Nursing Care of Patients With Transcatheter Closure of Atrial Septal Defect via Femoral Vein

Objective: To explore the operative nursing coordination method for the treatment of congenital atrial septal defect (ASD) by transcatheter closure of atrial septal defect via femoral vein. It provides useful experience for the treatment of congenital heart disease. Methods a total of 12 patients undergoing minimally invasive atrial septal defect closure via femoral vein from January 2017 to November 2017 in our department of cardiac surgery were selected as the subjects. All patients received transesophageal ultrasound guided ASD occlusion by femoral vein. The operation and nursing contents include preoperative care, the cooperation of the itinerant nurses, the coordination of the instrument nurses and the postoperative nursing. Results the operation of 12 patients in this group was successful. The diameter of the occluder was 17.1 + 4.5mm during the operation. The time of tracheal intubation was 2.4 + 0.7h, from the femoral vein to the sheath tube time was 38.7 + 9.4min, the occupancy of ICU was 12.5 + 2.6h after the operation. The average time of hospitalization was 4.5 + 1.8D. There were 2 cases of shunt 1mm immediately after operation. After 24h reexamination, the shunt disappeared, the heart murmur disappeared in the rest of the patients. No residual shunt and other complications occurred

Results of active surveillance of foodborne diseases in Pudong New Area of Shanghai, 2015-2018

Objective To understand the epidemic trend and characteristics of foodborne diseases caused by specific pathogens in Pudong New Area of Shanghai, so as to provide scientific evidence for disease prevention and control. Methods From 2015 to 2018, the infectious cases with diarrhea as the main complaint were collected from the sentinel hospital of foodborne disease active monitoring in Pudong New Area of Shanghai. Stool or anal swab samples were collected and tested for Vibrio parahaemolyticus, Salmonella, Shigella, diarrheogenic Escherichia coli, Campylobacter jejuni and Norovirus. At the same time, the profiles were collected and analyzed. Results In 2015-2018, 2 871 stool or anal swab samples of diarrhea cases were monitored and collected. The positive rate of pathogens was 23.55% (676/2 871), including Norovirus 20.04% (97/484), diarrheogenic Escherichia coli 11.84% (340/2 871), Campylobacter jejuni 7.21% (68/943), Vibrio parahaemolyticus 4.01% (115/2 871), Salmonella 3.27% (94/2 871) and Shigella 0.28% (8/2 871). The positive rate was higher in the third quarter, showing a significant peak in summer and autumn. Suspicious food was mainly mixed food (41.12%, 278/676), followed by aquatic animals and their products (22.19%, 150/676) and meat and meat products (10.95%, 74/676). Conclusion Norovirus and diarrheogenic Escherichia coli were the main pathogens of diarrhea cases in Pudong New Area of Shanghai. We should further improve the foodborne disease active monitoring system, carry out detailed epidemiological case investigation for specific pathogen positive cases, and provide technical support for effective prevention and control

The correlation between tic disorders and allergic conditions in children: A systematic review and meta-analysis of observational studies

AimTo evaluate the correlation between tic disorders and allergies and to inform strategies for the treatment and prevention of tic disorders.MethodsWe conducted online searches of the MEDLINE, Embase, Cochrane, CNKI, CBM, WanFang, and VIP Information databases. Case-control studies and cohort studies related to tic disorders and allergic conditions were searched. Two researchers screened the literature, extracted data, and evaluated quality in strict accordance with the predetermined retrieval strategy and inclusion criteria. Finally, RevMan 5.4 software was used to conduct a meta-analysis. We used the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach to rating the certainty of evidence about each allergy outcome as high, moderate, low, or very low.ResultsWe obtained seven eligible studies involving eight allergic conditions. The following allergic conditions were significantly associated with the presence of a tic disorder: asthma (OR = 1.90, 95% CI = 1.57–2.30, P < 0.001), allergic rhinitis (OR = 2.61, 95% CI = 1.90–3.57, P < 0.001), allergic conjunctivitis (OR = 3.65, 95% CI = 1.53–8,67, P = 0.003), eczema (OR = 3.87, 95% CI = 2.24–6.67, P < 0.001) and food allergy (OR = 2.79, 95% CI = 1.56–4.99, P < 0.001). There was no significant correlation between atopic dermatitis, urticaria, drug allergy, and tic disorder.ConclusionThe occurrence of tic disorders may be associated with the presence of certain allergic disorders. However, whether allergy is one of the causes of tic disorders remains unclear.Systematic review registrationThe registration number for this systematic review is PROSPERO: CRD42021231658

Efficacy and safety of pembrolizumab versus sintilimab treatment in patients with advanced squamous lung cancer: A real-world study in China

ImportanceBoth pembrolizumab and sintilimab have been approved by the Chinese State Drug Administration (NMPA) for the first-line treatment of patients with advanced squamous lung cancer. The differences of the two drugs in efficacy and safety are unclear.ObjectivesTo compare the real-world efficacy and safety of first-line treatments in patients with advanced squamous lung cancer.Materials and methodsThis was a retrospective review of patients with advanced squamous carcinoma who received sintilimab or pembrolizumab in combination with chemotherapy as first-line therapy between June 2018 and April 2022 in the Chinese PLA Hospital. The primary objective was to compare the objective response rate (ORR), progression-free survival (PFS), and overall survival (OS) between the two groups. Secondary objectives were to compare the disease control rate (DCR) and to analyze adverse events (AEs) between the two groups.ResultsA total of 164 patients were enrolled, including 63 patients (38.4%) in the sintilimab-combined chemotherapy group and 101 patients (61.6%) in the pembrolizumab-combined chemotherapy group. The ORR was 65.10% in the sintilimab group and 61.40% in the pembrolizumab group (P=0.634). The DCR was 92.10% and 92.10% in the sintilimab and pembrolizumab groups, respectively (P=0.991). The median PFS was 22.2 months for patients treated with sintilimab group compared with 16.5 months for patients treated with pembrolizumab group[hazard ratio (HR) = 0.743; 95% confidence interval (CI): 0.479-1.152; P = 0.599]. Patients treated with pembrolizumab did not achieve a median OS, and patients treated with sintilimab had a median OS of 30.7 months. In the sintilimab group, the incidence of all treatment-related adverse events (TRAEs) was 92.1% (58/63), and the incidence of grade 3-4 TRAEs of 42.9% (27/63). In the pembrolizumab group, the incidence of all TRAEs was 90.1% (91/101), and the incidence of grade 3-4 TRAEs was 37.6% (38/101).ConclusionIn the clinical treatment of Chinese patients with advanced squamous lung cancer, first-line treatment with sintilimab in combination with chemotherapy provided similar efficacy to pembrolizumab in combination with chemotherapy, and the treatment-related adverse effect profiles were comparable between the two groups, including similar rates of grade 3-4 and all adverse events

High drug-loaded microspheres enabled by controlled in-droplet precipitation promote functional recovery after spinal cord injury

High drug loading improves therapeutic efficacy and reduces side effects in drug delivery. Here, the authors use controlled diffusion of solvents to precipitate drug nanoparticles in polymer particles while the polymer is solidifying and demonstrate the particles for drug delivery in a spinal cord injury model. Drug delivery systems with high content of drug can minimize excipients administration, reduce side effects, improve therapeutic efficacy and/or promote patient compliance. However, engineering such systems is extremely challenging, as their loading capacity is inherently limited by the compatibility between drug molecules and carrier materials. To mitigate the drug-carrier compatibility limitation towards therapeutics encapsulation, we developed a sequential solidification strategy. In this strategy, the precisely controlled diffusion of solvents from droplets ensures the fast in-droplet precipitation of drug molecules prior to the solidification of polymer materials. After polymer solidification, a mass of drug nanoparticles is embedded in the polymer matrix, forming a nano-in-micro structured microsphere. All the obtained microspheres exhibit long-term storage stability, controlled release of drug molecules, and most importantly, high mass fraction of therapeutics (21.8-63.1 wt%). Benefiting from their high drug loading degree, the nano-in-micro structured acetalated dextran microspheres deliver a high dose of methylprednisolone (400 mu g) within the limited administration volume (10 mu L) by one single intrathecal injection. The amount of acetalated dextran used was 1/433 of that of low drug-loaded microspheres. Moreover, the controlled release of methylprednisolone from high drug-loaded microspheres contributes to improved therapeutic efficacy and reduced side effects than low drug-loaded microspheres and free drug in spinal cord injury therapy.Peer reviewe

Neural Stem Cells Engineered to Express Three Therapeutic Factors Mediate Recovery from Chronic Stage CNS Autoimmunity

© The American Society of Gene and Cell Therapy. Treatment of chronic neurodegenerative diseases such as multiple sclerosis (MS) remains a major challenge. Here we genetically engineer neural stem cells (NSCs) to produce a triply therapeutic cocktail comprising IL-10, NT-3, and LINGO-1-Fc, thus simultaneously targeting all mechanisms underlie chronicity of MS in the central nervous system (CNS): persistent inflammation, loss of trophic support for oligodendrocytes and neurons, and accumulation of neuroregeneration inhibitors. After transplantation, NSCs migrated into the CNS inflamed foci and delivered these therapeutic molecules in situ. NSCs transduced with one, two, or none of these molecules had no or limited effect when injected at the chronic stage of experimental autoimmune encephalomyelitis; cocktail-producing NSCs, in contrast, mediated the most effective recovery through inducing M2 macrophages/microglia, reducing astrogliosis, and promoting axonal integrity and endogenous oligodendrocyte/neuron differentiation. These engineered NSCs simultaneously target major mechanisms underlying chronicity of multiple sclerosis (MS) and encephalomyelitis (EAE), thus representing a novel and potentially effective therapy for the chronic stage of MS, for which there is currently no treatment available

Real-time Monitoring for the Next Core-Collapse Supernova in JUNO

Core-collapse supernova (CCSN) is one of the most energetic astrophysical events in the Universe. The early and prompt detection of neutrinos before (pre-SN) and during the SN burst is a unique opportunity to realize the multi-messenger observation of the CCSN events. In this work, we describe the monitoring concept and present the sensitivity of the system to the pre-SN and SN neutrinos at the Jiangmen Underground Neutrino Observatory (JUNO), which is a 20 kton liquid scintillator detector under construction in South China. The real-time monitoring system is designed with both the prompt monitors on the electronic board and online monitors at the data acquisition stage, in order to ensure both the alert speed and alert coverage of progenitor stars. By assuming a false alert rate of 1 per year, this monitoring system can be sensitive to the pre-SN neutrinos up to the distance of about 1.6 (0.9) kpc and SN neutrinos up to about 370 (360) kpc for a progenitor mass of 30$M_{\odot}$ for the case of normal (inverted) mass ordering. The pointing ability of the CCSN is evaluated by using the accumulated event anisotropy of the inverse beta decay interactions from pre-SN or SN neutrinos, which, along with the early alert, can play important roles for the followup multi-messenger observations of the next Galactic or nearby extragalactic CCSN.Comment: 24 pages, 9 figure