Research on the psychological stress and its associated factors of pregnant women during the epidemics of emerging infectious diseases / 公共卫生与预防医学

Objective To investigate the occurrence of maternal stress under the epidemic, and analyze its relevant factors, to provide a reference for improving pregnancy quality and psychological counseling services during pregnancy. Methods From April to July 2020, 293 pregnant women from maternity and childcare hospital in Wuhan and Huanggang were selected as the subjects of the cross-sectional survey. Results The average score of the PSS pressure scale for pregnant women was (17.75±6.07), among which no/mild, moderate and severe stress accounted for 22.8%, 63.1% and 14.1%, respectively. According to multiple linear regression analysis, the factors affecting the maternal stress level of pregnant women are poor psychological resilience (β=-0.206, 95% CI: -0.288~-0.124), low family income (β=-0.370, 95% CI: -0.729~-0.012), excessively fearful about their babies (β=1.775, 95% CI: 0.640~2.910) and themselves (β=1.695, 95% CI: 0.625~2.766) about infected with the new virus. Conclusion The present study explores the factors related to maternal stress and depression during the epidemic. For pregnant women with high psychological stress, it is recommended that medical staff and family members should take care of them in a timely manner, strengthen their social support, and provide psychological counseling positively in order to improve pregnant women's psychological mood and promote maternal and infant health.

Efficacy of gradual dural decompression in treatment of severe traumatic brain injury / 中华创伤杂志

Objective:To explore the effect of gradual dural decompression(GDD)in preventing intraoperative encephalocele in severe traumatic brain injury (TBI).Methods:A retrospective case-control study was conducted to analyze the clinical data of 78 patients with severe TBI admitted to Affiliated Hospital of North Sichuan Medical College from January 2015 to October 2018, including 55 males and 23 females, aged 15-68 years with an average age of 38.2 years. Thirty-eight patients were treated by GDD (GDD group). During the operation, the hematoma was cleared by opening a window in the area with more hematoma, then gradually cleared in the area without opening a window. Finally, the dural "junction" was cut and the skull was closed quickly after covering the dural patch. The other 40 patients were operated by fast open dural (FOD) operation (FOD group). The incidence of intraoperative encephalocele, intracranial pressure data at the time, 24 hours, 72 hours and 7 days after operation, incidence of delayed intracranial hematoma and glasgow outcome score (GOS) at 3 months after operation were compared between the two groups.Results:All patients (except for 26 deaths) were followed up for 3-14 months, with an average of 8 months. None had intraoperative encephalocele in GDD group, compared to 8 patients in FOD group ( P<0.05). Intracranial pressure in GDD group was respective (18.4±3.6)mmHg, (20.4±4.0)mmHg, (27.7±4.6)mmHg and (28.3±4.5)mmHg at the time, 24 hours, 72 hours and 7 days after operation, showing no significant differences compared to FOD group [(19.1±3.4)mmHg, (20.9±3.9)mmHg, (27.0±3.5)mmHg, (27.6±3.4)mmHg, respectively] ( P>0.05). There was no significant difference in the incidence of delayed intracranial hematoma between the two groups [16% (6/38) in GDD group and 16% (5/32) in FOD group (except 8 cases of intraoperative encephalocele)] ( P>0.05). Three months after operation, the good rate of GOS score of GDD group was 61% (23/28) higher than that of FOD group [28% (11/40)], and the mortality rate of GDD group was 21% (8/38) lower than that of FOD group [45% (18/40)] ( P<0.05). There was no significant difference between the two groups in medium severe disability and plant survival rate ( P>0.05). Conclusions:For patients with severe TBI, compared with FOD, GDD is more effective in reducing the incidence of intraoperative encephalocele, improving the prognosis and decreasing mortality.

Impacts of baseline peritoneal transport characteristics and their changes during follow up on the survival of peritoneal dialysis patients / 中华肾脏病杂志

Objective To evaluate the effects of baseline and changes of peritoneal transport characteristics on the prognosis of maintaining peritoneal dialysis (PD) patients.Methods Five hundred and eight-six PD patients who started PD from September 11,2006 to October 30,2014 in a single center were included and followed up until March 30,2016.According to their baseline D/Pcr value in peritoneal equilibrium test (PET),the patients were divided into high transport (H) group (D/ Pcr 0.82-1.03),high average transport (HA) group (D/Pcr 0.65-0.81),low average transport (LA) group (D/Pcr 0.50-0.64) and low transport (L) group (D/Pcr 0.34-0.49).According to the changes of follow-up D/Pcr comparing with baseline D/Pcr,the patients were also divided into ascending group,descending group and no-change group.The patient and technical survival rates were estimated by Kaplan-Meier analysis.Cox proportional hazards analyses were used to analyze the risk factors for PD patient death and technical failure.Results There were 67 patients in L group,229 patients in LA group,252 patients in HA group,and 38 patients in H group.The patient survival rate in H group was significantly lower than those of L group (P=0.036),LA group (P=0.008) and HA group (P=0.041).There was no significant difference on technical survival rate among these 4 groups.According to the tendency of follow-up D/Pcr changes,there were 127 patients in ascending group,101 patients in descending group and 179 patients in no-change group.There was no significant difference on patient survival among these 3 groups (P=0.064).However in patients with a high transport rate (D/Pcr≥0.65),the patient survival was lower in descending group than those in ascending group (P=0.033) and nochange group (P=0.049).Age over 65 years old (HR=2.499),malnutrition during follow-up (HR=3.144),ultrafiltration less than 400 ml/d during follow-up (HR=1.863) and high sensitive C reactive protein≥ 10 mg/L (HR=4.526) were the independent risk factors for patient death (all P ＜ 0.05).Gender (HR=1.609),age over 65 years old (HR=1.929),ultrafiltration less than 400 ml/d during follow-up (HR=1.708),high sensitive C reactive protein ≥10 mg/L (HR=1.829),malnutrition (HR=1.876) and change of peritoneal transport function (HR=0.579) affect technical failure (all P ＜ 0.05).Conclusions The survival rate of PD patients with basal high peritoneal transit is relatively low,especially for patients with descending transport rate during follow-up.The concern on the peritoneal transport status is constructive for the prognosis of PD patients.

Risk factors and outcomes of multiple episodes of peritoneal dialysis related bacterial peritonitis / 中华肾脏病杂志

Objective To investigate the risk factors and prognosis of peritoneal dialysis (PD)related bacterial peritonitis.Methods The clinical data of patients with PD related bacterial peritonitis from January 2006 to September 2016 in our hospital were retrospectively analyzed and followed up until December 2016.Patients were divided into two groups according to the frequency of peritonitis,single episode group and multiple episodes group (no less than two episodes of peritonitis).According to efficacy of therapy,the episodes of peritonitis were divided into two groups,cured group (no relapse,recurrence or repeat episodes) and failure group (relapse,recurrent or repeat infection after the therapy of initial episode).Logistic regression and Cox regression were used to analyze the risk factors for outcomes.Results Five hundred and fifty-nine patients had PD related bacterial peritonitis,including 339 patients in the single episode group and 220 patients in the multiple episodes group.Logistic analysis showed low serum albumin level (OR=787,P ＜ 0.001) and malnutrition (OR=0.422,P ＜ 0.001) at baseline were independent risk factors for multiple episodes (P ＜ 0.001).The technical survival was better in the single episode group than that in the multiple episodes group (75.2％ vs 36.2％,P=0.001) while the difference of survival rate was not significant between the two groups (48.2％ vs 24.1％,P=0.592).Five hundred and thirteen episodes of peritonitis were analyzed,including 147 episodes in failure group (88 relapse episodes,16 recurrent episodes and 43 repeat episodes) and 366 episodes in cured group.There were 78 patients in failure group and 253 patients in cured group.Logistic analysis showed prolonged response time (OR=1.200,P ＜ 0.001),Gram-positive bacteria infection (OR=1.736,P=0.022),higher hs-CRP level (OR=1.004,P=0.013),lower serum albumin level (OR=0.936,P=0.008) were independent risk factors for failure of therapy.Multivariate Cox regression showed prolonged response time (HR=1.120,P=0.032),Gram-positive bacteria infection (HR=2.462,P=0.002),higher hs-CRP level (HR=1.007,P=0.009) were independent risk factors for failure of therapy and higher serum albumin level (HR=0.942,P=0.048) was an independent protection factor.Conclusions Low serum albumin level and malnutrition at baseline are independent risk factors for patients with multiple peritonitis episodes.Prolonged response time,Gram-positive bacteria infection,the high hs-CRP level are independent risk factors for relapse or recurrent or repeat episodes while high serum albumin level was an independent protection factor.

The correlation between body mass index and percentage body fat in people of different gender and nationality and their application assessment / 国际检验医学杂志

Objective To analyze the correlation between body mass index(BMI)and percentage body fat(PBF)in people of dif-ferent nationality and gender,and assess the value of BMI and PBF in the diagnosis of obesity.Methods A total of 925 healthy a-dults who underwent physical examination in the hospital were enrolled in the study,bioelectrical impedance measurement was used to measure the weight,PBF,then analyze the correlation between BMI and PBF in people of different nationality and gender.Results In the normal and overweight population classified by BMI,;In underweight,overweight and obesity people,PBF of Han women were higher than that of Uighur women(P <0.05 ).In people of different gender and ethnic group,PBF was positively correlated with BMI(P <0.05).Using BMI≥28 kg/m2 as gold standard for the diagnosis of obesity,PBF have good sensitivity and low speci-ficity for the diagnosis of obesity in both of the two ethnic groups.Conclusion Compared with Uygur,Han have higher PBF at the same level of BMI.There is a malconformation between BMI and PBF.Evaluation of obesity could not simply rely on BMI,and should be analyzed combined with PBF.

Correlation between body fat distribution and cardiovascular risk factors in some patients with type 2 diabetes mellitus in Xinjiang region / 国际检验医学杂志

Objective To investigate the relation between the characteristics of body fat distribution and the cardiovascular risk factors in some patients with type 2 diabetes mellitus (T2DM)in Xinjiang region.Methods The percentage of body fat (PBF)and visceral fat area(VA)were determined in 155 cases of T2DM by using the Inbody 720 body composition analyzer.At the same time triglycerides(TG),total cholesterol(TC),high density lipoprotein(HDL-C),low density lipoprotein(LDL-C),blood pressure(BP), glycosylated hemoglobin HbA1c,body weight(W),body height,waist circumference ratio(WC)and hip circumference(HC)were also determined.The body mass index(BMI)and the waist to hip ratio was calculated.Results In both men and women,BMI in the subjects with visceral fat obesity(VFO)was higher than that with subcutaneous fat obesity(SFO).In males,TG in VFO was signif-icantly higher than that in SFO.PBF,TC and LDL-C in the female T2DM patients were significantly higher than those in the male T2DM patients.VA and PBF in the minority male patients were significantly higher than those in the Han nationality male patients (P <0.05).After correcting the age,course of disease and BMI,WHR in the female patients was positively correlated with DBP and PBF was positively correlated with LDL-C.In the male patients,there were correlations between BMI with SBP,between VA with DBP,and between VA with PBF and HDL-C;in the female patients,there were correlations between BMI with SBP and be-tween WHR with DBP.Conclusion The body fat distribution in the patients with T2DM in Xinjiang region is dominated by VFO. The cardiovascular risk factors are not only associated with the increase of body fat content,but more closely associated with VFO, moreover the differences in genders and nationalities exist.

Effects of nitrogen application levels on yield and active composition content of Desmodium styracifolium / 中国中药杂志

<p><b>OBJECTIVE</b>To find out the optimal nitrogen application level of Desmodium styracifolium.</p><p><b>METHOD</b>A field experiment using randomized block design was carried out to study the effects of 5 nitrogen application levels (150, 187.5, 225.0, 262.5 and 300.0 kg x hm(-2)) on yield and active component content of D. styracifolium.</p><p><b>RESULT</b>Nitrogen application could increase the yield and contents of polysaccharide, total flavonoides and total saponins of D. styracifolium. However, the enhancing extent of the active component content and the yield were not always significant with the increase of nitrogen level. In which, the yield were not significantly different among the nitrogen application levels of 225.0, 262.5, 300.0 kg x hm(-2) the polysaccharide content was no significantly difference among the nitrogen application levels of 225.0, 262. 5 and 300.0 kg x hm(-2), the total flavonoides content under the nitrogen level of 300.0 kg x hm(-2) was significantly lower than that of 150.0 kg hm(-2) (P < 0.01), and the total saponins content under the nitrogen level of 300.0 kg x hm(-2) was no significant difference compared with that of 262.5 kg x hm(-2).</p><p><b>CONCLUSION</b>The optimal nitrogen application level of D. styracifolium was 225.0-262.5 kg x hm(-2).</p>

Influence of apolipoprotein E polymorphism on acute-phase brain electrical activity after mild/moderate traumatic brain injury / 中华创伤杂志

Objective To investigate the influence of apolipoprotein E gene (APOE) polymorphism on the acute-phase brain electrical activity after mild/moderate traumatic brain injury. Methods The clinical data of 112 patients with mild/moderate traumatic brain injury were collected and the APOE genotypes were identified by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). The brain electrical activity in every patient was recorded twice by using electroencephalogram within one week after injury. Qualitative and quantitative methods were used to determine the variations of brain electrical activity. Chi-square test, variance analysis and logistic regression analyses via SPSS version 11.5 were performed among APOE genotypes, electroencephalogram data and clinical data. Results The distributions of APOE genetypes and alleles matched Haldy-Weinberg Law in 112 patients. Of 22 patients with APOEε4, 12 patients (55%) presented with deteriorated electroencephalogram, which was significantly higher than those (16 of 90 patients, 18%) without APOEε4 (P ＜ 0. 01). Comparison of the first and second electroencephalograms demonstrated that the slow waves were increased significantly in patients with APOEε4 ( P ＜ 0. 01 ) but decreased in patients with APOEε2 and APOEε3 (P ＜0.05). The reduction of slow waves in APOEε2 carriers was more obvious than APOEε3 carriers (P ＜0.05). Univariate and multivariate logistic regression analyses showed that APOEε4 was a risk factor to electroencephalogram aggravation after traumatic brain injury. Conclusion APOEε4 is a risk factor to electroencephalogram aggravation during acute stage after mild/moderate traumatic brain injury. However,APOEε2 seems to be beneficial for recovery of brain electrical activity.

Qualitative research on the demands of nursing staff on nursing repository / 中华护理杂志

Objective To explore the demands of nursing staff on nursing repository and provide reference for the develop-ment of nursing repository. Methods In-depth interview was conducted on 21 nursing staff by qualitative research. The themes were formed by category analysis. Results There were four themes about the demands of nursing staff on nursing repository:necessity to develop nursing repository ,contents of the repository ,forms of the repository and prospect of the reposi-tory. Conclusions Nursing staff need a nursing repository. They hope that the repository can provide comprehensive,concrete and practical knowledge,and provide a good interface with digitization. The design of repository should be consistent with in-ternational standards.