Knowledge, behavior and psychological status regarding COVID-19 in elementary and secondary school teachers / 上海预防医学

Objective To evaluate the knowledge, behavior and psychological status regarding COVID-19 epidemic in elementary and secondary school teachers, and to provide a reference for disease prevention and control at schools as well as for preparation of school returning. Methods A survey in 2 338 teachers was conducted using self-designed questionnaires about COVID-19. Results The overall awareness rate of COVID-19 knowledge was 88.79%, knowledge score was 10.65±1.09, and the school health teachers had higher score than other school staff (F＝23.87, P=0.000 1).Respondents with IP address in Hubei had higher score than those in Jiangsu, Zhejiang and Shanghai(F＝10.69, P=0.014).The top three knowledge resources were news apps (Toutiao, Tencent) (87.25%), WeChat (78.06%) and telecast (74.94%).The overall healthy behavior score was 43.59±3.12, and school doctors again had higher score than other school staff (F=11.48, P=0.02).Respondents with IP address in Hubei had higher score than those in Jiangsu, Zhejiang and Shanghai (F=17.08, P=0.000 7). During the epidemic, 100% respondents wore masks when taking public transportation, the highest rate of wearing masks, while 90.93% wore masks at family and friends gathering, the lowest rate of wearing masks.The top three types of masks being used were disposable medical masks (89.14%), surgical masks (43.63%) and N95 medical protective masks (34.09%).The highest rate of hand washing behavior was 99.83% for washing hands after going to toilet, while the lowest was 75.92% for washing hands after touching hair, ears and nose.The highest rate of other healthy behaviors was 94.14% for reducing family and friend gatherings, while the lowest was 71.60% for covering mouth and nose when sneezing or coughing. The correlation between health behavior and knowledge was statistically significant (r=0.081, P < 0.001).Correlation analysis showed that the degree of concern was related to the degree of teaching influence (r=0.768, P=0.0002), and the degree of anxiety was related to the degree of teaching influence (r=0.175, P < 0.001), while there was no correlation between the degree of concern and the degree of anxiety. Conclusion Elementary and secondary school teachers generally have high score in the COVID-19 knowledge test, and behaved well in wearing masks.Hand hygiene education should be further improved.There are concerns about the impact of COVID-19 epidemic on teaching.

Comparative study of early enteral nutrition between laparoscopic and open distal gastrectomy / 肠外与肠内营养

Objective:To investigate the effect of early postoperative enteral nutrition (EEN) on laparoscopic and open radical gastrectomy.Methods:From January 2015 to December 2016,68 patients with gastric cancer admited in Anqing Hospital,Anhui Medical University,were randomized into laparoscopic group (33 cases) and open group (35 cases).The following parameters were collected:(1) Surgical outcomes and complications;(2) EEN tolerance;(3) postoperative nutritional status;(4) starting time of postoperative chemotherapy.Results:There was no significant difference between groups in terms of operation time,number of lymph node,postoperative complications such as anastomotic fistula,pulmonary infection,incision infection (P ＞ 0.05);whereas the intraoperative blood loss was significantly less in laparoscopic group (P ＜ 0.01).(2) EEN tolerance:Postoperative discomforts,such as abdominal distension,diarrhea and other symptoms occurred significantly less in laparoscopic group (P ＜ 0.01),and time for TEN is significantly shorter (P ＜ 0.01).(3) Postoperative nutritional status:On the 7th day after operation,the nutrition status of the laparoscopic group improved earlier.There was significant difference regarding the detected blood level of prealbumin and C-reactive protein between the two groups (P ＜ 0.01).On the 14th day after operation,the nutritional status of the laparoscopic group improved significantly.The body weight,the right upper arm muscle circumference and the albumin were significantly different between two groups (P ＜ 0.05).(4) The number of cases receiving chemotherapy in patients with advanced gastric cancer was significantly higher in laparotomy group than that with open distal gastrectomy.Conclusion:Laparoscopic surgery for gastric cancer reduces surgical trauma,and leads to better EEN tolerance and earlier achieved TEN,which is conducive to improving postoperative nutritional status,as well as providing good conditions for adjuvant chemotherapy.

Comparison of the effects of different doses of dexmedetomidine combined with intercostal nerve block in regional adenomammectomy / 中华内分泌外科杂志

Objective To investigate the effect of different doses of dexmedetomidine combined with intercostal nerve block in regional adenomammectomy.Methods 112 patients receiving regional adenomammectomy and meeting criterions were selected from Oct.2013 to Oct.2016.And they were divided into control group and low,medium,and high dose group according to table of random number,with 28 cases in each group.Patients of the control group only received intercostal nerve block.Patients of low dose group received low dose of dexmedetomidine (0.7 μg/kg load dose and 0.25μg· kg-1·h-1 maintenance doses) combined with intercostal nerve block.Patients of medium dose group received medium dose of dexmedetomidine (0.7 μg/kg load dose and 0.5 μg·kg-1·h-1 maintenance doses) combined with intercostal nerve block.Patients of high dose group received high dose of dexmedetomidine (0.7 μg/kg load dose and 1 μg· kg-1·h-1 maintenance doses) combined with intercostal nerve block.Mean arterial pressure,heart rate,VAS score and sedation score of the four groups were detected and compared at T0,T1,T2,T3 and T4.Results The mean arterial pressure and heart rate of medium and high dose group were lower than those of the control group and low dose group at T1,T2,T3 (P＜0.05).The mean arterial pressure and heart rate of high dose group were lower than those in medium dose group at T1,T2,T3 (P＜0.05).VAS score of medium and high dose group were lower than those of the control group and low dose group (P＜0.05),while the difference was not statistically significant between medium and high dose group(P＞0.05).The sedation scores of low,medium and high dose groups were higher than those of the control group at T1,T2,T3 and T4 (P＜0.05),while the sedation score of high dose group were higher than those of low and medium dose groups at T1,T2,T3 and T4 (P＜0.05).Conclusion Medium and high dose of dexmedetomidine combined intercostal nerve block can effectively relieve pain for patients undergoing regional adenomammectomy,while high dose of dexmedetomidine is likely to cause bradycardia,hypotension and excessive sedation.Appropriate dosage should be chosen in clinical practice.

Impact of early health status on the risk of developing child overweight and obesity / 上海预防医学

Objective To investigate the impact of early health status on the risk of developing child overweight and obesity so as to provide evidences for preventive measures against child overweight and obesity.Methods Three schools were randomly selected from primary schools in Shanghai, and another three schools were randomly selected from 9-year schools in Shanghai.Retrospective surveys were conducted for 1 511 pupils selected from all the Grade One and Grade Two students of the above selected schools, the univariate and multivariate logistic regression analyses were used to analyze the early risk factors for child overweight and obesity.Results The results of univariate logistic regression analyses showed that for the children with relatively high birth weights, asthma, allergic constitution, histories of chronic diseases, relatively good appetite, relatively high ages that had been notified of their overweight and obesity, the detection rate of overweight and obesity was higher (P<0.05).The results of multivariate logistic regression analyses showed that birth weights(OR=2.699, 95%CI=1.097~6.644), allergic constitution(OR=1.498, 95%CI=1.044~2.149), histories of chronic diseases(OR=2.486, 95%CI=1.327~4.659) and appetite(OR=22.011, 95%CI=8.861~54.673) were the risk factors influencing child overweight and obesity (P<0.05).Conclusion Attention still needs to be paid to the body mass control of the children with relatively high birth weights, allergic constitution and histories of chronic diseases.Scientific and reasonable feeding at early stages as well as cultivating good eating and drinking habits may help prevent and control child overweight and obesity.

Pharmacological interventions for phantom limb pain / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To review the mechanisms and current clinical application of pharmacological interventions for phantom limb pain.</p><p><b>DATA SOURCES</b>Both Chinese and English language literatures were searched using MEDLINE (1982 - 2011), Pubmed (1982 - 2011) and the Index of Chinese Language Literature (1982 - 2011).</p><p><b>STUDY SELECTION</b>Data from published articles about pharmacological management of phantom limb pain in recent domestic and foreign literature were selected. Data extraction Data were mainly extracted from 96 articles which are listed in the reference section of this review.</p><p><b>RESULTS</b>By reviewing the mechanisms and current clinical application of pharmacological interventions for phantom limb pain, including anticonvulsants, antidepressants, local anaesthetics, N-methyl-D-aspartate receptor antagonists, non-steroidal anti-inflammatory drugs, tramadol, opioids, calcitonin, capsaicin, beta-adrenergic blockers, clonidine, muscle relaxants, and emerging drugs, we examined the efficacy and safety of these medications, outlined the limitations and future directions.</p><p><b>CONCLUSIONS</b>Although there is lack of evidence-based consensus guidelines for the pharmacological management of phantom limb pain, we recommend tricyclic antidepressants, gabapentin, tramadol, opioids, local anaesthetics and N-methyl-D-aspartate receptor antagonists as the rational options for the treatment of phantom limb pain.</p>

Effect of emodin in suppressing acute rejection following liver allograft transplantation in rats / 中国结合医学杂志

<p><b>OBJECTIVE</b>To investigate the mechanism of action of emodin for suppressing acute allograft rejection in a rat model of liver transplantation.</p><p><b>METHODS</b>Brown Norway (BW) recipient rats of orthotopic liver transplantation (OLT) were divided into three groups, Group A receiving isografting (with BW rats as donor), Group B receiving allografting (with Lewis rats as donor), Group C receiving allografting and emodin treatment (50 mg/kg daily). They were sacrificed on day 7 of post-transplantation, and their hepatic histology, plasma cytokine levels, and T-cell subset expression were detected.</p><p><b>RESULTS</b>Compared with those in Group A, rats: in Group B exhibited severe allograft rejection with a rejection activity index (RAI) of 7.67+/-0.98, extensive hepatocellular apoptosis with an apoptosis index (AI) of 35.83+/-2.32, and elevated plasma levels of interleukin-2 (IL-2), interleukin-10 (IL-10), tumor necrosis factor-alpha (TNF-alpha), CD4(+) and CD4 CD4(+)/CD8(+) ratio. However, recipients in Group C showed a decrease in histological grade of rejection and hepatocellular apoptosis, as well as a decrease in plasma levels of IL-2, TNF-alpha, CD4(+) and CD4(+)/CD8(+) ratio, but elevated levels of IL-10 as compared with the allograft group.</p><p><b>CONCLUSION</b>Post-OLT acute rejection could be attenuated by emodin, its mechanism of action may be associated with protecting hepatocytes from apoptosis, polarizing the Th 1 paradigm to Th2, and inhibiting the proliferation of CD4(+) T cell in plasma.</p>

Tissue engineered bone reconstruction with modified PLGA/Type-I collagen compound scaffold / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To fabricate bone grafts by bone marrow stromal cell combined with modified PLGA/Type-I collagen compound scaffold using tissue engineering method.</p><p><b>METHODS</b>The modified PLGA/Type-I collagen compound scaffold was fabricated. The rabbit primary cultured osteoblasts were identified and seeded onto the modified compound scaffold for one week in vitro. The adhesion and growth of cells were observed with scanning electron microscope. The complex of cells and scaffold was implanted into the subcutaneous region of rabbits and new bone formation was evaluated.</p><p><b>RESULTS</b>The rabbit bone marrow stromal cells were induced and differentiated into osteoblasts. The adhesion and growth of osteoblasts in cluster were observed on the surface of scaffolds. New bone formation was observed at one month postoperatively and active osteoblasts were found on the surface of the newly formed bone in vivo.</p><p><b>CONCLUSION</b>The complex of PLGA and type-I collagen is an appropriate biodegradable scaffold and can be applied in bone tissue engineering.</p>

Effects of physical and chemical properties of polymeric nerve conduit on peripheral neuranagenesis / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To evaluate the effects of degradation time and permeability of polymeric conduits on nerve regeneration.</p><p><b>METHODS</b>After establishment of rat models with over 10 mm gap of sciatic nerve in right hind legs,four kinds of poly (ester, carbonate) nerve conduits was used to bridge the gaps and one group without conduit in gaps was used as control. The nerve regeneration and conduit degradation were examined both macroscopically and microscopically. The contraction of the muscle controlled by regenerated nerve was measured electrophysiologically at 4, 12 and 20 weeks after the operation.</p><p><b>RESULT</b>Biodegradation time of nerve conduits in vivo was as fellows: 12 weeks in group A,4 weeks in group B and group C,and 20 weeks in group D,respectively. The histological quality of regenerative sciatic neurofibra in group A was the best among all groups (Mean rank 53.17, 38.83, 26. 60, 49.17 and 20.23,P<0.005), but the inflammatory reaction in group A was only less than that in group D and more than that in the other groups (Mean rank 45.87, 36.27, 34. 83, 51.63 and 21.4,P=0.001). The responsive rates of tibialis anterior muscle for electric stimulation in group A, B, C and D were 93.33%, 60%,20% and 73. 33%, respectively (P<0.005).</p><p><b>CONCLUSION</b>Absorbable conduits with relatively good permeability and appropriate middle degrade time improve nerve regeneration and renovate function.</p>