[Cognition and Ability of Emergency Physicians for Palliative Care in Tertiary Hospitals].

Objective To understand the cognition and related abilities of emergency physicians for palliative care in China. Methods A total of 115 emergency physicians were selected by convenient sampling to conduct a questionnaire survey.The questionnaire included the physicians' basic information,feelings and attitudes towards end-stage patients and their families,cognition of palliative care,and personal ability for palliative care. Results 25.2%,59.1%,and 15.7% of the emergency physicians considered they had "no understanding","partial understanding",and "full understanding" of palliative care,respectively.32(27.8%)physicians participated in palliative care-related lectures and they showed higher self-rated cognition levels(P=0.002).Wechat(39.1%),media(36.5%),and word of mouth(33.0%)were the main ways for emergency physicians to acquire the knowledge of palliative care.Among the emergency physicians,68.7% felt "powerless" in the face of end-stage patients,and 60.9% and 59.1% felt tangled and worried about death causing disputes,respectively.The emergency physicians had low self-rated ability in relieving dyspnea after removal of ventilator[3(2,4)]and eliminating the fear of death[3(3,4)].The self-rated cognition level of emergency physicians to palliative care was positively correlated with most of the self-rated ability indexes. Conclusions Lectures have a significant impact on emergency physicians' cognition level of palliative care.Most of the self-rated indexes of palliative care ability are positively correlated with the cognition level of palliative care.In the face of end-stage patients,most of the emergency physicians are powerless,tangled,and worried about disputes,and their self-rated indexes in relieving dyspnea after removal of ventilator and eliminating the fear of death are low,which necessitates relevant training.

[Response of Water-Vallisneria natans-Sediment System to Polyethylene Microplastics].

The microplastics in aquatic ecosystems pose a serious threat to ecological security and environmental health, which have received widespread attention. To reveal the response of a water-Vallisneria natans-sediment system to microplastics exposure, the V. natans was exposed to polyethylene microplastics （PE-MPs） with different mass fractions （1%-5%, sediment wet mass fraction）, and the effects of PE-MPs on the physiochemical indicators of water quality, morphological characteristics of submerged plants, physiological characters, antioxidant system, and microbial community structure in sediments were studied respectively. The results showed that the physiochemical properties of the water body were not significantly changed in the PE-MPs treatment group, whereas the plant height, oxidative stress index, and antioxidant system were significantly inhibited. For the plant height, the 1% PE-MPs treatment group height was only 47.44% of that in the control group. Chlorophyll a content was 81.04% of that in the control group, and the activities of catalase （CAT）, malondialdehyde （MDA）, and peroxidase （POD） increased by 233.70%, 117.82%, and 61.62%, respectively. Different mass fractions of PE-MPs had a certain impact on microbial community structure in sediments. The above results are helpful to improve the evaluation system of PE-MPs ecological risk in the water-submerged plant-sediment system.

12-Month clinical results of drug-coated balloons for de novo coronary lesion in vessels exceeding 3.0 mm.

The purpose of this observational study was to investigate the feasibility, initial safety, and efficacy of the SeQuent® Please DCB (B. Braun Melsungen, Germany) for patients with de novo coronary lesions in vessels exceeding 3.0 mm in a consecutive series of all comer percutaneous coronary intervention. A total of 120 patients (135 lesions) with de novo coronary lesions in vessels ≥ 3.0 mm treated with DCB were enrolled in this single-centre prospective observational study. The primary endpoint was target lesion failure (TLF), a composite endpoint of cardiac death, target vessel-myocardial infarction (TV-MI), and clinically driven target vessel revascularization (TLR) at 12 months. Safety endpoints included cardiac death, TV-MI, and definite target vessel thrombosis. 45.9% of the lesions were classified as complex (type B2/C). The reference vessel diameter was 3.09 ± 0.31 mm measured via quantitative coronary angiography analysis. Coronary dissections occurred in 42 patients (35.0%; Type A-B 14.1%; Type C 19.1%; Type D: 1.6%), two of which [1.6%; (type D dissection)] underwent bail-out stent implantation. 12-month follow-up was completed in 100% patients. The 12-month incidence of TLF was 3.4%. The clinically driven TLR occurred in four patients (3.4%). The incidence of TLR was low in patients without any detectable dissections, similar to those with dissections (3.8% vs. 2.5%; p = 0.146). No patient suffered cardiac death, TV-MI, or target vessel thrombosis. The study shows the feasibility, initial safety, and efficacy of coronary intervention using SeQuent® Please DCB for the treatment of patients with de novo lesion in vessels exceeding 3 mm. The study highlights that the coronary dissection (Type A-C) post DCB treatment occurs frequently but is safe at follow up.

[Swanson double-stem silicone implant arthroplasty of first metatarsophalangeal point].

OBJECTIVE: To evaluate the curative effectiveness of Swanson double-stem silicone implant arthroplasty on the reconstruction of first metatarsophalangeal joint. METHODS: Swanson double-stem silicone implant arthroplasty was performed on 10 patients, 2 males and 8 females, aged 60 (57-75), suffering from diseases of first metatarsophalangeal joint with 13 diseased joints, including hallux valgus with geriatric osteoarthritis (8 cases, 10 joints), rheumatoid arthritis (1 case, 2 joints), and traumatic arthritis (1 case, 1 joint). All patients were followed up for an average of 25 months (12-38 months). RESULTS: Eight patients felt complete satisfaction with the operation, 1 patient showed satisfaction to some extent, and 1 patient was not satisfied because of pain of the first matatarsophalangeal joint due to severe hyperosteogeny surrounding the cut bone face 3 years after the operation. Osteolysis around the silicone implant occurred in 2 cases without clinical symptoms, and no special treatment was given. CONCLUSION: With the advantages of alleviating pain, preserving the length and alignment of great toe, improving the function of walking, and correcting the deformity, Swanson double-stem silicone implant arthroplasty is effective on reconstruction of the first metatarsophalangeal joint.