Research on the Application of Evidence-Based Quality Control Circle to Improve the Implementation Rate of Airway Management Measures in Adult Critically Ill Patients

Objective: To explore the effect of evidence-based quality control circle (QCC) in improving the implementation rate of airway management measures in adult critically ill patients. Methods: Based on the Joanna Briggs Institute (JBI) evidence-based health care model, the best evidence of airway management in adult critically ill patients was obtained and applied to the clinic. Results: The total implementation rate of airway management measures in adult critically ill patients increased from 23.62% before the implementation of quality control circle to 88.82%, and the pulmonary infection rate in critically ill patients decreased from 42.31% to 21.74%, with statistical significance between the two groups (P 0.05). Conclusion: Evidence-based quality control circle activities can standardize the practice standards of airway management in critically ill patients, reduce the occurrence of patients’ airway related complications, and improve clinical outcomes.

钢渣与橡胶混合细集料混凝土力学性能与本构关系研究

文中采用橡胶颗粒替换部分钢渣细集料,分别制备出了橡胶含量为0%、10%、20%、30%、40%的钢渣与橡胶混合细集料混凝土.对钢渣与橡胶混合细集料混凝土的标准立方体抗压强度、轴心抗压强度、劈裂强度、抗折强度、弹性模量和本构关系等力学指标进行系统的分析与试验研究.结果表明:当橡胶掺量从0%~40%增大时,钢渣与橡胶混合细集料混凝土的抗压强度、抗折强度、弹性模量等均呈现下降的趋势.提出了钢渣与橡胶混合细集料混凝土的本构关系模型,理论值与试验值吻合较好,可应用于钢渣与橡胶混合细集料混凝土结构的受力分析.

基于工业大数据的重叠社区发现算法

为了深入挖掘和分析工业大数据隐藏的关系、趋势和模式,从而为企业提供更好的决策依据,结合随机游走和标签传播思想,提出一种基于工业大数据的重叠社区发现算法。设计了种子节点选取算法,通过随机游走计算各节点的重要性,选出不相关和重要性高的种子节点;提出重叠社区发现算法,对种子节点赋予唯一标签,迭代进行标签传播直到节点标签不再改变,根据节点标签得到最终的重叠社区划分结果。通过在真实数据集和人工数据集上进行对比实验表明,该算法可以在网络上有效发现高质量的重叠社区,并进一步解决工业大数据的数据分析、信息挖掘等核心问题。

利用光驱动的生物杂合系统实现CO_(2)转化生产化学品

太阳能作为清洁能源之一,为缓解化石燃料枯竭和温室气体排放等问题提供了一种高效、经济、可持续的解决方案.自然界中的植物和光合微生物通过自身的光合系统收集并转化太阳能,从而生产生物燃料和生物化学品.然而,由于自然光合系统存在光吸收范围相对较窄、光生电子在传输过程中易损耗等问题,限制了太阳能到化学品的转化效率.为了解决上述难题,科研人员模仿自然光合作用中的关键部分,探索构建人工光合系统,相关研究引起了广泛关注.本文通过将碲化镉量子点(CdTe QDs)与大肠杆菌(E.coli)相耦合,构建了一种光驱动无机-生物杂合系统(IBPHS),用于捕获太阳能并驱动CO_(2)转化合成高价值化学品.该系统主要由光催化模块和生物催化模块组成.在光催化模块中,通过生物合成CdTe QDs进行光能捕获,并将其转化为电子.通过敲除E.coli的Cd2+外排蛋白(ZNTA)编码基因,实现了E.coli胞内Cd2+过量积累.通过“时空耦合”方式,并借助共聚焦显微镜、高分辨率透射电镜和X射线能谱分析,确认了CdTe QDs在E.coli胞内的组装合成.利用紫外-可见分光光度计研究了光催化模块对光子的吸收能力.结果表明,光催化模块的吸收峰位于400-420 nm.利用瞬时光电流,评估了光催化模块的光生电子能力.实验发现,该模块可以产生0.07μA光电流,表明完成了光催化模块的构建.在生物催化模块中,将光催化模块产生的电子用于还原NAD+再生NADH.采用NADH生物传感器,分析了E.coli胞内NADH含量,结果表明,在蓝光照射下E.coli胞内NADH含量比黑暗条件下提高了5.1倍.在此基础上,通过表达NADH依赖型乳酸脱氢酶(LDH)将丙酮酸还原为乳酸,在蓝光光照下乳酸积累量达到了0.44 g/L,而黑暗条件下无乳酸积累,从而验证了生物催化模块的有效性.基于光催化模块和生物催化模块,进一步组装构建了IBPSH,用于驱动CO_(2)还原合成甲酸和丙酮酸.在蓝光照射下,IBPHS能够合成0.65 g/L甲酸和0.18 g/L丙酮酸,其CO_(2)利用速率分别达到51.98 mg/gDCW/h和21.92 mg/gDCW/h,超过了光合细菌.综上所述,本文利用光催化模块与生物催化模块相耦合的方式,组装构建了一种新型的人工光合系统,实现了光驱动CO_(2)还原合成高附加值化学品,为理性设计材料-生物杂合系统提供了借鉴,同时也为挖掘绿色生物制造潜力、开发太阳能化学制造平台提供参考.

Dynamic Regulation of Hydrogen Bonding Networks and Solvation Structures for Synergistic Solar‑Thermal Desalination of Seawater and Catalytic Degradation of Organic Pollutants

Although solar steam generation strategy is efficient in desalinating seawater,it is still challenging to achieve continuous solar-thermal desalination of seawater and catalytic degradation of organic pollutants.Herein,dynamic regulations of hydrogen bonding networks and solvation structures are realized by designing an asymmetric bilayer membrane consisting of a bacterial cellulose/carbon nanotube/Co_(2)(OH)_(2)CO_(3)nanorod top layer and a bacterial cellulose/Co_(2)(OH)_(2)CO_(3)nanorod(BCH)bottom layer.Crucially,the hydrogen bonding networks inside the membrane can be tuned by the rich surface–OH groups of the bacterial cellulose and Co_(2)(OH)_(2)CO_(3)as well as the ions and radicals in situ generated during the catalysis process.Moreover,both SO_(4)^(2−)and HSO_(5)−can regulate the solvation structure of Na^(+)and be adsorbed more preferentially on the evaporation surface than Cl^(−),thus hindering the de-solvation of the solvated Na^(+)and subsequent nucleation/growth of NaCl.Furthermore,the heat generated by the solar-thermal energy conversion can accelerate the reaction kinetics and enhance the catalytic degradation efficiency.This work provides a flow-bed water purification system with an asymmetric solar-thermal and catalytic membrane for synergistic solar thermal desalination of seawater/brine and catalytic degradation of organic pollutants.

Risk Factors Asscociated with Hypokalemia during Postanesthesia Recovery and Its Impact on Outcomes in Gynecological Patients:A Propensity Score Matching Study

Objective:This study aimed to explore the risk factors and outcomes of hypokalemia during the recovery period from anesthesia in the gynecological population.Methods:This retrospective cohort study included 208 patients who underwent gynecological surgery at our institution between January 2021 and March 2022.Data were collected for each patient,including demographics,disease status,surgical data,and clinical information.Preoperative bowel preparation,postoperative gastrointestinal function,and electrolyte levels were compared between the two groups using propensity score matching(PSM).Results:The incidence of hypokalemia(serum potassium level<3.5 mmol/L)during the recovery period from anesthesia was approximately 43.75%.After PSM,oral laxative use(96.4%vs.82.4%,P=0.005),the number of general enemas(P=0.014),and the rate of≥2 general enemas(92.9%vs.77.8%,P=0.004)were identified as risk factors for hypokalemia,which was accompanied by decreased PaCO_(2) and hypocalcemia.There were no significant differences in postoperative gastrointestinal outcomes,such as the time to first flatus or feces,the I-FEED score(a scoring system was created to evaluate impaired postoperative gastrointestinal function),or postoperative recovery outcomes,between the hypokalemia group and the normal serum potassium group.Conclusion:Hypokalemia during postanesthesia recovery period occurred in 43.75%of gynecological patients,which resulted from preoperative mechanical bowel preparation;however,it did not directly affect clinical outcomes,including postoperative gastrointestinal function,postoperative complications,and length of hospital stay.

Betulinic acid protects against ovarian impairment by decreasing F-2 toxin-induced oxidative stress and inflammation associated with the downregulation of p38 expression in mice

F-2 toxin is an estrogenic mycotoxin that causes reproductive disorders in animals.Betulinic acid(BA)is a natural pentacyclic lupane-structure triterpenoid that has diverse pharmacological activities.In this study,the antioxidative and anti-inflammatory effects of BA and its underlying mechanism are explored in F-2 toxin-triggered mouse ovarian damage.We found that BA alleviated the F-2 toxin-induced ovarian impairment by stimulating follicle growth,reducing inflammatory cell infiltration,repairing damaged mitochondria and endoplasmic reticulum.Simultaneously,BA not only reversed F-2 toxin-induced reduction of follicle stimulating hormone(FSH)and luteinizing hormone(LH)levels in the serum,but also restrained the protein expression of the estrogen receptors a(ERa)and ERβ.Moreover,BA restored the balance of F-2 toxin-induced ovarian redox system disorders.Subsequently,we found that 0.25 mg/kg BA played an anti-inflammatory role in the F-2 toxin-induced ovarian impairment by decreasing interleukin-1β(IL-1β).IL-6,and tumor necrosis factor-α(TNF-α)mRNA expression,as well as inhibiting p38 protein expression.These data demonstrated that BA exerts its protective effect on F-2 toxin-induced ovarian oxidative impairment and inflammation by inhibiting p38 expression,which implies a natural product-based medicine to ameliorate F-2 toxin-caused female reproductive toxicity and provides a detoxifying method for food contaminated by mycotoxin.

Prevalence and clinical impact of sarcopenia in liver transplant recipients:A meta-analysis

BACKGROUND The prevalence of sarcopenia in patients undergoing liver transplantation(LT)remains to be determined partly because of different diagnostic criteria.Sarcopenia has recently been recognized as a new prognostic factor for predicting outcomes in LT candidates.AIM To estimate the prevalence of sarcopenia and evaluate its clinical effect on LT candidates.METHODS This systematic search was conducted in PubMed,Web of Science,Embase,and Cochrane Library for original English-language articles that investigated the prevalence and influence of sarcopenia in patients undergoing LT from database inception to November 30,2022.Cohort studies of the definition of sarcopenia that estimate sarcopenia prevalence and evaluate its effect on clinical outcomes and the risk of mortality were included.RESULTS Twenty-five studies involving 7760 patients undergoing LT were included.The pooled prevalence of sarcopenia in patients undergoing LT was 40.7%[95%confidence intervals(95%CI):32.1-49.6].The 1-,3-,and 5-year cumulative probab-ilities of post-LT survival in patients with preoperative sarcopenia were all lower than those without sarcopenia(P<0.05).Sarcopenia was associated with an increased risk of post-LT mortality in patients undergoing LT(adjusted hazard ratio:1.58;95%CI:1.21-2.07).Patients with preoperative sarcopenia had a longer intensive care unit stay,a high risk ratio of sepsis,and serious post-LT complications than those without sarcopenia.CONCLUSION Sarcopenia is prevalent in a substantial proportion of patients undergoing LT and is strongly and independently associated with higher a risk of mortality risk.

Shape-influenced non-reciprocal transport of magnetic skyrmions in nanoscale channel

Skyrmions, with their vortex-like structures and inherent topological protection, play a pivotal role in developing innovative low-power memory and logic devices. The efficient generation and control of skyrmions in geometrically confined systems are crucial for the development of skyrmion-based spintronic devices. In this study, we focus on investigating the non-reciprocal transport behavior of skyrmions and their interactions with boundaries of various shapes. The shape of the notch structure in the nanotrack significantly affects the dynamic behavior of magnetic skyrmions. Through micromagnetic simulation, the non-reciprocal transport properties of skyrmions in nanowires with different notch structures are investigated in this work.

Critical Opalescence and Its Impact on the Jet Quenching Parameter q

Jet quenching parameter q is essential for characterizing the interaction strength between jet partons and nuclear matter.Based on the quark-meson model,we develop a new framework for calculating q at finite chemical potentials,in which q is related to the spectral function of the chiral order parameter.

Neuroimaging features in a patient with non-ketotic hyperglycaemic seizures: A case report

BACKGROUND Non-ketotic hyperglycaemic(NKH)seizures are a rare neurological complication of diabetes caused by hyperglycaemia in non-ketotic and non-hyperosmotic states.The clinical characteristics of NKH seizures are atypical and lack unified diagnostic criteria,leading to potential misdiagnoses in the early stages of the disease.CASE SUMMARY This report presents a rare case of NKH seizures in a 52-year-old male patient with a history of type 2 diabetes mellitus.We performed comprehensive magnetic resonance imaging(MRI)studies at admission,12 d post-admission,and 20 d post-discharge.The imaging techniques included contrast-enhanced head MRI,T2-weighted imaging(T2WI),fluid-attenuated inversion recovery(FLAIR),diffusion-weighted imaging,susceptibility-weighted imaging,magnetic reso-nance spectroscopy(MRS),and magnetic resonance venography.At the time of admission,T2WI and FLAIR of the cranial MRI showed that the left parieto-occipital cortex had gyrus-like swelling and high signal,and subcortical stripes had low signal.MRS showed a reduced N-acetylaspartate peak and increased creatine and choline peaks in the affected areas.A follow-up MRI 20 d later showed that the swelling and high signal of the left parieto-occipital cortex had disappeared,and the low signal of the subcortex had disappeared.CONCLUSION This case study provides valuable insights into the potential pathogenesis,diagnosis,and treatment of NKH seizures.The comprehensive MRI findings highlight the potential utility of various MRI sequences in diagnosing and characterizing NKH seizures.

Pathogenicity and transcriptomic profiling reveals immunology molecular hallmarks after CA10 virus infection

Background:Hand,foot and mouth disease(HFMD)is a common infectious disease caused by viral infection by a variety of enteroviruses,with coxsackievirus A 10(CA10)having become more prevalent in recent years.Methods:In this study,models of CA10 infection were established in 7-day-old Institute of Cancer Research(ICR)mice by intraperitoneal injection to analyze the pathogenicity of the virus.RNA sequencing analysis was used to screen the differentially expressed genes(DEGs)after CA10 infection.Coxsackievirus A 16(CA16)and enterovirus 71(EV71)infections were also compared with CA10.Results:After CA10 virus infection,the mice showed paralysis of the hind limbs at 3 days post infection and weight loss at 5 days post infection.We observed viral replication in various tissues and severe inflammatory cell infiltration in skeletal muscle.The RNA-sequencing analysis showed that the DEGs in blood,muscle,thymus and spleen showed heterogeneity after CA10 infection and the most upregulated DEGs in muscle were enriched in immune-related pathways.Compared with CA16 and EV71 infection,CA10 may have an inhibitory effect on T helper(Th)cell differentiation and cell growth.Additionally,the common DEGs in the three viruses were most enriched in the immune system response,including the Toll-l ike receptor pathway and the nucleotide-binding and oligomerization domain(NOD)-l ike pathway.Conclusions:Our findings revealed a group of genes that coordinate in response to CA10 infection,which increases our understanding of the pathological mechanism of HFMD.

Efficacy of graphene nanocomposites for air disinfection in dental clinics: A randomized controlled study

BACKGROUND Aerosols containing disease-causing microorganisms are produced during oral diagnosis and treatment can cause secondary contamination.AIM To investigate the use of graphene material for air disinfection in dental clinics by leveraging its adsorption and antibacterial properties.METHODS Patients who received ultrasonic cleaning at our hospital from April 2023 to April 2024.They were randomly assigned to three groups(n=20 each):Graphene nanocomposite material suction group(Group A),ordinary filter suction group(Group B),and no air suction device group(Group C).The air quality and air colony count in the clinic rooms were assessed before,during,and after the procedure.Additionally,bacterial colony counts were obtained from the air outlets of the suction devices and the filter screens in Groups A and B.RESULTS Before ultrasonic cleaning,no significant differences in air quality PM2.5 and colony counts were observed among the three groups.However,significant differences in air quality PM2.5 and colony counts were noted among the three groups during ultrasonic cleaning and after ultrasonic treatment.Additionally,the number of colonies on the exhaust port of the suction device and the surface of the filter were significantly lower in Group A than in Group B(P=0.000 and P=0.000,respectively).CONCLUSION Graphene nanocomposites can effectively sterilize the air in dental clinics by exerting their antimicrobial effects and may be used to reduce secondary pollution.

Major methods of seismic anisotropy

Seismic anisotropy reveals that seismic wave velocity, amplitude, and other physical properties show variations in different directions, which can be divided into lattice-preferred orientation(LPO) and shape-preferred orientation(SPO) according to its physical mechanisms. The main methods for studying seismic anisotropy include shearwave splitting analysis, P-wave travel time inversion and surface-wave tomography, etc. There are some differences and correlations among these methods. Seismic anisotropy is an important way to reveal the dynamic processes of crust-mantle evolution, and it is significant for monitoring crustal stress changes and improve seismic exploration studies. With the help of long-term observation, the application of machine learning techniques and combining inversion based on multiple phases would become potential developments in seismic anisotropy studies. This may improve the understanding of complex seismic anisotropic models, such as multiple layers anisotropy with an oblique axis of symmetry.

Suspected coexistence of perianal necrotizing sweet syndrome in chronic myelomonocytic leukemia:A case report

BACKGROUND Chronic myelomonocytic leukemia(CMML)complicated with Sweet syndrome(SS)is a rare hematological neoplasm.However,cases of concomitant development of perianal necrotizing SS(NSS)have not been reported.CASE SUMMARY We report a case of a 49-year-old male patient who underwent sequential procedures for hemorrhoids and perianal abscess.He developed postoperative incision infection and was referred to the department where the authors work.Initially,perianal necrotizing fasciitis secondary to incision infection after perianal abscess surgery was suspected.Despite receiving antibiotic therapy and undergoing surgical debridement,deeper necrotic areas formed in the patient’s perianal wounds,accompanied by persistent high fever.Blood and fungal cultures yielded negative results.The final diagnosis was corrected to be CMML with suspected concomitant perianal NSS.CONCLUSION CMML with perianal NSS is a rare condition,often misdiagnosed as perianal abscess or perianal necrotizing fasciitis.Conventional antibiotic therapy and surgical debridement are ineffective in managing this condition.

Retrospective analysis based on a clinical grading system for patients with hepatic hemangioma:A single center experience

BACKGROUND The optimal approach for managing hepatic hemangioma is controversial.AIM To evaluate a clinical grading system for management of hepatic hemangioma based on our 17-year of single institution experience.METHODS A clinical grading system was retrospectively applied to 1171 patients with hepatic hemangioma from January 2002 to December 2018.Patients were classified into four groups based on the clinical grading system and treatment:(1)Observation group with score<4(Obs score<4);(2)Surgical group with score<4(Sur score<4);(3)Observation group with score≥4(Obs score≥4);and(4)Surgical group with score≥4(Sur score≥4).The clinico-pathological index and outcomes were evaluated.RESULTS There were significantly fewer symptomatic patients in surgical groups(Sur score≥4 vs Obs score≥4,P<0.001;Sur score<4 vs Obs score<4,χ^(2)=8.60,P=0.004;Sur score≥4 vs Obs score<4,P<0.001).The patients in Sur score≥4 had a lower rate of in need for intervention and total patients with adverse event than in Obs score≥4(P<0.001;P<0.001).Nevertheless,there was no significant difference in need for intervention and total patients with adverse event between the Sur score<4 and Obs score<4(P>0.05;χ^(2)=1.68,P>0.05).CONCLUSION This clinical grading system appeared as a practical tool for hepatic hemangioma.Surgery can be suggested for patients with a score≥4.For those with<4,follow-up should be proposed.

城市更新的交通驱动力——北京地铁1号线与八通线贯通工程

北京市地铁1号线与八通线贯通工程是城市更新的重要举措,旨在提升交通基础设施的效率与便捷性。该项目位于朝阳区四惠交通枢纽,经过11个月的改造,实现了线路、供电、通信、信号等系统的互联互通。该项目自2021年8月29日贯通运营以来,极大地改善了乘客换乘效率,促进了城市中心区与副中心的无缝连接,有效推动了城市更新和绿色出行的发展。本文阐述了项目实施过程中的技术难题和创新经验,以及高效组织管理在城市更新中的关键作用。

Progress in Analytical Methods of Halogenated Disinfection By-Products

Ensuring the health and safety of drinking water is crucial for both nations and their citizens.Since the 20th century,the disinfection of drinking water,effectively controlling pathogens in water sources,has become one of the significant advances in public health.However,the disinfectants used in the process,such as chlorine and chlorine dioxide,react with natural organic matter in the water to produce disinfection by-products(DBPs).Most of these DBPs contain chlorine,and if the source water contains bromine or iodine,brominated or iodinated DBPs,collectively referred to as Halogenated disinfection byproducts(X-DBPs),are formed.Numerous studies have found that X-DBPs pose potential risks to human health and the environment,leading to widespread concern.Mass spectrometry has become an important means of discovering new types of X-DBPs.This paper focuses on the study of methods for analyzing X-DBPs in drinking water using mass spectrometry.

化妆品原料的过敏性体外方法——氨基酸衍生化反应法(ADRA)方法转化与验证

在皮肤致敏不良结果通路(AOP)的第一个关键事件中化学反应为亲电物质与皮肤蛋白中的亲核中心共价结合,即皮肤与物质接触后,可能与皮肤上的蛋白结合形成抗原,导致不良反应。采用半胱氨酸和赖氨酸衍生物替代皮肤组织,模拟皮肤蛋白与化合物结合,通过计算半胱氨酸和赖氨酸衍生物反应后耗竭值(百分比)将物质分类,以此区分皮肤敏化剂和非敏化剂,此种方法称之为氨基酸衍生化反应法(ADRA)。本实验选择10种致敏性已知的物质,探究ADRA方法用于化合物致敏性评价的准确度,并在10种物质中随机选取几种物质采用国内已转化验证过的方法直接反应多肽法(DPRA)对结果进行验证。结果表明,10种物质致敏性判定结果符合样品自身致敏性,认定ADRA致敏性判定准确度较好,可作为皮肤致敏AOP的第一个关键事件替代实验方法。

LIN28A attenuates high glucose-induced retinal pigmented epithelium injury through activating SIRT1-dependent autophagy

AIM:To evaluate the effects of LIN28A(human)on high glucose-induced retinal pigmented epithelium(RPE)cell injury and its possible mechanism.METHODS:Diabetic retinopathy model was generated following 48h of exposure to 30 mmol/L high glucose(HG)in ARPE-19 cells.Quantitative real-time polymerase chain reaction(qRT-PCR)and Western blot tested the expression of the corresponding genes and proteins.Cell viability as well as apoptosis was determined through cell counting kit-8(CCK-8)and flow cytometry assays.Immunofluorescence assay was adopted to evaluate autophagy activity.Caspase 3 activity,oxidative stress markers,and cytokines were appraised adopting their commercial kits,respectively.Finally,ARPE-19 cells were preincubated with EX527,a Sirtuin 1(SIRT1)inhibitor,prior to HG stimulation to validate the regulatory mechanism.RESULTS:LIN28A was downregulated in HG-challenged ARPE-19 cells.LIN28A overexpression greatly inhibited HGinduced ARPE-19 cell viability loss,apoptosis,oxidative damage as well as inflammatory response.Meanwhile,the repressed autophagy and SIRT1 in ARPE-19 cells challenged with HG were elevated after LIN28A overexpression.In addition,treatment of EX527 greatly inhibited the activated autophagy following LIN28A overexpression and partly abolished the protective role of LIN28A against HG-elicited apoptosis,oxidative damage as well as inflammation in ARPE-19 cells.CONCLUSION:LIN28A exerts a protective role against HG-elicited RPE oxidative damage,inflammation,as well as apoptosis via regulating SIRT1/autophagy.