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Objective To compare the analgesic effect of nalbuphine and sufentanil in preventing catheter-related bladder discomfort (CRBD) after transurethral ureteroscopic lithotripsy. Methods A total of 158 male patients undergoing transurethral ureteroscopic lithotripsy with general anesthesia, classified with American Society of Anesthesiologists (ASA) physical status as grade Ⅰ to Ⅲ, aged from 25 to 65 years old, were selected as subjects. Patients were randomly divided into two groups with 79 in each group: nalbuphine group (group N) and sufentanil group (group S). Patients in group N were treated with 0.2 mg/kg nalbuphine, while those in group S were treated with 0.2 μg/kg sufentanil at the induction of general anesthesia. The other procedures and drugs for anesthesia induction and maintenance were same in two groups. The frequency and severity of CRBD postoperatively, Ramsay sedation score, respiratory depression and postoperative nausea and vomiting were examined at 0 min (T0), 10 min(T1), 20 min (T2), 30 min (T3), and 1 h (T4) after recovery from general anesthesia. Results The incidence of CRBD at T3 and T4 were significantly higher than that at T0 in two groups. Compared with group S, the incidence and severity of CRBD were significantly lower in group N at T3(P＜0.05), and the Ramsay sedation score was higher in group N at T3 (P＜0.05). However, the incidence of postoperative adverse reactions was not significantly different between the two groups. Conclusions Nalbuphine used for induction of general anesthesia, can effectively reduce the incidence and severity of CRBD in male patients after transurethral ureteroscopic lithotripsy during anesthesia recovery period with fewer adverse reactions.

Considering that many hydrological analysis methods compare and analyze the runoff before and after the construction of the reservoir, without restoring the measured data of the hydrological station, in this case, when the length of the measured data series is short, the evaluation results will be affected. In this article, based on the runoff reduction of stations affected by water conservancy projects, an improved range of variability approach (RVA) which can be applied to 1-year hydrological change analysis is proposed by coupling the hydrological variation index with the appropriate upper and lower limit theory of RVA. As Jialing river watershed is selected as the research area, the runoff depth of Beibei station is reduced, and then the improved RVA is employed to analyze the degree of change in river water regime. It is concluded that the change degree of overall hydrological index in Beibei station is high, and the prediction of variation of water regime of Beibei station can be made with the aid of simulating the operation of cascade reservoirs, with the inflow of Beibei station in flood season to reduce, and the inflow in dry season to increase. The example verifies the effectiveness of the improved RVA method, and the analysis results can provide a reference for the adjustment of the operation mode of upstream cascade reservoirs.

Bacterial biofilm infection is a serious obstacle to clinical therapeutics. Photodynamic therapy (PDT) plays a dynamic role in combating biofilm infection by utilizing reactive oxygen species (ROS)-induced bacterial oxidation injury, showing advantages of mild side effects, spatiotemporal controllability and little drug resistance. However, superfluous glutathione (GSH) present in biofilm and bacteria corporately reduces ROS levels and seriously affects PDT efficiency. Herein, we have constructed a Cu2+-infused porphyrin metal–organic framework (MOF@Cu2+) for the enhanced photodynamic combating of biofilm infection by the maximum depletion of GSH. Our results show that the released Cu2+ from porphyrin MOF@Cu2+ could not only oxidize GSH in biofilm but also consume GSH leaked from ROS-destroyed bacteria, thus greatly weakening the antioxidant system in biofilm and bacteria and dramatically improving the ROS levels. As expected, our dual-enhanced PDT nanoplatform exhibits a strong biofilm eradication ability both in vitro and in an in vivo biofilm-infected mouse model. In addition, Cu2+ can promote biofilm-infected wound closing by provoking cell immigration, collagen sediment and angiogenesis. Besides, no apparent toxicity was detected after treatment with MOF@Cu2+. Overall, our design offers a new paradigm for photodynamic combating biofilm infection. [ABSTRACT FROM AUTHOR]

Background: Coronavirus disease 2019 (COVID-19) may predispose patients to thrombotic disease in the venous and arterial circulations. Methods: Based on the current debate on antiplatelet therapy in COVID-19 patients, we performed a systematic review and meta-analysis to investigate the effect of antiplatelet treatments. We searched PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and Web of Science on February 1, 2023, and only included Randomized clinical trials. The study followed PRISMA guidelines and used Random-effects models to estimate the pooled percentage and its 95% CI. Results: Five unique eligible studies were included, covering 17,950 patients with COVID-19. The result showed no statistically significant difference in the relative risk of all-cause death in antiplatelet therapy versus non-antiplatelet therapy (RR 0.94, 95% CI, 0.83–1.05, P = 0.26, I2 = 32%). Compared to no antiplatelet therapy, patients who received antiplatelet therapy had a significantly increased relative risk of major bleeding (RR 1.81, 95%CI 1.09–3.00, P = 0.02, I2 = 16%). The sequential analysis suggests that more RCTs are needed to draw more accurate conclusions. This systematic review and meta-analysis revealed that the use of antiplatelet agents exhibited no significant benefit on all-cause death, and the upper bound of the confidence interval on all-cause death (RR 95% CI, 0.83–1.05) suggested that it was unlikely to be a substantiated harm risk associated with this treatment. However, evidence from all RCTs suggested a high risk of major bleeding in antiplatelet agent treatments. Conclusion: According to the results of our sequential analysis, there is not enough evidence available to support or negate the use of antiplatelet agents in COVID-19 cases. The results of ongoing and future well-designed, large, randomized clinical trials are needed. [ABSTRACT FROM AUTHOR]

Aim: To examine how the effects of hardiness, self‐efficacy and positive academic emotion related to the SRL ability of undergraduate nursing students. Design: A cross‐sectional survey was designed. Methods: A total of 395 Chinese undergraduate nursing students from two undergraduate colleges filled out the questionnaires from May to June 2019. The relationships between hardiness, self‐efficacy, positive academic emotion and SRL ability were analysed by structural equation modelling. Results: The response rate was 94.05%. SRL ability was significantly positive correlated with hardiness, self‐efficacy and positive academic emotion in undergraduate nursing students. Self‐efficacy (β = 0.417, p < 0.001) and positive academic emotion (β = 0.232, p < 0.001) showed a direct effect on the SRL ability. Although hardiness showed no direct effect on the SRL ability, it affected SRL ability through three indirect ways: self‐efficacy (77.778%), positive academic emotion (14.184%) and the chain mediating effect from self‐efficacy to positive academic emotion (8.038%). Conclusions: Nursing students with a higher level of hardiness would have higher self‐efficacy, and more positive and stable academic emotions to obtain the better SRL ability. The produced model provides insights into several factors associated with SRL ability of nursing students. Hardiness, self‐efficacy and positive academic emotion should be emphasized in the education of nursing students because these factors could improve their SRL ability and promote their life‐long learning. [ABSTRACT FROM AUTHOR]

Highly b‐oriented MFI zeolite (abbreviated as BOMZ) membranes are attractive due to less grain boundary defects and straight channels normal to the substrate, enhancing selectivity and flux in membrane separation. Herein, we demonstrate a novel, effective and easily‐amplified printing‐transfer oriented‐seed‐layer technique to manufacture uniform BOMZ seed monolayer on porous supports. Furthermore, a facile and effective approach for the synthesis of highly BOMZ membranes by introducing poly(hexamethylene biguanide) hydrochloride as a twin crystal inhibitor during seeded growth is demonstrated. Well‐intergrown BOMZ membranes (∼650 nm thick) obtained on porous Al2O3 supports show a flux of 2.8 kg m−2 h−1 with a separation factor as high as 71 for pervaporation in the 60 °C feed of EtOH/H2O (5 wt%), which is much higher than those of random membranes. The developed seed assembly technique on porous supports underlines great potential for facile preparation of oriented seed layers on porous supports. [ABSTRACT FROM AUTHOR]

Vascular endothelial growth factor receptor 2 (VEGFR2)/KDR plays a critical role in tumor growth, diffusion, and invasion. The amino acid sequence homology of KDR between mouse and human in the VEGF ligand‐binding domain was low, thus the WT mice could not be used to evaluate Abs against human KDR, and the lack of a suitable mouse model hindered both basic research and drug developments. Using the CRISPR/Cas9 technique, we successfully inserted different fragments of the human KDR coding sequence into the chromosomal mouse Kdr exon 4 locus to obtain an hKDR humanized mouse that can be used to evaluate the marketed Ab ramucirumab. In addition, the humanized mAb VEGFR‐HK19 was developed, and a series of comparative assays with ramucirumab as the benchmark revealed that VEGFR‐HK19 has higher affinity and superior antiproliferation activity. Moreover, VEGFR‐HK19 selectively inhibited tumor growth in the hKDR mouse model but not in WT mice. The most important binding epitopes of VEGFR2‐HK19 are D257, L313, and T315, located in the VEGF binding region. Therefore, the VEGFR2‐HK19 Ab inhibits tumor growth by blocking VEGF‐induced angiogenesis, inflammation, and promoting apoptosis. To our best knowledge, this novel humanized KDR mouse fills the gaps both in an animal model and the suitable in vivo evaluation method for developing antiangiogenesis therapies in the future, and the newly established humanized Ab is expected to be a drug candidate possibly benefitting tumor patients. [ABSTRACT FROM AUTHOR]

Objective: To explore how the timing of the initial dressing change influences bacterial growth when alginate dressings were used after peripherally inserted central catheter (PICC) line insertion in tumor patients. Methods: In total, 186 tumor patients who had an alginate dressing after PICC insertion were randomly divided into a control group, observation group one (OG1), and observation group two (OG2). The control group had their first dressing change 48 h after PICC insertion, while OG1 was after 72 h and OG2 was after 96 h after. Samples were taken at the dressing change from the insertion site and surrounding skin. The results of the bacterial culture were compared to investigate how the timing of the first dressing change affected catheter infection. Results: Of the 186 patients, 29 had a positive bacterial culture. Of these, 10 were in the control group, 9 were in OG1, and 10 were in OG2. IBM SPSS Statistics 21.0 was adopted to analyze the correlation between the timing of the first dressing change and insertion site infection. No statistical significance between the timing of the first dressing change and insertion site infections was found (P > 0.05). Conclusions: The condition of each tumor patient should be comprehensively evaluated after PICC placement to determine when the first dressing change should occur, but it can likely be extended to 96 h after insertion to promote wound healing, reduce clinical workload, and lower patient economic burden. [ABSTRACT FROM AUTHOR]

Aim: To assess the influence of professional identity on work engagement among nurses working in nursing homes in China. Background: China is faced with an increasingly ageing population. There is a shortage of adequately trained nursing personnel and a high turnover rate among nurses. Work engagement is a key factor in improving nurses' performance and improving professional identity is critical to increase work productivity and satisfaction. Methods: We conducted a cross‐sectional survey of 272 nurses working in nursing homes. And the data were analysed by descriptive analyses, univariate analysis and Multiple regression analyses. Results: The overall average work engagement score was 3.99 ± 1.04. Professional identity was the only factor that significantly influenced the 'vigour' and 'absorption' of nurses. Age, ethnicity and professional identity were significant predictors of 'dedication'. Conclusions: A positive professional identity can lead to a better work engagement among nurses working in nursing homes in China. Implications for Nursing Management: To enhance the work engagement of nurses working in nursing homes, nursing leaders should create a respectful and equal work environment, create a favourable image of the industry and the profession and strengthen training to improve the professional identity. [ABSTRACT FROM AUTHOR]

Intensive efforts have been made to develop models of hRSV infection or disease using various animals. However, the limitations such as semi-permissiveness and short duration of infection have impeded their applications in both the pathogenesis of hRSV and therapeutics development. Here, we present a mouse model based on a Rag2 gene knockout using CRISPR/Cas9 technology. Rag2−/− mice sustained high viral loads upon intranasal inoculation with hRSV. The average peak titer rapidly reached 1 × 109.8 copies/g and 1c106 TCID50 in nasal cavity, as well as 1 × 108 copies/g and 1 × 105 TCID50 in the lungs up to 5 weeks. Mild interstitial pneumonia, severe bronchopneumonia, elevated cytokines and NK cells were seen in Rag2−/− mice. A humanized monoclonal antibody showed strong antiviral activity in this animal model, implying that Rag2−/− mice that support long-term stable infection are a useful tool for studying the transmission and pathogenesis of human RSV, as well as evaluating therapeutics. [ABSTRACT FROM AUTHOR]