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Objective@#To explore the relationship between isotemporal substitution of 10 min/d of vigorous physical activity (VPA), moderate physical activity (MPA), walking, sedentary behavior (SB) and sleep (SLP) and depression among vocational school students with different duration of moderate-to-vigorous physical activity (MVPA), so as to provide time allocation suggestions for reducing depression levels.@*Methods@#The convenient cluster sampling method was adopted to conduct a questionnaire survey among 8 149 grade one to grade three students in 14 vocational schools in Shanghai and Jiangsu Province from December 2021 to January 2022. According to whether the MVPA reached 60 min/d, the vocational school students were divided into the MVPA standard group and the MVPA non-standard group, and the isotemporal substitution model was used for analysis.@*Results@#About 19.81% of students were in the MVPA standard group. In the MVPA non-standard group, substituting MPA for all other studied behaviors and substituting SLP for walking and SB were negatively correlated with depression ( β =-0.78, -0.90, -0.88, -0.83; -0.07 , -0.05, P <0.05), and the association of MPA substitution was much greater than that of SLP substitution. In the MVPA standard group, replacing VPA, walking and SB with SLP were all negatively associated with depression ( β =-0.23, -0.12, -0.10 ), whereas replacing MPA, SB and SLP with VPA was all positively associated with depression ( β =0.15, 0.13, 0.23) ( P <0.05).@*Conclusion@#The MVPA level of vocational school students is low. The effects of isotemporal substitution for VPA and MPA are different when MVPA duration is up to standard and when MVPA duration is not up to standard. Appropriate time allocation suggestions should be provided based on the characteristics of adolescents with different MVPA durations.
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Objective:To analyze the relationship among hope trait, resilience and empathy of midwives, and to explore the mediating role of resilience between hope trait and empathy.Methods:A total of 370 midwives were investigated by general information questionnaire, Adult Hope Quality Scale, short version of Resilience Scale and Interpersonal Response Scale. Pearson correlation analysis was used to analyze the correlation among hope trait, resilience and empathy. Amos21.0 structural equation model was used to verify the mediating effect of resilience between hope trait and empathy. The mediating effects of empathy, hope and resilience were analyzed.Results:Hope trait was positively correlated with resilience and empathy ( r value was 0.504, 0.133, P<0.01 or 0.05), and resilience was positively correlated with empathy ( r value was 0.309, P<0.01) in midwives. Resilience partially mediated the relationship between hope trait and empathy, the mediating effect of resilience was 0.38. Conclusions:Managers should pay attention to the cultivation of midwives′ hope traits and psychological resilience, and actively improve the midwives′ psychological quality, so as to effectively improve the empathy ability and establish a harmonious and high-quality nurse patient relationship.
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Objective@#To investigate the expression of CD160 in HIV-specific T cells and their subsets in peripheral blood of asymptomatic human immunodeficiency virus (HIV) infected individuals.@*Methods@#A total of 43 asymptomatic HIV-infected individuals without antiretroviral therapy (ART) and 18 healthy controls were recruited from the No. 302 Hospital of PLA between June 2014 and November 2015. Peripheral blood mononuclear cells (PBMC) were isolated from peripheral bloods of these subjects. CD160 was stained with fluorescent antibody. Expression of CD160 in HIV-specific T cells and their subsets was detected by flow cytometry.@*Results@#The frequency and median fluorescence intensity (MFI) of CD160 on the whole HIV-specific CD4+ T cells and CD8+ T cells were higher than those in the healthy controls(P<0.01). In subsets of HIV-specific CD4+ T cells, the MFI of CD160 in CD4+ Tn cells and CD4+ Teff cells, and the frequency of CD160 in CD4+ Teff cells were significantly increased (P<0.01). CD8+ Tn fine, CD8+ Tcm cells and CD8+ Tem cells showed a significant upregulation in the frequency and MFI of CD160 (P<0.01).@*Conclusions@#Chronic HIV infection can lead to high expression of CD160 in HIV-specific T cells and their different subsets, causing cellular immune dysfunction, which may further impair the ability to control the HIV virus.
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Objective: To evaluate diagnostic value of three noninvasive examinations for coronary heart disease (CHD).Methods:A total of 500 subjects, who were suspected of CHD, first received diagnostic coronary angiography (CAG) and hospitalized in our department from May 2014 to May 2015, were selected.According to CAG results, they were divided into non-CHD control group (n=106), single vessel coronary disease group (n=199), double-vessel coronary disease group (n=95) and multi-vessel coronary disease group (n=100, ≥three vessel disease).Besides CAG, all subjects accomplished one of following examinations at least: (1) 24h dynamic ECG (Holter);(2) real-time three-dimensional echocardiography(RT-3DE);(3) radionuclide myocardial perfusion imaging (RMPI).Sensitivity, specificity and accuracy of these three examinations in diagnosing CHD were evaluated.Results: With CAG as the gold standard, compared with Holter and RT-3DE, there were significant rise in sensitivity(68.4%, 69.0% vs.92.9%), specificity (62.9%, 81.4% vs.88.5%) and accuracy (67.1%, 71.2% vs.91.9%) of RMPI (P<0.01 all), only specificity of RT-3DE was significantly higher than that of Holter, P=0.019.Conclusion:Noninvasive examination can be used as important method diagnosing CHD, which are important measures for noninvasive diagnosing and assessing CHD.Accuracy, sensitivity and specificity of RMPI are high, which is worth extending.
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Objective:To investigate reperfusion and secondary preventive drug therapy for ST-segment elevation myocardial infarction (STEMI) patients in provincial, city and county levels hospitals of China. Methods:A total of 18,967 STEMI patients within 7 days of symptom onset from 2013-01-01 to 2014-09-30 were enrolled by China acute myocardial infarction (CAMI) registry study group from 107 hospitals covering 31 provinces/autonomous regions, cities and counties in China;223 patients were excluded for key information missing. Demographic data, reperfusion as primary percutaneous coronary intervention (pPCI), thrombolytic therapy (TT) and secondary preventive drug therapy as aspirin, P2Y12 inhibitors, statins,β-blockers, angiotensin-converting enzyme inhibitor (ACEI)/angiotensin receptor antagonist (ARB) were analyzed and compared among 3 levels of hospitals. Results:There were 9,885/18,744 (52.7%) patients received reperfusion including 8,038 (42.9%) pPCI and 1,847 (9.9%) TT. Reperfusion rate in provincial hospital (61.8%, 4041/6537) was higher than city hospital (49.1%, 4728/9625) and county hospital (43.2%, 1116/2582), P Conclusion:In CAMI Registry, 70.8%arrived hospital within12 h of symptom onset had been treated by reperfusion therapy in China; the reperfusion rate in county hospital was obviously lower. The secondary preventive drug therapy condition was similar among 3 levels of hospitals.
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Objective To observe what changes the brown adipose tissue (BAT) of T2DM rat models would have,including morphology,function and specially expressed uncoupling protein (UCP1) after the gastric bypass (Roux-en-Y,RYGB) and to explore the effects of RYGB on BAT of T2DM rat models and its related mechanism in order to provide a theoretical and experimental basis for treatment of T2DM patients with RYGB.Methods SD rats were given a high-fat and high-sugar diet for two weeks,by injecting streptozotocin (STZ) 30 mg/kg intraperitoneally to build models.Blood glucose was measured after 72 h and 1 week by the fast blood glucose meter.The models were built successfully if blood glucose at both times were ≥ 16.7 mmol/L.Feeding environment:individually caged,standard rat feed,natural circadian cycle,indoor temperature (18±2)℃,indoor humidity (50±2)％.50 rats were randomly selected and dividing into four groups according to intervention methods:diabetes operation group (group A,n=10),undergoing RYGB surgery with the whole stomach kept;diabetes sham operation group (group B,n=10),the same anesthesia and incision as the previous RYGB group.The operation mode was anterior gastric wall incision and suture,jejunum transection in corresponding position and in situ anastomosis with the same suture method as group A;diabetes control group (group C,n=10),normally feeding after building models;and the last one was the healthy control group (group D,n=10):no special treatment,adequate water feeding ensured.The rest of rats remained to be used.The body mass (BM),fasting blood glucose (FBG),fasting serum insulin(Fins)before and at the 1st,2nd,4th and 8th week after surgery were measured.The number of transversal ceils was calculated by IPP6.0 image software and the average radius of fat cells was calculated.UCP1 expression was tested with western blot.Results ① The fasting blood glucose,fasting serum insulin level and the body weight of dia betic rats were higher than those of the control group,but the insulin sensitivity index was significantly lower.② HE Staining showed:diabetes operation group (group A) rats,compared with diabetes control group and diabetes sham operation group(group B),had obviously higher brown fat cell counts transversally and average radius,and the difference was statistically significant (P＜0.01).Diabetes operation group (group A) rats had no significant difference from the healthy control group(group D) rats,and the diabetes control group (group C) rats had no significant difference from sham operation group (group B) rats as well.③ Western blot showed that after the gastric bypass surgery,compared with the diabetes sham operation group (group B) and the diabetes control group (group C),UCP1 expression of brown adipose tissue of the diabetes operation group (group A) increased significantly (P＜0.05).The diabetes sham operation group (group B) had no significant difference from the diabetes control group (group C),and the diabetes operation group(Group A) had no significant difference from the healthy control group (Group D) as well (P＞0.05).Conclusion RYGB can reduce the body mass and insulin resistance (IR) of diabetic rats and,at the same time,promote the expression of UCP1 of brown adipose tissue.RYGB might increase the activity of brown adipose tissue by regulating the UCP1 signaling pathway to improve body's insulin resistance.
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Objective:To assess effect of detection of plasma N terminal pro brain natriuretic peptide (NT‐proBNP) and serum cystatin C (Cys C) combined Global Registry of Acute Coronary Events (GRACE) score on heart func‐tion and prognosis in patients with acute coronary syndrome (ACS) .Methods :According to GRACE score ,a total of 136 ACS patients were divided into low risk group (n=29) ,intermediate risk group (n=39) and high risk group (n=68) .Serum Cys C level and plasma NT‐proBNP level were measured in all groups .Incidence rate of major ad‐verse cardiovascular events (MACE) within three and six months was counted .Results:Among ACS patients ,com‐pared with low risk group ,there were significant rise in levels of NT‐proBNP [ (165.80 ± 51.62) ng/L vs .(193.13 ± 74.64) ng/L vs .(985.45 ± 152.69) ng/L] and Cys C [ (0.83 ± 0.38) mg/L vs .(0.9 ± 0.25) mg/L vs .(1.23 ± 0.23) mg/L] ,left ventricular end‐diastolic diameter [six months: (50 ± 3) mm vs .(55 ± 3) mm vs .(59 ± 5) mm] ,significant reduction in left ventricular ejection fraction [LVEF ,six months: (55 ± 7)% vs .(49 ± 5)% vs . (40 ± 7)% ] ,and significant rise in incidence rate of MACE (six months:2.94% vs .9.55% vs .30.88% ) ,and a‐bove indexes in high risk group were significantly higher than those of intermediate risk group except LVEF signifi‐cantly reduced , P<0.05 or <0.01 ;Pearson correlation analysis indicated that NT‐proBNP and Cys C levels were positively correlated with GRACE score (r=0.72 , P<0.05 ; r=0.65 , P<0.05) respectively .Conclusion:NT‐proBNP and Cys C level detection combined GRACE score could exactly response heart function and prognosis .
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Objective The coronary slow flow phenomenon (CSFP) is a coronary artery disease with a benign course,but its pathological mechanisms are not yet fully understood.The purpose of this controlled study was to investigate the cellular content of blood in patients diagnosed with CSFP and the relationship of this with coronary flow rates.Methods Coronary angiographies of 3368 patients were selected to assess thrombolysis in myocardial infarction (TIMI) frame count (TFC) values.Seventy eight of them had CSFP,and their demographic and laboratory findings were compared with 61 patients with normal coronary flow.Results Patients'demographic characteristics were similar in both two groups.Mean corrected TFC (cTFC) values were significantly elevated in CSFP patients (P ＜ 0.001).Furthermore,hematocrit and hemoglobin values,and eosinophil and basophil counts of the CSFP patients were significantly elevated compared with the values obtained in the control group (P =0.005,P =0.047,P =0.001 and P =0.002).The increase observed in hematocrit and eosinophil levels showed significant correlations with increased TFC values (r =0.288 and r =0.217).Conclusion Significant changes have been observed in the cellular composition of blood in patients diagnosed with CSFP as compared to the patients with normal coronary blood flow.The increases inhematocrit levels and in the eosinophil and basophil counts may have direct or indirect effects on the rate of coronary blood flow.
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This paper analyzed the status of the medical students'volunteer services in China and abroad , dis-cussed the feasibility and necessity of medical students'volunteer service .The influence factors , elvaluation and ef-fectiveness of the medical students'volunteer services were sumed up , and its development tendency was also dis-cussed .The following suggestions were put forward , namely improving the volunteer service participation , making the voluntary service a routine work , aiming to giving references for medical schools and volunteer organizations car-rying out the medical students'volunteer services .
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Objective To compare the clinical effects of improved posterolateral minimally invasive approach and traditional posterolateral approach combined with modular femoral head prosthesis in the treatment of femoral neck fractures in the elderly. Methods The study involved 70 patients with femoral neck fractures (26 males and 44 females; at age range of 67-95 years,mean 78.3 years) treated from October 2008 to June 2010.There were 62 patients with fresh femoral neck fractures and eight with old femoral neck fractures (2-4 months post-injury),all of whom were type Ⅲ or Ⅳ fractures according to the Garden' s classification.All surgeries were completed by the same operation group.The improved posterolateral minimally invasive approach group involved 32 patients including 12 males and 20 females and the traditional posterolateral approach group involved 38 patients including 14 males and 24 females.The two groups were compared in aspects of incision size,operative time,perioperative complications,prosthesis stability and hip functional recovery. Results All patients were followed up for an average of 16 weeks (range,12-18 weeks).The differences between the two groups were significant regarding the incision length,perioperative blood loss,and blood product transfusio amount (P ＜0.01 ),but insignificant in operative time ( P ＞ 0.05 ).All patients were able to take weight-bearing walk six weeks postoperatively.The two groups showed significant difference in the hip joint function by Chamley's criteria six weeks postoperatively ( P ＜ 0.05 ),but insignificant difference in the hip joint function by Harris' s criteria at the last follow-up ( P ＜ 0.05). Conclusion The modified posterolateral minimally invasive approach combined with modular femoral head prosthesis is a satisfactory method in treatment of femoral neck fractures in senile patients,for it can result in less intra-operative soft tissue damage and blood loss,as well as shorter rehabilitation time.
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Objective.To explore the prognostic influence factors of acute subdural hematoma.Methods The clinical data of 114 patients of acute subdural hematoma were analyzed retrospectively,they were divided into good prognosis group(62 patients) and poor prognosis group(52 patients) according to prognosis,analyzed the related factors for the prognosis were gualyzed in two groups.Results The prognosis of acute subdural hematoma with sex,weight was no significant correlation(all P＞0.05),but related with age,GCS score,pupillary changes,brain shift and hematoma volume(all P＜0.05).Conclusion Patient's age,GCS score,pupillary changes,brain shift and hematoma volume were the prognostic influence factors of acute subdural hematoma.
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ObjectiveTo evaluate the clinical outcome of new proximal femoral nail antirotation (PFNA) in treatment of subtrochanteric fractures. MethodsThere were 31 patients with traumatic subtrochanteric fractures intramedullarily fixed with PFNA. The patients included 14 males and 17 fe-males at a mean age of 54.6 years (range 34-90 years). According to Seinsheimer classification of sub-trochanteric fractures, 14 patients were with type Ⅱ fractures (including four patients with type ⅡA,seven with type ⅡB and three with type ⅡC), 12 with type Ⅲ fractures (including eight with type ⅢA and four with type ⅢB), two with type Ⅳ fractures and three with type Ⅴ fractures. Close reduction was performed under traction and C-arm fluoroscopy in 26 patients and open reduction through a mini-incision before inserting the nail in five patients due to difficult close reduction. ResultsThe operation lasted for a mean time of 72.5 minutes (range 45-120 minutes), with mean blood loss of 127.5 ml (range 100-350 ml). Of all, 27 patients (87.1%, 27/31) were followed up for a mean duration of 14.3 months (range 8-24 months), which showed fracture union in all patients, with a mean union period of 17.4 weeks (range 10-21 weeks). According to Harris Hip Rate Scale, the results were. excellent in 21 pa-tients, good in two and fair in four, with excellence rate of 85.2% (23/27). ConclusionsPFNA is an effective device for treatment of subtrochanteric fracture, with a high union rate and a low complication rate, for it has advantages of easy use and minor trauma, low bleeding and stable fixation in operation.
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Objective To investigate the feasibility, indications, operating technique and the clinical value of laparoscopeic surgery for ectopic pregnancy with prior history of obstetric and gynecologic operations. Methods 82 ectopic pregnancy patients with prior history of the obstetric and gynecologic operation were subjected to laparoscopic surgery. Among them, 60 patients had undergone prior obstetric and gynecologic operation only once, 21 patients had undergone twice, and the remaining one had undergone obstetric and gynecologic operation three times. The laparoscopic operation was completed in different ways as follows: puncture and injection of drug under laparoscopy, salpingectomy, resection of pregnancy in oviduct, removal of embryo through incision of oviduct under laparoscope, suction removal of embryo from oviduct, and new technique for pregnant surgery at interstitial portion. Results Of these 82 patients undergoing laparoscopic surgery, 73 cases had adhesion in different degree, and the adhesion rate was 89.0% (73/82). In the 60 patients with history of one operation, pelvic peritoneal adhesion was found in 51 patients, the adhesion rate was 85.0%. All 22 patients with two prior operations had pelvic peritoneal adhesion, and the rate was 100.0%. The laparoscopic surgery was successful in 70 cases. The rate of success was 85.4%, while in 12 patients, the operation was changed into laparectomy due to dense adhesion, and the rate was 14.6%. Of these 12 patients, in 5 of them there was endometriosis, in 6 patients chronic pelvic inflammation was found, 9 patients had a surgical history for ectopic pregnancy, 2 patients with the history of caesarean section, and one patient had a history of complicated gynecologic operation. Complications included colonic injury in one patient with ectopic pregnancy, and the operation was changed to laparotomy. Injury to the ureter happened in one patient. The operation time for laparoscopic surgery was 30-180 min. Conclusions The laparoscopic operation is an effective procedure and it has become a routine procedure for ectopic pregnancy with prior history of obstetric and gynecologic operation. Because of chronic pelvic inflammation and endometriosis, it is difficult to perform laparoscopic surgery successfully, and laparotomy should be anticipated at all time.
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Objective In order to predict or exclude early ectopic pregnancy.Methods Endomertrium of 49 early intrauterine and 52 ectopic pregnancy were observed by transvaginal ultrasonography. Trophoblastic artery flow were investigated surrounding the intrauterine embryo or within the endometrium.Results An endometrial three-line pattern resembled late proliferative endometrium of the normal menstrual cycle were seen in 42 ectopic pregnancy(80.8%). An endometrial three-line pattern were not seen in 49 early intrauterine pregnancy. Thirty-nine early intrauterine pregnancy had trophoblastic artery flow surrounding the intrauterine embryo or within the endometrium. None of ectopic pregnancy had trophoblastic artery flow within the endometrium.Conclusion Observation of endometrial three-line pattern and trophoblastic artery flow by transvaginal ultrasonography were useful for diagnosing eraly ectopic pregnancy.
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OBJECTIVE To develope an HPLC assay for the determination of tanshinoneⅡA.METHOD C18ODS column was used.The mobile phase was consisted of MeOH-water(70∶30).The detection wavelength was at 269 nm.RESULT The linear regression equation was Y=9725X-2584,r=0.9997.The average recovery was 98.29% with RSD=1.86%.(n=5).CONCLUSION The method may be used for quality control.
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Objective To evaluate the value of spiral CT and 3D reconstruction in diagnosis and treatment of tibial plateau fractures.Methods 25 cases with tibial plateau fractures were examined with plain radiograhs,spiral CT and 3D reconstruction during July,1998 to December,2000.The tibial plateau fractures were classified according to Schatzker′s classification on the X-rays and 3D reconstruction images.On the superior view the tibial plateau fractures were divided into anterior lateral,posterior lateral,anterior medial and posterior medial fractures.Results 3D reconstruction images of 25 plateau fractures were the same as what arthroendoscopy were.25 fractures(including 23 arthroscopic management fractures)were operated under 3D reconstruction guide.No one case was infected.The treatment was valid.Conclusion Spiral CT and 3D reconstruction can offer more accurate classification and complement to new spatial classification of fractures.Also can provide better planning and management for the tibial plateau fractures.
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Objective To explore the effect of Acorus gramimeus and its major components ?-asarone on N-methyl-D-asperate recepter 1 (NMDAR1) mRNA levels of hippocamp neurons in epileptic animal models induced by pentylenetetrazol (PTZ). Methods PTZ 60 mg/kg was injected to the abdominal cavity of three weeks Wistar rats to prepare epileptic animal models. The animal models were randomly divided into three groups: epilepsy control, A. gramimeus and ?-asarone as well as the normal control. Each group was administered through intraperitoneal injection. Both of two control groups were injected physiologic saline 1.0 mL/d, and the rest groups were injected A. gramimeus 2 350 mg/(kg?d) or ?-asarone 29 mg/(kg?d) for 7 d, respectively. All rats were treated by PTZ 60 mg/kg through intraperitoneal injection next day. After their behaviors were observed for 24 h, animals were sacrificed. The expressions of NMDAR1 mRNA in hippocamp CA1 and CA3 of all rats were detected by in situ hybridization and semiquantitative RT-PCR. Results The results of in situ hybridization showed that positive staining granules were located in the cyptoplasm of hippocamp neurons. The number of positive cells and average absorbance of A. gramimeus group or ?-asarone group was markedly less than that of epilepsy control (P
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OBJECTIVE:To investigate the effect of arsenic trioxide(As2O3) on the growth inhibition and apoptosis of gastric cancer cell SGC-7901 cultured in vitro in hypoxia condition.METHODS:The environment of hypoxia was established by using cobalt chloride.The gastric cancer cells were divided into three groups:normal group,hypoxia group and hypoxia combined with arsenic trioxide(0.5,1.0,2.0,5.0 and 10.0 ?mol?L-1)(HAT) group.The optical density of gastric cancer cell was determined by MTT method and inhibition rate was calculated at 24,48 and 72 h.The apoptosis rate of gastric caner cell was detected by using staining technique.RESULTS:After treated by 10.0 ?mol?L-1 arsenic trioxide for 24,48 and 72 h,the inhibition rates of SGC-7901 were 31.99%,55.98% and 72.40% for HAT group and 4.04%,6.65% and 8.11% for hypoxia groups,respectively;apoptosis rate were(42.88?1.72)%,(56.48?1.48)% and(65.52?1.00)% for HAT group and(2.08?0.28)%,(2.44?0.51)% and(2.76?0.67)% for hypoxia group,respectively.The difference between HAT group and hypoxia group was statistically significant(P
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Objective To evaluate the effects of epidural anesthesia by target controlled introduction (TCI) of 0.375% ropivacaine (Ropi) combined with propofol on the blood pressure (BP) and heart rate (HR) of the patients in different age during thoracotomy. Methods Seventy five ASA Ⅱ-Ⅲ patients undergoing elective resection of esophageal carcinoma were divided into 3 groups according to their age (25 each): groupⅠ (aged 40～59), group Ⅱ (aged 60～74) and group Ⅲ (aged ≥75). An epidural catheter was inserted at the T6～T8 interspace in all patients before induction, and then 5ml of 1% lidocaine was given to all the patients. For each patient, 6 ml of 0.375% Ropi was given epidurally. Anesthesia was induced with propofol TCI 3?g/ml, fentanyl 3?g/kg and atracurium 0.6mg/kg. Tracheal incubation was performed when bispectrum index (BIS) value was less than 50. The patients were mechanically ventilated. Anesthesia was maintained with propofol TCI and epidural anesthesia of 0.375% Ropi at 6ml/h. Propofol was subsequently adjusted to maintain BIS at 50～55 during operation. The concentrations of propofol TCI, mean arterial pressure (MAP), HR, and the amount of ephedrine were continuously monitored during anesthesia. Results MAP in group Ⅱ and Ⅲ was lower than that in groupⅠ (P0.05). The amount of ephedrine used in group Ⅱ and Ⅲ was higher than that in group Ⅰ (P