Effectiveness of homogenized nursing care intervention in postoperative bladder irrigation of urological system in primary hospitals-Taking the incidence of postoperative complications as an example: A retrospective study.

To explore the effect of homogenized nursing interventions for bladder irrigation after urological surgery in primary hospitals, and to further analyze the incidence of postoperative complications according to the different nursing methods. The experiment selected 110 patients with urological disorders who underwent bladder irrigation, and the subjects were admitted to the hospital from January 2020 to October 2023. The subjects were chronologically divided into a control group and an experimental group, with the admission time of the control group being between between January 2020 and October 2022. The experimental group was admitted between October 2022 and October 2023. Conventional nursing care and homogenized nursing care were used respectively, and the intervention effect of homogenized nursing care was assessed by comparing the patients' psychological state indexes, vital characteristic indexes, and the incidence of various postoperative complications under the 2 interventions. None of the indicators were statistically significant before the nursing intervention. In the comparison of nursing satisfaction and clinical comfort, the experimental group's nursing satisfaction was 94.5% and clinical comfort was 90.9%, which was significantly higher than that of the control group. In the comparison of the incidence of postoperative complications, the incidence of urinary retention in the experimental group was 1.82%, which was significantly lower than that of the control group. In addition, the total incidence of complications in the experimental group was 1.82%, which proved that the homogenized nursing intervention was effective in reducing the complications after urinary bladder irrigation. In multifactorial logistic regression analysis, after homogenized nursing intervention. The relative risks of the 4 complications were 1.836, 1.445, 1.993, and 2.138, respectively, which were significantly lower than those of conventional nursing intervention. In the ROC analysis, the AUC values of the 4 complications were 0.832, 0.731, 0.746, and 0.723, respectively. proving the superiority of homogenized care in preventing postoperative complications. Homogenized nursing intervention can effectively reduce the incidence of postoperative complications in patients with urological postoperative bladder irrigation, improve patients' symptoms and prognosis, and improve the quality of care and patients' quality of life.

Analysis of the nursing value of continuity care in the recovery of ureteral stone patients after Pneumatic ballistic lithotripsy: An observational study.

This study aims to assess nursing methods' effects on ureteral stone patients post-Pneumatic ballistic lithotripsy with double J-tube placement. Through comparing interventions' impact on recovery, complications, and overall quality of life, the study aims to establish a more effective nursing protocol for this patient group. This study investigates ureteral stone patients who underwent PL and subsequent double J-tube placement between January 2020 and October 2023. A total of 100 eligible subjects (n = 100), meeting the inclusion and exclusion criteria, were divided into an intervention group (n1 = 50) and a control group (n2 = 50) according to different treatments. The control group received routine in-hospital care combined with outpatient follow-up, while the intervention group underwent continuous care using the Omaha system. Nursing effects pre- and post-intervention were assessed using questionnaires, clinical indicators, and the Omaha evaluation system, evaluating aspects such as cognition, behavior, and status in terms of environment, psychosocial aspects, physiology, and health behavior. Additionally, complications during double J-tube placement and pain scores were compared among the patients. Prior to the intervention, no statistically significant differences were observed between the scores of both groups across environmental, psychosocial, physiological, and health behavioral domains. Subsequent to the nursing intervention on the first postoperative day, at discharge, and post-discharge, a statistically significant variance was evident between the groups across these domains (P < .05). Furthermore, the intervention group exhibited notably lower rates of infection, hematuria, and residual or fragmented stones, all significantly lower with a P-value of <.05, compared to the control group. While a reduction in tissue damage and acute kidney injury was observed in the intervention group compared to the control group, this difference did not reach statistical significance. Notably, 92% of patients in the intervention group reported no pain during the nursing intervention, in contrast to only 52% in the control group. Continuity care utilizing the Omaha system demonstrates favorable outcomes in managing double J stent placement post-PL among ureteral stone patients, notably leading to a significant reduction in both pain levels and the incidence of associated complications.

Prevalence of mild cognitive impairment and its association with malnutrition in older Chinese adults in the community.

Objective: This study aims to characterize the prevalence and associated factors of cognitive impairment in older adults within Chinese community settings. Background: Research exploring the interrelation between malnutrition and cognitive impairment in the older adult community-dwelling population is scarce. The impact of nutritional status on cognitive function in aging adults has not been definitively established. Methods: A cross-sectional survey was conducted in one urban and one rural community in Chengdu, China, from October 2022 to March 2023. The sample included 706 older adults. Logistic regression was utilized to determine independent risk factors for mild cognitive impairment (MCI). Results: The study found a significant prevalence of MCI at 32.0% among the older adult population. Among those suffering from malnutrition, 55.6% were affected by MCI. The logistic regression analysis indicated that malnutrition risk (OR = 2.192, 95% CI 1.431 to 3.357, p < 0.001), rural residence (OR = 1.475, 95% CI 1.003 to 2.170, p = 0.048), age (70-79 years old; OR = 2.425, 95% CI 1.611 to 3.651, p < 0.001; ≥80 years old: OR = 4.773, 95% CI 2.571 to 8.859, p < 0.001), male (OR = 1.584, 95% CI 1.085 to 2.313, p = 0.017), middle education level (OR = 0.986, 95% CI 1.627 to 5.482, p < 0.001), and ADL dependence (OR = 1.810, 95% CI 1.158 to 2.827, p = 0.009) were significantly associated with the occurrence of MCI. Conclusion: The findings indicate a widespread occurrence of MCI in community-dwelling older Chinese adults. The association between malnutrition, as measured by the Mini Nutritional Assessment-Short Form (MNA-SF), and cognitive decline is evident. Older adult individuals with nutritional risk, advancing age, rural residence, male gender, moderate education, and ADL dependency are at increased likelihood of developing MCI. Longitudinal research is needed to clarify the temporal relationships between MCI, demographic factors, and whether improvements in nutritional status or ADL can reduce the incidence of MCI in this population.

Differences in regional distribution and inequality in health workforce allocation in hospitals and primary health centers in China: A longitudinal study.

BACKGROUND: In 2009, China launched a new round of healthcare reform to provide households with secure, efficient, convenient, equitable and affordable healthcare services. Healthcare reform is underpinned by three critical pillars: the health workforce, funding, and infrastructure, with reform of the health workforce being particularly significant. OBJECTIVE: This study analyses the disparities in regional distribution and the inequity of healthcare workforce allocation across hospitals and primary health centers in China over twelve years. DESIGN: Retrospective longitudinal data from the National Health Statistics Yearbook 2011-2022 and National Statistical Yearbook in China from 2011 to 2022 were collected for analysis. PARTICIPANTS: The focus was on hospitals and primary health centers, explicitly examining their health technician and nursing workforce. METHODS: The research utilized four key indicators of the healthcare workforce to evaluate the distribution of health resources between hospitals and primary health centers. Furthermore, the Gini coefficient and Theil index were employed to assess the inequality in allocating the health workforce. RESULTS: Between 2010 and 2021, there was a nationwide increase in the ratio of health workers per 1000 population in hospitals and primary health centers. It is noted that rural districts had higher ratios than urban districts in terms of the number of health technicians and nurses per 1000 population, whether in hospitals or primary health centers; western districts had higher ratios than eastern and central districts did. In the same year, at different levels of medical institutions, the Theil indices of health technicians and nurses in hospitals were lower than those in primary health centers in terms of both demographic and geographical dimensions. Regarding the allocation of the health workforce by population, the Gini coefficient remained below 0.3, while for geographical allocation, it exceeded 0.4. CONCLUSIONS: This study analyzed the temporal trends and inequality of health-resource allocation at the hospital and primary health center levels in China, noting trends of improvements in the quantity and inequality in health workforce allocation from 2010 to 2021, suggesting the success of the government's efforts to advance healthcare reform since 2009. The allocation of health workforce based on population exhibits greater fairness compared to geographical distribution.

A preliminary study of the effectiveness of video visitation on depression and stress in mothers with preterm infants during the pandemic.

BACKGROUND AND PURPOSE: Parents of preterm infants experience anxiety and stress in the neonatal intensive care unit (NICU). Visitation restrictions due to COVID-19 have increased maternal pressure and limited bonding opportunities. Little research exists in Taiwan on using video conferencing as a solution. This study investigates depression and stress levels in mothers of preterm infants and evaluates the effectiveness of video visitation during NICU restrictions. METHODS: This study adopts a cross-sectional design and a qualitative survey. Mothers of premature infants were recruited and they participated in the study. Interventions for video visits were scheduled on the third day of admission to the NICU (T1) and during the second week of the study (T2). After each video visit, participants completed an online survey. The study's online survey used structured questionnaires including demographics, the Edinburgh Postnatal Depression Scale (EPDS) and the Parental Stress Scale (PSS): Infant Hospitalization (IH). RESULTS: A total of 51 mothers of preterm infants participated in the study. During the T1 and T2 periods, single mothers with lower educational levels and those aged below 30 experienced depression and high levels of stress. Lower birth weight and gestational age were associated with maternal depression. Video visitation intervention led to a significant decrease in depression scores (EPDS, T1: 11.3 ± 5.5 vs. T2: 10.1 ± 5.2, p = 0.039). Positive correlations were observed between EPDS and PSS: IH scores (p < 0 .005). CONCLUSION: Video visitation intervention can reduce maternal depression in mothers with preterm infants. Since it is practical, video visitation may be applied even after the pandemic.

A comprehensive analysis of the prognostic characteristics of microRNAs in breast cancer.

Both overall survival (OS) and disease-specific survival (DSS) are significant when determining a patient's prognosis for breast cancer (BC). The effect of DSS-related microRNAs on BC susrvival, however, is not well understood. Here, we spotted differentially expressed miRNAs (DEMs) in the TCGA database of BC DSS, identified eight DSS-related miRNAs, and constructed a risk model. AUC values at 1, 3, and 5 years were 0.852, 0.861, and 0.868, respectively, indicating a risk model's excellent prognostic prediction ability. Then, we validated miRNA roles in BC OS and finally defined miR-551b as an independently prognostic miRNA in BC. According to function analysis, miR-551b is strongly linked with the emergence and spread of cancer, including protein ubiquitination, intracellular protein transport, metabolic pathways, and cancer pathways. Moreover, we confirmed the low expression of miR-551b in BC tissue and cells. After miR-551b inhibition or overexpression, cell function was either dramatically increased or diminished, respectively, indicating that miR-551b could regulate BC proliferation, invasion, and migration. In conclusion, we thoroughly clarified BC-related miRNAs on DSS and OS and verified miR-551b as a crucial regulator in the development and prognosis of cancer. These results can offer fresh ideas for BC therapy.

Gender differences in geriatric depressive symptoms in urban China: the role of ADL and sensory and communication abilities.

Objectives: ADL and Sensory and Communication Abilities are important indicators of the quality of life of the elderly which are significant determinants of health, particularly in developing countries. The present cross-sectional study investigated effect of ADL and Sensory and Communication Abilities on depressive symptoms, as well as the the role of gender in these effects. Design: This is a cross-sectional study. Setting: A nationally representative cross-sectional survey among the Chinese population aged 60 years and over. Participants: A total of 163296 females and 148724 males aged 65 and over in 2019 in urban China. Outcome measures: Prevalence, risk factors and gender differences in geriatric depressive symptoms among urban elderly. Results: Approximately 95.69% of the participants had depressive symptoms according to the CESD-10, with no statistically significant gender difference of 52.15% in females and 47.85% in males. Logistic regression findings suggest that geriatric depressive symptoms are significantly associated with the lack of eldercare (OR=2.427, female; OR=1.426, male), living alone(OR= 1.430, female; OR= 1.179, male), ADL dysfunction (OR=1.528, female; OR=1.246, male), and impaired sensory and communication ability (OR=1.338, female; OR=1.185, male) among both female and male participants. Remarkably, geriatric depressive symptoms are only significantly associated with age (≥75, OR = 1.327), marital status (unmarried, OR=1.598), the number of children (no children, OR=2.271), and the living arrangement (living alone, OR= 1.430) among female participants. Conclusion: Significant gender differences in these associations were found for living alone, ADL dysfunction and impaired sensory and communication ability. Moreover, the study emphasized that the gender difference exists in terms of geriatric depression in urban China. Females are more likely to experience depressive than males with the same circumstances.

Multiple geriatric syndromes in community-dwelling older adults in China.

This study aims to assess the prevalence of geriatric syndromes and identify factors associated with multiple geriatric syndromes in community-dwelling older adults in China. We utilized a convenience sampling method to recruit older adults and from one rural and one urban community in Chengdu, China, from October 2022 to March 2023. A total of 706 older adults aged 60 years or older were included. Ten geriatric syndromes were investigated including two mental disorders: depressive symptoms, cognitive impairment; and eight somatic disorders: pain, falls, sleep disturbance, constipation, polypharmacy, multimorbidity, malnutrition and frailty. Multiple geriatric syndromes were defined as an individual having two or more geriatric syndromes. The data obtained were analysed using descriptive statistics. The independent risk factors for multiple geriatric syndromes were assessed using a logistic regression model. This study found that 90.5% of the participants had at least one geriatric syndrome, with 72.8% experiencing multiple geriatric syndromes. The top four geriatric syndromes in our study were polypharmacy (58.5%), malnutrition/at risk of malnutrition (43.1%), multimorbidity (42.1%), and frailty/prefrailty (34.3%). Of the older adults, 368(52.1%) had only somatic disorders, 18(2.5%) had only mental disorders and 253 (35.8%) had somatic-mental disorders. According to the logistic regression analysis, residence, age, marriage, BMI, and self-related health were significantly associated with multiple geriatric syndromes among older adults. This study highlights that multiple geriatric syndromes are prevalent among community-dwelling older adults in China, and underscores the significance of certain demographic factors in their occurrence. Future longitudinal studies are needed to establish the temporal relationship between multiple geriatric syndromes and these demographic factors, as well as to explore causal relationships and effective prevention strategies for geriatric syndrome.

Association of daily health behavior and activity of daily living in older adults in China.

This study aims to describe the activity of daily living (ADL) situation and determine the relationship between health behavior and ADL among older adults in China. A cross-sectional, observational study was conducted in one urban community and one rural community in Chengdu (a city located in Southwest China), China, from October 2022 to March 2023. A total of 706 older adults were included in this study. The associations between health behaviour and ADL were assessed by logistic regression model. Of the 706 older adults, 169 (23.9%) were disabled in ADL. According to the logistic regression analysis, age (60-69 years old: OR = 0.015, 95% CI 0.007 to 0.035, P < 0.001; 70-79 years old: OR = 0.116, 95% CI 0.060 to 0.227, P < 0.001), resident(OR = 0.568, 95% CI 0.330 to 0.976, P = 0.041), chronic disease (0 type: OR = 0.023, 95% CI 0.001 to 0.379, P = 0.008; 1-4 types: OR = 0.357, 95% CI 0.219 to 0.582, P < 0.001), no exercise (OR = 4.562, 95% CI 2.263 to 8.026, P < 0.001), and physical examination (OR = 2.217, 95% CI 1.294 to 3.496, P = 0.003) were significantly associated with ADL among older adults in Southwest China. This study showed that older adults had a higher ADL disability ratio. Age, resident, chronic disease, exercise and physical examination were associated with ADL among older adults. The study indicates that medium/high exercise maybe a protective factor for older adults, and nursing staff can encourage older adults to exercise when carrying out primary prevention measures. The government and public health institutions should give special attention to older adults and help them to acquire the habit of having an annual physical examination.

Evaluation of grouped capsule network for intracranial hemorrhage segmentation in CT scans.

Intracranial hemorrhage is a cerebral vascular disease with high mortality. Automotive diagnosing and segmentation of intracranial hemorrhage in Computed Tomography (CT) could assist the neurosurgeon in making treatment plans, which improves the survival rate. In this paper, we design a grouped capsule network named GroupCapsNet to segment the hemorrhage region from a Non-contract CT scan. In grouped capsule network, we constrain the prediction capsules for output capsules produced from different groups of input capsules with various types in each layer. This method can reduce the number of intermediate prediction capsules and accelerate the capsule network. In addition, we modify the squashing function to further accelerate the forward procedure without sacrificing its performance. We evaluate our proposed method with a collected dataset containing 210 intracranial hemorrhage CT scan slices. In experiments, our proposed method achieves competitive results in intracranial hemorrhage area segmentation compared to the existing methods.

Zerumbone-induced reactive oxygen species-mediated oxidative stress re-sensitizes breast cancer cells to paclitaxel.

Chemotherapy is an effective approach for cancer therapy when plant-derived sensitizers are combined with chemotherapeutics. Zerumbone, a natural phytochemical, has been documented to have various pharmacological roles. Here, we evaluated the chemosensitization potential of zerumbone in a breast cancer cell line in vitro. Zerumbone-induced cytotoxicity in MCF-7 cells was assessed by 3-[4,5-dimethylthiazole-2-yl]-2,5-diphenyltetrazolium bromide (MTT)-based metabolic analysis. Reactive oxygen species (ROS)-mediated mitochondrial membrane alterations, DNA damage, and apoptotic morphological changes were measured by fluorescence microscopy methods. A biochemical assay was employed to analyze Thiobarbituric acid reactive substances (TBARS) and antioxidant levels. Apoptotic marker expression levels were investigated by immunoblotting. MTT assay revealed that zerumbone significantly enhanced paclitaxel (PTX)-induced cell death in breast cancer cells in a concentration-dependent manner. Furthermore, our study demonstrated that zerumbone (15 µM) significantly enhanced ROS when combined with PTX (1 µM) treatment. Additionally, we observed that zerumbone enhanced the impairment of mitochondrial membrane potential and oxidative DNA damage, thereby inducing apoptosis in combination with PTX. Western blot analysis indicated that zerumbone significantly upregulated BAX, caspase-7, and caspase-9 expression and decreased BCL-2 expression, thereby inducing proapoptotic protein-mediated cell death combined with PTX. The prooxidant properties of zerumbone potentially resensitize breast cancer cells to PTX by enhancing intracellular ROS-mediated oxidative stress.

KIF23 promotes autophagy-induced imatinib resistance in chronic myeloid leukaemia through activating Wnt/ß-catenin pathway.

Imatinib, an inhibitor of tyrosine kinase, shows remarkable efficacy in chronic myeloid leukaemia (CML). Autophagy protects tumour cells against chemotherapeutic stimulation and contributes to imatinib resistance in CML. Kinesin family member 23 (KIF23) is involved in cytokinesis and associated with autophagy. The role of KIF23 in autophagy-induced imatinib resistance in CML was investigated. First, to induce drug resistance, CML cells were exposed to increasing concentrations of imatinib. The concentration of imatinib resistance in CML cells was screened through upregulation of 50% inhibitory concentration (IC50 ) values. KIF23 was elevated in imatinib-resistant tissues and cells of CML. Second, knockdown of KIF23 reduced IC50 values of imatinib-resistant CML cells to imatinib. Moreover, silence of KIF23 also suppressed cell proliferation and promoted apoptosis of imatinib-resistant CML cells. Third, immunofluorescence analysis showed that the number of LC3 bright spots in imatinib-resistant CML cells was reduced by silence of KIF23. Knockdown of KIF23 upregulated p62 expression and downregulated the expression ratio of LC3-II to LC3-I in imatinib-resistant CML cells. Last, silence of KIF23 decreased nuclear ß-catenin and increased cytoplasmic ß-catenin in imatinib-resistant CML cells. Activator of Wnt/ß-catenin attenuated KIF23 silence-induced increase of apoptosis and decrease of autophagy in imatinib-resistant CML cells. In conclusion, loss of KIF23 repressed autophagy-induced imatinib resistance in CML cells through inactivation of Wnt/ß-catenin pathway.

Down-regulation of MLLT1 super elongation complex subunit impairs the anti-tumor activity of natural killer cells in esophageal cancer.

Natural killer (NK) cells actively participate in anti-tumor immunity and are thus regarded as a promising tool in immunotherapy against esophageal cancer (EC). However, the mechanisms regulating NK cell activation and exhaustion have not been completely elucidated. In this study, we characterized the expression and function of MLLT1 super elongation complex subunit (MLLT1) in esophageal NK cells in a mouse EC model. MLLT1 was down-regulated in esophageal NK cells, especially NK cells expressing both T cell immunoglobulin and mucin-domain containing-3 (TIM-3) and lymphocyte activation gene3(LAG-3). In vitro knockdown of MLLT1 in NK cells resulted in significant decreases in the expression of IFN-γ and perforin, as well as impaired NK cell cytotoxicity on tumor cells. Adoptive transfer of MLLT-deficient NK cells into EC-bearing mice showed consistent impairment of NK cell anti-tumor activity, as evidenced by decreases in IFN-γ and perforin but not granzyme B. Furthermore, EC tissue cells, which were enriched from the esophagus of EC-bearing mice, induced down-regulation of MLLT1 in splenic NK cells. This down-regulation was partially restored by a TIM-3 blocking antibody. Therefore, this study indicated that TIM-3 signaling down-regulated MLLT1 in esophageal NK cells, and MLLT1 down-regulation undermined the tumoricidal function of NK cells in EC. Our study unveils a novel mechanism underlying NK cell exhaustion/dysfunction in the EC microenvironment. MLLT1 could be a potential target in future NK cell-mediated immunotherapy against EC.

[Enhancing Maternal-Infant Attachment in a Neonatal Intensive Care Unit During the Pandemic Prevention Period].

BACKGROUND & PROBLEMS: Parent-infant attachment is affected by parent-infant interaction. The limitations on related visitations during the COVID-19 pandemic suspended the opportunity to engage in kangaroo care (skin-to-skin contact) activities. These changes impacted parent-infant attachment in the neonatal intensive care unit. After investigation, the score of premature infant-parent attachment was found to be only 64.6 points during the period in which visitation limitations were in effect. PURPOSE: To enhance maternal-premature infant attachment during the pandemic period by 10% (from an average score of 64.6 to 71.1). RESOLUTION: This project involved nurses playing audio files provided by mothers to their premature infants, and recording a video and taking pictures of the infants during this process. This project used a cloud platform as bidirectional pipelines. Furthermore, emotional support and caring information were provided to the mothers via expressive arts therapy and phone interviews. RESULTS: After the intervention, the premature infant-parent attachment score rose to 74.4 from the pre-intervention score of 64.6. CONCLUSIONS: During pandemic control periods, traditional modes of care aimed at building infant-parent attachment are not applicable. The intervention project used was found to be an effective alternative approach to increasing maternal-premature infant attachment. Breaking the restrictions of time and place, this project applies family-centered care, and may provide a reference for developing software, hardware, and communication equipment for other care units related to newborns.

Interleukin-6 receptor alpha and CD27 discriminate intratumoral T helper 17 subpopulations with distinct functional properties in a mouse lung cancer model.

BACKGROUND: T helper 17 (Th17) cells actively participate in the tumor immune response in lung cancer. However, the heterogeneity and plasticity of intratumoral Th17 cells in lung cancer remain elusive. In this study, Th17 subpopulations were characterized in a mouse lung cancer model. METHODS: Urethane was administered to induce lung cancer in interleukin (IL)-17-EGFP transgenic mice. Flow cytometry was used to analyze the phenotypes, signaling status, and functions of Th17 subpopulations either in vivo or in vitro. The adoptive transfer assay and real-time polymerase chain reaction were applied to analyze the plasticity of Th17 subpopulations. RESULTS: IL-6Rαhigh CD27- Th17 and IL-6Rαlow CD27+ Th17 were identified in intratumoral Th17 cells. The two subpopulations expressed equivalent RORγt. However, the former expressed higher T-bet but lower Foxp3, more IL-17A and IFN-γ but less IL-10 than the latter. Furthermore, IL-6Rαhigh CD27- Th17 moderately inhibited the proliferation of lung cancer cells while IL-6Rαlow CD27+ Th17 could not. IL-6Rαhigh CD27- Th17 exhibited weaker Jun N-terminal kinases (JNK) signaling but stronger signal transducer and activator of transcription 3 (Stat3) signaling than IL-6Rαlow CD27+ Th17. The adoptive transfer assay indicated that both subpopulations downregulated RORγt in recipients' spleens but maintained RORγt in recipients' lungs. Meanwhile, IL-6Rαhigh CD27- Th17 expressed higher T-bet and IFN-γ than IL-6Rαlow CD27+ Th17 in the recipients. IL-6Rαlow CD27+ Th17 expressed Foxp3 and IL-10 in recipients' spleens but not lungs. CONCLUSIONS: This study reveals intratumoral Th17 subpopulations with distinct functional properties and signaling patterns, thus offering valuable insight into Th17 heterogeneity and plasticity in lung cancer.

Chondro-Protective Effects of Shikimic Acid on Osteoarthritis via Restoring Impaired Autophagy and Suppressing the MAPK/NF-κB Signaling Pathway.

Osteoarthritis (OA) is a major cause of cartilage pain and limited mobility in middle-aged and elderly individuals. The degeneration of cartilage induced by inflammation and cartilage anabolic and catabolic disorder plays a key role in OA. Shikimic acid (SA), a natural ingredient extracted from Illicium verum, has been shown to exert notable anti-inflammatory effects in previous studies, suggesting its potential effects in the treatment of OA. In this study, we revealed that the pretreatment of SW1353 human chondrocytes with SA before interleukin 1ß (IL-1ß) stimulation effectively decreased the expression of inducible nitric oxide synthase (iNOS), cyclooxygenase (Cox)-2, matrix metalloproteinases (MMPs; MMP3 and MMP13), a disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS)-5, type X collagen, and p62; increased the expression of type II collagen, ATG7, Beclin-1, and LC3; and increased the autophagic flux. Mechanistically, we found that SA suppressed the IL-1ß-induced activation of the mitogen-activated protein kinase (MAPK) and nuclear factor-kappaB (NF-κB) pathways. Furthermore, the results of safranin O staining and toluidine blue staining of primary rat cartilage chondrocytes and a trauma-induced rat model of OA showed that SA alleviated progression of OA in vivo. Collectively, our research enhances understanding of the mechanism of protective effect of SA against the progression of OA, which involves amelioration of cartilage degeneration, thereby providing new evidence for the use of SA as a therapy to prevent the development of OA.

[Construction of Graded Nursing Care Index System for Patients With Alzheimer's Disease].

Alzheimer's disease (AD) is one of the most common diseases in older populations. Its main clinical features include cognitive dysfunction, affective disorder, and abnormal mental behavior. Due to the lack of therapeutic drugs, professional care has become an important diagnostic and therapeutic strategy for Alzheimer's disease patients. At present, most Alzheimer's disease patients are cared for at home by relatives or caregivers, and less than l0% of city-based patients receive care in old-age institutions. Due to mixed treatment regimens in the hospital, care services do not necessarily match patient care needs and thus Alzheimer's disease patients do not receive adequate treatment. Developed countries have a mature care system for the elderly, but no graded care model for the elderly with Alzheimer's disease currently exists in China. In this paper, the author draws on the experience of developed countries to construct an index system for the graded care of Alzheimer's disease patients that is suited to conditions in China. This article addresses the burden faced by the elderly with Alzheimer's disease and the current standard of care for the elderly at home and abroad. After explaining the necessity of constructing a care model for the elderly with Alzheimer's disease, the author then explains the practicability of the care system proposed in this study in order to provide a whole-course care model for the mentally impaired elderly in China.

Urgent recommendation and practice of prevention and control of novel coronavirus disease 2019 (COVID-19) in intensive care units in West China Hospital of Sichuan University during the epidemics / 中国胸心血管外科临床杂志

@#Objective    To provide recommendations for the management of intensive care unit patients without novel coronavirus disease 2019 (COVID-19). Methods    We set up a focus group urgently and identified five key clinical issues through discussion. Total 23 databases or websites including PubMed, National Guideline Clearing-House, Chinese Center for Disease Control and Prevention and so on were searched from construction of the library until February 28, 2020. After group discussion and collecting information, we used GRADE system to classify the evidence and give recommendations. Then we apply the recommendations to manage pediatric intensive care unit in the department of  critical care medicine in our hospital. Results    We searched 13 321 articles and finally identified 21 liteteratures. We discussed twice, and five recommendations were proposed: (1) Patients should wear medical surgical masks; (2) Family members are not allowed to visit the ward and video visitation are used; (3) It doesn’t need to increase the frequency of environmental disinfection; (4) We should provide proper health education about the disease to non-medical staff (workers, cleaners); (5) Medical staff do not need wear protective clothing. We used these recommendations in intensive care unit management for 35 days and there was no novel coronavirus infection in patients, medical staff or non-medical staff. Conclusion    The use of evidence-based medicine for emergency recommendation is helpful for the scientific and efficient management of wards, and is also suitable for the management of general intensive care units in emergent public health events.