Smoking behaviour among male students in a Saudi University

Background: Smoking among university students is a social and public health problem worldwide. There is a high prevalence of smoking in Saudi Arabia.

Aims: To investigate the factors associated with the onset and cessation of smoking behaviour among university students in Saudi Arabia, and establish what contributes to changes of students' smoking behaviour.

Methods: A sample of 340 students from a national university in Saudi Arabia was randomly recruited and surveyed twice at a 5-month interval. Multiple ordinal logistic regression was run to compare changes in social, psychological and political factors and their impact on students' smoking behaviour.

Results: We found that beliefs supporting nonsmoking [e.g., religious prohibition of smoking] correlated with changes in smoking behaviour among university students [adjusted odds ratio [AOR] = 1.89, 95% confidence interval [CI] = 1.23– 2.91]. There was a significant positive correlation between government policy and changes in male university students' smoking behaviour [AOR = 0.46, 95% CI = 0.29–0.072]. The psychological effect of smoking, such as releasing psychological pressures, was also correlated with changes in smoking behaviour [AOR = 0.31, 95% CI = 0.21–0.47].

Conclusions: Our study suggests that the government can play a significant role in curbing smoking by strengthening beliefs promoting antismoking among university students, by developing corresponding policies against smoking, and by providing psychological consultation for them

Echocardiography in diagnosis of pediatric pulmonary artery sling / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To evaluate the application of echocardiography in diagnosis of pediatric pulmonary artery sling.</p><p><b>METHODS</b>Twenty-five children diagnosed as pulmonary artery sling in the Children's Hospital, Zhejiang University School of Medicine from July 2012 to August 2017, and 50 healthy children(control group) were enrolled in the study. Echocardiography was performed in all subjects. The origins of the left pulmonary artery(LPA) and right pulmonary artery(RPA) were observed; the internal diameters of LPA, RPA and main pulmonary artery(MPA) were measured; and the ratios of LPA/MPA and RPA/MPA were calculated. The value of RPA/MPA and LPA/MPA in diagnosing pulmonary artery sling was evaluated by ROC curve.</p><p><b>RESULTS</b>Echocardiography showed that the internal diameters of RPA were increased in all patients; while the LPA and blood flow signals in common pulmonary arterial bifurcation were not found in 24 cases, in whom the MPA was directly extended to the RPA, and the LPA was from the massive RPA. The ultrasound of one special case showed that there was no distinct bifurcation of MPA; the MPA walked to the right and then to the left with no change in the internal diameter. There were significant differences in RPA/MPA(0.50±0.05 vs. 0.71±0.15, =7.06, <0.01) and LPA/MPA(0.52±0.05 vs. 0.39±0.09, =6.94, <0.01) between controls and the patients. ROC curve analysis showed that the AUC of RPA/MPA and LPA/MPA in diagnosis of pulmonary artery sling were 0.90 and 0.89, respectively. When taking 0.60 as the cutoff value, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of RPA/MPA in diagnosis of pulmonary artery sling were 79%, 100%, 100%, 91% and 93%, respectively. When taking 0.43 as the cutoff value, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of LPA/MPA in diagnosis of pulmonary artery sling were 71%, 96%, 89%, 87% and 88%, respectively.</p><p><b>CONCLUSIONS</b>s Echocardiography can effectively diagnose pediatric pulmonary artery sling. The RPA/MPA ratio of 0.60 and the LPA/MPA ratio of 0.43 can be used as cutoff values for diagnosis.</p>

Perimembranous ventricular septal defect performed super minimally invasive trans intercostal device closure under the guidance of transesophageal echocardiography in children / 中华胸心血管外科杂志

Objective This study was aimed to discuss the safety, feasibility and availability of perimembranous ventricular septal defects(PmVSD) closure via super minimal intercostal incision under transesophageal echocardiography(TEE) guidance in children.Methods There were 81 cases of PmVSD via super minimally invasive transintercostal device closure operation(length of incision ≤ 1cm) from August 2014 to August 2016.TEE was used to guide and monitor the entire procedure.Assessed the effectiveness of device closure by postoperative regular follow-up.Results 80 patients were successfully operated by super minimally invasive transintercostal device closure in all 81 cases.Operation success rate reached 98.77%.The average diameter of ventricular septal defects was(3.72±0.96)mm.The average diameter of amplatzer occluder was(4.88±0.95)mm.Postoperative follow-up time was from 6 months to 24 months.One of 16 cases that with aneurysm of membranous septum had more than two shunts, remained a mild residual shunt beside of the amplatzer occluder but self cured during follow-up.Mild pericardial effusion was found in one patients after the operation and disappeared during follow-up.There were no cases of perioperative death, device deformation or displacement, residual shunt, complete atrioventricular block and valve involvement in the patients whom were successfully operated.One patient transferred to ventricular septal defect repair operation under direct visualization with a cardiopulmonary bypass, because ventricular fibrillation happened when guide wire passed the ventricular septal.Conclusion Super minimally invasive transintercostal device closure of PmVSD in children guided by TEE was safety and availability, that could avoid x-ray radiation and sternotomy, and operate simply, with small incision and low complication.

Discussion on imaging examination method and preoperative follow-up for gastric duplication in children / 中华超声影像学杂志

Objective To report the clinical and imaging characteristics of 9 cases of gastric duplication in children,as well as to probe into all kinds of imaging examination methods,with an aim to improve preoperative diagnostic accuracy.Methods Nine cases of children with gastric duplication that received surgical resection and were pathologically confirmed in our hospital from January 2009 to November 2016 were retrospectively analyzed.The clinical manifestations,complications,complicated malformation and imaging findings of the cases were summarized.Three asymptomatic cases were carried out regular ultrasound examination follows-up preoperatively.Results Gastric duplication in children varied in terms of cliuical manifestations.All the 9 cases were performed ultrasonography preoperatively,and 5 of them were accurately diagnosed.Meanwhile,7 cases received preoperative CT examination,with 2 cases being confirmed.Three cases received magnetic resonance imaging (MRI) examination,with 2 cases being confirmed.And 2 cases had upper abdominal gastrointestinal imaging (GI) examination,but no definite diagnosis was made.Three cases of asymptomatic children with enlarged lesion can be seen in follow-up.Conclusions Gastric duplication is a rare congenital malformation,ultrasound allows to clearly display the capsule wall structure and the relation between gastric duplication with gastric wall,which is associated with high utilization rate and diagnosis rate,and it can be served as the preferred imaging examination method for gastric duplication in children.

Risk factors for coronary artery aneurysms in children with Kawasaki disease / 中国医师杂志

Objective To explore risk factors for coronary artery aneurysms (CAA) in children with Kawasaki disease (KD),and reduce the rate of serious sequelae of cardiovascular diseases.Methods All the patients were diagnosed as KD in Children’s Hospital Affiliated to Medical College of Zhejiang University from January 2009 to January 2014.A total of 679 cases was included,and 42 with concurrent CAA,181 with concurrent coronary artery expansion (CAD),and 456 without coronary artery damage cases (non-coronary artery lesion,NCAL).Coronary artery damage was related to factors such as gender,age,fever,white blood cell count (WBC),hemoglobin (Hb),platelet count (PLT),erythrocyte sedimentation rate (ESR),C-reactive protein (CRP),alanine aminotransferase,serum potassium,plasma amino terminal brain natriuretic peptide precursor (NT-proBNP),and acrylic ball resistance.SPSS 18.0 software package was used for risk factor analysis.Qualitative data using chi-square test,was used to analyze the high risk factors of CAA group,and logistic multivariate regression analysis was also used.Results Chi-square test showed that male,with febrile days ＞ 14 d,NT-proBNP ≥ 1 000 ng/L,immunoglobulin resistance was more likely to have KD concurrent CAA (P ＜ 0.05).Multiple Logistic regression analysis showed that male [OR =4.092,95％ CI (1.514,11.060),P =0.004],febrile days ＞14 d [OR =12.436,95％ CI (4.599,33.631),P =0.000],NT-proBNP≥ 1 000 ng/L [OR =3.305,95％ CI (1.401,7.794),P =0.005],and immunoglobulin resistance [OR =3.842,95 ％ CI (1.562,9.453),P =0.000] were independent risk factors for KD concurrent CAA.Conclusions Male children,febrile days ＞ 14 d,NT-proBNP≥ 1 000 ng/L,and immunoglobulin resistance were independent risk factors of CAA.

Optimization of the Extraction Technology of Paeonia lactiflora by Mixed Uniform Design / 中国药房

OBJECTIVE:To optimize the extraction technology of Paeonia lactiflora. METHODS:The surface figure made by mixed uniform design combined with the quadratic polynomial stepwise regression equation is adopted to optimize the extraction technology of P. lactiflora by using the content of paeoniflorin as index,with extraction solvent,the amount of extraction solvent, extraction time,extraction times as factors. RESULTS:The optimal extraction technology of P. lactiflora was as follows as 90%ethanol,12-folds extraction solvent,extracting for 150 min,extracting for 2 times. The measured value of 3 validation tests were 2.848 4%,2.795 7%,2.841 9%(RSD=0.82%,n=3),which was close to the predicted value 2.848 4%. CONCLUSIONS:The method is convenient and accurate,and can be used for the extraction of P. lactiflora.

Simultaneous Determination of 20 Pigments in Illegally Dyed Chinese Herbs by HPLC-DAD / 医药导报

Objective To develop a HPLC-DAD method for the simultaneous determination of 20 synthetic pigments in dyed Traditional Chinese Medicine. Methods The samples were extracted with ultrasonic by 70% methanol, separated on a Agilent TC-C18 column ( 4. 6 mmí250 mm, 5 μm ) by gradient elution using a mobile phase made up of methanol and 0. 02 mol·L-1 ammonium acetate, and detected at 210-650 nm. The retention times and ultraviolet absorption spectrums were used to text and verify. Results The twenty red and orange synthetic pigments were separated and detected. OrangeIIsodium salt and 808 scarlet were detected in some batch of Croci stigma and Cinnabaris. Conclusion The method is simple, rapid, accurate, repeatable for determining twenty synthetic pigments in dyed Traditional Chinese Medicine.

Analysis on applying model of educating diabetics in health knowledge and filinging relevant data / 重庆医学

Objective To explore the effect of applying the management model of educating diabetics in health knowledge and filinging relevant data .Methods 1 000 patients with type 2 diabetes in hospital were randomly assigned into the experimental group and the control group ,and all of them received health education .In addition ,relevant data were filed in the experimental group ,then the compliance behavior ,general metabolic indicators and occurrences of complications were compared before and after the education in 1 ,3 and 6 months between these two groups .Results The general metabolic indicators in experimental group were better than the control group(P<0 .05);and the compliance behavior of the experimental group patients were improved obviously (P<0 .05);and the cases of the patients with complications from random visit were also obviously lower in the experimental group (P<0 .05) . After 1 month or 6 months ,the two groups of patients′qualities of life were significantly increased ,but the experimental group′was improved more obviously(P<0 .05) .After 6 months ,the degree of satisfaction of the experimental group was 91 .6% (458/500) , the control group′was 68 .2% (341/500) .The satisfaction of experimental group was significantly higher than the control group (P<0 .05) .Conclusion The management model to patients with type 2 diabetes could effectively improve patients′metabolic level and reduces the occurrences of complications and improves the therapeutic effect .

Value of echocardiography in the diagnosis of anomalous origin of left coronary artery from the pulmonary artery / 中华超声影像学杂志

Objective To explore the value of echocardiography in the diagnosis of anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) in children.Methods The echocardiographic images of 14 patients with ALCAPA confirmed by operation and 18 patients with endocardial fibroelastosis (EFE) diagnosed by clinical were compared and analyzed.Results Both ALCAPA and EFE exhibited obvious dilated left ventricle,decreased left ventricular systolic function,thick endocardium and mitral regurgitation of different degree.The former additionally showed dilated right coronary artery(RCA) with normal origin,left coronary artery(LCA) emerging from the root or wall of the pulmonary artery(PA),the retrograde flow into PA in LCA and abundant collateral vessels in myocardium.However the later exhibited normal diameter of LCA and RCA and no collateral vessels.Conclusions Color Doppler echocardiography not only demonstrates left ventricular systolic function,endocardium,mitrial regurgitation and collateral vessels in myocardium,but also shows the origination and courses of LCA clearly,which provide exact informations to diagnose ALCAPA.The echocardiography can be used as a powerful tool of ALCAPA diagnosis and preoperative assessment.

Investigation and management countermeasures on work situation of senior clinical nurses in a hospital / 重庆医学

Objective To investigate the current work situation of senior clinical nurses to provide some advices for the nursing management .Methods The self-made questionnaires were adopted to investigate the work situation of 60 senior nurses for conduc-ting the descriptive analysis .Results The senior nurses′ satisfaction degrees to the professional self -identity ,the chief nurse′s scheduling ,the current work environment ,the approval by hospital and the emphasis degree by the department were not high .They thought that the suitable position for them was the office nurse and the second was the responsibility group leader .Whereas ,the un-dertaking key post at present was the responsibility group leader and the second was the office nurse .Conclusion Due to the partic-ularity of nursing work and the physiological and psychological change ,the senior nurses are unsuitable to the busy front -line work ;the senior clinical nurses have the rich clinical experience ,the stronger communicational and organizational coordination abili-ty ,and are more suitable for the posts of the office nurse and health education nurse ,and second is the post of responsibility group leader .

The effection of Shenfu Injection (Ginseng-radix aconitum Injection) to the coagulation in the patient of multiple trauma complicated with shock / 中华急诊医学杂志

Objective To investigate the effection of Shenfu Injection (Ginseng-radix aconitum Injection)to the blood coagulation system and its prognosis in the patient of multiple trauma complicated with shock.Methods We prospectively studied 90 patients of multiple trauma complicated with shock,who came from the emergency center of the Second Affiliated Hospital of Medicine' s college of Zhe-Jiang University and emergency department of Lishui People' s Hospital from February 2007 to December 2011,and excluded those suffered with the dysfunction of coagulation system and uncontrolled ongoing bleeding before trauma.And then these eligible patients were randomly divided into two groups:treatment group ( 45 cases ) and control group (45 cases),the control group were received the routine treatment,the treatment group were received Shenfu Injection in early stage based on the routine treatment.The two groups were measured the platelet count (PLT),prothrombin time (PT),activated partial thromboplastin time (APTT),thrombin time (TT),fibrinogen (FIB) before treatment and 3,7 days after treatment.Results The differences of the PLT,PT,APTT,TT,FIB between the treatment group and control group at 3,7 d after the treatment was statistically significant (P ＜ 0.05 ). Conclusions Shenfu Injection has positive regulation to the coagulation system in the patient of multiple trauma complicated with shock.

Diagnosis of the downward displacement of the posterior leaflet of tricuspid valve from apical right heart two chamber view by echocardiography / 中华超声影像学杂志

Objective To evaluate the value of echocardiography method for diagnosis of the downward displacement of the posterior leaflet of tricuspid valve with apical right heart two chamber view (AP-RH-2CV). Methods Rotating the probe clockwise from apical four chamber view(AP-4CV) to AP-RH-2CV at the septial and posterior leaflet of tricuspid valve, the shape, moving and position of the posterior leaflet of the tricuspid valve were observed by displaying the degree of downward displacement of the septial and posterior leaflet of tricuspid valve. The location of the orifice of tricuspid regurgitation was examined by color Doppler flow imaging(CDFI). Results In 15 patients with Ebstein's anomaly from the AP-RH-2CV, the downward displacement of posterior leaflet of tricuspid valve was clearly observed at the AP-RH-2CV. These results of echocardiography were confirmed by surgery except one ease missing out mild downward displacement of the anterior leaflet of tricuspid valve. Moreover, all 15 patients showed the obvious downward displacement of the location of the orifice of tricuspid regurgitation from AP-RH-2CV by CDFI. Conclusions The AP-RH-2CV is an ideal view in diagnosis of the downward displacement of the posterior leaflet of tricuspid valve by echocardiography. The downward displacement of the location of the orifice of tricuspid regurgitation is a critical character for diagnosis of the downward displacement of the posterior leaflet of tricuspid valve by CDFI.

Cerebral functional improved in rats with severe acute monoxide poisoning by transplantation of neural stem-like cells derived from bone marrow mesenchymal stem cells / 中华急诊医学杂志

Objective To investigate cerebral functional remodeling of the rat with severe acute carbon monoxide poisoning transplanted with neural stem-like cells derived from bone marrow mesenchymal stem cells (MS-NSCs) . Method Forty Sprague-Dawley rats weighing 200 ～ 250 g were divided randomly into 4 groups: the normal control group, the poisoning control group, the bone marrow mesenchymal stem cells(BMSCs) transplantation group and the MS-NSCs transplantation group. BMSCs were harvested from whole bone marrow in vitro, then were differentiated into MS-NSCs under certain growth factors cocktail,and were followed by BrdU labelling.Twenty-four hours after poisoning, the seed cells were infused into brain via left internal carotid and the functional remodeling of cerebrum was assessed by neurological severity score(NSS) and Morris water maze(MWM) tests. Results There was no significant differences in NSS test between groups after transplantation. However, the differences in MWM test were very significant between 5 weeks after transplantation ( P < 0.01). Conclusions Transplantation of MS-NSCs may improved cerebral function of rats after severe acute CO poisoning. Moreover, the cultured and idfferentiated MS-NSCs induced in vitro preliminarily is potentially more efficient than directly transplanted BMSCs without culture and differentiation.

Cerebral white matter remodelling in rats with severe acute carbon monoxide poisoning after transplantation of neural stem-like cells derived from bone marrow mesenchymal stem cells / 中华急诊医学杂志

Objective To investigate changes in cerebral white matter after transplantation of neural stem like cells (MS-NSCs) derived from the bone marrow mesenchymal stem cells, in rats with severe acute carbon monoxide poisoning. Method Forty Sprague-Dawley rats weighing 200 ～ 250 g were divided randomly into 4 groups: the normal control group, the poisoned control group, the BMSCs transplanted group and the MS-NSCs transplanted group (each group 6 rats). BMSCs were harvested from whole bone marrow in vitro, and then differentiated into MS-NSCs under the cock tail of certain growth factors, followed by BrdU labelling. The seed cells were infused into the brain via the left internal carotid artery 24 hours post poisoning. Remodelling of cerebral white matter was assessed using H & E staining, myelin staining and immunohistochemitry assay after 5 weeks later. Results Cellular transplantation improved the compactness and orderliness of cerebral white matter. BrdU-positive cells were found in the focal insulted areas of sparse white matter; and greater numbers of Brdu-Positive ceus were observed in the MS-NSCs group thar in the BMSCs group (P ＜0.05). Conclusions MS-NSCs participates in the remodeling of cerebral white matter in rats with severe acute carbon monoxide poisoning, and shows promising evidence as seed cells transplanted for brain tissue regeneration.

Echocardiographic diagnosis of congenital supravalvular aortic stenosis in children / 中华超声影像学杂志

Objective To study the echocardiographic characteristics and its diagnosis value on congenital supravalvular aortic stenosis (SVAS) in children. Methods Thirty-one patients with SVAS diagnosed by multiplane echocardiography were enrolled in the study. Their echocardiographic characteristics were compared with cardiac catheterization, operation, and gene detection results. Echocardiographic changes were mainly observed in aortic valve, supravalve, descending aortic arch, pulmonary artery valve, main pulmonary artery and its branches,and coronary artery. Results Of the 31 patients,26 had hourglass type SVAS,4 hypoplastic type,and 1 membranous type; 2 patients had extremely mild stenosis (defined as a Doppler gradient <25 mm Hg) ,20 mild (25～49 mm Hg) ,5 moderate (50～75 mm Hg) ,and 4 severe C>75 mm Hg) ones. Nineteen patients were diagnosed with Williams syndrome by gene detection. Three patients were associated with aortic valve stenosis including one missed at the initial diagnosis; 10(32.26%) patients with pulmonary stenosis, including pulmonary valve stenosis in 6, left and right pulmonary artery stenosis in 3 ,and branch stenosis in 1:6 patients with coronary stenosis. Conclusions The sternal border and five chamber apical views are the best to detect SVAS. Williams syndrome patients are prone to SVAS.Pulmonary stenosis echocardiography forms a great proportion of the SVAS patients. Routine examination is necessary for coronary stenosis in cases of SVAS.

Role of adenovirus mediated CTLA4-Ig gene in the immune cells infiltration and cell apoptosis in murine liver transplantation / 中国普通外科杂志

Objective To investigate the role of B7/CD28 costimulation pathway blockade with adenovirus-mediated CTLA4-Ig gene in macrophage and CD8~+T cell infiltration and cell apoptosis in murine liver transplantation. Methods Rat pairs were divided into three groups: SD-to-Wistar transplantation control group, CsA-treated group and CTLA4-Ig-treated group. IHC and TUNEL were used to analyze the expression of CTLA4-Ig gene in liver and immune cells infiltrate and cell apoptosis in liver grafts. Pathology was done on all harvested grafts. ResultsCTLA4-Ig gene expression was positive in the donor liver on day 7 after administering adenovirus-mediated CTLA4-Ig gene via vein, and remained positive until day 60 after liver transplantation. Infiltration of immune cells in CTLA4-Ig-treated group was less than that in rejection control group. the apoptotic index of rejection group on day 3,5,7 was significantly higher than those of CTLA4-Ig-treated. Conclusions CTLA4-Ig gene was constantly expressed in the donor liver after single intravenousely injection into rats using adenovirus as vector. Adenovirus-mediated CTLA4-Ig gene therapy can inhibit infiltration of immune cells and apoptosis in grafts, thus prolonging the survival of recipients.

The in vitro immune effects of dendritoma formed by mouse hepatocellular carcinoma cells and lymphotactin gene modified dendritic cells / 中国病理生理杂志

AIM: To investigate the in vitro anti tumo r immune responses of dendritoma formed by mouse hepatocellular carcinoma cells and lymphotactin gene modified dendritic cells (DCs). METHODS: DCs prepared from mouse bone marrow were genetically mo dified by lymphotactin adenovirus, and fused with H22 cells by polyethylene glyc ol. RT-PCR and ELISA were employed to identify lymphotactin expression at mRNA a nd protein levels. The phenotypes and fusion efficiency were detected by FACS. T he stimulatory capacity of DC to T cells was detected by mixed leukocyte reactio n. The cytotoxicity activity against H22 cells was assayed by LDH method. RESULTS: Lymphotactin effectively expressed by DCLptn/H22 hybrid oma. DCLptn/H22 cells induced potent T cell proliferation effect and generated s trong CTL reaction against allogenic H22 cells. CONCLUSION: Lymphotactin genetic modification enhanced the in vitro immune activity of dendritoma.