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To assess the feasibility of percutaneous pedicle screw fixation assisted by a fully automated orthopedic robotic system for the treatment of isthmic spondylolisthesis and evaluate its early postoperative outcome. Totally 20 patients with isthmic spondylolisthesis who underwent surgical procedure by the same medical group from March 2020 to March 2023 were retrospectively analyzed, including 10 patients in the robot-assisted group (RA group) and the other 10 patients in the conventional free-hand technique group (FH group). Accuracy of screw insertion was determined using the Gertzbein-Robbins Scale. The accuracy of the novel robotic system was evaluated by comparing the screw position in the preoperative planning and measuring the entry point deviation distance and the trajectory rotation. The differences in operative time, intraoperative blood loss, radiographic fluoroscopy time and fluoroscopic dosage, and length of hospital stay were compared between the two groups. The lumbar visual analog scale scores before and 7 days after operation were analyzed to evaluate the improvement of low back pain as the early postoperative outcome. A total of 84 pedicle screws were placed. In the RA group, 97.5% of screws were Grade A, and 2.5% were Grade B. In the FH group, 88.6% of screws were Grade A, 9.1% were Grade B, and 2.3% were Grade C. No statistical difference was found in the operation time between two groups. The RA group showed a significant reduction in intraoperative blood loss, radiographic fluoroscopy time and fluoroscopic dosage, and length of hospital stay compared to the FH group. The low back pain in both groups was significantly improved after the operation. The novel orthopedic robotic system-assisted percutaneous pedicle screw fixation, with accurate intraoperative screw placement, less surgical damage, less fluoroscopy and shorter length of hospital stay, can be safe and effective for the surgical treatment of isthmic spondylolisthesis.

Background. Few large‐sample studies have examined the use of fecal management systems (FMSs) in intensive care units (ICUs) or evaluated the associated complications. This study aims to assess the effectiveness and safety of FMS for stool diversion in ICU patients with fecal incontinence (FI). Methods. We enrolled 381 FI patients, assigning them to either an FMS group (n = 134), which used a fecal management device, or a usual care (UC) group (n = 247) that received standard care including regular perianal cleaning. Results. The FMS group reported lower incidence and severity of incontinence‐associated dermatitis (IAD) and higher Braden Scale scores (10.42 ± 2.77) compared to the UC group (9.71 ± 2.56), indicating reduced pressure ulcer risk. Notably, FMS‐associated complications were minimal, with only 5 patients (3.73%) affected; one required surgical intervention for rectal mucosal bleeding. Conclusions. FMS significantly reduced stool‐associated skin irritation, lowered the incidence of IAD and pressure injuries, and improved nurses' convenience compared to UC. [ABSTRACT FROM AUTHOR]

Complex pathophysiological the specific mechanism of sepsis on CD4+ T-cell responses is less well understood. IL1 receptor accessory protein (IL1RAP) was found to be involved in activating host immune responses. Cecum ligation and puncture (CLP) was utilized to build a mouse sepsis model. The experiment was randomly divided into four groups: Sham, CLP, CLP + shNC, and CLP + shIL1RAP group. qRT-PCR suggested mRNA levels of IL1RAP were decreased when IL1RAP was knocked down with the mRNA levels of IL-1β, NF-κB, and p38 decreased. Histopathology showed severe pathological damage with alveolar integrity lost, red blood cells in the alveoli, massive inflammatory cell infiltration, and the alveolar wall was thickening in the CLP group. The inflammatory cytokine levels of TNF-α, IL-1β, and IFN-γ were elevated in CLP mice by ELISA. The counts of CD4+ T cells were decreased in sepsis mice in peripheral blood, spleen, and BALF by flow cytometry. However, the above was blocked down when using shIL1RAP. Western blot suggested sh IL1RAP inhibited IL-1β, NF-κB, and p38 protein expressions. We defined IL1RAP as a new target gene through NF-κB/MAPK pathways regulating CD4+ T lymphocyte differentiation mediated the progression of sepsis, which is potentially exploitable for immunotherapy. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study is to investigate the effects of emergency nursing interventions, specifically those based on the Pediatric Early Warning Score (PEWS), on children diagnosed with acute asthma, to promote the recovery of children with asthma and improve the quality of care for children with asthma., Methods: A total of 80 children, Acute asthma attacks under the age of 12, diagnosed with acute asthma and admitted to the Emergency Department of Hebei Children's Hospital between June 2018 and June 2019 were selected as participants for this study. They were randomly assigned to either the control group or the PEWS group. There was no significant statistical difference in age, gender, course of disease, and disease severity between the two groups of children. In the control group, children received standard emergency nursing interventions, while in the PEWS group, children received emergency nursing interventions based on the Pediatric Early Warning Score (PEWS). To evaluate the effectiveness of these interventions, several outcome measures were compared between the two groups. This included assessing the duration for symptoms to disappear, analyzing pulmonary function indicators and respiratory dynamics indicators, measuring scores from the Pediatric Asthma Quality of Life Questionnaire (PAQLQ), and evaluating nursing satisfaction., Results: Following the implementation of the nursing interventions, 1. The average cough disappearance time of children in the PEWS group was 1.97 days shorter than that in the control group, the average wheezing disappearance time was 0.97 days shorter, the average dyspnea disappearance time was 0.64 days shorter, and the average lung wheezing disappearance time was 1.19 days shorter, which indicated that emergency care based on PEWS shortened the duration of symptoms in children with asthma. 2. The average FEV1 of children in the PEWS group was 9.87% higher than the control group, the average FVC was 0.62L higher, the average PEF was 9.84% higher, the average V70 was 0.91% higher, the average V50 was 0.43% higher , and the average V25 was 0.37% higher, when compared with control group. These results indicates that emergency care based on PEWS enhances the lung function of children with asthma. 3. The average respiratory rate of children in the PEWS group was 8.05 times/min lower, and the average dynamic respiratory system compliance was 6.91 mL/cmH2O higher, than that in the control group, which indicated that emergency care based on PEWS improved respiratory dynamics indicators in children with asthma. 4. The average PAQLQ symptom dimension score of children in the PEWS group was 0.84 points higher, the average activity dimension score was 0.34 points higher, and the average emotional dimension score was 0.47 points higher when compared with the control group. This indicated that emergency care based on PEWS improves the quality of life of children with asthma. 5. The nursing satisfaction of children in the PEWS group was 95%, higher than 72.5% in the control group, indicating that emergency care based on PEWS improved the satisfaction of asthma children with the nursing process., Conclusion: The implementation of PEWS based emergency care in pediatric asthma patients has important clinical significance in promoting recovery and improving the quality of care for asthma patients. The implementation of emergency nursing interventions based on the Pediatric Early Warning Score (PEWS) for children with acute asthma has been found to be effective in promoting the recovery of their condition, enhancing their quality of life, and improving nursing satisfaction.

Background: Complex pathophysiological the specific mechanism of sepsis on CD4 + T-cell responses is less well understood. IL1 receptor accessory protein (IL1RAP) was found to be involved in activating host immune responses., Method: Cecum ligation and puncture (CLP) was utilized to build a mouse sepsis model. The experiment was randomly divided into four groups: Sham, CLP, CLP + shNC, and CLP + shIL1RAP group., Results: qRT-PCR suggested mRNA levels of IL1RAP were decreased when IL1RAP was knocked down with the mRNA levels of IL-1β, NF-κB, and p38 decreased. Histopathology showed severe pathological damage with alveolar integrity lost, red blood cells in the alveoli, massive inflammatory cell infiltration, and the alveolar wall was thickening in the CLP group. The inflammatory cytokine levels of TNF-α, IL-1β, and IFN-γ were elevated in CLP mice by ELISA. The counts of CD4 + T cells were decreased in sepsis mice in peripheral blood, spleen, and BALF by flow cytometry. However, the above was blocked down when using shIL1RAP. Western blot suggested sh IL1RAP inhibited IL-1β, NF-κB, and p38 protein expressions., Conclusions: We defined IL1RAP as a new target gene through NF-κB/MAPK pathways regulating CD4 + T lymphocyte differentiation mediated the progression of sepsis, which is potentially exploitable for immunotherapy.

Background: Oxidative stress and neuronal apoptosis have important roles in the pathogenesis after intracerebral hemorrhage (ICH). Previous studies have reported that low-density lipoprotein receptor-related protein 6 (LRP6) exerts neuroprotection in several neurological diseases. Herein, we investigate the role of LRP6 receptor activation with HLY78 to attenuate oxidative stress and neuronal apoptosis after ICH, as well as the underlying mechanism., Methods: A total of 199 CD1 mice were used. ICH was induced via injection of autologous blood into the right basal ganglia. HLY78 was administered via intranasal injection at 1 h after ICH. To explore the underlying mechanism, LRP6 siRNA and selisistat, a Sirt1 selective antagonist, were injected intracerebroventricularly at 48 h before ICH induction. Neurobehavioral tests, Western blot, and immunofluorescence staining were performed., Results: The expression of endogenous p-LRP6 was gradually increased and expressed on neurons after ICH. HLY78 significantly improved the short- and long-term neurobehavioral deficits after ICH, which was accompanied with decreased oxidative stress and neuronal apoptosis, as well as increased expression of p-GSK3 β , Sirt1, and PGC-1 α , as well as downregulation of Romo-1 and C-Caspase-3. LRP6 knockdown or Sirt1 inhibition abolished these effects of HLY78 after ICH., Conclusion: Our results suggest that administration of HLY78 attenuated oxidative stress, neuronal apoptosis, and neurobehavioral impairments through the LRP6/GSK3 β /Sirt1/PGC-1 α signaling pathway after ICH., Competing Interests: The authors declare that they have no conflict of interest., (Copyright © 2022 Peng Jin et al.)

Objective: The Cycle of Willis unites the internal carotid and vertebrobasilar system and maintains the stability of blood supply to the brain. This present study aims to analyze the anatomic variations in the anterior part of the Cycle of Willis., Methods: Forty five formalin-preserved human brains (90 cerebral hemispheres) with intact dura mater from Chinese adults were dissected under the surgical microscope. The anterior components of the Circle of Willis were observed and measured. Anatomic variations of this segment were observed and photographed. The data collected in this investigation was statistically analyzed., Results: In approximately 13.3% (6/45) of all cerebral samples, a caliber difference of ≥ 0.5 mm was noted between the left A1 and the right segments. The A2 segments of left and right hemispheres were derived from the contralateral A1 segment in 6.7% (3/45) of the brain specimens. Simple anterior communicating artery (ACoA) was observed in 37.8% (17/45) whereas complex ACoA was noted in 60% (27/45) of cerebral samples., Conclusion: As it demonstrates the anatomic variations of ACAC, all surgical approaches should be performed after angiographic demonstrations. Understanding of these anatomic variations plays a pivotal role in neurovascular procedures.