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Evaluation of a complex couplet care intervention in a neonatal intensive care unit:A mixed methods study protocol

Pediatric Investigation 2024年第2期8卷 139-148页

作者： Michella Bjerregaard Anna Axelin Emma Louise Malchau Carlsen Hans Okkels Birk Ingrid Poulsen Patrick Palisz Thomas Kallemose Anne Brødsgaard Department of Paediatric and Adolescent Medicine Copenhagen University Hospital Amager HvidovreHvidovreDenmark Department of Public Health Faculty of HealthResearch Unit for Nursing and HealthcareUniversity of AarhusAarhusDenmark Department of Nursing Science University of TurkuTurkuFinland Department of Clinical Medicine Faculty of Health and Medical ScienceUniversity of CopenhagenCopenhagenDenmark Department of Public Health Section of Health Service ResearchUniversity of CopenhagenCopenhagenDenmark Department of People and Technology Roskilde UniversityRoskildeDenmark Department of Clinical Research Copenhagen University Hospital Amager HvidovreHvidovreDenmark Department of Gynaecology and Obstetrics Copenhagen University Hospital Amager HvidovreHvidovreDenmark

Background:Families with an infant in need of intensive care most often experience a harmful separation after *** is due to a division of medical specialties into neonatal care and maternal ***,a couplet care intervention is implemented for mother-infant dyads in a neonatal intensive care *** study protocol provides a comprehensive evaluation of the *** aim is to evaluate the effect and implementation of a complex couplet care intervention to promote zero separation between mother and ***:The couplet care intervention is a family-centered model of care,where treatment-requiring mother-infant dyads will be admitted together and receive couplet care by neonatal *** study adheres to the framework of the Medical Research Council and will use a mixed methods embedded design comprising a quasi-experimental trial and a qualitative process ***,a health economic evaluation will be conducted to assess the cost-effectiveness of this complex couplet care ***:Separation of mother-infant dyads after birth has an adverse impact on family health and *** study protocol evaluates a complex couplet care *** this study,a first step is taken to help bridge the gap between current practices and a new care model to prevent the separation of mothers and their infants.

关键词： Complex interventions Couplet care Family-centered care Neonatology Zero separation

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Pipeline Embolization Device for intracranial aneurysms presenting with mass effect:a large Chinese cohort

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Stroke & Vascular Neurology 2024年第1期9卷 50-58页

作者： Yang Zhao Junlin Lu Hongqi Zhang Tianxiao LI Donglei Song Sheng Guan Aisha Maimaitili Yunyan Wang Wenfeng Feng Yang Wang Jieqing Wan Guohua Mao Huaizhang Shi Xinjian Yang Jianmin Liu Yuanli Zhao Department of Neurosurgery Beijing Tiantan HospitalCapital Medical UniversityBeijingChina Department of Neurosurgery Peking University International HospitalBeijingChina Department of Neurosurgery West China HospitalSichuan UniversityChengduSichuanChina Department of Neurosurgery Xuanwu HospitalCapital Medical UniversityBeijingChina Department of Interventional Neuroradiology Zhengzhou University People's HospitalZhengzhouHenanChina Department of Neurosurgery Shanghai Donglei Brain HospitalShanghaiChina Department of Interventional Neuroradiology The First Affiliated Hospital of Zhengzhou UniversityZhengzhouHenanChina Department of Neurosurgery The First Affiliated Hospital of Xinjiang Medical UniversityUrumqiXinjiangChina Department of Neurosurgery Qilu Hospital of Shandong University QingdaoJinanShandongChina Department of Neurosurgery Nanfang HospitalSouthern Medical UniversityGuangzhouGuangdongChina Department of Neurosurgery The First Affiliated Hospital of Nanchang UniversityNanchangJiangxiChina Department of Neurosurgery Renji HospitalSchool of MedicineShanghai Jiao Tong UniversityShanghaiChina Department of Neurosurgery The Second Affiliated Hospital of Nanchang UniversityNanchangJiangxiChina Department of Neurosurgery The First Affiliated Hospital of Harbin Medical UniversityHarbinHeilongjiangChina Department of Neurosurgery Changhai HospitalNaval Medical UniversityShanghaiChina

Background Unruptured intracranial aneurysm treatment aims to reduce the risk of aneurysm rupture and bleeding,relieves symptoms and improve the quality of life for *** study aimed to assess the safety and efficacy of Pipeline Embolization Device(PED,Covidien/Medtronic,Irvine,CA)treatment for intracranial aneurysms presenting with mass effect in real-world *** We selected patients from the PED in China Post-Market Multi-Center Registry Study with mass effect *** study endpoints included postoperative mass effect deterioration and mass effect relief at follow-up(3–36 months).We conducted multivariate analysis to identify factors associated with mass effect *** analyses by aneurysm location,size and form were also *** This study included 218 patients with a mean age of 54.3±11.8 years and a female predominance of 74.0%(162/218).The postoperative mass effect deterioration rate was 9.6%(21/218).During a median follow-up period of 8.4 months,the mass effect relief rate was 71.6%(156/218).Notably,immediate aneurysm occlusion following treatment was significantly associated with mass effect relief(OR 0.392,95%CI,0.170 to 0.907,p=0.029).Subgroup analysis demonstrated that adjunctive coiling contributed to mass effect relief in cavernous aneurysms,while dense embolism impeded symptom relief in aneurysms<10mm and saccular *** Our data confirmed the efficacy of PED in relieving mass *** findings of this study provide support for endovascular treatment to alleviate mass effect in unruptured intracranial *** registration number NCT03831672.

关键词： aneurysm intracranial Irvine

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Individualised evaluation based on pathophysiology for moyamoya vasculopathy:application in surgical revascularisation

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Stroke & Vascular Neurology 2024年第3期9卷 268-278,I0241-I0246页

作者： Xin Zhang Yu Lei Jiabin Su Chao Gao Yanjiang Li Rui Feng Ding Xia Peng Gao Yuxiang Gu Ying Mao Department of Neurosurgery Huashan Hospital Fudan UniversityShanghaiChina Department of Radiology Huashan Hospital Fudan UniversityShanghaiChina

Background Although bypass surgery is an effective treatment for moyamoya vasculopathy(MMV),the incidence of postoperative complications is still *** study aims to introduce a novel evaluating system based on individualised pathophysiology of MMV,and to assess its clinical *** This multicentre,prospective study enrolled adult patients with MMV from Huashan hospital,Fudan university and National Center for Neurological Disorders,China between March 2021 and February *** neuroimages containing structural and functional information were used to evaluate personalised disease severity and fused to localise the surgical field,avoid invalid regions and propose alternative recipient *** recipient artery was further selected intraoperatively by assessing regional haemodynamic and electrophysiological *** preanastomosis and postanastomosis data were compared with assist with the postoperative *** who received such tailored revascularisations were included in the novel group and the others were included in the traditional *** 30-day surgical outcomes and intermediate long-term follow-up were *** Totally 375 patients(145 patients in the novel group and 230 patients in the traditional group)were *** overall complication rate was significantly lower in the novel group(p˂0.001).In detail,both the rates of postoperative infarction(p=0.009)and hyperperfusion syndrome(p=0.010)were significantly *** functional outcomes trended to be more favourable in the novel group,though not significantly(p=0.260).Notably,the proportion of good functional status was higher in the novel group(p=0.009).Interestingly,the preoperative statuses of perfusion and metabolism around the bypass area were significantly correlated with the occurrence of postoperative complications(P˂0.0001).Conclusions This novel evaluating system helps to identify appropriate surgical field and recipient arteries during b

关键词： surgical bypass metabolism

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Chinese Society of Cardiology guidelines on the diagnosis and treatment of adult fulminant myocarditis

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Science China(Life Sciences) 2024年第5期67卷 913-939页

作者： Chinese Society of Cardiology,Chinese Medical Association,Writing Group Jiangang Jiang Hongyang Shu Dao Wen Wang Rutai Hui Chenze Li Xiao Ran Hong Wang Jing Zhang Shaoping Nie Guanglin Cui Dingcheng Xiang Qun Shao Shengyong Xu Discussion experts:Ning Zhou Yuming Li Wei Gao Yuguo Chen Yuan Bian Guoping Wang Liming Xia Yan Wang Chunxia Zhao Zhiren Zhang Yuhua Zhao Jianan Wang Shaoliang Chen Hong Jiang Jing Chen Xianjin Du Mao Chen Yinxian Sun Sheng Li Hu Ding Xueping Ma Hesong Zeng Li Lin Shenghua Zhou Likun Ma Ling Tao Juan Chen Yiwu Zhou Xiaomei Guo 不详 Tongji hospital Tongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030China Fuwai hospital National Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100037China Zhongnan hospital of Wuhan university Wuhan 430062China Fuwai Huazhong Cardiovascular hospital Zhengzhou 450003China Beijing Anzhen hospital Capital Medical UniversityBeijing 100029China Guangzhou General hospital of Guangzhou Military Command Guangzhou 510010China Harbin Medical university Cancer hospital Harbin 150081China Union hospital Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China Taida hospital Tianjin 300457China Peking university Third hospital Beijing 100191China Qilu hospital of Shandong university Jinan 250012China Kanghua hospital DongguanGuangzhou 523080China Second Affiliated hospital Zhejiang university School of Medicine Hangzhou 310003China Nanjing First hospital Nanjing Medical UniversityNanjing 210006China Renmin hospital of Wuhan university Wuhan 430060Wuhan West China hospital Sichuan UniversityChengdu 610044China First hospital of China Medical university Shenyang 110002China General hospital of Ningxia Medical university Yinchuan 750003China The Second Xiangya hospital Central South UniversityChangsha 410012China The First Affiliated hospital of USTC University of Science and Technology of ChinaHefei 230002China The First Affiliated hospital of Air Force Medical university Xi’an 710032China Central hospital of Wuhan City Wuhan 430014China Tongji Medical College Huazhong University of Science and TechnologyWuhan 430030China

Fulminant myocarditis is an acute diffuse inflammatory disease of *** is characterized by acute onset,rapid progress and high risk of *** pathogenesis involves excessive immune activation of the innate immune system and formation of inflammatory *** to China’s practical experience,the adoption of the“life support-based comprehensive treatment regimen”(with mechanical circulation support and immunomodulation therapy as the core)can significantly improve the survival rate and long-term *** emphasis is placed on very early identification,very early diagnosis,very early prediction and very early treatment.

关键词： fulminant myocarditis guidelines life support-based comprehensive treatment regimen diagnosis treatment cytokine storm overactivation of immunity

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Mitochondrial dysfunction and quality control lie at the heart of subarachnoid hemorrhage

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Neural Regeneration Research 2024年第4期19卷 825-832页

作者： Jiatong Zhang Qi Zhu Jie Wang Zheng Peng Zong Zhuang Chunhua Hang Wei Li Department of Neurosurgery Nanjing Drum Tower HospitalAffiliated Hospital of Medical SchoolNanjing University Department of Neurosurgery Nanjing Drum Tower HospitalClinical College of Nanjing Medical University

The dramatic increase in intracranial pressure after subarachnoid hemorrhage leads to a decrease in cerebral perfusion pressure and a reduction in cerebral blood *** are directly affected by direct factors such as ischemia,hypoxia,excitotoxicity,and toxicity of free hemoglobin and its degradation products,which trigger mitochondrial *** mitochondria release large amounts of reactive oxygen species,inflammatory mediators,and apoptotic proteins that activate apoptotic pathways,further damaging *** response to this array of damage,cells have adopted multiple mitochondrial quality control mechanisms through evolution,including mitochondrial protein quality control,mitochondrial dynamics,mitophagy,mitochondrial biogenesis,and intercellular mitochondrial transfer,to maintain mitochondrial homeostasis under pathological *** interventions targeting mitochondrial quality control mechanisms have emerged as promising therapeutic strategies for subarachnoid *** review provides an overview of recent research advances in mitochondrial pathophysiological processes after subarachnoid hemorrhage,particularly mitochondrial quality control *** also presents potential therapeutic strategies to target mitochondrial quality control in subarachnoid hemorrhage.

关键词： mitochondrial biogenesis mitochondrial dynamics mitochondrial dysfunction mitochondrial fission and fusion mitochondrial quality control mitophagy subarachnoid hemorrhage

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Prospective cohort study on facial profile changes in infants with Robin sequence and healthy controls

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World Journal of Pediatrics 2024年第6期20卷 581-589页

作者： Cornelia Wiechers Julian Sowula Karen Kreutzer Christoph E.Schwarz Christina Weismann Michael Krimmel Christian F.Poets Bernd Koos Department of Neonatology Tuebingen University HospitalCalwerstrasse 772076 TuebingenGermany Center for Cleft Lip Palate and Craniofacial MalformationsTuebingen University HospitalTuebingenGermany Department of Orthodontics Tuebingen University HospitalTuebingenGermany Department of Oral and Maxillofacial Surgery Tuebingen University HospitalTuebingenGermany

Background Various conservative and surgical approaches exist to treat Robin sequence(RS),but their effects on facial profile and mandibular catch-up growth are unclear.A functional treatment concept,used in our centre for 25 years,includes an individualized palatal plate with a velo-pharyngeal extension and intensive feeding *** We performed a prospective study to objectively describe facial profiles in infants with RS treated with the above *** with isolated RS were admitted to our tertiary perinatal and national referral centre for craniofacial malformations between May 2018 and Nov *** with RS received 3D-photographs during clinically indicated *** controls were recruited from Dec 2018 to Sep 2019 and received 3D-photographs every 3 *** digitally measured jaw index(JI),defined as alveolar overjet(O)x maxillary arch(U)/mandibular arch(L),and the soft tissue reference points A’-point,Nasion’,B’-point angle(ANB’),describing the relative position of maxilla to mandible,were *** mixed models were used to examine time trajectories in JI and ANB’.Results A total of 2073D images,obtained in 19 infants with RS and 32 controls,were *** and ANB’decreased over time in both groups[for JI−0.18(95%CI−0.25 to−0.10);for ANB’:−0.40°per month[(95%CI−0.48 to−0.32)]]but remained lower in controls[for JI−2.5(95%CI−3.2 to−1.8);for ANB’-1.7°(95%CI−2.4 to−1.0)].Also,the ANB’model showed a significant effect of the interaction term diagnosis x *** Based on longitudinal 3D images,we describe changes in objective parameters of facial profile in infants with and without RS during the first year of *** findings indicate catch-up growth in infants treated for RS.

关键词： Infant Mandibular catch-up growth Pre-epiglottic Baton Plate Robin sequence Three-dimensional photography

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Macrophage exosomes modified by miR-365-2-5p promoted osteoblast osteogenic differentiation by targeting OLFML1

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Regenerative Biomaterials 2024年第3期3卷 134-147页

作者： Caiyao Hou Yujue Zhang Zhaoyong Lv Yurun Luan Jun Li Chunxiu Meng Kun Liu Xin Luo Liyu Chen Fengzhen Liu Department of Materials Science and Engineering Liaocheng UniversityLiaocheng 252000China Liaocheng People's hospital Liaocheng Hospital Affliated Shandong First Medical UniversityLiaocheng 252000China The Second hospital Cheeloo College of MedicineShandong UniversityJinan 250023China

In the bone immune microenvironment,immune cells can regulate osteoblasts through a complex communication *** play a central role in mediating immune osteogenesis,exosomes derived from them have osteogenic regulation and can be used as cariers in bone tissue ***,there are problems with exosomal therapy alone,such as poor targeting,and the content of loaded molecules cannot reach the therapeutic *** this study,macrophage-derived exosomes modified with miR-365-2-5p were developed to accelerate bone ***3T3-E1 cells were incubated with the culture supermatants of Mo,M1 and M2 macrophages,and it was found that the culture medium of M2 macrophages had the most significant effects in contributing to ***-throughput sequencing identified that miR-365-2-5p was significantly expressed in exosomes derived from M2 *** incubated MC3T3-E1 with exosomes overexpressing or kmocking down miR-365-2-5p to examine the biological function of exosome miR-365-2-5p on MC3T3-E1 *** findings suggested that miR-365-2-5p secreted by exosomes increased the osteogenesis of ***,miR-365-2-5p had a direct influence over osteogenesis for *** analysis combined with dual luciferase detection indicated that miR-365-2-5p binded to the 3'-UTR of *** summary,exosomes secreted by M2 macrophages targeted OLFML1 through miR-365-2-5p to facilitate osteogenesis.

关键词： macrophage exosomes osteogenesis osteoimmunology

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Chinese Guidelines for the Diagnosis and Management of Atrial Fibrillation

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Journal of Geriatric Cardiology 2024年第3期21卷 251-314页

作者： Chang-Sheng MA Shu-Lin WU Shao-Wen LIU Ya-Ling HAN Chinese Society of Cardiology Chinese Medical Association Heart Rhythm Committee of Chinese Society of Biomedical Engineering Beijing Anzhen hospital Capital Medical University Guandong Provincial People’s hospital Shanghai First People’s hospital General hospital of Northern Theater Command 不详

Atrial fibrillation(AF)is the most common sustained cardiac arrhythmia,significantly impacting patients’quality of life and increasing the risk of death,stroke,heart failure,and *** the past two decades,there have been significant breakthroughs in AF risk prediction and screening,stroke prevention,rhythm control,catheter ablation,and integrated *** this period,the scale,quality,and experience of AF management in China have greatly improved,providing a solid foundation for the development of guidelines for the diagnosis and management of *** further promote standardized AF management,and apply new technologies and concepts to clinical practice in a timely and comprehensive manner,the Chinese Society of Cardiology of the Chinese Medical Association and the Heart Rhythm Committee of the Chinese Society of Biomedical Engineering have jointly developed the Chinese Guidelines for the Diagnosis and Management of Atrial *** guidelines have comprehensively elaborated on various aspects of AF management and proposed the CHA2DS2-VASc-60 stroke risk score based on the characteristics of AF in the Asian *** guidelines have also reevaluated the clinical application of AF screening,emphasized the significance of early rhythm control,and highlighted the central role of catheter ablation in rhythm control.

关键词： prevention sustained diagnosis

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Effect of cytochrome P4502C19(CYP2C19)gene polymorphism and clopidogrel reactivity on long term prognosis of patients with coronary heart disease after PCI

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Journal of Geriatric Cardiology 2024年第1期21卷 90-103页

作者： Cheng-Yan HU Yan-Ling WANG Zhen-Xing FAN Xi-Peng SUN Shuai WANG Zhi LIU Department of Geriatrics Fu Xing HospitalCapital Medical UniversityBeijingChina Department of Cardiology Xuanwu Hospital Capital Medical UniversityBeijingChina Emergency Department of Xuanwu hospital Capital Medical UniversityBeijingChina

Objective To investigate the impact of CYP2C19 gene polymorphism on clopidogrel reactivity and its association with longterm clinical outcome in patients with coronary heart disease(CHD)undergoing percutaneous coronary intervention(PCI).Methods In total,675 patients were *** on the platelet inhibition rate,patients were categorized into two groups:clopidogrel low responsiveness(CLR)and normal clopidogrel responsiveness(NCR).The CLR group was divided into ticagrelor and clopidogrel group based on the antiplatelet drugs used in the follow-up *** were classified into three groups(normal metabolizer,intermediate metabolizer,and poor metabolizer)based on the CYP2C19 *** aimed to evaluate the impact of CYP2C19 gene polymorphism on clopidogrel *** cumulative rates of 12-month all-cause deaths,major adverse cardiovascular events(MACCEs),and bleeding events were *** CLR was observed in 44.4%of the overall *** differences were observed in the platelet inhibition rate of clopidogrel among the three metabolic genotypes(P0.05).Conclusions Low response to clopidogrel in CHD patients is correlated with CYP2C19 gene ***2C19 genotyping combined with platelet reactivity is an independent predictor of 12-months MACCEs in patients with clopidogrel treatment after PCI,which is better than either test alone.

关键词： CYP2C19 drugs PCI

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Celastrus orbiculatus Extract Inhibits Immune Inflammatory Thrombotic State of B-Lymphoma

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Chinese Journal of Integrative Medicine 2024年第11期30卷 1018-1026页

作者： ZHU Miao SHI Qing-qing NI Jun WU Wei SUN Xing SUN Mei XU Kai-lin LIU Yan-qing GU Jian GU Hao Department of Hematology Clinical Medical Col ege Yangzhou University Yangzhou Institute of Hematology Department of Hematology The Affiliated Hospital of Xuzhou Medical University Department of Oncology The Affiliated Hospital of Yangzhou University Yangzhou University Department of Neurology The Affiliated Brain Hospital of Nanjing Medical University

Objective:To investigate the inhibitory effect of Celastrus orbiculatus extracts（COE） on the proliferation of lymphoma cells and the immune regulation ability on inflammation and thrombophilia in ***:The 38B9 lymphoma cells were treated with COE（160μg/mL） and CTX（25 μmol/L）.The apoptosis rate and cell cycle of each group were detected by flow *** secretion of inflammatory factors,including interleukin（IL）-6,IL-10,and tumor necrosis factor α（TNF-α）,in cell supernatant was detected by enzyme-linked immunosorbent assay（ELISA）.In vivo,BALB/c mice were subcutaneously injected with 38B9 lymphoma cells to establish lymphoma ***(3 mg·kg-1·d-1) and CTX(40 mg-kg-1·d-1) were administered to the model mice,*** expression of plasma inflammatory factors（IL-6,IL-10 and TNF-α） and thrombus indexes,including D-dimer（D-D）,von Willebrand factor（vWF） and tissue factor（TF）,were detected by ELISA before tumor bearing（1 d）,after tumor formation（14 d） and after intervention（21 d）.PicoGreen dsDNA was used to detect the level of serum neutrophil extracellular traps（NETs）.Flow cytometry was used to detect the expression of platelet activation marker calcium-dependent lectin-like receptor 2（CLEC-2）.The tumor growth and survival of mice were ***:The 38B9 lymphoma cells were apoptotic after the intervention of COE and *** ratio of G2-M phase cells decreased in COE intervented cells compared with the control cells（P<0.05）,and S phase cells decreased in CTX intervented cells（P<0.05）.Also,the secretion level of IL-6 was significantly reduced after COE or CTX intervention（P<0.05）,and IL-10 was significantly increased（P<0.05）.Furthermore,the tumor mass was reduced,and the median survival time was longer in COE and CTX intervented tumor-bearing mice than in nonintervented *** significantly lower levels of TNF-α,IL-6,NETs,TF,DD and CLEC-2,as well as higher IL-10 were observed in COE and CTX treatment mice in comparision with the control mice（P

关键词： Celastrus orbiculatus extract immune regulation lymphoma murine lymphoma cells proliferation inhibition thrombotic state tumor inflammation

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