BACKGROUND Gastrointestinal(GI)tumors are among the most prevalent malignancies,and surgical intervention remains a primary treatment modality.However,the complexity of GI surgery often leads to prolonged recovery and...BACKGROUND Gastrointestinal(GI)tumors are among the most prevalent malignancies,and surgical intervention remains a primary treatment modality.However,the complexity of GI surgery often leads to prolonged recovery and high postoperative complication rates,which threaten patient safety and functional outcomes.Enhanced recovery after surgery(ERAS)principles have been shown to improve perioperative outcomes through evidence-based,multidisciplinary care pathways.Despite its widespread adoption,there is a paucity of research focusing specifically on optimizing ERAS-guided nursing processes in the post-anesthesia care unit(PACU)and evaluating its impact on perioperative safety in patients undergoing GI tumor surgery.This study aimed to investigate whether an ERASbased PACU nursing protocol could enhance recovery,reduce complications,and improve patient safety in this surgical population.AIM To explore the impact of optimizing the recovery room nursing process based on ERAS on the perioperative safety of patients with GI tumors.METHODS A total of 260 patients with GI tumors who underwent elective surgeries under general anesthesia in our hospital from August 2023 to August 2025 and were then observed in the recovery unit(PACU)were selected.They were randomly divided into the observation group(the PACU nursing process was optimized based on ERAS)and the control group(the conventional PACU nursing process was adopted)by the random number grouping method,with 130 cases in each group.The time of gastric tube removal,urinary catheter removal,defecation time,hospital stay,time of leaving the room after tube removal,retention time in the recovery room,occurrence of complications,satisfaction and readmission rate were compared between the two groups after entering the room.Compare the occurrence of adverse events in the PACU nursing process between the two groups.RESULTS The time of gastric tube removal,urinary catheter removal,defecation time,hospital stay,retention time in the recovery room,total incidence of complications and readmission rate in the observation group were significantly lower than those in the control group,and the satisfaction rate was higher than that in the control group(P<0.05).The occurrence of adverse events in the PACU nursing process in the observation group was lower than that in the control group(P<0.05).CONCLUSION Optimizing the PACU nursing process based on ERAS can effectively accelerate the recovery process of patients undergoing GI tumor surgery,reduce adverse events,improve nursing satisfaction,and at the same time,lower the incidence of adverse events in the PACU nursing process,providing a more refined management basis for clinical practice.展开更多
Spinal cord injury(SCI) often results in permanent dysfunction of locomotion,sensation,and autonomic regulation,imposing a substantial burden on both individuals and society(Anjum et al.,2020).SCI has a complex pathop...Spinal cord injury(SCI) often results in permanent dysfunction of locomotion,sensation,and autonomic regulation,imposing a substantial burden on both individuals and society(Anjum et al.,2020).SCI has a complex pathophysiology:an initial primary injury(mechanical trauma,axonal disruption,and hemorrhage) is followed by a progressive secondary injury cascade that involves ischemia,neuronal loss,and inflammation.Given the challenges in achieving regeneration of the injured spinal cord,neuroprotection has been at the forefront of clinical research.展开更多
This editorial examines the emerging potential of traditional Chinese medicine(TCM)in enhancing postoperative recovery following gastroenteroscopy,highlighted by a 2025 randomized controlled trial by Hong et al.The st...This editorial examines the emerging potential of traditional Chinese medicine(TCM)in enhancing postoperative recovery following gastroenteroscopy,highlighted by a 2025 randomized controlled trial by Hong et al.The study,involving 120 patients,demonstrates that meridian flow injection(MFI)combined with transcutaneous electrical acupoint stimulation(TEAS)significantly improves gastrointestinal(GI)function,evidenced by a reduced time to first defecation(3.20±1.04 days vs 3.98±1.27 days,P<0.001),lowers stress biomarkers(e.g.,reduced cortisol and norepinephrine),and enhances clinical efficacy(93.33%vs 75.00%,P=0.006).Leveraging TCM’s five-element theory and Ziwu Liuzhu timing,the intervention targets key acupoints such as Zusanli(ST36)with a herbal paste comprising Qingpi,Houpu,and rhubarb,delivered transdermally to optimize bioavailability.This approach harmonizes ancient TCM principles with contemporary evidence-based practice,offering a holistic strategy to address postoperative nausea,delayed motility,and patient discomfort.Currently,integrative methods like MFI-TEAS are gaining traction,supported by recent meta-analyses that affirm TEAS’s efficacy in accelerating GI recovery across surgical contexts,including shortened times to first exhaust and defecation.This reflects a growing recognition of TCM’s role in perioperative care amidst rising global endoscopy demands.Looking forward,future research should prioritize multicenter,doubleblinded trials to enhance generalizability,adhere to standardized reporting frameworks such as CONSORT and STRICTA,and employ advanced tools like multiomics and functional magnetic resonance imaging to elucidate mechanistic pathways,including gut-brain axis modulation and microbiota-immune interactions.Such developments promise to refine these interventions,fostering a seamless integration of TCM with Western medicine and delivering tailored,patientcentered solutions to improve postoperative outcomes worldwide.展开更多
Spontaneous recovery frequently proves maladaptive or insufficient because the plasticity of the injured adult mammalian central nervous system is limited.This limited plasticity serves as a primary barrier to functio...Spontaneous recovery frequently proves maladaptive or insufficient because the plasticity of the injured adult mammalian central nervous system is limited.This limited plasticity serves as a primary barrier to functional recovery after brain injury.Neuromodulation technologies represent one of the fastest-growing fields in medicine.These techniques utilize electricity,magnetism,sound,and light to restore or optimize brain functions by promoting reorganization or long-term changes that support functional recovery in patients with brain injury.Therefore,this review aims to provide a comprehensive overview of the effects and underlying mechanisms of neuromodulation technologies in supporting motor function recovery after brain injury.Many of these technologies are widely used in clinical practice and show significant improvements in motor function across various types of brain injury.However,studies report negative findings,potentially due to variations in stimulation protocols,differences in observation periods,and the severity of functional impairments among participants across different clinical trials.Additionally,we observed that different neuromodulation techniques share remarkably similar mechanisms,including promoting neuroplasticity,enhancing neurotrophic factor release,improving cerebral blood flow,suppressing neuroinflammation,and providing neuroprotection.Finally,considering the advantages and disadvantages of various neuromodulation techniques,we propose that future development should focus on closed-loop neural circuit stimulation,personalized treatment,interdisciplinary collaboration,and precision stimulation.展开更多
The major aim of stroke therapy is to stimulate brain repair and improve behavioral recovery after cerebral ischemia.One option is to stimulate endogenous neurogenesis in the subventricular zone and direct the newly f...The major aim of stroke therapy is to stimulate brain repair and improve behavioral recovery after cerebral ischemia.One option is to stimulate endogenous neurogenesis in the subventricular zone and direct the newly formed neurons to the damaged area.However,only a small percentage of these neurons survive,and many do not reach the damaged area,possibly because the corpus callosum impedes the migration of subventricular zone-derived stem cells into the lesioned cortex.A second major obstacle to stem cell therapy is the strong inflammatory reaction induced by cerebral ischemia,whereby the associated phagocytic activity of brain macrophages removes both therapeutic cells and/or cell-based drug carriers.To address these issues,neurogenesis was electrically stimulated in the subventricular zone,followed by isolation of proliferating cells,including newly formed neurons,which were subsequently mixed with a nutritional hydrogel.This mixture was then transferred to the stroke cavity of day 14 post-stroke mice.We found that the performance of the treated animals improved in behavioral tests,including novel object,open field,hole board,grooming,and“time-to-feel”adhesive tape tests.Furthermore,immunostaining revealed that the stem cell marker nestin,the neuroepithelial marker Mash1,and the immature neuronal marker doublecortin-positive cells survived in the transplanted area for 2 weeks,possibly due to reduced phagocytic activity and supportive angiogenesis.These results clearly indicate that the transplantation of committed subventricular zone stem cells combined with a protective nutritional gel directly into the infarct cavity after the peak of stroke-induced neuroinflammation represents a feasible approach to improve neurorestoration after cerebral ischemia.展开更多
Convex feasibility problems are widely used in image reconstruction,sparse signal recovery,and other areas.This paper is devoted to considering a class of convex feasibility problem arising from sparse signal recovery...Convex feasibility problems are widely used in image reconstruction,sparse signal recovery,and other areas.This paper is devoted to considering a class of convex feasibility problem arising from sparse signal recovery.We rst derive the projection formulas for a vector onto the feasible sets.The centralized circumcentered-reection method is designed to solve the convex feasibility problem.Some numerical experiments demonstrate the feasibility and e ectiveness of the proposed algorithm,showing superior performance compared to conventional alternating projection methods.展开更多
The remodeling of axonal connections following injury is an important feature driving functional recovery.The reticulospinal tract is an interesting descending motor tract that contains both excitatory and inhibitory ...The remodeling of axonal connections following injury is an important feature driving functional recovery.The reticulospinal tract is an interesting descending motor tract that contains both excitatory and inhibitory fibers.While the reticulospinal tract has been shown to be particularly prone to axonal growth and plasticity following injuries of the spinal cord,the differential capacities of excitatory and inhibitory fibers for plasticity remain unclear.As adaptive axonal plasticity involves a sophisticated interplay between excitatory and inhibitory input,we investigated in this study the plastic potential of glutamatergic(vGlut2)and GABAergic(vGat)fibers originating from the gigantocellular nucleus and the lateral paragigantocellular nucleus,two nuclei important for locomotor function.Using a combination of viral tracing,chemogenetic silencing,and AI-based kinematic analysis,we investigated plasticity and its impact on functional recovery within the first 3 weeks following injury,a period prone to neuronal remodeling.We demonstrate that,in this time frame,while vGlut2-positive fibers within the gigantocellular and lateral paragigantocellular nuclei rewire significantly following cervical spinal cord injury,vGat-positive fibers are rather unresponsive to injury.We also show that the acute silencing of excitatory axonal fibers which rewire in response to lesions of the spinal cord triggers a worsening of the functional recovery.Using kinematic analysis,we also pinpoint the locomotion features associated with the gigantocellular nucleus or lateral paragigantocellular nucleus during functional recovery.Overall,our study increases the understanding of the role of the gigantocellular and lateral paragigantocellular nuclei during functional recovery following spinal cord injury.展开更多
Sludge,the massive by-product of the sewage system,became a major challenge for the wastewater treatment industry.Yet,conventional methods often face challenges like low efficiency,high energy consumption,and environm...Sludge,the massive by-product of the sewage system,became a major challenge for the wastewater treatment industry.Yet,conventional methods often face challenges like low efficiency,high energy consumption,and environmental pollution.Especially,the improper treatment and disposal of toxic sludge generated from different industrial processes or specific wastewater treatment operations exerted significant pressure and threat to hydrosphere,pedosphere,atmosphere and even biosphere.展开更多
1.The development history of enhanced recovery after surgery(ERAS)Enhanced recovery after surgery(ERAS)is a multimodal perioperative care approach that has evolved over the past 2 decades since its inception.In 1997,P...1.The development history of enhanced recovery after surgery(ERAS)Enhanced recovery after surgery(ERAS)is a multimodal perioperative care approach that has evolved over the past 2 decades since its inception.In 1997,Professor Henrik Kehlet,also known as the“father of ERAS”,from the University of Copenhagen in Denmark first proposed the ERAS concept and discovered its clinical feasibility and superiority,achieving remarkable results.ERAS was initially applied in colorectal surgery;subsequently,the concept gradually gained popularity and application worldwide.展开更多
Background Recovery colleges (RCs) support personal recovery through education, skill development and social support for people with mental health problems, carers and staff. Guided by co-production and adult learning...Background Recovery colleges (RCs) support personal recovery through education, skill development and social support for people with mental health problems, carers and staff. Guided by co-production and adult learning principles, RCs represent a recent mental health innovation. Since the first RC opened in England in 2009, RCs have expanded to 28 countries and territories. However, most RC research has been conducted in Western countries with similar cultural characteristics, limiting understanding of how RCs can be culturally adapted. The 12-item Recovery Colleges Characterisation and Testing (RECOLLECT) Fidelity Measure (RFM) evaluates the operational fidelity of RCs based on 12 components, but cultural influences on these components remain underexplored.Aims To assess associations between Hofstede’s cultural dimensions and RFM items to identify cultural influences on fidelity components.Methods A cross-sectional survey of RC managers was conducted across all 221 RCs. Mixed-effects regression models examined associations between Hofstede’s country-level cultural dimensions and item-level RFM scores, adjusted for healthcare expenditure and income inequality. Four cultural dimensions, obtained from Hofstede, were analysed: individualism (prioritising personal needs), indulgence (enjoyment-oriented), uncertainty avoidance (preference for predictability) and long-term orientation (future-focused).Results The RFM was completed by 169 (76%) RC managers. Seven RFM items showed associations with cultural dimensions. Equality was linked to short-term orientation, while learning was associated with individualism and uncertainty avoidance. Both individualism and indulgence influenced co-production and community focus. Commitment to recovery was shaped by all four cultural dimensions, with the strongest associations seen for individualism and indulgence. Individualism enhanced explicit focus on strengths-based practice, while uncertainty avoidance influenced course distinctiveness.Conclusions This study demonstrates how culture shapes RC fidelity components, providing actionable insights for cultural adaptation. Incorporating under-represented dimensions, such as collectivism and restraint, could improve the RFM’s global applicability, facilitating implementation. Future research should explore cultural nuances, engage diverse stakeholders and refine fidelity measures to enhance RC inclusivity and effectiveness worldwide.展开更多
Objective:To investigate the effects of performance-linked early rehabilitation management model on the recovery of neurological function,motor function and activities of daily living in patients after intracerebral h...Objective:To investigate the effects of performance-linked early rehabilitation management model on the recovery of neurological function,motor function and activities of daily living in patients after intracerebral hemorrhage surgery.Methods:A randomized controlled trial design was adopted.A total of 120 patients after cerebral hemorrhage surgery admitted to our hospital from June 2023 to June 2024 were selected as the research subjects and were randomly divided into the experimental group and the control group,with 60 cases in each group according to the random number table method.The control group received routine postoperative care and rehabilitation guidance in neurosurgery,while the experimental group implemented an efficacy linkage early rehabilitation management model on the basis of routine care.Before the intervention,4 weeks after the intervention,and 12 weeks after the intervention,the National Institutes of Health Stroke Scale(NIHSS),the Fugl-Meyer Assessment of Motor Function(FMA),and the Barthel Index(BI)were used to assess the degree of neurological deficits,motor function,and activities of daily living in patients,respectively.Results:After 4 weeks and 12 weeks of intervention,the NIHSS scores of the experimental group[(8.5±2.1)points,(5.2±1.8)points]were significantly lower than those of the control group[(10.8±2.4)points,(7.9±2.2)points](P<0.01);FMA scores[(58.4±10.2)points,(78.6±12.4)points]and BI scores[(55.3±11.5)points,(72.8±13.2)points]were significantly higher than those of the control group[(45.2±9.8)points,(62.3±11.7)points;(42.1±10.6)points,(58.4±12.5)points](P<0.01).Conclusion:The performance-linked early rehabilitation management model can effectively promote the recovery of neurological and motor functions in patients after cerebral hemorrhage surgery and significantly improve their ability to take care of themselves in daily living.It is an efficient rehabilitation management strategy.展开更多
FeCl_(3) solution is commonly used in the etching process of stainless steel.The typical etching waste liquid contains a significant amount of Fe^(3+),Fe^(2+),Cr^(3+),and Ni^(2+),making it difficult to reuse and posin...FeCl_(3) solution is commonly used in the etching process of stainless steel.The typical etching waste liquid contains a significant amount of Fe^(3+),Fe^(2+),Cr^(3+),and Ni^(2+),making it difficult to reuse and posing pollution issues.The FeCl_(3) etching waste liquid was the present subject,which aimed to extract Cr^(3+)and Ni^(2+)by selectively adjusting process parameters.Additionally,it investigates the migration behavior and phase transition mechanisms of the iron,chromium,and nickel in different solution systems during treatment,systematically elucidating the regeneration mechanisms of FeCl_(3) etching waste liquid.The results indicate that Cr and Ni can be recycled by controlling parameters such as pH value,temperature,and the valence states of the ions.Following a selective reduction of Fe^(3+)to Fe^(2+)using Fe powder,98.3%of Cr^(3+)was recovered by adjusting the solution’s pH.Subsequently,93.3%of Ni^(2+)was extracted from the Cr-depleted solution through further adjustments to the process parameters.The recovered Cr and Ni can be used to prepare Fe–Cr and Fe–Ni alloy powders.Furthermore,the FeCl_(3) etching solution was regenerated by oxidizing Fe^(2+)and recovering impurities.The theoretical support for the development of new processes for treating FeCl_(3) etching waste liquid is provided.展开更多
BACKGROUND Surgical resection is the primary treatment for gastric cancer,but it often leads to slow recovery,high complications,and poor psychological health.The effectiveness of enhanced recovery after surgery(ERAS)...BACKGROUND Surgical resection is the primary treatment for gastric cancer,but it often leads to slow recovery,high complications,and poor psychological health.The effectiveness of enhanced recovery after surgery(ERAS)as a new nursing model postsurgery remains uncertain.AIM To investigate the clinical effect of accelerated recovery nursing program based on multidisciplinary collaboration model in gastric cancer surgery.METHODS A total of 120 patients who underwent radical gastrectomy at our hospital from January 2023 to December 2024 were included in the study.They were divided into two groups of 60 each:The control group,which received routine care,and the study group,which received ERAS based on multidisciplinary collaboration.Both groups received care until discharge.We compared gastrointestinal recovery,psychological status,Short Form 36 Health Survey scores,Pittsburgh Sleep Quality Index,complications,and nursing satisfaction between the two groups.RESULTS The study group had significantly shorter defecation time,bowel sound recovery time,and flatus time compared to the control group(P<0.05).The Hamilton Anxiety Scale and Hamilton Depression Rating Scale scores were also significantly lower in the study group(P<0.05).Additionally,the study group reported better sleep quality(P<0.05)and had fewer postoperative complications.Their Short Form 36 Health Survey scores and nursing satisfaction were higher than those of the control group,with all differences being statistically significant(P<0.05).CONCLUSION The ERAS based on multidisciplinary collaboration in patients undergoing radical gastrectomy can accelerate postoperative recovery,reduce the occurrence of complications,and improve psychological state,quality of life,sleep quality and nursing satisfaction.展开更多
BACKGROUND Limited evidence exists regarding the role of enhanced recovery after surgery(ERAS)protocols in optimizing pain management and functional recovery after colorectal cancer(CRC)surgery.AIM To evaluate the imp...BACKGROUND Limited evidence exists regarding the role of enhanced recovery after surgery(ERAS)protocols in optimizing pain management and functional recovery after colorectal cancer(CRC)surgery.AIM To evaluate the impact of ERAS protocols on postoperative pain management and functional recovery in patients undergoing CRC surgery.METHODS A total of 109 patients with CRC admitted to The Third Affiliated Hospital of Jinzhou Medical University between June 2021 and June 2024 were enrolled in this study.They were divided into two groups:A control group(n=50)receiving standard perioperative care and an observation group(n=59)managed under an ERAS protocol.Clinical outcomes,including postoperative pain intensity[assessed using the Visual Analogue Scale(VAS)],functional recovery indicators(time to first ambulation,bowel sound recovery,first anal gas discharge,and first defecation),average sleep duration on postoperative day 3,sleep quality(measured using the Pittsburgh Sleep Quality Index),length of hospitalization,quality of life(evaluated using the Short Form 36 Health Survey),and incidence of postoperative complications(e.g.,surgical site infection,pulmonary infection,abdominal distension/pain,and intestinal obstruction),were systematically compared between the two groups.RESULTS The observation group exhibited significantly lower VAS scores at 72 hours postoperatively,shorter durations of maximum VAS scores,earlier recovery of functional indicators(time to first ambulation,bowel sound recovery,first anal gas discharge,and first defecation),and shorter hospitalization compared with the control group.Additionally,average sleep duration on postoperative day 3 was significantly longer in the observation group.Furthermore,the observation group demonstrated significantly improved sleep quality(lower Pittsburgh Sleep Quality Index scores)and higher quality of life(higher Short Form 36 Health Survey scores across all domains)than both the baseline and control groups.The incidence of total postoperative complications was also significantly lower in the observation group than in the control group.CONCLUSION ERAS protocols are highly effective in relieving postoperative pain,accelerating functional recovery,and improving overall clinical outcomes in patients with CRC undergoing surgery,supporting their broader clinical application.展开更多
BACKGROUND Laparoscopic cholecystectomy is the primary method for treating cholecystitis.Traditional postoperative care has poor outcomes for patient recovery.The enhanced recovery after surgery(ERAS)model is increasi...BACKGROUND Laparoscopic cholecystectomy is the primary method for treating cholecystitis.Traditional postoperative care has poor outcomes for patient recovery.The enhanced recovery after surgery(ERAS)model is increasingly applied in clinical settings.However,the impact of this nursing model on patients undergoing laparoscopic cholecystectomy remains unclear.AIM To evaluate the effects of ERAS on postoperative gastrointestinal recovery and quality of life in patients undergoing laparoscopic cholecystectomy.METHODS This is a retrospective study design in which we collected clinical data from 120 patients who underwent laparoscopic cholecystectomy at our hospital.Patients were divided into a control group(n=60)and a study group(n=60)based on the type of nursing intervention.The control group received conventional care,while the study group received ERAS.We assessed gastrointestinal recovery,quality of life,and nursing satisfaction before and after the nursing interventions in both groups.RESULTS After nursing care,the gastrointestinal recovery times(time to bowel sounds return,time to flatus,time to first bowel movement,and time to first meal)in the study group were significantly shorter than those in the control group,with statistically significant differences between the two groups(P<0.05).Additionally,the quality of life in the study group was significantly higher than that in the control group(P<0.05).The nursing satisfaction in the study group was also significantly higher than that in the control group,with statistically significant differences between the two groups(P<0.05).CONCLUSION In summary,compared to conventional nursing,ERAS can more rapidly promote gastrointestinal recovery and improve the quality of life in patients after laparoscopic cholecystectomy.Further clinical application of this approach is warranted.展开更多
BACKGROUND Current standard nursing practices demonstrate limited effectiveness in perioperative colorectal cancer(CRC)management,highlighting the need to explore alternative care strategies that improve clinical outc...BACKGROUND Current standard nursing practices demonstrate limited effectiveness in perioperative colorectal cancer(CRC)management,highlighting the need to explore alternative care strategies that improve clinical outcomes.AIM To investigate the impact of music therapy and anesthesia recovery care on anesthesia recovery in patients with CRC undergoing laparoscopic radical resection.METHODS One hundred and twenty patients scheduled for elective laparoscopic CRC radical resection at Affiliated Hospital of Jiangnan University from January 2022 to May 2024 were enrolled.The patients were assigned to control(n=60,receiving standard nursing care)and observation groups(n=60,receiving music therapy,anesthesia recovery care,and standard nursing care).We comparatively analyzed the time to regain consciousness,extubation time,and length of stay in the postanesthesia care unit;heart rate,systolic blood pressure,and diastolic blood pressure before anesthesia and during recovery;cortisol,aldosterone,norepinephrine,and adrenaline levels before anesthesia and 24 hours postoperatively;Postoperative Quality of Recovery Scale scores;and complication rates between the groups.RESULTS The observation group exhibited a significantly shorter time to regain consciousness,extubation time,and postanesthesia care unit stay than the control group(P<0.05).During the recovery period,heart rate,systolic blood pressure,and diastolic blood pressure significantly increased in both groups compared with preanesthesia levels,with the levels in the observation group being significantly lower than those in the control group(P<0.05).At 24 hours postoperatively,cortisol,aldosterone,norepinephrine,and adrenaline levels were elevated in both groups compared with preanesthesia levels,with levels in the observation group being significantly lower than those in the control group(P<0.05).The observation group achieved significantly higher Postoperative Quality of Recovery Scale scores than the control group(P<0.05).Moreover,the complication rate in the observation group was significantly lower than that in the control group(10.00%vs 40.00%,P<0.05).CONCLUSION Music therapy combined with anesthesia recovery care remarkably boosted the quality of anesthesia recovery in patients undergoing laparoscopic CRC radical resection,mitigated fluctuations in vital signs and stress responses,improved postoperative recovery quality,and reduced complication rates,demonstrating substantial clinical value.展开更多
Schwann cell transplantation is considered one of the most promising cell-based therapy to repair injured spinal cord due to its unique growth-promoting and myelin-forming properties.A the Food and Drug Administration...Schwann cell transplantation is considered one of the most promising cell-based therapy to repair injured spinal cord due to its unique growth-promoting and myelin-forming properties.A the Food and Drug Administration-approved Phase I clinical trial has been conducted to evaluate the safety of transplanted human autologous Schwann cells to treat patients with spinal cord injury.A major challenge for Schwann cell transplantation is that grafted Schwann cells are confined within the lesion cavity,and they do not migrate into the host environment due to the inhibitory barrier formed by injury-induced glial scar,thus limiting axonal reentry into the host spinal cord.Here we introduce a combinatorial strategy by suppressing the inhibitory extracellular environment with injection of lentivirus-mediated transfection of chondroitinase ABC gene at the rostral and caudal borders of the lesion site and simultaneously leveraging the repair capacity of transplanted Schwann cells in adult rats following a mid-thoracic contusive spinal cord injury.We report that when the glial scar was degraded by chondroitinase ABC at the rostral and caudal lesion borders,Schwann cells migrated for considerable distances in both rostral and caudal directions.Such Schwann cell migration led to enhanced axonal regrowth,including the serotonergic and dopaminergic axons originating from supraspinal regions,and promoted recovery of locomotor and urinary bladder functions.Importantly,the Schwann cell survival and axonal regrowth persisted up to 6 months after the injury,even when treatment was delayed for 3 months to mimic chronic spinal cord injury.These findings collectively show promising evidence for a combinatorial strategy with chondroitinase ABC and Schwann cells in promoting remodeling and recovery of function following spinal cord injury.展开更多
The M1/M2 phenotypic shift of microglia after spinal cord injury plays an important role in the regulation of neuroinflammation during the secondary injury phase of spinal cord injury.Regulation of shifting microglia ...The M1/M2 phenotypic shift of microglia after spinal cord injury plays an important role in the regulation of neuroinflammation during the secondary injury phase of spinal cord injury.Regulation of shifting microglia polarization from M1(neurotoxic and proinflammatory type)to M2(neuroprotective and anti-inflammatory type)after spinal cord injury appears to be crucial.Tryptanthrin possesses an anti-inflammatory biological function.However,its roles and the underlying molecular mechanisms in spinal cord injury remain unknown.In this study,we found that tryptanthrin inhibited microglia-derived inflammation by promoting polarization to the M2 phenotype in vitro.Tryptanthrin promoted M2 polarization through inactivating the cGAS/STING/NF-κB pathway.Additionally,we found that targeting the cGAS/STING/NF-κB pathway with tryptanthrin shifted microglia from the M1 to M2 phenotype after spinal cord injury,inhibited neuronal loss,and promoted tissue repair and functional recovery in a mouse model of spinal cord injury.Finally,using a conditional co-culture system,we found that microglia treated with tryptanthrin suppressed endoplasmic reticulum stress-related neuronal apoptosis.Taken together,these results suggest that by targeting the cGAS/STING/NF-κB axis,tryptanthrin attenuates microglia-derived neuroinflammation and promotes functional recovery after spinal cord injury through shifting microglia polarization to the M2 phenotype.展开更多
When disruptions occur, the airlines have to recover from the disrupted schedule. The recovery usually consists of aircraft recovery, crew recovery and passengers' recovery. This paper focuses on the integrated re...When disruptions occur, the airlines have to recover from the disrupted schedule. The recovery usually consists of aircraft recovery, crew recovery and passengers' recovery. This paper focuses on the integrated recovery, which means above-mentioned two or more recoveries are considered as a whole. Taking the minimization of the total cost of assignment, cancellation and delay as an objective, we present a more practical model, in which the maintenance and the union regulations are considered. Then we present a so-called iterative tree growing with node combination method. By aggregating nodes, the possibility of routings is greatly simplified, and the computation time is greatly decreased. By adjusting the consolidating range, the computation time can be controlled in a reasonable time. Finally, we use data from a main Chinese airline to test the algorithm. The experimental results show that this method could be used in the integrated recovery problem.展开更多
BACKGROUND Although the 2021 Chinese Clinical Practice Guidelines for Enhanced Recovery after Surgery(ERAS)provide recommendations for ERAS in gastrointestinal surgery,the clinical application of standard ERAS nursing...BACKGROUND Although the 2021 Chinese Clinical Practice Guidelines for Enhanced Recovery after Surgery(ERAS)provide recommendations for ERAS in gastrointestinal surgery,the clinical application of standard ERAS nursing models is challenging due to the variety of diseases involved in gastrointestinal surgery and the com-plex factors contributing to patient stress responses.Moreover,stress responses are more severe in older adult patients.Therefore,precision medicine is required to improve the quality of nursing care and promote postoperative recovery in gastrointestinal surgery.and demonstrate nursing benefits through clinical practice.METHODS This randomized clinical trial first established an evidence-based nursing ERAS protocol in older adult patients based on literature related to perioperative nursing measures for gastrointestinal surgery stress response.Next,392 older adult patients who underwent gastrointestinal surgery and were admitted to our hospital between December 2021 and June 2023 were categorized into two groups to receive evidence-based(study group)or conventional(control group)ERAS nursing models,respectively.Intraoperative physiological parameters during surgery and postoperative recovery indicators were compared between the groups.RESULTS Among 64 domestic and international studies,the stress responses of older adult patients mainly included emotional anxiety,sleep disorders,gastrointestinal discomfort,physical weakness,pain,and swelling.The appropriate nursing interventions included comprehensive psychological counseling,pre-and postoperative nutritional support,temperature control,pain management,and rehabilitation training.Compared with the control group,the study group showed lower heart rate,mean arterial pressure,blood glucose level,and adrenaline level;shorter duration of drainage tube placement,time to first flatus,time to first ambulation,and postoperative hospital stay;lower anxiety scores on postoperative day 3;and lower incidences of postoperative infection,obstruction,poor wound healing,and gastrointestinal reactions were lower in the study group(all P<0.05).CONCLUSION The evidence-based nursing measures targeting stress responses based on the conventional ERAS nursing model resulted in stable intraoperative physiological parameters during surgery,promoted postoperative recovery,and reduced the incidence of complications.展开更多
基金Supported by 2025 Henan Medical Education Research Project,No.WJLX2025038.
文摘BACKGROUND Gastrointestinal(GI)tumors are among the most prevalent malignancies,and surgical intervention remains a primary treatment modality.However,the complexity of GI surgery often leads to prolonged recovery and high postoperative complication rates,which threaten patient safety and functional outcomes.Enhanced recovery after surgery(ERAS)principles have been shown to improve perioperative outcomes through evidence-based,multidisciplinary care pathways.Despite its widespread adoption,there is a paucity of research focusing specifically on optimizing ERAS-guided nursing processes in the post-anesthesia care unit(PACU)and evaluating its impact on perioperative safety in patients undergoing GI tumor surgery.This study aimed to investigate whether an ERASbased PACU nursing protocol could enhance recovery,reduce complications,and improve patient safety in this surgical population.AIM To explore the impact of optimizing the recovery room nursing process based on ERAS on the perioperative safety of patients with GI tumors.METHODS A total of 260 patients with GI tumors who underwent elective surgeries under general anesthesia in our hospital from August 2023 to August 2025 and were then observed in the recovery unit(PACU)were selected.They were randomly divided into the observation group(the PACU nursing process was optimized based on ERAS)and the control group(the conventional PACU nursing process was adopted)by the random number grouping method,with 130 cases in each group.The time of gastric tube removal,urinary catheter removal,defecation time,hospital stay,time of leaving the room after tube removal,retention time in the recovery room,occurrence of complications,satisfaction and readmission rate were compared between the two groups after entering the room.Compare the occurrence of adverse events in the PACU nursing process between the two groups.RESULTS The time of gastric tube removal,urinary catheter removal,defecation time,hospital stay,retention time in the recovery room,total incidence of complications and readmission rate in the observation group were significantly lower than those in the control group,and the satisfaction rate was higher than that in the control group(P<0.05).The occurrence of adverse events in the PACU nursing process in the observation group was lower than that in the control group(P<0.05).CONCLUSION Optimizing the PACU nursing process based on ERAS can effectively accelerate the recovery process of patients undergoing GI tumor surgery,reduce adverse events,improve nursing satisfaction,and at the same time,lower the incidence of adverse events in the PACU nursing process,providing a more refined management basis for clinical practice.
文摘Spinal cord injury(SCI) often results in permanent dysfunction of locomotion,sensation,and autonomic regulation,imposing a substantial burden on both individuals and society(Anjum et al.,2020).SCI has a complex pathophysiology:an initial primary injury(mechanical trauma,axonal disruption,and hemorrhage) is followed by a progressive secondary injury cascade that involves ischemia,neuronal loss,and inflammation.Given the challenges in achieving regeneration of the injured spinal cord,neuroprotection has been at the forefront of clinical research.
文摘This editorial examines the emerging potential of traditional Chinese medicine(TCM)in enhancing postoperative recovery following gastroenteroscopy,highlighted by a 2025 randomized controlled trial by Hong et al.The study,involving 120 patients,demonstrates that meridian flow injection(MFI)combined with transcutaneous electrical acupoint stimulation(TEAS)significantly improves gastrointestinal(GI)function,evidenced by a reduced time to first defecation(3.20±1.04 days vs 3.98±1.27 days,P<0.001),lowers stress biomarkers(e.g.,reduced cortisol and norepinephrine),and enhances clinical efficacy(93.33%vs 75.00%,P=0.006).Leveraging TCM’s five-element theory and Ziwu Liuzhu timing,the intervention targets key acupoints such as Zusanli(ST36)with a herbal paste comprising Qingpi,Houpu,and rhubarb,delivered transdermally to optimize bioavailability.This approach harmonizes ancient TCM principles with contemporary evidence-based practice,offering a holistic strategy to address postoperative nausea,delayed motility,and patient discomfort.Currently,integrative methods like MFI-TEAS are gaining traction,supported by recent meta-analyses that affirm TEAS’s efficacy in accelerating GI recovery across surgical contexts,including shortened times to first exhaust and defecation.This reflects a growing recognition of TCM’s role in perioperative care amidst rising global endoscopy demands.Looking forward,future research should prioritize multicenter,doubleblinded trials to enhance generalizability,adhere to standardized reporting frameworks such as CONSORT and STRICTA,and employ advanced tools like multiomics and functional magnetic resonance imaging to elucidate mechanistic pathways,including gut-brain axis modulation and microbiota-immune interactions.Such developments promise to refine these interventions,fostering a seamless integration of TCM with Western medicine and delivering tailored,patientcentered solutions to improve postoperative outcomes worldwide.
基金supported by the National Natural Science Foundation of China,No.82371399(to YY)the Natural Science Foundation of Jiangsu Province,No.BK20221206(to YY)+1 种基金the Young Elite Scientists Sponsorship Program of Jiangsu Province,No.TJ-2022-028(to YY)the Scientific Research Program of Wuxi Health Commission,No.Z202302(to LY)。
文摘Spontaneous recovery frequently proves maladaptive or insufficient because the plasticity of the injured adult mammalian central nervous system is limited.This limited plasticity serves as a primary barrier to functional recovery after brain injury.Neuromodulation technologies represent one of the fastest-growing fields in medicine.These techniques utilize electricity,magnetism,sound,and light to restore or optimize brain functions by promoting reorganization or long-term changes that support functional recovery in patients with brain injury.Therefore,this review aims to provide a comprehensive overview of the effects and underlying mechanisms of neuromodulation technologies in supporting motor function recovery after brain injury.Many of these technologies are widely used in clinical practice and show significant improvements in motor function across various types of brain injury.However,studies report negative findings,potentially due to variations in stimulation protocols,differences in observation periods,and the severity of functional impairments among participants across different clinical trials.Additionally,we observed that different neuromodulation techniques share remarkably similar mechanisms,including promoting neuroplasticity,enhancing neurotrophic factor release,improving cerebral blood flow,suppressing neuroinflammation,and providing neuroprotection.Finally,considering the advantages and disadvantages of various neuromodulation techniques,we propose that future development should focus on closed-loop neural circuit stimulation,personalized treatment,interdisciplinary collaboration,and precision stimulation.
基金supported by European Union Funding Programme,PNRR,No. 760058(to DMH)the UEFISCDI Project,No. PN-III-P4-IDPCE-2020-059(to APW)
文摘The major aim of stroke therapy is to stimulate brain repair and improve behavioral recovery after cerebral ischemia.One option is to stimulate endogenous neurogenesis in the subventricular zone and direct the newly formed neurons to the damaged area.However,only a small percentage of these neurons survive,and many do not reach the damaged area,possibly because the corpus callosum impedes the migration of subventricular zone-derived stem cells into the lesioned cortex.A second major obstacle to stem cell therapy is the strong inflammatory reaction induced by cerebral ischemia,whereby the associated phagocytic activity of brain macrophages removes both therapeutic cells and/or cell-based drug carriers.To address these issues,neurogenesis was electrically stimulated in the subventricular zone,followed by isolation of proliferating cells,including newly formed neurons,which were subsequently mixed with a nutritional hydrogel.This mixture was then transferred to the stroke cavity of day 14 post-stroke mice.We found that the performance of the treated animals improved in behavioral tests,including novel object,open field,hole board,grooming,and“time-to-feel”adhesive tape tests.Furthermore,immunostaining revealed that the stem cell marker nestin,the neuroepithelial marker Mash1,and the immature neuronal marker doublecortin-positive cells survived in the transplanted area for 2 weeks,possibly due to reduced phagocytic activity and supportive angiogenesis.These results clearly indicate that the transplantation of committed subventricular zone stem cells combined with a protective nutritional gel directly into the infarct cavity after the peak of stroke-induced neuroinflammation represents a feasible approach to improve neurorestoration after cerebral ischemia.
基金Supported by the Natural Science Foundation of Guangxi Province(Grant Nos.2023GXNSFAA026067,2024GXN SFAA010521)the National Natural Science Foundation of China(Nos.12361079,12201149,12261026).
文摘Convex feasibility problems are widely used in image reconstruction,sparse signal recovery,and other areas.This paper is devoted to considering a class of convex feasibility problem arising from sparse signal recovery.We rst derive the projection formulas for a vector onto the feasible sets.The centralized circumcentered-reection method is designed to solve the convex feasibility problem.Some numerical experiments demonstrate the feasibility and e ectiveness of the proposed algorithm,showing superior performance compared to conventional alternating projection methods.
基金supported by the Deutsche Forschungsgemeinschaft(DFG),TRR274(Project ID 408885537,Sy Nergy,EXC 2145/ID 390857198,to FMB)。
文摘The remodeling of axonal connections following injury is an important feature driving functional recovery.The reticulospinal tract is an interesting descending motor tract that contains both excitatory and inhibitory fibers.While the reticulospinal tract has been shown to be particularly prone to axonal growth and plasticity following injuries of the spinal cord,the differential capacities of excitatory and inhibitory fibers for plasticity remain unclear.As adaptive axonal plasticity involves a sophisticated interplay between excitatory and inhibitory input,we investigated in this study the plastic potential of glutamatergic(vGlut2)and GABAergic(vGat)fibers originating from the gigantocellular nucleus and the lateral paragigantocellular nucleus,two nuclei important for locomotor function.Using a combination of viral tracing,chemogenetic silencing,and AI-based kinematic analysis,we investigated plasticity and its impact on functional recovery within the first 3 weeks following injury,a period prone to neuronal remodeling.We demonstrate that,in this time frame,while vGlut2-positive fibers within the gigantocellular and lateral paragigantocellular nuclei rewire significantly following cervical spinal cord injury,vGat-positive fibers are rather unresponsive to injury.We also show that the acute silencing of excitatory axonal fibers which rewire in response to lesions of the spinal cord triggers a worsening of the functional recovery.Using kinematic analysis,we also pinpoint the locomotion features associated with the gigantocellular nucleus or lateral paragigantocellular nucleus during functional recovery.Overall,our study increases the understanding of the role of the gigantocellular and lateral paragigantocellular nuclei during functional recovery following spinal cord injury.
基金supported by National Natural Science Foundation of China(Nos.52370025,22176012)BUCEA Post Graduate Innovation Project(No.PG2024086)。
文摘Sludge,the massive by-product of the sewage system,became a major challenge for the wastewater treatment industry.Yet,conventional methods often face challenges like low efficiency,high energy consumption,and environmental pollution.Especially,the improper treatment and disposal of toxic sludge generated from different industrial processes or specific wastewater treatment operations exerted significant pressure and threat to hydrosphere,pedosphere,atmosphere and even biosphere.
文摘1.The development history of enhanced recovery after surgery(ERAS)Enhanced recovery after surgery(ERAS)is a multimodal perioperative care approach that has evolved over the past 2 decades since its inception.In 1997,Professor Henrik Kehlet,also known as the“father of ERAS”,from the University of Copenhagen in Denmark first proposed the ERAS concept and discovered its clinical feasibility and superiority,achieving remarkable results.ERAS was initially applied in colorectal surgery;subsequently,the concept gradually gained popularity and application worldwide.
基金This study is part of the RECOLLECT 2 programme,a five-year(2020-2025)project funded by the National Institute for Health and Care Research,which investigates the effectiveness and cost-effectiveness of recovery colleges.
文摘Background Recovery colleges (RCs) support personal recovery through education, skill development and social support for people with mental health problems, carers and staff. Guided by co-production and adult learning principles, RCs represent a recent mental health innovation. Since the first RC opened in England in 2009, RCs have expanded to 28 countries and territories. However, most RC research has been conducted in Western countries with similar cultural characteristics, limiting understanding of how RCs can be culturally adapted. The 12-item Recovery Colleges Characterisation and Testing (RECOLLECT) Fidelity Measure (RFM) evaluates the operational fidelity of RCs based on 12 components, but cultural influences on these components remain underexplored.Aims To assess associations between Hofstede’s cultural dimensions and RFM items to identify cultural influences on fidelity components.Methods A cross-sectional survey of RC managers was conducted across all 221 RCs. Mixed-effects regression models examined associations between Hofstede’s country-level cultural dimensions and item-level RFM scores, adjusted for healthcare expenditure and income inequality. Four cultural dimensions, obtained from Hofstede, were analysed: individualism (prioritising personal needs), indulgence (enjoyment-oriented), uncertainty avoidance (preference for predictability) and long-term orientation (future-focused).Results The RFM was completed by 169 (76%) RC managers. Seven RFM items showed associations with cultural dimensions. Equality was linked to short-term orientation, while learning was associated with individualism and uncertainty avoidance. Both individualism and indulgence influenced co-production and community focus. Commitment to recovery was shaped by all four cultural dimensions, with the strongest associations seen for individualism and indulgence. Individualism enhanced explicit focus on strengths-based practice, while uncertainty avoidance influenced course distinctiveness.Conclusions This study demonstrates how culture shapes RC fidelity components, providing actionable insights for cultural adaptation. Incorporating under-represented dimensions, such as collectivism and restraint, could improve the RFM’s global applicability, facilitating implementation. Future research should explore cultural nuances, engage diverse stakeholders and refine fidelity measures to enhance RC inclusivity and effectiveness worldwide.
文摘Objective:To investigate the effects of performance-linked early rehabilitation management model on the recovery of neurological function,motor function and activities of daily living in patients after intracerebral hemorrhage surgery.Methods:A randomized controlled trial design was adopted.A total of 120 patients after cerebral hemorrhage surgery admitted to our hospital from June 2023 to June 2024 were selected as the research subjects and were randomly divided into the experimental group and the control group,with 60 cases in each group according to the random number table method.The control group received routine postoperative care and rehabilitation guidance in neurosurgery,while the experimental group implemented an efficacy linkage early rehabilitation management model on the basis of routine care.Before the intervention,4 weeks after the intervention,and 12 weeks after the intervention,the National Institutes of Health Stroke Scale(NIHSS),the Fugl-Meyer Assessment of Motor Function(FMA),and the Barthel Index(BI)were used to assess the degree of neurological deficits,motor function,and activities of daily living in patients,respectively.Results:After 4 weeks and 12 weeks of intervention,the NIHSS scores of the experimental group[(8.5±2.1)points,(5.2±1.8)points]were significantly lower than those of the control group[(10.8±2.4)points,(7.9±2.2)points](P<0.01);FMA scores[(58.4±10.2)points,(78.6±12.4)points]and BI scores[(55.3±11.5)points,(72.8±13.2)points]were significantly higher than those of the control group[(45.2±9.8)points,(62.3±11.7)points;(42.1±10.6)points,(58.4±12.5)points](P<0.01).Conclusion:The performance-linked early rehabilitation management model can effectively promote the recovery of neurological and motor functions in patients after cerebral hemorrhage surgery and significantly improve their ability to take care of themselves in daily living.It is an efficient rehabilitation management strategy.
基金financially supported by the National Natural Science Foundation of China(Nos.52074078 and 52374327)the Applied Fundamental Research Program of Liaoning Province(No.2023JH2/101600002)+5 种基金the Liaoning Provincial Natural Science Foundation of China(No.2022-YQ-09)the Shenyang Young Middle-Aged Scientific and Technological Innovation Talent Support Program,China(No.RC220491)the Liaoning Province Steel Industry-University-Research Innovation Alliance Cooperation Project of Bensteel Group,China(No.KJBLM202202)the Fundamental Research Funds for the Central Universities,China(Nos.N2201023 and N2325009)the Key Scientific Research Project of Liaoning Provincial Department of Education(2024JYTZD-03)the 111 Project(B16009).
文摘FeCl_(3) solution is commonly used in the etching process of stainless steel.The typical etching waste liquid contains a significant amount of Fe^(3+),Fe^(2+),Cr^(3+),and Ni^(2+),making it difficult to reuse and posing pollution issues.The FeCl_(3) etching waste liquid was the present subject,which aimed to extract Cr^(3+)and Ni^(2+)by selectively adjusting process parameters.Additionally,it investigates the migration behavior and phase transition mechanisms of the iron,chromium,and nickel in different solution systems during treatment,systematically elucidating the regeneration mechanisms of FeCl_(3) etching waste liquid.The results indicate that Cr and Ni can be recycled by controlling parameters such as pH value,temperature,and the valence states of the ions.Following a selective reduction of Fe^(3+)to Fe^(2+)using Fe powder,98.3%of Cr^(3+)was recovered by adjusting the solution’s pH.Subsequently,93.3%of Ni^(2+)was extracted from the Cr-depleted solution through further adjustments to the process parameters.The recovered Cr and Ni can be used to prepare Fe–Cr and Fe–Ni alloy powders.Furthermore,the FeCl_(3) etching solution was regenerated by oxidizing Fe^(2+)and recovering impurities.The theoretical support for the development of new processes for treating FeCl_(3) etching waste liquid is provided.
文摘BACKGROUND Surgical resection is the primary treatment for gastric cancer,but it often leads to slow recovery,high complications,and poor psychological health.The effectiveness of enhanced recovery after surgery(ERAS)as a new nursing model postsurgery remains uncertain.AIM To investigate the clinical effect of accelerated recovery nursing program based on multidisciplinary collaboration model in gastric cancer surgery.METHODS A total of 120 patients who underwent radical gastrectomy at our hospital from January 2023 to December 2024 were included in the study.They were divided into two groups of 60 each:The control group,which received routine care,and the study group,which received ERAS based on multidisciplinary collaboration.Both groups received care until discharge.We compared gastrointestinal recovery,psychological status,Short Form 36 Health Survey scores,Pittsburgh Sleep Quality Index,complications,and nursing satisfaction between the two groups.RESULTS The study group had significantly shorter defecation time,bowel sound recovery time,and flatus time compared to the control group(P<0.05).The Hamilton Anxiety Scale and Hamilton Depression Rating Scale scores were also significantly lower in the study group(P<0.05).Additionally,the study group reported better sleep quality(P<0.05)and had fewer postoperative complications.Their Short Form 36 Health Survey scores and nursing satisfaction were higher than those of the control group,with all differences being statistically significant(P<0.05).CONCLUSION The ERAS based on multidisciplinary collaboration in patients undergoing radical gastrectomy can accelerate postoperative recovery,reduce the occurrence of complications,and improve psychological state,quality of life,sleep quality and nursing satisfaction.
文摘BACKGROUND Limited evidence exists regarding the role of enhanced recovery after surgery(ERAS)protocols in optimizing pain management and functional recovery after colorectal cancer(CRC)surgery.AIM To evaluate the impact of ERAS protocols on postoperative pain management and functional recovery in patients undergoing CRC surgery.METHODS A total of 109 patients with CRC admitted to The Third Affiliated Hospital of Jinzhou Medical University between June 2021 and June 2024 were enrolled in this study.They were divided into two groups:A control group(n=50)receiving standard perioperative care and an observation group(n=59)managed under an ERAS protocol.Clinical outcomes,including postoperative pain intensity[assessed using the Visual Analogue Scale(VAS)],functional recovery indicators(time to first ambulation,bowel sound recovery,first anal gas discharge,and first defecation),average sleep duration on postoperative day 3,sleep quality(measured using the Pittsburgh Sleep Quality Index),length of hospitalization,quality of life(evaluated using the Short Form 36 Health Survey),and incidence of postoperative complications(e.g.,surgical site infection,pulmonary infection,abdominal distension/pain,and intestinal obstruction),were systematically compared between the two groups.RESULTS The observation group exhibited significantly lower VAS scores at 72 hours postoperatively,shorter durations of maximum VAS scores,earlier recovery of functional indicators(time to first ambulation,bowel sound recovery,first anal gas discharge,and first defecation),and shorter hospitalization compared with the control group.Additionally,average sleep duration on postoperative day 3 was significantly longer in the observation group.Furthermore,the observation group demonstrated significantly improved sleep quality(lower Pittsburgh Sleep Quality Index scores)and higher quality of life(higher Short Form 36 Health Survey scores across all domains)than both the baseline and control groups.The incidence of total postoperative complications was also significantly lower in the observation group than in the control group.CONCLUSION ERAS protocols are highly effective in relieving postoperative pain,accelerating functional recovery,and improving overall clinical outcomes in patients with CRC undergoing surgery,supporting their broader clinical application.
文摘BACKGROUND Laparoscopic cholecystectomy is the primary method for treating cholecystitis.Traditional postoperative care has poor outcomes for patient recovery.The enhanced recovery after surgery(ERAS)model is increasingly applied in clinical settings.However,the impact of this nursing model on patients undergoing laparoscopic cholecystectomy remains unclear.AIM To evaluate the effects of ERAS on postoperative gastrointestinal recovery and quality of life in patients undergoing laparoscopic cholecystectomy.METHODS This is a retrospective study design in which we collected clinical data from 120 patients who underwent laparoscopic cholecystectomy at our hospital.Patients were divided into a control group(n=60)and a study group(n=60)based on the type of nursing intervention.The control group received conventional care,while the study group received ERAS.We assessed gastrointestinal recovery,quality of life,and nursing satisfaction before and after the nursing interventions in both groups.RESULTS After nursing care,the gastrointestinal recovery times(time to bowel sounds return,time to flatus,time to first bowel movement,and time to first meal)in the study group were significantly shorter than those in the control group,with statistically significant differences between the two groups(P<0.05).Additionally,the quality of life in the study group was significantly higher than that in the control group(P<0.05).The nursing satisfaction in the study group was also significantly higher than that in the control group,with statistically significant differences between the two groups(P<0.05).CONCLUSION In summary,compared to conventional nursing,ERAS can more rapidly promote gastrointestinal recovery and improve the quality of life in patients after laparoscopic cholecystectomy.Further clinical application of this approach is warranted.
文摘BACKGROUND Current standard nursing practices demonstrate limited effectiveness in perioperative colorectal cancer(CRC)management,highlighting the need to explore alternative care strategies that improve clinical outcomes.AIM To investigate the impact of music therapy and anesthesia recovery care on anesthesia recovery in patients with CRC undergoing laparoscopic radical resection.METHODS One hundred and twenty patients scheduled for elective laparoscopic CRC radical resection at Affiliated Hospital of Jiangnan University from January 2022 to May 2024 were enrolled.The patients were assigned to control(n=60,receiving standard nursing care)and observation groups(n=60,receiving music therapy,anesthesia recovery care,and standard nursing care).We comparatively analyzed the time to regain consciousness,extubation time,and length of stay in the postanesthesia care unit;heart rate,systolic blood pressure,and diastolic blood pressure before anesthesia and during recovery;cortisol,aldosterone,norepinephrine,and adrenaline levels before anesthesia and 24 hours postoperatively;Postoperative Quality of Recovery Scale scores;and complication rates between the groups.RESULTS The observation group exhibited a significantly shorter time to regain consciousness,extubation time,and postanesthesia care unit stay than the control group(P<0.05).During the recovery period,heart rate,systolic blood pressure,and diastolic blood pressure significantly increased in both groups compared with preanesthesia levels,with the levels in the observation group being significantly lower than those in the control group(P<0.05).At 24 hours postoperatively,cortisol,aldosterone,norepinephrine,and adrenaline levels were elevated in both groups compared with preanesthesia levels,with levels in the observation group being significantly lower than those in the control group(P<0.05).The observation group achieved significantly higher Postoperative Quality of Recovery Scale scores than the control group(P<0.05).Moreover,the complication rate in the observation group was significantly lower than that in the control group(10.00%vs 40.00%,P<0.05).CONCLUSION Music therapy combined with anesthesia recovery care remarkably boosted the quality of anesthesia recovery in patients undergoing laparoscopic CRC radical resection,mitigated fluctuations in vital signs and stress responses,improved postoperative recovery quality,and reduced complication rates,demonstrating substantial clinical value.
基金supported in part by NIH R01 NS100531,R01 NS103481NIH R21NS130241(to LD)+3 种基金Merit Review Award I01 BX002356,I01 BX003705 from the U.S.Department of Veterans AffairsIndiana Spinal Cord and Brain Injury Research Foundation(No.19919)Mari Hulman George Endowment Funds(to XMX)Indiana Spinal Cord&Brain Injury Research Fund from ISDH(to NKL and LD)。
文摘Schwann cell transplantation is considered one of the most promising cell-based therapy to repair injured spinal cord due to its unique growth-promoting and myelin-forming properties.A the Food and Drug Administration-approved Phase I clinical trial has been conducted to evaluate the safety of transplanted human autologous Schwann cells to treat patients with spinal cord injury.A major challenge for Schwann cell transplantation is that grafted Schwann cells are confined within the lesion cavity,and they do not migrate into the host environment due to the inhibitory barrier formed by injury-induced glial scar,thus limiting axonal reentry into the host spinal cord.Here we introduce a combinatorial strategy by suppressing the inhibitory extracellular environment with injection of lentivirus-mediated transfection of chondroitinase ABC gene at the rostral and caudal borders of the lesion site and simultaneously leveraging the repair capacity of transplanted Schwann cells in adult rats following a mid-thoracic contusive spinal cord injury.We report that when the glial scar was degraded by chondroitinase ABC at the rostral and caudal lesion borders,Schwann cells migrated for considerable distances in both rostral and caudal directions.Such Schwann cell migration led to enhanced axonal regrowth,including the serotonergic and dopaminergic axons originating from supraspinal regions,and promoted recovery of locomotor and urinary bladder functions.Importantly,the Schwann cell survival and axonal regrowth persisted up to 6 months after the injury,even when treatment was delayed for 3 months to mimic chronic spinal cord injury.These findings collectively show promising evidence for a combinatorial strategy with chondroitinase ABC and Schwann cells in promoting remodeling and recovery of function following spinal cord injury.
基金supported by the National Natural Science Foundation of China,Nos.82071387(to HT),81971172(to YW)the Natural Science Foundation of Zhejiang Province,China,No.LY22H090012(to HT)the Basic Research Project of Wenzhou City,China,No.Y20220923(to MZ)。
文摘The M1/M2 phenotypic shift of microglia after spinal cord injury plays an important role in the regulation of neuroinflammation during the secondary injury phase of spinal cord injury.Regulation of shifting microglia polarization from M1(neurotoxic and proinflammatory type)to M2(neuroprotective and anti-inflammatory type)after spinal cord injury appears to be crucial.Tryptanthrin possesses an anti-inflammatory biological function.However,its roles and the underlying molecular mechanisms in spinal cord injury remain unknown.In this study,we found that tryptanthrin inhibited microglia-derived inflammation by promoting polarization to the M2 phenotype in vitro.Tryptanthrin promoted M2 polarization through inactivating the cGAS/STING/NF-κB pathway.Additionally,we found that targeting the cGAS/STING/NF-κB pathway with tryptanthrin shifted microglia from the M1 to M2 phenotype after spinal cord injury,inhibited neuronal loss,and promoted tissue repair and functional recovery in a mouse model of spinal cord injury.Finally,using a conditional co-culture system,we found that microglia treated with tryptanthrin suppressed endoplasmic reticulum stress-related neuronal apoptosis.Taken together,these results suggest that by targeting the cGAS/STING/NF-κB axis,tryptanthrin attenuates microglia-derived neuroinflammation and promotes functional recovery after spinal cord injury through shifting microglia polarization to the M2 phenotype.
文摘When disruptions occur, the airlines have to recover from the disrupted schedule. The recovery usually consists of aircraft recovery, crew recovery and passengers' recovery. This paper focuses on the integrated recovery, which means above-mentioned two or more recoveries are considered as a whole. Taking the minimization of the total cost of assignment, cancellation and delay as an objective, we present a more practical model, in which the maintenance and the union regulations are considered. Then we present a so-called iterative tree growing with node combination method. By aggregating nodes, the possibility of routings is greatly simplified, and the computation time is greatly decreased. By adjusting the consolidating range, the computation time can be controlled in a reasonable time. Finally, we use data from a main Chinese airline to test the algorithm. The experimental results show that this method could be used in the integrated recovery problem.
文摘BACKGROUND Although the 2021 Chinese Clinical Practice Guidelines for Enhanced Recovery after Surgery(ERAS)provide recommendations for ERAS in gastrointestinal surgery,the clinical application of standard ERAS nursing models is challenging due to the variety of diseases involved in gastrointestinal surgery and the com-plex factors contributing to patient stress responses.Moreover,stress responses are more severe in older adult patients.Therefore,precision medicine is required to improve the quality of nursing care and promote postoperative recovery in gastrointestinal surgery.and demonstrate nursing benefits through clinical practice.METHODS This randomized clinical trial first established an evidence-based nursing ERAS protocol in older adult patients based on literature related to perioperative nursing measures for gastrointestinal surgery stress response.Next,392 older adult patients who underwent gastrointestinal surgery and were admitted to our hospital between December 2021 and June 2023 were categorized into two groups to receive evidence-based(study group)or conventional(control group)ERAS nursing models,respectively.Intraoperative physiological parameters during surgery and postoperative recovery indicators were compared between the groups.RESULTS Among 64 domestic and international studies,the stress responses of older adult patients mainly included emotional anxiety,sleep disorders,gastrointestinal discomfort,physical weakness,pain,and swelling.The appropriate nursing interventions included comprehensive psychological counseling,pre-and postoperative nutritional support,temperature control,pain management,and rehabilitation training.Compared with the control group,the study group showed lower heart rate,mean arterial pressure,blood glucose level,and adrenaline level;shorter duration of drainage tube placement,time to first flatus,time to first ambulation,and postoperative hospital stay;lower anxiety scores on postoperative day 3;and lower incidences of postoperative infection,obstruction,poor wound healing,and gastrointestinal reactions were lower in the study group(all P<0.05).CONCLUSION The evidence-based nursing measures targeting stress responses based on the conventional ERAS nursing model resulted in stable intraoperative physiological parameters during surgery,promoted postoperative recovery,and reduced the incidence of complications.
