Animals ; SARS-CoV-2 ; Antibodies, Neutralizing ; Macaca mulatta ; COVID-19/prevention & control* ; Antibodies, Viral ; Vaccines

OBJECTIVES: Safe and effective anticoagulation is essential for hemodialysis patients who are at high risk of bleeding. The purpose of this trial is to evaluate the effectiveness and safety of two-stage regional citrate anticoagulation (RCA) combined with sequential anticoagulation and standard calcium-containing dialysate in intermittent hemodialysis (IHD) treatment. METHODS: Patients at high risk of bleeding who underwent IHD from September 2019 to May 2021 were prospectively enrolled in 13 blood purification centers of nephrology departments, and were randomly divided into RCA group and saline flushing group. In the RCA group, 0.04 g/mL sodium citrate was infused from the start of the dialysis line during blood draining and at the venous expansion chamber. The sodium citrate was stopped after 3 h of dialysis, which was changed to sequential dialysis without anticoagulant. The hazard ratios for coagulation were according to baseline. RESULTS: A total of 159 patients and 208 sessions were enrolled, including RCA group (80 patients, 110 sessions) and saline flushing group (79 patients, 98 sessions). The incidence of severe coagulation events of extracorporeal circulation in the RCA group was significantly lower than that in the saline flushing group (3.64% vs. 20.41%, P<0.001). The survival time of the filter pipeline in the RCA group was significantly longer than that in the saline flushing group ((238.34±9.33) min vs. (221.73±34.10) min, P<0.001). The urea clearance index (Kt/V) in the RCA group was similar to that in the saline flushing group with no statistically significant difference (1.12±0.34 vs. 1.08±0.34, P=0.41). CONCLUSIONS Compared with saline flushing, the two-stage RCA combined with a sequential anticoagulation strategy significantly reduced extracorporeal circulation clotting events and prolonged the dialysis time without serious adverse events.
Humans ; Citric Acid/adverse effects* ; Prospective Studies ; Sodium Citrate ; Hemorrhage/chemically induced* ; Citrates/adverse effects* ; Anticoagulants/adverse effects* ; Renal Dialysis/adverse effects*

Objective: By implementing the best practice of bedtime and position after diagnostic adult lumbar puncture,we hope to establish a scientific and standardized nursing routine for lumbar puncture, shorten the bed-rest time after lumbar puncture, and improve the comfort of patients. Methods: By reviewing literatures related to positions after adult lumbar puncture and post-dural puncture headache, six best practice were concluded. By combining the best evidence and the clinical circumstances, the evidenced-based criteria were established and then applied in the Neurology Department. Results: After two rounds of reviews, the results showed that except the 93.3% compliance with the new evidence, all other four criteria had 100% complacence. Comparing before and after applying the evidence, there was no statistically significant difference for the occurrence of post-dural puncture headache or dizziness(P>0.05), there was a statistically significant reduction of back pain from 28.3%(30/106) to 15.1%(18/119)(χ² value was 5.799, P<0.05) when the evidence was applied. Conclusions The best practice shows that patients needn′t lie on bed for 4 to 6 hours after lumbar puncture, the occurrence of back pain is lowered and the comfort level of the patient is improved in those who rest with pillow or activities.

Keratinized mucosa in oral cavity plays an important role in periodontal health. The defect of keratinized mucosa may increase the risks of complication of oral implant surgery and restoration. Graft of keratinized tissue and connective tissue are still the gold standard for treating keratinized mucosa defect now. The current research focus on how to modulate non-keratinized mucosa to highly-efficient and minimally-invasive keratinized mucosa. Keratinocytes are critical components of oral mucosa and its final differentiation into keratinized mucosa is controlled by the connective tissue microenvironment involving a variety of molecules and ions. To fully understand keratinized differentiation of keratinocyte, this review focuses on its influence factors and possible mechanisms under the differentiation.

Objective To grasp the current situation and trend of health personnel development in public TCM hospitals through the analysis of health personnel statistics data of public TCM hospitals in China; To provide decision-making references for management departments. Methods Data were from the National Health and Family Planning Commission Statistical Information Center. This article analyzed staff number, the average speed of development, the average annual growth rate, health staff age, academic qualifications and job titles and other indicators of TCM public hospitals during 2010-2015. Results From 2010 to 2015, there was an annual increasing tendency of the number of TCM health personnel, and the average annual growth rate was 5.9％, but the growth of the percentage of the TCM health personnel to the total health personnel was only 0.3％. In 2015, the proportion of TCM health personnel was less than 50％; the doctor-to-nurse ratio was 1:1.18; the educational level of postgraduate and undergraduate were 14.0％ and 48.0％ respectively, less than the average level of national hospitals. Conclusion From 2010 to 2015, there is an increasing tendency of the TCM health personnel of public TCM hospitals, but the proportion of TCM health personnel is low. The doctor-to-nurse ratio is reasonable gradually, but there is still a gap compared with the average level of the national hospitals. The average age of technical health personnel tends to be younger. The proportion of high educational level health personnel is increasing, but the proportion of senior technical position is reduced. The management departments should take appropriate measures to promote the rational allocation of human resources and development of TCM hospitals.

BACKGROUND:Poly(butylene succinate) (PBS) and polypropylenecarbonate (PPC) are new medical materials developed in recent years, characterized as good biocompatibility, biodegradability and the low price. OBJECTIVE:To prepare the PBS/PPC biofilm by electrostatic spinning method and evaluate its physical and chemical properties, degradation performance and effect on cel proliferationin vitro. METHODS:The PBS/PPC biofilm was prepared using electrostatic spinning method: 0.9 g PBS and 0.9 g PPC were dissolved in 10 mL of trichloromethane at room temperature and stirred magneticaly until they were fulydissolved. Then, the spinning solution was added into a spinning tube with a distance of about 15 cm and at a voltage of 18 kV. The surface morphology was observed by scanning electron microscopy. The intensity, contact angle and water absorption, pH value and weight loss in the process ofin vitro degradation were measured. MG63 cels were co-cultured with the biofilm for 7 days and cel proliferation was detected by cel counting kit-8. RESULTS AND CONCLUSION: The PBS/PPC biofilm showed a porous structure with interconnected pores. The fiber diameter was about 0.88 μm, the average aperture was about 5.68 μm, the porosity was 78.3%, the fracture intensity was 2.31 MPa, the elongation rate at break was 23.48%, the average value of contact angle was 87°, and the water absorption rate was 68.54%. During the biofilm degradation, the pH value decreased gradualy andreduced to 6.76 at 12 weeks; meanwhile, the biofilm degraded equaly and gradualy, and the weight loss rate was 6.04% at the end of the 12th week. The results of cel counting kit-8 showed that the PBS/PPC biofilm could promote cel proliferation. Overal, the PBS/PPC biofilm has good physical and chemical properties, good space-making feature, wettability and degradability, which can provide sufficient time for bone tissue regeneration.

Objective To quantitatively evaluate the difference in global longitudinal strain(GLS)and global circumferential strain (GCS)of three-layers of cardium between diabetes mellitus (DM)patients using layer-specific speckle-tracking imaging.Methods Fifty-seven DM patients and sixty matched controls were enrolled in the study.GLS and GCS of three-layer cardium were assessed using layer-specific speckle-tracking imaging,available by GE Vivid E9 and EchoPac workstation.Results GLS of three-layer cardium in DM patients were significantly lower than those in normal controls (all P <0.05).GCS of endo-and mid-cardium were significantly lower in DM patients than in normal controls (P < 0.05 ).There was no statistical difference of GCS of epi-cardium between the two groups (P > 0.05 ).GLS and GCS of three-layer cardium was highest in endo-cardium and lowest in epi-cardium.Conclusions GLS of three-layer cardium may be a sensitive indicator of early left ventricular systolic dysfunction in DM patients with normal ejection fraction.

Objective To evaluate the effect of parathyroid hormone(1-34) [PTH(1-34)] and coralline hydroxyapatite(CHA) on bone regeneration of peri-implant bone defects.Methods Two implant sites were prepared on both sides of tibia in 8 mongrel dogs.The bone defect was created along one bone wall of each implant site.Implants were implanted into the implant sites,then CHA was grafted into the bone defects.After surgery,the animals were randomly divided into two groups.PTH(1-34) (40 μg/kg) was used for subcutaneous injection to the experimental group for three consecutive days,meanwhile the same amount of saline was given to the control group.Half of the animals of each group were sacrificed after 4 weeks and 8 weeks respectively.Specimens were subjected to implant pull-out strength tests,X-ray picture and histological observation.Results The bone density of bone defects in the experimental group were higher than that in the control group.No low-density images was observed between the implants and bone at 4 weeks and 8 weeks.The maximum pull-out force value of the experimental group(199.8 N,411.5 N) was higher at 4 weeks and 8 weeks than that of the control group(100.1 N,184.5 N) (P＜0.05).The pull-out force value of the experimental group at 4 weeks and the pull-out force value of the control group at 8 weeks were similar.The new bone trabecular around CHA of experimental group was thicker at 4 weeks.Implant surface contacted to the new bone directly without fiber.CHA granules of the experimental group at 8 weeks were fewer than that of the control group.New bone tissue of the experimental group was denser.The contact area between implant surface and new bone was wider in experimental group than in the control group.Conclusions PTH(1-34) and CHA can promote bone regeneration of peri-implant bone defects,shorten the implants and bone healing cycle and improve the implants osseointegration.

Objective To Analyze the development tendency and major influential factors of the resource and service of traditional medicine (TM) by contrasting the statistical data between China and India.Methods The research data came from the governmental statistical date of traditional medicine.The main statistical indicators included:number of TM hospitals,number of beds in TM institutions,number of health personnel of TM,number of visits and inpatients of TM institutions.A contrastive analysis was given based on these data over the period of 2008-2012.Results In 2012,the number of traditional Chinese medicine (TCM) hospital per ten million populations was 25.1,the number of Traditional Indian Medicine (TIM) hospital per ten million populations was 25.9; the number of beds in TCM institutions per ten thousand populations was 4.5,the number of beds in TIM institutions per ten thousand populations was 0.5; the number of TCM physicians and physician assistants per ten thousand populations was 2.6,the number of TIM physicians and physician assistants per ten thousand populations was 5.9.In 2012,the numbers of visits and inpatients of governmental public TCM hospitals were 426.671 million and 16.882 million; the numbers of visits and inpatients of governmental public TIM hospitals were 73.445 million and 0.947 million.Conclusion There was no significant difference in the number of TM hospitals per ten million populations between China and India.China had obviously advantages in the number of beds in TM institutions,number of visits and inpatients of TM institution.India had obviously advantages in the number of TM health personnel.

Objective:To explore the impacts of right ventricular alternative site pacing on left ventricle contractibility and sys-tolic synchronicity by real-time three dimensional echocardiography .Methods :Tweenty patients with atrio-ventricular (AV ) blocks undergoing dual-chamber pacemaker implantation were divided into the right ventricular apex pacing group (Group RVA) and the right ventricular outflow tract pacing group (Group RVOT ) according to the different pacing sites . Left ventricular volume ,ejection fraction and LV regional wall motion were assessed by echocardiography before and 3 months after operation .The left ventricle contractibility and systolic synchronicity were compared between the two groups .Results:Stand-ard deviation and difference of time to minimum systolic volume (Tmsv-dif ,Tmsv-dif% ,Tmsv-sd ,Tmsv-sd% ) of 16 seg-ments ,12 segments and 6 segments ,LV volume ,excursion and regular 2D parameters do not differ .Conclusions :RVA and RVOT pacing are the same in terms of LV synchrony in short time follow-up .