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Objective:To investigate the status quo and influencing factors of decision-making regret of surrogate decision makers (SDMs) in neurocritically ill patients.Methods:This study was a cross-sectional survey. A total of 110 critically ill patients admitted to Department of Neurosurgery, First Affiliated Hospital of Anhui University of Traditional Chinese Medicine from August 2021 to April 2022 were selected as the research objects by convenient sampling method. Different methods were adopted in the research including general information questionnaire, Chinese Version of Decision-Making Regret Assessment Scale, Disease-Related Knowledge Awareness Questionnaire, General Self-Efficacy Scale, Self-Rating Anxiety Scale, Self-Rating Depression Scale to conduct a questionnaire survey on SDMs in neurocritically ill patients. Multiple linear stepwise regression was used to analyze the influencing factors of decision-making regret in SDMs in neurocritically ill patients.Results:Among the 110 patients with severe neurological diseases, 50.0% (55/110) had no regret, 30.9% (34/110) had mild regret, and 19.1 (21/110) had moderate and severe regret. The results of univariate analysis showed that gender had a statistically significant effect on the score of SDMs decision regret in neurocritical patients ( t=6.57, P<0.05). The age, relationship with patients, education level, decision-making style, place of residence, and monthly income of the family had no effect on the score of regret in decision-making ( t=0.09-1.01, all P>0.05). The results of correlation analysis showed that the score of decision-making regret of SDMs in neurocritically ill patients was negatively correlated with the scores of disease-related knowledge and self-efficacy ( r=-0.342, -0.252, both P<0.05), and positively correlated with the scores of anxiety and depression ( r=0.403, 0.360, both P<0.05). The results of multiple linear regression showed that gender, disease-related knowledge, self-efficacy, anxiety and depression were important factors affecting the decision-making regret of SDMs in neurocritically ill patients ( t values were -3.37-4.31, all P<0.05). Conclusions:SDMs in neurocritically ill patients have a higher degree of decision-making regret, and gender, disease-related knowledge, self-efficacy, anxiety, depression are important influencing factors, suggesting that medical staff can alleviate the decision-making regret of SDMs through decision-making assistance interventions.
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The study is designed to explore new methods of evaluation for teachers′ comprehensive ability in general medicine. In the whole education process of resident aiming at general practitioner (GP) residency post competency, the authors made comprehensive evaluation of GP faculty, and created a comprehensive GP faculty evaluation model of result orientation. The efforts aim at exploring and introducing faculty evaluation methods and promoting education quality, in order to develop outstanding GP residents of strong post competency.
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Objective:To explore the mediating role of self-control in the relationship between alexithymia and internet addiction.Methods:From August to September 2019, a total of 433 college students were selected from three universities in Jiangxi province by cluster random sampling method. The Chinese internet addiction scale-revised, the twenty-item Toronto alexithymia scale and brief self-control scale were used for questionnaire testing. SPSS 23.0 software was used for descriptive statistics, Pearson correlation analysis and PROCESS V3.5 macro program was used to test the mediating effect.Results:The total scores of alexithymia, internet addiction and self-control were (53.61±9.44), (45.31±9.84) and (41.91±6.09), respectively. Pearson correlation analysis showed that alexithymia was significantly positively correlated with internet addiction ( r=0.47, P<0.01), and significantly negatively correlated with self-control ( r=-0.37, P<0.01). The negative correlation between self-control and internet addiction was significant ( r=-0.46, P<0.01). Multivariate hierarchical regression analysis showed that alexithymia directly predicted internet addiction after controlling the influence of gender. Self-control played a partially mediating role in the relationship between alexithymia and internet addiction (effect size=0.13, 95% CI: 0.082-0.185), the mediating effect accounted for 25% of the total effect. Conclusion:Alexithymia not only directly affects college students′ internet addiction, but also indirectly affects college students′ internet addiction through self-control.
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Since the outbreak of coronavirus disease 2019 (COVID-19) , in order to relieve the pressure of outpatient services, especially fever clinic service in hospital, and to avoid the cross-infection among patients, the general practice team of Sir Run Run Shaw Hospital has opened free online counseling service. This article introduces the workflow and related contents of the online counseling mode of general practice under the COVID-19 epidemic situation, so as to provide reference for medical institutions to implement "internet+general practice" mode of counseling service.
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Objective@#To investigate the preventive effect of resin infiltration and adhesive on early erosive enamel wear.@*Methods@#Orthodontic reduction premolars collected from Central Laboratory of Nanjing Stomatological Hospital, Medical School of Nanjing University were used to prepare 70 specimens. Forty samples were divided into eight groups (n=5) and treated with different conditions (pH=1.6, 2.4, 3.2 or 4.0 hydrochloric acid solution, etching time was 30 or 60 s), and the conditions for obtaining early erosive enamel samples were selected. Based on this procedure, thirty early erosive enamel samples were made and divided into three groups: control group, resin infiltration group, and adhesive group. And the treatment of 30 days acid abrasion cycle was carried out. Confocal microscopy was used to measure the thickness changes of enamel or material before and after cycle.@*Results@#Early erosive enamel samples was obtained when pH was 4.0 and etching time was 60 s. After 30 days cycle, the wear of enamel was (29.71±6.72) μm in control group, (5.60±2.24) μm in resin infiltration group and (2.89±1.03) μm in adhesive group. In infiltration group and adhesive group, lower enamel was not affected by the cycle, and the material loss ratios of the infiltration resin group and adhesive group were 0.41±0.14 and 0.29±0.13, respectively. The ratio of material loss was not significantly different (P>0.05). But infiltration group lost (12.95±2.22) μm of enamel during the application of the material.@*Conclusions@#Resin infiltration and adhesive have the same short-term protective effect against early erosive enamel wear. Adhesive has less damage to enamel and better effect.
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Objective To study the expressions and clinical significances of activating transcription factor 3 (ATF3) and Runt-related transcription factor 2 (Runx2) in breast carcinoma tissues.Methods The expressions of ATF3 and Runx2 were detected in 105 cases of primary breast invasive ductal carcinoma (IDC) and their matched para-tumor breast tissues by immunohistochemistry.The relationships between the two transcription factors and the clinical pathological features of IDC patients were analyzed.Results The positive expression rates of ATF3 and Runx2 in IDC group were 80.95％ (85/105) and 69.52％ (73/105) respectively,much higher than those in para-tumor breast tissues 11.43 ％ (12/105) and 8.57％ (9/105),with statistically significant differences (x2 =102.097,P =0.000;x2 =11.595,P =0.001).ATF3 and Runx2 expressions showed significant relationships with histological grade (x2 =14.623,P =0.001;x2 =24.891,P =0.000),lymph node metastasis (x2 =7.059,P =0.008;x2 =6.358,P =0.012) and pTNM stage of IDC (x2 =5.807,P =0.016;x2 =4.902,P =0.027),while both were not correlated with patients' age (x2 =0.274,P =0.601;x2 =1.554,P =0.213) and tumor size (x2 =2.476,P =0.290;x2 =5.261,P =0.072).There was a significant positive relationship between ATF3 and Runx2 in breast carcinoma (C =0.498,P =0.000).Conclusion The over-expressions of ATF3 and Runx2 may participate in the tumorigenesis,invasion,metastasis and clinical stage of breast carcinoma,which suggests that they may be key factors to evaluate malignant degree and prognosis of breast carcinoma.
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Endoplasmic reticulum stress will be happened when cells suffer from severe adverse stimulation.Endoplasmic reticulum stress can induce autophagy.Autophagy and endoplasmic reticulum stress can protect cell for survival, however, they can trigger cell death.In tumor cells, the mutual regulation of autophagy and endoplasmic reticulum stress leads to the imbalance between cell survival and death, which is one of the important factors in determining the efficacy of some antitumor drugs.This paper reviews the progress on autophagy induced by endoplasmic reticulum stress in tumor and the effect of autophagic inhibitors on chemosensitivity.
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Objective To explore the effectiveness and compliance of ketogenic-diet(KD) treatment for infantile spasm(IS).Methods Ninety-eight IS patients who were treated with KD in Wuhan Children's Hospital from March 2009 to June 2015 were analyzed by using retrospective case-control study,the patients were divided into 4 groups:newly diagnosed IS patients group (group A,including 24 patients),one antiepileptic drug (AEDs) failure IS patients (group B,including 28 patients),two and more AEDs failure IS patients (group C,including 29 patients),and two or more AEDs combined with ACTH failure IS patients(group D,including 17 patients).The spasm-free andretention rates after 3,6 and 12 months KD treatment were compared among these groups.Results Overall retention rate was 80.6％ (79/98 cases),69.4％ (68/98 cases),and 42.9％ (42/98 cases)at 3,6,12 months,respectively.The 3-month retention rate in group A,B,C and D was 83.3 ％ (20/24 cases),78.6％ (22/28 cases),82.7％ (24/29 cases) and 76.4％ (13/17 cases) respectively,and there was no significant difference among these groups (P ＞ 0.05).The 6-month retention rates in each group was 75.0％ (18/24 cases),67.9％ (19/28 cases),68.8％ (20/29 cases) and 65.0％ (11/17 cases) in sequence,and there was also no significant difference among these groups(P ＞0.05).The 12-month retention rate was 54.2％ (13/24 cases),21.4％ (6/28 cases),48.3％ (14/29 cases) and 52.9％ (9/17 cases) in group A,B,C and D in sequence,the 12-month retention rate of group B was significantly lower than that of other 3 groups,and the differences were statistically significant(x2 =5.973,4.508,4.727,all P ＜ 0.05),and there was no significant difference among the A,C,D groups (all P ＞ 0.05).The spasm-free rate at 3,6,12 months of KD treatment was 19.4％ (19/98 cases),20.4％ (20/98 cases),30.6％ (30/98 cases).The 3-month spasm-free rate in A,B,C,D groups were as follow:41.7％ (10/24 cases),14.3％ (4/28 cases),10.3％ (3/29 cases),11.8％ (2/17 cases),respectively.The 3-month spasm-free rate in group A was significantly higher than that of other 3 groups,and the differences were statistically significant (x2 =10.238,9.219,6.697,all P ＜ 0.05),but there was no significant difference among the B,C,D groups (all P ＞ 0.05).The 6-month spasm-free rates were 41.7％ (10/24 cases),14.3％ (4/28 cases),13.8％ (4/29 cases),and 11.8％ (2/17 cases) in group A,B,C and D in order,and the spasm-free rate in group A was significantly higher than that of other 3 groups,and the differences were statistically significant(x2 =4.924,5.249,4.298,all P ＜ 0.05),but there was no significant difference among the A,C,D groups (all P ＞ 0.05).The 12-month spasm-free rates were 54.2％ (13/24 cases),21.4％ (6/28 cases),24.1％ (7/29 cases),and 23.5 ％ (4/17 cases) in group A,B,C and D,and the spasm-free rate in group A was significantly higher than that in other 3 groups,and the differences were statistically significant(x2 =8.354,7.923,4.364,all P ＜ 0.05),but there was no significant difference among the A,C,D groups (all P ＞ 0.05).Conclusions The spasm-free rate of KD therapy for newly-diagnosed IS is higher than that of IS patients whose drug-therapy failed.KD therapy may be the top priority for IS patients and part of those patients whose drug-therapy failed can still get seizure-free with KD diet.
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Objective To investigate alterations of endothelial microparticles(EMPs) levels in patients with coronary heart dis‐ease(CHD) ,and to evaluate the relationship between EMPs and interleukin‐6(IL‐6) and C‐reactive protein(CRP) .Methods A to‐tal of 38 patients with CHD were divided into myocardial infarction(MI) group(13 cases) and unstable angina(UA) group(13 ca‐ses) and stable angina(SA) group(12 cases) ,and 12 healthy subjects were enrolled as control group .Levels of EMPs were meas‐ured by using flow cytometry technique .Concentration of IL‐6 and CRP were determined by using enzyme linked immunosorbent assay and special protein analysis respectively .Results Compared with SA group and control group ,levels of EMPs were signifi‐cantly increased in MI group and UA group(P<0 .05) .Levels of EMPs in patients with CHD were significantly correlated with IL‐6 and CRP ,with correlation coefficient of 0 .79 and 0 .50 respectively(P<0 .05) .Conclusion EMPs could contribute to monitoring and evaluating the degree of endothelial cells injury in patients with CHD as a laboratory indicator .EMPs might enhance the vascu‐lar inflammation in patients with CHD ,and further accelerate the development of CHD .
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Objective To analyze the chromosome karyotypes,prenatal diagnosis indications and pregnancy outcomes of high-risk pregnant women in Guangzhou.Methods 2 475 cases pregnant women with screening high risk were operated amniocen-tesis or cordocentesis from January 2010 to September 2012,then amniotic fluids and cord bloods were cultured and the cell were collected for chromosome preparation,G banding,karyotype analysis.We completed follow-up works lastly.Results 38 cases were detected chromosomal abnormality(including 12 cases Down′s syndrome,9 cases sex chromosome abnormality,7 cases transloca-tion,5 cases Edwards′syndrome,2 cases inversion,2 cases deletion,1 cases triploid),the abnormal rate was 1.54%.132 cases were detected chromosomal polymorphism(60 cases 1,9,16qh+ ,30 cases inv(9),25 cases D/Gs+ ,17 cases Y polymorphism).Research on prenatal diagnosis indications,there were 449 cases advanced age,668 cases Down′s screening with high risk,158 cases with ab-normal B ultrasound screening,38 cases with adverse pregnancy history.Conclusion The highest percentage abnormal karyotype is Down′s syndrome.Down′s screening high risk is the main reason for prenatal diagnosis.It is very important to do prenatal diagnos-tic and system B ultrasound for the high-risk pregnant women.
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Objective To evaluate the efficacy of aminolevulinic acid hydrochloride photodynamic therapy (ALA-PDT) combined with multi-function electronic therapeutic device in the treatment of condyloma acuminatum.Methods Sixty cases with condyloma acuminatum were divided into two groups with 30 cases each according to the treatment method.The combination group was treated with ALA-PDT combined with multi-function electronic therapeutic device,and the control group was treated only with multi-function electronic therapeutic device.Once a week,treatment was not more than three weeks.The adverse reaction was observed.The efficacy was evaluated after 1 week's treatment.The recurrence rate was evaluated after 1,6 months' s treatment.Results The cure rate was 80.00％ (24/30) and 96.67％ (29/30) in combination group and control group,and there was no significant difference (P ＞ 0.05).The recurrence rate was 8.33％ (2/24),12.50％(3/24) in combination group and 17.24％ (5/29),41.38％ (12/29) in control group after 1,6 months's treatment,and there was no significant difference after 1 month's treatment (x2 =0.298,P ＞ 0.05),but there was significant difference after 6 months' s treatment (x2 =4.030,P ＜ 0.05).There was no system adverse reaction,the adverse reaction was 16 cases in combination group and 44 cases in control group.Conclusion ALA-PDT combined with multi-function electronic therapeutic device in the treatment of condyloma acuminatum can improve the cure rate,decrease the recurrence rate and adverse reaction.
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Objective To evaluate the clinical significance of detecting serum anti-Saccharomyces cerevisiae antibody (ASCA)IgG and IgA in the diagnosis of Crohn′s disease(CD).Methods A total of 51 patients with CD were enrolled as CD group and 22 healthy volunteers as healthy control group.The serum samples of both groups were collected.ASCA-IgG and ASCA-IgA were determined with enzyme linked immunosorbent assay (ELISA).According to Montreal standard,patients with CD were divided into subgroup according to the age of onset (A),lesion (L),clinical behavior (B).The sensitivity, specificity and positive predictive value of both groups were calculated.Chi-square test was performed for count data analysis.Results The sensitivities of ASCA-IgG and ASCA-IgA in CD group were 45 .1 % and 35 .3%,respectively,while in the healthy control group which were 0 and 9.1 %,respectively.There were significant differences between two groups (χ2 =14.49 and 5 .31 ,both P 0.05 ).The sensitivities of ASCA-IgG in CD patients with complications and without complications were 56.3% and 26.3%,respectively,and there was significant difference (χ2 =4.31 ,P <0.05).Conclusions Serum ASCA-IgG is not suitable for population screening,however it has certain value for the differential diagnosis of CD.The clinical value of detecting ASCA-IgG is higher than that of detecting ASCA-IgA.
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Objective To explore the strategies and effectiveness of perioperative fluid administration during pediatric kidney transplantation.Methods In our study,we evaluated the heart function and compliance of pediatric patients preoperatively,and then formulated perioperative fluid management strategy according to children’s circulation feature.The electrolytic balance was kept and complications were prevented.Results Twenty-nine out of all 48 children experienced electrolyte disturbance to different extents on day 1 postoperatively,which improved on day 2 after prompt management.There were five cases of oliguria,three cases of delayed graft function(DGF),one case of heart failure and multiple organ failure respectively.Conclusion Such nursing strategies like formulation of reasonable fluid infusion plan according to the physiological features of pediatric recipients,keeping the electrolytic balance and careful management of fluid at polyuria,oliguria and anuria,care critical for the children to live through the perioperative periods.
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Objective To explore of integrated traditional Chinese and Western medicine treatment for peri -menopausal dysfunctional uterine bleeding ( bleeding ) .Methods According to the digital table ,was ginen to 66 pa-tients with perimenopausal dysfunctional uterine bleeding were randomly divided into the two groups .The control group uses the conventional western medicine treatment ,the treatment group was treated by combined Western and Chinese medicine .Before and after treatment ,the endometrial thickness ,hemoglobin value of the two groups was recorded ,and the clinical efficacy of the two groups was evaluated .Results The treatment group in the treatment of uterine endom-etrial thickness,hemoglobin value and clinical effective rate was (6.69 ±1.96) mm,(97.04 ±15.48) g/L,97%, which was better than those of the control group [(8.09 ±2.44) mm,(87.13 ±20.83) g/L,85%] (t =2.575, 2.129,χ2 =9.452,all P<0.05).Conclusion The joint Chinese and Western medicine treatment for Peri-menopa-usal dysfunctional uterine bleeding and it is worthy of promotion .
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@#Objective To study the clinical efficacy of wrist-ankle acupuncture on post-traumatic stress disorder (PTSD) after work-related injury. Methods 62 patients were divided into observation group (n=30) and control group (n=32). The observation group accepted wrist-ankle acupuncture combined with Paroxetine, and the control group accepted Paroxetine only. They were assessed with Clinical Administered PTSD Scale (CAPS), Hamilton Depression Rating Scale for Depression (HAMD), and Hamilton Anxiety Scale (HAMA) before, 6 weeks and 12 weeks after treatment. Results The scores of CAPS, HAMD and HAMA reduced in both groups (P<0.01) after treatment, and the reduction rate was greater in the observation group than in the control group (P<0.05). Conclusion Wrist-ankle acupuncture may further relieve PTSD after work-related injury
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Objective To explore the effect of the synthetic rehabilitation therapy for the stroke patients with cognitive deficits,and the improvement of the patients'motor function and independent living ability.Methods The synthetic rehabilitation therapy was carried out in 136 stroke patients with cognitive deficits.The synthetic rehabilitation therapy including :acupuncture,hyperbaric oxygen therapy ,cognitive training and physical therapy etc.The patients'cognitive function,motor function and independent living ability were evaluated and analyzed statistically before and after the treatment.Results the patients'cognitive function,motor function and independent living ability are significantly higher after the treatment (P＜0.01).Conduston The synthetic rehabilitation therapy can significantly improve the cognitive function of the patients with cognitive deficits,and it can improve their motor function and independent living ability.
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In order to make good use of laboratory opening,the way,method together with the effect of laboratory opening in our college were analyzed and discussed in this paper. The perfect practice effect shows that laboratory opening plays an important role in cultivation for independent research abilities and scientific innovative abilities of undergraduates.
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We provide laboratory for students to design and complete experiment independently,and examine their operation ability in course of experiment.After accomplishing their experiments,the students must write a disquisition on it.Through this exploration experimentation,we have trained students scientific analysis ability and innovation ability and make them benefit form it in their future study and work.
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BACKGROUND: Previously, there are some researches on studying the effects of hypoxia or hypothermia singly. Nowadays, study on the synthetic action of hypoxia and hypothermia has been attached widely importance.OBJECTIVE: To explore the combination effects of acute hypothermia and hypoxia on superoxide dismutase(SOD) and malondialdehyde in normal rabbits and rabbits with myocardial ischemia.DESIGN: Randomized controlled trial.SETTING, MATERIALS and INTERVENTIONS: Experimental site:Physiological Laboratory of Youjiang Ethnic Medical College. A total of 32 healthy rabbits weighed between 1.8to 2.5 kg were chosen. They were randomly divided into 4 groups each with 8 rabbits: normal group, hypothermia and hypoxia group, ischemic group with normal temperature and oxygen,ischemic group with hypothermia and hypoxia. Normal rabbits and ischemic rabbits were put in fridge at low temperature( -10 ± 2) ℃ and low oxygen (oxygen content of 8.5% ) for one hour and tested activity of SOD and concentration of malondialdehyde in serum.MAIN OUTCOME MEASURES: Comparison of serum SOD and malondialdehyde between normal rabbits and myocardial ischemic rabbits under the acute hypothermia and hypoxia conditions.RESULTS: The SOD level of rabbits in hypothermia and hypoxia group [(371.04 ± 29.96) kNU/L] was much lower than that of normal temperature and oxygen group[ (424.09 ± 22.59) kNU/L] ( t = 5.21, P < 0.01) while the content of malondialdehyde[ (5.58 ± 0. 44) μ mol/L] was greater than that of normal group[ (4.44 ± 1.11) μ mol/L] ( t = 3.21, P < 0.05) . In myocardial ischemia group with hypothermia and hypoxia, SOD was greatly lower than that of myocardial ischemia group with normal temperature and oxygen(t=4.37, P < 0.01) while the malondialdehyde was greatly higher than that of ischemic group with normal temperature and oxygen group(t=2.94, P <0.05).CONCLUSION: The combined effects of acute hypothermia and hypoxia will aggravate the damage to body.
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Objective To develop a new method for detection of anti-dsDNA antibodies Methods Plasma double stranded DNA were used as antigen substrate and derived with fluorescence thiazole orange homodimer Capillary electrophoresis with laser induced fluorescence was used for the detection of anti dsDNA antibodies of patient with Systemic lupus erythematosus (SLE) Results 23 out of 40 patients with SLE were positive(57 5%); 1 out of 25 patients with other autoimmune disease were positive; none of 45 controls were positive Comparison of this assay with Farr and dot immunobinding assay(DIBA)shows that CE LIF was more sensitive than DIBA and more specific than Farr Conclusions The assay was rapid, simple and reproducible CE LIF may become a routine assay for determination of anti dsDNA antibodies