Abstract:Rehabilitation robot is a kind of device that combines robot technology with medical technology and is designed to assist rehabilitation training of individuals with impaired motor functions. It is widely used in the rehabilitation treatment of stroke, spinal cord injury, and other diseases. This paper summarizes the classification of rehabilitation robots from the clinical perspective, and analyzes the clinical application of rehabilitation robots in recent years. Currently, rehabilitation robots have shown promising outcomes in the fields of stroke and spinal cord injury, and their integration and innovation with various technologies have significantly enhanced their efficiency and precision. In the evolving landscape dominated by clinical research, patients, rehabilitation therapists, engineers, and physicians all play pivotal roles. The application and promotion of rehabilitation robots in clinical practice still face many challenges, but also have great development potential.

Abstract:Objective To search and summarize the evidence of dyslipidemia management in patients with ischemic stroke. Methods According to the evidence-based problem identified by the PIPOST model, the guidelines, expert consensus, systematic review, and evidence summary about the management of dyslipidemia in ischemic stroke were retrieved in the National Institute for Health and Care Excellence and other related guide networks, American Stroke Association, European Stroke Organisation and other professional associations, and PubMed, Cochrance Library, CNKI and other databases from inception until Sep. 30, 2023. Two researchers evaluated the quality of the literatures and extracted the evidence according to the Australia Joanna Briggs Institute evidence-based health care center tools. Results A total of 2 630 articles were retrieved, and 18 articles were included through preliminary screening and re-screening, including 13 guidelines and 5 expert consensus. Twenty-eight pieces of evidence were summarized from 5 aspects: evaluation, management objectives, drug intervention, non-drug intervention, and follow-up management. Conclusion The summary of evidence for the management of dyslipidemia in patients with ischemic stroke can provide evidence-based basis for clinical practice.

Abstract:Objective To evaluate the effect of problem-solving quality control circle (QCC) in regulating the use of antiplatelet agents in patients with acute ischemic stroke (AIS) after endovascular treatment. Methods A QCC was established, and the theme of the activity was “shortening the sequential treatment time of antiplatelet agents in AIS patients after endovascular treatment”. From Jan. 2019 to Dec. 2020 (before the implementation of the QCC), 121 AIS patients who underwent mechanical thrombectomy and bridging sequential treatment of antiplatelet agents in our center were enrolled. The main factors affecting the time of sequential treatment of antiplatelet agents were analyzed, and the QCC intervention measures for improving the current situation were proposed. In addition, 95 AIS patients who received the same treatment in our center from Jan. to Dec. 2021 (after the implementation of the QCC) were enrolled to implement the intervention measures of problem-solving QCC, and the application was evaluated and analyzed. Results There were no significant differences in age, gender, admission National Institutes of Health stroke scale score, or onset-to-recanalization time between the pre- and post-QCC groups (all P＞0.05). Before the implementation of the QCC, the duration of drug interruption was 133 (110, 175) min, the sequential treatment time was 367 (183, 496) min, and the non-compliance rate of sequential treatment time was 45.5% (55/121). According to Plato’s 80/20 rule, the main reasons for the non-compliance of sequential treatment time were long waiting time for computed tomography (CT) examination (36.4%, 20/55), waiting time for interpretation of CT results ＞60 min (27.3%, 15/55), and nurses not knowing the patients’ oral medication time (20.0%, 11/55). After the implementation of the QCC, the duration of drug interruption was 38 (25, 71) min, the sequential treatment time was 257 (210, 298) min, and the non-compliance rate of sequential treatment time was 7.4% (7/95), which were significantly different from those before the implementation of the QCC (all P＜0.001). Before and after the implementation of the QCC, 3 and 2 patients had symptomatic intracranial hemorrhage within 7 d of sequential treatment, and the difference was not significant (P＞0.05); there was no gastrointestinal bleeding within 7 d of sequential treatment. Conclusion The application of problem-solving QCC can standardize the administration process of antiplatelet agents for AIS patients after mechanical thrombectomy, shorten the duration of drug interruption of patients, specify the bridging time of oral drugs, and improve the medication safety of patients.

Abstract:Objective To construct an on-the-job training program for brain and heart health managers, so as to provide reference for their training. Methods According to the documents on the construction and development of stroke centers and the responsibilities of brain and heart health managers issued by the Stroke Prevention and Treatment Engineering Committee of National Health Commission of China, a preliminary draft of the training program for brain and heart health managers was constructed by literature review and group discussion, considering the training status of brain and heart health managers in China. Delphi method was used to consult 15 experts from 9 tertiary first-class hospitals in 6 provinces on stroke treatment, nursing, management, and education to further form an on-the-job training program for brain and heart health managers. Results A total of 2 rounds of expert consultation were conducted. The effective response rates of the 2 rounds of expert consultation questionnaires were 100%, and the expert authority coefficients were 0.913 and 0.917, respectively. The final on-the-job training program for brain and heart health managers was formed, including training conditions of access (9 items), training objectives (5 items), training content (3 level-1 items, 8 level-2 items, and 39 level-3 items), and training methods and evaluation (4 level-1 items and 10 level-2 items). Conclusion The on-the-job training program for brain and heart health managers in this study is scientific and reliable, and can provide guidance and reference for standardized job training for brain and heart health managers; however, it needs further improvement.

Abstract:Objective To establish a multidisciplinary team (MDT)-based management program for the prevention and control of multi-drug resistant organism (MDRO) infection in cerebrovascular intensive care unit (ICU) and to evaluate its efficacy. Methods A total of 161 patients with cerebrovascular diseases, who met the admission criteria and were admitted to the ICU of Department of Cerebrovascular Medicine of The First Affiliated Hospital of Naval Medical University (Second Military Medical University), were enrolled using convenience sampling method. Among them, 79 patients (admitted from Jan. to Jun. 2022) were in control group and 82 patients (admitted from Sep. 2022 to Feb. 2023) were in intervention group. The control group received routine infection control management, while the intervention group received the MDRO infection prevention and control management program based on MDT in ICU of cerebrovascular medicine departments. The incidence of MDRO infection of the patients and the compliance rates of MDRO prevention and control measures (including the implementation of isolation measures, isolation medical orders, isolation identification and disinfection measures of the patients, and the hand hygiene implementation and awareness of MDRO prevention and control knowledge of medical staff) were analyzed and compared between the 2 groups. Results In the intervention group, the incidence of MDRO infection was significantly decreased from 45.57% (36/79) in the control group to 28.05% (23/82) (P＜0.05); the compliance rates of implementation of isolation measures, isolation medical orders, isolation identification and disinfection measures of the patients, and hand hygiene implementation and awareness of MDRO prevention and control knowledge of medical staff were significantly increased from 79.63% (86/108), 70.51% (55/78), 76.47% (78/102), 71.32% (97/136), 86.28% (283/328), and 82.24% (125/152) to 92.00% (69/75), 90.00% (63/70), 92.50% (74/80), 93.48% (86/92), 92.66% (265/286), and 93.91% (108/115), respectively (all P＜0.05). Conclusion MDT-based MDRO infection prevention and control management program can effectively reduce MDRO infection in ICU of cerebrovascular medicine departments and improve the compliance of MDRO nosocomial infection prevention and control.

Abstract:Objective To investigate the application of a new delivery balloon dilation catheter (Fastunnel catheter) in the interventional treatment of intracranial atherosclerotic stenosis. Methods From Nov. 2022 to Feb. 2023, 10 patients with intracranial atherosclerotic stenosis were treated with balloon dilatation and stenting using Fastunnel catheter in our center. The application value of Fastunnel catheter was evaluated by collecting and analyzing the baseline information, imaging characteristics, treatment, and perioperative complications of the patients. Results There were 6 males and 4 females, with an average age of (62.7±6.7) years old. All the 10 patients were successfully treated with surgery. The operation duration was 16-65 (37.3±18.2) min, the radiation exposure time was 9-23 (15.9±4.7) min, the radiation dose was 1 381-4 901 (2 643.7±1 131.7) mGy, and the dose area product was 5 707-38 112 (17 526.8±10 809.5) μGy·m². None of the 10 patients had bleeding- or ischemia-related complications during the perioperative period. Conclusion Fastunnel catheters have good safety for intracranial artery stenosis, can effectively simplify the operation procedure, and have advantages in shortening the operation time and reducing the radiation exposure of doctors and patients.

Abstract:Objective To develop an efficient exosome-based delivery method to effectively transport therapeutic nucleic acid to liver cancer tissue for the treatment of primary hepatic cancer. Methods HEK293T cells were transfected with a recombinant plasmid expressing SP94 and CD47, and the exosomes were extracted and isolated. Exosomes were identified by transmission electron microscope, nanometer particle tracking analysis, and Western blotting. The mice were injected with 200 μg DiD labeled unmodified exosomes and SP94 modified exosomes via tail vein, and the targeting effect of exosomes on liver cancer tissue was detected and analyzed using small animal in vivo imaging. The unmodified exosomes and CD47 modified exosomes were incubated with macrophages (RAW264.7) and mouse hepatoma cells (Hepa1-6) to verify the phagocytosis of the modified exosomes by the cells. Polo-like kinase 1 (PLK1) small interfering RNA (siRNA) was loaded into different modified exosomes by electroporation and then the exosomes were co-incubated with Hepal-6 cells, and the cell apoptosis was detected by flow cytometry. The modified exosomes loaded with PLK1 siRNA were injected into the tail vein to systematically study and analyze the therapeutic effect of PLK1 siRNA on primary hepatic cancer in mice. Results SP94 modification enhanced the targeting effect of exosomes on liver cancer tissue, and CD47 modification reduced the phagocytosis of exosomes by macrophages. PLK1 siRNA delivered by SP94 and CD47 double-modified exosomes increased the apoptosis of hepatoma cells. In the primary hepatic cancer mice, SP94 and CD47 double-modified exosomes loaded with PLK1 siRNA could effectively inhibit the growth of liver cancer nodules and prolong the survival time of tumor-bearing mice. Conclusion SP94 and CD47 double-modified exosomes can efficiently deliver therapeutic nucleic acid PLK1 siRNA to target liver cancer and effectively inhibit the growth of liver cancer.

Abstract:Objective To establish an inflammation model in neonatal SD rats and to explore the mechanism by which microRNA-219 (miR-219) promotes oligodendrocyte maturation. Methods Sixty SD rats were randomly assigned to control group, lipopolysaccharide ［LPS］ group (LPS 0.15 mg/kg, intraperitoneal injection), LPS＋miR-219 agomir group (LPS 0.15 mg/kg, intraperitoneal injection; miR-219 agomir 3 μL, intraventricular injection), miR-219 antagomir group (miR-219 antagomir 3 μL, intraventricular injection), or LPS＋miR-219 agomir＋U0126 group (LPS 0.15 mg/kg, intraperitoneal injection; miR-219 agomir 3 μL, intraventricular injection; U0126 30 mg/kg, intraperitoneal injection). The rats were sacrified on the 7^th and 14^th day of life and the brain tissue was harvested. The expression levels of miR-219 and inflammatory factors interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) mRNA were detected by quantitative polymerase chain reaction. The expression levels of myelin basic protein (MBP) and extracellular signal-regulated kinase 1/2 (ERK 1/2) were detected by Western blotting. The number of oligodendrocytes in the corpus callosum was observed by immunofluorescence. Results Compared with the control group, the expression levels of IL-1β and TNF-α mRNA were significantly increased after intraperitoneal injection of LPS in rats (both P＜0.01), and the expression of miR-219 was significantly decreased (P＜0.01). Compared with the LPS group, the expression levels of MBP and ERK 1/2 were significantly increased after miR-219 agomir was used to enhance the expression of miR-219 in the brain of rats (both P＜0.01), with increased oligodendrocytes in the corpus callosum. Compared with the control group, the expression levels of MBP and ERK 1/2 were significantly decreased after miR-219 antagomir was used to reduce the expression of miR-219 in the brain of rats (both P＜0.01), with decreased oligodendrocytes in the corpus callosum. After treatment with the ERK 1/2 pathway inhibitor U0126, the maturation promoting effect of miR-219 on oligodendrocytes was significantly inhibited (P＜0.01). Conclusion miR-219 can promote the maturation of oligodendrocytes in rat brain through the ERK 1/2 pathway.

Abstract:Objective To investigate the knowledge of mood disorders and attitude towards the treatment of mood disorders among community residents in Shanghai, Wuhan, Harbin and Shenzhen. Methods From Jun. 2017 to Dec. 2019, outpatients from psychiatric hospitals and community health centers in Shanghai, Wuhan, Harbin and Shenzhen were recruited as the survey subjects, and were investigated by random sampling. A self-designed questionnaire on awareness of mood disorders was used to investigate the knowledge of mood disorders and attitude towards the treatment. In a face-to-face interview, the evaluators instructed the participants to download the “mood thermometer” mobile terminal (APP), and the participants completed the survey online. The awareness of mood disorders was investigated by multiple-choice questions. The frequency and cross-tabulation methods in multiple response analysis were used for analysis. Results The survey received a total of 1 289 valid questionnaires. The frequency of knowing the name of mood disorders from high to low was major depressive disorder (87.9%, 1 133/1 289), melancholic depression (57.3%, 739/1 289), mania psychosis (50.7%, 653/1 289), mania (40.1%, 517/1 289), bipolar affective disorder (23.6%, 304/1 289), manic-depressive disorder (23.1%, 298/1 289), mood disorder (22.6%, 291/1 289), manic episode (21.3%, 275/1 289), bipolar disorder (14.4%, 185/1 289), and hypomania (14.0%, 180/1 289). The recognition rates for typical cases of depressive disorder and mania were 61.5% (793/1 289) and 41.9% (540/1 289), respectively. Specialist clinics, women, students and on the job, divorce/separation and higher education level were associated with high recognition rates of depressive disorder and mania. The participants learned about the mood disorder knowledge through the Internet, television broadcasting, magazines and books, relatives and friends, and community publicity. Regarding the necessity of acquiring knowledge of mood disorders, 66.2% (853/1 289) of the participants thought that it was necessary, 30.7% (396/1 289) considered it was unnecessary, and 3.1% (40/1 289) chose not to answer. Regarding the attitude towards mood disorder treatment strategies, 62.2% (802/1 289) of the participants thought that psychotherapy and medication were needed, 13.9% (179/1 289) thought that psychotherapy only (or counseling) was needed, and 4.8% (62/1 289) thought that there was no treatment. There were significant differences in the attitudes towards the treatment strategies of mood disorders among the participants with different genders, occupations, marital statuses and education levels (all P＜0.01). The female, working, married/cohabiting, and lower educated participants believed that not only psychotherapy was needed, but also medication. Conclusion The overall awareness level of community residents in Shanghai, Wuhan, Harbin and Shenzhen on mood disorders, especially mania and bipolar disorder, is unsatisfactory. It is still necessary to strengthen the popularization and publicity of mood disorder knowledge, so as to improve the early recognition and standard diagnosis and treatment of mood disorders.

Abstract:Objective To investigate the predictive value of neutrophil to lymphocyte ratio (NLR) for the prognosis of patients with stroke warning syndrome (SWS). Methods From Jul. 2013 to Jan. 2020, 83 SWS patients admitted to The First Affiliated Hospital of Naval Medical University (Second Military Medical University) were retrospectively enrolled. According to the modified Rankin scale (mRS) score, the patients were divided into good prognosis group (mRS score≤2, n＝72) and poor prognosis group (mRS score＞2, n＝11). The clinical characteristics, laboratory data and imaging data were recorded, and the NLR was calculated according to the results of emergency blood routine test. Logistic regression model was used to analyze the influencing factors of poor prognosis of SWS patients. The receiver operating characteristic (ROC) curve was used to evaluate the predictive effect of NLR for the prognosis of SWS patients. Results The average age of SWS patients was (59.10±13.11) years old, and 65 patients had new cerebral infarction. Admission National Institutes of Health stroke scale (NIHSS) score and NLR of the patients in the poor prognosis group were significantly higher than those in the good prognosis group, while the hemoglobin level was significantly lower than that in the good prognosis group (all P＜0.05). There were no significant differences in ABCD2 (age, blood pressure, clinical features, duration of symptoms and diabetes) score, intravenous thrombolysis, or new infarction between the 2 groups (all P＞0.05). Multivariate logistic regression analysis showed that admission NIHSS score (odds ratio ［OR］ 1.46, 95% confidence interval ［CI］ 1.15-1.86, P＝0.002) and NLR (OR 2.05, 95% CI 1.07-3.92, P＝0.031) were independent risk factors for poor prognosis of SWS patients. ROC curve analysis showed a cutoff value of 2.82 for NLR in predicting poor prognosis in SWS patients, with a value of area under curve of 0.75, a sensitivity of 72.7%, and a specificity of 81.9%. Conclusion Higher admission NIHSS score and NLR are independently correlated with poor prognosis of SWS patients, and NLR has moderate diagnostic value for poor prognosis of SWS patients.

Abstract:Objective To observe the morphology of cervical intervertebral foramen and the related diameters in 3-dimensional space in patients with cervical intervertebral radiculopathy with C₅/C₆ intervertebral foramen stenosis, and to discuss the clinical significance. Methods A total of 492 patients with cervical spondylotic radiculopathy with C₅/C₆ intervertebral foramen stenosis, who underwent surgery in The Second Affiliated Hospital of Naval Medical University (Second Military Medical University) from Sep. 2014 to Jul. 2019, were randomly enrolled as case group and examined by anterior and lateral X-ray of the cervical vertebra, cervical computed tomography (CT), and cervical magnetic resonance imaging. In addition, 191 healthy adults who came to the hospital for health examination were enrolled as normal adult group. The morphology of C₅/C₆ intervertebral foramen was observed using CT 3-dimensional reconstruction images and X-ray films; and the upper anteroposterior diameter, lower anteroposterior diameter, longitudinal diameter, cross-sectional area, and disc height were measured under optimal projection angle. The differences between the case group and the normal adult group, between the observation side (stenosis or severe stenosis) intervertebral foramen and the contralateral intervertebral foramen of the case group, and between the male and female patients of the case group were analyzed. Results The morphology of C₅/C₆ intervertebral foramen in the case group was mainly spindle and irregular due to osteophyte hyperplasia. The mean transverse diameter, longitudinal diameter, cross-sectional area, and mean disc height of observation side intervertebral foramen in the case group were (5.81±1.40) mm, (10.45±1.70) mm, (50.02±15.46) mm², and (4.99±0.89) mm, respectively, which were significantly lower than those in the normal adult group (［7.60±1.37］ mm, ［11.66±1.95］ mm, ［72.80±22.48］ mm², and ［5.78±0.95］ mm, respectively) (all P＜0.05). There were no significant differences in the above-mentioned diameters between the observation side and contralateral intervertebral foramen of the case group or between the male and female patients (all P＞0.05). Conclusion The morphology changes of cervical intervertebral foramen lead to decreases in the mean transverse diameter and cross-sectional area in patients with cervical spondylotic intervertebral radiculopathy with C₅/C₆ intervertebral foramen stenosis. During intraoperative decompression, more attention should be paid to the effective enlargement of the transverse diameter of the intervertebral foramen, so as to improve the effect of the operation.

Abstract:Objective To investigate the correlations between the essential frailty toolset (EFT) score and five times sit-to-stand (FTSTS), 30-second sit-to-stand (30s-STS), 1-minute sit-to-stand (1min-STS), and 6-minute walk test (6MWT) in patients with coronary artery disease (CAD) aged 60-80 years old, so as to determine the physical exercise function indicators for clinical assessment of patients with CAD combined frailty. Methods A total of 78 CAD patients admitted to the Department of Cardiovasology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from Jan. 2020 to Dec. 2021 were retrospectively enrolled. They were assigned to 2 groups according to the EFT score: frailty group (EFT score≥1, n＝28) or non-frailty group (EFT score＝0, n＝50). The basic information, FTSTS, 30s-STS, 1min-STS, 6MWT, left ventricular ejection fraction (LVEF), and blood indexes were collected, and their correlations with frailty were statistically analyzed. Receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of the above indexes for frailty in patients with old myocardial infarction (MI) or without MI, and the optimal cutoff value was determined. Results Compared with the non-frailty group, the frailty group had lower body mass index (［23.14±3.03］ kg/m² vs ［24.78±3.29］ kg/m², P＝0.033), higher N-terminal pro-brain natriuretic peptide level (199.40 ［55.32, 1 012.65］ mmol/L vs 99.75 ［41.36, 217.75］ mmol/L, P＝0.016), and lower LVEF, 30s-STS, 1min-STS and 6MWT (［56.99±10.20］% vs ［62.15±6.45］%, ［10.93±2.98］ repetitions vs ［14.50±2.63］ repetitions, ［21.32±5.45］ repetitions vs ［27.30±5.62］ repetitions, and ［412.84±62.34］ m vs ［470.04±56.41］ m, all P＜0.01). Spearman correlation analysis showed that the 30s-STS, 1min-STS, and 6MWT were moderately or highly negatively correlated with the EFT score (r_s＝－0.575, －0.493, and －0.467). ROC curve analysis showed that in the patients without MI the area under curve (AUC) value was 0.85 for 30s-STS diagnosing frailty (sensitivity 66.7%, specificity 92.9%, optimal cutoff value ≤13 repetitions), 0.82 for 1min-STS (sensitivity 60.6%, specificity 92.9%, optimal cutoff value ≤27 repetitions), and 0.80 for 6MWT (sensitivity 78.8%, specificity 78.6%, optimal cutoff value ≤446.55 m); in the patients with old MI the AUC value was 0.81 for 30s-STS (sensitivity 94.1%, specificity 71.4%, optimal cutoff value ≤10 repetitions), 0.72 for 1min-STS (sensitivity 94.1%, specificity 57.1%, optimal cutoff value ≤19 repetitions), and 0.68 for 6MWT (sensitivity 94.1%, specificity 42.9%, optimal cutoff value ≤387.45 m). Conclusion The 30s-STS, 1min-STS, and 6MWT are moderately or highly negatively correlated with the degree of frailty in CAD patients, and they are effective tools for clinical assessment of frailty. The 30s-STS is a good physical exercise function indicator for clinical assessment of frailty in CAD patients with or without MI combined frailty.

Abstract:Objective To develop a functional assessment scale for pain in lower extremities and waist in island officers and soldiers, and to verify its reliability and validity. Methods Through fieldwork, interviews, discussions, literature and book reading, and expert meetings, a functional assessment scale for pain in lower extremities and waist in island officers and soldiers was developed, and then the scale was validated in an island unit. Reliability evaluation was carried out by internal consistency and retest reliability. Validity assessment was implemented by exploratory and validation factor analyses. Correlations between visual analogue scale (VAS), Oswestry disability index (ODI), self-rating anxiety scale (SAS), self-rating depression scale (SDS) and the various dimensions of the functional assessment scale for the pain were analyzed by Pearson linear correlation. Results A 4-dimension 20-item functional assessment scale for pain in lower extremities and waist in island officers and soldiers was successfully developed. The internal consistency Cronbach’s α coefficient was 0.927 and the retest reliability was 0.884; the cumulative variance contribution rate was 81.276%; the factor model fitted well (χ²/df＝2.106, goodness-of-fit index＝0.822, adjusted goodness-of-fit index＝0.766, root of mean square residual＝0.025, comparative fit index＝0.947, root mean square error of approximation＝0.088); the composite reliability of each dimension of the scale was greater than 0.7, the average variance extracted (AVE) was greater than 0.5, and the root value of AVE was greater than the correlation coefficient between each dimension. There were correlations between the pain severity dimension of the functional assessment scale for pain in lower extremities and waist in island officers and soldiers and VAS, between training readiness and daily life dimensions and ODI, and between psychological impact dimension and SAS and SDS (all P＜0.01). Conclusion The functional assessment scale for pain in lower extremities and waist in island officers and soldiers has excellent reliability and validity, and can be used to evaluate the pain in lower extremities and waist in island officers and soldiers.

Abstract:Intestinal microflora is an important biological community in human body. Extensive research has been done in this filed, but investigation on the influence of anesthetic drugs on intestinal microflora remains limited. We analyzed the research literature on the interaction between intestinal microflora and inhaled anesthetics, intravenous anesthetics, and opioid medications. The results showed that anesthetic drugs could change the composition of the intestinal microflora and influence its function. And these changes were related to postoperative cognitive dysfunction, sepsis, and other diseases. However, current research lacks large-scale studies and comprehensive data analysis. Future efforts should focus on refining research methodologies and transitioning from animal models to human studies to elucidate the underlying mechanisms, provide guidance for the use of anesthetic drugs, and enhance surgical treatment and postoperative recovery of patients.

Abstract:Heliox is a mixture of helium and oxygen in a certain proportion. Traditionally, it is mainly used as respiratory gas in deep diving operations. In recent years, heliox has been used in the prevention and treatment of respiratory diseases, ischemic diseases, and decompression sickness because it can reduce respiratory resistance, increase tissue oxygen content, and inhibit inflammatory response. In the future, with in-depth study of heliox, its application will continue to widen. This article systematically introduces the application of heliox in medical practice from 4 aspects: physical and chemical properties, disease prevention and treatment, treatment methods, and risk control, hoping to provide a reference for further research.

Abstract:Objective To verify the disinfection effect of low-temperature plasma on respiratory viruses in simulated warship airtight cabins. Methods Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) particles were harvested from the sputum of a patient and coated on several smooth plastic pieces to simulate surface contamination. Three separate isolation wards (each about 20 m²) were used to simulate warship airtight cabins. Plastic pieces (3 detection time points, 9 pieces for each group) were placed in the wards for the 3 groups, namely, experimental group (treated with low-temperature plasma), positive control group (treated with chlorine-containing disinfectants), and blank control group. Samples were taken at 3 time points and detected by SARS-CoV-2 antigen test and quantitative polymerase chain reaction. Results The SARS-CoV-2 antigens on the surface of all contaminated pieces were positive before disinfection. At 1, 30 and 60 min after disinfection, the antigens of 3 samples turned negative in the experimental group, 0, 2 and 3 samples turned negative in the positive control group, and 0, 0 and 1 sample turned negative in the blank control group. The effects of different treatment methods on the Ct values of open reading frame 1ab (ORF1ab) and nucleocapsid protein (N) genes were significant (both P＜0.01), and the Ct values of ORF1ab and N genes in the experimental group and positive control group were significantly higher than those in the blank control group (all P＜0.05). The Ct value was high and stable in the experimental group, and the variation was smaller than the other 2 groups. Conclusion Low-temperature plasma can effectively inactivate SARS-CoV-2, and its thoroughness and uniformity are prior to chlorine-containing disinfectants. It is suitable for disinfection of the air and surface of the ship cabin.

Abstract:Objective To explore the effects of Astragalus polysaccharide (APS) on nuclear factor erythroid 2-related factor 2 (Nrf2) pathway and serum oxidation indicators in chronic unpredictable mild stress (CUMS)-induced depression model mice. Methods Thirty-six BALB/c mice were randomly assigned to normal control group, CUMS group, CUMS＋fluoxetine group (CUMS＋F group), or CUMS＋APS group, with 9 mice in each group. The mice in the CUMS, CUMS＋F and CUMS＋APS groups were stimulated by CUMS for 4 weeks to construct depression models. After successful modeling, the mice in the CUMS＋F group were intraperitoneally injected with 10 mg/kg of fluoxetine daily, the mice in the CUMS＋ APS group were given 400 mg/kg of APS by gavage daily, and the mice in the normal control group and CUMS group were given an equal volume of normal saline for 4 weeks. The depression status of the mice was observed by behavioral experiment after drug intervention. After 4 weeks of drug intervention, the eye socket blood was collected, and the levels of malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), superoxide anion (O₂^·) and hydroxyl radical (·OH) in the mouse serum were detected using enzyme-linked immunosorbent assay. The expression of Nrf2 in mouse hippocampal tissue was detected by Western blotting. Results Compared with the CUMS group, the immobility time of mice was significantly shortened in the CUMS＋F group and CUMS＋APS group in the tail suspension experiment (both P＜0.01), while the sucrose preference rate, crossing times of open-field test, and the entry times of open arm and time spent in open arm in the elevated cross maze experiment were significantly increased (P＜0.05, P＜0.01); the level of MDA in the mouse serum was significantly decreased (both P＜0.05), while the levels of SOD, GSH-Px,O₂^· and ·OH were significantly increased (P＜0.05, P＜0.01); and the expression level of Nrf2 in the mouse hippocampal tissue was significantly increased (P＜0.05, P＜0.01). Conclusion APS can improve the depressive state of CUMS-induced depression model mice, which may be achieved by regulating Nrf2 pathway in hippocampal tissue and serum oxidative indicators.

Abstract:Objective To analyze the clinical manifestations, diagnosis and treatment measures of patients with coronavirus disease 2019 (COVID-19)-associated organizing pneumonia (OP), so as to improve the clinicians’ awareness and treatment of the disease. Methods The clinical data, diagnosis and treatment of 2 cases of COVID-19-associated OP from our hospital were summarized. Relevant case data were retrieved from the PubMed database, and the demographic characteristics, imaging manifestations, diagnosis and treatment process, and outcomes of patients with COVID-19-associated OP were summarized and analyzed. Results A total of 45 patients with COVID-19-associated OP were retrieved from PubMed database. A total of 47 patients were enrolled in the data analysis, and the age ranged from 25 to 84 (59.6±13.0) years old, with 35 (74.5%) males and 12 (25.5%) females. Thirty-one (66.0%) patients were diagnosed as severe or critical COVID-19, and 34 (72.3%) patients required respiratory support. The duration from initial diagnosis of COVID-19 to clinical diagnosis of OP was 12-68 (32.3±13.5) d. Twenty (42.6%) patients were initially cured and discharged or only observed at home, and then were diagnosed as OP due to recurrence of symptoms; 27 (57.4%) patients were hospitalized before diagnosis of OP. The computed tomography (CT) results of 44 (93.6%) patients showed multiple lesions in both lungs, and the main lesion patterns were consolidation (35 cases, 74.5%), ground glass opacity (31 cases, 66.0%), interlobular septal thickening (14 cases, 29.8%) and linear shadow (14 cases, 29.8%), and 28 (59.6%) cases of the lesions showed typical peripheral distribution. Forty-five (95.7%) patients were treated with glucocorticoids. All patients were clinically stable during the follow-up period. Conclusion COVID-19-associated OP may be related to the pulmonary sequelae of COVID-19 and persistent hypoxia in some severe patients. Chest CT plays an important role in the diagnosis of OP. Glucocorticoid therapy can achieve a good prognosis, but the optimal dose and course of treatment still need further clinical research.

Abstract: