abroad were systematically searched， and the modeling mechanisms and evaluation systems of carotid vulnerable plaque animal models were systematically assessed based on diagnostic criteria of both traditional Chinese and western medicine. Analysis of the clinical correspondence indicated that existing animal models can be categorized into four types： simple high-fat diet， surgical induction combined with high-fat feeding， genetic engineering combined with high-fat feeding， and drug induction combined with high-fat feeding. Among these， the compound strategy of surgical induction combined with high-fat feeding has become the current mainstream approach， showing good concordance with western medicine. The study found that the double balloon injury rabbit model and the ApoE^-/- mouse carotid artery tandem constriction combined with high-fat feeding model demonstrated a high degree of clinical correspondence with both traditional Chinese and western medicine in terms of vulnerable plaque imaging and pathological features. Nevertheless， existing models still face significant technical limitations in faithfully simulating plaque pathology and in translating findings to clinical applications. To address these challenges， integrating complex comorbidity mechanism construction， multimodal dynamic mechanism monitoring， and collaborative evaluation systems of traditional Chinese and western medicine could enable the development of highly concordant carotid vulnerable plaque disease-syndrome combination animal models. Such models would provide a reproducible experimental platform for targeted drug development to regulate plaque stability and for individualized precision treatment， as well as a theoretical basis for innovation in clinical diagnostic and therapeutic strategies.

Objective: To understand the implementation of daily study time standard among secondary school students in Shandong Province, so as to provide scientific basis for the formulation and implementation of relevant policies. Methods: From January to May 2023, a multi stage random sampling method was used to select 8 725 middle school students in Shandong Province. A survey questionnaire was designed based on the Requirements for Daily Study Time of Primary and Secondary School Students(GB/T 17223-2012), to investigate indicators such as students daily learning schedule, sleep and physical activity time, break time and scheduling requirements. Results: The compliance rates for daily study time in junior and senior high school students in Shandong Province were 29.2% and 23.6%, respectively, with a statistically significant difference ( χ 2=33.63, P <0.01). Compliance rates for sleep duration, physical activity and recess time, morning and afternoon class hours, and class duration were 19.3%, 26.2%, 30.5%, 73.2% and 16.2%. Class duration compliance was relatively high, with rates of 96.7% in junior high and 94.4% in senior high school students. There was a statistically significant difference in compliance rates for extended class breaks between different educational stages ( χ 2= 81.78, P <0.01), with rates of 84.6% in junior high and 83.4% in senior high school students. As students progressed through their educational stages, compliance rates for physical activities, class breaks, consecutive classes, and total weekly class hours showed a decreasing trend, with rates of 31.8% and 18.3%, 35.7% and 23.1%, 60.5% and 29.6%, 55.2% and 35.1% in junior and senior high school students, respectively. Conclusions The revised standard of Requirements for Daily Study Time of Primary and Secondary School Students(GB/T 17223-2012) optimizes the daily study and life schedule of middle school students to a certain extent. However, daily study time for middle school students in Shandong Province exceeds standard. Relevant departments need to enhance their ability to implement standards and strengthen the supervision of policy standards implementation.

Objective:To evaluate the clinical efficacy of individualized thrombolysis-assisted comprehensive intervention for deep vein thrombosis (DVT) in the lower limbs.Methods:This study included 32 patients with acute lower limb DVT diagnosed by angiography who received treatment at the Jianhu Clinical Medical College of Yangzhou University from March 2012 to November 2021. These patients first received implantation of an inferior vena cava filter. Then they were divided into a control group and an observation group based on treatment methods. The control group received thrombolytic catheterization and a routine infusion of urokinase. In the observation group, balloon dilation was performed first, and a large lumen catheter was used to draw blood clots. Subsequently, urokinase at a dose based on fibrinogen measurement was injected through a thrombolytic catheter. Swelling reduction, venous patency, and complications of the affected limbs were monitored.Results:In the control group, the difference in thigh circumference before treatment was (4.65 ± 1.06) cm, and after treatment, it was (2.76 ± 1.25) cm. In the observation group, the difference in thigh circumference before treatment was (4.73 ± 1.03) cm, and it was (1.40 ± 0.83) cm after treatment. In the control group, the difference in calf circumference before treatment was (2.24 ± 0.90) cm, and it was (1.56 ± 0.86) cm after treatment. In the observation group, the difference in calf circumference before treatment was (2.40 ± 0.83) cm, and it was (0.80 ± 0.73) cm after treatment. After treatment, the differences in thigh circumference and calf circumference between the healthy and affected sides were statistically significant ( t = 3.58, 2.67, both P < 0.05). After treatment, there was a significant difference in venous patency between the control and observation groups (34.02% [33/97] vs. 68.18% [60/88], t = 3.44, P < 0.05). After 12 months of follow-up, the Villalta scale score, which was used to evaluate post-thrombotic syndrome, was (9.23 ± 4.07) points in the control group, which was significantly different from (5.73 ± 3.39) points in the observation group ( t = 2.62, P < 0.05). Conclusion:Individualized thrombolysis-assisted comprehensive intervention is highly effective in the treatment of DVT in the lower limbs and results in few complications.

The report summarized the experience in perinatal nursing for 1 case of third trimester complicated with pulmonary arteriovenous fistula.The highlights of nursing for the case were as follows.A professional team was set up for division and cooperation of labor in perinatal nursing;relevant conditions were identified precisely,and relevant emergency care was well done;appropriate methods for pregnancy termination and anesthesia were selected,and relevant intraoperative nursing was performed smoothly;a whole process of fine management was adopted,and the occurrence of serious complications was prevented effectively;personalized guidance for breastfeeding was provided after delivery.After the comprehensive management of the multidisciplinary team,both mother and baby were discharged safely.

Objective:To explore the clinical effects of a series of posture intervention strategies on correcting abnormal fetal position, so as to provide a basis for Clinical position management and promotion of natural delivery.Methods:This study was a randomized controlled trial. The convenience sampling method was used to select 196 full-term primiparas women with abnormal fetal orientation confirmed by ultrasound as single fetal head position in the Women′s Hospital, School of Medicine, Zhejiang University from March to October 2022 as the research objects. They were divided into control group 106 cases and research group 90 cases by random number table method. The control group received normal nursing and chose comfortable position by themselves during labor. The research group received a series of ultrasound-guided postural intervention strategies for postural management in the first and second stages of labor on the basis of normal nursing. The angle of progression and the midline angle, the fetal orientation, fetal orientation during complete uterine orifice and delivery outcome were compared between the two groups.Results:Finally, 190 cases were included, 105 cases in the control group and 85 cases in the research group. There were 76 vaginal deliveries in the research group and 95 in the control group. The rate of anterior occipital position and the angle of fetal head rotation in the research group were 73.68% (56/76) and 64.55 (37.90, 85.55)°, which were higher than 45.26% (43/95) and 33.00 (14.00, 60.00)° in the control group;the midline angle of the research group was 57.10(38.50, 75.80)°, which was lower than 80.00 (52.50, 90.30)° of the control group. There was significant difference between the two groups ( χ2 = 14.14, Z = 4.17, - 3.74, all P<0.01). The first stage of labor was 522.50 (413.00, 695.00) minutes and the total stage of labor was 611.00 (488.00, 812.00) minutes in the research group, which was lower than 620.00 (450.00, 795.00) and 700.00 (539.00, 904.00) minutes in the control group ( Z = - 2.34, - 2.03, both P<0.05). Conclusions:The application of the serial position intervention strategy under the ultrasound guidance during the labor process can improve the abnormal fetal position, shorten the first stage of labor time effectively and safely, while it does not have any significant effect on the improvement of the delivery outcome.

Humans ; SARS-CoV-2 ; COVID-19 ; Antibodies ; Antibodies, Viral/therapeutic use* ; Antibodies, Neutralizing/therapeutic use*

OBJECTIVE: To analyze the predictors of successful weaning off extracorporeal membrane oxygenation (ECMO) after extracorporeal cardiopulmonary resuscitation (ECPR). METHODS: The clinical data of 56 patients with cardiac arrest who underwent ECPR in Hunan Provincial People's Hospital (the First Affiliated Hospital of Hunan Normal University) from July 2018 to September 2022 were retrospectively analyzed. According to whether ECMO was successfully weaning off, patients were divided into the successful weaning off group and the failed weaning off group. The basic data, duration of conventional cardiopulmonary resuscitation (CCPR, the time from cardiopulmonary resuscitation to ECMO), duration of ECMO, pulse pressure loss, complications, and the use of distal perfusion tube and intra-aortic balloon pump (IABP) were compared between the two groups. Univariate and multivariate Logistic regression analyses were performed to identify the risk factors for weaning failure of ECMO. RESULTS: Twenty-three patients (41.07%) were successfully weaned from ECMO. Compared with the successful weaning off group, patients in the failed weaning off group were older (years old: 46.7±15.6 vs. 37.8±16.8, P < 0.05), higher incidence of pulse pressure loss and ECMO complications [81.8% (27/33) vs. 21.7% (5/23), 84.8% (28/33) vs. 39.1% (9/23), both P < 0.01], and longer CCPR time (minutes: 72.3±19.5 vs. 54.4±24.6, P < 0.01), shorter duration of ECMO support (hours: 87.3±81.1 vs. 147.7±50.8, P < 0.01), and worse improvement in arterial blood pH and lactic acid (Lac) levels after ECPR support [pH: 7.1±0.1 vs. 7.3±0.1, Lac (mmol/L): 12.6±2.4 vs. 8.9±2.1, both P < 0.01]. There were no significant differences in the utilization rate of distal perfusion tube and IABP between the two groups. Univariate Logistic regression analysis showed that the factors affecting the weaning off ECMO of ECPR patients were pulse pressure loss, ECMO complications, arterial blood pH and Lac after installation [pulse pressure loss: odds ratio (OR) = 3.37, 95% confidence interval (95%CI) was 1.39-8.17, P = 0.007; ECMO complications: OR = 2.88, 95%CI was 1.11-7.45, P = 0.030; pH after installation: OR = 0.01, 95%CI was 0.00-0.16, P = 0.002; Lac after installation: OR = 1.21, 95%CI was 1.06-1.37, P = 0.003]. After adjusting for the effects of age, gender, ECMO complications, arterial blood pH and Lac after installation, and CCPR time, showed that pulse pressure loss was an independent predictor of weaning failure in ECPR patients (OR = 1.27, 95%CI was 1.01-1.61, P = 0.049). CONCLUSIONS Early loss of pulse pressure after ECPR is an independent predictor of failed weaning off ECMO in ECPR patients. Strengthening hemodynamic monitoring and management after ECPR is very important for the successful weaning off ECMO in ECPR.
Humans ; Extracorporeal Membrane Oxygenation ; Blood Pressure ; Retrospective Studies ; Perfusion ; Cardiopulmonary Resuscitation

Objective:To summarize the nursing care experience of intrauterine infection complicated with septic shock in middle pregnancy for a patient with recurrent spontaneous abortion and postpartum hemorrhage during anti shock treatment.Methods:On June 2020, one patient with recurrent spontaneous abortion was admitted to our hospital with intrauterine infection in the second trimester of pregnancy. Close observation of disease changes, formulate personalized emergency plan, respond quickly when the condition changes, cooperate closely and actively rescue, observation and nursing of postoperative hemorrhage, anti-infective therapy timely, psychological nursing and health education. After active rescue and careful nursing, the patient recovered and discharged 8 days after abortion.Results:After active treatment and careful nursing, the patient recovered well and recovered 8 days after operation.Conclusion:For patients with intrauterine infection, especially patients with recurrent spontaneous abortion, close observation , timely initiation of emergency plans, termination of pregnancy effective anti-infection treatment, and psychological nursing and health guidance are essential to ensure the life safety of patients and promote reproductive health.

Objective:To establish and evaluate a new diagnostic model for significant liver tissue damage in patients with chronic hepatitis B virus (HBV) infection in the immune tolerance phase.Methods:The clinical data of 275 chronic HBV infection patients in the immune tolerance phase who underwent liver biopsy from January 2015 to November 2020 in the Hwa Mei Hospital, University of Chinese Academy of Sciences were included. According to the liver pathological changes, patients were divided into

Qingweisan is one of the classical prescriptions commonly used in the treatment of oral diseases. By means of Bibliometrics， the authors collected the ancient books on Qingweisan and sifted out 411 valid data， involving 116 classics of traditional Chinese medicine. The historical origin， drug composition， indications， principle of composition， dosage，and preparation of Qingweisan were statistically analyzed， and it was found that the prescription originated from the Treatise on Spleen and Stomach（《脾胃论》） by LI Dongyuan and is composed of Rehmanniae Radix， Angelica Sinensis， Cortex Moutan， Coptidis Rhizoma and Cimicifugae Rhizoma， with the functions of clearing stomach， purging fire， cooling blood and dispersing depression. And Qingweisan was mainly used to treat toothache， headache， and preference for cold and aversion to heat caused by "excessive heat in yang brightness meridian". There were 352 indications recorded， most of which followed LI Dongyuan's theory and the expanded indications reached 70 kinds. Specifically， toothache （132） was the most， accounting for 22.49% of the total indications， followed by headache （60， 10.22%）. In addition， Qingweisan was widely used in modern clinical practice for multiple system diseases， among which oral system （197） was dominant， accounting for 72.69%， followed by skin system （28， 10.33%） and digestive system （27， 9.96%）. Although the indications were wide， the pathogenesis always belonged to "upward attack of stomach fire". Through the excavation and statistical analysis of the ancient books on Qingweisan and its modern clinical application， the authors aimed to provide a more scientific reference for the research and application of classical famous prescriptions.