护士主导的心力衰竭门诊的效果:一项系统综述

目的心力衰竭是全球日益严重的主要公共卫生问题。护士主导的心力衰竭门诊在管理心力衰竭方面发挥着重要作用。该研究进行了一项系统综述,以描述护士主导心力衰竭门诊的内容及其影响。方法在PubMed、Embase、Web of Science和Cochrane Library中对护士主导心力衰竭门诊的研究进行了检索。检索最初于2022年10月23日进行,并于2023年11月21日进行更新。文章由两名独立研究者按照乔安娜-布里格斯研究所标准进行评估。本系统综述已在PROSPERO上注册(CRD42022352209)。结果共纳入12篇文献。护士主导心衰门诊的内容包括:药物滴定、教育咨询、基于循证的延续护理、社会心理支持、体格检查和心理健康评估、治疗监测和调整、随访和电话咨询。多数研究报告认为护士主导的心力衰竭门诊取得了积极的临床效果。4项研究对生活质量进行了调查,结果不一;4项研究对药物滴定的疗效进行了调查,结果总体上是积极的。仅2项研究对成本效果进行了评估,仍需更多相关研究进行验证。结论护士主导的心力衰竭门诊在很大程度上显示出对患者结局、生活质量、药物滴定效果的积极影响。

灌肠袋回流灌肠对先天性巨结肠小儿回流灌肠时间的影响

目的探讨利用灌肠袋回流灌肠对先天性巨结肠儿回流灌肠时间的影响。方法试验组利用灌肠袋灌肠,对照组给予传统灌肠。结果试验组灌肠各个阶段所需时间均明显短于对照组(P<0.05);各个阶段对回流灌肠时间的影响从高到低依次为液体流出>注入灌肠液>准备用物>插入肛管>其他。结论利用灌肠袋对先天性巨结肠小儿行回流灌肠可显著缩短所需时间。

SiO2同步合成与固载酞菁的制备及可见光催化性能

首先通过对羟基苯甲酸和8-羟基喹啉分别与4-硝基邻苯二腈反应制备了羧基苯氧基邻苯二腈(CPPN)和喹啉氧基邻苯二腈(QPN),然后利用开环反应将CPPN键合到聚甲基丙烯酸缩水甘油酯改性的硅胶(PGMA/SiO2)表面,得到键合有邻苯二腈的硅胶CPPN-PGMA/SiO2,再通过“同步合成与固载”的方法在PGMA/SiO2表面固载喹啉氧酞菁(QPc)或金属喹啉氧酞菁(MQPc),制备了固载化的酞菁QPc-PGMA/SiO2或CoQPc-PGMA/SiO2。通过红外光谱、扫描电镜、热重分析、紫外-可见漫反射光谱等对其结构、形貌和酞菁键合量进行表征和测定。考察了催化剂DBU用量对“同步合成与固载”酞菁过程的影响。最后以亚甲基蓝(MB)和苯酚为目标降解物,研究所制得的固载化酞菁催化剂QPc-PGMA/SiO2或CoQPc-PGMA/SiO2的可见光催化活性。结果表明,借助“同步合成与固载”的方法能够成功在PGMA/SiO2表面固载喹啉氧酞菁(QPc)或金属喹啉氧酞菁(CoQPc),得到固载化酞菁QPc-PGMA/SiO2或CoQPc-PGMA/SiO2。在可见光照射下,QPc-PGMA/SiO2和CoQPc-PGMA/SiO2均具有较好的光催化活性。较低浓度时,CoQPc-PGMA/SiO2催化降解亚甲基蓝的效果优于QPc-PGMA/SiO2;碱性条件有利于CoQPc-PGMA/SiO2光催化降解MB性能的发挥,在pH值为10.0时,0.2g/L的CoQPc-PGMA/SiO2能使MB的降解率高达97%以上。固载化金属酞菁周边取代基的性质对其光催化降解苯酚有一定的影响,有供电子共轭效应的CoQPc-PGMA/SiO2对苯酚的光降解效果最优,5min内苯酚的降解率达58%,2h内苯酚的降解率高达100%。此外,固载化金属酞菁还具有良好的重复使用性。

Discharge planning for children with ventricular septal defect and pulmonary arterial hypertension in China

Objective:To evaluate the effectiveness of discharge planning on maternal caring knowledge,maternal caring behavior,maternal discharge readiness and the rehospitalization of children with ventricular septal defect and pulmonary arterial hypertension(VSD-PAH).Background:Children with congenital heart disease(CHD)with pulmonary arterial hypertension(PAH)have more complications after surgery than those without PAH.Discharge planning is an effective strategy to help children leave the hospital safely,and receive appropriate care after discharge.Methods:A quasi-experimental design was used.Sixty children and their mothers were recruited and divided into two groups:the control group received conventional care,the intervention group received both conventional care and additional discharge planning care.Results:(1)After admission,maternal caring knowledge between the two groups was similar.(2)At discharge,maternal discharge readiness,maternal caring knowledge and maternal caring behavior in the intervention group was significantly higher compared to the control group(t=3.35,p=0.001;F=84.74,p<0.001;F=23.82,p<0.001).This difference persisted after discharge,and was evident at one month and three months after discharge.(3)However,no significant difference in the readmission rate of children after discharge was evident between the two groups.Conclusions:Discharge planning improves the maternal discharge readiness,maternal caring knowledge and maternal caring behaviors.However,this planning did not reduce the readmission rate of children with CHD-PAH.

A Rapid Identification Method for Germplasm Materials Resistant to Citrus Huanglongbing Disease

[Objectives]This study was conducted to develop a rapid identification method for citrus germline materials resistant to Huanglongbing disease and lay a basis for accelerating citrus breeding for resistance to Huanglongbing and increasing the breeding efficiency.[Methods]Thirty-six citrus germplasms suspected to be resistant to citrus Huanglongbing disease were collected.The method of direct high grafting to citrus trees infected with Huanglongbing pathogen was adopted.The resistance of the test materials was identified and evaluated by field symptoms combined with quantitative PCR.It was defined as the top grafting identification method.[Results]The test materials that were grafted in spring started to germinate after one month,and three months late(June 5,2018)typical mottled yellowing on leaves was observed on KH-14 for the first time.After four months(July 5,2018)of top grafting,typical mottled yellowing occurred on 23 materials,and 11 materials showed no such symptom.After six months(September 4,2018)of top grafting,although the growth of KH-18,KH-12,KHY-4,KHY-5 and KHY-6 were normal,yellowing was observed on their leaves.Only KH-21 grew well,and showed no yellow shoots and yellowing leaves.It was identified as the material with resistance to Huanglongbing disease.Quantitative PCR tests on the above six materials showed that KH-21 was negative and other five were positive.Real-time fluorescence quantitative PCR test indicated that the average Huanglongbing bacteria amount in KH-21 was 1870.0 cell/μg DNA,and the average Huanglongbing bacteria amount in the control material was 372285.5 cell/μg DNA,indicating KH-21 was resistant to Huanglongbing bacteria.[Conclusions]The method for infecting bacteria by top grafting takes six months,can detect large amount of seedlings,and is time-saving,efficient,cost-saving and accurate.This method can quickly identify the resistance of citrus varieties to citrus Huanglongbing disease,and can be popularized and used in the identification of citrus Huanglongbing disease resistance.

Enhanced charge collection of AgNWs-based top electrode to realize high-performance,all-solution processed organic solar cells

All-solution processed organic solar cells are the ultimate aim of printable photovoltaics,but their electrical losses arising from poor contact of top electrodes greatly limit efficiency improvement.To solve the problem,a solution-processed hybrid top electrode was constructed using silver nanowires(AgNWs)as the skeleton and ZnO nanoparticles(ZnO-NPs)as the matrix.When constructing the skeleton,a spin-rinsing treatment was first used to reduce the amount of the residual insulating polyvinylpyrrolidone wrapped around the AgNWs to promote intimate contact among the AgNWs in the skeleton.Then,the ZnO-NPs matrix was deposited onto the AgNWs skeleton,bridging the AgNWs skeleton with the underlayer ZnO-NPs electron transporting layer(ETL).The underlayer ZnO-NPs ETL can also induce the growth of the ZnO-NPs matrix to minimize lattice mismatch,which creates additional transport channels from the ETL to the AgNWs skeleton for charge collection.As a result,the obtained electrode significantly enhances the electrical contact in the device,thus delivering record power conversion efficiencies of 16.04%and 14.54%for rigid and flexible all-solution processed OSCs,respectively.

Conditional reprogramming:next generation cell culture

Long-term primary culture of mammalian cells has been always difficult due to unavoidable senescence. Conventional methods for generating immortalized cell lines usually require manipulation of genome which leads to change of important biological and genetic characteristics. Recently, conditional reprogramming(CR) emerges as a novel next generation tool for long-term culture of primary epithelium cells derived from almost all origins without alteration of genetic background of primary cells. CR cocultures primary cells with inactivated mouse 3T3-J2 fibroblasts in the presence of RHO-related protein kinase(ROCK) inhibitor Y-27632, enabling primary cells to acquire stem-like characteristics while retain their ability to fully differentiate. With only a few years’ development, CR shows broad prospects in applications in varied areas including disease modeling, regenerative medicine, drug evaluation, drug discovery as well as precision medicine. This review is thus to comprehensively summarize and assess current progress in understanding mechanism of CR and its wide applications, highlighting the value of CR in both basic and translational researches and discussing the challenges faced with CR.

“Reinforced concrete”-like flexible transparent electrode for organic solar cells with high efficiency and mechanical robustness

Flexible transparent electrodes(FTEs) with robust mechanical stability are crucial for the industrial application of flexible organic solar cells(OSCs). However, their production remains challenging owing to the difficulty in balancing the conductivity,transmittance, and adhesion of FTEs to substrates. Herein, we present the so-called “reinforced concrete” strategy which finetunes the structure of silver nanowires(Ag NWs)-based FTEs with polydopamine(PDA) possessing good adhesion properties and moderate reducibility. The PDA reduces Ag+to form silver nanoparticles(Ag NPs) which grow like “rivets” at the Ag NW junction sites;PDA stabilizes the Ag NW skeleton and improves the adhesion between the Ag NWs and polyethylene terephthalate(PET) substrate and interface layer. The obtained Ag NW:PDA:Ag NP FTE exhibits excellent optoelectronic properties and high mechanical stability. The resulting flexible OSCs exhibit 17.07% efficiency, high flexibility during 10,000 bending test cycles, and robust peeling stability. In addition, this “reinforced concrete”-like FTE provides great advantages for the production of large-area flexible OSCs, thereby paving a new way toward their commercial application.

Genomic evolution during locoregional recurrence in colorectal cancer determined by whole-exome sequencing: a retrospective observational study

Objective:The genomic landscapes of metastatic colorectal cancer(mCRC)have been extensively studied;however,the genetic mechanisms underlying the locoregional recurrence(LR)of CRC remain unclear.The objective of our study was to investigate genomic evolution during LR in CRC using high-throughput sequencing.Methods:Twenty-three CRC patients with matched primary and LR tissues were recruited from Nanfang Hospital and Zhejiang Cancer Hospital between January 2011 and December 2018.The last date of follow-up was March 2020.Tissue samples were analyzed by whole-exome sequencing and the genomic profiles were depicted by single nucleotide variation,mutational signature,copy number variation,clonal architecture,and other features.The evolutionary process was speculated with comparison of the genetic variations between primary and LR lesions.The disseminating clusters from primary to LR lesions were identified by variant allele frequency dynamics.Furthermore,the early-recurrent biomarker was explored by comparing the indel signature between early-and late-recurrent patients.The study was approved by the Institutional Review Board of Nanfang Hospital of Southern Medical University(approval No.2020010)on September 11,2020.Results:The results highlighted distinct origins of LR between patients with high microsatellite instability and microsatellite stability.LR lesions evolved independently in patients with high microsatellite instability,while LR lesions were highly clonally related to the primary lesions in patients with microsatellite stability.Late-acquired variations in LR lesions encompassed a wide range of driver genes involved in histone methylation,DNA replication,T cell activation,PDCD1 gain,and LMNA loss.Furthermore,clonal analysis of the disseminating cells identified a dominant polyclonal seeding pattern during LR.The indel signature ID4 was associated with significantly shorter disease-free survival in patients with relapsed CRC according to a public dataset.Conclusion:These findings pose a challenge for the development of new approaches targeting the interactions of multiple clones in the establishment of LR and in terms of optimizing the clinical management of susceptible patients.

Rice disease identification method based on improved CNN-BiGRU

In the field of precision agriculture,diagnosing rice diseases from images remains challenging due to high error rates,multiple influencing factors,and unstable conditions.While machine learning and convolutional neural networks have shown promising results in identifying rice diseases,they were limited in their ability to explain the relationships among disease features.In this study,we proposed an improved rice disease classification method that combines a convolutional neural network(CNN)with a bidirectional gated recurrent unit(BiGRU).Specifically,we introduced a residual mechanism into the Inception module,expanded the module's depth,and integrated an improved Convolutional Block Attention Module(CBAM).We trained and tested the improved CNN and BiGRU,concatenated the outputs of the CNN and BiGRU modules,and passed them to the classification layer for recognition.Our experiments demonstrate that this approach achieves an accuracy of 98.21%in identifying four types of rice diseases,providing a reliable method for rice disease recognition research.

百部生物碱的全合成

百部生物碱是从直立百部(Stemona sessilifolia)和其近缘植物的根部分离得到一类生物碱。在分子结构上,这类生物碱通常具有[1,2-b]吡咯并[1,2-a]氮杂卓的母核结构,并且由于在母核的多个位置有不同的取代基,从而表现出结构及生物活性的多样性,因而百部生物碱的全合成研究引起国内外化学家的关注。但是由于百部生物碱结构中具有复杂的多环结构及多个手性中心,此类天然产物的全合成研究具有较大的挑战。近年来,化学家们相继开发并应用高对映选择性的反应及串联反应等高效的策略,完成了多个百部生物碱的全合成研究,为百部生物碱进行深入生物活性研究及开发利用奠定了坚实的基础。本文基于本课题组的相关研究内容,综述了各种类型百部生物碱近年来的全合成研究进展。

Non-Hermitian topological coupler for elastic waves

Non-Hermitian topological systems,by combining the advantages of topological robustness and sensitivity induced by nonHermiticity,have recently emerged and attracted much research interest.Here,we propose a device based on the topological coupler in elastic waves with non-Hermiticity,which contains two topological domain walls and four ports.In this device,topological robustness routes the transmission of waves,while non-Hermiticity controls the gain or loss of waves as they propagate.These mechanisms result in continuous and quantitative control of the energy distribution ratio of each port.A nonHermitian Hamiltonian is introduced to reveal the coupling mechanism of the topological coupler,and a scattering matrix is proposed to predict the energy distribution ratio of each port.The proposed topological coupler,which provides a new paradigm for the non-Hermitian topological systems,can be employed as a sensitive beam splitter or a coupler switch.Moreover,the topological coupler has potential applications in information processing and logic operation in elastic circuits or networks,and the paradigm also applies to other classical systems.