Engagement with health research summaries via digital communication to All of Us participants.

OBJECTIVE: Summaries of health research can be a complementary way to return value to participants. We assess how research participants engage with summaries via email communication and how this can be improved. MATERIALS AND METHODS: We look at correlations between demographic subgroups and engagement in a longitudinal dataset of 305 626 participants (77% are classified as underrepresented in biomedical research) from the All of Us Research Program. We compare this against engagement with other program communications and use impact evaluations (N = 421 510) to measure the effect of tailoring communication by (1) eliciting content preferences, (2) Spanish focused content, (3) informational videos, and (4) article content in the email subject line. RESULTS: Between March 2020 and October 2021, research summaries reached 67% of enrolled participants, outperforming other program communication (60%) and return of results (31%), which have a high uptake rate but have been extended to a subset of eligible participants. While all demographic subgroups engage with research summaries, participants with higher income, educational attainment, White, and older than 45 years open and click content most often. Surfacing article content in the email subject line and Spanish focused content had negative effects on engagement. Video and social media content and eliciting preferences led to a small directional increase in clicks. DISCUSSION: Further individualization of tailoring efforts may be needed to drive larger engagement effects (eg, delivering multiple articles in line with stated preferences, expanding preference options). Our findings are likely a conservative representation of engagement effects, given the coarseness of our click rate measure. CONCLUSIONS: Health research summaries show promise as a way to return value to research participants, especially if individual-level results cannot be returned. Personalization of communication requires testing to determine whether efforts are having the expected effect.

Feasibility of wearable sensor signals and self-reported symptoms to prompt at-home testing for acute respiratory viruses in the USA (DETECT-AHEAD): a decentralised, randomised controlled trial.

BACKGROUND: Early identification of an acute respiratory infection is important for reducing transmission and enabling earlier therapeutic intervention. We aimed to prospectively evaluate the feasibility of home-based diagnostic self-testing of viral pathogens in individuals prompted to do so on the basis of self-reported symptoms or individual changes in physiological parameters detected via a wearable sensor. METHODS: DETECT-AHEAD was a prospective, decentralised, randomised controlled trial carried out in a subpopulation of an existing cohort (DETECT) of individuals enrolled in a digital-only observational study in the USA. Participants aged 18 years or older were randomly assigned (1:1:1) with a block randomisation scheme stratified by under-represented in biomedical research status. All participants were offered a wearable sensor (Fitbit Sense smartwatch). Participants in groups 1 and 2 received an at-home self-test kit (Alveo be.well) for two acute respiratory viral pathogens: SARS-CoV-2 and respiratory syncytial virus. Participants in group 1 could be alerted through the DETECT study app to take the at-home test on the basis of changes in their physiological data (as detected by our algorithm) or due to self-reported symptoms; those in group 2 were prompted via the app to self-test only due to symptoms. Group 3 served as the control group, without alerts or home testing capability. The primary endpoints, assessed on an intention-to-treat basis, were the number of acute respiratory infections presented (self-reported) and diagnosed (electronic health record), and the number of participants using at-home testing in groups 1 and 2. This trial is registered with ClinicalTrials.gov, NCT04336020. FINDINGS: Between Sept 28 and Dec 30, 2021, 450 participants were recruited and randomly assigned to group 1 (n=149), group 2 (n=151), or group 3 (n=150). 179 (40%) participants were male, 264 (59%) were female, and seven (2%) identified as other. 232 (52%) were from populations historically under-represented in biomedical research. 118 (39%) of the 300 participants in groups 1 and 2 were prompted to self-test, with 61 (52%) successfully completing self-testing. Participants were prompted to home-test more frequently due to symptoms (41 [28%] in group 1 and 51 [34%] in group 2) than due to detected physiological changes (26 [17%] in group 1). Significantly more participants in group 1 received alerts to test than did those in group 2 (67 [45%] vs 51 [34%]; p=0·047). Of the 61 individuals who were prompted to test and successfully did so, 19 (31%) tested positive for a viral pathogen-all for SARS-CoV-2. The individuals diagnosed as positive for SARS-CoV-2 in the electronic health record were eight (5%) in group 1, four (3%) in group 2, and two (1%) in group 3, but it was difficult to confirm if they were tied to symptomatic episodes documented in the trial. There were no adverse events. INTERPRETATION: In this direct-to-participant trial, we showed early feasibility of a decentralised programme to prompt individuals to use a viral pathogen diagnostic test based on symptoms tracked in the study app or physiological changes detected using a wearable sensor. Barriers to adequate participation and performance were also identified, which would need to be addressed before large-scale implementation. FUNDING: Janssen Pharmaceuticals.

BECN1 regulates FADD/RIPK1/Caspase-8 complex formation via RIPK1 ubiquitination by downregulating OTUD1 in MI/R induced myocyte apoptosis.

BACKGROUND: Cardiomyocyte apoptosis plays a vital role in myocardial ischemia-reperfusion (MI/R) injury; however, the role of beclin1 (BECN1) remains unclear. This study aimed at revealing the function of BECN1 during cardiomyocyte apoptosis after MI/R injury. METHODS: In vivo, TTC and Evan's blue double staining was applied to verify the gross morphological alteration in both wild type (WT) mice and BECN1 transgene mice (BECN1-TG), and TUNEL staining and western blot were adopted to evaluate the cardiomyocyte apoptosis. In vitro, a hypoxia/reoxygenation (H/R) model was established in H9c2 cells to simulate MI/R injury. Proteomics analysis was preformed to verify if apoptosis occurs in the H/R cellular model. And apoptosis factors, RIPK1, Caspase-1, Caspase-3, and cleaved Caspase-3, were investigated using western bolting. In addition, the mRNA level were verified using RT-PCR. To further investigate the protein interactions small interfering RNA and lentiviral transfection were used. To continue investigate the protein interactions, immunofluorescence and coimmunoprecipitation were applied. RESULTS: Morphologically, BECN1 significantly attenuated the apoptosis from TTC-Evan's staining, TUNEL, and cardiac tissue western blot. After H/R, a RIPK1-induced complex (complex II) containing RIPK1, Caspase-8, and FADD was formed. Thereafter, cleaved Caspase-3 was activated, and myocyte apoptosis occurred. However, BECN1 decreased the expression of RIPK1, Caspase-8, and FADD. Nevertheless, BECN1 overexpression increased RIPK1 ubiquitination before apoptosis by inhibiting OTUD1. CONCLUSIONS: BECN1 regulates FADD/RIPK1/Caspase-8 complex formation via RIPK1 ubiquitination by downregulating OTUD1 in C-Caspase-3-induced myocyte apoptosis after MI/R injury. Therefore, BECN1 can function as a cardioprotective candidate.

Risk Factors for Cancer Malnutrition after Radical Tumor Resection.

Objective: To investigate the risk factors for cancer malnutrition after radical tumor resection. Methods: A total of 110 cancer patients who used parenteral nutrition from January 2022 to June 2023 were selected for retrospective analysis and 50 patients who did not need parenteral nutrition support after radical tumor resection were selected as the control group to analyze the general data of the two groups. Univariate and multivariate logistic analyses were used to determine the factors influencing malnutrition in patients supported by parenteral nutrition after radical tumor resection. Results: The age(P = .032), body mass index(P = .012), education level(P = .025), per capita monthly household income(P = .029), concurrent chemotherapy ratio(P = .035), phobia disease progression(P = .037), and depression(P = .038) of patients who underwent parenteral nutrition after radical tumor resection were all influencing factors, and the differences were statistically significant (P < .034). After undergoing a radical tumor resection, patients with dysphagia grade 2-3, loss of appetite grade 2-3, and nausea and vomiting grade 2-3, as well as diarrhea grade 2-3, require parenteral nutrition support. The risk factors for malnutrition in patients who require such support include age, education, per capita household income, fear of disease progression, depression, pain, and diarrhea. Conclusion: Patients may suffer from malnutrition after radical tumor resection and need parenteral nutrition support, including age, education level, per capita monthly household income, fear of disease progression, depression, pain, diarrhea, etc., so in clinical nursing, nursing staff should pay more attention to such high-risk factors, so as to carry out personalized nursing programs for patients undergoing radical tumor resection and improve the effectiveness of disease treatment.

Genome-wide association analysis of agronomic traits related to eggplant fruits: a review / 生物工程学报

Eggplant is an important horticultural crop and one of the most widely grown vegetables in the Solanaceae family. Eggplant fruit-related agronomic traits are complex quantitative traits with low efficiency and long cycle time for traditional breeding selection. With the rapid development of high-throughput sequencing technology and bioinformatics tools, genome-wide association study (GWAS) has shown great application potential in analyzing the genetic rules of complex agronomic traits related to eggplant fruits. This paper first reviews the progress of genome-wide association analysis in eggplant fruit shape, fruit color and other fruit-related agronomic traits. Subsequently, aiming at the problem of missing heritability, which is common in the genetic studies of eggplant quantitative traits, this paper puts forward the development strategies of eggplant GWAS in the future based on the hot spots of application of four GWAS strategies in the research of agronomics traits related to eggplant fruits. Lastly, the application of GWAS strategy in the field of eggplant molecular breeding is expected to provide a theoretical basis and reference for the future use of GWAS to analyze the genetic basis of various eggplant fruit-related traits and to select fruit materials that meet consumer needs.

Unilateral Abduction Dorsiflexion Mechanism Brace as an Attractive Alternative of Congenital Talipes Equino-Varus Treatment - a Preliminary Report.

Ponseti method of CTEV treatment includes use of a foot orthosis, compliance with this can be a challenge. A new brace- Abduction Dorsiflexion Mechanism brace (ADM, C-Prodirect) was introduced to address this. The aim of the study was to assess whether the new ADM brace improves compliance and prevents relapse in children with corrected clubfoot. Eight children with unilateral CTEV who did not tolerate the standard brace were included in the study. All children had been previously treated with Ponseti casting, Achilles tenotomy and Ponseti AFO Abduction Brace (C-Prodirect®). The mean age of children included was 27 months. Parents' satisfaction with the brace was assessed using Client Satisfaction with Device (CSD) questionnaire. Parents reported better tolerance of the brace by the child in six out of eight cases. ADM brace is viable alternative in maintaining correction of unilateral idiopathic CTEV when compliance to standard AFO abduction brace is poorly tolerated.

Knowledge, attitude, behaviour, and influencing factors of home-based medication safety among community-dwelling older adults with chronic diseases: a cross-sectional study.

BACKGROUND: Older adults with chronic diseases require long-term medication. However, due to lack of drug knowledge and hypomnesia, older adults with chronic diseases are prone to adverse drug events and increased medical costs. This study aimed to explore the status and influencing factors of home-based medication safety among community-dwelling older adults with chronic diseases in China to provide a basis for follow-up to conduct targeted health education. METHODS: Overall, 427 community-dwelling older adults with chronic diseases participated in this study. The Knowledge, Attitude, and Behaviour of Medication Safety among Older Adults with Chronic Diseases Questionnaire was used to assess their home-based medication safety. Multivariate linear regression was used to identify the factors influencing knowledge, attitude, and behaviour regarding medication safety. RESULTS: The average score of home-based medication safety among older adults with chronic diseases was 68.26 ± 8.96, indicating that they had a moderate grasp of medication safety. The scoring rate of each subscale was ranked from high to low as follows: behaviour (84.51%), knowledge (63.33%), and attitude (47.39%). Stepwise linear regression analysis showed that medication safety knowledge, attitudes, and behaviours were significantly associated with higher monthly income, adverse drug events, and taking medicine several times a day (p < 0.05). Additional influencing factors included having fewer chronic diseases, being female, higher educational attainment, taking medicines multiple kinds a day, better self-care ability, and non-hospitalisation for chronic illnesses (p < 0.05). CONCLUSION: Medical staff and community workers should pay attention to the drug safety of older adults with different characteristics and mobilise their enthusiasm for participation to improve their medication self-management ability. TRIAL REGISTRATION: Chinese Clinical Trial Register: ChiCTR2200060987 ; reg. date: 15/06/2022.

Synergistic effects of lipopolysaccharide and rotenone on dopamine neuronal damage in rats.

INTRODUCTION: The etiology of Parkinson's disease (PD) is still unknown. Until now, oxidative stress and neuroinflammation play a crucial role in the pathogenesis of PD. However, the specific synergistic role of oxidative stress and neuroinflammation in the occurrence and development of PD remains unclear. METHODS: The changes in motor behavior, dopamine (DA) neurons quantification and their mitochondrial respiratory chain, glial cells activation and secreted cytokines, Nrf2 signaling pathway, and redox balance in the brain of rats were evaluated. RESULTS: Lipopolysaccharide (LPS)-induced neuroinflammation and rotenone (ROT)-induced oxidative stress synergistically aggravated motor dysfunction, DA neuron damage, activation of glial cells, and release of related mediators, activation of Nrf2 signaling and destruction of oxidative balance. In addition, further studies indicated that after ROT-induced oxidative stress caused direct damage to DA neurons, LPS-induced inflammatory effects had stronger promoting neurotoxic effects on the above aspects. CONCLUSIONS: Neuroinflammation and oxidative stress synergistically aggravated DA neuronal loss. Furtherly, oxidative stress followed by neuroinflammation caused more DA neuronal loss than neuroinflammation followed by oxidative stress.

The association of air pollutants with hospital outpatient visits for child and adolescence psychiatry in Shenzhen, China.

BACKGROUND: Although exposure to ambient air pollution has been associated with mental disorder, little is known about its potential effects on children and adolescents, especially in Chinese population. We aimed to reveal the relationship of air pollutants with hospital outpatient visits for child and adolescence psychiatry (HOVCAP) in Shenzhen. METHODS: A case-crossover study based on time-series data was applied, and a distributed lag non-linear model (DLNM) was used to evaluate the non-linear and delayed effects of 4 major air pollutants (NO2, PM2.5, SO2 and O3) on HOVCAP. Least absolute shrinkage and selection operator (LASSO) regression was used to control the multicollinearity between covariates and to filter variables. RESULT: A total of 94,660 cases aged 3-18 were collected from 2014 to 2019 in the Mental Health Center of Shenzhen. Results of pollutants at mode value (M0) showed that in the single lag effect result, when the average daily concentration of NO2 at 24 µg/m3, there was a significant effect on HOVCAP over lag 1, lag 4 and lag 5, respectively. The cumulative RR of NO2 M0 value to the outpatient visits were 1.438 (1.137-1.818) over lag 0-2, 1.454 (1.120-1.887) over lag 0-3, 1.466 (1.084-1.982) over lag 0-4, 1.680 (1.199-2.354) over lag 0-5, 1.993 (1.369-2.903) over lag 0-6, and 2.069 (1.372-3.119) over lag 0-7. However, PM2.5, SO2, O3 were not associated with HOVCAP over neither single lag effects nor cumulative effects. The RR values both shown an increase either when NO2 increases by 10 units or when the maximum concentration of NO2 is reached. CONCLUSION: Our study suggests that exposure to the normal air quality of NO2 in Shenzhen may associated with the risk of HOVCAP. However, PM2.5, SO2, O3 were not associated with HOVCAP.

Evaluation of the predictive effect of parafoveal blood flow density of macula on the number of intravitreal Conbercept injections in patients with branch retinal vein occlusion / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate blood flow density within 300μm(FD-300)around the foveal avascular zone(FAZ)in optical coherence tomography angiography(OCTA)of patients with macular edema(ME)complicated with non-ischemic branch retinal vein occlusion(BRVO), and to explore and evaluate the predictive effect of this parameter on the number of intraocular drug injections.METHODS: A retrospective case study. A total of 50 patients(50 eyes)who were diagnosed as non-ischemic BRVO combined with ME and received intravitreal conbercept(IVC)in the Affiliated Eye Hospital of Nanjing Medical University from January 2021 to March 2022 were selected, and they were treated with 3+PRN regimen. The 25 cases(25 eyes)treated with intraocular injection ≤5 times were classified as group B, and 25 cases(25 eyes)treated with intraocular injection &#x003E;5 times were classified as group C, and 25 fellow eyes were randomly selected as control group A. OCTA was used to scan the macular area in 3mm×3mm to collect images of retinal blood flow, the central macular thickness(CMT)and FD-300. The CMT, best-corrected visual acuity(BCVA), and FD-300 were compared between the two groups at baseline, 1, 3, 6 and 12mo after the third injection.RESULTS: The BCVA(LogMAR)of the affected eye in both groups B and C at 1, 3, 6 and 12mo after the third injection was significantly lower than baseline(all P&#x003C;0.05); the CMT and FD-300 were significantly lower than baseline(all P&#x003C;0.05). Pearson correlation analysis showed that the change of BCVA(LogMAR)was positively correlated with the baseline FD-300 and CMT(group B: r=0.77, 0.70, all P&#x003C;0.01; group C: r=0.89, 0.78, all P&#x003C;0.01). The number of intraocular injections was negatively correlated with the baseline FD-300(group B: r=-0.63, P&#x003C;0.01; group C: r=-0.71, P&#x003C;0.01). Logistic regression analysis showed that the FD-300 at baseline is a factor that affects the number of intraocular drug injection.CONCLUSION: IVC can effectively alleviate macular edema of the affected eye,improve visual acuity and reduce FD-300. The eyes with worse BCVA and lower FD-300 at baseline may require more injections of anti-VEGF. Observation of FD-300 with OCTA can better predict eventual vision recovery of non-ischemic BRVO with ME before treatment.

Effect of Nucleolin on Lymphoma Proliferation by Regulating Thymidine Kinase 1 / 中国实验血液学杂志

OBJECTIVE@#To investigate the mechanism of nucleolin (NCL) involved in lymphoma proliferation by regulating thymidine kinase 1 (TK1).@*METHODS@#Twenty-three patients with diffuse large B-cell lymphoma (DLBCL) were selected and divided into initial treatment group (14 cases) and relapsed/refractory group (9 cases). Serum TK1 and C23 protein in peripheral blood mononuclear cells were detected. Cell models of CA46-NCL-KD (CA46-NCL-knockdown) and CA46-NCL-KNC (CA46-NCL-knockdown negative control) were established by lentivirus vector mediated transfection in Burkitt lymphoma cell line CA46. The half maximal inhibitory concentration (IC50) of CA46-NCL-KD, CA46-NCL-KNC, and CA46 to adriamycin were detected by cell proliferation assay (MTS). The expression of NCL mRNA and protein in CA46-NCL-KD and CA46-NCL-KNC cells were dectected by Q-PCR and Western blot, respectively. The cell cycle of CA46-NCL-KD, CA46-NCL-KNC, and CA46 cells were detected by flow cytometry. The expression of TK1 protein in CA46-NCL-KD and CA46-NCL-KNC cells was detected by an enhanced chemiluminescence (ECL) dot blot assay.@*RESULTS@#The level of serum TK1 in the initial treatment group was 0.43(0-30-1.01) pmol/L, which was lower than 10.56(2.19-14.99) pmol/L in the relapsed/refractory group (P<0-01), and the relative expression level of NCL protein in peripheral blood was also significantly lower. The IC50 of CA46-C23-KD cells to adriamycin was (0.147±0.02) μg/ml, which was significantly lower than (0.301±0.04) μg/ml of CA46-C23-KNC cells and (0.338±0.05) μg/ml of CA46 cells (P<0.05). Compared with CA46-NCL-KNC cells, the expression of NCL mRNA and protein, TK1 protein decreased in CA46-NCL-KD cells, and the proportion of S phase and G2/M phase also decreased, while G0/G1 phase increased in cell cycle.@*CONCLUSION@#The increased expression of NCL in DLBCL and CA46 cells indicates low sensitivity to drug. NCL may participate in regulation of lymphoma proliferation by affecting TK1 expression, thereby affecting the drug sensitivity.

A Retrospective Study on the Efficacy and Safety of Idarubicin Combined with High-Dose Cytarabine Consolidation in Patients with Acute Myeloid Leukemia over 60 Years of Age in First Remission / 中国实验血液学杂志

OBJECTIVE@#To evaluate the efficacy and safety of idarubicin combined with high-dose cytarabine as a post-remission therapy for elderly patients with acute myeloid leukemia (AML).@*METHODS@#From November 2017 to June 2021, 24 AML patients aged ≥60 years who were in complete remission for the first time were enrolled in consolidation chemotherapy with idarubicin (10 mg/m2 intravenously once for day 1) combined with high-dose cytarabine (1.5 g/m2 intravenously over 3 hours every 12 hours for day 1-3), and the efficacy and safety were observed.@*RESULTS@#Among the 24 patients, there were 12 males and 12 females, the median age was 65 (60-78) years old, and the median follow-up time was 23.3 (2-42.7) months. By the end of the follow-up, 15 patients relapsed and 11 patients died. The median disease-free survival (DFS) was 9 months and there were 3 cases of 2-year DFS. The median overall survival (OS) was 16.2 months, and there were 4 cases of 2-year OS. In terms of safety, 6 patients had grade 1-2 non-hematological adverse reactions, 12 patients had grade 3-4 hematological adverse reactions, and a total of 6 patients developed infection after consolidation chemotherapy. Multivariate analysis showed that two induction cycles and high-risk cytogenetic abnormalities were the adverse factors of DFS and OS in elderly patients with AML in this study.@*CONCLUSION@#For AML patients ≥60 years old in first complete remission, idarubicin combined with high-dose cytarabine as post-remission therapy has a better safety, but compared with other regimens does not improve the prognosis of elderly patients, which needs further exploration.

Current status changing trend and influencing factors of pancreatic cancer disease burden in Chengde of Hebei Province in 2010 - 2020 / 公共卫生与预防医学

Objective To analyze the disease burden status, trends and possible influencing factors of pancreatic cancer in Chengde of Hebei from 2010 to 2020, in order to provide theoretical basis for the preventionof pancreatic cancer. Methods Using the global burden of disease open database, the incidence rate, mortality, years of life lost (YLL), years of life lost with disability (YLD) and disability adjusted life year (DALY) of pancreatic cancer in the region are obtained,average annual percent change (AAPC) was calculated using joinpoint model to test the trend of disease burden change of pancreatic cancer patients from 2010 to 2020. At the same time, the patient characteristics such as hypertension, diabetes and other categorical variables were set as dummy variables, and the risk factors affecting the mortality of patients with pancreatic cancer were analyzed by linear regression. Results In 2010, there were 15 new cases of pancreatic cancer and 13 deaths in Chengde District , Hebei Province. The YLLs caused by pancreatic cancer accounted for 70.67% of DALY. In 2020, there were 160 new cases of pancreatic cancer and 147 deaths in Chengde, Hebei Province. The YLLs caused by pancreatic cancer accounted for 96.02% of DALY. From 2010 to 2020, the incidence of pancreatic cancer increased by 9.79%, and the incidence rate increased by 7.81%, showing an obvious upward trend (APCC =2.20%, P 28.0 and pancreatitis (OR=1.574 , 95% CI: 1.328-3.045) were all risk factors for death of patients with pancreatic cancer (OR>1) . Conclusion From 2010 to 2020, the incidence and mortality of pancreatic cancer among local residents in Chengde of Hebei showed an upward trend, and the disease burden was also increasing year by year. The basic diseases of diabetes and chronic pancreatitis increase the death risk and should be protected.

Incidence and related factors of umbilical venous catheter tip migration / 中华围产医学杂志

Objective:To analyze the incidence and the related factors of umbilical vein catheter (UVC) tip migration within 7 d after umbilical vein catheterization.Methods:This prospective study involved neonates who were successfully indwelled with UVCs in the Department of Neonatology of Gansu Provincial Women and Child-care Hospital from June 2020 to December 2021. The position of the UVC tip, length of umbilical stump, body weight, and abdominal circumference were recorded after the UVCs were inserted successfully, and the changes in these four data at 2, 24, 48, 72 h, and 7 d after catheterization were analyzed and compared. All the subjects were divided into the non-migrate group, inward migration group, and outward migration group. Chi-square test, Mann-Whitney U test, or Kruskal Wallis H test were used for statistical analysis. Results:A total of 157 newborns were enrolled, with 51 cases in the inward migration group, 62 cases in the outward migration group, and 44 cases in the non-migrate group. There were no significant differences among the three groups regarding gestational age, birth weight, gender, born through cesarean section, age at the time of catheterization, use of sedation, and feeding modes (all P>0.05). The migration rates of UVCs tip at 2, 24, 48, 72 h, and 7 d after catheterization were 0, 27.4% (43/157), 27.2% (31/114), 25.3% (21/83), and 29.0% (18/62), respectively. The cumulative migration rates at 24, 48, 72 h, and 7 d were 27.4% (43/157), 47.1% (74/157), 60.1% (95/157), and 72.0% (113/157), respectively. Compared with the non-migrate group, the inward migration group had a shorter umbilical cord stump at 24 and 48 h [0.5 cm (0.4-0.5 cm) vs 0.6 cm (0.5-0.8 cm); 0.4 cm (0.3-0.5 cm) vs 0.5 cm (0.5-0.6 cm), Z=－5.55 and －3.69, both P<0.05], less abdominal circumference increment at 48 and 72 h [0.6 cm (0.5-1.0 cm) vs 0.9 cm (0.7-1.2 cm); 0.6 cm (0.3-0.9 cm) vs 0.9 cm (0.7- 1.3 cm), Z=－2.03 and －2.09, both P<0.05)], and more weight loss percentage [－4.7% (－6.0%-－3.6%) vs －3.1% (－3.7%-－2.2%); －6.0% (－7.5%-－5.0%) vs －3.9% (－5.1%-－2.4%), Z=－3.75 and －2.96, both P<0.05]. The abdominal circumference increased more in the outward migration group at 24, 48, 72 h, and 7 d than those in the non-migrate group [1.6 cm (0.9-1.9 cm) vs 0.7 cm (0.5-0.9 cm); 1.5 cm (1.2-1.8 cm) vs 0.9 cm (0.7-1.2 cm); 1.7 cm (1.3-1.9 cm) vs 0.9 cm (0.7-1.3 cm); 1.6 cm (1.1-1.9 cm) vs 0.9 cm (0.6-1.3 cm), Z=－4.82, －4.79, －3.74, and －3.09, all P<0.05]. Conclusion:The incidence of UVC tip migration is high, which could be affected by dryness and retraction of the umbilical cord stump and the change in neonatal abdominal circumference and body weight.

Exploration and application of "internet + mobile medicine" in the process management of standardized residency training of obstetrics and gynecology / 中华医学教育探索杂志

Objective:To assess the application effect of "internet + mobile medicine" on the process management of standardized residency training of obstetrics and gynecology.Methods:A total of 43 teachers including 14 administrators and 29 instructors who were not directly responsible for management, and 41 residents who participated in the standardized training in our base were enrolled as research objects. The data of process management were sorted by internet technology, and combined with personal wishes and casting lots, the residents were divided into two groups: the control group ( n=21) adopted traditional way while the observation group ( n=20) used mobile medicine for process management. By conducting multi-dimensional questionnaire and data comparison, we analyzed the evaluation of teachers and residents, the scores of different stage of residents, and the satisfaction of cervical cancer postoperative patients to medical care under different process management mode. SPSS 22.0 software was used for t test and chi-square test. Results:The application of "internet + mobile medicine" in standardized residency training obtained positive evaluation both by teachers and residents, and the ratio of considering "necessary" to reform the traditional residency training management mode in residents [95.1%(39/41)] and administrators [92.9%(13/14)] were both higher than that in instructors [62.1%(18/29)]. And 78.6%(11/14) of the administrators believed that cloud data management took less time. After 6 months of process management by different modes, the clinical diagnosis and treatment ability and skill operation ability scores of observation group were higher than those of control group [(93.6±5.6) vs. (89.4±5.7); (89.6±8.8) vs. (84.0±8.7)]. The "overall medical satisfaction rate" of cervical cancer patients was relatively high in both groups [100%(30/30) vs. 93.3%(28/30)], and the "very satisfied rate" of patients in the mobile medical group was higher than that in the traditional group [86.7%(26/30) vs. 63.3%(19/30)].Conclusion:The application of "internet + mobile medicine" is conducive to strengthening the process management and optimizing the quality of standardized residency training management of obstetrics and gynecology.

Effect of dual wavelength laser in the treatment of chronic periodontitis and the influence of cytokines in gingival crevicular fluid / 中国医师进修杂志

Objective:To investigate the clinical efficacy and prognostic factors of Neodymium doped: Yttrium Aluminum Garnet (Nd:YAG ) laser combined with Erbium:Yttrium Aluminum Garnet (Er:YAG) laser assisted subgingival scaling root planing (SRP) in the treatment of periodontitis.Methods:A prospective research method was adopted. A total of 66 patients with periodontitis treated in Hebei Chest Hospital from August 2018 to August 2020 were selected and divided into experimental group and control group according to the random number table method, with 33 cases in each group. The control group was treated with SRP, and the experimental group received Er:YAG laser curettage combined with root surface leveling on the basis of SRP, and irradiated the periodontal pocket with Nd:YAG laser. The changes of periodontal clinical indicators and cytokine levels in gingival crevicular fluid were examined before treatment, 4 weeks and 12 weeks after treatment. The patients were divided into PD<3 mm group and PD ≥ 3 mm group according to the probing depth (PD) of periodontal pocket after 12 weeks of treatment, the clinical data of the two groups were compared and analyzed, and the Logistic regression analysis was performed to analyze the risk factors affecting the prognosis of patients with periodontitis after laser treatment.Results:After 4 and 12 weeks of treatment, the PD, clinical attachment loss (CAL), sulcus bleeding index (SBI) and plaque index (PLI) of the two groups were significantly lower than those before treatment ( P<0.05), and the PD, CAL, SBI and PLI in experimental group were significantly lower than those in control group, after 4 weeks of treatment: (3.36 ± 0.21) mm vs. (3.91 ± 0.39) mm, (4.14 ± 0.67) mm vs. (4.75 ± 0.73) mm, (1.83 ± 0.20) scores vs. (2.58 ± 0.17) scores, (1.29 ± 0.24) scores vs. (1.61 ± 0.52) scores; after 12 weeks of treatment: (3.04 ± 0.28) mm vs. (3.66 ± 0.54) mm, (3.91 ± 0.47) mm vs. (4.68 ± 0.66) mm, (0.88 ± 0.06) scores vs. (1.35 ± 0.14) scores, (1.05 ± 0.31) scores vs. (1.57 ± 0.56) scores, the differences were statistically significant ( P<0.05). After 12 weeks of treatment, the levels of interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor-α (TNF-α), matrix metalloproteinase-8 (MMP-8) and interleukin-1β (IL-1β) in gingival crevicular fluid in experimental group were significantly decreased compared with those in control group: (2.95 ± 0.19) μg/L vs. (4.32 ± 0.84) μg/L, (2.63 ± 0.82) μg/L vs. (3.58 ± 0.51) μg/L, (12.42 ± 1.19) μg/L vs. (13.26 ± 0.68) μg/L, (4.15 ± 1.12) ng/L vs. (5.36 ± 0.42) ng/L, (2.65 ± 0.08) ng/L vs. (4.12 ± 0.19) ng/L, the differences were statistically significant ( P<0.05), while the level of transforming growth factor-β (TGF-β) was significantly increased compared with that in control group: (51.35 ± 8.95) ng/L vs. (44.90 ± 5.84) ng/L, and the differences between the groups were statistically significant ( P<0.05). Logistic regression analysis showed that the clinical indexes PD, SBI, PLI, IL-6, IL-8, TNF- α, MMP-8, IL-1β and crown root ratio of gingival crevicular fluid were all the risk factors for prognosis of periodontitis treated with dual wavelength laser ( P<0.05). Conclusions:Nd:YAG laser combined with Er:YAG laser assisted SRP can obtain good curative effect in the treatment of periodontitis. Periodontal clinical indexes PD, SBI, PLI, gingival crevicular fluid IL-6, IL-8 and TNF-α, MMP-8, IL-1β level and crown root ratio were independent risk factors for the prognosis of periodontitis treated with dual wavelength laser.

Risk factors of hydrocephalus secondary to severe intraventricular hemorrhage in preterm infants / 中国新生儿科杂志

Objective:To study the risk factors of secondary hydrocephalus after severe intraventricular hemorrhage (IVH) in preterm infants for prevention and early identification of post-hemorrhagic hydrocephalus (PHH).Methods:From June 2013 to June 2021, preterm infants with severe IVH admitted to our hospital were retrospectively analyzed. They were assigned into PHH group and non-PHH group. Rank sum test or chi-square test was used for comparison between the two groups and multivariate logistic regression analysis was used to analyze the risk factors of PHH in preterm infants.Results:A total of 246 preterm infants with severe IVH were enrolled, including 68 cases (27.6%) in the PHH group and 178 cases (72.4%) in the non-PHH group. Multivariate logistic stepwise regression analysis showed that male gender ( OR=2.014, 95% CI 1.063-3.817), gestational age ≤30 week ( OR=2.240, 95% CI 1.210-4.146), 5-min Apgar score ≤5 ( OR=3.980, 95% CI 1.483-10.685), placental abruption ( OR=2.940, 95% CI 1.324-6.531) were independent risk factors for PHH in preterm infants and thrombocytopenia was the protective factor for PHH in preterm infants ( OR=0.305, 95% CI 0.147-0.632). The incidence of moderate thrombocytopenia in non-PHH group was significantly higher than PHH group ( P<0.05). No significant differences existed in the incidences of mild and severe thrombocytopenia between the two groups ( P>0.05). Conclusions:Male gender, gestational age ≤30 week, 5-min Apgar score ≤5, placental abruption are risk factors for PHH in premature infants with severe IVH and moderate thrombocytopenia has protective effects.

Risk factors for retinopathy of prematurity in very low birth weight infants / 中国新生儿科杂志

Objective:To study the risk factors for retinopathy of prematurity (ROP) in very low birth weight infants (VLBWIs).Methods:From October 2020 to December 2021, VLBWIs with gestational age(GA) ≤32 weeks admitted to the neonatal department of our hospital were retrospectively studied. According to the occurrence of ROP, they were assigned into ROP group and non-ROP group. The clinical data of the two groups were compared and the risk factors of ROP in VLBWI were analyzed.Results:A total of 251 VLBWIs were enrolled, including 60 cases (23.9%) in ROP group and 191 (76.1%) in non-ROP group. The GA and birth weight (BW) of ROP group were significantly lower than non-ROP group [28(26,30) w vs. 29(28,31) w, 1 035(840,1 285) g vs. 1 260(1 110,1 380) g, respectively, all P<0.001]. The ROP group had longer duration of oxygen therapy [42.0(26.0, 53.5) d vs. 24.0(18.0, 34.0) d], higher incidences of blood transfusion [2.5(1.0, 3.0) times vs. 2.0 (1.0, 2.0) times] and hyperglycemia (80.0% vs. 16.8%), higher average [(5.6±0.5) mmol/L vs. (5.1±0.5) mmol/L] and peak [10.4(7.8,13.2) mmol/L vs. 6.5(6.1,6.8) mmol/L] blood glucose levels in the first week than the non-ROP group (all P<0.001). Multivariate analysis showed that longer duration of oxygen therapy ( OR=1.047, 95% CI 1.008-1.087, P=0.018) and higher peak blood glucose level in the first week ( OR=1.268, 95% CI 1.092-1.474, P=0.002) were the independent risk factors for ROP. Conclusions:Longer duration of oxygen therapy and higher peak of blood glucose level in the first week are risk factors for ROP in VLBWIs.

The assessment value of endothelial glycocalyx degradation products in pulmonary edema patients with acute respiratory distress syndrome / 中华急诊医学杂志

Objective:To investigate the application of endothelial glycocalyx degradation products in assessing the severity of pulmonary edema in patients with acute respiratory distress syndrome (ARDS).Methods:A prospective study was conducted to select patients diagnosed with ARDS at Wuxi People's Hospital from July 1, 2018 to December 31, 2019. The extravascular lung water index (EVLWI) was recorded within 2 h after admission by continuous cardiac output with pulse indicator. The indexes of glycocalyx degradation products syndecan-1 (SDC-1), heparan sulfate (HS), hyaluronic acid (HA) and the concentrations of inflammatory factors [blood tumor necrosis factor α (TNF-α), interleukin (IL)-6 and IL-10] were measured by enzyme-linked immunosorbent assay. Pearson correlation method was adopted to analyze the correlation of glycocalyx degradation products with EVLWI and inflammatory factors in ARDS patients. The patients were divided into the mild pulmonary edema group and severe pulmonary edema group according to EVLWI at the cut-off value of 10 mL/kg, and the differences of glycocalyx degradation products and inflammatory factors between the two groups were compared. Receiver operating characteristic (ROC) curve of the subjects were plotted to analyze the value of glycocalyx degradation products in determining the severity of pulmonary edema.Results:A total of 85 ARDS patients were enrolled. Pearson correlation analysis showed that SDC-1, HS, and HA were all positively correlated with IL-6, TNF-α, EVLWI (all P<0.05), but did not correlate with IL-10 (all P>0.05). Comparison of indicators between the mild pulmonary edema group (39 cases) and the severe pulmonary edema group (46 cases) showed that: IL-6[(33.63±3.43) ng/L vs. (39.99±4.64) ng/L], TNF-α[(43.38±6.05) ng/L vs. (50.79±7.35) ng/L], SDC-1[(494.13±47.23) ng/L vs. (563.50±56.36) ng/L], HS[(114.02±18.39) ng/mL vs. (138.93±17.02) ng/mL], and HA[(441.44±62.52) ng/mL vs. (546.23±85.24) ng/mL] were statistically different between the two groups(all P<0.05). Whereas, IL-10 [(24.37±10.11) ng/L vs. (28.75±11.98) ng/L] was not statistically different between the two groups ( P>0.05). ROC curve analysis showed that the combined prediction of SDC-1, HA and HS indicators was superior to the single indicator. The area under the ROC curve combining the three indicators was 0.928 (95% CI: 0.872-1.000), with a sensitivity and specificity of 87.5% and 86.7%, respectively. Conclusions:There is a positive correlation between glycocalyx degradation products SDC-1, HS, HA and EVLWI in ARDS patients. The application of these three glycocalyx degradation products can be used as a reliable indicators for judging the severity of pulmonary edema in ARDS patients.

Practice and effect of construction of rational drug use mode of PIVAS by the activities of quality control circle / 药学实践杂志

Objective To establish a rational drug use model of PIVAS and promote the rational drug use in clinical practices by enhancing the quality of prescription review by pharmacists. Methods The PIVAS physician orders received from 2014 to 2021 were extracted through the hospital information management (HIS) system. The types of irrational physician orders were statistically analyzed, the improvements were made by the method of quality control circle (QCC). Results The model of PIVAS rational drug use formed a standardized process. The proficiency of physician order review was improved. From 2014 to 2021, the number and proportion of unreasonable physician orders in PIVAS decreased year by year. Every type of unreasonable physician orders was improved year by year. Conclusion The professional and technical levels of pharmacist for physician order review at our hospital were improved by the model of PIVAS rational drug use. The quality of pharmaceutical service was significantly improved which ensured the safety of patients' medication.