BACKGROUND Coronavirus disease 2019(COVID-19)pneumonia with severe septic shock and acute respiratory distress syndrome(ARDS)are critical illnesses for patients following transplant.Intravenous immunoglobulin(IVIG)pla...BACKGROUND Coronavirus disease 2019(COVID-19)pneumonia with severe septic shock and acute respiratory distress syndrome(ARDS)are critical illnesses for patients following transplant.Intravenous immunoglobulin(IVIG)plays a role in both immune support and inflammation control,especially in immunocompromised patients.This case report describes the first successful experience using IVIG and pulse steroids to manage this critical condition following lung transplantation.CASE SUMMARY A 65-year-old male patient reported a history of chronic obstructive pulmonary disease and poor lung function and received bilateral sequential lung transplantations.Postoperatively,he developed COVID-19 pneumonia,severe septic shock,and ARDS.He recovered from this critical condition after empirical antibiotics administration and veno-venous extracorporeal membrane oxygenation,in addition to IVIG and pulse steroids.CONCLUSION IVIG is a valuable adjunct in managing severe sepsis in lung transplant recipients after COVID-19 infection.We aim,for the first time,to report the success of such a management approach for COVID-19 ARDS and sepsis in the post-lung transplant setting.With further investigations,this is a starting point for wider analysis of such an approach in this setting and consequently helps guide clinical practice for such a challenging patient population moving forward.展开更多
Background: Puffy hand syndrome (PHS) is a rare complication primarily associated with intravenous drug use (IVDU), characterized by chronic swelling and fibrosis of the hands due to lymphatic damage. Concurrent pulmo...Background: Puffy hand syndrome (PHS) is a rare complication primarily associated with intravenous drug use (IVDU), characterized by chronic swelling and fibrosis of the hands due to lymphatic damage. Concurrent pulmonary complications, such as pneumonia and pneumothorax, significantly contribute to increased morbidity in this population. Case Presentation: We report the case of a 28-year-old female who injects drugs, and presents with fever, bilateral hand edema, and respiratory symptoms. Clinical evaluation revealed erythema and edema of both hands, elevated inflammatory markers, and a left lower lobe infiltration that progressed to pneumothorax. A diagnosis of PHS and left lower lobe pneumonia complicated by pneumothorax was established. Management and Outcomes: The patient was treated with broad-spectrum antibiotics, including ceftriaxone, levofloxacin, dexamethasone, and oxygen supplementation, as well as antipyretics. She demonstrated partial clinical improvement and was referred to another hospital’s thoracic surgery department for specialized care. Conclusions: This case underscores the importance of early recognition and multidisciplinary management of rare but serious complications in IVDU patients. Further research is necessary to elucidate the interplay between lymphatic dysfunction and pulmonary pathophysiology in this demographic.展开更多
The responses of drip-irrigated rice physiological traits to water and fertilizers have been widely studied.However,the responses of yield,root traits and their plasticity to the nitrogen environment in different nitr...The responses of drip-irrigated rice physiological traits to water and fertilizers have been widely studied.However,the responses of yield,root traits and their plasticity to the nitrogen environment in different nitrogen-efficient cultivars are not fully understood.An experiment was conducted from 2020-2022 with a high nitrogen use efficiency(high-NUE)cultivar(T-43)and a low-NUE cultivar(LX-3),and four nitrogen levels(0,150,300,and 450 kg ha^(-1))under drip irrigation in large fields.The aim was to study the relationships between root morphology,conformation,biomass,and endogenous hormone contents,yield and NUE.The results showed three main points:1)Under the same N application rate,compared with LX-3,the yield,N partial factor productivity(PFP),fine root length density(FRLD),shoot dry weight(SDW),root indole-3-acetic acid(IAA),and root zeatin and zeatin riboside(Z+ZR)of T-43 were significantly greater by11.4-18.9,11.3-13.5,11.6-15.7,9.9-31.1,6.1-48.1,and 22.8-73.6%,respectively,while the root-shoot ratio(RSR)and root abscisic acid(ABA)were significantly lower(P<0.05);2)nitrogen treatment significantly increased the rice root morphological indexes and endogenous hormone contents(P<0.05).Compared to N0,the yield,RLD,surface area density(SAD),root volume density(RVD),and root endogenous hormones(IAA,Z+ZR)were significantly increased in both cultivars under N2 by 61.6-71.6,64.2-74.0,69.9-105.6,6.67-9.91,54.0-67.8,and 51.4-58.9%,respectively.Compared with N3,the PFP and N agronomic efficiency(NAE)of nitrogen fertilizer under N2 increased by 52.3-62.4 and39.2-63.0%,respectively;3)the responses of root trait plasticity to the N environment significantly differed between the cultivars(P<0.05).Compared with LX-3,T-43 showed a longer root length and larger specific surface area,which is a strategy for adapting to changes in the nutrient environment.For the rice cultivar with high-NUE,the RSR was optimized by increasing the FRLD,root distribution in upper soil layers,and root endogenous hormones(IAA,Z+ZR)under suitable nitrogen conditions(N2).An efficient nutrient acquisition strategy can occur through root plasticity,leading to greater yield and NUE.展开更多
The Interpretation of Nursing Guidelines for Intravenous Thrombolysis in Acute Ischemic Stroke offers comprehensive recommendations across five key domains:hospital organizational management,patient condition monitori...The Interpretation of Nursing Guidelines for Intravenous Thrombolysis in Acute Ischemic Stroke offers comprehensive recommendations across five key domains:hospital organizational management,patient condition monitoring,complication observation and management,positioning and mobility away from the bed,and quality assurance.These Guidelines encompass all the phases of intravenous thrombolysis care for patients experiencing acute ischemic stroke.This article aims to elucidate the Guidelines by discussing their developmental background,the designation process,usage recommendations,and the interpretation of evolving perspectives,thereby providing valuable insights for clinical practice.展开更多
This study aimed to explore the specific application effect of specialist nursing intervention in intravenous therapy on elderly patients with peripherally inserted central catheters(PICC).From November 2023 to Novemb...This study aimed to explore the specific application effect of specialist nursing intervention in intravenous therapy on elderly patients with peripherally inserted central catheters(PICC).From November 2023 to November 2024,a total of 60 elderly patients with PICC admitted to Guiqian International General Hospital were selected as research subjects.Using a digital random table method,these patients were randomly divided into a control group and an experimental group,with 30 patients in each.The control group received routine nursing care,while the experimental group received specialized intravenous therapy nursing intervention in addition to routine care.The nursing effects of both groups were comprehensively evaluated,including treatment compliance,psychological state,quality of life,incidence of complications,and satisfaction with nursing care.The results showed that after the intervention,the treatment compliance in the experimental group was significantly higher than that of the control group(P<0.05).Additionally,scores on the Self-Rating Anxiety Scale(SAS)and Self-Rating Depression Scale(SDS)were markedly lower in the experimental group compared to the control group(P<0.05),indicating improved psychological well-being.The experimental group also scored higher in all dimensions of quality of life(P<0.05),and had a lower complication rate and higher satisfaction with nursing care(P<0.05).In conclusion,the application of specialized intravenous therapy nursing intervention in the care of elderly patients with PICC can significantly enhance treatment compliance,improve psychological status,elevate quality of life,and reduce complications,demonstrating strong clinical value and providing important guidance for future treatment and nursing of such patients.展开更多
Drip irrigation and flood irrigation are major irrigation methods for maize crops in the Hetao Irrigation District,Inner Mongolia Autonomous Region,China.This research delves into the effects of these irrigation metho...Drip irrigation and flood irrigation are major irrigation methods for maize crops in the Hetao Irrigation District,Inner Mongolia Autonomous Region,China.This research delves into the effects of these irrigation methods on carbon dioxide(CO_(2))exchange and crop growth in this region.The experimental site was divided into drip and flood irrigation zones.The irrigation schedules of this study aligned with the local commonly used irrigation schedule.We employed a developed chamber system to measure the diurnal CO_(2)exchange of maize plants during various growth stages under both drip and flood irrigation methods.From May to September in 2020 and 2021,two sets of repeated experiments were conducted.In each experiment,a total of nine measurements of CO_(2)exchange were performed to obtain carbon exchange data at different growth stages of maize crop.During each CO_(2)exchange measurement event,CO_(2)flux data were collected every two hours over a day-long period to capture the diurnal variations in CO_(2)exchange.During each CO_(2)exchange measurement event,the biological parameters(aboveground biomass and crop growth rate)of maize and environmental parameters(including air humidity,air temperature,precipitation,soil water content,and photosynthetically active radiation)were measured.The results indicated a V-shaped trend in net ecosystem CO_(2)exchange in daytime,reducing slowly at night,while the net assimilation rate(net primary productivity)exhibited a contrasting trend.Notably,compared with flood irrigation,drip irrigation demonstrated significantly higher average daily soil CO_(2)emission and greater average daily CO_(2)absorption by maize plants.Consequently,within the maize ecosystem,drip irrigation appeared more conducive to absorbing atmospheric CO_(2).Furthermore,drip irrigation demonstrated a faster crop growth rate and increased aboveground biomass compared with flood irrigation.A strong linear relationship existed between leaf area index and light utilization efficiency,irrespective of the irrigation method.Notably,drip irrigation displayed superior light use efficiency compared with flood irrigation.The final yield results corroborated these findings,indicating that drip irrigation yielded higher harvest index and overall yield than flood irrigation.The results of this study provide a basis for the selection of optimal irrigation methods commonly used in the Hetao Irrigation District.This research also serves as a reference for future irrigation studies that consider measurements of both carbon emissions and yield simultaneously.展开更多
Cryogenic valves play a crucial role in the production and transportation of liquefied natural gas(LNG),and are primarily responsible for efficiently controlling the inflow and outflow of LNG and regulating pressure.H...Cryogenic valves play a crucial role in the production and transportation of liquefied natural gas(LNG),and are primarily responsible for efficiently controlling the inflow and outflow of LNG and regulating pressure.However,due to their operation in low-temperature and high-humidity environments,crucial components such as drip trays are susceptible to frosting,which may lead to LNG leakage,thereby causing severe safety incidents.In this study,the user-defined function(UDF)is employed to redevelop Fluent,which integrates the frost growth model with the Eulerian multiphase flow model,to conduct a quantitative analysis of frosting on drip trays of cryogenic valves.The effects of environmental parameters,such as wind speed,ambient temperature,air humidity,and cold surface temperature on the growth of the frost layer were analyzed.This study reveals a limiting wind speed between 1 m/s and 2 m/s.Upon reaching this limit speed,the growth of the frost layer reaches its maximum,and further increases in the wind speed have no significant effect on the growth of the frost layer.Furthermore,the influence of the change in the flow field on droplet impingement and freezing during the growth of the frost layer is considered through the coupling method of the kinematic characteristics of water droplets and the collection coefficient of water droplets.This study identifies the influence of different parameters on the droplet impact efficiency,leading to the modification of the frost layer on the drip tray.展开更多
Background A deterioration in the meat quality of broilers has attracted much more attention in recent years.L-malic acid(MA)is evidenced to decrease meat drip loss in broilers,but the underlying molecular mechanisms ...Background A deterioration in the meat quality of broilers has attracted much more attention in recent years.L-malic acid(MA)is evidenced to decrease meat drip loss in broilers,but the underlying molecular mechanisms are still unclear.It’s also not sure whether the outputs obtained under experimental conditions can be obtained in a com-mercial condition.Here,we investigated the effects and mechanisms of dietary MA supplementation on chicken meat drip loss at large-scale rearing.Results Results showed that the growth performance and drip loss were improved by MA supplementation.Meat metabolome revealed that L-2-aminoadipic acid,β-aminoisobutyric acid,eicosapentaenoic acid,and nicotinamide,as well as amino acid metabolism pathways connected to the improvements of meat quality by MA addition.The transcriptome analysis further indicated that the effect of MA on drip loss was also related to the proper immune response,evidenced by the enhanced B cell receptor signaling pathway,NF-κB signaling pathway,TNF signaling pathway,and IL-17 signaling pathway.Conclusions We provided evidence that MA decreased chicken meat drip loss under commercial conditions.Metabolome and transcriptome revealed a comprehensive understanding of the underlying mechanisms.Together,MA could be used as a promising dietary supplement for enhancing the water-holding capacity of chicken meat.展开更多
The combination therapy of magnetic hyperthermia and thermosensitive liposomes(TSL)is an emerging and effective cancer treatment method.The heat generation of magnetic nanoparticles(MNPs)due to an external alternating...The combination therapy of magnetic hyperthermia and thermosensitive liposomes(TSL)is an emerging and effective cancer treatment method.The heat generation of magnetic nanoparticles(MNPs)due to an external alternating magnetic field can not only directly damage tumor cells,but also serves as a triggering factor for the release of doxorubicin from TSL.The aim of this study is to investigate the effects in the degree of tumor cell damage of two proposed injection strategies that consider intravenous administration.Since both MNPs and TSL enter the tumor region intravenously,this study establishes a biological geometric model based on an experiment-based vascular distribution.Furthermore,this study derives the flow velocity of interstitial fluid after coupling the pressure distribution inside blood vessels and the pressure distribution of interstitial fluid,which then provides the convective velocity for the calculation of subsequent nanoparticle concentration.Different injection strategies for the proposed approach are evaluated by drug delivery result,temperature distribution,and tumor cell damage.Simulation results demonstrate that the proposed delayed injection strategy after optimization can not only result in a wider distribution for MNPs and TSL due to the sufficient diffusion time,but also improves the distribution of the temperature and drug concentration fields for the overall efficacy of combination therapy.展开更多
Objective:Early thrombolytic therapy for ischemic stroke within the therapeutic window is associated with improved clinical outcomes.This study investigated whether optimizing intravenous thrombolytic(IVT)therapy stra...Objective:Early thrombolytic therapy for ischemic stroke within the therapeutic window is associated with improved clinical outcomes.This study investigated whether optimizing intravenous thrombolytic(IVT)therapy strategies for stroke could reduce treatment delays.Methods:To reduce delays in IVT therapy for ischemic stroke,a series of quality improvement measures were implemented at a tertiary hospital in Hangzhou,Zhejiang Province,from June 2021 to August 2023,which included developing a timeline process management system,forming a nurse-led stroke process management team,providing homogeneous training,standardizing the IVT therapy process for ischemic stroke,and introducing an incentive policy.During the pre-(from June 2021 to February 2022,group A)and post-(from March to November 2022,group B1;from December 2022 to August 2023,group B2[implementation of an additional incentive policy])of the implementation the strategy,the door-tocomputed tomographic angiography(CTA)time(DCT),CTA time,neurology consultation to consent for IVT,CTA-to-needle time(CNT),and door-to-needle time(DNT),the percentage of people who underwent CTA within 20 min,15 min,and 10 min and DNT within 60 min,45 min,and 30 min were collected and compared.Results:Following the implementation of the standardized IVT process management strategy for stroke,the DNT for group B1 and group B2 were 30(24,44)min and 31(24,41)min,respectively,both significantly lower than the 46(38,58)min in group A(P<0.001);the median DCT were both 13 min in group B1 and B2 lower than 17min in group A(P<0.001);the median CTA were 12 min in Group B1 and 9 min in Group B2 lower than 14 min in group A(P<0.001);similar results were observed during the neurology consultation to obtain consent for IVT and CNT.Compared with group A,the proportion of DCT20 min,15 min,and 10 min was higher in groups B1 and B2(P<0.05),and the same result was observed at DNT60 min,45 min,and 30 min(P<0.05).However,the additional incentive policy did not significantly differ between Group B2 and Group B1.Conclusions:Optimizing IVT therapy for ischemic stroke is a feasible approach to limit the DNT to 30 min in ischemic stroke,significantly reducing delays within the therapeutic window and increasing the number of patients meeting target time segments.Additionally,generating a timeline for the IVT therapy process by scanning positioning quick response codes was a significant breakthrough in achieving the informatization of IVT quality management for stroke.展开更多
Objective: To evaluate the efficacy of Compound Danshen Dripping Pills(CDDP) combined with isosorbide mononitrate(ISMN) versus ISMN alone for treating angina pectoris in patients.Methods: The Pub Med, Web of Science, ...Objective: To evaluate the efficacy of Compound Danshen Dripping Pills(CDDP) combined with isosorbide mononitrate(ISMN) versus ISMN alone for treating angina pectoris in patients.Methods: The Pub Med, Web of Science, Cochrane Library, Embase China National Knowledge Infrastructure, China Biomedical Literature Service System, Chinese Medical Journal Database, and Wan Fang MED databases were searched from inception to November 2022. Randomized controlled trials(RCTs) and cohort studies were included. The primary outcomes were angina symptom and electrocardiography(ECG) efficacy, angina symptom efficacy, and ECG efficacy. The protocol was registered with PROSPERO No. CRD42022314774.Results: Our study included 7 245 patients with angina(59 RCTs, 11 cohort studies). When ISMN was combined with CDDP, the efficacy of angina symptom and ECG [odds ratio(OR) = 4.824, 95% confidence interval(CI) = 3.636–6.401, P = 0.000], the efficacy of angina symptom(OR = 4.347, 95% CI = 3.635–5.198,P = 0.000), the efficacy of ECG(OR = 3.364, 95% CI = 2.767–4.089, P = 0.000) were better than that of patients treated with ISMN alone. CDDP combined with ISMN was superior to ISMN alone in reducing triglyceride(TG) [mean difference(MD) =-35.176, 95% CI =-37.439 to-32.912, P = 0.000], total cholesterol(TC)(MD =-24.296, 95% CI =-26.429 to-22.163, P = 0.000), the duration of angina attack(MD =-1.991, 95% CI =-2.349 to-1.633, P = 0.000), and the frequency of angina attack [standardized MD(SMD) =-2.840, 95% CI =-3.416 to-2.265, P = 0.000]. There was no increase in adverse events between CDDP combined with ISMN and ISMN alone(OR = 0.513, 95% CI = 0.421–0.626, P = 0.000).Conclusion: CDDP combined with ISMN improved treatment efficacy and was well tolerated. Therefore,this combination could be used as an alternative treatment. However, clinical and patient conditions should be considered.展开更多
Objective: To explore the clinical effectiveness of combined use of intravenous pain pump with Parecoxib injection in alleviating pain in patients during the early postoperative period after thoracoscopic surgery. Met...Objective: To explore the clinical effectiveness of combined use of intravenous pain pump with Parecoxib injection in alleviating pain in patients during the early postoperative period after thoracoscopic surgery. Methods: Eighty patients who underwent thoracoscopic surgery in a tertiary hospital were selected as the study subjects and randomly divided into two groups, with 40 patients in each group. The control group received routine postoperative treatment with intravenous pain pump, while the experimental group received Parecoxib in addition to the standard postoperative pain pump treatment. Visual Analog Scale (VAS) pain scores were used to evaluate postoperative pain relief in both groups, along with adverse reactions, postoperative complications, and patient satisfaction with pain relief. Results: Patients who received Parecoxib injection in addition to the routine use of intravenous pain pump had VAS pain scores lower than 3 points at 6 h, 12 h, 24 h, and 36 h postoperatively compared to those in the control group. The incidence of postoperative lung collapse, pleural effusion, and pulmonary infections was also significantly lower in the experimental group. The differences between the two groups were statistically significant (P Conclusion: Early combined use of Parecoxib injection in the early postoperative period after thoracoscopic surgery has shown good clinical efficacy. It can reduce the level of pain in patients, promote effective coughing and expectoration, facilitate early mobilization of patients, improve patient compliance, reduce complications, shorten hospital stay, and expedite patient recovery. Therefore, it is worth promoting the widespread clinical application of Parecoxib injection in this setting.展开更多
Objective:To compare the effects of adding rocuronium and nitroglycerin to ropivacaine in intravenous regional anesthesia(IVRA)on pain and hemodynamic parameters.Methods:This randomized controlled trial was done in 20...Objective:To compare the effects of adding rocuronium and nitroglycerin to ropivacaine in intravenous regional anesthesia(IVRA)on pain and hemodynamic parameters.Methods:This randomized controlled trial was done in 2023.Participants were 177 candidates for forearm operation surgery under IVRA selected from Valiasr Hospital,Arak,Iran.They were allocated by block randomization to three different groups,namely nitroglycerin group,rocuronium group and control group.Hemodynamic parameters were recorded before tourniquet application up to postoperative recovery time.Sensory block and motor block onset and duration and pain were also evaluated.The data analysis was carried out by IMB SPSS software 20.0.Results:177 Eligible patients were included in study,with 59 in each group.Time to sensory and motor block onset in the nitroglycerin group was significantly less than the other groups and the time of motor block in the rocuronium group was statistically higher than the control and the nitroglycerin groups(P<0.001).Seven participants in the nitroglycerin group experienced headache and three from the rocuronium group experienced dizziness.The side effects occurrence in the nitroglycerin group was more prevalent than in the control and rocuronium groups(P=0.009).Conclusions:Nitroglycerin significantly reduces the time to sensory and motor block onset,while rocuronium is more effective in prolonging the time of motor block.Although there is no difference between nitroglycerin and rocuronium respecting the pain score and opioid need administration,nitroglycerin is associated with a higher prevalence of medication side effects.Therefore,both nitroglycerin and rocuronium can be used as adjuvant for IVRA.The final choice relies on patients’conditions and anesthesiologists’judgment.展开更多
Background:Shenzao dripping pill(SZDP)is empirically prescribed for treating cardiac diseases.Nevertheless,there is a lack of comprehensive knowledge regarding the underlying mechanisms contributing to its therapeutic...Background:Shenzao dripping pill(SZDP)is empirically prescribed for treating cardiac diseases.Nevertheless,there is a lack of comprehensive knowledge regarding the underlying mechanisms contributing to its therapeutic effects.The objective of this study is to investigate the underlying mechanism of SZDP against chronic myocardial ischemia(CMI)in a rat model.Methods:In this study,we utilized electrocardiographic and echocardiographic detection along with pathological tissue analysis to evaluate the efficacy of SZDP.The integration of network pharmacology and metabolomics was conducted to investigate the mechanisms.Molecular docking and molecular dynamics simulations were used to validate the binding energy between the compounds of SZDP and the associated targets.Results:The results showed that SZDP was able to improve T wave voltage,reverse CMI abnormalities in ejection fraction and fractional shortening,and restore histopathological heart damage.Metabolomics results indicated that disturbances of metabolic profile in CMI rats were partly corrected after SZDP administration,mainly affecting purine metabolism.13-Docosenamide may be the potential metabolic biomarker of the therapeutic application of SZDP for CMI.Integrating network pharmacology and metabolomics,thiopurine S-methyltransferase(TPMT),xanthine dehydrogenase/oxidase(XDH),bifunctional purine biosynthesis protein ATIC(ATIC),and cytochrome p4501A1(CYP1A1)were identified as possible targets of SZDP to exert therapeutic effects by enhancing the metabolic levels of L-Tryptophan,Deoxyribose 1-phosphate and Phosphoribosyl formamidocarboxamide.Conclusion:SZDP has a therapeutic effect on CMI by regulating metabolite levels,acting on the targets of TMPT,XDH,ATIC,and CYP1A1,and reducing cardiomyocyte injury and myocardial fibrosis.展开更多
Objective: To explore the effectiveness of applying patient simulators combined with Internet Plus scenario simulation teaching models on intravenous (IV) infusion nursing education, and to provide scientific evidence...Objective: To explore the effectiveness of applying patient simulators combined with Internet Plus scenario simulation teaching models on intravenous (IV) infusion nursing education, and to provide scientific evidence for the implementation of advanced teaching models in future nursing education. Methods: Enrolled 60 nurses who took the IV infusion therapy training program in our hospital from January 2022 to December 2023 for research. 30 nurses who were trained in traditional teaching models from January to December 2022 were selected as the control group, and 30 nurses who were trained with simulation-based teaching models with methods including simulated patients, internet, online meetings which can be replayed and scenario simulation, etc. from January to December 2023 were selected as the experimental group. Evaluated the learning outcomes based on the Competency Inventory for Nursing Students (CINS), Problem-Solving Inventory (PSI), comprehensive learning ability, scientific research ability, and proficiency in the theoretical knowledge and practical skills of IV infusion therapy. Nursing quality, the incidence of IV infusion therapy complications and nurse satisfaction with different teaching models were also measured. Results: The scientific research ability, PSI scores, CINS scores, and comprehensive learning ability of the experimental group were better than those of the control group (P 0.05), and their assessment results of practical skills, nursing quality of IV infusion therapy during training, and satisfaction with teaching models were all better than those of the control group with statistical significance (P < 0.05). The incidence of IV infusion therapy complications in the experimental group was lower than that in the control group, indicating statistical significance (P < 0.05). Conclusions: Teaching models based on patient simulators combined with Internet Plus scenario simulation enable nursing students to learn more directly and practice at any time and in any place, and can improve their proficiency in IV infusion theoretical knowledge and skills (e.g. PICC catheterization), core competencies, problem-solving ability, comprehensive learning ability, scientific research ability and the ability to deal with complicated cases. Also, it helps provide high-quality nursing education, improve the nursing quality of IV therapy, reduce the incidence of related complications, and ensure the safety of patients with IV therapy.展开更多
BACKGROUND Stellate ganglion block is a commonly used sympathetic nerve block technique that restores the balance of the sympathetic and vagal nervous systems of the body and inhibits sympathetic nerve activity.AIM To...BACKGROUND Stellate ganglion block is a commonly used sympathetic nerve block technique that restores the balance of the sympathetic and vagal nervous systems of the body and inhibits sympathetic nerve activity.AIM To analyze the effect of a stellate ganglion block combined with total diploma intravenous anesthesia on postoperative pain and immune function in patients undergoing laparoscopic radical gastric cancer(GC)surgery to provide a refe-rence basis for the formulation of anesthesia protocols for radical GC surgery.METHODS This study included 112 patients who underwent laparoscopic radical surgery for GC between January 2022 and March 2024.There was no restriction on sex.The patient grouping method used was a digital random table method,and the num-ber of cases in each group was 56.The control group was administered total intravenous anesthesia,and the observation group compounded the stellate gan-glion block according to the total intravenous anesthesia protocol.Postoperative hemodynamics,pain levels,and immune indices were compared between the groups.RESULTS The heart rate and mean arterial pressure in the observation group after in-tubation were lower than those in the control group(P<0.05).Pain levels were compared between the two groups at 2 hours,12 hours,24 hours,and 48 hours after surgery(P>0.05).The number of CD3+,CD4+,and CD4+/CD8+cells at the end of surgery was higher in the observation group than in the control group,and the number of CD8+cells was lower in the observation group than in the control group(P<0.05).There were no significant differences between the two groups in terms of propofol dosage,awakening time,extubation time,or postoperative adverse reactions(P>0.05).CONCLUSION The application of a stellate ganglion block combined with total intravenous anesthesia had no significant effect on postoperative pain levels in patients undergoing laparoscopic radical GC surgery.However,it can safely reduce the effect of surgery on the immune function of patients and is worth applying in clinical practice.展开更多
BACKGROUND The possible existence of an acini–islet–acinar(AIA)reflex,involving mutual amylase and insulin interactions,was investigated in the current acute experiment on pigs.AIM To confirm the existence of an AIA...BACKGROUND The possible existence of an acini–islet–acinar(AIA)reflex,involving mutual amylase and insulin interactions,was investigated in the current acute experiment on pigs.AIM To confirm the existence of an AIA reflex and justify the placement of the exocrine and endocrine pancreatic components within the same organ.METHODS The study was performed on six pigs under general anesthesia.An intravenous glucose tolerance test was performed,with a bolus infusion of 50%glucose to the jugular vein,while amylase(5000 U/kg)or vehicle intrapancreatic infusions were administered via the pancreaticoduodenalis cranialis artery during 30 min with a 1 mL/min flow rate.RESULTS The amylase infusion to pancreatic arterial circulation inhibited and delayed the insulin release peak which is usually associated with the highest value of blood glucose and is typically observed at 15 min after glucose infusion,for>1 h.The intrapancreatic infusion of the vehicle(saline)did not have any effect on the time frame of insulin release.Infusion of 1%bovine serum albumin changed the insulin release curve dramatically and prolonged the high range of insulin secretion,far beyond the glucose peak.CONCLUSION Intrapancreatic arterial infusion of amylase interrupted the integrated glucose–insulin interactions.This confirms an AIA reflex and justifies placement of the exocrine and endocrine pancreatic components within the same organ.展开更多
Intravenous infusion,a common clinical drug treatment method,is widely used in the treatment of various diseases.Due to the invasive nature of puncture during intravenous infusion,patients may inevitably experience re...Intravenous infusion,a common clinical drug treatment method,is widely used in the treatment of various diseases.Due to the invasive nature of puncture during intravenous infusion,patients may inevitably experience resistance and tension when facing nursing staff performing infusion procedures.Additionally,the complexity of the nursing staff’s work and the impact of the infusion therapy environment can exacerbate the tension between nurses and patients,leading to risks such as drug leakage and needlestick injuries.This article focuses on the factors influencing extravasation during intravenous infusion and elaborates on how high-quality nursing interventions can reduce the incidence of adverse events during intravenous infusion.These interventions aim to improve patient satisfaction with intravenous infusion nursing care and ensure the safety of intravenous infusion procedures.展开更多
Heparin-induced thrombocytopenia(HIT) is a relatively infrequent complication of heparin administration. HIT can cause devastating thrombosis, making it one of the most serious adverse drug reactions encountered in cl...Heparin-induced thrombocytopenia(HIT) is a relatively infrequent complication of heparin administration. HIT can cause devastating thrombosis, making it one of the most serious adverse drug reactions encountered in clinical practice. We successfully treated a case of severe HIT presenting with thrombosis and life-threatening bleeding complications with intravenous immunoglobulin(IVIG), platelet transfusion and oral anticoagulant Rivaroxaban. In this case, we considered that IVIG played the most important role by preventing further thrombosis, increasing the platelet count, and ensuring the efficacy of Rivaroxaban. We therefore suggest that IVIG might be the optimal treatment for patients with this urgent condition.展开更多
More and more attention is being focused on saline water utilization in irrigation due to the shortage of fresh water to agriculture in many regions. For purpose of reducing the risks of using of saline water for irri...More and more attention is being focused on saline water utilization in irrigation due to the shortage of fresh water to agriculture in many regions. For purpose of reducing the risks of using of saline water for irrigation, the mechanism of soil moisture and salinity distribution and transport should be well understood for developing optimum management strategies. In this paper, field experiments were carried out at Junggar Basin, China, to study the effects of drip irrigation water quality and drip tape arrangement on distribution of soil salinity and soil moisture. Six treatments were designed, including two drip tape arrangement modes and three irrigation water concentration levels （0.24, 4.68, and 7.42 dS m^-l）. Results showed that, soil moisture content （SMC） directly beneath the drip tape in all treatments kept a relatively high value about 18% before boll opening stage; the SMC in the narrow strip in single tape arrangement （Ms） plot was obviously lower than that in the double tapes arrangement （Md） plot, indicating that less sufficient water was supplied under the same condition of irrigation depth, but there was no significant reduction in yield. Mulching had not significant influence on salt accumulation but the drip tape arrangement, under the same condition of irrigation water depth and quality, compared with Md, Ms reduced salt accumulation in root zone and brought about relatively high cotton yield.展开更多
文摘BACKGROUND Coronavirus disease 2019(COVID-19)pneumonia with severe septic shock and acute respiratory distress syndrome(ARDS)are critical illnesses for patients following transplant.Intravenous immunoglobulin(IVIG)plays a role in both immune support and inflammation control,especially in immunocompromised patients.This case report describes the first successful experience using IVIG and pulse steroids to manage this critical condition following lung transplantation.CASE SUMMARY A 65-year-old male patient reported a history of chronic obstructive pulmonary disease and poor lung function and received bilateral sequential lung transplantations.Postoperatively,he developed COVID-19 pneumonia,severe septic shock,and ARDS.He recovered from this critical condition after empirical antibiotics administration and veno-venous extracorporeal membrane oxygenation,in addition to IVIG and pulse steroids.CONCLUSION IVIG is a valuable adjunct in managing severe sepsis in lung transplant recipients after COVID-19 infection.We aim,for the first time,to report the success of such a management approach for COVID-19 ARDS and sepsis in the post-lung transplant setting.With further investigations,this is a starting point for wider analysis of such an approach in this setting and consequently helps guide clinical practice for such a challenging patient population moving forward.
文摘Background: Puffy hand syndrome (PHS) is a rare complication primarily associated with intravenous drug use (IVDU), characterized by chronic swelling and fibrosis of the hands due to lymphatic damage. Concurrent pulmonary complications, such as pneumonia and pneumothorax, significantly contribute to increased morbidity in this population. Case Presentation: We report the case of a 28-year-old female who injects drugs, and presents with fever, bilateral hand edema, and respiratory symptoms. Clinical evaluation revealed erythema and edema of both hands, elevated inflammatory markers, and a left lower lobe infiltration that progressed to pneumothorax. A diagnosis of PHS and left lower lobe pneumonia complicated by pneumothorax was established. Management and Outcomes: The patient was treated with broad-spectrum antibiotics, including ceftriaxone, levofloxacin, dexamethasone, and oxygen supplementation, as well as antipyretics. She demonstrated partial clinical improvement and was referred to another hospital’s thoracic surgery department for specialized care. Conclusions: This case underscores the importance of early recognition and multidisciplinary management of rare but serious complications in IVDU patients. Further research is necessary to elucidate the interplay between lymphatic dysfunction and pulmonary pathophysiology in this demographic.
基金supported by the National Natural Science Foundation of China(31860345 and 31460541)the Youth Innovative Top Talents Project of Shihezi University,China(CXBJ202003)the Third Division of Xinjiang Production and Construction Corps Scientific and Technological Achievements Transfer and Transformation Project,China(KJ2023CG03)。
文摘The responses of drip-irrigated rice physiological traits to water and fertilizers have been widely studied.However,the responses of yield,root traits and their plasticity to the nitrogen environment in different nitrogen-efficient cultivars are not fully understood.An experiment was conducted from 2020-2022 with a high nitrogen use efficiency(high-NUE)cultivar(T-43)and a low-NUE cultivar(LX-3),and four nitrogen levels(0,150,300,and 450 kg ha^(-1))under drip irrigation in large fields.The aim was to study the relationships between root morphology,conformation,biomass,and endogenous hormone contents,yield and NUE.The results showed three main points:1)Under the same N application rate,compared with LX-3,the yield,N partial factor productivity(PFP),fine root length density(FRLD),shoot dry weight(SDW),root indole-3-acetic acid(IAA),and root zeatin and zeatin riboside(Z+ZR)of T-43 were significantly greater by11.4-18.9,11.3-13.5,11.6-15.7,9.9-31.1,6.1-48.1,and 22.8-73.6%,respectively,while the root-shoot ratio(RSR)and root abscisic acid(ABA)were significantly lower(P<0.05);2)nitrogen treatment significantly increased the rice root morphological indexes and endogenous hormone contents(P<0.05).Compared to N0,the yield,RLD,surface area density(SAD),root volume density(RVD),and root endogenous hormones(IAA,Z+ZR)were significantly increased in both cultivars under N2 by 61.6-71.6,64.2-74.0,69.9-105.6,6.67-9.91,54.0-67.8,and 51.4-58.9%,respectively.Compared with N3,the PFP and N agronomic efficiency(NAE)of nitrogen fertilizer under N2 increased by 52.3-62.4 and39.2-63.0%,respectively;3)the responses of root trait plasticity to the N environment significantly differed between the cultivars(P<0.05).Compared with LX-3,T-43 showed a longer root length and larger specific surface area,which is a strategy for adapting to changes in the nutrient environment.For the rice cultivar with high-NUE,the RSR was optimized by increasing the FRLD,root distribution in upper soil layers,and root endogenous hormones(IAA,Z+ZR)under suitable nitrogen conditions(N2).An efficient nutrient acquisition strategy can occur through root plasticity,leading to greater yield and NUE.
文摘The Interpretation of Nursing Guidelines for Intravenous Thrombolysis in Acute Ischemic Stroke offers comprehensive recommendations across five key domains:hospital organizational management,patient condition monitoring,complication observation and management,positioning and mobility away from the bed,and quality assurance.These Guidelines encompass all the phases of intravenous thrombolysis care for patients experiencing acute ischemic stroke.This article aims to elucidate the Guidelines by discussing their developmental background,the designation process,usage recommendations,and the interpretation of evolving perspectives,thereby providing valuable insights for clinical practice.
文摘This study aimed to explore the specific application effect of specialist nursing intervention in intravenous therapy on elderly patients with peripherally inserted central catheters(PICC).From November 2023 to November 2024,a total of 60 elderly patients with PICC admitted to Guiqian International General Hospital were selected as research subjects.Using a digital random table method,these patients were randomly divided into a control group and an experimental group,with 30 patients in each.The control group received routine nursing care,while the experimental group received specialized intravenous therapy nursing intervention in addition to routine care.The nursing effects of both groups were comprehensively evaluated,including treatment compliance,psychological state,quality of life,incidence of complications,and satisfaction with nursing care.The results showed that after the intervention,the treatment compliance in the experimental group was significantly higher than that of the control group(P<0.05).Additionally,scores on the Self-Rating Anxiety Scale(SAS)and Self-Rating Depression Scale(SDS)were markedly lower in the experimental group compared to the control group(P<0.05),indicating improved psychological well-being.The experimental group also scored higher in all dimensions of quality of life(P<0.05),and had a lower complication rate and higher satisfaction with nursing care(P<0.05).In conclusion,the application of specialized intravenous therapy nursing intervention in the care of elderly patients with PICC can significantly enhance treatment compliance,improve psychological status,elevate quality of life,and reduce complications,demonstrating strong clinical value and providing important guidance for future treatment and nursing of such patients.
基金supported by the Shandong Province Natural Science Foundation Youth Branch(ZR2023QC157)the National Natural Science Foundation of China(51979233)+1 种基金the Key Research and Development Project of Shaanxi Province(2022KW-47,2022NY-220)the Heze University Doctoral Research Fund(XY21BS24,XY22BS17).
文摘Drip irrigation and flood irrigation are major irrigation methods for maize crops in the Hetao Irrigation District,Inner Mongolia Autonomous Region,China.This research delves into the effects of these irrigation methods on carbon dioxide(CO_(2))exchange and crop growth in this region.The experimental site was divided into drip and flood irrigation zones.The irrigation schedules of this study aligned with the local commonly used irrigation schedule.We employed a developed chamber system to measure the diurnal CO_(2)exchange of maize plants during various growth stages under both drip and flood irrigation methods.From May to September in 2020 and 2021,two sets of repeated experiments were conducted.In each experiment,a total of nine measurements of CO_(2)exchange were performed to obtain carbon exchange data at different growth stages of maize crop.During each CO_(2)exchange measurement event,CO_(2)flux data were collected every two hours over a day-long period to capture the diurnal variations in CO_(2)exchange.During each CO_(2)exchange measurement event,the biological parameters(aboveground biomass and crop growth rate)of maize and environmental parameters(including air humidity,air temperature,precipitation,soil water content,and photosynthetically active radiation)were measured.The results indicated a V-shaped trend in net ecosystem CO_(2)exchange in daytime,reducing slowly at night,while the net assimilation rate(net primary productivity)exhibited a contrasting trend.Notably,compared with flood irrigation,drip irrigation demonstrated significantly higher average daily soil CO_(2)emission and greater average daily CO_(2)absorption by maize plants.Consequently,within the maize ecosystem,drip irrigation appeared more conducive to absorbing atmospheric CO_(2).Furthermore,drip irrigation demonstrated a faster crop growth rate and increased aboveground biomass compared with flood irrigation.A strong linear relationship existed between leaf area index and light utilization efficiency,irrespective of the irrigation method.Notably,drip irrigation displayed superior light use efficiency compared with flood irrigation.The final yield results corroborated these findings,indicating that drip irrigation yielded higher harvest index and overall yield than flood irrigation.The results of this study provide a basis for the selection of optimal irrigation methods commonly used in the Hetao Irrigation District.This research also serves as a reference for future irrigation studies that consider measurements of both carbon emissions and yield simultaneously.
基金officially supported by the National Natural Science Foundation of China(Grant Nos.42276225,51879125)the Postgraduate Research&Practice Innovation Program of Jiangsu Province(Grant No.SJCX23_2208)。
文摘Cryogenic valves play a crucial role in the production and transportation of liquefied natural gas(LNG),and are primarily responsible for efficiently controlling the inflow and outflow of LNG and regulating pressure.However,due to their operation in low-temperature and high-humidity environments,crucial components such as drip trays are susceptible to frosting,which may lead to LNG leakage,thereby causing severe safety incidents.In this study,the user-defined function(UDF)is employed to redevelop Fluent,which integrates the frost growth model with the Eulerian multiphase flow model,to conduct a quantitative analysis of frosting on drip trays of cryogenic valves.The effects of environmental parameters,such as wind speed,ambient temperature,air humidity,and cold surface temperature on the growth of the frost layer were analyzed.This study reveals a limiting wind speed between 1 m/s and 2 m/s.Upon reaching this limit speed,the growth of the frost layer reaches its maximum,and further increases in the wind speed have no significant effect on the growth of the frost layer.Furthermore,the influence of the change in the flow field on droplet impingement and freezing during the growth of the frost layer is considered through the coupling method of the kinematic characteristics of water droplets and the collection coefficient of water droplets.This study identifies the influence of different parameters on the droplet impact efficiency,leading to the modification of the frost layer on the drip tray.
基金This study was funded by the Key Laboratory of Feed and Livestock and Poultry Products Quality&Safety Control,Ministry of Agriculture(2021202201)Reform and Development Project of BAAFS(XMS202322).
文摘Background A deterioration in the meat quality of broilers has attracted much more attention in recent years.L-malic acid(MA)is evidenced to decrease meat drip loss in broilers,but the underlying molecular mechanisms are still unclear.It’s also not sure whether the outputs obtained under experimental conditions can be obtained in a com-mercial condition.Here,we investigated the effects and mechanisms of dietary MA supplementation on chicken meat drip loss at large-scale rearing.Results Results showed that the growth performance and drip loss were improved by MA supplementation.Meat metabolome revealed that L-2-aminoadipic acid,β-aminoisobutyric acid,eicosapentaenoic acid,and nicotinamide,as well as amino acid metabolism pathways connected to the improvements of meat quality by MA addition.The transcriptome analysis further indicated that the effect of MA on drip loss was also related to the proper immune response,evidenced by the enhanced B cell receptor signaling pathway,NF-κB signaling pathway,TNF signaling pathway,and IL-17 signaling pathway.Conclusions We provided evidence that MA decreased chicken meat drip loss under commercial conditions.Metabolome and transcriptome revealed a comprehensive understanding of the underlying mechanisms.Together,MA could be used as a promising dietary supplement for enhancing the water-holding capacity of chicken meat.
基金Project supported in part by the National Natural Science Foundation of China(Grant Nos.62471144 and 62071124)in part by the Conselho Nacional de Desenvolvimento Científico e Tecnológico(BR)(CNPq)(Grant No.315546/2021-2)。
文摘The combination therapy of magnetic hyperthermia and thermosensitive liposomes(TSL)is an emerging and effective cancer treatment method.The heat generation of magnetic nanoparticles(MNPs)due to an external alternating magnetic field can not only directly damage tumor cells,but also serves as a triggering factor for the release of doxorubicin from TSL.The aim of this study is to investigate the effects in the degree of tumor cell damage of two proposed injection strategies that consider intravenous administration.Since both MNPs and TSL enter the tumor region intravenously,this study establishes a biological geometric model based on an experiment-based vascular distribution.Furthermore,this study derives the flow velocity of interstitial fluid after coupling the pressure distribution inside blood vessels and the pressure distribution of interstitial fluid,which then provides the convective velocity for the calculation of subsequent nanoparticle concentration.Different injection strategies for the proposed approach are evaluated by drug delivery result,temperature distribution,and tumor cell damage.Simulation results demonstrate that the proposed delayed injection strategy after optimization can not only result in a wider distribution for MNPs and TSL due to the sufficient diffusion time,but also improves the distribution of the temperature and drug concentration fields for the overall efficacy of combination therapy.
基金supported by Zhejiang Provincial Medical and Health Science and Technology Plan Project(2023KY448).
文摘Objective:Early thrombolytic therapy for ischemic stroke within the therapeutic window is associated with improved clinical outcomes.This study investigated whether optimizing intravenous thrombolytic(IVT)therapy strategies for stroke could reduce treatment delays.Methods:To reduce delays in IVT therapy for ischemic stroke,a series of quality improvement measures were implemented at a tertiary hospital in Hangzhou,Zhejiang Province,from June 2021 to August 2023,which included developing a timeline process management system,forming a nurse-led stroke process management team,providing homogeneous training,standardizing the IVT therapy process for ischemic stroke,and introducing an incentive policy.During the pre-(from June 2021 to February 2022,group A)and post-(from March to November 2022,group B1;from December 2022 to August 2023,group B2[implementation of an additional incentive policy])of the implementation the strategy,the door-tocomputed tomographic angiography(CTA)time(DCT),CTA time,neurology consultation to consent for IVT,CTA-to-needle time(CNT),and door-to-needle time(DNT),the percentage of people who underwent CTA within 20 min,15 min,and 10 min and DNT within 60 min,45 min,and 30 min were collected and compared.Results:Following the implementation of the standardized IVT process management strategy for stroke,the DNT for group B1 and group B2 were 30(24,44)min and 31(24,41)min,respectively,both significantly lower than the 46(38,58)min in group A(P<0.001);the median DCT were both 13 min in group B1 and B2 lower than 17min in group A(P<0.001);the median CTA were 12 min in Group B1 and 9 min in Group B2 lower than 14 min in group A(P<0.001);similar results were observed during the neurology consultation to obtain consent for IVT and CNT.Compared with group A,the proportion of DCT20 min,15 min,and 10 min was higher in groups B1 and B2(P<0.05),and the same result was observed at DNT60 min,45 min,and 30 min(P<0.05).However,the additional incentive policy did not significantly differ between Group B2 and Group B1.Conclusions:Optimizing IVT therapy for ischemic stroke is a feasible approach to limit the DNT to 30 min in ischemic stroke,significantly reducing delays within the therapeutic window and increasing the number of patients meeting target time segments.Additionally,generating a timeline for the IVT therapy process by scanning positioning quick response codes was a significant breakthrough in achieving the informatization of IVT quality management for stroke.
文摘Objective: To evaluate the efficacy of Compound Danshen Dripping Pills(CDDP) combined with isosorbide mononitrate(ISMN) versus ISMN alone for treating angina pectoris in patients.Methods: The Pub Med, Web of Science, Cochrane Library, Embase China National Knowledge Infrastructure, China Biomedical Literature Service System, Chinese Medical Journal Database, and Wan Fang MED databases were searched from inception to November 2022. Randomized controlled trials(RCTs) and cohort studies were included. The primary outcomes were angina symptom and electrocardiography(ECG) efficacy, angina symptom efficacy, and ECG efficacy. The protocol was registered with PROSPERO No. CRD42022314774.Results: Our study included 7 245 patients with angina(59 RCTs, 11 cohort studies). When ISMN was combined with CDDP, the efficacy of angina symptom and ECG [odds ratio(OR) = 4.824, 95% confidence interval(CI) = 3.636–6.401, P = 0.000], the efficacy of angina symptom(OR = 4.347, 95% CI = 3.635–5.198,P = 0.000), the efficacy of ECG(OR = 3.364, 95% CI = 2.767–4.089, P = 0.000) were better than that of patients treated with ISMN alone. CDDP combined with ISMN was superior to ISMN alone in reducing triglyceride(TG) [mean difference(MD) =-35.176, 95% CI =-37.439 to-32.912, P = 0.000], total cholesterol(TC)(MD =-24.296, 95% CI =-26.429 to-22.163, P = 0.000), the duration of angina attack(MD =-1.991, 95% CI =-2.349 to-1.633, P = 0.000), and the frequency of angina attack [standardized MD(SMD) =-2.840, 95% CI =-3.416 to-2.265, P = 0.000]. There was no increase in adverse events between CDDP combined with ISMN and ISMN alone(OR = 0.513, 95% CI = 0.421–0.626, P = 0.000).Conclusion: CDDP combined with ISMN improved treatment efficacy and was well tolerated. Therefore,this combination could be used as an alternative treatment. However, clinical and patient conditions should be considered.
文摘Objective: To explore the clinical effectiveness of combined use of intravenous pain pump with Parecoxib injection in alleviating pain in patients during the early postoperative period after thoracoscopic surgery. Methods: Eighty patients who underwent thoracoscopic surgery in a tertiary hospital were selected as the study subjects and randomly divided into two groups, with 40 patients in each group. The control group received routine postoperative treatment with intravenous pain pump, while the experimental group received Parecoxib in addition to the standard postoperative pain pump treatment. Visual Analog Scale (VAS) pain scores were used to evaluate postoperative pain relief in both groups, along with adverse reactions, postoperative complications, and patient satisfaction with pain relief. Results: Patients who received Parecoxib injection in addition to the routine use of intravenous pain pump had VAS pain scores lower than 3 points at 6 h, 12 h, 24 h, and 36 h postoperatively compared to those in the control group. The incidence of postoperative lung collapse, pleural effusion, and pulmonary infections was also significantly lower in the experimental group. The differences between the two groups were statistically significant (P Conclusion: Early combined use of Parecoxib injection in the early postoperative period after thoracoscopic surgery has shown good clinical efficacy. It can reduce the level of pain in patients, promote effective coughing and expectoration, facilitate early mobilization of patients, improve patient compliance, reduce complications, shorten hospital stay, and expedite patient recovery. Therefore, it is worth promoting the widespread clinical application of Parecoxib injection in this setting.
基金approved by the Ethics Committee of Arak University of Medical Sciences,Arak,Iran(No.IR.ARAKMU.REC.1402.033)registered in the Iranian Registry of Clinical Trials(No.IRCT20141209020258N183).
文摘Objective:To compare the effects of adding rocuronium and nitroglycerin to ropivacaine in intravenous regional anesthesia(IVRA)on pain and hemodynamic parameters.Methods:This randomized controlled trial was done in 2023.Participants were 177 candidates for forearm operation surgery under IVRA selected from Valiasr Hospital,Arak,Iran.They were allocated by block randomization to three different groups,namely nitroglycerin group,rocuronium group and control group.Hemodynamic parameters were recorded before tourniquet application up to postoperative recovery time.Sensory block and motor block onset and duration and pain were also evaluated.The data analysis was carried out by IMB SPSS software 20.0.Results:177 Eligible patients were included in study,with 59 in each group.Time to sensory and motor block onset in the nitroglycerin group was significantly less than the other groups and the time of motor block in the rocuronium group was statistically higher than the control and the nitroglycerin groups(P<0.001).Seven participants in the nitroglycerin group experienced headache and three from the rocuronium group experienced dizziness.The side effects occurrence in the nitroglycerin group was more prevalent than in the control and rocuronium groups(P=0.009).Conclusions:Nitroglycerin significantly reduces the time to sensory and motor block onset,while rocuronium is more effective in prolonging the time of motor block.Although there is no difference between nitroglycerin and rocuronium respecting the pain score and opioid need administration,nitroglycerin is associated with a higher prevalence of medication side effects.Therefore,both nitroglycerin and rocuronium can be used as adjuvant for IVRA.The final choice relies on patients’conditions and anesthesiologists’judgment.
基金funded by Scientific and Technological Planning Project of Guangzhou City(Grant No.201803010115)Projects of The National Natural Science Foundation of China(Grant No.82173972)+1 种基金2021 Traditional Chinese Medicine(Medicine of South China)Industry Talents Project-Innovation Team of South China Medicine Resources,Guangdong Provincial Basic and Applied Basic Research Fund(Grant No.2023A1515011147)supported by the Key Unit of Chinese Medicine Digitalization Quality Evaluation of State Administration of Traditional Chinese Medicine.
文摘Background:Shenzao dripping pill(SZDP)is empirically prescribed for treating cardiac diseases.Nevertheless,there is a lack of comprehensive knowledge regarding the underlying mechanisms contributing to its therapeutic effects.The objective of this study is to investigate the underlying mechanism of SZDP against chronic myocardial ischemia(CMI)in a rat model.Methods:In this study,we utilized electrocardiographic and echocardiographic detection along with pathological tissue analysis to evaluate the efficacy of SZDP.The integration of network pharmacology and metabolomics was conducted to investigate the mechanisms.Molecular docking and molecular dynamics simulations were used to validate the binding energy between the compounds of SZDP and the associated targets.Results:The results showed that SZDP was able to improve T wave voltage,reverse CMI abnormalities in ejection fraction and fractional shortening,and restore histopathological heart damage.Metabolomics results indicated that disturbances of metabolic profile in CMI rats were partly corrected after SZDP administration,mainly affecting purine metabolism.13-Docosenamide may be the potential metabolic biomarker of the therapeutic application of SZDP for CMI.Integrating network pharmacology and metabolomics,thiopurine S-methyltransferase(TPMT),xanthine dehydrogenase/oxidase(XDH),bifunctional purine biosynthesis protein ATIC(ATIC),and cytochrome p4501A1(CYP1A1)were identified as possible targets of SZDP to exert therapeutic effects by enhancing the metabolic levels of L-Tryptophan,Deoxyribose 1-phosphate and Phosphoribosyl formamidocarboxamide.Conclusion:SZDP has a therapeutic effect on CMI by regulating metabolite levels,acting on the targets of TMPT,XDH,ATIC,and CYP1A1,and reducing cardiomyocyte injury and myocardial fibrosis.
文摘Objective: To explore the effectiveness of applying patient simulators combined with Internet Plus scenario simulation teaching models on intravenous (IV) infusion nursing education, and to provide scientific evidence for the implementation of advanced teaching models in future nursing education. Methods: Enrolled 60 nurses who took the IV infusion therapy training program in our hospital from January 2022 to December 2023 for research. 30 nurses who were trained in traditional teaching models from January to December 2022 were selected as the control group, and 30 nurses who were trained with simulation-based teaching models with methods including simulated patients, internet, online meetings which can be replayed and scenario simulation, etc. from January to December 2023 were selected as the experimental group. Evaluated the learning outcomes based on the Competency Inventory for Nursing Students (CINS), Problem-Solving Inventory (PSI), comprehensive learning ability, scientific research ability, and proficiency in the theoretical knowledge and practical skills of IV infusion therapy. Nursing quality, the incidence of IV infusion therapy complications and nurse satisfaction with different teaching models were also measured. Results: The scientific research ability, PSI scores, CINS scores, and comprehensive learning ability of the experimental group were better than those of the control group (P 0.05), and their assessment results of practical skills, nursing quality of IV infusion therapy during training, and satisfaction with teaching models were all better than those of the control group with statistical significance (P < 0.05). The incidence of IV infusion therapy complications in the experimental group was lower than that in the control group, indicating statistical significance (P < 0.05). Conclusions: Teaching models based on patient simulators combined with Internet Plus scenario simulation enable nursing students to learn more directly and practice at any time and in any place, and can improve their proficiency in IV infusion theoretical knowledge and skills (e.g. PICC catheterization), core competencies, problem-solving ability, comprehensive learning ability, scientific research ability and the ability to deal with complicated cases. Also, it helps provide high-quality nursing education, improve the nursing quality of IV therapy, reduce the incidence of related complications, and ensure the safety of patients with IV therapy.
基金The Kunshan Social Development Science and Technology Special Project,No.KS2241.
文摘BACKGROUND Stellate ganglion block is a commonly used sympathetic nerve block technique that restores the balance of the sympathetic and vagal nervous systems of the body and inhibits sympathetic nerve activity.AIM To analyze the effect of a stellate ganglion block combined with total diploma intravenous anesthesia on postoperative pain and immune function in patients undergoing laparoscopic radical gastric cancer(GC)surgery to provide a refe-rence basis for the formulation of anesthesia protocols for radical GC surgery.METHODS This study included 112 patients who underwent laparoscopic radical surgery for GC between January 2022 and March 2024.There was no restriction on sex.The patient grouping method used was a digital random table method,and the num-ber of cases in each group was 56.The control group was administered total intravenous anesthesia,and the observation group compounded the stellate gan-glion block according to the total intravenous anesthesia protocol.Postoperative hemodynamics,pain levels,and immune indices were compared between the groups.RESULTS The heart rate and mean arterial pressure in the observation group after in-tubation were lower than those in the control group(P<0.05).Pain levels were compared between the two groups at 2 hours,12 hours,24 hours,and 48 hours after surgery(P>0.05).The number of CD3+,CD4+,and CD4+/CD8+cells at the end of surgery was higher in the observation group than in the control group,and the number of CD8+cells was lower in the observation group than in the control group(P<0.05).There were no significant differences between the two groups in terms of propofol dosage,awakening time,extubation time,or postoperative adverse reactions(P>0.05).CONCLUSION The application of a stellate ganglion block combined with total intravenous anesthesia had no significant effect on postoperative pain levels in patients undergoing laparoscopic radical GC surgery.However,it can safely reduce the effect of surgery on the immune function of patients and is worth applying in clinical practice.
文摘BACKGROUND The possible existence of an acini–islet–acinar(AIA)reflex,involving mutual amylase and insulin interactions,was investigated in the current acute experiment on pigs.AIM To confirm the existence of an AIA reflex and justify the placement of the exocrine and endocrine pancreatic components within the same organ.METHODS The study was performed on six pigs under general anesthesia.An intravenous glucose tolerance test was performed,with a bolus infusion of 50%glucose to the jugular vein,while amylase(5000 U/kg)or vehicle intrapancreatic infusions were administered via the pancreaticoduodenalis cranialis artery during 30 min with a 1 mL/min flow rate.RESULTS The amylase infusion to pancreatic arterial circulation inhibited and delayed the insulin release peak which is usually associated with the highest value of blood glucose and is typically observed at 15 min after glucose infusion,for>1 h.The intrapancreatic infusion of the vehicle(saline)did not have any effect on the time frame of insulin release.Infusion of 1%bovine serum albumin changed the insulin release curve dramatically and prolonged the high range of insulin secretion,far beyond the glucose peak.CONCLUSION Intrapancreatic arterial infusion of amylase interrupted the integrated glucose–insulin interactions.This confirms an AIA reflex and justifies placement of the exocrine and endocrine pancreatic components within the same organ.
基金Henan Medical Science and Technology Research and Development Program in 2023“Analysis of Causes of Extravasation in Intravenous Infusion and Construction of Nursing Intervention Model”(Project No.LHGJ20230029)。
文摘Intravenous infusion,a common clinical drug treatment method,is widely used in the treatment of various diseases.Due to the invasive nature of puncture during intravenous infusion,patients may inevitably experience resistance and tension when facing nursing staff performing infusion procedures.Additionally,the complexity of the nursing staff’s work and the impact of the infusion therapy environment can exacerbate the tension between nurses and patients,leading to risks such as drug leakage and needlestick injuries.This article focuses on the factors influencing extravasation during intravenous infusion and elaborates on how high-quality nursing interventions can reduce the incidence of adverse events during intravenous infusion.These interventions aim to improve patient satisfaction with intravenous infusion nursing care and ensure the safety of intravenous infusion procedures.
文摘Heparin-induced thrombocytopenia(HIT) is a relatively infrequent complication of heparin administration. HIT can cause devastating thrombosis, making it one of the most serious adverse drug reactions encountered in clinical practice. We successfully treated a case of severe HIT presenting with thrombosis and life-threatening bleeding complications with intravenous immunoglobulin(IVIG), platelet transfusion and oral anticoagulant Rivaroxaban. In this case, we considered that IVIG played the most important role by preventing further thrombosis, increasing the platelet count, and ensuring the efficacy of Rivaroxaban. We therefore suggest that IVIG might be the optimal treatment for patients with this urgent condition.
基金supported by the National Natural Science Foundation of China(40771097)the Special Fund of Industrial(Agriculture)Research for Public Welfare of China(200903001)
文摘More and more attention is being focused on saline water utilization in irrigation due to the shortage of fresh water to agriculture in many regions. For purpose of reducing the risks of using of saline water for irrigation, the mechanism of soil moisture and salinity distribution and transport should be well understood for developing optimum management strategies. In this paper, field experiments were carried out at Junggar Basin, China, to study the effects of drip irrigation water quality and drip tape arrangement on distribution of soil salinity and soil moisture. Six treatments were designed, including two drip tape arrangement modes and three irrigation water concentration levels （0.24, 4.68, and 7.42 dS m^-l）. Results showed that, soil moisture content （SMC） directly beneath the drip tape in all treatments kept a relatively high value about 18% before boll opening stage; the SMC in the narrow strip in single tape arrangement （Ms） plot was obviously lower than that in the double tapes arrangement （Md） plot, indicating that less sufficient water was supplied under the same condition of irrigation depth, but there was no significant reduction in yield. Mulching had not significant influence on salt accumulation but the drip tape arrangement, under the same condition of irrigation water depth and quality, compared with Md, Ms reduced salt accumulation in root zone and brought about relatively high cotton yield.
