医护联合查房在心内科ICU中的临床实践

Objective: To establish a good communicational bridge among patients, doctors and nurses, and promote quality of holistic nursing through collaborative ward rounds, as well as hoping to further develop the collaborative ward rounds of doctors, nurses, dietitians, rehabilitation and oral care division after putting forward high quality care. Method：The patients in ICU of cardiology between October 2011 and October 2013 were separately selected as control group and experimental group according to the admission before and after 1 year. The control group accepted separately traditional rounds of doctors and nurses from October 2011 to October 2012 and experimental group implemented the collaborative ward rounds by doctors and nurses twice a day from October 2012 to October 2013. Compared the quality of care of between two groups. Result：In experimental group, the satisfactions of hospitalized patients and doctors to nurses’ work, the average length of stay of patients and the turnover rate of ward beds were all better than those of control group, which were statistically significant (P<0.05). Conclusion: Collaborative ward rounds by doctors and nurses can promote quality of care and improve the working efficiency of ward. 目的  在优质护理服务提出前提下，通过医护联合查房，为患者、医生、护士三方提供良好沟通的桥梁，全面提高护理质量，希望之后进一步发展为医生、护士、营养师、康复师与口腔护理师共同联合查房。方法  选择2011年10月—2013年10月入住心内科ICU患者，选择前后各1年为对照阶段和实验阶段，比较两阶段的护理服务质量、对照组（2011年10月—2012年10月）实行传统医生、护士分开查房；实验组（2012年10月—2013年10月）实施每天两次医生、护士联合查房；结果  实验组患者的住院满意度、医生对护士工作满意度、患者平均住院日及病区床位周转率均比对照组提高，差异有统计学意义（P<0.05)。 结论  医护联合查房，可以提高护理质量、病区工作效率

Contact Stress Prediction Model for Variable Hyperbolic Circular Arc Gear Based on the Optimized Kriging-Response Surface Model

In order to study the influence of design parameters (pressure angle, tooth width, tooth line radius, modulus, and moment) on contact stress of variable hyperbolic circular arc gear (VHCAG) and to obtain the best manufacturing parameters, The Kriging-Response Surface Model, a hybrid surrogate model with adaptive quantum particle swarm optimization (QPSO) algorithm was proposed to establish the expression prediction model for the relation between design parameters and contact stress. An intelligent quantum particle swarm optimization algorithm based on adaptive weight and natural selection is proposed to optimize the parameters of Gaussian variation function of the kriging surrogate model to improve its fitting accuracy. The global search ability of quantum particles is improved, and the accuracy and stability of the algorithm are improved by adjusting the weight of quantum particles adaptively and by optimizing the elimination iteration process, and the response relationship between design parameters and contact stress was established. The binomial response surface model of gear design parameters and contact stress is established based on the output obtained through the improved kriging model; this simplifies the complex expression of the kriging model. The effects of parameters and their cross-terms on contact stress are analysed based on the contact stress prediction model established by using the optimized Kriging-Response Surface Model hybrid surrogate model. The hybrid Kriging-Response Surface Model surrogate model lays a foundation for the research on the reliability and robust optimization of cylindrical gears with variable hyperbolic arc tooth profile

Crosstalk of nervous and immune systems in pancreatic cancer

Pancreatic cancer is a highly malignant tumor known for its extremely low survival rate. The combination of genetic disorders within pancreatic cells and the tumor microenvironment contributes to the emergence and progression of this devastating disease. Extensive research has shed light on the nature of the microenvironmental cells surrounding the pancreatic cancer, including peripheral nerves and immune cells. Peripheral nerves release neuropeptides that directly target pancreatic cancer cells in a paracrine manner, while immune cells play a crucial role in eliminating cancer cells that have not evaded the immune response. Recent studies have revealed the intricate interplay between the nervous and immune systems in homeostatic condition as well as in cancer development. In this review, we aim to summarize the function of nerves in pancreatic cancer, emphasizing the significance to investigate the neural-immune crosstalk during the advancement of this malignant cancer

The effect of personalized intervention on the cognitive function of elderly inpatients

目的  对住院老年患者进行早期认知功能护理干预，评价其效果。方法  2013年1月—2015年1月入院老年科病房的120名患者，运用MMSE量表对其认知功能进行评价，观察干预效果。结果  MMSE总分及MMSE量表中时间定向、短期记忆及插画条目干预后有改善（P＜0.05），地点定向、语言记忆、注意力、物品命名、语言复述、阅读能力、语言能力及语言表达条目改善不明显（P＞0.05）。 结论  个性化的认知干预能够延缓和改善患者认知功能障碍，提高老年患者的生活质量。Objectives: To assess the effect of the early cognitive function nursing intervention on the cognitive function of elderly inpatients. Methods: A total of 120 elderly inpatients in geriatrics ward were rolled from January 2013 to January 2015, and we evaluate the cognitive function of them and gave personalized intervention to them by MMSE scale. Results: The total score of MMSE was increased (P＜0.05); The entries of time orientation, short-term memory and illustration were improved significantly after three-month intervention (P＜0.05); The entries of place orientation, language, memory, attention, article name, repeat language, reading skills, language skills and language were not improved significantly. Conclusions:  Personalized cognitive intervention could improve the cognitive dysfunction and the quality of life of elderly patients

Genomic Inference of the Metabolism and Evolution of the Archaeal Phylum Aigarchaeota

Microbes of the phylum Aigarchaeota are widely distributed in geothermal environments, but their physiological and ecological roles are poorly understood. Here we analyze six Aigarchaeota metagenomic bins from two circumneutral hot springs in Tengchong, China, to reveal that they are either strict or facultative anaerobes, and most are chemolithotrophs that can perform sulfide oxidation. Applying comparative genomics to the Thaumarchaeota and Aigarchaeota, we find that they both originated from thermal habitats, sharing 1154 genes with their common ancestor. Horizontal gene transfer played a crucial role in shaping genetic diversity of Aigarchaeota and led to functional partitioning and ecological divergence among sympatric microbes, as several key functional innovations were endowed by Bacteria, including dissimilatory sulfite reduction and possibly carbon monoxide oxidation. Our study expands our knowledge of the possible ecological roles of the Aigarchaeota and clarifies their evolutionary relationship to their sister lineage Thaumarchaeota

Identifying risk factors for cesarean scar pregnancy: a retrospective study of 79 cases

 Objectives: To explore the possible risk factors for cesarean scar pregnancy (CSP), the incidence of which is increasing rapidly in China. Material and methods: 79 patients with CSP and 69 non-CSP expectant mothers with at least 1 previous cesarean section were employed in the study. The obstetric histories of the participants were collected and analyzed using Chi square test. Results: We found that 77.2% CSP patients had ≥ 3 pregnancies and only 36.2% women had ≥ 3 pregnacies in non-CSP group. During the previous cesarean delivery, 21.5% of CSP patients had entered the first stage of labor, which was 43.5% in non-CSP group (P < 0.05). Cephalopelvic disproportion occurred in 51.9% of CSP patients, which was significantly higher than that (23.2%) in non-CSP group (P < 0.01). 11.4% of CSP patients had undergone cesarean section due to breech and shoulder presentation in the past, which was only 1.4% in non-CSP group. However, no significance was noted (P > 0.05). We did not find significant differences between the CSP and non-CSP patients in maternal age, multiple cesarean sections, gestational age, emergency or elective caesarean section. Conclusions: Multiple pregnancies, absence of the first stage of labor, and cephalopelvic disproportion might be the risk factors for the occurrence of CSP.  

Sulfated tyrosines 27 and 29 in the N-terminus of human CXCR3 participate in binding native IP-10

Aim: Human CXCR3, a seven-transmembrane segment (7TMS), is predominantly expressed in Th1-mediated responses. Interferon-γ-inducible protein 10 (IP-10) is an important ligand for CXCR3. Their interaction is pivotal for leukocyte migration and activation. Tyrosine sulfation in 7TMS is a posttranslational modification that contributes substantially to ligand binding. We aimed to study the role of tyrosine sulfation of CXCR3 in the protein's binding to IP-10. Methods: Plasmids encoding CXCR3 and its mutants were prepared by PCR and site-directed mutagenesis. HEK 293T cells were transfected with plasmids encoding CXCR3 or its variants using calcium phosphate. Transfected cells were labeled with [35S]-cysteine and methionine or [35S]-Na2SO3 and then analyzed by immunoprecipitation to measure sulfation. Experiments with 125I-labeled IP-10 were carried out to evaluate the affinity of CXCR3 for its ligand. Calcium influx assays were used to measure intercellular signal transduction. Results: Our data show that sulfate moieties are added to tyrosines 27 and 29 of CXCR3. Mutation of these two tyrosines to phenylalanines substantially decreases binding of CXCR3 to IP-10 and appears to eliminate the associated signal transduction. Tyrosine sulfation of CXCR3 is enhanced by tyrosyl protein sulfotransferases (TPSTs), and it is weakened by shRNA constructs. The binding ability of CXCR3 to IP-10 is increased by TPSTs and decreased by shRNAs. Conclusions: This study identifies two sulfated tyrosines in the N-terminus of CXCR3 as part of the binding site for IP-10, and it underscores the fact that tyrosine sulfation in the N-termini of 7TMS receptors is functionally important for ligand interactions. Our study suggests a molecular target for inhibiting this ligand-receptor interaction

Enhanced Delivery of Rituximab Into Brain and Lymph Nodes Using Timed-Release Nanocapsules in Non-Human Primates.

Tumor metastasis into the central nervous system (CNS) and lymph nodes (LNs) is a major obstacle for effective therapies. Therapeutic monoclonal antibodies (mAb) have revolutionized tumor treatment; however, their efficacy for treating metastatic tumors-particularly, CNS and LN metastases-is poor due to inefficient penetration into the CNS and LNs following intravenous injection. We recently reported an effective delivery of mAb to the CNS by encapsulating the anti-CD20 mAb rituximab (RTX) within a thin shell of polymer that contains the analogs of choline and acetylcholine receptors. This encapsulated RTX, denoted as n-RTX, eliminated lymphoma cells systemically in a xenografted humanized mouse model using an immunodeficient mouse as a recipient of human hematopoietic stem/progenitor cells and fetal thymus more effectively than native RTX; importantly, n-RTX showed notable anti-tumor effect on CNS metastases which is unable to show by native RTX. As an important step toward future clinical translation of this technology, we further analyzed the properties of n-RTX in immunocompetent animals, rats, and non-human primates (NHPs). Our results show that a single intravenous injection of n-RTX resulted in 10-fold greater levels in the CNS and 2-3-fold greater levels in the LNs of RTX, respectively, than the injection of native RTX in both rats and NHPs. In addition, we demonstrate the enhanced delivery and efficient B-cell depletion in lymphoid organs of NHPs with n-RTX. Moreover, detailed hematological analysis and liver enzyme activity tests indicate n-RTX treatment is safe in NHPs. As this nanocapsule platform can be universally applied to other therapeutic mAbs, it holds great promise for extending mAb therapy to poorly accessible body compartments