Objective To investigate the application value of multifunctional dynamic flat panel X-ray detector in intravenous pyelography.Methods Total 540 patients with intravenous pyelography were divided into multifunctional dynamic flat panel X-ray detector group (300 cases) and conventional flat panel X-ray detector group (240 cases) by random digits table method.Image quality,radiation dosage and examination time were analyzed and compared between the two groups.Results There was no statistical difference between the two groups in image quality (P ＞ 0.05).The examination time and radiation dosage was (25.5 ± 8.2) min and (12.5 ± 6.8) mAs respectively in multifunctional dynamic flat panel X-ray detector group and (39.2 ± 12.1) min and (23.6 ± 7.6) mAs in conventional flat panel X-ray detector group.The differences had statistical significance (P ＜ 0.01).Conclusions Multifunctional dynamic flat panel X-ray detector in intravenous pyelography can provide lower radiation dose,shorter examination time and higher image quality.It has obvious advantages in urography.

Objective To study the relationship between reactive oxygen species (ROS) as well as total antioxidant capacity ( TAC ) within follicle fluid and body mass index ( BMI ) in patients with polycystic ovary syndrome (PCOS).Methods All patients enrolled in this study were infertile women receiving in vitro fertilization-embryo transfer (IVF-ET) treatment.55 PCOS patients were divided into over-weight group ( n =23 ) and non-over-weight group ( n =32 ).Another 55 age-matched non-PCOS women were also divided into control group ( n =30) and overweight group ( n =25 ).Plasma sex hormone,triglycerides,and total cholesterol were determined.On oocyte retrieval day after ovarian stimulation,ROS and TAC in follicular fluid were assayed.Results Subjects in over-weight and PCOS over-weight groups had higher triglycerides than those in control and PCOS non-over-weight groups [ ( 1.9 ±1.1,1.7 ± 0.9,1.0 ± 0.5,1.2 ± 0.7 ) mmol/L,respectively,all P＜0.05],so did total cholesterol [ ( 4.8 ± 1.2,5.2 ± 1.1,4.0 ± 0.6) mmol/L,respectively,all P＜0.05].In PCOS over-weight group,ROS and ROS/TAC within follicular fluid were ( 35.4 ± 6.7 ) RLU/S and 39.8 ± 22.0,both were higher than those in the other 3 groups ( all P＜0.05).TAC [ (0.8 ± 0.5 ) Mm] was lower in PCOS over-weight group than that among the other 3 groups( all P＜0.05 ).ROS/TAC was higher in PCOS non-over-weight group than that of control group ( 26.5 ± 14.5 vs 14.2 ± 12.5,P＜0.05 ).Univariate analysis showed that both ROS and ROS/TAC within follicular fluid in PCOS patients were positively correlated with BMI ( r =0.34 and r =0.32,both P＜0.05 ).Conclusion Abnormal oxidative stress exists in follicular fluid of PCOS patients,and the oxidative stress parameters show positive correlation with BMI.

Objective To investigate the status on health‐related knowledge and skills among the patients in the Chongqing area and to provide basis for developing public health‐related knowledge and skills .Methods Seven hundred and sixty‐eight patients from 8 general hospitals were sampled ,using the stratified random sampling method .A cross‐sectional investigation on health literacy was conducted with questionnaire“ health awareness survey of patients”,and SAS8 .0 was used to statistically analyze the data .Results The awareness rate of health literacy in Chongqing was 4 .82% .As for the 3 health literacy related aspects including basic health concept and knowledge ,health lif‐estyle and behaviors ,and the health related skills ,the rates were 16 .28% ,2 .21% and 38 .41% respectively .Besides ,the rate of the 5 as‐pects including health conception ,the prevention of infection ,the prevention of chronic diseases ,the safety and the first aid ,the basic medical treatment of analysis were 10 .68% ,20 .31% ,8 .59% ,23 .57% ,10 .68% respectively .There noticed significant differences in different re‐gions ,education ,profession ,the condition of relatives engaged in medical ,medical insurance category(P<0 .05) .Profession and the condition of relatives engaged in medical were the main influencing factors on the level of health‐related knowledge and skills among the patients(P<0 .05) .Conclusion The prevalence of basic health‐related knowledge and skills is low in Chongqing city and we should make comprehensive interventions to improve health liter of patients .

This article was aimed to study effect of D-ribose on the high-energy phosphate metabolism of skeletal muscle tissues of tired mice. The model was made by burden swimming. And then, the mice were divided into four groups, which were the model group, D-ribose group, caffeine group, and D-ribose with caffeine group). Intragastric administrations of drugs were given to all mice in four groups, three times per day. And all mice continued to swim for three days. The time of swimming was recorded. Gastrocnemius of mice were removed after swimming or 3 days later to measure the concentration of ATP, ADP, AMP and IMP with the HPLC. The results showed that compared with the control group, the time of burden s wimming was significantly prolonged for mice in the D-ribose group and the D-ribose with caffeine group. After three-day recovery, the concentration of ATP, AMP and IMP of gastrocnemius in the D-ribose group and the D-ribose with caffeine group mice was significantly increased. There was no significant difference in the caffeine group mice. It was concluded that D-ribose is involved in the high-energy phosphate metabolism of skeletal muscle tissues of tired mice . D-ribose promotes the recovery of ATP concentration in the gastrocnemius of tired mice, and prolongs the time of burden swimming. Therefore, it has a certain anti-fatigue effect .

Objective: To investigate the perceptions towards preoperative assessment of the elderly patients undergoing elective surgery among surgical nurses, providing scientific basis for standardizing preoperative assessment. Methods: Eleven nurses were chosen in surgical ward. Data were collected by using semi-structured in-depth interviews and were analyzed with the Colaizzi method. Results: Four themes were extracted: Necessity of surgical nurses for preoperative assessment of elderly patients undergoing elective surgery; Perceptions towards the contents of preoperative assessment; Current status of preoperative assessment; Suggestions for preoperative assessment. Conclusions Surgical nurses play an important role in preoperative assessment of elderly patients undergoing elective surgery and they emphasize the comprehensive preoperative assessment contents. However, comprehensive geriatric assessment is rarely used, lacking of uniform and standard criteria. We suggest to standardize preoperative assessment, improving the implementation rate and perioperative care, thus promoting rehabilitation.

Objective:To conduct Meta-analysis of the effectiveness of improved activity mode in prevention of peripherally inserted central catheter (PICC) related thrombosis in tumor patients.Methods:PubMed, The Cochrane Library, CNKI, Wanfang Database and VIP database were conducted computer retrieval of studies on improved activity mode and PICC related thrombosis in tumor patients from January 1, 2010 to December 31, 2019. A total of two researchers independently screened literature, extracted data and evaluated the quality of literature. The RevMan 5.3 software was used for Meta-analysis of the included studies.Results:A total of 7 randomized controlled trials (RCT) were included in this study. Meta-analysis results showed that compared with the conventional catheterization side upper limb exercise group, the incidence of catheter-related venous thrombosis in tumor patients in the improved activity mode group was reduced ( OR=0.22, 95% CI=0.13-0.38, P<0.01) , and the maximum blood flow velocity of the axillary vein was increased ( MD=1.03, 95% CI=0.64-1.42, P<0.01) . Conclusions:Improved activities on the limb of catheterization can effectively accelerate the blood flow velocity of the axillary vein after PICC catheterization in tumor patients and reduce the occurrence of catheter-related venous thrombosis.

Objective To analyze the risk factors of intraoperative hypothermia in patients undergoing radical thyroidectomy under laparoscopy and to construct a nomogram prediction model. Methods A total of 336 patients who underwent laparoscopic radical thyroidectomy were selected as study subjects. According to intraoperative body temperature, they were divided into hypothermia group (195 cases) and normal temperature group (141 cases). The risk factors of intraoperative hypothermia in patients undergoing laparoscopic radical thyroidectomy were analyzed using the Logistic regression model. The nomogram prediction model was constructed using R software. The prediction performance of the nomogram prediction model was evaluated using the receiver operating characteristic (ROC) curve, calibration curve, and Hosmer-Lemeshow goodness-of-fit test. Results There were significant differences in age, intraoperative blood loss, amount of fluid infusion, and operation time between the two groups (P < 0.05). Multivariate Logistic regression analysis showed that age>60 years, intraoperative blood loss >60 mL, amount of fluid infusion>1 000 mL, and operation time>2.5 h were risk factors for intraoperative hypothermia in patients undergoing laparoscopic radical thyroidectomy (P < 0.05). A nomogram prediction model was constructed based on the four risk factors. The ROC curve showed that the area under the curve was 0.912 (95%CI, 0.884 to 0.941). The calibration curve and Hosmer-Lemeshow goodness-of-fit test showed that the slope of the calibration curve was close to 1 (χ²=9.140, P=0.243). Conclusion The nomogram prediction model based on age, intraoperative blood loss, amount of fluid infusion, and operation time has good predictive value for intraoperative hypothermia in patients undergoing laparoscopic radical thyroidectomy.

OBJECTIVE：To evalua te the economics of glecaprevir/pibrentasvir （G/P）versus elbasvir/grazoprevir （EBR/GZR） in chronic hepatitis C genotype 1b（GT1b）treatment-naive patients without cirrhosis ，and to provide evidence support for medical and health decision-making. METHODS ：Under assuming the bid price of G/P and EBR/GZR therapy schemes before medical insurance negotiation was adopted （scenario 1）and assuming that the price of EBR/GZR was reduced by 85％ and the price of G/P was reduced by 80％（scenario 2），Markov model was developed to simulate the lifetime cost and health outcomes progress of 10 000 untreated chronic hepatitis C GT 1b treatment-naive patients without cirrhosis and calculate incremental cost-effectiveness ratio（ICER）. Single factor sensitivity analysis and probability sensitivity analysis were conducted to verify the results. The highest price（price reduction ratio ）of G/P scheme was analyzed with cost-effectiveness advantage ，when other parametes kept stable under scenario 2. RESULTS ：Under 2 kinds of scenarios ，compared with EBR/GZR scheme ，G/P scheme had higher cost （scenario 1：68 800 yuan vs. 62 338 yuan；scenario 2：13 760 yuan vs. 11 490 yuan）and healty utility （scenario 1：14.97 QALY vs. 14.90 QALY；scenario 2：14.97 QALY vs. 14.90 QALY），and ICER value of G/P was lower than willingness-to-pay threshold （scenario 1：92 314 yuan/QALY；scenario 2：32 428 yuan/QALY）. The change of most parameters in single factor sensitivity analysis didn ’t influence the results of base-case analysis ，and the findings from the base-case analysis were confirmed by probability sensitivity analyses. The price of G/P scheme needed to be reduced by at least 62％ to realize cost-effective advantage. CONCLUSIONS ： Under the set price scenario ，G/P scheme has cost-effectiveness advantages than EBR/GZR scheme in chronic hepatitis C GT 1b treatment-naive patients without cirrhosis.

Retrospective analysis of the clinical data of a child with type 102 mental retardation caused by DDX3X gene mutation in the pediatric diagnosis of the First Affiliated Hospital of Zhengzhou University in April 2019.A 2 years and 3 months old girl with " delay for more than 1 year" , using second-generation sequencing technology for full exon detection, and the result is DDX3X gene 13 th exon c. 1463G>A hybridization mutation, this is a new mutation.There are no Chinese cases reported with DDX3X gene mutations, and there are 8 related cases were reported in foreign literature, all children have different degrees of intellectual disability.So patients with unexplained intellectual disability(especially female patients) need to be wary of the possibility of DDX3X gene mutation.

Objective To investigate the community structure and spatial distribution of wild myomorpha in the plague foci of Lianghe County,Yunnan Province.Methods From December 2015 to October 2016,in Mangdong,Hexi,Nangsong and other places in Lianghe County,forest landscape samples were randomly selected in different altitude gradients (1 000 ～,1 200 ～,1 400 ～,≥ 1 600 m).Peanut was used as a bait for trapping myomorpha,and the community structure of myomorpha was analyzed.Results A total of 663 myomorpha were collected and the density was 7.97％ (663/8 320),which were divided into 16 species,11 genus,5 families,and 3 orders.Rattus tanezumi (30.62％,203/663) was the dominant species.In the 1 000-＜ 1 200 m altitude gradient,the richness of myomorpha was the highest (13 kinds).In the 1 400-＜ 1 600 m altitude gradient,the index of diversity (2.094 2) was the highest.With the increase of altitude,the ecological dominance were increased,and the values were 0.672 2,0.774 2,0.842 8,and 0.882 4,respectively,whereas the evenness presented a decreasing trend,and the values were 0.269 2,0.197 1,0.142 8,and 0.162 0.Conclusions The Rattus tanezumi has presented a single dominant distribution at different elevation and the number and the species of the wild rodent with superior position have increased with the altitude increased in Lianghe focus.With the increase of altitude,the diversity and the evenness have increased,whereas the richness and the dominance have decreased.