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ObjectiveTo investigate the prevalence of polycystic ovary syndrome (PCOS) among female college students at a university in Fuzhou City, Jiangxi Province, and to facilitate early detection and intervention of PCOS. MethodsUsing a stratified sampling method, a total of 450 female freshmen were randomly selected for PCOS screening. A self-designed questionnaire was used for data collection, covering menstrual status, high androgen signs, lifestyle, dietary habits, and awareness of PCOS. Sample t test and χ2 test were used to compare the basic information and dietary habits between PCOS and non-PCOS cases. The correlation between various indicators and the prevalence of PCOS was analyzed by a logistic regression model. ResultsA total of 12 PCOS cases were identified, with a prevalence rate of 2.99%. PCOS cases exhibited statistically significant differences compared to non-PCOS cases in terms of waist-to-hip ratio, waist circumference, abdominal obesity, the proportion of overweight or obese individuals, and a preference for sweet food (all P<0.05). Multivariate logistic regression analysis revealed a significant correlation between preference for sweet food and the occurrence of PCOS (OR=4.858, 95%CI=1.199‒19.675,P=0.027), as well as a significant correlation with PCOS accompanied by abdominal obesity (OR=7.083, 95%CI=0.773‒64.937, P=0.048). Among the female college students surveyed, 37.90% had never heard of PCOS, 51.62% were only familiar with the name of the disease, and 10.47% had attempted to search for PCOS-related information. ConclusionThe prevalence of PCOS among female college students should not be overlooked and unhealthy dietary habits may be a crucial factor contributing to the occurrence of PCOS during this period. Early screening for PCOS during puberty is crucial.
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Portal vein thrombosis is one of the common complications of liver cirrhosis, and anticoagulation is currently the main treatment method for this disease. Since low-molecular-weight heparin must be injected and vitamin K antagonists require regular monitoring of international normalized ratio (INR), direct oral anticoagulants have become a research hotspot in replacement therapy with the advantages of convenient oral administration, no need for INR monitoring, and high recanalization rate. This article summarizes the advances in direct oral anticoagulants in the treatment of cirrhosis-associated portal vein thrombosis, in order to lay a foundation for further clinical studies.
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OBJECTIVE@#To systematically evaluate the effect of early systematic rehabilitation on muscle strength and prognosis of patients undergoing mechanical ventilation in intensive care unit (ICU).@*METHODS@#Cochrane Library, PubMed, Embase, China National Knowledge Infrastructure (CNKI), VIP database (VIP) and Wanfang database were searched by computer for randomized controlled trial (RCT) on early systematic rehabilitation of patients undergoing mechanical ventilation in ICU published from the establishment of the database to October 2022. The observation group was given early systematic rehabilitation, while the control group was given routine activities. The outcome indicators included Medical Research Council muscle strength score (MRC score), incidence of ICU-acquired weakness (ICU-AW), 36-item short form health survey scale (SF-36), length of hospital stay, and hospital mortality. Two researchers independently screened the literature, extracted the data, and evaluated the quality of the literature to conduct a Meta-analysis of the studies that met the quality criteria. Funnel plot was used to analyze the publication bias of each study.@*RESULTS@#A total of 14 articles were enrolled, 13 in English and 1 in Chinese. A total of 1 835 patients were involved, including 922 cases in the observation group and 913 cases in the control group. The overall literature quality was good. Compared with the control group, the incidence of ICU-AW in the observation group was significantly reduced [relative risk (RR) = 0.78, 95% confidence interval (95%CI) was 0.62-0.98, P < 0.05], but the MRC score was not significantly increased [weighted mean difference (WMD) = 2.51, 95%CI was 0.77-4.25, P = 0.05]. There were no significant differences in ICU mortality (RR = 1.05, 95%CI = 0.59-1.87, P > 0.05), hospital mortality (RR = 1.15, 95%CI was 0.76-1.74, P > 0.05), length of ICU stay (WMD = -3.02, 95%CI was -7.29-1.24, P > 0.05), total length of hospital stay (WMD = -3.67, 95%CI was -8.04-0.70, P > 0.05), and physical component summary (PCS; WMD = 1.83, 95%CI was -0.28-3.93, P > 0.05) and mental component summary (MCS; WMD = 1.72, 95%CI was -0.76-4.20, P > 0.05) of SF-36 scale at 6 months after discharge between the two groups. It was shown by funnel plot that the publication bias of each literature was relatively small, manifested as the effect points included in the literature were basically in a "inverted funnel" shape and symmetrical, in terms of MRC score, incidence of ICU-AW, mortality, length of hospital stay and scores of SF-36 scale.@*CONCLUSIONS@#Early systematic rehabilitation can significantly reduce the incidence of ICU-AW, without increasing the mortality, and has no significant improvement on muscle strength and physical function.
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Humanos , Respiración Artificial , Unidades de Cuidados Intensivos , Pronóstico , Incidencia , Fuerza MuscularRESUMEN
Objective To construct and validate a nomogram risk model for predicting concurrent aspi-ration.Methods Fifty-five stroke patients with aspiration(the aspiration group)and 55 patients without aspi-ration(the control group)admitted to this hospital from April 2021 to April 2023 were selected as the study objects.Clinical data of the two groups of patients were collected,univariate and multivariate logistic regres-sion were used to analyze the risk factors of stroke with aspiration,and R software was used to construct a no-mogram risk model of stroke with aspiration based on the screened risk factors,and the accuracy of this model in predicting stroke complicated aspiration was validated.Results Age(≥60 years),infarct site(brain stem),lesion site(multiple),hypertension component ratio,NIHSS score and Hcy and hs-CRP levels in the aspiration group were higher than those in the control group,with statistical significance(P<0.05).Multiva-riate logistic regression analysis showed that age(≥60 years old),infarct site(brainstem),lesion site(multi-ple),hypertension and NIHSS score(high)were the risk factors affecting aspiration in stroke patients(P<0.05).The results of the nomogram model showed that NIHSS score was the strongest predictor of aspiration in stroke patients,followed by age(≥60 years old),infarct site(brain stem),lesion site(multiple),and hy-pertension.Model validation results showed that the area under the curve of receiver operating characteristic(ROC)curve of the nomogram was 0.885(95%CI:0.701-0.945),and the consistency index was 0.831.H-L goodness of fit test showed that there was no significant difference between the predicted value and the actu-al observed value(x2=4.112,P=0.459),indicating that the prediction accuracy and differentiation of the model were good.Conclusion Age(≥60 years old),infarct site(brainstem),lesion site(multiple),hypertension,NIHSS score(high),Hcy(high)and hs-CRP(high)were the risk factors affecting aspiration in stroke pa-tients.The nomogram model could effectively predict the risk of aspiration in stroke patients.
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Objective:To study the effect of rapamycin on the disorder of CD4 + T cell subsets in Graves′ ophthalmopathy(GO) mice, as well as the ophthalmopathy and hyperthyroidism phenotype, providing new possibilities for the treatment of GO. Methods:6-8 weeks old female Balb/c mice were injected intramuscularly with adenovirus expressing the A-subunit of TSHR(A-sub-Ad) 9 times. Rapamycin was given by embedding in the feed(14 ppm). The animals were euthanized 4 weeks after the final injection to obtain blood, spleen cells, thyroid glands, and orbital tissue. TT 4, thyrotropin receptor antibody(TRAb), thyroid, and orbital pathologic changes were detected, and the CD4 + T cell subgroup was evaluated by flow cytometry and immunohistochemistry. Results:After final immunization, the mice showed characteristics of GO: increased retrobulbar fibrosis and retrobulbar adipogenesis that indicated ophthalmopathy, increased autoantibodies, and serum total thyroxin that indicated hyperthyroidism. After the intervention of rapamycin, retrobulbar fibrosis and retrobulbar adipogenesis were significantly improved, and the incidence of ophthalmopathy was reduced from 80%-90% to 20%. Moreover, the increase of total thyroxin was reduced from 80% to 20%, and the metabolic condition and thyroid pathology were also improved. Flow cytometry of the spleen, immunohistochemistry of the thyroid and orbital tissue revealed that GO mice exhibited Th1 dominance in Th1/Th2 balance and reduction of Treg cells. After the intervention of rapamycin, flow cytometry showed that the ratio of Th1 and Th17 cells decreased and the ratio of Th2 and Treg cells increased. Immunohistochemistry of thyroid and orbital tissues also confirmed improvement of Th1/Th2 cell imbalance and Treg cell reduction.Conclusion:GO mouse model showed a significant imbalance of CD4 + T cell subsets, and rapamycin could not only regulate the disorder of CD4 + T cell subsets in GO mice, but also effectively improve the phenotype of ophthalmopathy and hyperthyroidism. Therefore, the imbalance of CD4 + T cell subsets is one of the etiological intervention targets of GO, and rapamycin is a potential intervention mode of GO, which can be further explored by randomized clinical studies in the future.
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Objective:To investigate the effects of matrine on proliferation, apoptosis and radiotherapy sensitivity of uveal melanoma cells.Methods:An animal experiment study. In vitro experiment: MuM2B cells of human choroidal melanoma were randomly divided into control group and matrine 0.25, 0.50, 1.00, 2.00 g/L groups. The cell morphology was observed by transmission electron microscope. Cell proliferation was detected by thiazole blue colorimetry. The mRNA and relative expression levels of CyclinD D (CyclinD), B lymphoblastoma-2 (Bcl-2) and Bcl2-associated X protein (Bax) were detected by real-time polymerase chain reaction and Western blot. In vivo experiment: BALB/C mice were injected with MuM2B cell suspension subcutaneously on the back of forelimb to prepare transplanted tumor model. After successful modeling, they were randomly divided into blank group and matrine treatment group with different concentrations. Mice in blank group were injected with phosphate buffer subcutaneously. Mice in different matrine treatment groups were injected with 15, 25, 50, 100 mg/kg matrine subcutaneously, respectively, for 7 consecutive days. The tumor was weighed and its volume was measured after the last administration. Single factor analysis of variance was used to compare different groups. The t test was used for pairwise comparison between groups. Results:In the control group, the cell structure was normal, the distribution was uniform, and no or rare nuclear pyknosis was seen. With the increase of matrine dosage, the nuclear pyretosis increased gradually and cell morphology changed obviously. Compared with the control group, the cell survival rate in 0.50, 1.00 and 2.00 g/L groups gradually decreased with matrine concentration increasing and treatment time prolongating, the relative expression levels of CyclinD and Bcl-2 mRNA and protein gradually decreased, and the relative expression levels of Bax mRNA and protein gradually increased. Under the same radiation dose X-ray irradiation, the cell survival rate of 0.50, 1.00 and 2.00 g/L groups gradually decreased, and the differences were statistically significant ( P<0.05). Compared with blank group, the tumor weight and volume of mice in different doses of matrine group were significantly decreased, and the differences were statistically significant ( P<0.05). Conclusion:Matrine can down-regulate the expression of CyclinD and Bcl-2, up-regulate the expression of Bax, promote the apoptosis of MuM2B human melanoma cells, inhibit cell proliferation, and enhance cell radiosensitivity.
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Objective:To explore the application effect of online and offline blended learning combined with Jigsaw teaching in arterial blood specimen collection of undergraduate nursing interns.Methods:A total of 135 undergraduate nursing interns were randomly divided into the experimental group ( n=66) and the control group ( n=69). The experimental group used the blended learning combined with Jigsaw teaching, while the control group adopted the blended learning combined with PBL teaching. The theoretical examination before and after class, the skill assessment after training, the nursing clinical decision-making consciousness scale, and the teaching satisfaction survey were conducted in the two groups. SPSS 28.0 was used for t-test and Chi-square test. Results:After teaching, the total score of courses and the score of theoretical examination and skill assessment of the experimental group were higher than those of the control group, and the differences were statistically significant ( P<0.05). The total score and the multi-dimension scores of the nursing clinical decision-making consciousness scale in the experimental group were higher than those in the control group, and the differences were statistically significant ( P<0.05). The teaching satisfaction of the experimental group was 92.42% (61/66), which was significantly higher than that of the control group [69.57% (48/69)], and the differences were statistically significant ( P<0.05). Conclusion:Blended learning combined with Jigsaw teaching is applied to collect arterial blood specimens for undergraduate nursing interns, which is beneficial to improve the academic performance and clinical decision-making ability of nursing students.
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【Objective】 To construct the secretory expression system of insect cells to express the secretory TSHR A subunit protein in the ovarian cells of Spotoma oryzae (sf9). 【Methods】 A recombinant plasmid containing the target protein was constructed, and then the positive bacmid was screened out by the blue and white spots experiment. The verified bacmid was transfected into SF9 insect cells to obtain recombinant baculovirus. The virus was amplified, and the titer level was detected by virus plaque assay. Finally, Western blotting was used to identify the expression of the recombinant protein and optimize the expression conditions. 【Results】 During the construction of the protein expression system, PCR identification and sequencing results confirmed the correctness of the sequences of the recombinant plasmid and the recombinant bacmid. After the transfection of the bacmid, the signs of virus budding were observed in sf9 cells. The virus was collected and amplified. The titer of P1 generation virus was 2×107 pfu/m according to the plaque assay. The recombinant protein was identified by Western blotting and confirmed to be exogenous into the culture medium. The optimal condition for virus infection and protein expression was 72 h after the infection when the multiplicity of infection (MOI) was 1. 【Conclusion】 We constructed an insect cell expression system secreting TSHR 22-289 (55 ku), and the protein could be successfully glycolyzed. This system provides a preliminary basis for the construction and production of its industrial platform and also provides a useful tool for studies on TSHR protein and prevention of GO in the future.
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Objective:To explore the application effect of online teaching mode on nursing experimental course.Methods:A total of 615 students in 4 classes of the Batch 2017 nursing undergraduates completed learning tasks such as teaching videos, notifications and tests on the ChaoXing platform (hereinafter as "ChaoXing"). And they learned online and had interactive discussions through Zoom cloud meeting system (hereinafter as "Zoom"). Online questionnaires were conducted to collect feedback on classroom teaching effects. SPSS 25.0 was performed for statistical analysis.Results:Among all nursing students, 445 (76.72%) students rated the content of the experimental course with a score of 16 or above, 540 (93.11%) ones felt that the "course content integrity" was good, 439 (75.70%) ones felt that "they have enough time to understand the important and difficult knowledge", 432 (74.48%) ones thought that "this learning method is very interesting", and 181 (31.21%) ones believed that "compared to the traditional way, this kind of teaching method is preferred" and thought online teaching could effectively enhance the enthusiasm for learning at home. While, 185 (31.90%) students disagreed with those above because that the instability of the network affected the sense of class experience, the lack of molds at home and the simulated clinical environment affected the sense of participation, and the inconvenience of taking notes or without books, etc.Conclusion:The "ChaoXing + Zoom" teaching method has been applied to nursing experimental teaching and achieved good results, but it still needs to assist offline practice to consolidate operational knowledge and skills. This teaching method is worthy of popularization and application during the epidemic period.
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Objective:To survey the first-aid ability of general practitioners (GPs) and the emergency service capacity of primary health institutions in southern Zhejiang province.Methods:The questionnaire of first-aid ability of GPs in primary care institution was developed on the basis of the Delphi method during August to October 2018. The questionnaire was employed in a survey on the first-aid ability among 480 GPs from 169 community health service centers of three regions in southern Zhejiang province. The survey covered basic information and first-aid skills and emergency response ability of GPs, and the emergency facilities of primary health institutions.Results:A total of 480 questionnaires were distributed and 447 were retrieved with an recovery rate of 93. 1%(447/480). Among the 447 responders, 55.9% (250/447) were males, 70.9% (317/447) had bachelor′s degree or above, and 60.2% (269/447) had middle and senior professional titles. There were 99.6% (445/447), 86.6% (387/447), 76.1% (340/447) and 69.8% (312/447) responders considered cardiopulmonary resuscitation(CPR), electrical defibrillation, respiratory balloon and endotracheal intubation as important first-aid skills, and corresponding mastery rates were 84.3% (377/447), 32.0% (143/447), 55.2% (247/447) and 12.9% (58/447), respectively. The 92.4% (413/447) responders thought that the rescue ability of common emergency and critical illness was the most important, while only 32.4% (145/447) responders mastered it. Least responders [41.4%(185/447)] thought that ability of using bedside ultrasound was important, and the corresponding mastery rate was only 3.8%(17/447); 77.4%(346/447) of general practitioners believed that CPR machines was important, while the available rate of CPR machines in primary health care institutions was only 16.0%(27/169).Conclusion:The GPs in southern Zhejiang province have a good grasp of cardiopulmonary resuscitation skills, but have a low mastery rate of first-aid skills such as electrical defibrillation, tracheal intubation, and emergency rescue capabilities, which are quite different from their perceived importance evaluation.
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Objective:To investigate the status of time management and self-regulated learning of undergraduate nursing students, and to explore the correlation and influencing factors between them.Methods:In March, 2020, 873 undergraduate nursing students from a nursing college of a medical university in Chongqing were investigated with General Information Questionnaire, Adolescent Time Management Disposition Questionnaire and Self-regulated Learning Status Questionnaire. SPSS 22.0 was used for data analysis. Independent sample t-test, one-way ANOVA, pearson correlation analysis and multiple stepwise regression analysis were used for further analysis. Results:Total scores of time management disposition and self-regulated learning status were separately (153.58±18.62) points and (81.73±14.11) points. Scores of both items were influenced by different grades, whether or not they were student cadres, whether they voluntarily applied for nursing profession and whether they would like to take the postgraduate entrance examination. Correlation study showed that the score of time management disposition was significantly positively correlated with the score of self-regulated learning ( P < 0.01). And multiple stepwise regression study showed that time value, time monitoring and time efficacy entered the regression equation ( R2 = 0.353, adjusted R2 = 0.351, F = 153.073, P < 0.01). Conclusion:The undergraduate nursing students' time management disposition and self-regulated learning are at a moderate to good level. Each dimension of the time management disposition somewhat forecasts the self-regulated learning learning situation of the students. The self-regulated learning status of the nursing students can be enhanced by fostering their time management abilities.
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Objective:To investigate the application value of pre-suture craniotomy combined with intracranial pressure monitoring in surgery for posttraumatic acute diffuse brain swelling (PADBS).Methods:One hundred and fifty-seven patients with PADBS admitted to our hospital from February 2015 to December 2019 were chosen in our study; 68 patients (control group), admitted to our hospital from February 2015 to June 2017, underwent controlled decompression under intracranial pressure monitoring; and 89 patients (treatment group), admitted to our hospital from June 2017 to December 2019, were performed pre-suture craniotomy combined with controlled decompression under intracranial pressure monitoring. The craniotomy time, brain tissue exposure time, cranial closure time, incidence of acute encephalocele, and Glasgow outcome scale (GOS) scores at 6 months after injury were retrospectively analyzed and compared between the two groups.Results:As compared with those in the control group, the patients in the treatment group had significantly longer intraoperative craniotomy time ([19.2±1.6] min vs. [15.4±1.4] min), significantly shorter exposure time of brain tissues ([18.5±2.4] min vs. [26.3±2.2] min), significantly shorter time of cranial closure ([11.2±1.5] min vs. [18.3±2.1] min), and statistically lower incidence of acute encephalocele (22.5% vs. 38.2%), P<0.05). The good prognosis rate of the treatment group (70.8%) was significantly higher than that of the control group (50.0%), and the mortality rate (6.7%) was statistically lower than that of the control group (17.6%, P<0.05). Conclusion:Pre-suture craniotomy combined with controlled decompression under intracranial pressure monitoring can shorten the time of cranial closure and brain tissue exposure, reduce the incidence of acute encephalocele, and ultimately improve the prognosis of patients with posttraumatic acute diffuse brain swelling.
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【Objective】 To compare the effects of low flux and high flux hemodialysis on insulin resistance (IR), inflammatory factors and coronary artery calcification(CAC) in patients with non-diabetic end-stage renal disease (ESRD), and analyze the related factors affecting the prognosis survival of patients. 【Methods】 A total of 217 patients with non-diabetic ESRD treated in our hospital from February 2015 to April 2017 were selected and randomly divided into control group (n=108) and observation group (n=109) according to the random number table. Low flux and high flux hemodialysis were adopted respectively. Baseline data, renal function, lipid metabolism, inflammatory factors, IR, CAC, complications, outcomes and health and economic benefits of the two groups were compared. The patients were followed up for 3 years and divided into survival group (n=130) and death group (n=75). The clinical data of the two groups were compared and related factors affecting the prognosis and survival were analyzed. 【Results】 Scr, BUN, UAER, TC, TG and LDL-C in the two groups were significantly lower than those before treatment [control group: Scr (μmol/L)349.62±37.16 vs 201.73±24.58, BUN (mmol/L) 28.43±5.39 vs20.81±3.47, UAER(μg /min)60.14±11.52 vs 55.73±9.86, TC (mmol/L)5.46±0.93 vs 4.75±0.69, TG (mmol/L)2.58±0.64 vs 2.13±0.57, LDL-C(mmol/L)3.69±0.73 vs 2.45±0.60; observation group: Scr (μmol/L) 352.14±38.29 vs 136.85±16.47, BUN (mmol/L) 27.96±5.25 vs17.56±3.68, UAER(μg /min) 60.32±12.07 vs 49.85±7.42, TC (mmol/L)5.48±0.97 vs 4.27±0.56, TG (mmol/L) 2.55±0.62 vs 1.49±0.35, LDL-C(mmol/L) 3.72±0.74 vs1.91±0.48), and eGFR and HDL-C were significantly higher than those before treatment [control group: eGFR(mL/min/1.73m)29.32±3.25 vs 72.54±7.86, HDL-C(mmol/L)1.13±0.24 vs1.28±0.31, observation group: eGFR(mL/min/1.73m)30.05±3.29 vs 121.63±13.34, HDL-C(mmol/L)1.09±0.22 vs 1.57±0.46), differences between groups were statistically significant (P<0.05); FBG, FINS, HOMA-IR, IL-6, IL-8, TNF-α and hs-CRP in the two groups were significantly lower than those before treatment [control group: FBG(mmol/L)4.99±0.95 vs 4.52±0.63, FINS(mU/L)12.93±2.54 vs10.15±2.21, HOMA-IR 2.87±0.54 vs 2.04±0.43, IL-6(pg/mL)120.16±13.54 vs 75.94±9.28, IL-8(mg/L)56.83±6.15 vs 41.52±5.38, TNF-α(ng/L)50.03±5.42 vs 45.62±4.81, hs-CRP(mg/L)26.75±2.79 vs 14.37±2.19; observation group: FBG(mmol/L)5.01±0.97 vs 4.11±0.56, FINS(mU/L)13.07±2.62 vs 8.86±1.79, HOMA-IR 2.91±0.55 vs 1.62±0.31, IL-6(pg/mL)119.85±12.91 vs 31.07±4.46, IL-8(mg/L)57.04±6.09 vs 32.65±4.27, TNF-α(ng/L)49.78±5.36 vs 40.15±4.27, hs-CRP(mg/L)23.04±2.82 vs 7.56±1.03], and the CACS score was significantly higher than that before treatment(control group: 26.75±2.79 vs 53.68±26.93, observation group: 27.04±2.82 vs 75.49±7.66), differences between groups are statistically significant (all P<0.05). Compared with the control group, the total incidence of complications during dialysis was significantly lower in the observation group (P<0.05), and has more economic advantages.Venerable age(OR=1.893, P<0.05), low HDL-C level(OR=0.575, P<0.05), high CACS score(OR=2.384, P<0.05), and high hs-CRP level(OR=3.526, P<0.05) were independent risk factors affecting the survival rate of non-diabetic ESRD patients after dialysis treatment (P<0.05). 【Conclusion】 Compared with low-flux hemodialysis, high-flux hemodialysis has significant effects in improving renal function, lipid metabolism, IR, micro-inflammatory state, and reducing CAC progression and complications, with more prominent cost-effectiveness advantages. HDL-C and Hs-CRP levels and CACS scores of patients should be closely monitored during clinical application, and active preventive measures should be taken to improve the survival rate of patients.
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Objective@#To study the influences of dihydrotestosterone (DHT) on the development of experimental autoimmune Graves disease (EAGD), and to observe the effect of DHT on cytokines in male BALB/c mice model.@*Methods@#Male BALB/c mice aged 6-8 weeks were divided into 4 groups using random number table: (1) control group; (2) EAGD group; (3) placebo group; (4) DHT group. EAGD mice were induced with an adenovirus expressing the human thyroid stimulating hormone receptor antibody A-subunit (Ad-TSHR289). DHT (5mg) or a matching placebo were implanted one week before the first immunization. Thyroid hormones were detected with radioimmunoassay kit.. Cytokines [such as interferonγ (IFNγ), interleukin (IL)-4, IL-10, IL-9, and IL-17] producing cells from the spleen were detected using flow cytometry.@*Results@#As expected Ad-TSHR289 treatment increased total thyroxine [EAGD group vs. control group: (117.76±32.69) nmol/L vs. (33.08±12.61) nmol/L, P<0.0001] and free thyroxine [EAGD group vs. control group: (15.01±11.55) pmol/L vs. (3.55±1.88) pmol/L, P<0.0001]. Treatment of DHT slightly lowered thyroid hormones [DHT group vs. placebo group: total thyroxine (114.80±44.27) nmol/L vs. (123.17±77.73) nmol/L; free thyroxine (13.48±6.01) pmol/L vs. (14.19±12.65) pmol/L], without significant difference (all P>0.05)]. However, the percentage of IL-10, but not IFN γ, IL-4, IL-9 and IL-17, secreted spleen cells increased in DHT group than in the placebo group [(7.11±3.29)% vs. (3.51±1.36)%, P<0.05].@*Conclusion@#The effects of DHT on thyroid hormone are mild. It might play an immunomodulatory role in the male mouse Graves disease model by up-regulating the cytokine IL-10.
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Objective@#To investigate the effect of LncRNA OIP5-AS1 on radiosensitivity of non-small cell lung cancer (NSCLC) cells and its mechanism.@*Methods@#The radiation-resistant cell A549R was established by using A549 cells irradiated by X-ray 6Gy in 5 fractions. The expression levels of OIP5-AS1 and miR-34c-5p in A549 and A549R cells were detected by qRT-PCR. OIP5-AS1 inhibitor or miR-34c-5p mimetic was transfected into A549R cells, or OIP5-AS1 overexpression plasmid was transfected into A549 cells. Cell apoptosis was detected by flow cytometry. Cell radiosensitivity was analyzed by colony formation assay. The expression levels of p-Chk2 and p-ATM proteins were measured by Western blot. Dual luciferase assay was adopted to verify the relationship between OIP5-AS1 and miR-34c-5p.@*Results@#Compared with A549 cells, the expression of OIP5-AS1 was significantly up-regulated in A549R cells (1.97±0.11 vs.1.01±0.05, P<0.05), whereas the expression of miR-34c-5p was remarkably down-regulated (0.43±0.02 vs.1.02±0.06, P<0.05). The expression levels of p-Chk2 and p-ATM proteins in A549R cells in the silencing OIP5-AS1+ 6Gy group were significantly lower (0.43±0.03 vs.1.39±0.15, 0.51±0.0 5 vs.1.21± 0.11, both P<0.05), whereas the apoptotic rate was significantly higher than those in the silencing control+ 6Gy group [(13.29±1.25)% vs. (28.47±2.31)%, P<0.05)]. The expression levels of p-Chk2 and p-ATM proteins in A549 cells in overexpressing OIP5-AS1+ 6Gy group were significantly higher than those in overexpression control+ 6Gy group (1.23±0.13 vs.0.75±0.06, 1.08±0.11 vs.0.59±0.04, both P<0.05). Inhibiting miR-34c-5p expression reversed the effect of silencing OIP5-AS1 on survival fraction of A549R cells (SER=1.42). OIP5-AS1 negatively regulated the expression of miR-34c-5p.@*Conclusion@#Silencing OIP5-AS1 enhances the radiosensitivity of radiation-resistant A549 cells by up-regulating the expression of miR-34c-5p, providing a potential target for radiotherapy of NSCLC cells.
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@#The access negotiations of National Reimbursement Drug List (NRDL) in China from 2017 to 2019 effectively improved the availability and affordability of high-value innovative drugs. However,the actual outpatient reimbursement of most negotiated drugs is lower,which affects the patients" health insurance funds. In this paper,97 negotiated drugs in 337 overall planning cities were selected as samples to analyze the outpatient reimbursement for negotiated drugs. The results showed that the reimbursement level of 40 negotiated drugs was less than 50% in over 70% cities,which can be mainly interpreted as absence or imperfection of outpatient reimbursement policies for special diseases. Finally,this paper puts forward suggestions and protocols for improving the outpatient medical insurance through realizing outpatient overall planning,improving outpatient reimbursement policies for special diseases,and exploring innovative payment,ensuring the achievement of the access to NRDL.
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Objective:To investigate the application effect of workshop in pediatric intravenous indwelling needle training for nursing undergraduates.Methods:A total of 214 undergraduate nursing interns were randomly divided into experimental group ( n=106) and control group ( n=108). Workshop teaching model was used in the experimental group, while the traditional teaching model in the control group. Clinical Decision Making in Nursing Scale (CDMNS), General Self-efficacy Scale (GSES) and theoretical assessment of the two groups were compared respectively before and after training, and operation evaluation was performed after training. Results:Scores of GSES, theory and operation evaluation in the experimental group were all higher than those in the control group with statistically significant differences ( P<0.05). The scores of clinical decision-making awareness was higher in the experimental group than in the control group, but the difference was not statistically significant ( P>0.05). Conclusion:Application of workshop teaching model in the training of pediatric patients with intravenous indwelling needles could enhance nursing students' self-efficacy, theoretical and operational achievements, thus improve the teaching quality.
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Objective:To explore the effect of project management method on improving the quality of clinical teaching of nursing undergraduates.Methods:Forty-six nursing undergraduate interns from 2017-2018 academic year and 2018-2019 academic year of general surgery in a Affiliated Children's Hospital of Chongqing Medical University were selected as the research objects. By using the method of project management, the problems that need to be improved in various teaching links of students in the process of clinical practice were sorted out and summarized, so that the quality control of clinical teaching could be used in entrance education, clinical teaching and practical nursing. The students' clinical safety behavior management and graduation summary were standardized and humanized, and the changes of satisfaction, theoretical results, skill operation results and comprehensive quality results of the students before and after the implementation were compared. SPSS 17.0 were used to conduct chi-square test and t test. Results:After the implementation of the project management, the satisfaction of the undergraduate nursing interns with the teaching level of the teachers and the communication between teachers and students were both improved, and their theoretical and operational skills were also improved during the internship, with statistical significance ( P<0.05). Conclusion:Project management is a new method for the management of nursing practice teaching and significantly improves the quality of clinical teaching.
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Objective To investigate the clinical effect of preoperative computed tomography (CT) measurement of acetabulum femoral neck combined anteversion in primary total hip arthroplasty (THA).Methods From March 2016 to may 2018,48 patients (90 hips) with developmental dysplasia of the hip (DDH) who were treated with THA in the orthopaedic department of Jiangmen Central Hospital were measured by X-ray and spiral CT three-dimensional reconstruction technology before operation,and the best combined anteversion angle of acetabulum was determined before implementing THA,which was CT group;the remaining 42 patients were not measured by CT before operation,which was X-ray group.The difference of acetabulum cup anteversion angle,acetabulum femoral neck combined anteversion angle and preoperation angle were evaluated by three-dimensional computed tomography (3D-CT) in CT group.Results There was no significant difference in operative time,intraoperative blood loss,time of getting out of bed and length of lower limbs between the two groups (P > 0.05).In CT group,the acetabulum cup anteversion and acetabulum femoral neck anteversion were close to the pre-operative angle at 2 and 3 months postoperatively (P > 0.05).The Harris hip score of CT group was significantly higher than that of X-ray group at 2 and 3 months after operation,and the incidence of deep vein thrombosis was 6.25%,significantly lower than that of X-ray group (21.43%) (P <0.05).The incidence of dislocation,infection and periprosthetic fracture was slightly lower than that of X-ray group,but the difference was not statistically significant (P > 0.05).Conclusions For DDH patients who received THA for the first time,preoperative CT measurement of acetabulum femoral neck combined with anteversion is conducive to the formulation of the best combined anteversion adjustment scheme,which can obtain the maximum initial stability,improve the surgical effect and reduce the occurrence of dislocation of prosthesis.
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Objective:To study the influencing factors of diabetic retinopathy (DR) in patients with type 2 diabetes mellitus (T2DM), and to explore the control countermeasures.Methods:The patients definitely diagnosed with T2DM in the Ophthalmology department from July 2017 to January 2019 were enrolled as subjects. The clinical data of patients were collected. According to eye examination results, they were divided into T2DM with DR group and T2DM without DR group. Clinical data of both groups were compared. Multivariate stepwise logistic regression analysis was performed to analyze the risk factors for DR in T2DM patients.Results:The proportion of diabetic nephropathy and diabetic peripheral neuropathy in T2DM with DR group was significantly higher than that in patients with T2DM without DR ( P<0.05). The T2DM duration, retinal arteriosclerosis, diastolic blood pressure (DBP), systolic blood pressure (SBP), glycosylated hemoglobin (HbA1c) and low-density lipoprotein cholesterol (LDL-C) in T2DM with DR group were significantly higher than those in T2DM without DR group ( P<0.05). The postprandial 2h C-peptide in T2DM with DR group was significantly lower than that in T2DM without DR group ( P<0.05). Multivariate stepwise logistic regression analysis showed that diabetic nephropathy , diabetic peripheral neuropathy, T2DM duration, SBP, DBP, HbA1c and LDL-C were the influencing factor of DR. Conclusions:Diabetic nephropathy , diabetic peripheral neuropathy, T2DM duration, SBP, DBP, HbA1c and LDL-C are related to occurrence of DR. In the control, health education should be strengthened for high-risk populations with long T2DM duration. In the community management, the management for blood lipids, blood pressure and blood glucose in diabetic patients should be further strengthened.