Humans ; COVID-19 ; SARS-CoV-2

Objective:To simulate the biomechanical characteristics of the real human thoracic cavity with a multi-spring group variable damping structure, and to design a new cardiopulmonary resuscitation training manikin based on the simulated thoracic biomechanical characteristics combined with the original electronic feedback system, and to test its application effect in cardiopulmonary resuscitation (CPR) teaching.Methods:A total of 60 undergraduate students majoring in five-year clinical medicine of Batch 2019 in Naval Medical University were selected as the research objects and were randomly divided into the experimental group and the control group, with 30 students in each group. The control group used the traditional manikin for CPR training, and the experimental group used the new type of manikin for CPR training based on the control group. After the training, the two groups of personnel were assessed for single skill. The single skill was mainly manual CPR operations, including artificial respiration and chest compressions. The theory and skill operation assessment of CPR and satisfaction for teaching method in the two groups were compared. SPSS 23.0 was used for statistical analysis.Results:The students in the experimental group scored (54.33±3.09) points in the single skill operation assessment, which were significantly better than that of the students in the control group [(52.33±3.08) points], and the difference was statistically significant ( P<0.05). The follow-up questionnaire showed that the students in the experimental group had a better evaluation of the teaching and training effect of the new type of manikin. Conclusion:Compared with the traditional manikin, the new CPR manikin can simulate the CPR emergency scene of the real human body, which can effectively improve the CPR teaching effect of standardized training for medical students, and help the standardization, normalization, and popularization of CPR technology in China.

Objective:To evaluate the efficacy and safety of a novel domestic pulmonary thromoboectomy system Tendvia TM in the treatment for high-risk patients complicated with acute pulmonary embolization (APE). Methods:The study was designed as a prospective single-center clinical trial. Twenty-four high-risk patients with APE were recruited and underwent percutaneous mechanical thromoectomy (PMT) with the Tendvia TM pulmonary thromoboectomy system. The primary efficacy endpoint was the reduction of RV/LV ratio at the post-operative 48 h. The secondary efficacy endpoints included technical success rate, mean pulmonary arterial pressure (mPAP), arterial PaO 2 and the instant post-operative thrombus clearance rate. The evaluation of the safety included the intraoperative complications and related complications during the follow-up period associated with the PMT operation and the major adverse event (MAE) rate within the post-operative 48 h. The pre-and post-operative data were compared with paired sample t-test or Wilcoxon rank sum test to evaluate the efficacy and safety of Tendvia TM pulmonary thromoboectomy system. Results:The technical success rate of PMT with Tendvia TM pulmonary thromoboectomy system was 100% (24/24). The 48 h pre-operative RV/LV ratio was 1.19±0.25 and the post-operative RV/LV ratio was 0.82±0.16. The mean RV/LV ratio of the patients was decreased by 0.37±0.25 at post-operative 48 h with significant statistical difference ( t=7.03, P<0.001). The 48 h pre-operative mPAP was (31.09±6.09) mmHg and the post-operative mPAP was (25.91±4.36) mmHg. The mPAP of the patients was reduced by 5.18 mmHg at post-operative 48 h with significant statistical difference ( t=6.73, P<0.001). The pre-operative PaO 2 was (74.66±11.28) mmHg and the post-operative PaO 2 was (88.01±10.57) mmHg. The pressure of oxygen in artery was increased by 13.36 mmHg. The differences were statistically significant( t=-4.08, P<0.001). The rate of thrombus removal was 68.17%±22.66%. 87.5% (21 cases) of patients achieved a thrombus removal greater than grade Ⅱ. One patient underwent catheter directed thrombolysis (CDT) after PMT based on the evaluation of operator. The patient′s thrombus removal achieved grade Ⅲ after 48 h and the CDT was ceased. Hemoptysis occurred intra-operatively in one case underwent PMT and the symptom of the patient was alleviated with conservative medication. The MAE incidence within the post-operative 48 h was 4.17% (1/24). No device-related mortality or all-cause mortality occurred in the trial. Conclusions:The Tendvia TM pulmonary thromoboectomy system is a safe and effective device to remove the pulmonary arterial thrombus for the treatment of patients with APE. The Tendvia TM pulmonary thromoboectomy system can be a new choice in the treatment for the patients with APE.

Objective:To observe any effect of repeated magnetic stimulation of the spine on lower urinary tract function and the life quality of patients with neurogenic bladder after suprasacral spinal cord injury (SCI).Methods:Fifteen suprasacral SCI patients whose lower urinary tract function was not improving were enrolled. In the first 2 weeks, all received water drinking management and intermittent catheterization, while in the following 4 weeks they were additionally provided with daily transspinal magnetic stimulation at the level of the spinous process of the first lumbar vertebra five times a week. The stimulation frequency was 1Hz. The patients kept voiding diaries. Their urodynamics were quantified using neurogenic bladder symptom scoring (NBSS) and a life quality scale.Results:The frequency of catheterization and the average voided volume, as well as the maximum detrusor pressure during the storage phase, maximum bladder capacity, maximum urethral pressure during the voiding phase and voiding efficiency at the end of the sixth week were significantly different from those at the end of the second week and before the intervention. The average NBSS and life quality scores then showed significant differences from the earlier time points.Conclusion:Repeteitive transspinal magnetic stimulation of the spine can improve lower urinary tract functioning and the life quality of persons with neurogenic bladder after a suprasacral SCI.

Objective To evaluate the effect of mesenchymal stem cell (MSC) coated-islets on instant blood-mediated inflammatory reaction (IBMIR) after islet transplantation. Methods MSC labeled with tracer and human islets were placed into an ultra-low adsorption cell culture dish, shaken and mixed twice at an interval of 0.5 h, and then incubated at 37 ℃ and 5% CO₂ for 24 h to obtain MSC-coated islets. The coating effect of MSC and in vitro function of the islets were assessed. A blood circulation tube-shaped model was established in vitro. In the blank control group, 0.2 mL of islet culture solution was added. In the islet group, 800 islet equivalent quantity (IEQ) of uncoated islets were supplemented. In the MSC-coated islets group, 800 IEQ of MSC-coated islets were added, and circulated for 60 min at 37 ℃. A portion of 0.5 mL blood sample was taken for routine blood test at 0, 30 and 60 min, respectively. After 60 min circulation, the blood sample was filtered with a 70 μm filter to collect plasma, blood clots and islets. Blood clots and islets were subject to hematoxylin-eosin (HE) staining and immunohistochemical staining. Morphological changes and the aggregation of CD11b-positive cells surrounding the islets were observed. The contents of plasma thrombin-antithrombin complex (TAT), tissue factor (TF), C3a, C5b-9, interleukin (IL)-1β, IL-6, tumor necrosis factor (TNF)-α, monocyte chemoattractant protein (MCP)-1 and IL-8 were determined by enzyme-linked immune absorbent assay. Results After 24 h co-incubation, the islets were coated by MSC, with a coating degree of approximately 80%. In the islet and MSC-coated islet group, a large quantity of neutrophils and monocytes were observed surrounding the blood clots and islets, and the quantity of CD11b-positive cells in the MSC-coated islet group was less compared with that in the islet group. After co-incubation with the whole blood for 0, 30 and 60 min, the quantity of platelets, neutrophils and monocytes was declined in the MSC-coated and islet groups, and gradually decreased over time. Compared with the blank control group, the quantity of platelets, monocytes and neutrophils was lower, whereas the TF content was higher in the MSC-coated islet group. Compared with the islet group, the quantity of platelets, monocytes and neutrophils was higher, whereas the TAT and TF contents were less in the MSC-coated islet group, the differences were statistically significant (all P < 0.05). Compared with the blank control group, the expression levels of C3a, C5b-9, IL-6, TNF-α and IL-8 were up-regulated in the MSC-coated islet group. Compared with the islet group, the expression levels of C3a, C5b-9, IL-1β, IL-6, TNF-α, IL-8 and MCP-1 were down-regulated in the MSC-coated islet group, and the differences were statistically significant (all P < 0.05). Conclusions MSC-coated islets may reduce the exposure of islet TF in the blood and prevent the incidence of IBMIR during the coagulation response stage, thereby mitigating the injury and loss of islet allograft in the early stage of islet transplantation.

Osteoporotic vertebral compression fracture (OVCF) can lead to lower back pain and may be even accompanied by scoliosis, neurological dysfunction and other complications, which will affect the daily activities and life quality of patients. Vertebral augmentation is an effective treatment method for OVCF, but it cannot correct unbalance of bone metabolism or improve the osteoporotic status, causing complications like lower back pain, limited spinal activities and vertebral refracture. The post-operative systematic and standardized rehabilitation treatments can improve curative effect and therapeutic efficacy of anti-osteoporosis, reduce risk of vertebral refracture, increase patient compliance and improve quality of life. Since there still lack relevant clinical treatment guidelines for postoperative rehabilitation treatments following vertebral augmentation for OVCF, the current treatments are varied with uneven therapeutic effect. In order to standardize the postoperative rehabilitation treatment, the Spine Trauma Group of the Orthopedic Branch of Chinese Medical Doctor Association organized relevant experts to refer to relevant literature and develop the "Guideline for postoperative rehabilitation treatment following vertebral augmentation for osteoporotic vertebral compression fracture (2022 version)" based on the clinical guidelines published by the American Academy of Orthopedic Surgeons (AAOS) as well as on the principles of scientificity, practicality and advancement. The guideline provided evidence-based recommendations on 10 important issues related to postoperative rehabilitation treatments of OVCF.

Objective:To explore the clinical value by analyzing the application of abdominal aortic balloon occlusion in the uterine curettage treatment for patients with cesarean scar pregnancy (CSP).Methods:Totally 42 CSP patients in the first Affiliated Hospital of Zhengzhou University were analyzed retrospectively, 21 cases in the observation group, placing the balloon catheter to the abdominal aorta under the renal artery under the digital substraction angiography(DSA), conducting curettage under hysteroscopy or uterine laparoscopy immediately, and making intermittent blockage in abdominal aorta blood flow during the surgery;21 patients in the control group, conducting uterine artery embolization (UAE) before operation, conducting curettage under hysteroscopy or uterine laparoscopy after 1-3 days. The fluoroscopy time under DSA, body surface radiation dose, intraoperative blood loss, operation time, incidence of postoperative adverse reactions, hospitalization time and follow-up menstruation were comparatively analyzed.Results:All patients operated and retained the uterus successfully. In the control group, all 21 patients had different degrees of fever, pain and other symptoms after UAE. In the observation group and control group, the fluoroscopy time and body surface radiation dose under DSA respectively were (7.4±1.4) s, (5.4±1.1) mGy and (1 142.8±315.5) s, (1 442.0±300.0) mGy (both P<0.01);the average amount of intraoperative blood loss were (22±15), (19±14) ml ( P>0.05), the time of uterine curettage were (37±20), (42±19) minutes ( P>0.05);hospitalization time were (5.0±0.9), (7.7±1.3) days ( P<0.01). The follow-up period was more than 3 months, no adverse reactions were observed in the observation group; 4 cases of menstrual reduction and 1 case of intrauterine adhesions were found in the control group. Conclusion:Abdominal aortic balloon occlusion and UAE could effectively reduce intraoperative bleeding in uterine curettage for patients with CSP; abdominal aortic balloon occlusion has significant reduction of the X-ray dose, shorter hospitalization time, and fewer adverse events comparing to UAE.

Objective:To explore the effects of structured instructive feedback in nursing teaching with high-fidelity scenario simulation.Methods:From August 2017 to June 2019, this study selected 70 nursing undergraduate students of Grade 2016 in experimental group and 62 nursing undergraduate students of Grade 2015 in control group by convenience sampling. Control group carried out the method of instructive feedback, while experimental group implemented method of structured instructive feedback. The effects were compared with the performance self-rating scale for nursing students on simulation training and examination results.Results:At the end of the course, the score of the performance self-rating scale for nursing students on simulation training of students in experimental group was higher than that in control group with a statistical differences ( P<0.05) . There were no statistical differences in the scenario simulation performance and the total performance of students between two groups at the end of the course ( P>0.05) . Conclusions:Structured instructive feedback can improve the clinical skills of nursing and teaching effects, but there is still room for improvement.

Objective To evaluate the clinical application effect of a specific antibody detection kit for human echinococcosis (hydatidosis kit),and provide technical support for further optimization of the production process of hydatidosis kit.Methods Using the method of retrospective investigation,1 481 patients with hydatidosis and 1 055 no-hydatidosis patients who were diagnosed by operation,pathology (gold standard) and hydatidosis kit in First Affiliated Hospital of Xinjiang Medical University,from 2012 to 2016 were selected.The clinical data was analyzed.The diagnostic performance of the kit was evaluated.The stepwise discriminant analysis method was applied to construct discriminant analysis function and establish a diagnostic model for echinococcosis.The detection efficiency of four antigens in hydatidosis kit was analyzed.Results A total of 2 536 patients [1 275 males,1 261 females,aged (41.62 ± 18.43) years old] were investigated,with the highest proportion in the 30-59 age group (1 489cases).Liver was the main organ affected by echinococcosis.The sensitivity,specificity and consistency of the hydatidosis kit were 94.80％ (1 404/1 481),71.00％ (749/1 055),and 84.90％ (2 153/2 536),Yoden index was 0.66 and Kappa value was 0.68.The stepwise discriminant analysis function Y =0.777X1 + 0.258X2 + 0.241X3-1.575 was constructed by the stepwise discriminant analysis method.There was no significant difference between the consistency of stepwise discriminant analysis model and the current diagnostic criteria (85.73％ vs 84.90％,x2 =0.694,P ＞ 0.05).The consistency of differential diagnosis between vesicular and cystic echinococcosis was 76.07％ (1 068/1 404).There was no significant difference in the detection efficacy between Echinococcus granulosus cystic fluid antigen (EgCF) and hydatidosis kit (P ＞ 0.05).Conclusions The diagnosis and differential diagnosis efficiency of hydatidosis kit is high.It is suitable for clinical diagnosis and field epidemiological investigation of echinococcosis in hospitals at all levels.EgCF can be used as the antigen of echinococcosis monoantigen strip,and can be applied in the epidemiological investigation of echinococcosis.

Objective? To explore the patients' needs-oriented staged care protocol on self-care ability in colostomy patients. Methods? Totally 74 colostomy patients from Xuanwu Hospital, Capital Medical University were selected by convenient sampling from December 2015 to February 2017 and divided into the experiment group (n=39) and the control group (n=35). Patients in the control group received conventional care for stomy, while patients in the experiment group received the patients' needs-oriented staged care. The self-care ability were compared between the two groups. Results? The stomy care ability score of the experiment group totaled (32.15±6.43), while that of the control group totaled [(28.94±3.91), (t=2.558, P＜ 0.05)]. Conclusions? The patients' needs-oriented staged care protocol can effectively improve the self-care ability of colostomy patients and provide an effective path for clinical nursing work.