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ObjectiveTo investigate the effect of microemulsion on the distribution of index components in different phases of Zexietang extract based on high performance liquid chromatography（HPLC） and phase separation process. MethodParticle size meter and transmission electron microscope were used to characterize the colloidal particles in blank microemulsion， aqueous extract of Zexietang and microemulsion extract of Zexietang. The phase separation process was established by high-speed centrifugation and dialysis， and based on this process， the aqueous extract and microemulsion extract of Zexietang were separated into the true solution phase， the colloidal phase and the precipitation phase， respectively. The contents of six components， including atractylenolide Ⅲ， atractylenolide Ⅱ， 23-acetyl alisol C， alisol A， alisol B and alisol B 23-acetate， were determined by HPLC with the mobile phase of water（A）-acetonitrile（B） for gradient elution（0-5 min， 40%-43%B； 5-20 min， 43%-45%B； 20-45 min. 45%-60%B； 45-75 min， 60%-80%B）. The solubility of the index components in water and microemulsion was determined by saturation solubility method. ResultThe colloidal particles in the aqueous extract， microemulsion extract and blank microemulsion were all spherical， and the particle size， polydispersity index（PDI） and Zeta potential of the colloidal particles were in the order of aqueous extract >microemulsion extract >blank microemulsion. The results of phase separation showed that the colloidal phase and the true solution phase could be completely separated by dialysis for 2.5 h， and the phase separation process was tested to be stable and feasible. Compared with the aqueous extract of Zexietang， the use of microemulsion as an extraction solvent could increase the contents of atractylenolide Ⅲ， 23-acetyl alisol C， atractylenolide Ⅱ ， alisol A， alisol B and alisol B 23-acetate by 3.75， 6.82， 35.47， 10.66， 35.41， 27.75-fold， and could increase the extraction efficiencies of the latter five constituents by 2.03， 1.15， 1.70， 6.43， 5.53 times. The solubility test showed that the microemulsion could significantly improve the solubility of atractylenolide Ⅱ， alisol A， alisol B and alisol B 23-acetate， but it had less effect on the solubility of atractylenolide Ⅲ and 23-acetyl alisol C. ConclusionMicroemulsion can improve the extraction efficiency and increase the distribution of the index components in the colloidal phase state of Zexietang to different degrees， providing a reference for the feasibility of microemulsion as an extraction solvent for traditional Chinese medicine.
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ObjectiveBased on serum pharmacochemistry and ultra performance liquid chromatography-quadrupole-time-of-flight mass spectrometry（UPLC-Q-TOF-MS） the transitional components in the serum of rats after intragastric administration of water extract of Alismatis Rhizoma（AR）and salt-processed Alismatis Rhizoma（SAR） were compared. MethodSD rats were randomly divided into blank group, AR group（10 g·kg-1） and SAR group（10 g·kg-1）, 3 rats in each group, the administration groups were given AR and SAR aqueous extracts by gavage, respectively, and the blank group was given an equal volume of drinking water by gavage once in the morning and once in the evening, for 3 consecutive days. Sixty minutes after the last administration, blood was collected from the eye orbits, and the serum samples were prepared. The serum samples were prepared on an ACQUITY UPLC BEH C18 column（2.1 mm×50 mm, 1.7 μm） with the mobile phase of acetonitrile（A）-0.1% formic acid aqueous solution（B） in a gradient elution（0-10 min, 10%-50% A; 10-27 min, 50%-95%A; 27-27.1 min, 95%-10% A; 27.1-30 min, 10%A）, the data were collected at a flow rate of 0.3 mL·min-1 in positive ion mode with a scanning range of m/z 100-1 200. Based on the self-constructed chemical composition library of AR, the total ion flow diagrams and secondary MS fragmentation information of the aqueous extracts of AR and SAR, as well as the administered serum and the blank serum, were compared with each other by UNIFI 1.9.2, so as to deduce the possible blood-migrating constituents and their cleavage patterns in the aqueous extracts, and the response intensity ratios of each chemical component were calculated before and after processing. ResultA total of 20 components, including 5 prototypical components and 15 metabolites, were analyzed and deduced from the serum of rats given aqueous extract of AR. And 14 components, including 5 prototypical components and 9 metabolites, were analyzed and deduced from the serum of rats given aqueous extract of SAR. Of these, 13 components were common to both of them, including 5 prototypical components and 8 metabolites. The 5 prototypical components were 16-oxoalisol A, alisol A 24-acetate, alisol A, alisol B and alisol C. The metabolites were mainly involved in phase Ⅰ metabolism（oxidation） and phase Ⅱ metabolism（glucuronidation）. There was a big change in the intensity of response of the common components before and after salt-processing, and the response intensities of the prototypical components, 16-oxoalisol A, alisol B and alisol C, were elevated, while the type and response intensity of metabolites were generally decreased, and it was hypothesized that the metabolic rate of terpenoids might be slowed down after salt-processing of AR, so that the blood-migrating constituents could participate in the metabolism of the body more in the form of prototypes. ConclusionSalt-processing of AR may promote the absorption of prototypical components into the blood by slowing down the metabolic rate of terpenoids, which can provide support for the research on material basis of AR and SAR.
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Objective:To explore the application effect of "sandwich" teaching in the standardized residency training of blood purification center.Methods:A total of 72 residents who participated the standardized residency training of blood purification center of The Third Hospital of Mianyang from July 2019 to November 2019 and December 2019 to April 2020 were selected to be divided into control group and research group in average. The control group used traditional teaching and the research group took "sandwich" teaching, respectively. The two groups of subject assessment results and post competency before and after the teaching were compared. SPSS 23.0 software was used for t test and chi square test. Results:The research group's academic knowledge test scores and practical operation skills test scores were (91.64±5.38) points and (86.81±5.30) points respectively, and those in the control group were (84.25±5.26) points and (78.28±5.07) points respectively, and the scores in the study group were higher than those in the control group ( P<0.05). After teaching, the assessment scores of personal quality, professional knowledge, professional skills, professional ability and self-concept of the research group were (18.61±2.38) points, (18.28±2.29) points, (17.56±2.20) points, (18.81±2.41) points and (17.75±2.34) points respectively, and those in the control group were (16.42±2.19) points, (15.81±2.37) points, (15.06±2.41) points, (16.31±2.35) points and (15.31±2.28) points respectively. All above scores of the two groups after teaching were higher than those before teaching ( P<0.05), and those of the research group after teaching were higher than those of the control group ( P<0.05). Conclusion:"Sandwich" teaching can improve the examination results and post competency of the residents during the standardized residency training of the blood purification center.
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Background Polycyclic aromatic hydrocarbons (PAHs) are one of the most widely distributed and harmful organic pollutants in the atmosphere. Objective To investigate the distribution characteristics and composition sources of PAHs in the atmosphere of two districts of Lanzhou from 2019 to 2020 and evaluate the health risks of PAHs via inhalation to different populations. Methods The PAHs concentrations in two urban areas (Chengguan District and Xigu District) of Lanzhou City from January 2019 to December 2020 were regularly monitored. Mann-Whitney U test was used to compare differences in target pollutant concentrations between the two areas. Diagnostic ratio method and principal component analysis were adopted for source identification. Incremental lifetime cancer risk (ILCR) model was applied to evaluate the health risks of PAHs. Results The M (P25, P75) PAHs concentrations in Chengguan District and Xigu District were 24.04 (14.59, 41.81) ng·m−3 and 25.97 (18.59, 42.56) ng·m−3, respectively, with no significant difference (Z=−0.970, P>0.05). As to seasonal distribution, most PAHs monomer concentrations in Chengguan District were higher than those in Xigu District in summer, and the concentrations of benzo[a]anthracene and benzo[g,h,i]perylene in Chengguan District were also higher than those in Xigu District in spring and autumn (P<0.05), but there were no significant differences in PAHs monomer concentrations between the two urban areas in winter (P>0.05). Ring number of PAHs exhibited seasonal fluctuations. In winter and spring, the highest proportions in Chengguan District and Xigu District were both 4-ring PAHs (37.32%-41.73%, 35.20%-39.66%), and in summer and autumn, the highest proportions were both 2- and 3-ring PAHs (39.38%-49.54%, 47.17%-51.23%). The results of diagnostic ratio method revealed mixed atmospheric PAHs sources in the two urban areas, including fossil fuel, coal, and biomass combustion. The results of principal component analysis showed that the cumulative contribution rate of the four principal component factors reached 79.54%. Principal component 1 included phenanthrene, anthracene, fluoranthene, pyrene, chrysene, benzo[a]anthracene, benzo[b]fluoranthene, benzo[k]fluoranthene, and benzo[a]pyrene; principal component 2 included acenaphthene and dibenzo[a,h]anthracene; principal component 3 was fluorene; principal component 4 was naphthalene. The results of health risk assessment showed that the ILCR values of adult males, adult females, and children in Chengguan District were 2.30×10−6, 2.16×10−6, and 1.73×10−6, respectively; and those in Xigu District were 1.58×10−6, 1.48×10−6, and 1.19×10−6, respectively; all were greater than 10−6. Conclusion PAHs pollution exists in the atmosphere of the two urban areas of Lanzhou City, mainly comes from mixed sources of fossil fuels, coal, and biomass burning, and may pose potential carcinogenic risks to the population.
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Background Because of high working intensity, high responsibility, and unexpected situations, health care workers may suffer great work pressure, which may lead to health damage. Objective To explore the self-rated health status and its influencing factors such as demographic and occupational-related factors of medical staff in Lanzhou. Methods In-service medical staff were selected by using cluster random sampling method from 18 public hospitals in Lanzhou City and were investigated with a self-made questionnaire and the Self-rated Health Measurement Scale (SRHMS). SRHMS includes 48 items in 10 dimensions, which are divided into three sub-scales of physical health, mental health, and social health, and another independent dimension is overall health. The scores were converted into a percentage scale and expressed as the percentage of measured score to full score; a higher score indicated better health, and >70% was considered good health status. t test, Kruskal-Wallis H test, and Spearman correlation were used to analyze the scores of SRHMS and the demographic and occupational-related factors affecting the scores of physical, mental, and social health sub-scales. Results A total of 2989 valid questionnaires were recovered. There were statistically significant differences in total score and the scores of physical, mental, and social health among medical staff of different age, educational background, length of service, and weekly working hours groups (P < 0.05). The percentage of total score to full score in the medical staff was 71.41%, but the scores of physical, mental, and social health sub-scales and total scale of selected participants were all lower than the corresponding domestic norms (t=−3.323, −12.283, −7.157, −9.659, P < 0.05); the percentage of psychological symptoms and negative emotions in mental health scale to full score was the lowest, only 58.39%. Educational background, length of service, and weekly working hours were negatively correlated with physical health score (r=−0.061, −0.060, −0.165, P < 0.05); professional title was positively correlated with mental health score (r=0.045, P < 0.05), while educational background and weekly working hours were negatively correlated with it (r=−0.051, −0.172, P < 0.05). Monthly income, professional title, and length of service were positively correlated with social health score (r=0.040, 0.049, 0.071, P < 0.05), while educational background and weekly working hours were negatively correlated with it (r=−0.038, −0.110, P < 0.05). Conclusion The self-rated health status of selected medical staff in Lanzhou is generally good, but lower than that of the norm, especially the mental health score is the lowest. The self-rated health score of total scale is correlated with education, length of service, professional title, and working time per week.
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Background Air pollutants PM2.5 and its adsorbed metal elements are important factors affecting public health. Objective To explore the distribution characteristics and sources of metal elements in atmospheric PM2.5 in Lanzhou from 2019 to 2020, and to assess the health risks of metal elements to different groups of residents through inhalation. Methods From January 2019 to December 2020 in two districts of Lanzhou City (Chengguan District and Xigu District), regular PM2.5 and metal elements [antimony (Sb), aluminum (Al), arsenic (As), beryllium (Be), cadmium (Cd), chromium (Cr), mercury (Hg), lead (Pb), manganese (Mn), nickel (Ni), selenium (Se), and thallium (Tl)] were regularly monitored, and their concentrations were described by the median (M) and 25th and 75th percentiles (P25, P75) as not following a normal distribution (because the detection rates of the five elements Be, Cr, Hg, Ni, and Se were less than 70%, the five elements were not included in subsequent analysis), and then compared with the secondary concentration limits in the Ambient Air Quality Standards (GB 3095-2012). The differences between the medians of the two groups were compared by the Mann-Whitney U rank sum test, and the differences among the medians of multiple groups were compared by the Kruskal-Wallis H rank sum test; the enrichment factor (EF) method and principal component analysis were used to evaluate the pollution degree of the metals and their sources; the health risks of five non-carcinogenic metals (Sb, Al, Pb, Mn, and Tl) and two carcinogenic metals (As and Cd) in PM2.5 were evaluated by hazard index (HI) and hazard quotient (HQ) using the incremental lifetime cancer risk (LCR) model and the non-carcinogenic risk assessment model, respectively. Results The PM2.5 concentrations [M (P25, P75)] in Lanzhou City were 38.50 (26.00, 65.00) and 41.00 (29.00, 63.10) μg·m−3 in 2019 and 2020, respectively, and the difference was not statistically significant (Z=−0.989, P > 0.05). The average levels of the metal elements from high to low were: Al > Pb > Mn > As > Cd > Sb > Tl, and the annual average concentration of each metal element in 2019 was higher than that in 2020 (P<0.05). The M ( P25, P75) of PM2.5 concentrations in Chengguan and Xigu districts were 52.98 (17.00, 61.00) and 55.40 (17.00, 67.00) μg·m−3, respectively, with no statistically significant differences (P<0.05); the concentrations of Sb and Al in Chengguan District were lower than those in Xigu District (P<0.05), and the concentrations of other metal elements were not different between the two areas (P>0.05). There were seasonal differences in the concentrations of PM2.5 and seven metal elements in Lanzhou City (except PAl=0.007, the other Ps < 0.001). The results of the enrichment factor method showed that the EF values of the six metals (Sb, Al, As, Cd, Pb and Tl) were all greater than 1. Among them, except As, the EF values of other metal elements were all greater than 10, and the EF values of Al and Cd were both greater than 100. The results of principal component analysis showed that the variance contributions of the three principal components were 45.61%, 24.22%, and 14.42%, and the cumulative contribution reached 84.25%. The principal component 1 included Pb, As, Cd, and Sb, the principal component 2 included Al and Mn, and the principal component 3 contained Tl. The non-carcinogenic risks of the five metals were, in descending order, Al > Mn > Pb > Tl > Sb, among which the HQ values of the remaining four metals were less than 1 for adults and children, except the HQ value of Al for adults, which was greater than 1. The ILC values of carcinogenic metal As for adult males, adult females, and children were 2.68×10−5, 2.51×10−5, and 1.45×10−5, respectively; the ILC values of carcinogenic metal Cd for adult males, adult females, and children were 1.53×10−6, 1.43×10−6, and 8.26×10−7, respectively. Conclusion There is pollution of atmospheric PM2.5 and its adsorbed metal elements in Lanzhou. As and Cd elements may pose potential carcinogenic risks to the residents.
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Objective:To explore the association between dopamine-β-hydroxylase (DβH), norepinephrine transporter (NET) gene polymorphisms and panic disorder(PD).Methods:The structured clinical interview for the diagnostic and statistical manual of mental disorders fourth edition (DSM-Ⅳ) axis Ⅰ disorders was administered by trained clinical psychiatrist, 139 patients with PD(PD group) and 196 healthy controls(control group) were enrolled in the study.Single nucleotide polymorphism(SNP) genotyping was performed using an improved multiplex ligation detection reaction technique.SPSS 16.0 and PLINK softwares were used to compare the allele frequency and genotype distribution.Results:(1)Compared with control group, PD group carried more G allele(76.3% vs 68.4%) and fewer A allele(23.7% vs 31.6%) in NET rs5569, and the difference was significant(χ 2=4.986, OR=0.67, 95% CI: 0.47-0.95, P<0.05). However, the correlation was no longer significant after adjusting for Bonferroni’s multiple testing( P>0.05). (2)The additive model of NET rs5569 showed a association with PD ( OR=0.68, 95% CI: 0.48-0.96, P<0.05). And the recessive model of DβH rs1611114 showed a association with PD( OR=0.42, 95% CI: 0.18-0.96, P<0.05). However, these correlations were no longer significant after adjusting for Bonferroni's multiple testing( P>0.05). (3)No matter allele or genotype, there were no significant differences in DβH (rs129882, rs1611114, rs1611115) and NET (rs2242446, rs28386840) gene polymorphisms between panic disorder group and control group(all P>0.05). Conclusion:The present study indicates that there is no significant association of DβH and NET gene polymorphisms with PD.
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Objective:To analyze the arsenic exposure of industrial residents and its influencing factors, so as to provide scientific basis for protecting the health of industrial residents.Methods:In 2017, the samples of PM 2.5, drinking water and soil were collected by using cross-sectional survey and were tested for arsenic contents in Xigu District, Lanzhou City. The environmental arsenic exposure was analyzed by using Environmental Protection Agency of USA health risk assessment models. The levels of urinary arsenic and blood arsenic were measured in residents who included adults, children and teenagers. The internal exposure level of arsenic and its influencing factors were analyzed. The correlation between arsenic and internal and external exposure factors were also analyzed. The content of arsenic was expressed by geometric mean. Results:A total of 84 samples of PM 2.5 were collected, and the content of air arsenic was 7.53 ng/m 3. A total of 108 samples of drinking water were collected, and the content of water arsenic was 0.002 2 mg/L. A total of 40 samples of soil were collected, and the content of soil arsenic was 0.14 mg/kg. The total non-carcinogenic risk of environmental arsenic was 0.39, which was lower than the acceptable level of non-carcinogenic risk (1.00). The total carcinogenic risk of environmental arsenic was 6.59 × 10 -5. The total carcinogenic risk of arsenic was the highest through drinking water exposure and followed by the respiratory inhalation exposure, accounting for 78.60% [(5.18 × 10 -5)/(6.59 × 10 -5)] and 20.79% [(1.37 × 10 -5)/(6.59 × 10 -5)] of the total carcinogenic risk of environmental arsenic, respectively. There were 135 subjects, and 135 blood samples were collected. The content of blood arsenic was 0.92 μg/L. The level of blood arsenic of adults (1.05 μg/L) was higher than that of children and teenagers (0.75 μg/L, U = - 3.594, P < 0.05). One hundred and thirty-five urinary samples were collected, and the content of urinary arsenic was 14.17 μg/L. There was a positive correlation between urinary arsenic and blood arsenic ( r = 0.357, P < 0.05). Blood arsenic levels were positively correlated with the total carcinogenic risk and the risk of carcinogenesis through respiratory, oral and skin exposures ( r = 0.252, 0.244, 0.255, 0.255, P < 0.05). Conclusion:Arsenic in the environment of industrial areas has a potential carcinogenic risk to the residents, so the intake of arsenic in drinking water through oral exposure and respiratory inhalation exposure should be limited.
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The present research work primarily investigated whether spinosin has the potential of improving the pathogenesis of Alzheimer’s disease (AD) driven by β-amyloid (Aβ) overproduction through impacting the procession of amyloid precursor protein (APP). Wild type mouse Neuro-2a cells (N2a/WT) and N2a stably expressing human APP695 (N2a/APP695) cells were treated with spinosin for 24 h. The levels of APP protein and secreted enzymes closely related to APP procession were examined by western blot analysis. Oxidative stress related proteins, such as nuclear factor-erythroid 2-related factor 2 (Nrf2), and heme oxygenase-1 (HO-1) were detected by immunofluorescence assay and western blot analysis, respectively. The intracellular reactive oxygen species (ROS) level was analyzed by flow cytometry, the levels of Aβ1-42 were determined by ELISA kit, and Thioflavin T (ThT) assay was used to detect the effect of spinosin on Aβ1-42 aggregation. The results showed that ROS induced the expression of ADAM10 and reduced the expression of BACE1, while spinosin inhibited ROS production by activating Nrf2 and up-regulating the expression of HO-1. Additionally, spinosin reduced Aβ1-42 production by impacting the procession of APP. In addition, spinosin inhibited the aggregation of Aβ1-42. In conclusion, spinosin reduced Aβ1-42 production by activating the Nrf2/HO-1 pathway in N2a/WT and N2a/ APP695 cells. Therefore, spinosin is expected to be a promising treatment of AD.
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Objective:To explore whether brain-derived neurotrophic factor (BDNF) promoter methylation status is associated with panic disorder(PD), and then assess the effect of the BDNF gene methylation status on the severity of clinical symptoms in PD.Methods:The methylation levels of the BDNF gene were compared between 111 patients with PD and 130 matched healthy controls using MethylTarget approach.In addition, the panic disorder severity scale(PDSS), Hamilton anxiety rating scale(HAM-A), and Hamilton depression rating scale(HAM-D) were respectively assessed to all subjects.Results:(1)The result showed that 7 CpG regions from the promoter regions of the BDNF gene were sequenced.However, there was no statistically significant differences between cases and controls in terms of BDNF DNA methylation status ( OR=1.087, 95% CI=0.849-1.391, P>0.05). (2)Spearman correlation analysis revealed that the hypermethylation of BDNF gene was significantly associated with the severity of the depressive symptoms in PD patients (all P<0.05). The methylation levels of BDNF gene was not significantly related to the severity of anxiety and panic in PD patients(all P>0.05). Conclusion:No association between BDNF promoter methylation status and panic disorder is found in Chinese Han population, but BDNF promoter methylation status may be related to the severity of depressive symptoms in patient with panic disorder.
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Objective:To investigate the value of nomogram predictive model established by the risk factors of upper extremity venous thrombosis risk associated with peripherally venous inserted central catheter (PICC) in cancer patients.Methods:A total of 1 032 patients who underwent PICC insertion between January 2016 and March 2017 in Zhejiang Cancer Hospital were selected by using prospective cohort study and convenience sampling. Risk factors of upper extremity venous thrombosis risk associated with PICC in cancer patients were evaluated by using Cox regression model. The nomogram predictive model of upper extremity venous thrombosis risk associated with PICC insertion was constructed. Bootstrap method was used to complete the inside check, and figure calibration was used to verify the nomogram.Results:A multivariate Cox regression analysis showed that trombosis history ( HR = 27.82, 95% CI 8.17-94.88, P < 0.01) and hyperlipidemia ( HR = 3.01, 95% CI 1.31-6.93, P = 0.009) were independent risk factors for upper extremity venous thrombosis associated with PICC. The nomogram model C-index was 0.71 (95% CI 0.63-0.80) based on the above risk factors, which indicated that the nomogram had a good differentiation. The calibration curve for predicting the probability of upper extremity venous thrombosis risk associated with PICC within one week, two weeks and one month deviated slightly from the standard curve, suggesting that the model might overestimate the risk of upper extremity venous thrombosis associated with PICC in cancer patients. Conclusions:The nomogram model has a good predictive value and strong operability, which can be used to predict the probability of upper extremity venous thrombosis associated with PICC in cancer patients after PICC insertion. It can provide a reference for identifying the high-risk cancer patients and formulating proper therapeutic strategies.
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Objective@#To explore the perception and evaluation of patients with somatic symptom disorder about their own diseases and treatment, and to provide theoretical basis for design of illness perception questionnaire for patients with somatic symptoms disorder.@*Methods@#A semi-structured interview was conducted among 15 initial and untreated patients with somatic symptom disorder using the descriptive qualitative study. The data were sorted, encoded, classified, summarized and refined using MAXQDA10 software.@*Results@#Three main themes and six sub-themes of illness perception in patients with somatic symptom disorder were analyzed and sorted out: (1) symptom recognition: including three sub-themes, low understanding of the disease and denial of somatic symptoms as mental illness; (2)drug taking concerns: including two sub-themes worrying about side effects of drugs, drug addiction and having difficulty to stick to the long-term regular medication; (3)emotional reaction: including the obvious negative emotions of depression and helplessness sub-theme.@*Conclusion@#Patients with somatic symptom disorder have a general bias in illness perception, which has a potential adverse effect on treatment compliance. Therefore, it is necessary for clinical medical staff to early estimate patients’illness perception, and carry out mental health education and rational emotional behavior therapy.
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Objective To explore the perception and evaluation of patients with somatic symptom disorder about their own diseases and treatment,and to provide theoretical basis for design of illness percep-tion questionnaire for patients with somatic symptoms disorder. Methods A semi-structured interview was conducted among 15 initial and untreated patients with somatic symptom disorder using the descriptive quali-tative study. The data were sorted,encoded,classified,summarized and refined using MAXQDA10 software. Results Three main themes and six sub-themes of illness perception in patients with somatic symptom dis-order were analyzed and sorted out:(1) symptom recognition:including three sub-themes,low understanding of the disease and denial of somatic symptoms as mental illness;(2)drug taking concerns:including two sub-themes worrying about side effects of drugs,drug addiction and having difficulty to stick to the long-term reg-ular medication;(3)emotional reaction:including the obvious negative emotions of depression and helpless-ness sub-theme. Conclusion Patients with somatic symptom disorder have a general bias in illness percep-tion,which has a potential adverse effect on treatment compliance. Therefore,it is necessary for clinical med-ical staff to early estimate patients’illness perception,and carry out mental health education and rational e-motional behavior therapy.
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Objective To understand the serum gonadal hormone level of female patients with panic disorder(PD),and to analyze its relationship with the disease severity.Methods The chemiluminescence method was adopted to detect serum gonadal hormone level in 57 female patients with panic disorder and 74 healthy subjects,the panic disorder severity scale (PDSS),Hamilton anxiety scale (HAMA) and Hamilton depression scale (HAMD) were simultaneously used to conduct the investigation.Results The serum pituitary prolactin (PRL) level in the female patients with PD had lower level was higher than that in the control group,the difference was statistically significant (P＜0.05);the luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels were lower than those in the control group(P＜0.05).The difference of the serum testosterone,estradiol and progesterone levels between the female patients with panic disorder and control group was not statistically significant (P＞0.05).The correlation analysis found that serum T level in the female patients with PD was negatively correlated with the disease severity of panic disorder,HAMD total score,retardation factor and sleep disorder factor (P＜0.05).Serum LH and FSH were positively correlated with the anxiety somatic factor of HAMA (P＜0.05).Serum FSH level was positively correlated with anxiety somatization and the sleep disorder factor of HAMD (P＜0.05).Conclusion The disorder of gonadal hormone levels may exist in the female patients with PD,and the serum T level is correlated with the PD severity and depressive symptoms.
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Objective@#To explore the effects of temperature on the daily cases of varicella.@*Methods@#The data of daily cases of varicella was collected during 2008 to 2016 in Lanzhou from National Notifiable Disease Report System, and the meteorological data at the same period was integrated from Gansu Meteorological Administration. Distributed lag nonlinear model was fitted to reveal the relationship between the daily mean temperature and the daily cases of varicella and susceptible population. The minimum morbidity temperature was defined as the reference for the estimation of RRs in different temperature level (-5.2 ℃, 1.7 ℃, 20.1 ℃ and 25.4 ℃).@*Results@#The total of 21 254 cases were reported from 2008 to 2016, of which the ratio of male to female was 1.28 (11 951/9 303) and people aged 6-14 years accounted for 52.87%. The relationship between the daily mean temperature and the daily cases of varicella was M type. For all subjects, the accumulative effects of temperature had statistical significance from lag 0-14 d when temperatures was at -5.2 ℃, 1.7 ℃ and 20.1 ℃,while the RRs (95%CI) were 1.87 (1.64-2.12) , 1.33 (1.10-1.62) ,1.60 (1.38-1.86) ,while from lag 0-7 d when temperatures was at 25.4 ℃,and the RR (95%CI) was 2.51 (1.93-3.27) . The RR value of accumulative effects was 6.23(95%CI: 4.38-8.86) on lag 7 d when temperatures was at -5.2 ℃, which was the highest value at different temperature during lag days. The cumulative effects trends of different temperatures were similar for different gender population or different age subjects. However, the cumulative effects of was highest for children aged 6-14 years among all subjects, and the value of RR was 6.12 (95%CI:3.71-10.10) on lag 5d when temperatures was at -5.2 ℃.@*Conclusion@#We conclude that the increasing risk of varicella is associative with low and high temperature in Lanzhou. The effects of low temperature are stronger than those of high temperature. The children aged 6-14 years belong to the high-risk population of varicella.
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Objective To explore the mediating effects of security on the severity of panic disorder and life events.Methods Security Questionnaire(SQ),life event scale(LES)were used to investigate 97 cases of patients with panic disorder and 108 cases of normal control group. The severity of panic disorder was assessed by panic disorder severity scale(PDSS).And the correlation and hierarchical regression analy-sis were used.Results ①The panic disorder patients' positive life stimulation(7.95±6.00)were less than that the normal control group's(18.06± 13.60),negative life stimulation and total life events stimulation ((36.64±29.98),(44.59±31.24))were higher than that of the normal control group(respectively(10.19± 7.89),(28.25±14.51)),the differences were statistically significant(all P<0.05).Panic disorder patients' interpersonal security certainty in control and total score(respectively(18.89 ± 8.66),(17.88 ± 7.58), (36.76±13.47))were lower than that the normal control group(respectively(26.64±9.33),(24.34±8.33), (50.98±15.31)),the differences were statistically significant(all P<0.01).②Severity of panic disorder and positive life events were negatively related to positive events,the total score of security,interpersonal securi-ty,certainty in control(r=-0.262--0.392);severity of panic disorder were positively related to the negative life stimulation and total life event(r=0.346,0.280)(all P<0.01).③Security played a partial mediating role between the negative life events and the severity of panic disorder(beta value decreased from 0.346 to 0.253).Conclusion The patients with panic disorder have more negative life events,lower security.And negative life events and lower security are related to the severity of panic disorder.And security plays a partial mediating effect between the negative life events and the severity of panic disorder.
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Objective To explore the application effect of elaborate and staged teaching in the teaching of emergency nursing practice.Methods 65 cases of intern nursing students in emergency department from June 2015 to July 2015 were selected as the control group,and the traditional clinical teaching mode was adopted for this group.68 cases of intern nursing students in emergency department from August 2015 to September 2015 were selected as the experimental group,and elaborate and staged teaching was adopted to make teaching requirements in order to carry out the clinical practice teaching.The resuits of two groups of intern nursing students in theoretical score and practice score undergoing different kinds of teaching modes were contrasted and analyzed,and the teaching satisfaction degree for the intern nursing students were recorded.All the data were analyzed by t test with independent sample.Results The theoretical knowledge score [(82.0 ± 1.7) vs.(77.5 ± 2.0)],practice performance score [(80.5 ± 1.3) vs.75.5 ± 2.5)] and teaching satisfaction degree [(93.3 ± 1.3) vs.(75.5 ± 2.5)] of the experimental group were significantly better than those of the control group,and the differences were all statistically significant (P＜0.05).Conclusion Elaborate and staged teaching is helpful for nursing students to master the knowledge and clinical practice skills in emergency nursing,and can improve the teaching satisfaction of the nursing students.There is certain kind of value for promotion for this mode.
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Objective To explore the association between monoamine oxidase A (MAOA) variable number tandem repeat (VNTR) polymorphism and panic disorder,and then to compare panic disorder(PD) severity patient with different MAOA VNTR genotypes.Methods The structured clinical interview for the diagnostic and statistical manual of mental disorders fourth edition (DSM-Ⅳ) Axis I Disorders (SCID-1) was administered by a trained clinical psychiatrist,135 patients with PD and 195 healthy controls were recruited.MAOA-VNTR polymorphism were measured by fluorescent tags amplification product length polymorphism technology,Chi-square test was used to compare the distribution difference between each genotype and the allele frequency distribution.Results ①Whether male or female,there was no statistically significant difference between case group and healthy control group in the genotype and allele frequencies of MAOA-VN-TR polymorphism (x2=1.574,1.894,3.588;all P＜0.05).② There was no statistically significant difference between genotypes and panic disorder severity in the male with panic disorder ((14.46± 3.53),(14.15 ± 4.02);t=-0.247,P＞0.05).③)However,there was significant difference between genotypes and panic disorder severity in the female with panic disorder((13.15±3.47),(16.57±4.34),(15.27±4.91);F=4.222,P＜ 0.05).MAOA VNTR-L/L carriers experienced more serious panic (16.57 ± 4.34) than the patient with MAOA VNTR-H/H (13.15±3.47) (P＜0.01) by LSD multiple test.Conclusion No association between MAOA-VNTR polymorphism and panic disorder is found in Chinese Han population,but low activity homozygous genotype may be related to the severity of panic disorder in female patient with panic disorder.
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Objective To evaluate the cleanliness of frequently touched object surfaces in a hospital and efficacy of intervention measures.Methods Compliance to cleaning of frequently touched object surfaces before and after intervention was surveyed by fluorescence labeling method,SPSS 17.0 statistical software was used to analyze data.Results Before and after intervention,6 800 items in 400 wards were investigated,compliance rates to cleaning of hospital object surfaces before and after intervention were 14.71％ and 54.76％ respectively(P＜0.001);differences in compliance rates to cleaning of object surfaces in common wards and special wards before and after interven tion were both statistically significant(both P＜0.001);after intervention,compliance rates to cleaning of object surfaces in wards and toilets increased significantly compared with before intervention,which increased by 41.57％ and 33.00 ％ respectively,differences were statistically significant (both P＜0.001);after intervention,compliance rates to cleaning of different object surfaces increased by 21.50％-52.00％ (all P＜0.001).Conclusion Scientific and effective intervention measures can improve the cleaning effectiveness of frequently touched object surfaces,which can improve the environmental quality of hospital.
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The relationship between thyroid diseases and cerebrovascular diseases is getting increasingly attention. Studies have shown that thyroid diseases are associated with many kinds of cerebrovascular diseases, such as ischemic cerebrovascular disease, moyamoya disease, cerebral venous thrombosis, and artery dissection. This article review the advances in research on the correlation between thyroid diseases and cerebrovascular diseases.