The effectiveness of extended postpartum comprehensive health care bundle selected outcomes of women with preeclampsia at 6 months: protocol of a randomized controlled trial

Background: Women who have experienced pre-eclampsia (PE) may also face additional health problems in later life, as the condition is associated with an increased risk of death from 2-fold increased risk of long-term cardiovascular disease (CVD), hypertension, stroke, an approximate 5-12-fold increased risk of end-stage renal disease (ESRD), metabolic syndrome, and diabetes. Methods: Method was randomized controlled trial. Women with PE who delivered in PGIMER will be enrolled and will be allocated into experimental ad control group using a computer random table with allocation concealment. Enrolment will be done at the time of discharge; baseline assessment will be done 6 weeks and the intervention bundle will be implemented to the women in experimental group. The women in control group will receive routine care. Women in both the groups will be followed up at 6 months. Conclusions: This study aims to determine the effectiveness of “extended postpartum comprehensive health care bundle (EP CHC bundle)” on selected outcomes of women with preeclampsia at 6 months. The comprehensive health care bundle will be designed with the inputs from all stakeholders, has the potential to suit the dynamic nature of management of women with preeclampsia after delivery. CTRI registration number: CTRI/2021/04/032749 ON 12/4/2021

Jouissance and Passage to Civil Life: The Case of a Former FARC-EP Combatant / Gozo e passagem para a vida civil: o caso de um ex-combatente das FARC-EP

Abstract: We present some research findings on the subjective responses around the jouissance, before the semblances offered by the Other, in the case of a former FARC-EP combatant. The purpose was to locate the significant coordinates that determine their position of jouissance with respect to their choice to sign the Peace Agreement with the Colombian State. As a finding, this step was possible when re-encountering the master signifiers that give consistency to his illusion of being something for the Other, maintaining a certain share of drive satisfaction, structural, beyond the phenomenology of the war scenario.

Resumo: Apresentamos alguns achados de pesquisa sobre as respostas subjetivas em torno do gozo, diante dos semblantes oferecidos pelo Outro, no caso de um ex-combatente das FARC-EP. O objetivo foi localizar as coordenadas significativas que determinam sua posição de gozo em relação à escolha de assinar o acordo de paz com o Estado colombiano. Como constatação, esse passo foi possível ao reencontrar os significantes-mestre que dão consistência à sua ilusão de ser algo para o Outro, mantendo certa parcela de satisfação pulsional, estrutural, para além da fenomenologia do cenário de guerra.

Speed of Pitch Change in People with Parkinson's Disease: A Pilot Study

Objective: To examine laryngeal maximum performance through a novel pitch diadochokinetic (DDK) task in people with Parkinson's disease (PD) and healthy controls. Methods: This exploratory pilot study included a total of eight people with PD (seven male and one female) and eight healthy controls. Participants were instructed to rapidly transition or alternate between a chosen comfortable low and high pitch and were instructed to complete the task as a pitch glide. An Auditory Sawtooth Waveform Inspired Pitch Estimator-Prime model was used to first extract the pitch contour and then a customized MATLAB algorithm was used to compute and derive measures of pitch range and pitch slope. Results: Pitch range and slope were reduced in some participants with PD. Effects of age and disease duration were observed in people with PD: reductions in both pitch measures with increase in age and disease duration. Conclusions: A novel pitch DDK task may supplement the conventional laryngeal DDK task in the evaluation and treatment of motor speech and voice disorders. Individual variability analysis may provide specific diagnostic and therapeutic insights for people with PD.

Objetivo: Examinar el máximo rendimiento laríngeo a través de una novedosa tarea diadococinética de tono (DDK, por sus siglas en inglés) en personas con enfermedad de Parkinson (EP) y controles sanos. Métodos: Este estudio piloto exploratorio incluyó un total de ocho personas con EP (siete hombres y una mujer) y ocho controles sanos. Se instruyó a los participantes para que hicieran una transición rápida o alternaran entre un tono bajo y uno alto que les resultara cómodo y se les indicó que completaran la tarea como un deslizamiento de tono. Se utilizó un modelo de Estimador de Tono Inspirado en la Forma de Onda de Diente de Sierra Auditiva-Prime para extraer primero el contorno del tono y luego se utilizó un algoritmo MATLAB personalizado para calcular y derivar medidas de rango de tono y pendiente de tono. Resultados: El rango y la pendiente de tono se redujeron en algunos participantes con EP. Se observaron efectos de la edad y la duración de la enfermedad en personas con EP: reducciones en ambas medidas de tono con el aumento de la edad y la duración de la enfermedad. Conclusiones: Una nueva tarea de DDK de tono podría complementar la tarea DDK laríngea convencional en la evaluación y el tratamiento de trastornos motores del habla y de la voz. El análisis de la variabilidad individual podría proporcionar información específica de diagnóstico y terapéutica para personas con EP.

Conocimiento y autoeficacia de la enfermera: o profesional para la aplicación del proceso de enfermería en un hospital de tercer nivel de atención / Knowledge and self-efficiency of the professional nursing for the application of the nursing processes in a hospital of a tercer level of attention / Conhecimento e autoeficácia do profissional enfermeiro para a aplicação do processo de enfermagem em um hospital de terceiro nível de assistência

Introducción: El proceso de enfermería (PE) es la herramienta metodológica que permite al profesional de enfermería brindar cuidados centrados en la persona; por lo que su conocimiento y aplicación a nivel hospitalario permite la evaluación del cuidado formal de enfermería. La autoeficacia es a la creencia que posee el profesional de enfermería para desempeñar las acciones necesarias para obtener los resultados deseados. Metodología: Tipo de estudio analítico, trasversal, prospectivo muestra de 213 enfermeros, 181 licenciatura y 32 de especialidad, se aplicó una encuesta y se analizaron los datos mediante SPSS V.25 se utilizó de estadística descriptiva e inferencial, para la correlación de variables se utilizó Pearson y para comparación de los grupos t de student. Resultados: se observó diferencia estadísticamente significativa en el promedio de conocimientos del PE en los grupos de estudios y en la autoeficacia, en la etapa de diagnóstico (t: -2.986, gl 46, p= 0.005), y de evaluación (t: -2.029, gl 50, p= 0.048), y en la autoeficacia en la dimensión de Persuasión verbal (t= -2.364, gl = 211, p= 0.019). Discusión: Los resultados concuerdan con varios autores respecto a que entre mayor es el grado académico mayor es nivel de conocimientos y de la autoeficacia para aplicar el proceso de enfermería. Conclusiones: Se tiene mayor conocimientos y autoeficacia del PE por parte de los enfermeros especialistas. No existe relación entre las variables de autoeficacia y conocimiento

Introduction: The nursing process (EP) is the methodological tool that allows the nursing professional to provide person-centered care; therefore, its knowledge and application at the hospital level allows the evaluation of formal nursing care. Self-efficacy is the belief held by the nursing professional to perform the necessary actions to obtain the desired results. Objective: To compare and analyze the relationship between the level of knowledge and self-efficacy of nursing graduates and specialists in the application of the EP in a third level of care institution. Method: Analytical, prospective, cross-sectional study, sample of 213 nurses, 181 undergraduate and 32 specialty nurses, a survey was applied, and data were analyzed using SPSS V.25, descriptive and inferential statistics were used, Pearson was used for correlation of variables and Student's t-test was used for comparison of groups. Results: A statistically significant difference was observed in the average PE knowledge in the study groups and in self-efficacy, in the diagnosis stage (t: -2.986, gl 46, p=: 0.005), and evaluation (t: -2.029, gl 50, p=: 0.048), and in self-efficacy in the Verbal Persuasion dimension (t= -2.364, gl = 211, p= 0.019). Discussion: The results agree with several authors regarding that the higher the academic degree, the higher the level of knowledge and self-efficacy to apply the nursing process. Conclusions: There is greater knowledge and self-efficacy of EP by specialist nurses. There is no relationship between the variables of self-efficacy and knowledge

Antecedentes: O processo de enfermagem (EP) é a ferramenta metodológica que permite ao profissional de enfermagem prestar cuidados centrados na pessoa; portanto, o seu conhecimento e aplicação a nível hospitalar permite a avaliação dos cuidados de enfermagem formais. Auto-eficácia é a crença do profissional de enfermagem de realizar as acções necessárias para obter os resultados desejados. Objectivo: Comparar e analisar a relação entre o nível de conhecimentos e a auto-eficácia dos licenciados e especialistas de enfermagem na aplicação do PE numa instituição de cuidados de terceiro nível. Método: Estudo observacional, prospectivo, transversal, comparativo, amostra de 213 enfermeiros, 181 licenciados e 32 especialistas, foi aplicado um inquérito e os dados foram analisados usando SPSS V.25. Foram usadas estatísticas descritivas e inferenciais, Pearson foi usado para a correlação de variáveis e o teste t de Student foi usado para a comparação de grupos. Resultados: Foram observadas diferenças estatisticamente significativas no conhecimento médio de EP nos grupos de estudo e na auto-eficácia, na fase de diagnóstico (t: -2,986, gl 46, p=: 0,005), e na avaliação (t: -2,029, gl 50, p=: 0,048), e na auto-eficácia na dimensão de Persuasão Verbal (t= -2,364, gl = 211, p= 0,019). Discussão: Os resultados concordam com vários autores quanto ao grau académico, maior o nível de conhecimento e auto-eficácia para aplicar o processo de enfermagem. Conclusões: Há um maior conhecimento e auto-eficácia do PE por enfermeiros especializados. Não há relação entre as variáveis de auto-eficácia e de conhecimento

Missed tubal ectopic pregnancy in hysterectomised patient: a rare case report

Tubal ectopic pregnancy (EP) in hysterectomised patient is uncommon. It has propensity to be overlooked. We report a rare case of missed tubal ectopic in 46 years old hysterectomised patient. She presented with abdominal pain and adnexal mass on imaging. Diagnosis was only possible intraoperatively owing to overlapping symptoms and imaging features with that of ovarian tumor.

Association between sleep and obesity in adults / 预防医学

Objective@#To examine the associations of sleep with overweight/obesity and central obesity in adults, so as to provide insights into improving sleep quality and preventing obesity in adults.@*Methods@#Demographics, height, body weight, waist circumstance and sleep status were collected from the Hubei Provincial Surveillance Program for Adult Chronic Diseases and Their Risk Factors in 2020. Subjects' sleep condiction, overweight/obesity and central obesity were descriptively analyzed. The associations of sleep with overweight/obesity and central obesity were examined using a multivariable logistic regression model.@*Results@#A total of 17 789 participants were recruited, with an average age of (56.21±13.05) years, 61.50% women, and mean duration of (7.18±1.56) h/d. There were 7 019 participants with snoring/asphyxia/suffocation (39.46%), 6 108 participants with sleep difficulty (34.34%), 8 064 participants with night waking at least twice (45.33%), 268 participants taking hypnotics (1.51%), and 6 267 participants with early morning awakening and difficulty in sleep again (35.23%), and there were 8 960 participants with overweight/obesity (50.37%) and 6 148 participants with central obesity (34.56%). Multivariable logistic regression analysis showed that sleep duration of <7 h/d (OR=1.081, 95%CI: 1.007-1.159), snoring/asphyxia/suffocation (OR=2.367, 95%CI: 2.222-2.521), and night waking at least twice (OR=1.106, 95%CI: 1.028-1.191) significantly correlated with overweight/obesity, and sleep duration of >8 h/d (OR=0.834, 95%CI: 0.761-0.913), snoring/asphyxia/suffocation (OR=2.153, 95%CI: 2.019-2.297), and night waking at least twice (OR=1.193, 95%CI: 1.105-1.288) were statistically associated with central obesity.@*Conclusion@#Sleep duration, snoring/asphyxia/suffocation and night waking are associated with overweight/obesity and central obesity.

Clinical Efficiency and Safety of Hypofractionated Thoracic Radiotherapy Combined with EP Chemotherapy on Patients with Limited-stage Small-cell Lung Cancer / 肿瘤防治研究

Objective To investigate the efficacy and safety of hypofractionated thoracic radiotherapy combined with EP chemotherapy in the treatment of limited-stage small-cell lung cancer (LS-SCLC). Methods A total of 117 patients with LS-SCLC were enrolled and randomly divided into test group (n=59) and control group (n=58). Patients in the experiment group were given hypofractionated thoracic radiotherapy combined with EP chemotherapy, while patients in the control group were given hyperfractionation radiotherapy combined with EP chemotherapy. Objective response rate (ORR), 2-year overall survival (OS), 2-year progression free survival (PFS), and immune cell level were used to evaluate clinical efficacy. We compared the incidence of side effects between the two groups. Results After the treatment, the ORR of patients in the test group was higher than that in the control group (P > 0.05). The mean OS and PFS of patients in the test group were significantly longer than those in the control group (P < 0.05). The levels of CD3+, CD4+, CD4+/CD8+, and NK cells in the test group were significantly higher, whereas the levels of CD8+ were significantly lower than those in the control group (P < 0.05). The incidence of radiation pneumonitis, radiation esophagitis, and severe dermatitis in the test group was significantly lower than that in the control group (P < 0.05). Conclusion Hypofractionated radiotherapy combined with EP chemotherapy for treatment of LS-SCLC can effectively improve the anticancer efficacy and patient survival, reduce the damage to the body's immune function, and alleviate adverse reaction of radiotherapy.

Effects of moxibustion on serum levels of β-EP, SP and expression of IL-1β and COX-2 protein in brainstem in rats with migraine / 中国针灸

OBJECTIVE@#To observe the effects of moxibustion at "Baihui" (GV 20) and "Dazhui" (GV 14) at different time points on the serum level of β-endorphin (β-EP), substance P (SP) and expression of interleukin-1β (IL-1β) and cyclooxygenase-2 (COX-2) protein in brainstem in rats with migraine, and to explore the effect and mechanism of moxibustion in preventing and treating migraine.@*METHODS@#Forty male SD rats were randomly divided into a blank group, a model group, a prevention+treatment (PT) group and a treatment group, 10 rats in each group. Except the blank group, the rats in the remaining groups were injected with nitroglycerin subcutaneously to prepare migraine model. The rats in the PT group were treated with moxibustion 7 days before modeling (once a day) and 30 min after modeling, while the rats in the treatment group were treated with moxibustion 30 min after modeling. The "Baihui" (GV 20) and "Dazhui" (GV 14) were taken for 30 minutes each time. The behavioral scores in each group were observed before and after modeling. After intervention, ELISA method was used to detect the serum level of β-EP and SP; the immunohistochemistry method was used to detect the number of positive cells of IL-1β in brainstem; the Western blot method was used to detect the expression of COX-2 protein in brainstem.@*RESULTS@#Compared with the blank group, the behavioral scores in the model group were increased 0-30 min, 60-90 min and 90-120 min after modeling (P<0.01); compared with the model group, in the treatment group and the PT group, the behavioral scores were decreased 60-90 min and 90-120 min after modeling (P<0.01). Compared with the blank group, in the model group, the serum level of β-EP was decreased (P<0.01), while the serum level of SP, the number of positive cells of IL-1β in brainstem and the expression of COX-2 protein were increased (P<0.01). Compared with the model group, in the PT group and and the treatment group, the serum level of β-EP was increased (P<0.01), while the serum level of SP, the number of positive cells of IL-1β and the expression of COX-2 protein in brainstem were decreased (P<0.01, P<0.05). Compared with the treatment group, in the PT group, the serum level of β-EP was increased and COX-2 protein expression was decreased (P<0.05).@*CONCLUSION@#Moxibustion could effectively relieve migraine. The mechanism may be related to reduce the serum level of SP, IL-1β and COX-2 protein expression in brainstem, and increase the serum level of β-EP, and the optimal effect is observed in the PT group.

Curative effect of wrist-ankle acupuncture on postpartum abdominal pain and its influence on serum β-EP level in puerpera / 中国针灸

OBJECTIVES@#To observe the clinical effect of wrist-ankle acupuncture on postpartum abdominal pain and its influence on serum beta-endorphin (β-EP) level in puerpera.@*METHODS@#Seventy patients with postpartum abdominal pain were randomly divided into an acupuncture + herbal medication group (35 cases, 1 case dropped out) and a herbal medication group (35 cases, 2 cases dropped out). In the herbal medication group, 1 day after delivery, modified shenghua decoction was taken orally, one dose a day. In the acupuncture + herbal medication group, on the basis of herbal medication, wrist-ankle acupuncture was given at the Lower 1 and Lower 2 of the ankles, once daily. The duration of treatment was 3 days in the two groups. Before and after treatment, the score of visual analogue scale (VAS) for pain, serum β-EP level, uterine fundus height, postpartum conditions of lochia and the uterine recovery at 42 days postpartum were compared in the patients of the two groups.@*RESULTS@#At each time point after treatment (24 h, 48 h and 72 h after delivery), VAS scores and the uterine fundus height were reduced as compared with those before treatment (2 h after delivery) in the two groups (P<0.05); these indexes in the acupuncture + herbal medication group were lower than those in the herbal medication group (P<0.05). After treatment (72 h after delivery), β-EP levels in the serum were increased when compared with those before treatment in the two groups (P<0.05), and the β-EP level in the acupuncture + herbal medication group was higher than that in the herbal medication group (P<0.05). The volume of postpartum lochia discharge in the acupuncture + herbal medication group was higher than that in the herbal medication group (P<0.05), while the duration of postpartum lochia discharge and the total time of lochia discharge were shorter (P<0.05). Regarding the recovery of the uterus at 42 days postpartum, there was no statistical significance between the two groups (P>0.05).@*CONCLUSIONS@#Wrist-ankle acupuncture obviously reduces the degree of postpartum abdominal pain and promotes the lochia discharge and the uterine recovery. The effect mechanism may be related to the up-regulation of serum β-EP level and the increase of pain threshold so that analgesia is obtained.

Tube-nesting EP:A new faster method to get more mouse bone marrow cells / 中国免疫学杂志

Objective:To explore a method to obtain more mouse bone marrow cells more quickly.Methods:Take both lower limbs of the same mouse,the bone marrow cells were obtained by either the tube-nesting EP method or the traditional syringe irrigation method,recorded the time and quantity of bone marrow cells,to analyze the proportion of viable cells by flow cytometry,and to detect the proliferation of these bone marrow cells used CCK-8 method.Results:Compared with the traditional syringe irrigation method,the time of obtaining mouse bone marrow cells by tube-nesting EP method was shorter(P<0.000 1).Compared with the traditional syringe irrigation method,the number of bone marrow cells obtained by tube-nesting EP method was more(P<0.05).The proportion of live cells and proliferation ability of bone marrow cells obtained by the two methods were identical.Conclusion:Tube-nesting EP method is a new faster method to get more mouse bone marrow cells.

The effect of adeno⁃associated virus delivery of shRNA against EP3 receptors in the bilateral lateral parabrachial nucleus of rats on fever / 安徽医科大学学报

Objective @#To investigate the effect of adeno⁃associated virus ( AAV) delivery of short hairpin RNA ( shRNA) against the Ptger3 gene in the lateral parabrachial nucleus (LPB) on the fever induced by microinjection of prostaglandin E2 (PGE2 ) into the LPB and the intraperitoneal injection of lipopolysaccharide (LPS) .@*Methods@#AAV2⁃shRNA⁃Ptger3(EP3) ⅣEGFP ( shRNA⁃EP3) and AAV2⁃ CMV⁃ EGFP ( shRNA⁃control) viruses were constructed and transfected the rat LPB by stereotaxic injection. Four weeks later, the transfection efficiency of AAV viruses was observed by fluorescence microscopy , and the knockdown efficiency was determined by real⁃time PCR of EP3 receptor mRNA on the LPB. The effects of microinjection of saline or PGE2 in the LPB or intraperitoneal injection of LPS on body temperature (Tcore ) and energy expenditure (EE) of shRNA⁃control group and shRNA⁃EP3 group were monitored using an animal monitoring system with temperature telemetry.@*Results @# AAV virus transfecnificant difference in basal body temperature between shRNA⁃control group and shRNA⁃EP3 group. Tcore and EE were briefly and slightly increased after microinjection of saline in the LPB , but there was no significant difference between the two groups. Compared with the shRNA⁃control group , the febrile response induced by LPB PGE2 was attenuated in the shRNA⁃EP3 group (P < 0. 05) . Furthermore , the knockdown of EP3 receptor of LPB also attenuated the LPS⁃induced fever, and the Tcore 5. 5 h post⁃LPS in the shRNA⁃EP3 rats increased compared with the baseline (P < 0. 05) , which was lower than that in the shRNA⁃control rats ( P < 0. 01) . @*Conclusion @#EP3 receptor knockdown in LPB attenuates the febrile response induced by microinjection of PGE2 in the LPB and intraperitoneal injection of LPS , suggesting that EP3 receptors of LPB mediate the pyrogenic action of LPB PGE2 and partly participate in LPS⁃induced fever.

Role Of Ultrasound In Ectopic Pregnancy

Introduction: Ectopic pregnancy (EP)is an implantation occurring outside the uterine cavity. Before introduction of diagnostic role of USG in ectopic pregnancy (EP) it was used to be mediate the time of surgery. Currently ultrasonography is regarded as the gold standard method for diagnosing ectopic pregnancy (EP).It may identify masses as small as 10 mm in diameter in the adnexa and details about character of the mass. It also evaluates the content of endometrial cavity and assess presence of free peritoneal fluid. Color flow Doppler technology may even further improve the accuracy of diagnosis. In present study we analysed diagnostic accuracy of trans abdominal USG in patients presented to tertiary care hospital with suspected ectopic pregnancy (EP). To evaluateAims And Objectives: transabdominal USG features in ectopic pregnancy and correlate them with surgical findings. Material And Method: Amongst the patients referred to radiology department of our hospital from January 2022 to September 2022 for first trimester ultrasound, those with the suspected ectopic pregnancy and who underwent surgical treatment for ectopic pregnancies were enrolled. Transabdominal USG was performed preoperatively in all cases by Philips affinity 30 machine. On transabdominal USG adnexal mass with pelvic fluid was found in 19 (66 %), Pelvic fluid withoutResult: adnexal mass in 7 (24 %), mild hemoperitoneum in 9 (31 %), moderate hemoperitoneum in 9 (31 %), severe hemoperitoneum in 5 (17 %) and thickened endometrium in 2 (7 %) cases. Out of total Salpingostomy was performed in 2 (7 %), Salpingectomy was performed in 24 (83 %) and Salpingectomy with oophorectomy in 3 (10 %). USG Sensitivity was found 100 %,Specificity as 66.67 %, Positive Predictive value as 96.30 % and negative predictive value as 100 %. Conclusion: A high level of suspicion, early diagnosis, and treatment enhance the chance for future reproduction. Early diagnosis is made possible by ultrasound. Therefore, ultrasounds should be performed to determine the viability and location of all early pregnancies.

Prácticas y saberes de excombatientes de las FARC-EP sobre el tratamiento de la leishmaniasis cutánea / Practices and knowledge of ex-combatents of the FARC-EP on the treatment of cutaneous leishmaniasis

RESUMEN Introducción: La Leishmaniasis es una enfermedad infecciosa parasitaria zoonótica que afecta la piel, las mucosas y las vísceras. Es endémica en 98 países y hay más de 350 millones de personas en riesgo de transmisión. En Colombia, los campamentos de las antiguas Fuerzas Armadas Revolucionarias de Colombia, se ubicaban en zonas selváticas donde la enfermedad está presente. El objetivo del presente trabajo está dirigido a describir las prácticas y saberes de los excombatientes de las FARC-EP sobre la Leishmaniasis cutánea y su manejo en escenarios de combate al convivir con esta enfermedad. Métodos: El estudio es cualitativo/exploratorio, donde se abordaron los conocimientos sobre la enfermedad y su forma de transmisión, como también aquellas prácticas relacionadas con el uso de medicamentos para su tratamiento. Resultados: En el análisis de las entrevistas se encontró que los excombatientes conocen el ciclo de la enfermedad desde sus vivencias y por transmisión oral, como también de prácticas curativas propias adaptadas al contexto del conflicto armado, esta experiencia los llevó a desarrollar estrategias de gestión del conocimiento basado en la evidencia. Discusión: Las entrevistas dan cuenta del conocimiento empírico y clínico de los excombatientes sobre el ciclo de la enfermedad; no existe un registro documental, ni manuales de procedimientos realizados en la selva por las FARC-EP sobre tratamiento de enfermedades; los miembros de las FARC-EP a desarrollar estrategias de gestión del conocimiento basados en la evidencia; el contexto de conflicto afectó de manera importante el tiempo y los recursos técnicos para manejar la Leishmaniasis, esto posibilitó las respuestas alternativas a la enfermedad documentadas en este trabajo.

ABSTRACT Introduction: Leishmaniasis is a zoonotic parasitic infectious disease that affects the skin, mucous membranes and viscera. It is endemic in 98 countries and there are more than 350 million people at risk of transmission. In Colombia, the camps of the former Revolutionary Armed Forces of Colombia were located in jungle areas where the disease is present. The objective of this work is aimed at describing the practices and knowledge of ex-combatants of the FARC-EP about cutaneous Leishmaniasis and its management in combat scenarios when living with this disease. Methods: The study is qualitative/exploratory, where knowledge about the disease and its form of transmission were addressed, as well as those practices related to the use of medications for its treatment. Results: In the analysis of the interviews it was found that the ex-combatants know the cycle of the disease from their experiences and by oral transmission, as well as their own healing practices adapted to the context of the armed conflict, this experience led them to develop knowledge management strategies based on the evidence. Discussion: The interviews give an account of the empirical and clinical knowledge of the ex-combatants about the cycle of the disease; There is no documentary record, nor manuals of procedures carried out in the jungle by the FARC-EP on the treatment of diseases; the members of the FARC-EP to develop evidence-based knowledge management strategies; the context of conflict significantly affected the time and technical resources to manage Leishmaniasis, this made possible the alternative responses to the disease documented in this work.

Factors affecting poor eyesight among primary and middle schoolstudents in Tongzhou District / 预防医学

Objective@#To investigate the prevalence and influencing factors of poor eyesight among primary and middle school students in Tongzhou District, Beijing Municipality, so as to provide the evidence for developing control strategies for poor eyesight among primary and middle school students.@* Methods@#Grades 3 to 6 students in district- and township-level primary schools, grades 1 to 3 students in district- and township-level junior high schools, and grades 1 to 3 district- and township-level high schools were sampled in Tongzhou District using the stratified cluster sampling method from 2020 to 2021. Basic information, daily activity, sleep duration and eye-using habits were collected using the specific questionnaires for poor eyesight and influencing factors among students in the 2018 national program for common diseases and health risk factors surveillance program among Chinese students, and the height and body weight were measured. Factors affecting poor eyesight were among primary and middle school students identified using a multivariable logistic regression model. @*Results@#A total of 771 valid questionnaires were recovered, and the respondents included 392 male students (50.84%) and 379 female students (49.16%), and 321 primary school students (41.63%), 228 junior high school students (29.57%) and 222 high school students (28.79%). The prevalence of poor eyesight was 73.54% among the respondents. Multivariable logistic regression analysis showed that education phase (junior high school, OR=2.940, 95%CI: 1.931-4.476; high school, OR=5.998, 95%CI: 3.701-9.723) , obesity (OR=1.989, 95%CI: 1.258-3.146), daily exercise duration of less than 1 h (OR=1.931, 95%CI: 1.351-2.760), daily sleep duration of less than 8 h (OR=1.719, 95%CI: 1.193-2.477), at least 33 cm distance between a reading book and eyes (sometimes, OR=2.165, 95%CI: 1.320-3.550; never, OR=2.634, 95%CI: 1.767-3.928) and continuous short-distance eye use duration of 1 h and longer (OR=1.455, 95%CI: 1.020-2.078) were associated with poor eyesight among primary and middle school students.@*Conclusions@# The prevalence of poor eyesight is high among primary and middle school students in Tongzhou District. Higher grade, obesity, inadequate exercise and sleep duration and poor eye-using habits may increase the risk of poor eyesight.

Research progress on the effect of sleep on obesity among adults / 预防医学

Abstract@#Obesity is a major global public health problem. Long-term sleep deprivation has been identified as a major risk factor of obesity among adults, and oversleeping is found to correlate with the increased risk of obesity. Based on systematic reviews, meta-analysis and prospective cohort studies of the association between sleep and obesity among adults published during the period between 2017 and April, 2022, this review summarizes the direct impact of sleep on obesity among adults, the improvements of adult obesity by sleep and the immune, endocrine, energy metabolism, dietary habit and psychological mechanisms of obesity affected by sleep, so as to provide insights into the development of interventions against adult obesity.

Effect of ergosterol peroxide derivatives on the proliferation ，migration and invasion of human triple negative breast cancer cell / 中国药房

OBJECT IVE To study the effects of ergosterol peroxide derivatives EP-3P on the proliferation ，migration and invasion of human tripe negative breast cancer cell MDA-MB- 231，and to provide reference for the development of breast cancer related drugs. METHODS MTT assay was adopted to detect the proliferation of MDA-MB- 231 cells after treated with 0（blank control），1.25，2.5，5，10，20，40 μmol/L EP-3P for 24，48 and 72 h. Wound healing assay and Transwell chamber method were adopted to detect the migration and invasion ability of MDA-MB- 231 cells after treated with 0（blank control ），5，10，20 EP-3P for 24 h. The apoptosis and cell cycle distribution were detected by flow cytometry. Western blot assay was used to detect the expressions of B-cell lympho ma-2（Bcl-2），Bcl-2 associated X protein （Bax），caspase-3，cleaved-caspase-3，cytochrome C （Cyt-C），matrix metalloproteinase- 2（MMP-2）and MMP- 9. RESULTS Compared with blank control group ，2.5，5，10，20，40 μmol/L EP-3P could significantly increase the inhibitory rate of cell proliferation （P＜0.05 or P＜0.01）in a dose and time- dependent manner. After 24 h treatment of EP- 3P（10，20 μmol/L），the rate of cell migration and the number of invasive cells were decreased significantly （P＜0.01），and cell was arrested at G 2/M stage （P＜0.05 or P＜0.01）；the apoptotic rate was increased significantly （P＜0.05）；the protein expressions of Bax ，Cyt-C and cleaved-caspase- 3 were upregulated significantly ， while those of Bcl- 2，caspase-3，MMP-2 and MMP- 9 were downregulated significantly （P＜0.01）. CONCLUSIONS EP-3P can inhibit the proliferation ，migration and invasion of human tripe negative breast cancer cells MDA-MB- 231 through mitochondrial mediated endogenous caspase pathway ，and induce the apoptosis of cells .

Third‑line chemotherapy after resistance to Etoposide, Cisplatin‑ Etoposide, Methotrexate, Actinomycin (EP‑EMA) in high risk gestational trophoblastic neoplasia: Experience at the Philippine General Hospital / Philippine Journal of Obstetrics and Gynecology

Objective@#To describe the experience of the Division of Trophoblastic Diseases of the Philippine General Hospital with the various third‑line chemotherapeutic regimens among high‑risk gestational trophoblastic neoplasia (GTN) patients who experienced resistance after receiving the etoposide, cisplatin–etoposide, methotrexate, actinomycin (EP‑EMA) regimen@*Materials and Methods@#This was a 17‑year descriptive study that included all patients who used various salvage chemotherapy after resistance to EP‑EMA as treatment for metastatic, high‑risk GTN at the Philippine General Hospital from January 2002 to December 2018. The medical records of eligible patients were retrieved and assessed. All abstracted data were analyzed retrospectively. Descriptive statistics were used to compute for percentages for the various demographic characteristics of the sample population@*Results@#From January 2002 to December 2018, a total of 291 patients with metastatic, high‑risk gestational GTN were treated at the Philippine General Hospital. Of these, only seven patients received various third‑line chemotherapy regimens after resistance to EP‑EMA. One patient was excluded due to incomplete data. Among the third‑line chemotherapeutic regimens used, 3 patients received paclitaxel/carboplatin, two of whom went into remission while one expired. One patient had vincristine, bleomycin, and cisplatin (VBP) with two adjunctive surgeries in the form of hysterectomy and thoracotomy. She also went into remission. Two patients received paclitaxel–cisplatin/paclitaxeletoposide (TP/TE) as third line of treatment. The first was shifted back to EP‑EMA and eventually developed chemoresistance to EP‑EMA and had multiple toxicities. After multidisciplinary conference with the patient and family, they decided to go home and refused further chemotherapy. The other patient had TP/TE followed by bleomycin–etoposide–cisplatin, with adjunctive hysterectomy. Despite multiple cycles of chemotherapy, the disease persisted. She was offered palliative care and the family decided to bring her home. Both patients eventually expired at home@*Conclusion@#No conclusion can be made about the most effective third line chemotherapy for resistant high‑risk GTN because of the limited cases included in this study. An individualized approach is still recommended. Physicians and centers for patients caring for such patients are encouraged to report their experience to improve the management of future patients

Association between sleep duration and hypertension among adults in Zhejiang Province / 预防医学

Objective@#To investigation the correlation between sleep duration and hypertension among adults in Zhejiang Province, and to provide scientific evidence for the prevention and control of hypertension.@*Methods@#Permanent residents at age of 18 years and older were enrolled from 10 surveillance sites for risk factors of chronic diseases included in the 2018 China Chronic Diseases and Risk Factors Surveillance Program. Subjects' demographic characteristics, smoking, alcohol consumption, sleep duration and development of hypertension were collected, and following complex weighting calculations, the association between sleep duration and hypertension were examined using a multivariable logistic regression model.@*Results@#Totally 5 770 adults were included, including 2 952 men (50.72%) and 3 178 women (49.28%), and the prevalence of hypertension was 29.39% (2 702 cases). There were 712 (8.37%), 1 077 (18.77%), 1 582 (28.68%), 1 717 (34.60%) and 682 adults (9.57%) with sleep duration of <6 h/d, 6 to 7 h/d, 7 to 8 h/d, 8 to 9 h/d and 9 h/d and longer, respectively. Taking the sleep duration of 7 to 8 h/d as a reference, multivariable logistic regression analysis identified a significant association between sleep duration of <6 h/d and the risk of hypertension (OR=1.709, 95%CI: 1.184-2.466), a significant association between sleep duration of 9 h/d and longer and the risk of hypertension (OR=1.369, 95%CI: 1.006-1.862) in men, significant associations between sleep duration of <6 h/d (OR=2.174, 95%CI: 1.528-3.093) and 6 to 7 h/d (OR=1.412, 95%CI: 1.078-1.850) and the risk of hypertension in women, and significant associations between sleep duration of <6 h/d (OR=3.095, 95%CI: 1.025-9.347) and 6 to 7 h/d (OR=2.046, 95%CI: 1.156-3.622) and the risk of hypertension in residents at ages of 18 to 44 years.@*Conclusions@#Short sleep duration may increase the risk of hypertension among adults at ages of 18 to 44 years in Zhejiang Province. Short sleep duration may increase the risk of hypertension in women and long sleep duration may increase the risk of hypertension in men.

Variables psicológicas asociadas al estrés Postraumático en desmovilizados de las Fuerzas Armadas Revolucionarias de Colombia (FARC-EP) / Psychological variables associated with post-traumatic stress in demobilized members of the Revolutionary Armed Forces of Colombia (FARC-EP)

Resumen: Objetivo: Evaluar la relación entre el estrés post traumático y variables psicológicas asociadas, en guerrilleros desmovilizados las Fuerzas Armadas Revolucionarias de Colombia (FARC-EP) en el departamento de Córdoba, Colombia. Método: Estudio cuantitativo, transversal, de alcance correlacional. Participaron 48 guerrilleros mayores de edad (34 hombres y 14 mujeres) pertenecientes al Frente 58 de esta agrupación, a quienes se les aplicó los cuestionarios Lista de chequeo de estrés post traumático (PCL-5), la escala de distrés psicológica de Kessler, el cuestionario de creencias básicas (CBI), la escala de la esperanza de Herth y la escala de bienestar compuesto (WBC). Resultados: Los participantes no presentaban síntomas de estrés post traumático, tenían bajos niveles de estrés y de cambios en las creencias básicas, igualmente presentaban altos niveles de esperanza y de bienestar físico y psicológico. Para detectar posibles predictores del TEPT se desarrolló un análisis de regresión múltiple en el cual el 48% de la varianza total fue explicado por el distrés psicológico y las creencias básicas. Conclusión: Se evidencia la necesidad de desarrollar estudios que profundicen en las características del estado psicológico de los ex guerrilleros de la FARC-EP, con el fin de aclarar las variables involucradas que favorecen los procesos de reintegración a la vida civil.

Abstract: Objective: To evaluate the relationship between post-traumatic stress and associated psychological variables in demobilized guerrillas from the Revolutionary Armed Forces of Colombia (FARC-EP) in the department of Córdoba, Colombia. Method: We carried out a quantitative, cross-sectional study of correlational scope, in which 48 guerrillas of legal age participated (34 men and 14 women) belonging to the 58th Front of this group. The Post Traumatic Stress Checklist (PCL-5), the Kessler psychological distress scale, the basic beliefs questionnaire (CBI), the Herth hope scale and the composite well-being scale (WBC) were applied. Results: The participants did not present symptoms of post traumatic stress, they had low levels of stress and changes in basic beliefs, they also presented high levels of hope and physical and psychological well-being. To detect possible predictors of PTSD, a multiple regression analysis was developed in which 48% of the total variance was explained by psychological distress and basic beliefs. Conclusion: There is evidence of the need to develop studies that delve into the characteristics of the psychological state of former FARC-EP guerrillas, in order to clarify the variables involved that favor the processes of reintegration into civilian life.

Factors affecting remission to salvage chemotherapy with EtoposideCisplatin/Etoposide-MethotrexateActinomycin D (EP-EMA regimen) among chemoresistant high-risk Gestational Trophoblastic Neoplasia patients admitted in a tertiary institution: A 10-year retrospective descriptive study / Philippine Journal of Obstetrics and Gynecology

Background@#Approximately 20%–25% of high-risk gestational trophoblastic neoplasia (GTN) patients initially treated with first-line chemotherapy regimen develop resistance to the regimen. The EP-EMA (Etoposide-cisplatin and etoposide, methotrexate and actinomycin D) regimen is the most commonly utilized second-line agent. @*Objective@#This study aimed to identify factors leading to remission using etoposide and cisplatin-etoposide, methotrexate, and Actinomycin D (EP-EMA) as salvage chemotherapy among resistant high-risk GTN.@*Methods@#This is a retrospective descriptive study that reviewed the medical records of patients admitted in the section of trophoblastic diseases diagnosed with high-risk GTN from January 2006 to December 2015. @*Results@#The medical records of 20 patients were retrieved and reviewed. The complete remission rate with EP-EMA is 60% (12/20). The overall survival rate for 1 year is 70% (14/20). Only 20% of the patients went home against advice and did not complete treatment. This regimen reported toxicities ranging from Grade 2–4 myelosuppression and electrolyte imbalance. Forty-five percent had Grade 4 neutropenia and Grade 2 anemia and 20% had Grade 2 thrombocytopenia. Hypokalemia and hypomagnesemia were noted in 8 patients (40%). Although not statistically significant, a trend showed that those in the remission group mostly had Stage III diseases with metastasis only in the lungs, prognostic score of between 7 and 12, and with beta-human chorionic gonadotropin (β-hCG) levels <10,000 mIu/ml at the start of EP-EMA treatment.@*Conclusion@#There is an improved response with EP-EMA chemotherapy across the years in our institution. Factors such as stage of disease, pulmonary metastasis, and low β-hCG at the start EP-EMA chemotherapy denote a possible good response and may contribute to patients' complete remission with EP-EMA chemotherapy. However, further studies with larger patient sample size are recommended to support the latter.