Purpose To explore the practical value of enteral nutrition care guided by evidence-based concepts in preventing enteral nutritional complications in critically ill neurosurgical patients. Methods Three hundred critically ill patients from March 2020 to October 2021 from our neurosurgery department were included in the study. Patients were divided into a control group (March to December 2020, n = 150) and a study group (January to October 2021, n = 150) according to the order of their admission. The control group received conventional enteral nutrition care, and the study group received enteral nutrition care based on evidence-based concept guidance. The levels of serum nutritional indicators [hemoglobin (Hb), albumin (ALB), and total protein (TP)], feeding compliance rate, the incidence of complications (gastric retention, bloating, diarrhea, reflux, vomiting, aspiration, stress ulcers, etc.), and prognosis during the observation period were compared between the two groups. The scores of the questionnaire of knowledge, attitude, and practice on nutrition among neurosurgical nurses before and after the implementation of evidence-based care were compared among nursing staff in the study group. Results At 1 and 2 weeks after enrollment, Hb, ALB, and TP levels were lower in both groups than before enrollment in the same group ( P < 0.05). At 2 weeks after enrollment, Hb, ALB, and TP levels were higher in both groups than at 1 week after enrollment in the same group ( P < 0.05). At 1 and 2 weeks after enrollment, Hb, ALB, and TP levels were higher in the study group than in the control group ( P < 0.05). At 7 days after feeding, the feeding compliance rate was higher in the study group (94.67%) than in the control group (70.00%) ( P < 0.05). The total complication rate was lower in the study group (8.00%) than in the control group (16.00%) ( P < 0.05). The percentage of good prognosis was higher in the study group (34.00%) than in the control group (23.33%) ( P < 0.05). After the implementation of evidence-based care, caregivers in the study group scored higher on nutrition knowledge, nutrition attitudes, and nutrition practices than those before the implementation ( P < 0.05). Conclusion The implementation of evidence-based nursing interventions in critically ill neurosurgical patients based on evidence-based concepts is of great clinical value in correcting their nutritional status, preventing enteral nutritional complications, improving prognosis, and enhancing the nutritional knowledge, attitudes, and practices of nursing staff.

Background Hirschsprung's disease (HD) is a commonly digestive malformation in children that usually requires surgery. This study aims to evaluate the short-term efficacy of conventional laparoscopic surgery (CLS), transumbilical single-hole laparoscopic surgery (TU-LESS), and robotic surgery (RS) in the treatment of Hirschsprung's disease. Methods 90 patients with Hirschsprung's disease undergone laparoscopic surgery at our center between 2015 and 2019, divided into three groups (group CLS, TU-LESS and RS), were retrospectively analysed. Results CLS and TU-LESS group showed no significant difference in operation duration ( P  > 0.05) but shorter operation duration than the RS group ( P   0.05). Conclusion The three surgical methods for HD revealed similar efficacy, where TU-LESS and CLS spent less time than RS; TU-LESS led to the most aesthetic effect, followed by CLS and RS.

Background Previous studies have linked internet use with several beneficial outcomes for brain health, but there is little data on this among older Chinese. Objective The goal of this study was to explore the association between internet use and cognitive impairment and to explore the possible mechanisms by which internet use prevents cognitive decline. Methods The current study consisted of two cohorts: one from the China Longitudinal Aging Study (CLAS), which included 610 older adults with mild cognitive impairment (MCI), 192 with dementia, and 2,218 healthy older adults; the second cohort included 39 healthy adults from the Shanghai brain health foundation (SHBHF2016001), who underwent T1 cranial magnetic resonance imaging at baseline, from which their volumes of the hippocampus, amygdala, and globus pallidus were calculated. Moreover, they were also followed up for 1 year. Through standardized questionnaires, detailed general demographic information and internet use information was obtained. The cognitive diagnosis of each participant was made by attending psychiatrists at baseline, and their overall cognitive function was assessed by the mini-mental state examination (MMSE) and Montreal Cognitive Assessment (MoCA). Results In cohort 1, after controlling age, gender, smoker, tea drinker, take exercise, diabetes, and hypertension, we found that internet use was associated with MCI ( P = 0.015, OR = 0.478, 95% CI: 0.264~0.867), but not for dementia ( P = 0.205, OR = 0.393, 95% CI: 0.093~1.665). In cohort 2, we found that the globus pallidus volume of internet users was significantly larger than that of non-users, and the MMSE change score was lower ( P < 0.05). The results of partial correlation analysis (controlled for sex, age and education) showed that the change of MMSE value was positively correlated with the volume of left globus pallidus ( r = 0.547, P = 0.004). Conclusions Internet use might be a protective factor for mild cognitive impairment among the Chinese elderly, and it may prevent a decline in cognitive decline by affecting the volume of the globus pallidus.

The manufacturer's instructions for the venereal disease research laboratory (VDRL) antigen test for diagnosing neurosyphilis describe testing of serum samples and do not include procedures for cerebrospinal fluid (CSF) testing. This study compared the CSF-VDRL test with 10 μL of antigen (CSF-VDRL-10) according to the American Public Health Association to the CSF-VDRL test with 17 μL of antigen (CSF-VDRL-17) according to the VDRL serum procedure. A total of 121 neurosyphilis patients and 86 syphilis/non-neurosyphilis patients were included. The sensitivities of the CSF-VDRL-10 and CSF-VDRL-17 tests were comparable for neurosyphilis diagnosis. The positive rate of the CSF-VDRL-17 test was higher than that of the CSF-VDRL-10 test. In all, 78.3% of the quantitative CSF-VDRL-17 results were consistent with those of the CSF-VDRL-10 test, 18.4% exhibited one-titer higher results than those of the CSF-VDRL-10 test, and 3.4% had positive CSF-VDRL-17 results but negative CSF-VDRL-10 results. The CSF-VDRL test with 17 μL of antigen was more sensitive, and it is worth performing longitudinal studies to understand its practical implications.

Background People's lifestyles may have changed during the COVID-19 pandemic, which may have a profound impact on pregnant women and newborns. This study aims to assess the effects of the COVID-19 pandemic on uninfected pregnant women and their newborns, including potential environmental factors. Methods We retrospectively analyzed the pregnancy complications of 802 cases in the pandemic group and 802 controls in the pre-pandemic group in a matched nested case-control study, and evaluated the association with sociodemographic features, lifestyles, and other factors in 311 pregnant women with adverse pregnancy outcomes. Results Compared to the pre-pandemic group, the rates of anemia, vaginitis, shoulder dystocia, and adverse pregnancy outcomes such as preterm birth were increased in the pandemic group. After controlling for the covariates, we observed a higher risk of adverse pregnancy outcomes in the pandemic group. Pregnant women with adverse pregnancy outcomes had an increased rate of anemia and vaginal candidiasis. Conclusion COVID-19 pandemic has profound effects on adverse pregnancy outcomes, suggesting the importance of ensuring regular prenatal checkups and keeping a healthy lifestyle.

The efficacy and safety of early renal replacement therapy (eRRT) for critically ill patients with acute kidney injury (AKI) remain controversial. Therefore, the purpose of our study was to perform an up-to-date meta-analysis with the trial sequential analysis (TSA) of randomized controlled trials (RCTs) to evaluate the therapeutic effect of eRRT on patients in an intensive care unit (ICU). We extensively searched MEDLINE, EMBASE, LILACS, the Cochrane Central Register of Controlled Trials and ClinicalTrials.gov, Gray Literature Report, and Bielefeld Academic Search Engine (BASE), and conducted an updated search on December 27, 2021. The included studies were RCTs, which compared the efficacy and safety of eRRT and delayed renal replacement therapy (dRRT) on critically ill patients with AKI. We adopted TSA and sensitivity analysis to strengthen the robustness of the results. About 12 RCTs with a total of 5,423 participants were included. Patients receiving eRRT and dRRT had the similar rate of all-cause mortality at day 28 (38.7% vs. 38.9%) [risk ratio (RR), 1.00; 95%CI, 0.93–1.07, p = 0.93, I 2 = 0%, p = 0.93]. A sensitivity and subgroup analysis produced similar results for the primary outcome. TSA showed that the required information size was 5,034, and the cumulative Z -curve crossed trial sequential monitoring boundaries for futility. Patients receiving eRRT had a higher rate of renal replacement therapy (RRT) (RR, 1.50, 95% CI: 1.28–1.76, p < 0.00001, I 2 = 96%), and experienced more adverse events comparing to those receiving dRRT (RR: 1.41, 95% CI: 1.22–1.63, p < 0.0001, heterogeneity not applied). The most remarkable and important experimental finding is that, to our knowledge, the current meta-analysis included the largest sample size from the RCTs, which were published in the past 10 years to date, show that eRRT had no significant survival benefit for ill patients with AKI compared with dRRT and TSA indicating that no more studies were needed to confirm it.