Replantation of traumatic amputation in children has its own characteristics. This consensus primarily focuses on the issues related to the treatment of traumatically amputated limb injuries in children. Organised along a timeline, the consensus summarises domestic and international clinical experiences in emergency care and injury assessment of traumatic limb amputation limbs, indications and contraindications for replantation surgery, principles and procedures of replantation surgery, postoperative medication and management, as well as rehabilitation in children. The aim of this consensus is to propose standardise the treatment protocols for limb replantation for children therefore to serve as a reference for clinical practitioners in medical practices, and further improve the treatment and care for the traumatic limb amputations in children.

Objective:To understand the status of psychological capital and disaster preparedness of clinical nurses and analyze the relationship between them.Methods:From August to October 2020, 508 clinical nurses were selected from 8 Class Ⅲ hospitals in Zhejiang province by convenience sampling method. General information questionnaire, nurses' psychological capital questionnaire and disaster preparedness questionnaire were used. A total of 508 questionnaires were sent out and 503 valid questionnaires were collected with an effective rate of 99.01%.Results:The total score of disaster preparedness score of 503 clinical nurses was (179.53±41.11) points, mean items score was (3.99±0.91) points, psychological capital was (91.86±14.68) points, mean items score was (4.49±0.73) points. Correlation analysis showed that nurses' psychological capital was positively correlated with disaster preparedness ( r value was 0.610, P<0.05). Regression analysis showed that psychological capital, department, working years, whether participated in disaster training and disaster event rescue had significant impact on disaster preparedness of clinical nurses ( t values were 2.002-16.770, P<0.01 or 0.05). Conclusions:The knowledge, skills and post disaster management of clinical nurses are still deficient. Psychological capital affects the level of disaster preparedness of nurses to a certain extent. Nursing managers should formulate targeted intervention measures to enhance the level of psychological capital of nurses, so as to better improve the disaster preparedness of clinical nurses.

OBJECTIVE: To test the validity and reliability of the Chinese version of Mobile Phone Involvement Questionnaire (MPIQ) in college students. METHODS: We assessed the degree of phone dependence using the MPIQ among 2122 college students. One month later, 60 students were randomly selected for assessment with the MPIQ, and the ROC curve was generated to evaluate the true positive rate (sensitivity) and false positive rate at different cutoff values to determine the optimal cutoff score of the MPIQ. RESULTS: Among 98.9% of the participants who finished all the items, their MPIQ scores show a positive skew distribution and a one-factor structure. The load scores of the items ranged from 0.54 to 0.77. The Cronbach's α coefficient and the Spearman Brown split reliability were 0.84 and 0.83, respectively, the correlation coefficients between the items and total score ranged from 0.54 to 0.76, and the test-retest reliability was 0.48 ( < 0.001). At the optimal cut-off score of 32, the sensitivity and the specificity of the MPIQ were 0.634 and 0.652, respectively. CONCLUSIONS At the optimal cut-off score of 32, the MPIQ has good validity and reliability for assessing phone dependence among college students.
Cell Phone ; Humans ; Reproducibility of Results ; Students ; Surveys and Questionnaires

OBJECTIVE: To investigate the association of mobile phone use with sleep disorder and unhealthy eating behavior among college students of a medical university in Guangzhou. METHODS: Mobile Phone Involvement Questionnaire (MPIQ), Pittsburgh Sleep Quality Index (PSQI) and the Three Factor Eating Questionnaire Revised 21 Item (TFEQ-R21) were used to survey 2122 undergraduates of the medical university. One-sample t test, One-way ANOVA and multiple linear regression analysis were used to analyze the data. RESULTS: Age, body mass index (BMI), phone use before sleep, phone use frequency, sleep quality (assessed by total PSQI score) and the dimension scores of TFEQ-R21 for uncontrolled eating, cognitive restraint, and emotional eating were all significantly correlated with the total score of MPIQ ( < 0.05). Phone use before sleep, high frequency of mobile phone use, poor sleep quality and emotional eating were associated with high MPIQ scores, while lower cognitive restraint and emotional eating tendency were correlated with lower scores of MPIQ. Bivariate analysis revealed that age (=0.088, < 0.001), BMI (=0.055, < 0.05), PSQI scores (=0.204, < 0.001), TFEQ-UE scores (=0.199, < 0.001), TFEQ-CR scores (=-0.076, < 0.001), TFEQ-EE scores (=0.170, < 0.001), phone use before sleep (=0.429, < 0.001), and phone use frequency (=0.316, < 0.001) were all significantly correlated with MPIQ scores; multiple linear regression analysis showed that model 4 incorporating the scores of TFEQ-UE, TFEQ-CR, and TFEQ-EE explained up to 21.8% of the main effect (adjusted R= 21.5%). CONCLUSIONS Mobile phone overuse is associated with poor sleep quality and unhealthy eating behaviors, and education and interventions for mobile phone use is essential among college students.
Cell Phone ; Feeding Behavior ; Humans ; Sleep Wake Disorders ; Students ; Universities

Objective To explore the efficacy ofTiaogan-Bushen-Xiaoji recipe (TGBSXJ Recipe) on overall survival and progression free survival (PFS) in patients with advanced breast cancer.Methods A total of 105 patients with advanced breast cancer, who received the first-line treatment, were divided into two groups, 56 cases in the control group and 49 in the experimental group. The control group received standard therapy according to guidelines, including chemotherapy, targeted therapy, endocrine therapy and treatment of bisphosphonates.The experimental group received the treatment of TGBSXJ Recipe besides the standard therapy. The overall survival (OS), progression-free survival (PFS) and Karnofsky (KPS) of the patients in two groups were observed and compared. The treatment ended with the sighs of the observation ending, the second progress for the disease or death.Results The overall survival of the experimental group was significantly higher than that of the control group [OS: 58.2(50.7-65.8)/monthsvs. 43.8(30.6-51.6)/months,P=0.040]. The PFS of the experimental group was significantly higher than the control group [PFS: 30.7(23.8-37.7)/monthsvs. 15.2(11.3-19.1)/months,P=0.001]. The KPS of the experimental group was significantly higher than the control group (88.6 ± 10.0vs. 80.5 ± 19.0,t=2.654). The PFS of the triple negative breast cancer (TNBC) in the experimental group was significantly higher than control group [(25.1(12.1-38.0)/monthsvs. 9.9(4.7-15.0)/months,P=0.038].Conclusions The TGBSXJ recipe could extend the OS and PFS and improve the life quality of the patients with advanced breast cancer. In this study, no severe adverse effects had been found in the experimental group.

Epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) targeted treatment has been a standard therapy for advanced non-small cell lung cancer (NSCLC), but it is not tolerated well by all patients. In China, some studies have reported that traditional Chinese medicinal herbs (TCMHs) may increase efficacy and reduce toxicity when combined with EGFR-TKI, but outside of China few studies of this kind have been attempted.

It has been demonstrated that the activated protein C (APC) plays an important role in the inhibition of inflammation. The activation of protein C can be significantly enhanced by the endothelial cell protein C receptor (EPCR). Previous studies proposed that the APC regulates the inflammatory response in endothelial cells by suppressing the expression of adhesion molecules and the secretion of chemokines and cytokines. However, the precise mechanism of the inhibitory effect of APC on inflammation is still poorly understood. In the present study, we evaluated the anti-inflammatory effect of recombinant human APC (rhAPC) and whether its inhibitory effect is conducted through the EPCR-dependent mechanism on human umbilical vein endothelial cells (HUVECs). By exposing HUVECs to: (1) TNF-alpha; (2) rhAPC plus TNF-alpha; (3) anti EPCR antibody that prevents rhAPC interaction with EPCR; (4) TNF-alpha plus anti EPCR antibody; (5) rhAPC plus TNF-alpha in the presence of anti EPCR antibody, we found that APC was able to significantly inhibit the TNF-alpha-induced secretion of cytokines such as IL-1beta and IL-8, as well as the expression of adhesion molecules such as ICAM-1, VCAM-1 and E-selction in HUVECs. These results reveal a novel pathway by which APC protects endothelial cells from inflammatory mediators through an EPCR-dependent mechanism.
Antigens, CD ; metabolism ; Cells, Cultured ; Cytokines ; metabolism ; Endothelial Protein C Receptor ; Human Umbilical Vein Endothelial Cells ; drug effects ; Humans ; Inflammation ; metabolism ; Protein C ; pharmacology ; Receptors, Cell Surface ; metabolism ; Tumor Necrosis Factor-alpha ; antagonists & inhibitors

The protein C anticoagulant pathway plays a fundamental role in the control of coagulation system and inflammatory response. It has been well established that physiological levels of shear stress induce endothelial structural change and modulate gene and protein expression. However, the role of shear stress in protein C pathway remains unknown. In the present study, we evaluated the effect of shear stress on the activation of protein C as well as on the expression of endothelial protein C receptor (EPCR) and thrombomodulin (TM) in human umbilical vein endothelial cells (HUVECs) which were exposed to TNF-alpha alone, shear stress alone, and TNF-alpha under shear stress. We found: (1) Either TNF-alpha or shear stress alone significantly reduced EPCR expression and protein C activation in HUVECs; and simultaneous exposure of HUVECs to TNF-alpha and shear stress resulted in a further decrease of EPCR expression and protein C activation (P<0.05); (2) Simultaneous exposure of HUVECs to TNF-alpha and shear stress resulted in the increase of soluble EPCR level more significantly than did the exposure of HUVECs to either TNF-alpha or shear stress alone (P<0.05); (3) Shear stress significantly increased TM expression on HUVECs, whereas TNF-alpha inhibited TM expression; shear stress could strongly neutralize TNF-alpha's inhibitive effect on TM expression. We therefore conclude that shear stress may play an important role in protein C pathway, which may be fulfilled by regulating EPCR expression and TM expression in endothelial cells.
Antigens, CD ; genetics ; metabolism ; Biomechanical Phenomena ; Cells, Cultured ; Endothelial Cells ; cytology ; metabolism ; Endothelial Protein C Receptor ; Humans ; Protein C ; metabolism ; Receptors, Cell Surface ; genetics ; metabolism ; Shear Strength ; Stress, Mechanical ; Thrombomodulin ; genetics ; metabolism ; Umbilical Veins ; cytology

To study the effects of intraperitoneal chemotherapy (IPC) plus Shenmai Injection (SMI) in treating advanced colorectal cancer following radical resections.

OBJECTIVE: To explore the mechanism of Baisuifang Granule in treating cognitive malfunction after cerebral infarction. METHODS: One hundred and sixty patients with cerebral infarction were divided randomly into two groups. Eighty patients were treated with Baisuifang Granule and 80 with nimodipine for two months. Clinical observation and laboratory examinations were performed for Mini-Mental State Examination (MMSE), clinical symptoms, Chinese Stroke Scale (CSS), hemorrheological indexes and fibrinogen before and after the treatment. RESULTS: Baisuifang Granule could improve MMSE, reduce the scores of clinical symptoms and CSS, and meliorate the blood rheology. The total effective rate for clinical symptoms in the Baisuifang treated group accounted to 76.25%, with statistical difference comparing to 58.75% of nimodipine treated group (P<0.05). There was significant difference in symptom integral, CSS and whole blood viscosity at the high shear rate, respectively (P<0.01). CONCLUSION: Baisuifang Granule is an effective Chinese medicine for treating cognitive malfunction after cerebral infarction.