目的 觀察社區康復護理對地震傷截癱患者的療效。 方法 2008年12月－2009年6月，選取都江堰市多家醫院共87例康復期地震傷截癱患者，其中觀察組選取在社區采取康復護理措施的患者，對照組選取在住院期間進行健康宣教和出院時按常規進行出院指導的患者，比較兩組研究對象的日常生活活動能力、并發癥發生率和治療效果。 結果 觀察組日常生活活動能力優于對照組（F=8.042，P=0.009），并發癥發生率低于對照組（泌尿系統感染：χ2=6.464，P=0.011），治療效果優于對照組（U=598.500，P=0.001）。 結論 社區康復護理有利于改善地震傷截癱患者的日常生活活動能力并預防并發癥，對提高患者的生存質量有著十分重要的意義。
In order to standardize and improve the level of TCM diagnosis and treatment of uterine prolapse, the Gynecology Branch of China Association of Traditional Chinese Medicine and the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine took the lead in initiating the revision of the "Guidelines for the TCM diagnosis and treatment of uterine prolapse". Based on the existing relevant literature, the guideline revision working group strictly abides by the principles and steps of evidence-based guideline revision, and establishes a multi-disciplinary and multi-field expert team to standardize the guideline revision work. This plan focuses on the necessity of guideline revision, the establishment and division of labor of the guideline project team, the determination of clinical problems, the screening and evaluation of evidence, and the formation of recommendations.
Objective To investigate a suspected outbreak of hospital-acquired infections caused by Mycobacterium chelonae related to flexible bronchoscope (hereinafter referred to as “bronchofibroscope”) and apply targeted high-throughput sequencing (tNGS) technology for etiological analysis, providing references for controlling hospital infection outbreaks. Methods A retrospective survey of patients who were detected with Mycobacterium chelonae through tNGS testing of bronchoalveolar lavage fluid (BALF) after bronchofibroscopy at the Zhengdong District, People’s Hospital of Henan University of Chinese Medicine, People’s Hospital of Zhengzhou between May 1, 2018 and March 18, 2024. The causes were investigated through comprehensive measures including on-site epidemiological surveys and environmental health assessments, and intervention measures were developed and evaluated for effectiveness. Results A total of 52 patients were included. Mycobacterium chelonae was detected in 30 patients, nosocomial infection was excluded in all cases. The suspicious contaminated bronchofibroscope lavage fluid and its cleaning and disinfection equipment, environment and other samples were collected. The traditional microbial culture results were negative. The tNGS results showed that Mycobacterium chelonae was detected in bronchofibroscope lavage fluid (sequence number 156), and all the patients with Mycobacterium chelonae detected in BALF used the bronchofibroscope. It was judged that this event was a pseudo-outbreak of nosocomial infection caused by the contamination of bronchofibroscope with the patient’s BALF. After three months of continuous follow-up after the comprehensive control measures were taken, Mycobacterium chelonae was not detected by tNGS in bronchofibroscope lavage fluid or patients’ BALF. All patients in the hospital improved and discharged without any new cases. The pseudo-outbreak of nosocomial infection was effectively controlled. Conclusions There are many links in the reprocessing of bronchofibroscope, which is easy to cause pollution, and the management needs to be strengthened. tNGS detection has the characteristics of high efficiency, few background bacteria and clear pathogen spectrum, which can be used as a supplementary means for the investigation of nosocomial infection outbreaks, and is of great significance for identifying the source of infection and determining the transmission route.
ObjectiveTo explore the role of joint regulation of Wnt and bone morphogenetic protein (BMP) signaling pathways in the differentiation of human induced pluripotent stem cells (hiPSCs) into cardiomyocytes.MethodsHiPSCs were cultured and observed under inverted phase contrast microscope. Immunofluorescence staining was used to observe the expressions of hiPSCs pluripotent markers (OCT3/4, NANOG, and TRA-1-60). HiPSCs were passaged which were taken for subsequent experiments within the 35th passage. When the fusion degree of hiPSCs was close to 100%, the CHIR99021 (Wnt pathway activator) was added on the 0th day of differentiation. Different concentrations of IWP4 (inhibitor of Wnt production) were added on the 3rd day of differentiation, and the best concentration of IWP4 was added at different time points. The optimal concentration and the best effective period of IWP4 were obtained by detecting the expression of troponin T (TNNT2) mRNA by real-time fluorescence quantitative PCR. Then, on the basis of adding CHIR99021 and IWP4, different concentrations of BMP-4 were added on the 5th day of differentiation, and the best concentration of BMP-4 was added at different time points. The optimal concentration and best effective period of BMP-4 were obtained by detecting the expression of TNNT2 mRNA. Finally, hiPSCs were divided into three groups: Wnt group, BMP group, and Wnt+BMP group. On the basis of adding CHIR99021 on the 0th day of differentiation, IWP4, BMP-4, and IWP4+BMP-4 were added into Wnt group, BMP group, and Wnt+BMP group respectively according to the screening results. Cells were collected on the 7th and the 15th days of differentiation. The expressions of myocardial precursor cell markers [ISL LIM homeobox 1 (ISL1), NK2 homeobox 5 (NKX2-5)] and cardiomyocyte specific markers [myocyte enhancer factor 2C (MEF2C), myosin light chain 2 (MYL2), MYL7, and TNNT2] were detected by real-time fluorescent quantitative PCR. Cells were collected on the 28th day of differentiation, and the expression of cardiac troponin T (cTnT) was detected by flow cytometry and immunofluorescence staining.ResultsThe results of cell mophology and immunoflurescence staining showed that the OCT3/4, NANOG, and TRA-1-60 were highly expressed in hiPSCs, which suggested that hiPSCs had characteristics of pluripotency. The optimal concentration of IWP4 was 10.0 μmol/L (P<0.05) and the best effective period was the 3rd day (P<0.05) in inducing hiPSCs to differentiate into cardiomyocytes. The optimal concentration of BMP-4 was 20.0 ng/mL (P<0.05) and the best effective period was the 3rd day (P<0.05). The relative expressions of ISL1, NKX2-5, MEF2C, MYL2, MYL7, and TNNT2 mRNAs, the positive expression ratio of cTnT detected by flow cytometry, and sarcomere structure detected by immunofluorescence staining of Wnt+BMP group were superior to those of Wnt group (P<0.05).ConclusionJoint regulation of Wnt and BMP signaling pathways can improve the differentiation efficiency of hiPSCs into cardiomyocytes.