Abstract:Objective To prepare enoxaparin sodium-polycaprolactone(LMWH-PCL)sustained-release microspheres,observe their surface morphology,and test their physical properties,we aimed to provide a preparation method for the clinical application of low-molecular heparin sustained-release microspheres.Methods Microspheres were fabricated by the W/O/W method.The surface topological morphology of microsphere preparations was characterized using scanning electron microscopy(SEM),while the size distribution characteristics of particulate populations were quantitatively determined using a laser diffraction particle size analysis system.The drug loading and encapsulation rate of the drugs in the microspheres were determined using the measurement of anti-Xa factor potency method.Results Scanning electron microscopy and laser particle sizing showed that the larger the molecular weight of polycaprolactone,the more spherical the microsphere morphology,and the more homogeneous the particle size.However,the results of drug loading rate and encapsulation rate of enoxaparin sodium in microspheres determined by potency method were unsatisfactory.Conclusion LMWH-PCL microspheres could release the drug,which verified the feasibility of the microspheres for slow drug release.

Abstract:Objective This study aims to develop an evaluation index system for extracorporeal membrane oxygenation(ECMO)nursing care quality,thereby providing guidance and establishing standards to enhance clinical practice and improve the quality of ECMO nursing care.Methods Utilizing the"Structure--Process-Outcome"quality framework,preliminary indices for evaluation were formulated via literature analysis and expert interviews.Subsequent refinement was achieved via two iterative rounds of Delphi expert consultations,where indices were critically evaluated,modified,and assigned weights reflecting their importance in ECMO nursing care.Results The expert engagement was quantitatively assessed via two iterative rounds,revealing high levels of expertise with familiarity coefficients(0.937 and 0.962),judgment coefficients(0.968 and 0.975),and authority of the expert opinions(0.952 and 0.968)across the consultations.Statistical significance in agreement was achieved with Kendall's W coefficients of 0.134 and 0.119(P<0.05).The finalized index system comprises three primary indexes,8 secondary indexes,and 47 tertiary indexes.Conclusion The study established a comprehensive index system for evaluating ECMO nursing quality,which supports improvements in clinical practice and patient care through a structured assessment framework.

Abstract:Objective To investigate the correlation between continuous anion gap(AG)detection and 28-day mortality in critically ill patients undergoing continuous renal replacement therapy(CRRT).Methods A retrospective study was conducted on 143 critically ill patients with acute kidney injury who underwent CRRT in our intensive care unit from March 2021 to September 2024.According to the 28-day survival outcome,all patients were divided into death group and survival group.AG levels were monitored before CRRT(preCRRT)and 24 h after CRRT(postCRRT 24 h),and △AG(preCRRT-postCRRT 24 h AG)changes were recorded.Results According to the 28-day overall survival data,all participants were divided into a survival group(n=68)and a death group(n=75).The median follow-up time from ICU admission to discharge or death was 18.60(8.53,38.16)days.The preCRRT or postCRRT 24 h AG levels in death group was significantly higher than that in survival group(P<0.05),and △AG in death group was significantly lower than that in survival group(P<0.05).In restricted cubic spline analysis,preCRRT AG,postCRRT 24 h AG,and △AG were linearly correlated with 28 d mortality risk.After adjusting for other confounding factors,multivariate COX regression analysis showed that preCRRT AG,postCRRT 24 h AG and △AG were independent predictors of 28 d mortality risk in critically ill patients receiving CRRT(P<0.05).ROC curve analysis showed that preCRRT AG and postCRRT 24 h AG had predictive value of 0.886(95%CI:0.847-0.927)and 0.883(95%CI:0.844-0.922)for 28 d mortality risk,which was better than sequential orgen failure assessment score[0.656(95%CI:0.593-0.719)]and estimated glomerular filtration rate[0.591(95%CI:0.525-0.657)].Conclusion Higher preCRRT or postCRRT 24 h AG levels and smaller△AG were all significantly associated with an increased risk of death at 28 days in critically ill patients receiving CRRT.

Abstract:Objective To investigate the effects of hyperoxia exposure on intestinal bacteria metabolite short-chain fatty acids(SCFAs)in mice using metabolomics and to further elucidate the regulatory effect of butyrate on hyperoxia-induced intestinal injury and neutrophil activation.Methods 12 male C57BL/6 mice were randomly divided into a hyperoxia group(n=6,80%O2)and a control group(n=6,room air),for 96 hours.Colonic contents were collected for targeted SCFA detection.In addition,further butyric acid intervention and hyperoxia experiments were performed.32 male C57BL/6 mice of the same strain were selected,weighed and randomly divided into 4 groups(n=8 each):saline control group,saline hyperoxia group,sodium butyrate control group and sodium butyrate hyperoxia group.The saline control group and the sodium butyrate control group were maintained in an oxygen tank with normoxic environment for 96 h.The saline hyperoxia group and the sodium butyrate hyperoxia group were exposed to hyperoxia(FiO2 80%)for 96 h.Mice in the sodium butyrate group received daily sodium butyrate gavage(5 000 mg/kg),and the control group received equivalent sterile saline.Gavage was administered early three days before the start of the experiment and continuously for four days after the start of the experiment.Intestinal histopathological injury,intestinal barrier damage,inflammatory reactivity,and neutrophil activation were detected.Results Hyperoxia significantly reduced colonic levels of the SCFAs acetate,propionate,butyrate,and hexanoate(all VIP>1,P<0.05).Butyrate supplementing alleviated hyperoxia-induced intestinal histopathological damage and cell apoptosis.It attenuated intestinal barrier damage and upregulated the expression of tight junction proteins ZO-1(P=0.015)and occludin(P=0.002).Butyrate reduced intestinal inflammation,decreasing levels of the pro-inflammatory cytokines TNF-α and IL-1β(both P<0.0001),while increasing the anti-inflammatory cytokine IL-10(P<0.0001).Furthermore,butyrate attenuated hyperoxia-induced intestinal neutrophil activation,evidenced by decreased MPO levels(P<0.0001),and down-regulated expression of neutrophil related cytokines CXCL-1,CCL-3 and IL-8(all P<0.0001).Conclusion Hyperoxia inhibits the metabolism of SCFA(especially butyric acid)in the gut microbiota of mice,and supplementing butyrate reduces hyperoxia-induced intestinal injury by regulating neutrophil activation.