Objectives: Intensive care unit (ICU) patients are at high risk of medical device related pressure injury (MDRPI). This study aims to ascertain the MDRPI prevalence in ICU patients and analyse the risk factors of MDRPI. Background:The occurrence of MDRPI not only increases hospitalisation time with pain and economic burden, but also causes medical disputes. A better understanding of this condition will increase knowledge and facilitate the ability to recognise and prevent MDRPI for clinical nursing staff. However, there are few multicentre studies of MDRPI prevalence in ICU patients in China. Design:A cross-sectional study design was employed.Methods: Data from 694 patients in 66 adult ICU at 30 hospitals in China were included between October 2018 and March 2019. The stage of each MDRPI was determined according to the definitions of National Pressure Ulcer Advisory Panel. The study methods were followed by the STORBE guidelines. Results:The overall prevalence rate of MDRPI was 13.1% (91/694), with 98 anatomic locations in total. The most common stages of MDRPI were stage 1 (54.1%, 53/98), stage 2 (15.3%, 15/98) and mucosal membrane pressure injury (15.3%, 15/98). MDRPI mainly occurred in the finger (32.7%, 32/98), followed by nose (18.4%, 18/98). The prevalence rate of MDRPI caused by CPAP or BiPAP masks (25%) was highest. Lower Braden scores and having skin oedema were risk factors for MDRPI in adult ICU patients. Conclusion:The prevalence of MDRPI in this study was still high. Nurses should take these related factors into consideration when taking care of ICU patients, and appropriate prevention measures should be adopted to decrease the prevalence of MDRPI.Relevance to clinical practice: The study can help to improve the PI prevention efforts in ICU patients specific to medical device related PI.

To investigate structural and functional brain changes in patients with primary open-angle glaucoma (POAG) by using voxel-based morphometry based on diffeomorphic anatomical registration through exponentiated Lie algebra (VBM-DARTEL) and blood oxygenation level dependent functional magnetic resonance imaging (BOLD-fMRI), respectively.Thirteen patients diagnosed with POAG and 13 age- and sex-matched healthy controls were enrolled in the study. For each participant, high-resolution structural brain imaging and blood flow imaging were acquired on a 3.0-Tesla magnetic resonance imaging (MRI) scanner. Structural and functional changes between the POAG and control groups were analyzed. An analysis was carried out to identify correlations between structural and functional changes acquired in the previous analysis and the retinal nerve fiber layer (RNFL).Patients in the POAG group showed a significant (P < 0.001) volume increase in the midbrain, left brainstem, frontal gyrus, cerebellar vermis, left inferior parietal lobule, caudate nucleus, thalamus, precuneus, and Brodmann areas 7, 18, and 46. Moreover, significant (P < 0.001) BOLD signal changes were observed in the right supramarginal gyrus, frontal gyrus, superior frontal gyrus, left inferior parietal lobule, left cuneus, and left midcingulate area; many of these regions had high correlations with the RNFL.Patients with POAG undergo widespread and complex changes in cortical brain structure and blood flow. (ClinicalTrials.gov number: NCT02570867).

The survey could make managers know their prevalence level of pressure ulcers and provide priorities for clinical nurses.

BackgroundBlack extrinsic discoloration in primary dentition is a common clinical and aesthetic problem that can co-occur with dental caries, the most common oral diseases in childhood. Although the role of bacteria in the formation of pigment and caries in primary dentition is important, their basic features still remain a further mystery.MethodsUsing targeted sequencing of the V1-V3 hypervariable regions of bacterial 16S ribosomal RNA (rRNA) genes, we obtained a dataset consisting of 831,381 sequences from 111 saliva samples and 110 supragingival plaque samples from 40 patients with pigment (black extrinsic stain), 20 with caries (obvious decay), and 25 with both pigment and caries and from 26 healthy individuals. We applied a Dirichlet multinomial mixture (DMM)-based community typing approach to investigate oral microbial community types.ResultsOur results revealed significant structural segregation of microbial communities, as indicated by the identification of two plaque community types (A and B) and three saliva community types (C-E). We found that the independent occurrence of the two plaque community types, A and B, was potentially associated with our oral diseases of interest. For type A, three co-occurring bacterial genus pairs could separately play a potential role in the formation of pigment (Leptotrichia and Fusobacterium), caries (unclassified Gemellales and Granulicatella), and mixed caries and pigment (Streptococcus and Mogibacterium). For type B, three co-occurring bacterial genera (unclassified Clostridiaceae, Peptostreptococcus, and Clostridium) were related to mixed pigment and caries. Three dominant bacterial genera (Selenomonas, Gemella, and Streptobacillus) were linked to the presence of caries.ConclusionsOur study demonstrates that plaque-associated oral microbial communities could majorly contribute to the formation of pigment and caries in primary dentition and suggests potential clinical applications of monitoring oral microbiota as an indicator for disease diagnosis and prognosis.Electronic supplementary materialThe online version of this article (doi:10.1186/s12864-016-2891-z) contains supplementary material, which is available to authorized users.

Seeking for suitable conjunctival reconstruction substitutes to overcome the limitations of current substitutes, such as amniotic membrane, is urgent. Decellularized tissues have become a promising strategy for tissue engineering. In this study, we prepared decellularized porcine pericardium (DPP) scaffolds by the phospholipase A2 method and crosslinked them with aspartic acid (Asp) and human endothelial growth factor (hEGF) to enhance biological performance on the DPP, obtaining DPP-Asp-hEGF scaffolds. In vitro DPP showed lower apoptosis, highly desirable, well preservation of extracellular matrix components, and favorable macro-microstructure, which was confirmed by histology, immunofluorescence, electron microscopy, collagen and DNA quantification, and cytotoxicity assay, compared to the native porcine pericardium (NPP). The crosslinked efficacy of the DPP-Asp-hEGF was furtherer verified by in vitro experiments with Fourier transform infrared (FTIR) and X-ray diffraction (XRD). Through animal models of conjunctiva defect model, the DPP-Asp-hEGF revealed a closed, multilayer epithelium with an equal amount of goblet cells and no indication for conjunctival scarring after 28 days, compared to amniotic membrane (AM) groups and sham groups. These results suggested that DPP-Asp-hEGF can offer a good conjunctival reconstructive substitute both in structure and in function.

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Background: The diagnosis of ocular myasthenia gravis (OMG) in adult patients remained challenged and the characteristics of diplopia and ophthalmoplegia in OMG is unclear. Methods: Retrospective case series study of medical records of 40 adult patients diagnosed with OMG at The First Affiliated Hospital of Jinan University from June, 2016 to December, 2019, was performed to analyze the clinical features, diagnostic tests and preferential affected extraocular muscles of OMG. Results: 40 adult patients with OMG were involved and men represented 20 (50%) of cases. Mean age (±SD) among men was 49 ± 21 years (range: 19-81 years) and 40 ± 15 years (range: 21-65 years) among women. 18 patients (45.0%) were 18 to 39 years old, 12 patients (30.0%) were 40 to 59 years old, 9 patients (22.5%) were 60 to 79 years old, 1 patients (2.5%) over 80 years old. The median course of the disease among all the patients was 6 months (ranged: 1 month to 10 years). Neostigmine test was positive in 32 of 40 patients (80.0%), acetycholine receptors antibodies assay was positive in 4 of 40 patients (10.0%), Thymus CT showed abnormal findings in 5 of 40 patients (12.5%). At the first visit, 27 patients (67.5%) showed diplopia only, 9 patients (22.5%) showed ptosis only, 4 patients (10.0%) showed diplopia with ptosis. The most paralytic EOM, determined through light reflection, cover-uncover test and red glass test for patients presented with diplopia only (n=27) and diplopia with ptosis (n=9), was lateral rectus (51.6%), superior rectus (19.4%), medial rectus (12.9%), inferior rectus (9.8%), superior oblique (3.2%), inferior oblique (3.2%) in order. Conclusions: OMG mainly affected adults at the working ages. Diplopia serves as initial symptom in most adult patients with OMG and lateral rectus is most susceptible.

Introduction: To investigates the impact of online study during COVID-19 on myopia in Chinese primary school students and to further analyze the influencing factors of myopia, so as to provide theoretical basis for prevention and control of myopia. Objectives: Cross-sectional study. A total of 905 primary school students from grade 1-6 in Guangzhou city were included in the study. Data were collected from uncorrected visual acuity (UCVA), non-cycloplegic photo refraction and an online questionnaire. Myopia was defined as visual acuity < 1.0 or spherical equivalent (SE) of ≤ − 0.50 diopters (D) in either eye. Chi-square and binary logistic regression analysis were applied to investigate the prevalence of myopia for different groups and potential risk factors on myopia. Results: A total of 905 students were evaluated. The mean (standard deviation) age was 9.7(±1.82) years. 699 students were identified to have myopic refractive error making the prevalence of 77.2% ([95% confidence interval (CI): 75.5%-80.0%]; myopia prevalence significantly increased with grade level, from 61.9% (95% CI: 54.0%-69.8%) at grade 1 to 84.0% (95% CI: 80.5%-90.1%) at grade 6. Low myopia (-3.0 D≤ SE ≤ -0.50 D) was account for 83.5% (95% CI: 80.3%-86.3%) among the myopia group, with the mean (standard deviation) SE (-1.32±0.66) D. Compared with children without myopia, the dry symptoms were more serious in myopic students (81.8% vs. 25.2%, χ 2 = 5.811, P = 0.016). Moreover, myopia prevalence significantly differences among different exposure natural light level (χ 2 = 8.382, P = 0.039). Binary logistic regression analysis showed children who spent more time on online-study or had higher grade level had a higher risk of myopia (OR: 1.147, 95% CI: 1.044-1.259; OR: 1.147, 95% CI: 1.044-1.259). Conclusions: The prevalence of myopia in primary school students from grade 1 to grade 6 in Guangzhou city is higher than previous study conducted in Guangzhou after the online-study during COVID-19. Myopia was significantly positively associated with higher grade, spending a less time outdoors; notably, playing with electronics had the greatest influence on the risk of myopia.