右美托咪定对脊柱手术患者术中血流动力学和失血量的影响:系统回顾和荟萃分析

目的 右美托咪定是一种高选择性的α2肾上腺素能受体激动剂,具有降低血压和心率的作用。本研究旨在探讨右美托咪定对脊柱手术患者术中血流动力学和失血量的影响。方法 检索Web of Science、MEDLINE、EMBASE和Cochrane图书馆截至2023年2月发表的随机对照研究,比较右美托咪定和生理盐水对脊柱手术术中血流动力学和失血量的影响。根据研究间的异质性采用固定或随机效应模型。结果 纳入21项随机对照研究,共1388例患者。右美托咪定的使用增加了术中低血压(OR:2.11;95%CI:1.24-3.58;P=0.006)和心动过缓(OR:2.48;95%CI:1.57-3.93;P=0.0001)的总体风险。特别是在给予负荷剂量时,低血压(OR:2.00;95%CI:1.06-3.79;P=0.03)和心动过缓(OR:2.28;95%CI:1.42-3.66;P=0.0007)的风险更为显著。当右美托咪定与静脉麻醉联合使用时,患者更容易出现血流动力学不稳定的情况,包括低血压(OR:2.90;95%CI:1.24-6.82;P=0.01)和心动过缓(OR:2.66;95%CI:1.53-4.61;P=0.0005)。与吸入麻醉联合时,仅增加了心动过缓的风险(OR:4.95;95%CI:1.41-17.37;P=0.01)。然而,当与静吸复合麻醉联合使用时,并未增加低血压和心动过缓的风险。此外,右美托咪定还增加了重度低血压的风险(OR:2.57;95%CI:1.05-6.32;P=0.04),但对轻度低血压的影响并不显著。对于心动过缓而言,无论是轻度(OR:2.55;95%CJ:1.06-6.15;P=0.04)还是重度(OR:2.45;95%CI:1.43-4.20;P=0.001)的风险都有所增加。总体而言,右美托咪定对术中失血量的影响并不显著,但在与吸入麻醉联合时,失血量显著减少(MD:-82.97;95%CI:-109.04--56.90;P<0.001)。结论 右美托咪定在脊柱手术过程中增加了低血压和心动过缓的风险。给予负荷剂量或与不同麻醉维持方式联合使用可能会对术中血流动力学和失血量产生不同的影响。然而,目前的研究结果仍需进一步证实和探讨。

Direct Regeneration of Spent Lithium-Ion Battery Cathodes:From Theoretical Study to Production Practice

Direct regeneration method has been widely concerned by researchers in the field of battery recycling because of its advantages of in situ regeneration,short process and less pollutant emission.In this review,we firstly analyze the primary causes for the failure of three representative battery cathodes(lithium iron phosphate,layered lithium transition metal oxide and lithium cobalt oxide),targeting at illustrating their underlying regeneration mecha-nism and applicability.Efficient stripping of material from the collector to obtain pure cathode material has become a first challenge in recycling,for which we report several pretreatment methods currently available for subsequent regeneration processes.We review and discuss emphatically the research progress of five direct regeneration methods,including solid-state sintering,hydrothermal,eutectic molten salt,electrochemical and chemical lithiation methods.Finally,the application of direct regeneration technology in production practice is introduced,the problems exposed at the early stage of the industrialization of direct regeneration technol-ogy are revealed,and the prospect of future large-scale commercial production is proposed.It is hoped that this review will give readers a comprehensive and basic understanding of direct regeneration methods for used lithium-ion batteries and promote the industrial application of direct regeneration technology.

Correction:Direct Regeneration of Spent Lithium‑Ion Battery Cathodes:From Theoretical Study to Production Practice

The Highlights session of the article unfortunately was taken falsely from another manuscript.The correct Highlights session is now in place.The correct is:Analyze the primary causes of cathode failure in three representative batteries,illustrating their underlying regeneration mechanism.

The evolution and significance of medicine and food homology

Historical insights into medicine and food homology(MFH)Evolution of the MFH theory MFH,a basic concept in traditional Chinese medicine(TCM),suggests that many materials function as both food and medicine,providing nourishment and simultaneously treating ailments.This concept has evolved significantly throughout TCM history^([1]).Integral to this evolution was the discovery of certain materials with dual purposes during early searches for food.These materials not only offer sustenance and nutrition but are also capable of treating simple illnesses^([2]).

Construction of competency evaluation system for infection control personnel in traditional Chinese medicine hospitals

Background:This study uses a literature review and the Delphi expert consultation method to construct a competency evaluation model for infection control personnel in traditional Chinese medicine(TCM)hospitals.The aim is to strengthen infection control management in TCM hospitals,assess the competency of infection control personnel in their positions,and assist them in identifying the competencies that need improvement.Methods:Based on the literature research method and the Delphi expert consultation method,a competency model for the position was constructed through two rounds of expert consultations,analyzing the relationships between various factors and establishing a hierarchical structure model.Pairwise comparisons were made among the elements at the same level to construct a judgment matrix.Through the analytic hierarchy process,the weight coefficients of the indicators at each level in the competency model were obtained.Results:This study conducted a comprehensive assessment of various capabilities and practices related to hospital infection control.The survey results indicate that participants excelled in multiple areas,with a high overall satisfaction rate.95.28%of participants were able to develop hospital infection monitoring plans based on national infection control policies,demonstrating a good understanding and execution of these policies.94.09%of participants were familiar with high-risk populations and key departments in the hospital.91.73%of participants were able to establish monitoring scopes based on the trends of multidrug-resistant bacteria and conduct information monitoring,reflecting strong response capabilities.92.91%of participants were able to collaborate with relevant departments to conduct bacterial resistance monitoring,showing a good team spirit.94.49%of participants were able to perform targeted monitoring,including surgical site infections,indicating that they have effective monitoring strategies.91.34%of participants were able to collect and organize monitoring data and establish a systematic database,demonstrating good data management skills.90.16%of participants were able to interpret laws and regulations related to hospital infection management,indicating a high level of legal knowledge.89.37%of participants generally possessed good communication skills.92.52%of participants were able to guide medical staff on occupational safety and protective knowledge,showing an emphasis on occupational health.Participants demonstrated a strong desire to learn and innovate,with 87.01%actively participating in continuing education and research activities,reflecting a pursuit of professional development.Conclusion:Based on the results of the two rounds of expert consultations,a competency evaluation model for infection control personnel in TCM hospitals was formed.Through the analytic hierarchy process,the weight coefficients of various indicators at different levels in the model were obtained,and the research results have good scientific validity and reliability.

The effect of HPV infection on mental health status in women

Human papillomavirus(HPV)infection is one of the most common sexually transmitted infections globally,and its close association with the development of cervical cancer has become a major public health concern.HPV infection not only leads to physical health problems,but also has an impact on a woman’s mental health,such as:severe anxiety,fear,depression,negativity,and other psychological distress.The purpose of this review is to systematically summarize the current knowledge on this topic and to explore its current development in accordance with the PRISMA guidelines.We can provide interventions that may alleviate or even eliminate psychological problems in women,depending on their psychological characteristics.A total of 82 records were included in the study,including 37 papers on the effect of HPV infection on the mental health status of women and 45 studies on the effect of implementing interventions on the mental health of patients with HPV infection.The results show that HPV infection can make women produce anxiety,depression,shame,low self-esteem and other negative psychological.However,active and proper medical treatment,psychological counseling and support,and strengthening health education have positive effects on HPV-infected women,and can promote the mental health of HPV-infected women.

Application of an electrophysiological technique combined with auricular acupuncture in gynecological perioperative gastrointestinal dysfunction

Objective:This study aimed to evaluate the effectiveness and safety of combining low-frequency pulsed electrophysiological techniques with auricular acupuncture(a fusion of traditional Chinese and Western medicine)for patients experiencing perioperative gastrointestinal dysfunction(POGD)following gynecological surgery.Methods:Eighty patients undergoing gynecological surgery were randomly assigned to an experimental group and a control group.Both groups received enhanced recovery after surgery(ERAS)care,with the experimental group receiving additional treatment combining electrophysiology and auricular acupuncture.Postoperative recovery indicators,including bowel sound recovery time,time to first exhaust and defecation,duration and incidence of abdominal pain and distension,nausea and vomiting,and specific gastrointestinal markers(HSP70,I-FABP,DAO,D-lactate),were monitored and compared between the two groups.Results:After treatment,the postoperative bowel sound recovery time,first postoperative exhaust time,duration of abdominal pain,and duration of abdominal distension were shorter in the experimental group than in the control group(P<0.05).The 6-hour and 48-hour integral values of the experimental group were significantly lower than those of the control group.In the experimental group,60%of the patients were completely cured of gastrointestinal function after surgery,whereas only 32.5%of the patients in the control group were cured.The main symptom scores(abdominal pain,abdominal distension,nausea and vomiting)on the third postoperative day and the total symptom scores on the third postoperative day were significantly lower in the experimental group than in the control group(P<0.05).The values of HSP70,I-FABP,DAO,and D-lactate in the experimental group on postoperative day one were significantly lower than those in the control group(P<0.05).Conclusion:The combination of the Chinese and Western medicine ERAS programs of low-frequency pulse electrophysiology technology plus auricular acupuncture can accelerate local gastrointestinal blood circulation during the perioperative period of gynecology,promote the recovery of gastrointestinal function,promote anal exhaustion,and prevent the occurrence of postoperative abdominal pain and bloating.The combination of Chinese and Western medicine ERAS can increase gastrointestinal fluid secretion,increase gastrointestinal hormone and blood flow values,increase gastrointestinal electrophysiological detection values,and change the indicators of gastrointestinal dysfunction.

Application of transcutaneous electrical acupoint stimulation in perioperative gynecology

Transcutaneous electrical acupoint stimulation(TEAS)is also known as low-frequency pulsed electrophysiological technology.TEAS is an enhanced recovery after surgery,which covers the preoperative,intraoperative,and postoperative phases of the perioperative period,and the core concept is to promote the rapid recovery of patients.TEAS helps to repair local smooth muscle as well as nerves caused by surgery,increase blood circulation in the damaged area,restore innervation and vascular function,restore the balance of local venous and lymphatic circulation,reduce local pain as well as local tissue edema,reduce the occurrence of complications,reduce surgical discomfort,enhance therapeutic effects,and promote rapid recovery from surgery.

Progress and Prospects of the Natural Restoration of Damaged Vegetation after the Earthquake

Vegetation plays an important role in soil and water conservation, water conservation and carbon sequestration of an ecosystem. The restoration of damaged vegetation is of great significance to the maintenance of species diversity and the restoration of the regional ecological environment. It is also one of the most effective measures to improve the fragile ecosystem. This paper summarizes the research results from decades of damaged vegetation recovery in the process of vegetation recovery, the main driving factor and the restoration mode.

玻璃体注射抗VEGF药物对全身VEGF浓度的影响

脉络膜视网膜疾病已经成为影响人类视力的严重问题,血管内皮生长因子(vascular endothelial growth factor,VEGF)的异常表达导致眼底血管通透性增加和新生血管的形成。玻璃体抗VEGF药物注射可快速抑制眼内VEGF水平,有效控制疾病发展,目前抗VEGF治疗已成为眼科广泛应用的治疗手段。然而,研究表明玻璃体内抗VEGF药物进入循环系统后降低血浆VEGF浓度,药物无意义的脱靶效应可能导致全身不良反应。对于高龄患者、患有严重合并症患者、哺乳期妇女、早产儿等特殊人群,应关注多次注射后的全身VEGF抑制。本文通过探讨抗VEGF治疗的药物代谢动力学、全身不良反应、对侧眼效应、对母乳和早产儿的影响,对玻璃体注射抗VEGF药物的全身影响进行综述,以期对临床抗VEGF治疗提供可参考的信息。

Synergistic Modification of PVC with Nitrogen-Containing Heterocycle and Tung-Oil Based Derivative for Enhanced Heat Stabilization and Plasticization Behavior

The additives present in polyvinyl chloride(PVC)materials are the major source of organic by-products during PVC degradation.The thermal stabilizer and plasticizer are the main additives that endow PVC with the required properties during its processing.However,these two additives easily migrate when samples are obtained by physical mixing of the additives with PVC.This causes the reduction of PVC sample efficacy and the increase in the formation of organic by-products in the radiolysis process.In this work,two kinds of grafted PVC samples(tungoil derivative grafted PVC and Atz grafted PVC,abbreviated as P-GT4 and P-AZ3)were synthesized by chemical grafting of 3-amino-1,2,4-triazole(Atz)and tung-oil derivative on PVC,respectively.These two PVC samples were then blended at different mass ratios to obtain hybrid PVC materials with excellent plasticization,thermal stability and migration resistance ability.Differential scanning calorimetry(DSC),discoloration,Congo red test and thermogravimetric analysis(TGA)showed that when the mass ratio of P-GT4 to P-AZ3 in the mixed PVC resin was 1:3,the resulting P1:3-GT4-AZ3(P4)presented the best plasticization and thermal stability.The kinetics of thermal decomposition showed that the activation energy of P4 was much higher than that of the reference material[PVC/DOTP/CaSt2/ZnSt2,PVC/CZ41 for short]at mass lossα=20%and 80%.In addition,the leaching test showed that P4 material possessed excellent migration resistance ability.

The Promoting Effect of Multifunctional Groups on the Thermal and Mechanical Properties of PVC Materials

The development of PVC materials grafted with mannich base originated from myrcene(P-MAM-g,where the mannich base derived from myrcene is abbreviated as MAM)via green and effective synthetic methods is a good strategy to avoid unacceptable discoloration and deterioration of thermal and mechanical properties caused by autocatalytic dehydrochlorination(DHC)during PVC processing.In this study,MAM with double bonds,amino groups,ester groups,and phospholipid groups was introduced into the chains of PVC to improve the thermal stability of PVC.The experimental results showed that the covalent attachment of MAM to PVC enhanced both the initial and the long-term stability of PVC.The enhanced performance of P-MAM-g compared with unmodified PVC is attributed to the simultaneous introduction of double bonds and amino groups into the PVC structure.The double bonds trapped the unstable chlorine atoms originated from the degradation of the PVC chain and reacted with the labile macromolecular radicals originated from PVC,thus inhibiting the radical degradation of the PVC chain.Furthermore,the amino groups absorbed the HCl produced in the degradation of PVC,inhibiting the adverse effects of HCl.P-MAM-g displayed better intrinsic flexibility and anti-migration ability of organic functional components compared with the control PVC materials.A possible stabilizing mechanism of the P-MAM-g was also presented.

Traditional Chinese medicine during the COVID-19 pandemic:recent successes and future perspectives

The article titled“Three medicines and three formulas in COVID-19:from bench to bedside”introduces the clinical effects and mechanisms of three medicinal products and three prescription formulas(TMTF)from traditional Chinese medicine(TCM)as used during the COVID-19 pandemic[1].

Successful re-challenge of PD-1 inhibitors in combination with bevacizumab and pemetrexed for multiple primary NSCLC progressing on prior PD-1 inhibitor therapy:one case report

Lung cancer is a malignant tumor with high incidence and mortality rates in China and worldwide.Approximately 10%of these diseases are caused by multiple primary non-small cell lung cancers(NSCLC).Traditional antitumor therapies,such as chemotherapy,radiotherapy,and targeted therapy,have limited efficacy in the treatment of advanced synchronous multiple primary NSCLC.Immunotherapy is considered the standard of care for advanced or recurrent NSCLC,however,approximately 60%of patients develop primary or secondary resistance to treatment.There are no standard recommendations for overcoming immune resistance.We describe a case of simultaneous multiple primary NSCLC in a patient who received programmed death factor-1(PD-1)inhibitor monotherapy and developed brain metastases.After receiving second-line treatment with a combination of another PD-1 inhibitor,pemetrexed,and bevacizumab,the patient achieved complete remission,although they experienced grade 3 immune-related adverse reactions.Immune re-challenge is safe and feasible,and choosing a synergistic combination regimen is one of the options to overcome immune resistance.A larger sample size is needed to confirm the effectiveness and safety of this strategy in patients with NSCLC resistant to prior PD-1 inhibitors.

GLP-1类似物利拉鲁肽联合门冬胰岛素30对2型糖尿病患者认知功能障碍的影响

目的探究GLP-1类似物利拉鲁肽联合门冬胰岛素30治疗2型糖尿病患者认知功能障碍的临床疗效。方法连续入选2014年9月-2016年1月山东省滕州市中心人民医院内住院的2型糖尿病患者132例,将患者随机分成门冬胰岛素30治疗组(对照组,66例)和利拉鲁肽联合门冬胰岛素30治疗组(实验组,66例),治疗1年后随访结果,比较分析治疗前后两组患者血糖、血脂、体重指数及认知功能的变化情况。结果治疗1年后随访,实验组的血糖、体重指数较对照组改善,认知功能量表MMSE、MoCA、CMS总分均高于对照组(P<0.05)。结论利拉鲁肽联合门冬胰岛素30在控制血糖、降血脂、改善体重指数方面的临床疗效优于单纯的门冬胰岛素30,且有效改善糖尿病患者认知功能。

超声乳化联合房角分离术与小梁切除术治疗急性闭角型青光眼合并白内障

目的:比较白内障超声乳化联合房角分离术与单纯小梁切除术治疗急性闭角型青光眼合并白内障的临床疗效。方法:选取我院就诊的急性闭角型青光眼合并白内障患者46例60眼,其中行白内障超声乳化联合房角分离术30眼(A组),单纯行小梁切除术30眼(B组);观察术后4、7d,1、3mo,患者BCVA(LogMAR视力)、眼压、中央前房深度及视野情况。结果:术后3mo A组BCVA为0.20±0.18显著高于B组0.39±0.09(P<0.05)。A组术前眼压(18.3±4.6mmHg)与术后3mo(17.2±1.9mmHg)无差异(P>0.05);术前B组眼压(18.2±5.0mmHg)与术后3mo(12.4±2.1mmHg)有差异(P<0.05);术后3mo,A组和B组眼压比较有差异(P<0.05)。术前A组前房深度(2.23±0.21mm)与术后3mo(3.46±0.10mm),B组术前前房深度(2.21±0.12mm)与术后3mo(3.36±0.09mm)均有差异(P<0.05)。A组术前视野缺损度(6.32±1.57db)与术后3mo(6.54±1.42db),B组术前视野缺损度(6.31±1.46db)与术后3mo(6.57±1.52db)均无差异(P>0.05)。结论:白内障超声乳化联合房角分离术与单纯小梁切除术对急性闭角型青光眼眼压均能有效控制。

电子喉镜窄带成像技术模式在早期喉癌诊断中的应用及其与病理结果一致性的研究

目的探讨电子喉镜窄带成像技术(NBI)模式在早期喉癌诊断中的应用及与病理结果的一致性。方法选取该院喉部病变患者80例,均行电子喉镜白光、NBI检查和病理检查,比较电子喉镜NBI模式与白光模式检查结果及图像质量,分析电子喉镜NBI模式与病理结果的一致性。结果80例喉部病变患者均为单发病灶。病理性质为阳性(恶性)的29例中,鳞状细胞癌22例(Ⅴ型),原位癌7例(Ⅴ型);阴性(非恶性)的51例中,5例中度不典型增生(Ⅳ型),18例单纯增生(Ⅲ型),18例慢性喉炎(Ⅱ型),10例声带息肉(Ⅰ型)。80例喉部病变患者电子喉镜NBI模式下阳性30例,阴性50例;白光模式下阳性23例,阴性57例;电子喉镜NBI模式检查敏感度、阴性预测值及准确度均高于白光模式,差异有统计学意义(P<0.05);电子喉镜NBI模式检查图像中,病变轮廓及微血管形态评分均高于白光模式,差异有统计学意义(P<0.05);电子喉镜NBI模式与病理结果符合率为80.00%(Kappa=0.733,P=0.000)。结论电子喉镜NBI模式下黏膜表层微血管形态和结构清晰可见,更易识别早期病变,判断病变范围,且诊断结果与病理结果一致性较高,在早期喉癌诊断中具有良好的应用前景。

The effect of painting therapy in cancer patients:a scoping review

Objective:To analyze the effect of drawing therapy in cancer patients and to explore the effect of drawing therapy on negative emotions and quality of life of cancer patients,in order to provide reference for future related research.Methods:A computer search of Embase,Web of Science,Cochrane Library,PubMed,China Knowledge Network,Wanfang database,Vipshop database and China Biomedical Literature Service was conducted to retrieve relevant studies on the application of painting therapy in cancer patients from the database to December 2022,using the scoping review method as a guide.Results:A total of 15 publications were included,including 10 randomized controlled trials,4 class experimental studies and 1 cohort study,with full text summarizing the type of painting therapy,painting duration,intervention period,interventionist and treatment adherence.The main indicators of outcome included physiological indicators such as nausea and vomiting,negative emotions such as anxiety and depression and quality of life such as fatigue status and sleep quality in cancer patients.Conclusions:Painting therapy can reduce the degree of nausea,reduce negative emotions such as anxiety and depression,reduce fatigue,improve sleep quality and improve quality of life in cancer patients,but the degree of vomiting in cancer patients still needs to be further explored.In the future,we need to extend the follow-up period of painting therapy and explore the long-term effect of painting therapy applied in cancer patients.

Effects of positive thinking intervention on negative emotions and quality of life in stroke patients:a scoping review

Objective:To analyze domestic and international studies on the effects of positive thought intervention therapy on negative emotions and the quality of life of stroke patients to provide a reference for future related studies.Methods:Using the scoping review method as a guide,computer searches of PubMed,Web of Science,Embase,Cochrane Library,China National Knowledge Infrastructure,Wanfang Database,China Vipers Full Text Database and China Biomedical Literature Database were conducted to collect relevant studies on the application of positive thinking interventions in stroke patients from the establishment to January 2023,and the literature was screened according to the inclusion and exclusion criteria,and the data were extracted and analyzed by two investigators independently.Results:The search yielded 964 publications,and a total of 19 were included.The time of publication,study site,study population,study design,study length,and type of results of the included studies was summarized and analyzed.Conclusions:Positive thinking-based interventions have shown significant changes in negative emotions such as anxiety and depression in stroke patients and can reduce somatic pain,enhance their social integration,and improve their quality of life.However,interventions in the areas of self-compassion,artificial intelligence and the adoption of tailoring need to be further explored.

Effect of different nursing interventions on the incidence of peritonitis in peritoneal dialysis patients at home: a network meta-analysis

Objective:Bayesian network meta-analysis was used to evaluate the effect of different nursing interventions on the incidence of peritonitis in peritoneal dialysis patients at home.Methods:Cochrane Library,PubMed,Embase,Web of Science,China Biology Medicine disc,CNKI and Wanfang data were searched to identify randomized controlled trials(RCTs)investigating the effects of different nursing interventions or health education on peritonitis in home peritoneal dialysis patients from the establishment of each database to March 2022.After literature screening,the Cochrane 5.1 evaluation tool was used to assess quality,Review Manager 5.4 software was used to generate a literature quality evaluation chart and R4.1.2 software,JAGS package,and GEMTC package were used for statistical analysis.Results:A total of 9 RCTs involving 8 different nursing interventions and a total of 1011 patients were included in the meta-analysis.The incidence of peritonitis for the eight nursing interventions,ranked from highest to lowest,were:systematic nursing,Omaha system case management intervention,routine care+health promotion mode,PD specialist nurse-led multi-disciplinary network platform management mode,5E rehabilitation nursing mode,routine care+Omaha extended nursing service,one-on-one coordinated family support intervention,and routine care.Conclusions:Systematic nursing was found to be the most effective intervention in reducing the incidence of peritonitis in peritoneal dialysis patients at home.However,this conclusion needs to be further verified by more high-quality,multicenter and large sample RCTs.