Objective To investigate the effect of"zero channel"emergency mode on the treatment of patients with severe traumatic brain injury.Methods A total of 147 patients with severe traumatic brain injury admitted to the Second Hospital of Jiaxing from January 2020 to December 2021 were selected as study objects.Sixty-two patients hospitalized in traditional emergency mode from January to December 2020 were included in control group,and 85 patients hospitalized in"zero channel"emergency mode from January to December 2021 were included in observation group.The initiation time of rescue,completion time of CT examination,completion time of blood transfusion,duration of operation,clinical prognosis and complication rate were compared between two groups.Results The initiation time of rescue,completion time of CT examination,completion time of blood transfusion,and duration of operation in observation group were significantly shorter than those in control group(P<0.05).The proportion of good recovery in observation group was significantly higher than that in control group(68.20%vs.38.70%,χ2=12.671,P<0.001).The complication rate of observation group was significantly lower than that of control group(21.18%vs.80.65%,χ2=51.000,P<0.001).Conclusion"Zero channel"emergency mode can effectively shorten the treatment time of patients with severe traumatic brain injury,improve the success rate of rescue,reduce the incidence of complications,worthy of clinical use and promotion.

Objective:To explore the effect of combining hand-brain perception training with hand-brain motor training based on mirror neuron theory on the recovery of upper limb function after a stroke.Methods:A group of 105 stroke survivors with upper limb dysfunction were randomly divided into a hand-brain perception (HP) group, a hand-brain motor (HM) group, and a combination (C) group, each of 35. In addition to conventional rehabilitation treatment (including exercise therapy, occupational therapy and physical factor therapy), the HP and HM groups were given hand-brain perception training and hand-brain motor training respectively, while group C was provided with both. Before the intervention and after 4 weeks, the upper limb motor functioning of all of the participants was assessed using the simplified version of the Fugl-Meyer upper limb motor function scale (FMA-UE). Sensory functioning was quantified using the tactile Semmes Weinstein monofilament examination (SWME), and the modified Barthel index (MBI) was used to quantify the participants′ ability in the activities of daily living.Results:After the intervention the average FMA-UE, MBI and SWME scores of all three groups had improved significantly, with group C′s average FMA-UE and MBI scores significantly better than the other two groups′ averages. The average SWME score of group C was then significantly better than that of group HM.Conclusions:Hand-brain perception combined with hand-brain motor training based on mirror neuron theory can further promote the recovery of upper limb sensory and motor functioning of stroke survivors., Such therapy is worthy of clinical promotion and application.

Liver fibrosis is primarily driven by the activation of hepatic stellate cells(HSCs),a process associated with ferroptosis.Ginsenoside Rb1(GRb1),a major active component extracted from Panax ginseng,inhibits HSC activation.However,the potential role of GRb1 in mediating HSC ferroptosis remains un-clear.This study examined the effect of GRb1 on liver fibrosis both in vivo and in vitro,using CCl4-induced liver fibrosis mouse model and primary HSCs,LX-2 cells.The findings revealed that GRb1 effectively inactivated HSCs in vitro,reducing alpha-smooth muscle actin(a-SMA)and type Ⅰ collagen(Col1A1)levels.Moreover,GRb1 significantly alleviated CCl4-induced liver fibrosis in vivo.From a mechanistic standpoint,the ferroptosis pathway appeared to be central to the antifibrotic effects of GRb1.Specifically,GRb1 promoted HSC ferroptosis both in vivo and in vitro,characterized by increased glutathione depletion,malondialdehyde production,iron overload,and accumulation of reactive oxygen species(ROS).Intriguingly,GRb1 increased Beclin 1(BECN1)levels and decreased the System Xc-key subunit SLC7A11.Further experiments showed that BECN1 silencing inhibited GRb1-induced effects on HSC ferroptosis and mitigated the reduction of SLC7A11 caused by GRb1.Moreover,BECN1 could directly interact with SLC7A11,initiating HSC ferroptosis.In conclusion,the suppression of BECN1 counteracted the effects of GRb1 on HSC inactivation both in vivo and in vitro.Overall,this study highlights the novel role of GRb1 in inducing HSC ferroptosis and promoting HSC inactivation,at least partly through its modulation of BECN1 and SLC7A11.

OBJECTIVE Cognitive deficit is a com-mon comorbidity in temporal lobe epilepsy(TLE)and that is not well controlled by current therapeutics.Currently,how epileptic seizure affects cognitive performance remains largely unclear.The subiculum is the major out-put of the hippocampus,which projects to entorhinal cor-tex and other more distinct brain regions.Physiologically,the subiculum codes spatial working memory and naviga-tion information including place,speed,and trajectory.Importantly,prior studies have noted the importance of the subiculum in the beginning,spreading,and generaliz-ing process of hippocampal seizure.How seizure-activated neurons in subiculum participate in cognitive impairment remains largely elusive.METHODS In this study,we sought to label the subicular seizure-activated c-fos+ neu-rons with a special promoter with enhanced synaptic activity-responsive element E-SARE in the subiculum,combined with chemogenetics and designer receptors exclusively activated by designer drugs(DREADDs),Ca2+ fiber photometry approaches,and behavioral tasks,to reveal the role of these neurons in cognitive impairment in epilepsy.RESULTS We found that chemogenetic inhibi-tion of subicular seizure-tagged c-fos+ neurons(mainly CaMK Ⅱ α+ glutamatergic neurons)alleviates seizure generalization and improves cognitive performance in the hippocampal CA3 kindling TLE model.While inhibition of seizure-labeled c-fos+ GABAergic interneuron shows no effect on seizure and cognition.As a comparison,che-mogenetic inhibition of the whole subicular CaMK Ⅱ α+ neuron impairs cognitive function in na?ve mice in basal condition.Notably,inhibition of subicular seizure-tagged c-fos+ neurons enhances the recruitment of cognition-responsive c-fos+ neurons via increasing neural excitability during cognition tasks.CONCLUSION Our results dem-onstrate that subicular seizure-activated c-fos+ neurons contribute to cognitive impairment in TLE,suggesting sei-zure-tagged c-fos+ neurons as the potential therapeutic target to alleviate cognitive impairment in TLE.

Objective: To investigate the clinical features of anti-signal recognition particle (SRP) antibody-positive patients with dermatomyositis/clinically amyopathic dermatomyositis (DM/CADM) . Methods: Clinical data were collected from 90 patients with DM/CADM, who were hospitalized at the Department of Dermatology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from June 2015 to July 2017. Immunoblotting assay was performed to determine the serum level of anti-SRP antibody in these patients. Statistical analysis was carried out using t test and Chi-square test. Results: Of the 90 patients with DM/CADM, 11 (12.2%) were positive for serum anti-SRP antibody, including 6 with DM and 5 with CADM. Among 82 adult patients with DM/CADM, the prevalence of malignant tumors was significantly higher in the patients with anti-SRP antibody than in those without (7/9 vs. 31.5%[23/73], χ² = 7.394, P = 0.006) . The 11 patients with anti-SRP antibody had typical DM skin lesions, and their cutaneous dermatomyositis disease area and severity index (CDASI) was 18.1 ± 2.9. The prevalence of "angel wings sign" (aliform erythema on the trunk) was significantly higher in the patients with anti-SRP antibody than in those without (7/11 vs. 29.9%[20/67], Fisher′s exact test, P = 0.028) . The positive rate of antinuclear antibody was significantly higher in the patients with anti-SRP antibody than in those without (4/8 vs. 16.7%[13/78], χ² = 6.053, P = 0.014) . Magnetic resonance imaging of muscles of both thighs of the 10 patients with anti-SRP antibody (6 with DM and 4 with CADM) showed the presence of abnormal signals in the thigh muscle group in 8, swelling of the muscle group in 2, subcutaneous edema in 2, myofascial swelling in 1, and no abnormities in 2. No interstitial lung disease or myocardial involvement was observed in the patients with anti-SRP antibody. Conclusions The anti-SRP antibody-positive patients with DM/CADM showed a high prevalence of "angel wings sign" , and a high risk of malignant tumors. Early detection of the anti-SRP antibody in patients with DM/CADM is helpful to predict the occurrence of malignant tumors.

Objective To explore the effects of multidisciplinary teamwork continuity of care for community-dwelling patients with advanced renal cell carcinoma treated with targeted drugs.Methods A total of 80 patients with stage IV renal cell carcinoma treated in our hospital from February 2014 to February 2017 were enrolled using convenience sampling method,and were randomly divided into the experimental group and the control group using random number table,with 40 cases in each group.Both groups were given routine nursing care,and multidisciplinary teamwork continuity of care was adopted in the experimental group additionally.Results One month after intervention,the patients' score of medication compliance questionnaire in the experimental group was significantly higher than that in the control group(P＜0.05);three months after intervention,the quality of life(QLQ-C30) score of the experimental group was significantly improved than that of the control group(P＜0.05),and the number of rehospitalization was significantly less than that in the control group(P＜0.05).The number and severity of adverse effects in the experimental group were lower than those in the control group,and no case of stopping medication or decreasing doses occurred.Conclusion The multidisciplinary teamwork continuity of care model can enhance health status of community-dwelling patients,improve medication compliance and quality of life,and reduce readmission.

Oxidative stress induced by free fatty acid aggravates endothelial injury, which leads to diabetic cardiovascular complications. Reduction of intracellular oxidative stress may attenuate these pathogenic processes. The dietary polyphenol resveratrol reportedly exerts potential protective effects against endothelial injury. This study determined whether resveratrol can reduce the palmitic acid (PA)-induced generation of reactive oxygen species (ROS) and further explored the underlying molecular mechanisms. We found that resveratrol significantly reduced the PA-induced endothelial ROS levels in human aortic endothelial cells. Resveratrol also induced endothelial cell autophagy, which mediated the effect of resveratrol on ROS reduction. Resveratrol stimulated autophagy via the AMP-activated protein kinase (AMPK)-mTOR pathway. Taken together, these data suggest that resveratrol prevents PA-induced intracellular ROS by autophagy regulation via the AMPK-mTOR pathway. Thus, the induction of autophagy by resveratrol may provide a novel therapeutic candidate for cardioprotection in metabolic syndrome.
AMP-Activated Protein Kinases ; metabolism ; Animals ; Antioxidants ; pharmacology ; Autophagy ; drug effects ; Cells, Cultured ; Endothelial Cells ; Humans ; Male ; Mice ; Mice, Inbred C57BL ; Oxidative Stress ; drug effects ; Reactive Oxygen Species ; metabolism ; Resveratrol ; pharmacology ; Signal Transduction ; drug effects ; TOR Serine-Threonine Kinases ; metabolism

Objective To evaluate the effect of enclosed safety blood sampling device in prevention of arterial catheter-related bloodstream infection.Methods Totally 510 patients who received successful radial and brachial artery cannulation in ICU of the Second Hospital of Jiaxing between June and December 2016 were selected according to the table of random number and randomly and equally divided into a control group and an experimental group. The patients in the control group received conventional blood sampling with arterial transducers, while the patients in the experimental group received blood sampling with Safedraw enclosed safety blood sampling devices. Their incidence of complications and AC-BSI related to arterial catheter were observed. Results The incidence of complications related to arterial catheter of the patients in the experimental group was 31.76%, lower than that of the patients in the control group, 42.74% (x2=6.576,P<0.05); the incidence of AC-BSI of the patients in the experimental group was 3.92%, lower than that of the patients in the control group, 8.23% (x2=4.156,P<0.05).Conclusions Enclosed safety blood sampling device used in pressure measurement for artery cannulation can effectively reduce the incidence of complications and AC-BSI related to arterial catheter, thus worthy of clinical expansion.

Objective To establish the integrated prevention and control guide for multidrug-resistant organism (MDRO), guide nursing staff to strengthen prevention and control for MDRO and to compare the rate of implementation in preventive and control measures along with the discovery rate of MDRO before and after implementing guide.Methods The main problems of prevention and control management for MDRO were analyzed and induced with the methods of literature search, interviews with medical staff in ICU, referring to relevent clinical data and so on. The prevention and control guide was formulated according to expert consensus on MDRO, hospital infection management system of MDRO, clinical practice demand and so on. The prevention and control guide was implemented involving carrying out evidence-base training, building up prevention and control process, quality control and so on from July 2015 to June 2016. All patients of ICU in the Second Hospital of Jiaxing between July 2014 and June 2016 were divided into two groups before (n=622) and after (n=604) implementing prevention and control guide by purposive sampling. The discovery situation of MDRO was investigated. Besides, the implementation situation of preventive and control measures was evaluated by selecting 380 patients and 375 patients from two groups separately.Results After implementing prevention and control guide for MDRO, the rate of implementation in preventive and control measures (90.40%) significantly improved compared to that before implementation (70.00%) along with the discovery rate of MDRO (8.77%) decreased compared to that before implementation (16.08%) with significant differences (P<0.05). Conclusions The application of prevention and control guide for MDRO can effectively decrease the discovery rate of MDRO in ICU, make prevention and control work of MDRO more scientific, standardized, systematized and have a good clinical guidance role for prevention and control for MDRO of critical patients.

Objective To explore the application effect of "world cafe" mode in the summary of nursing quality.MethodsFrom September 2015 to December 2015,the nursing department discussed the topics of nursing quality summary according to the "world cafe" mode,finally the duration of nursing quality discussion, the structural proportion of participants and the satisfaction of all participants were taken as observation indexes to compare with the traditional nursing quality review meeting held during March to June 2015. According to the "world cafe" mode, the discussion table of nursing summary was established nursing quality,the contents of nursing quality discussion were standardized,and participants of the seminar and the time were made. ResultsAfter the application of "world cafe" mode,the total conference time shortened to 1.5 h from 3 h before the application,and the repeat situation of participants′ statement and the rectification views were obviously improved (χ2=34.737,5.963;P<0.05). After the application of "world cafe" mode,participants were mainly clinical nurses,which accounted for 53.4%,and the structural situation of participants was significantly different (χ2=27.086,P<0.05). There were significant differences in satisfaction before and after the application of "world cafe" mode (χ2=4.706,P=0.03).ConclusionsThe application of "world cafe" mode fully shows the divergent thinking of clinical nurses,and embodies the idea of improving nursing quality of nurses at different levels,which can discover the key problem of nursing quality,provide practical measures for the improvement of nursing quality in next stage,set stage for the implementation of nursing work,shorten the conference time and improve the work efficiency and satisfaction of nurses. This method will have broad research and application prospect as a means to improve the nursing quality.