Development of Korean Adult Patients Delirium Screening Tool / 임상간호연구

Purpose@#The purpose of this study was to develop a Korean Adult Patients Delirium Screening Tool (K-APDS) for those admitted to general wards, and to verify its reliability and validity. @*Methods@#For the development of the tool, 12 items were derived through the results of literature review and focus group interviews with general ward nurses, and the content validity was confirmed by experts. To verify the reliability and validity of the developed tool, 317 adult patients who were admitted to general wards of three tertiary general hospitals from October to November 2022 were evaluated by the attending nurse and data were collected. @*Results@#After factor analysis for construct validity verification, two factors were extracted, which explained 60.1% of the total variance. After the validation of the control group, the difference in the delirium incidence scores calculated using the K-APDS between the delirium group and non-delirium group was very significant (Z=-10.82, p<.001).To verify the criterion validity, K-APDS, Delirium Observation Screening, and Pearson's correlation coefficient were checked and found to be .94 (p<.001). The predictive validity test reported that the sensitivity was 91.1%, specificity was 82.4%, positive predictive value was 52.6%, and negative predictive value was 97.8%. The reliability of K-APDS was found to be high with Cronbach’s ⍺=.91. @*Conclusion@#K-APDS can screen for delirium with 2 or more points, excellent validity and reliability have been verified. Therefore, this tool could be applied immediately in the clinical field, and will contribute to the early detection of delirium, enabling rapid interventions.

Characteristics of injuries among primary and middle school students in Panyu District / 预防医学

Objective @#To investigate the injury characteristics among primary and middle school students in Panyu District, Guangzhou City, so as to provide the evidence for developing the strategies for prevention and control of injuries.@*Methods@# The data of 6 to 18 years old primary and middle school students with initial diagnosis of injury at Panyu District Central Hospital from 2014 to 2019 were collected. The basic characteristics of injury cases, the causes, time and place of injury development were analyzed by a descriptive epidemiological method.@*Results@#Totally 10 833 primary and middle school students with injury were reported in Panyu District from 2014 to 2019, including 7 401 boys and 3 432 girls, with a boy/girl ratio of 2.16∶1. The injury predominantly occurred in primary school students (6 903 cases, 63.72%). The causes of injury mainly included fall (4 457 cases, 41.14%), animal injury (2 593 cases, 23.94%), blunt injury (1 682 cases, 15.53%), knife/sharp instrument injury (923 cases, 8.52%) and traffic injury (731 cases, 6.75%). The place of injury development mainly included home (4 267 cases, 39.39%), school and public place (3 184 cases, 29.39%), and road/street (1 854 cases, 17.11%). The injury predominantly occurred from August to October (3 289 cases, 30.36%), and the activities at the time of injury mainly included leisure activities (3 860 cases, 35.63%), life activities (2 662 cases, 24.57%) and sports (1 929 cases, 17.81%). The characteristics of injury mainly included contusion/abrasion (4 528 cases, 41.80%), sharp instrument/bite/open injury (4 019 cases, 37.10%) and fracture (871 cases, 8.04%), and the upper limb was the main injury site (3 552 cases, 32.79%). There were 9 877 cases with mild injuries (91.18%), and 10 451 cases left hospitals after seeing a doctor (96.47%).@*Conclusions@#Fall is the main causes of injury among primary and middle school students in Panyu District, and boys and primary school students are high-risk groups for injury. Family prevention should be emphasized, and health education pertaining to injury should be intensified among students during the long holidays and leisure activities.

Bioactive hyaluronic acid fragments inhibit lipopolysaccharide-induced inflammatory responses via the Toll-like receptor 4 signaling pathway / 医学前沿

The high- and the low-molecular weight hyaluronic acids (HMW-HA and LMW-HA, respectively) showed different biological activities in inflammation. However, the role of LMW-HA in inflammatory response is controversial. In this study, we aimed to investigate the effect of bioactive hyaluronan (B-HA) on lipopolysaccharide (LPS)-induced inflammatory responses in human macrophages and mice. B-HA was produced from HA treated with glycosylated recombinant human hyaluronidase PH20. Human THP-1 cells were induced to differentiate into macrophages. THP-1-derived macrophages were treated with B-HA, LPS, or B-HA + LPS. The mRNA expression and the production of inflammatory cytokines were determined using quantitative real-time PCR and enzyme-linked immunosorbent assay. The phosphorylation levels of proteins in the nuclear factor-κB (NF-κB), mitogen-activated protein kinase (MAPK), and IRF-3 signaling pathways were measured using Western blot. The in vivo efficacy of B-HA was assessed in a mouse model of LPS-induced inflammation. Results showed that B-HA inhibited the expression of TNF-α, IL-6, IL-1, and IFN-β, and enhanced the expression of the antiinflammatory cytokine IL-10 in LPS-induced inflammatory responses in THP-1-derived macrophages and in vivo. B-HA significantly suppressed the phosphorylation of the TLR4 signaling pathway proteins p65, IKKα/β, IκBα, JNK1/2, ERK1/2, p38, and IRF-3. In conclusion, our results demonstrated that the B-HA attenuated the LPS-stimulated inflammatory response by inhibiting the activation of the TLR4 signaling pathway. B-HA could be a potential anti-inflammatory drug in the treatment of inflammatory disease.

Observation of the effect of early enteral nutrition based on feeding process in patients with acute exacerbation of chronic obstructive pulmonary disease and respiratory failure / 中华急诊医学杂志

Objective:To investigate the effects of enteral nutrition feeding process in critically ill patients on nutritional status, inflammation indexes and cardiopulmonary function in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and respiratory failure with mechanical ventilation.Methods:From December 2017 to January 2020, 60 patients who were diagnosed with AECOPD complicated with respiratory failure requiring mechanical ventilation were selected from the Department of Intensive Medicine of our hospital. The patients were divided into group A and group B according to the random number table method. Group A underwent conventional early enteral nutrition (EN) treatment, group B implemented early EN according to the enteral nutrition feeding process. The nutritional status, inflammation indicators, cardiopulmonary function, mechanical ventilation time and length of ICU stay before and after nutritional support between the two groups were comparedResults:After 2 weeks of nutritional support, the serum total protein (TP), albumin (ALB), prealbumin (PA) and hemoglobin (HB) in group B were increased by [(9.91±0.60)g/L, (7.6±0.58)g/L, (30.07±4.65)mg/L, and (15.43±1.18)g/L, which were significantly higher than those in group A (5.69±0.80)g/L, (4.20±0.47)g/L, (15.97±3.05)mg/L, and (6.70±0.49)g/L, respectively], and the difference between the two groups was statistically significant ( P<0.05). The high sensitivity C-reactive protein (hs-CRP), procalcitonin (PCT), and plasma lactic acid (LA) in group B were decreased by 39.07±5.55, 1.24±0.22, and 1.11±0.13, which were significantly higher than those in group A (18.94±3.18, 0.58±0.17 and 0.70±0.09, respectively), and the difference between the two groups was statistically significant ( P<0.05). There was no significant difference in N-terminal-type brain urine peptide precursor (Nt-proBNP) and ejection fraction (LVEF) before and after nutritional support between groups A and B ( P>0.05). The blood oxygen partial pressure (PaO 2) and PaO 2/ inhaled oxygen fraction (FiO 2) of group B before tracheal intubation and 24 h after tracheal intubation were increased by (25.17±1.71) mmHg and (231.53±5.39)%, which were significantly higher than those of group A [(12.17±1.59) mmHg and (164.60±5.66)%, respectively]. The blood carbon dioxide partial pressure (PaCO 2) in group B was decreased by (25.26±1.66)mmHg, which was significantly higher than that in group A (20.11±1.08) mmHg, and the difference between the two groups was statistically significant ( P<0.05). The mechanical ventilation time and length of ICU stay in group B were significantly lower than those in group A (10.17±0.46) d vs (12.30±0.64) d, (15.70±0.23) d vs (17.93±0.52) d, all P<0.05). Conclusion:When compared with conventional early enteral feeding, early enteral nutrition based on the enteral nutrition feeding process in AECOPD with respiratory failure and mechanical ventilation patients can improve the nutritional status, reduce the level of inflammatory indicators and the inflammatory response, and shorten the mechanical ventilation time and length of ICU stay.

Preparation and identification human anti-Siglec-9 Fab fragment antibody / 中国免疫学杂志

Objective:The prokaryotic expression vector of human anti-Siglec-9 Fab fragment antibody was constructed and purified,while was identified. Methods:The variable and conserved regions of heavy chain and light chain were obtained by polymerase chain reaction respectively(PCR),which was combined by overlap extension PCR and was digested with restriction enzyme,and then it was transformed into Escherichia coli BL21 and was purified by His-trap Lambda Fab column and AKTA system. SDS-PAGE,ELISA and Western blot were used for the identification of human anti-Siglec-9 Fab fragment antibody. The effect of human anti-Siglec-9 Fab fragment antibody on regulating the mRNA expression of TNF-α,IL-1,IL-6,IL-8 was detected by real-time PCR. Results:Successfully obtained the chains of heavy and light, while constructed an activation human anti-Siglec-9 Fab fragment antibody which could specifically bind to Siglec-9 protein. The human anti-Siglec-9 Fab fragment antibody could specifically bind to Siglec-9 was confirmed by SDS-PAGE,ELISA and Western blot. The human anti-Siglec-9 Fab fragment antibody inhibited the mRNA expression of TNF-α,IL-1, IL-6,IL-8. Conclusion:Successful prokaryotic expression,purification,character analysis,and suppressed the mRNA expression of in-flammatory cytokines with the human anti-Siglec-9 Fab fragment antibody and lay the biology foundation for the further study.

Open surgery vs endovascular repair for popliteal artery aneurysms / 中华普通外科杂志

Objective To compare the safety and efficacy of surgical and endovascular management for popliteal artery aneurysms.Methods The clinical data of 28 patients with popliteal artery aneurysm admitted to our department from December 2009 to March 2015 was analyzed retrospectively.12 patients underwent open surgery,and 16 did endovascular repair.Results In the surgical operation group (12 cases),the mean length of hospital stay was 18 ± 3 days,with 1 case suffering from delayed wound healing,and 1 case of anastomotic pseudoaneurysm The vascular graft patency rate was 100％ at 1 year (12/12),and 75％ (9/12) at 2 years.In the endovascular repair treatment group(16 cases),the average time of hospitalization was (10 ± 2) days.The patency rate of vascular stent was 93.3％ (14/15) at 1 year,and 86.7％ (13/15) at 2 years (all P ＞ 0.05).Surgical operation had longer hospitalization and more complications than endovascular repair.Conclusions Endovascular repair provides similar shortterm patency rate to that of surgical operation treatment,but with shorter hospitalizations and less complications in patients with popliteal artery aneurysms.Viabahn stenting helps improve the patency rate.

Effect of vitamin D supplementation on insulin resistance and blood glucose in people who are obese or people with abnormal glucose metabolism:A meta-analysis / 中华内分泌代谢杂志

Objective To systematically review the evidence for the effect of vitamin D supplementation on insulin resistance and blood glucose in people who are obese or people with abnormal glucose metabolism. Methods We searched databases including Pubmed, Elsevier, Web of Science, and WANFANG Database etc. for randomized controlled trials comparing vitamin D or analogues with placebo. We extracted data on insulin resistance and blood glucose, including homeostasis model assessment of insulin resistance( HOMA-IR), fasting blood glucose, HbA1C (% ). A1l data were analyzed using Review Manager 5. 0. Results Nine studies involving 867 participants were included. The results of meta-analysis showed that: ( 1 ) For people who are obese and with abnormal glucose metabolism, meta-analysis showed a small improvement in HOMA-IR(SMD -0. 34,95% CI -0. 61 to -0. 06, P<0. 05) and a small effect on fasting glucose (SMD -0. 41 mmol/ L, 95% CI -0. 68 to -0. 15, P<0. 05),while such effects were not seen in people who are obese but with normal blood glucose. (2) No serious adverse events were associated with the administration of vitamin D. Conclusion vitamin D supplementation may be benefit for improving insulin resistance and fasting blood glucose in people who are obese and with abnormal glucose metabolism, but has no effect on obese people with normal blood glucose.

Relationship between serum bilirubin and serum C-peptide levels in patients with type 2 diabetes mellitus / 中华内分泌代谢杂志

[Summary] The relationship between serum bilirubin and serum C-peptide levels in patients with type 2 diabetes mellitus was investigated. The clinical and laboratory data of 206 healthy subjects and 271 type 2 diabetic patients were collected. The partial correlation analysis and multiple linear regression analysis showed that serum bilirubin was positively correlated with fasting C-peptide, postprandial C-peptide, and the difference between postprandial C-peptide and fasting C-peptide levels(β=0. 171, 0. 111,0. 052,P<0. 05 or P<0. 01).

Application of systematic training methods for new nurses in central sterile supply department / 中国实用护理杂志

Objective To discuss the systematic training method for new nurses in central sterile supply department(CSSD),in order to improve the training effects of new nurses and special practice ability,and make them to be qualified for jobs in CSSD.Methods 18 new nurses in CSSD were divided into the control group and the experimental group with 9 nurses in each group.The experimental group adopted systematic training method combining with unit tests and comprehensive evaluation.The control group chose the traditional training method.The testing results were compared between two groups.Results The experimental group all passed through the unit evaluation and comprehensive evaluation,could work independently after the training,got excellent achievement in comprehensive assessment of the department after 3 months on-the-job,and could finish all the work and solve various emergencies.4 passengers failed in unit assessment in the control group,and 3 failed in the comprehensive evaluation.The average results in the experimental group were obviously higher than that of the control group.Conclusions Scientific training content,the systematic training method,comprehensive evaluation method can avoid the blindness and arbitrariness in training and improve training effect.The implementation of unit access system and post access system in standardized training of new nurses can improve the study enthusiasm and strengthen the risk and responsibility consciousness of nurses,which is beneficial to the growth of new nurses and professional value guidance.

Investigation and analysis of the anxious condition of nurses and correlative factors / 中国实用护理杂志

Objective To explore the anxious condition of nurses and correlative factors,and to explore the relationship between the nurses' anxiety and the correlative factors,so that can help the management echelon and nurses to correctly understand the relationship of anxiety and pressure,and control and handle the anxiety problem of nurses fundamentally,and improve the physical and mental health,work efficiency and nursing quality of nurses. Methods A questionnaire investigation was conducted in 85 nurses from a certain hospital in Harbin about the anxiety,life events,work stressor and the relationship between them. Results 30 nurses had anxiety(the anxiety group),another 55 nurses showed no anxiety(the nonanxiety group).The comparison of items in life events inventory showed that great difference existed in pregnancy,addition of new family members,the difficulty of training their children,property damage or being stolen,living apart with the spouse,magnificent changes of the life style,having got severe illness or wound.In the aspect of work sttessor scale,professional and career issues,workload and allocation of time,working environment,patient care and interaction showed significant difference.The work pressure was significantly associated with the level of anxiety. Conclusions Our finding suggest that effective stress management strategies should be implemented to reduce or eliminate work pressure of nurses,carry out training to improve the self-regulation ability of nurses,and if necessary biofeedback therapy can be introduced.

Correction between cytokine expressions in circulating CD4~+ CD28~-T cells and Graves'ophthalmopathy / 中华内分泌代谢杂志

The immune effect of CD4~+CD28~-T cells on Graves'ophthalmopathy(GO)was investigated.The expressions of interferon-γ(IFN-γ),interleukin-2(IL-2),and IL-4 in CD4~+ CD28~-T ceils were assayed by flow cytometry in GO patients,Graves'disease(GD)patients without ophthalmopathy,and healthy control subjects.The results showed that the percentage of CD4~+CD28~-T cells significantly increased in GO patients(P<0.05),with increased IFN-γ expression(P<0.05)and decreased IL-2 expression(P<0.05).These changes were closely correlated with clinical activity score(P<0.05).There were no significant differences in IL-4 expression among three groups.The resuh suggests that CIM~+ CD28~- T cells which hishly secrete IFN-γare related to the pathological lesion of GO.

Effect of valsartan on the expressions of Toll-like receptor 4 and myeloid differentiation factor 88 in the arteries of diabetic rats / 中华内分泌代谢杂志

ay be useful for preventing or treating early inflammation in the arteria of diabetic rats.

Comparison of Efficacy for Diabetic Rats Treated with Two Types of Microencapsulated adult Pig Pancreatic Islets / 中国医师杂志

Objective To observe and compare the functions of two types microencapsulated adult pig pancreatic islets in vivo.Methods The diabetic rats induced by streptozocin were divided into four groups:control group,non-encapsulated islet transplantation group,encapsulated islet with sodium alginate membrane transplantation group and encapsulated islet with agarose membrane transplantation group.All rats received intraperitoneal of islet transplantation.Results There were no significant difference in mean level of the blood glucose before transplantation among four groups.On the 7th day after transplantation,the mean level of the blood glucose in four groups were (22 67?1 15)mmol/L,(18 58?2 66)mmol/L(12 27?1 36)mmol/L and (12 38?2 68) mmol/L,respectively.There were significant difference between two encapsulated islet groups as compared with the other two groups(P