Isolated traumatic gallbladder injury: A case report

BACKGROUND Isolated gallbladder injury(GI)(IGI)directly induced by abdominal trauma is rare.Symptoms,indications,and imaging examinations of IGI are frequently non-specific,posing tremendous diagnostic challenges,which are simple to overlook and may have severe implications.Improving doctors'understanding of gallbladder injury(GI)facilitates early detection and decreases the likelihood of severe consequences,including death.CASE SUMMARY We report a case of IGI caused by blunt violence(after falling from three meters with the umbilicus as the stress point)and performed laparoscopic repair of the gallbladder rupture,which helps clinicians understand IGI and reduce the severe consequences of delayed diagnosis.Through extensive medical history and dynamic abdominal ultrasound evaluation,doctors can identify GI early and begin surgery,thereby decreasing the devastating repercussions of delayed diagnosis.CONCLUSION This article aims to improve clinicians'understanding of IGI and propose a method for the diagnosis and treatment of GI.

Short- and long-term results of open vs laparoscopic multisegmental resection and anastomosis for synchronous colorectal cancer located in separate segments

BACKGROUND It remains unclear whether laparoscopic multisegmental resection and ana-stomosis(LMRA)is safe and advantageous over traditional open multisegmental resection and anastomosis(OMRA)for treating synchronous colorectal cancer(SCRC)located in separate segments.AIM To compare the short-term efficacy and long-term prognosis of OMRA as well as LMRA for SCRC located in separate segments.METHODS Patients with SCRC who underwent surgery between January 2010 and December 2021 at the Cancer Hospital,Chinese Academy of Medical Sciences and the Peking University First Hospital were retrospectively recruited.In accordance with the RESULTS LMRA patients showed markedly less intraoperative blood loss than OMRA patients(100 vs 200 mL,P=0.006).Compared to OMRA patients,LMRA patients exhibited markedly shorter postoperative first exhaust time(2 vs 3 d,P=0.001),postoperative first fluid intake time(3 vs 4 d,P=0.012),and postoperative hospital stay(9 vs 12 d,P=0.002).The incidence of total postoperative complications(Clavien-Dindo grade:≥II)was 2.9%and 17.1%(P=0.025)in the LMRA and OMRA groups,respectively,while the incidence of anastomotic leakage was 2.9%and 7.3%(P=0.558)in the LMRA and OMRA groups,respectively.Furthermore,the LMRA group had a higher mean number of lymph nodes dissected than the OMRA group(45.2 vs 37.3,P=0.020).The 5-year overall survival(OS)and disease-free survival(DFS)rates in OMRA patients were 82.9%and 78.3%,respectively,while these rates in LMRA patients were 78.2%and 72.8%,respectively.Multivariate prognostic analysis revealed that N stage[OS:HR hazard ratio(HR)=10.161,P=0.026;DFS:HR=13.017,P=0.013],but not the surgical method(LMRA/OMRA)(OS:HR=0.834,P=0.749;DFS:HR=0.812,P=0.712),was the independent influencing factor in the OS and DFS of patients with SCRC.CONCLUSION LMRA is safe and feasible for patients with SCRC located in separate segments.Compared to OMRA,the LMRA approach has more advantages related to short-term efficacy.

Effect and Significance of Comprehensive Training in Infection Prevention and Control on the Psychological Health of Oral Health Staff

Background:Oral health staff have close contact with patients in the process of diagnosis and treatment,and it is inevitable for them to come into contact with patients’secretions.Therefore,oral health staff are at greater risk of infectious diseases in their daily work,and their psychological health is also greatly challenged.Objective:To study the effect and significance of comprehensive training in infection prevention and control on the psychological health of oral health staff.Methods:We selected 400 oral health staff from a tertiary stomatological hospital in Guangzhou,China in this study.The respondents were randomly divided into an intervention group and a control group.After the first round of investigation,the intervention group received comprehensive training in prevention and control of infection for three months,while the control group received no intervention.Results:The comprehensive training in infection prevention and control improved the respondents’psychological health and job satisfaction.Further strengthening infection prevention and control training for oral health staff will increase their self-confidence,improve their mental health,and increase their job satisfaction.Conclusion:For oral health staff,it is particularly important to formulate an effective and operable preventive and control training program and then implement it in a standardized manner.

Transcellular transport characteristics of huperzine alone or in combination with ginkgolide B across Caco-2 and Madin-Darby canine kidney cell monolayer

Objective:To study the various processes involved in transcellular transport(TT) of huperzine A alone or in combination with ginkgolide B in Caco-2 and Madin-Darby canine renal(MDCK)cell monolayer.Methods:The transepithelial passage was assayed in the apical-to-basolateral(AP to BL) direction and opposite direction(BL to AP) in both cell lines.The determination of huperzine A and ginkgolide B were performed by high performance liquid chromatography(HPLC).The passage rates of huperzine A and ginkgolide B were calculated.Bi-directional TT(absorption and secretion) were taken in huperzine A and ginkgolide B in Caco-2 and MDCK cell monolayer.Results:TT absorption and secretion kinetics of huperzine A and ginkgolide B across two cells existed at the same time.The passage rates of huperzine A were increased significantly with adding different concentrations of ginkgolide B.Conclusions:The compound preparations of HA in combination with CB for dementia caused by cerebral ischemic have synergistic effects on the pharmacodynamics,and improve the bioavailability through BBB.

Comparison of microendoscopic discectomy and open discectomy for single-segment lumbar disc herniation

BACKGROUND Lumbar disc herniation is a common disease.Endoscopic treatment may have more advantages than traditional surgery.AIM To compare the clinical efficacy and safety of microendoscopic discectomy(MED)and open discectomy with lamina nucleus enucleation in the treatment of singlesegment lumbar intervertebral disc herniation.METHODS Ninety-six patients who were operated at our hospital were selected for this study.Patients with single-segment lumbar disc herniation were admitted to the hospital from March 2018 to March 2019 and were randomly divided into the observation group and the control group with 48 cases in each group.The former group underwent lumbar discectomy and the latter underwent laparotomy and nucleus pulpectomy.Surgical effects were compared between the two groups.RESULTS In terms of surgical indicators,the observation group had a longer operation time,shorter postoperative bedtime and hospital stay,less intraoperative blood loss,and smaller incision length than the control group(P<0.05).The excellent recovery rate did not differ significantly between the observation group(93.75%)and the control group(91.67%).Visual analogue scale pain scores were significantly lower in the observation group than in the control group at 1 d,3 d,1 mo,and 6 mo after surgery(P<0.05).The incidence of complications was significantly lower in the observation group than in the control group(6.25%vs 22.92%,P<0.05).CONCLUSION Both MED and open discectomy can effectively improve single-segment lumbar disc herniation,but MED is associated with less trauma,less bleeding,and a lower incidence of complications.

Traditional Chinese medicine nursing protocols for COVID-19

In order to facilitate nurses to understand the key points of COVID‑19’s common syndromes,master the key points of nursing with syndrome differentiation,use the advantages of traditional Chinese medicine(TCM)nursing characteristics,standardize TCM nursing behavior,and improve the TCM nursing effect,through the search of relevant information,combined with the clinical practice experience of more than 1 month of front‑line anti‑epidemic nursing staff,the TCM nursing protocols for COVID‑19(draft)were formed.After four rounds of expert consultation and discussion,and 15 times of collation and revision,the final version of TCM nursing protocols for COVID‑19 was formed.The TCM nursing protocols for COVID‑19 include the following five parts:key points of common syndromes,nursing for common symptoms/syndromes,TCM special nursing,healthy guidance,and difficulties in nursing;it is scientific and practical,and can provide clinical guidance for nursing of patients with COVID‑19.

Clinical Effect of Magnetic Resonance Imaging and 64-slice Spiral CT in the Diagnosis of Ischemic Heart Disease Patients

Objective:To explore the clinical methods and clinical effects of applying magnetic resonance imaging(MRI)and 64・slice spiral computed tomography(CT)in the diagnosis of patients with ischemic heart disease.Methods:100 patients with ischemic heart disease were selected as the research objects.Selecting the patients from May 2020 to May 2021 as a sample,the patients were divided into two groups,and different diagnostic methods were used to compare the clinical diagnosis effects.Results:In terms of the diagnostic accuracy of the two groups of patients,the maximum value was 92.00%(experimental group)and the minimum value was 80.00%(control group).There was a big difference in data between the two groups,P<0.05,which was statistically significant.The patient9s(experimental group)diagnosis accuracy rate is highe Conclusion:In the process of research work for patients with ischemic heart disease,it is particularly important to diagnose the patients.The combined application of and 64-slice spiral CT can improve the clinical diagnosis efficiency and achieve significant results.

Ginsenoside rg3 reduces body weight by regulating fat content and browning in obese mice

Objective:To determine the effects of ginsenoside rg3 on the body weight of C57BL/6J obese mice and to investigate its underlying weight loss mechanisms with a focus on white fat browning-related factors.Methods:Eight-week-old C57BL/6J male mice were fed a high-fat diet for 12 successive weeks to construct the obese model.C57BL/6J male mice were fed a standard chow diet to construct normal control group.After 8 weeks of intervention with ginsenoside rg3,the food intake,body weight,body fat mass,blood sugar,and lipid profiles of the mice in each group were detected.Hematoxylin and eosin(HE)staining was used to observe the histological morphology of the adipose tissues.Real-time polymerase chain reaction(RT-PCR)and Western blotting(WB)were applied to detect the gene and protein expression levels of peroxisome proliferators-activated receptor gama(PPARg),Peroxisome proliferatoractivated receptor-gamma coactivator-1alpha(PGC-1a),PR domain containing 16(PRDM16),and uncoupling protein 1(UCP-1).Results:Compared to normal control group mice,the body weight,food intake,body fat composition,and blood lipid levels of model group mice increased significantly.After 8 weeks of intervention with ginsenoside rg3,body weight,body fat composition,food intake,and blood lipid profiles decreased.HE staining showed that ginsenoside rg3 can improve white adipocyte hypertrophy to a certain extent.RTPCR and WB demonstrated that ginsenoside rg3 can increase the mRNA and protein expression levels of PPARg,PGC-1a,PRDM16,and UCP-1 in the adipose tissues of obese mice.Conclusion:The weight reduction effect of ginsenoside rg3 may be related to the promotion of white fat browning.

Disease spectrum analysis of hospitalized children in China: A study of 18 tertiary children's hospitals

Importance: Morbidity and mortality of children are important indicators of the performance of the public health system in any country. In China, the children's disease spectrum has gradually changed in recent years. However, the gender- and age-specific disease spectrum for hospitalized children under 15 years old is still unclear. Objective: To explore the gender- and age-based distribution of diseases in hospitalized children under 15 years in China. Methods: Medical records home page data for 2016 to 2018 were collected from 18 tertiary children's hospitals in China. The gender- and age-specific disease spectrum was analyzed, using the tenth revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). Results: The most common diseases were those of the respiratory system (25.7% of all 2232142 hospitalized children). The top three diseases for boys were diseases of the respiratory system (25.6%), diseases of the digestive system (11.4%) and certain conditions originating in the perinatal period (8.6%). The top three diseases for girls were diseases of the respiratory system (25.9%), certain conditions originating in the perinatal period (10.1%), and factors influencing health status and contact with health services (9.4%).The most common diseases for children under 1 year old were certain conditions originating in the perinatal period (38.1%). For all other age groups, the most common conditions were respiratory diseases (33.8% for those aged 1–3 years, 25.2% for those aged 4–6 years, and 12.2% for those aged 7–14 years). Interpretation: This study analyzed the medical records home pages of 18 children's hospitals to provide the first overview of the disease spectrum and its gender- and age-specific distribution among children in China.

National survey of the awareness and implementation status of early pulmonary rehabilitation for patients with critical illness in departments of pulmonary and critical care medicine in 2019

To the Editor:The aim of early pulmonary rehabilitation(PR)in the intensive care unit(ICU)is to reduce the incidence of post-ICU syndrome,increase the number of ventilator-free days,reestablish and improve functional capacity,improve health-related life quality,promote mental health,and enhance participation in everyday life.PR in the ICU is highly effective and plays an important role in recovery of patients with reduced exercise endurance,functional capacity,and health-related life quality.Several surveys outside China have assessed the implementation of early rehabilitation in the ICU,[1]but there are few data from China.This study aimed to investigate the awareness and implementation of early PR in secondary-and tertiary-class hospitals with pulmonary and critical care medicine(PCCM)standardized certification.PCCM staff members were recruited to fill out a selfdesigned questionnaire.We defined early PR as PR within 5 days of ICU admission.

Does the homologous booster with the inactivated coronavirus disease 2019 vaccine work for the omicron variant?Real-world evidence from Jilin,China

To the Editor:The latest variant of concern,Omicron,has become the dominant global variant immediately after it was first reported in November 2021.[1]It contains>30 mutations in the spike protein,with 17 mutations in the receptor-binding domain,rendering it with increased transmissibility and capacity for immune evasion.[1,2]Moreover,the waning of protection has been observed over time since the coronavirus disease 2019(COVID-19)vaccination.[3]Therefore,a booster is highly recommended.A large-scale study in the UK assessing the effectiveness of the booster vaccination with either the BNT162b2 or mRNA-1273 indicated that the booster shot substantially increased protection against symptomatic infection in patients with the confirmed Omicron variant infection.[3]However,although the laboratory study has illustrated that the homologous booster with the inactivated COVID-19 vaccine could also yield potent neutralizing activity against the Omicron variant,[4]clinical evidence regarding the effectiveness of this vaccination program is limited.

Effect of Bushenyisui Formula on brain tissue apoptosis and Bcl-2 in beta-amyloid protein-induced Alzheimer's disease rat models

OBJECTIVE： To investigate the effect of Bushenyisui Formula on cell apoptosis and positive B cell lym- phoma （Bcl-2） in the Brain of rat models of Alzheim- er＇s disease （AD） induced by beta-amyloid protein （All3） and the mechanism underlying the effect. METHODS： Total of 40 SD rats, 20 females and 20 males, were randomly assigned to 4 groups, con- trolled group （A）, model group （B）, conventional treatment group （C） and Bushenyisui Formula treat- ment （BYFT） group （D）, 10 rats in each group. AI3 1-42 was injected into the bilateral hippocampus of the rats in group B, C and D to create the models of AD. Sham operation was performed on the rats of group A in the same way by injecting equal volume of 0.9% sodium chloride solution into their bilateral hippocampus. 5 days after operation, Bushenyisui Formula was intraperitoneally administered at a dose of 450 mg/kg to the rats of group D （QD） for 20 days. Equal volume of 0.9% sodium chloride solution was intraperitoneally injected into the rats of group B with the same procedure. C suspension （20 mg/mL） was intraperitoneally injected into the rats of group B with the same procedure. The number of apoptot- ic cells in Brain and the positive Bcl-2 were count- ed. The changes of learning and memory abilities were evaluated using Y-maze. RESULTS： Right after the establishment of the mod- els, group B, C and D compared to group A respec- tively, the outcomes of Y-maze were significantly different from that of group A, which suggested ob- vious learning and memory disorder in those groups （P〈0.01）. After treatment, the times of elec- tronic shocks of group C and D were significantly less than that of group B （P〈0.05）, and the numbers of apoptotic cells and positive Bcl-2 were signifi- cantly different from those of group B, apoptotic sells＇ number of group C and D smaller than that of group B and the number of positive Bcl-2 greater than that of group B. CONCLUSION： Bushenyisui Formula could increase the number of Bcl-2 in brain, which improved the function of nervous system pertaining to learning and memory abilities.

Chronic wound biofilms: diagnosis and therapeutic strategies

Objective:To review the diagnosis of chronic wound biofilms and discuss current treatment approaches.Data sources:Articles included in this review were obtained from the following databases:Wanfang,China National Knowledge Infrastructure,PubMed,and the Web of Science.We focused on research published before August 2019 with keywords including chronic wound,biofilm,bacterial biofilms,and chronic wound infection.Study selection:Relevant articles were selected by carefully reading the titles and abstracts.Further,different diagnosis and clinical treatment methods for chronic wound biofilm were compared and summarized from the selected published articles.Results:Recent guidelines on medical biofilms stated that approaches such as the use of scanning electron microscopy and confocal laser scanning microscopy are the most reliable types of diagnostic techniques.Further,therapeutic strategies include debridement,negative pressure wound therapy,ultrasound,antibiotic,silver-containing dressing,hyperbaric oxygen therapy,and others.Conclusion:This review provides the identification and management of biofilms,and it can be used as a tool by clinicians for a better understanding of biofilms and translating research to develop best clinical practices.

Epidemiological characteristics and clinical manifestations of pediatric patients with COVID-19 in China: A multicenter retrospective study

Importance:The Coronavirus disease 2019(COVID-19)global pandemic poses a considerable challenge for pediatricians.Objective:This study aimed to identify the epidemiological characteristics and clinical features of pediatric patients with COVID-19 in China.Methods:This multicenter retrospective study included pediatric patients from 46 hospitals in China,covering 12 provinces and two municipalities.Epidemiological,demographic,clinical,laboratory,treatment,and outcome data were analyzed.Results:In total,211 pediatric patients with COVID-19 were included in this study.The median age was 7.0 years(range:22 days to 18 years).Approximately 16.3%of the patients exhibited asymptomatic infections,23.0%had upper respiratory tract infections,and 60.7%had pneumonia,including two with severe pneumonia and one with critical illness.Approximately 78.7%of the pediatric patients occurred in familial clusters.The most three common symptoms or signs at onset in children with COVID-19 were fever(54.5%),cough(49.3%),and pharyngeal congestion(20.8%).Only 17.6%of the patients presented with decreased lymphocyte count,whereas 13.6%had increased lymphocyte count.Among the patients with pneumonia who exhibited abnormal chest computed tomography findings,18.2%(23/127)of the patients had no other symptoms.Generally,the chest radiographs showed abnormalities that affected both lungs(49.6%);ground-glass opacity(47.2%)was the most common manifestation.The cure and improvement rates were 86.7%(183/211)and 13.3%(28/211),respectively.Only one patient with an underlying condition received invasive mechanical ventilation;none of the patients died.Interpretation:Similar to adults,children of all age groups are susceptible to COVID-19.Fortunately,most pediatric patients have mild symptoms or remain asymptomatic,despite the high incidence of pneumonia.Decreased proportions of white blood cells and lymphocytes are less frequent in children than in adults.