联络小组工作模式在糖尿病社区干预中的效果评价

目的探讨社区糖尿病联络小组在社区糖尿病患者管理中的作用与护理效果。方法以糖尿病专科医生及护士为主导,成立4个糖尿病联络小组,每个小组包括1名医生和2名护士,以医院附近的居民小区内的120名糖尿病患者为对象进行干预。干预前后进行对比。结果经过糖尿病联络小组干预3个月后,本社区糖尿病患者对糖尿病相关知识及操作技能的掌握程度显著提高(P<0.01),对胰岛素注射管理及低血糖处理的正确率明显提高(P<0.05)。结论社区糖尿病联络小组提高了糖尿病患者对糖尿病知识的掌握,减少了患者不正确的护理方式,自我管理技能显著提高。     

经圆窗径路导入正庚醇建立老年性聋模型的实验研究

目的 研究经耳后圆窗径路向C57BL/6Cnc小鼠内耳导入正庚醇对其听性脑干诱发电位(ABR)的影响,并建立老年性耳聋模型.方法 选取30只健康4周龄C57BL/6Cnc小鼠,随机分成实验组和对照组,每组15只.实验组经耳后圆窗径路缓慢导入正庚醇5μL,对照组经耳后圆窗径路缓慢导入0.9％氯化钠注射液5μL.各组小鼠分...     

Modified Chevron Osteotomy with Distal Soft Tissue Release for Treating Moderate to Severe Hallux Valgus Deformity: A Minimal Clinical Important Difference Values Study

ObjectiveTo explore whether modified Chevron osteotomy together with distal soft tissue release would correct moderate to severe HV deformity and what is the minimal clinical important difference (MCID) for objective and subjective evaluating parameters.MethodsFrom March 2018 to January 2019, 40 hallux valgus patients (including moderate to severe) were enrolled in this retrospective study. The cohort included four males and 36 females. The average age at surgery was 50.95 (range 22–75) years. All patients underwent modified Chevron osteotomy together with distal soft tissue release and completed at least one follow‐up at clinic. The American Orthopaedic Foot and Ankle forefoot score (AOFAS, forefoot), Visual Analog Scale (VAS), and Foot Function Index (FFI) were all collected before and after surgery. Besides, the hallux valgus angle (HVA), 1st–2nd intermetatarsal angle (IMA) and distal metatarsal articular angle (DMAA) were measured both before surgery and at last follow‐up. All MCID values were calculated by employing distribution‐based method.ResultsThirty‐seven patients (92.5%) showed satisfied result at a mean 14.3‐month follow‐up (range 13–22 month). Two patients complained about residual pain at the bunion, and overcorrection (hallux varus) occurred in one patient. Meanwhile, no patient observed nonunion. Being female, age more than 60, residual HVA deformity (>15°), and post IMA more than 9° showed no statistical relationship with the post‐operation residual pain (P > 0.05). However, high VAS score before surgery (more than 7) showed strong correlation with residual pain (P < 0.01). The subjective MCID value was 9.50 for AOFAS, 18.92 for FFI, and 1.27 for VAS, respectively.ConclusionThe modified Chevron osteotomy together with distal soft tissue release could achieve a satisfied result for moderate to severe HV deformity at early follow‐up. The residual pain was associated with severe pain before surgery (VAS more than 7).

This study aimed to explore:

1. The clinical result of Chevron osteotomy combined with distal soft tissue release for moderate to severe HV patients;
2. The actual subjective MCID values (derived from Patient Reported Outcomes) of AOFAS, VAS, and FFI of HV patients who underwent such a procedure;
3. The objective (detected from measurements) MCID values of hallux valgus angle (HVA), 1st–2nd intermetatarsal angle (IMA), and distal metatarsal articular angle (DMAA).

The retrospective study aimed to provide more options for surgeons when selecting proper procedure for treating moderate to severe HA patients.     

Pre-attack and pre-episode symptoms in cluster headache: a multicenter cross-sectional study of 327 Chinese patients

BackgroundThere have been a few studies regarding the pre-attack symptoms (PAS) and pre-episode symptoms (PES) of cluster headache (CH), but none have been conducted in the Chinese population. The purpose of this study was to identify the prevalence and features of PAS and PES in Chinese patients, as well as to investigate their relationships with pertinent factors.MethodsThe study included patients who visited a tertiary headache center and nine other headache clinics between January 2019 and September 2021. A questionnaire was used to collect general data and information about PAS and PES.ResultsAmong the 327 patients who met the CH criteria (International Classification of Headache Disorders, 3rd edition), 269 (82.3%) patients experienced at least one PAS. The most common PAS were head and facial discomfort (74.4%). Multivariable logistic regression analysis depicted that the number of triggers (OR = 1.798, p = 0.001), and smoking history (OR = 2.067, p = 0.026) were correlated with increased odds of PAS. In total, 68 (20.8%) patients had PES. The most common symptoms were head and facial discomfort (23, 33.8%). Multivariable logistic regression analysis showed that the number of triggers were associated with increased odds of PES (OR = 1.372, p = 0.005).ConclusionsPAS are quite common in CH patients, demonstrating that CH attacks are not comprised of a pain phase alone; investigations of PAS and PES could help researchers better understand the pathophysiology of CH.     

Status and influencing factors of patients with kinesiophobia after insertion of peripherally inserted central catheter: A cross-sectional study

This study aimed to investigate the current status and influencing factors of kinesiophobia in patients after insertion of peripherally inserted central catheter (PICC).A total of 240 patients with PICC were included. Their postinsertion status and influencing factors were investigated using the general information questionnaire, Tampa Scale of Kinesiophobia (TSK), Medical Coping Modes Questionnaire, Numerical Rating Scale, and Self-rating Anxiety Scale.The mean TSK score was 36.49 ± 4.19 points, and 89 patients (37.08%) had kinesiophobia. Multiple linear regression analysis showed that factors such as education level, age, monthly income level, catheterization history, face, pain level, anxiety, and number of needle insertions influenced postoperative kinesiophobia in patients with PICC (P < .05). The total variation in the TSK score was 71.8%.The incidence of kinesiophobia was relatively high after PICC insertion. The medical staff needs to undertake targeted intervention measures to help minimize kinesiophobia after PICC insertion, allowing patients to perform scientifically correct functional exercises and attain physical recovery.     

Excellent Photonic and Mechanical Properties of Macromorphic Fibers Formed by Eu3+-Complex-Anchored,Unzipped, Multiwalled Carbon Nanotubes

The macromorphic properties of carbon nanotubes perform poorly because of their size limitations: nanosize in diameters and microsize in length. In this work, to realize these dual purposes, we first used an electrochemical method to tear the surface of multiwalled carbon nanotubes (MWCNTs) to anchor photonic Eu³⁺-complexes there. Through the polar reactive groups endowed by the tearing, the Eu³⁺-complexes coordinate at the defected structures, obtaining the Eu³⁺-complex-anchored, unzipped, multiwalled carbon nanotubes (E-uMWCNTs). The controllable surface-breaking retains the MWCNTs’ original, excellent mechanical properties. Then, to obtain the macromorphic structure with infinitely long fibers, a wet-spinning process was applied via the binding of a small quantity of polyvinyl alcohol (PVA). Thus, the wet-spun fibers with high contents of E-uMWCNTs (E-uMWCNT-Fs) were produced, in which the E-uMWCNTs took 33.3 wt%, a high ratio in E-uMWCNT-Fs. On the other hand, due to the reinforcing effect of E-uMWCNTs, the highest tensile strength can reach 228.2 MPa for E-uMWCNT-Fs. Meanwhile, the E-uMWCNT-Fs show high-efficiency photoluminescence and excellent media resistance performance due to the embedding effect of PVA on the E-uMWCNTs. Therefore, E-uMWCNT-Fs can exhibit excellent luminescence properties in aqueous solutions at pH 4~12 and in some high-concentration metal-ion solutions. Those distinguished performances promise outstanding innovations of this work.     

Impact of Obesogenic Environments on Sugar-Sweetened Beverage Consumption among Preschoolers: Findings from a Cross-Sectional Survey in Beijing

The excessive consumption of sugar-sweetened beverages (SSBs) has been proven to be critical for obesity among preschoolers. This study aimed to describe the SSB consumption rates among preschoolers in the Dongcheng District of Beijing, China, and to explore the association between obesogenic environmental determinants and consumption. We applied a stratified cluster sampling method and recruited 3057 primary caregivers of preschoolers in June 2019 to participate in the survey. The caregivers reported their children’s consumption rates of six categories of SSBs and their exposure rates to SSB-related obesogenic environments. The associations between them were tested using multivariate logistic regression models. The mean (SD) age of the children was 5.6 (0.6) years and nearly half (48.3%) were girls. About 84.5% of the children had consumed SSBs over the past three months, and sugar-sweetened milk beverages had the highest consumption rate. Higher exposure to advertisements for the corresponding SSB categories in children, higher frequency rates of consuming SSBs and of taking children to fast-food restaurants in caregivers, and lower frequency rates of reading the Nutrition Facts Panels by caregivers were associated with higher SSB consumption rates among children (p < 0.05 in all of the SSB categories investigated, except for the Nutrition Facts Panel reading behaviors for the sports and energy beverages). SSB consumption among preschoolers is of concern, and comprehensive policy actions and education are urgently needed.     

神经导航辅助显微手术在神经外科中的应用

目的：探讨神经导航技术在神经外科领域的应用前景和总结应用神经导航辅助显微神经外科手术切除位于脑重要功能区和深部小病灶的经验和体会。方法：我院2000年11月至2001年3月采用StealthStation神经导航系统辅助显微手术切除的颅内病灶18例,额叶6例（其中3例为于运动区）,顶叶4例,枕叶2例,颞叶1例,桥小脑角2例,小脑半球3例,脑膜瘤6例,胶质瘤4例,炎性肉芽肿2例,血管网织细胞瘤3例,脂肪瘤,三叉神经纤维瘤和寄生虫感染各1例,结果：神经导航总体误差1．8－5．7mm,平均2．8mm,病灶全切除14例,次全切4例,位于运动区的3例小病灶,手术全切除后无任何神经功能障碍,结论：Stealth Station神经导航系统定位准确,尤其是对位于脑深部和重要功能区的小病灶,辅助显微手术效果显。     

Construction of sulfur-containing N-vinylimides: N-addition of imides to propargyl sulfonium salts

An N-addition reaction between imides and propargyl sulfonium salts was developed to afford sulfur-containing N-vinylimides with moderate to excellent yields. Under the activation of NaOAc·3H₂O, imides could undergo deprotonation and propargyl sulfonium salts could isomerize to allenic sulfonium salts. The N-nucleophilic attack initiates the reaction and gives the desired products. Various imides, including arylimides, aliphatic imides and N-(arylsulfonyl) alkyl acylamides, and even bioactive saccharin, thalidomide and pomalidomide could provide organosulfur N-vinylimides compounds. The simple, mild and metal-free reaction conditions, the broad scope of substrates, gram-scale synthesis and convenient transformation embody the synthetic superiority of this process.

An N-addition reaction between imides and propargyl sulfonium salts was developed to afford sulfur-containing N-vinylimides with moderate to excellent yields.

N-vinylimides represent crucial structural motifs due to the importance of these frameworks (Fig. 1), which are the core structure found in biologically active structures,¹ functional materials² and natural products such as the parazoanthines A–E.³ They can also serve as versatile synthetic intermediates in the synthesis of β-2-amino acid derivatives⁴ and other complex structures.⁵Open in a separate windowFig. 1Representative functional N-vinylimides scaffolds.Due to the importance of these N-vinylimides frameworks, the growing interest in this featured moiety has catalyzed a recent spurt of attention for methodology appropriate for its construction. Conventionally, protocols for the synthesis of this important substrate class included transition-metal-catalyzed en-imidic C(sp²)–N bond formation reactions of imides with vinyl halides, pseudohalides or alkynes. The main strategies involved Cu-catalyzed Chan–Lam–Evans reactions,⁶ Ru-catalyzed hydroimidation reaction of imide with alkyne⁷ and Pd-catalyzed oxidative amination of alkenes.⁸ In 2021, Sandtorv''s group reported Cu-catalyzed Chan–Lam–Evans reaction for coupling cyclic imides and alkenylboronic acids by forming C(sp²)–N-bonds, enables the practical and mild preparation of (E)-enimides (Scheme 1a).^6a In 2020, Schaub''s group reported Ru-phosphine catalyzed hydroimidation reaction of cyclic amides with acetylene under low pressure, affording new method for synthesis of N-vinylimides (Scheme 1b).^7a Hull''s group reported Pd-catalyzed anti-Markovnikov oxidative amination reaction, alkenes are shown to react with imides in the presence of a palladate catalyst to generate the terminal imide, providing mild and robust complementary routes (Scheme 1c).^8a Besides, rarely examples of organo-catalytic conjugate additions of imides to acetylene can also provide methods for the synthesis of N-vinylimides.⁹Open in a separate windowScheme 1Approaches for vinylation of imides.The previously reported synthesis strategies mainly involved the use of expensive Ru and Pd-catalysts, otherwise toxic copper catalyst, and the structural limitations imposed to phthalimide and therefore specialized. Considering the limitation in generality, the harsh reaction condition, and the use of metal-catalysis decreased the attractiveness for synthetic applications, the development of new kind of vinylation reagents and their application of building N-vinylimides in a simple, mild, metal-free and efficient manner are highly desirable.Our earlier work inspired our interest in synthesis of N-vinylimides by employing propargyl sulfonium salts as vinylation reagent. We have been exploring new reaction patterns of sulfonium salts and developed propargyl sulfonium salts involved [3 + 2] annulation/substitution reaction and N-addition/[2,3]-sigmatropic rearrangement reaction in an acyclic model.¹⁰ Based on our processive interests on constructing N-functionalized vinylation reaction and exploring the diverse reactive pathway of propargyl sulfonium salts, we herein report the realization of inorganic base promoted N-addition reaction of imides and propargyl sulfonium salts, delivering potential bioactive sulfur-containing N-vinylimides in moderate to excellent yields (Scheme 1).We began our investigation by selecting phthalimide 1a and propargyl sulfonium salt 2a as model substrates (†).Optimization of the reaction conditions^a