背景:膝骨关节炎是一种常见的关节软骨及周围组织损伤的慢性炎症性疾病,而免疫细胞在膝骨关节炎免疫炎症反应中起到重要作用,但其中的具体机制仍有待深入研究。目的:采用孟德尔随机化方法来评估731种免疫细胞表型与膝骨关节炎风险之间...背景:膝骨关节炎是一种常见的关节软骨及周围组织损伤的慢性炎症性疾病,而免疫细胞在膝骨关节炎免疫炎症反应中起到重要作用,但其中的具体机制仍有待深入研究。目的:采用孟德尔随机化方法来评估731种免疫细胞表型与膝骨关节炎风险之间的潜在因果关系。方法:使用全基因组关联分析(GWAS)目录中公开获取731种免疫细胞表型的全基因组关联分析统计数据(从GCST0001391到GCST0002121)和IEUGWAS数据库中膝骨关节炎的全基因组关联分析数据(ebi-a-GCST007090)。采用逆方差加权法、MR-Egger回归法、加权中位数法、加权模型法和简单模型法来研究免疫细胞与膝骨关节炎之间的因果关系。敏感性分析用于检验孟德尔随机化分析结果是否可靠,然后以同样方法进行反向孟德尔随机化分析。结果与结论:①正向分析结果表明,共有4种免疫细胞表型与膝骨关节炎有显著的因果关系(FDR<0.20),其中B细胞中的CD27 on CD24+CD27+(OR=1.026,P=0.00026,Pfdr=0.18)、髓系细胞中的CD33 on CD33dim HLA DR-(OR=1.014,P=0.00050,Pfdr=0.18)以及Treg细胞中的CD45RA+CD28-CD8br%CD8br(OR=1.001,P=0.00078,Pfdr=0.18)与膝骨关节炎风险呈直接的正向因果关联;单核细胞中PDL-1 on monocyte(OR=0.952,P=0.00098,Pfdr=0.18)与膝骨关节炎风险呈直接的负向因果关联。②反向分析结果表明,当膝骨关节炎作为暴露数据时,与731种免疫细胞表型均不具有显著因果关系(FDR<0.20)。③敏感性分析结果显示:双向孟德尔随机化的Cochran’s Q检验和MR-Egger回归法结果P值均大于0.05,表明免疫细胞表型与膝骨关节炎之间的因果效应分析不存在显著的异质性和多效性。④上述结果证实,CD27 on CD24+CD27+,CD33 on CD33dim HLA DR-,CD45RA+CD28-CD8br%CD8br以及PDL-1 on monocyte免疫细胞表型与膝骨关节炎之间可能具有较为显著的潜在因果关系,这为研究膝骨关节炎的生物学机制及探索膝骨关节炎的早期防治提供有价值的线索,也为干预性药物的开发提供了新的方向。展开更多
目的:应用基于循证的最佳实践以降低ICU患者身体约束缺陷发生率。方法:采用循证护理的方法获取最佳实践证据,将证据应用于本院两院区的EICU,其中老院区EICU为观察组、新院区EICU为对照组,比较两院区EICU患者一般资料、身体约束使用率、...目的:应用基于循证的最佳实践以降低ICU患者身体约束缺陷发生率。方法:采用循证护理的方法获取最佳实践证据,将证据应用于本院两院区的EICU,其中老院区EICU为观察组、新院区EICU为对照组,比较两院区EICU患者一般资料、身体约束使用率、缺陷发生率(非计划拔管、水肿、谵妄)。结果:两组身体约束患者性别、年龄、是否使用中枢神经系统兴奋药、约束部位间差异比较无统计学意义(P > 0.05),在约束用具方面比较差异具有统计学意义(P 2 = 4.521, P = 0.033),两组身体约束患者非计划拔管率及比较,差异无统计学意义(P > 0.05),两组患者谵妄发生率及水肿发生率比较,差异具有统计学意义(P Objective: To apply evidence-based best practices to reduce the incidence of body restraint defects in ICU patients. Methods: The evidence-based nursing method was used to obtain evidence-based best practices, and the evidence was applied to the two EICUs in the hospital, with the old EICU as the observation group and the new EICU as the control group. The general information, body restraint use rate, and defect incidence (unplanned extubation, edema, delirium) of patients in the two EICUs were compared. Results: There was no significant difference in gender, age, use of central nervous system stimulants, and restraint site between the two groups (P > 0.05), but there was a significant difference in restraint equipment (P P = 0.033), but there was no significant difference in the incidence of unplanned extubation and comparison between the two groups (P > 0.05). There was a significant difference in the incidence of delirium and edema between the two groups (P < 0.05). Conclusion: After the evidence-based standardized body restraint management strategy was applied to EICU patients, it was found that the rate of body restraints on patients was reduced, while the incidence of constraints defects such as edema and delirium was also reduced. To a certain extent, it improved nursing quality and improved the patients’ medical experience.展开更多
文摘背景:膝骨关节炎是一种常见的关节软骨及周围组织损伤的慢性炎症性疾病,而免疫细胞在膝骨关节炎免疫炎症反应中起到重要作用,但其中的具体机制仍有待深入研究。目的:采用孟德尔随机化方法来评估731种免疫细胞表型与膝骨关节炎风险之间的潜在因果关系。方法:使用全基因组关联分析(GWAS)目录中公开获取731种免疫细胞表型的全基因组关联分析统计数据(从GCST0001391到GCST0002121)和IEUGWAS数据库中膝骨关节炎的全基因组关联分析数据(ebi-a-GCST007090)。采用逆方差加权法、MR-Egger回归法、加权中位数法、加权模型法和简单模型法来研究免疫细胞与膝骨关节炎之间的因果关系。敏感性分析用于检验孟德尔随机化分析结果是否可靠,然后以同样方法进行反向孟德尔随机化分析。结果与结论:①正向分析结果表明,共有4种免疫细胞表型与膝骨关节炎有显著的因果关系(FDR<0.20),其中B细胞中的CD27 on CD24+CD27+(OR=1.026,P=0.00026,Pfdr=0.18)、髓系细胞中的CD33 on CD33dim HLA DR-(OR=1.014,P=0.00050,Pfdr=0.18)以及Treg细胞中的CD45RA+CD28-CD8br%CD8br(OR=1.001,P=0.00078,Pfdr=0.18)与膝骨关节炎风险呈直接的正向因果关联;单核细胞中PDL-1 on monocyte(OR=0.952,P=0.00098,Pfdr=0.18)与膝骨关节炎风险呈直接的负向因果关联。②反向分析结果表明,当膝骨关节炎作为暴露数据时,与731种免疫细胞表型均不具有显著因果关系(FDR<0.20)。③敏感性分析结果显示:双向孟德尔随机化的Cochran’s Q检验和MR-Egger回归法结果P值均大于0.05,表明免疫细胞表型与膝骨关节炎之间的因果效应分析不存在显著的异质性和多效性。④上述结果证实,CD27 on CD24+CD27+,CD33 on CD33dim HLA DR-,CD45RA+CD28-CD8br%CD8br以及PDL-1 on monocyte免疫细胞表型与膝骨关节炎之间可能具有较为显著的潜在因果关系,这为研究膝骨关节炎的生物学机制及探索膝骨关节炎的早期防治提供有价值的线索,也为干预性药物的开发提供了新的方向。
文摘目的:应用基于循证的最佳实践以降低ICU患者身体约束缺陷发生率。方法:采用循证护理的方法获取最佳实践证据,将证据应用于本院两院区的EICU,其中老院区EICU为观察组、新院区EICU为对照组,比较两院区EICU患者一般资料、身体约束使用率、缺陷发生率(非计划拔管、水肿、谵妄)。结果:两组身体约束患者性别、年龄、是否使用中枢神经系统兴奋药、约束部位间差异比较无统计学意义(P > 0.05),在约束用具方面比较差异具有统计学意义(P 2 = 4.521, P = 0.033),两组身体约束患者非计划拔管率及比较,差异无统计学意义(P > 0.05),两组患者谵妄发生率及水肿发生率比较,差异具有统计学意义(P Objective: To apply evidence-based best practices to reduce the incidence of body restraint defects in ICU patients. Methods: The evidence-based nursing method was used to obtain evidence-based best practices, and the evidence was applied to the two EICUs in the hospital, with the old EICU as the observation group and the new EICU as the control group. The general information, body restraint use rate, and defect incidence (unplanned extubation, edema, delirium) of patients in the two EICUs were compared. Results: There was no significant difference in gender, age, use of central nervous system stimulants, and restraint site between the two groups (P > 0.05), but there was a significant difference in restraint equipment (P P = 0.033), but there was no significant difference in the incidence of unplanned extubation and comparison between the two groups (P > 0.05). There was a significant difference in the incidence of delirium and edema between the two groups (P < 0.05). Conclusion: After the evidence-based standardized body restraint management strategy was applied to EICU patients, it was found that the rate of body restraints on patients was reduced, while the incidence of constraints defects such as edema and delirium was also reduced. To a certain extent, it improved nursing quality and improved the patients’ medical experience.
