Objective To investigate the prevalence of undernutrition, nutritional risks, and the application of nutrition supports in different hospitals in Shandong province, and to estimate the related complication rate.Methods Totally 2792 patients from different hospitals in Shandong were enrolled, and their nutritional risks were assessed using Nutritional Risk Screening (NRS) 2002. The application of nutritional supports, the length of hospital stay, and the incidences of infectious and non-infectious complications were documented. Results The incidences of undernutrition and nutritional risk among patients in large hospitals were significantly higher than those in middle and small hospitals (5.6%, 1.6%, 2. 7%; 27.3%, 15.4%, 18.3%; P =0. 000). The overall rate of nutritional support was 43. 60%, and there were significant difference among patients in different hospitals (51.5 %, 30. 8 %, 20.9 %, P = 0. 000). Parenteral nutrition was most widely applied. Among the 483 patients in large hospitals, the incidence of complication in patients with nutritional risks was significantly higher than those without nutritional risks (31.3% versus 13.7%, P =0. 000). Of the "with nutritional risk" patients, the infectious complications were significantly lower in the nutritional support group (P = 0. 000). Of the patients without nutritional risks, there was no statistical difference between the nutritional support group and the non-support group. (P ＞ 0. 05). Conclusions NRS 2002 is a useful tool for the assessment of nutritional status among inpatients. Proper nutritional support can reduce the incidence of complications for patients with nutritional risks.

Objective To integrate the self-developed Web-based early warning management system into EMR system to decrease average medical fee as well as the occurrences of cost overrun,arrearage for self-paid fee and etc.Methods The method mapped into image for users' browse based on using the user-defined URL extension characteristic of EMR system,combining the advantages of Web platform in handling Http request,applying Java as well as SQL technology to obtain source data,integrating statistical analysis for multi-dimensional comparative analysis as well as visualization technology.Results This system changed the behavior pattern of early warning and supervision in course,relieved work burden of medical staffs,and helped hospital achieve high economic management benefit.Conclusion The application of crossplatform system realizes high effect and provides approaches for expanding other functions.

The First Hospital Affiliated to Xi'an Jiaotong University adopted PDCA cycle management tool and used planning,implementing,inspection,processing and other links in the specific application of promoting hospital social evaluation.After a certain stage,we summed up the work and changed the chaotic work status of social evaluation management.Comparing with the existing literature,this paper concluded that the application of this tool can promote the research of hospital quality and service management,promote the practice of building harmonious doctor -patient relationship.It is worth to promote the application of PDCA cycle management in hospital social evaluation.

Objective:To study clinical features of rheumatoid arthritis (RA) patients with peripheral neuropathy (PN).Methods:The clinical data of 46 RA patients with PN in the First Affiliated Hospital of Zhengzhou University from August 2012 to August 2019 were retrospectively analyzed, including clinical manifestations, laboratory and imaging results, previous treatment, treatment and clinical outcome. The other 92 RA patients without PN at the same period were selected as controls.Results:In RA patients with PN, the male to female ratio was 1∶2.1 with an average age (59.1±11.8) years. The course of RA and PN was 102.0 (19.0-156.0) months and 4.2 (0.7-5.5) months respectively. Numbness (84.8%, 39/46) and muscle weakness (21.7%, 10/46) were the most common symptoms. According to results of electromyography, polyneuropathy (60.0%, 27/46) was the predominant manifestation, followed by mononeuritis multiplex (31.1%, 14/46). Compared to RA patients, rheumatoid factor (RF) ( P<0.001) and the percentage of cutaneous vasculitis ( P=0.042) were higher in RA patients with PN. Logistic regression analysis revealed significant correlation between RF>178.4 IU/ml ( OR＝5.626, 95% CI 2.509-12.618, P<0.001) and development of PN. Paresthesia in 27 patients (58.7%, 27/46) were relieved after treatment of high dose glucocorticoid and immunoglobulins (IVIG). Twelve patients were followed up regularly and the mean duration of follow-up was 17.0(4.8-52.8)months. Paresthesia in 10 (10/12) patients were relieved compared to that at discharge, 1 (1/12) patient achieved complete remission. Conclusion:Numbness and muscle weakness are the common symptoms in RA patients with PN and polyneuropathy is the main type. RF>178.4 IU/ml is correlated with the development of PN in RA patients. Intensive treatment such as high dose glucocorticoid and IVIG are effective.

In order to investigate the expression levels of Pin1 mRNA and protein in cervical cancer and its association with Ki67 and their clinical significance, amplification of Pin1 gene was examined by RT-PCR, and the expression of both Pin1 and Ki67 protein was detected by immunohistochemistry in cervical cancer tissues. It was shown that the expression levels of Pin1 were higher in cervical cancer than in normal cervical tissues (P < 0.05). The expression of Pin1 protein was increased progressively along with the disease process from normal cervix to CIN and to cervical cancer (P < 0.05). No significant difference in the Pin1 expression was found between disease stages (FIGO), pathological grades or pelvic lymph node metastasis status (P > 0.05). The expression of Pin1 was significantly higher in adenocarcinoma than in squamous carcinoma of the uterine cervix (P < 0.05). In cervical cancer, the overexpression of Pin1 was positively correlated with that of Ki67 (P < 0.05). These results suggested that the overexpression of Pin1 was closely related with cancer cell proliferation or progression of cervical cancer and contributed to oncogenesis. Pin1 may serve as a potential marker for cervical cancer diagnosis.
Cervical Intraepithelial Neoplasia/metabolism ; Ki-67 Antigen/*biosynthesis ; Ki-67 Antigen/genetics ; Peptidylprolyl Isomerase/*biosynthesis ; Peptidylprolyl Isomerase/genetics ; Tumor Markers, Biological ; Uterine Cervical Neoplasms/*metabolism

Objective To observe the early changes of related indexes after high dose of 60Co γ-ray irradiation on rhesus monkey hematopoietic system.Methods A total of 33 rhesus monkeys were randomly divided into normal control and different irradiation control group,rhesus monkeys in irradiation control group were given different doses(4,8,12 Gy) irradiation to establish acute radiation sickness(ARS) models.XE-2100 automatic blood cell analyzer detected the peripheral blood before and after the irradiation of 3,6,9,12,24,48,80 h.The rhesus monkeys were sacrificed to have a observation of sternum pathological changes at 6,48 and 80 h after 4,8,12 Gy 60Co γ-ray irradiation.Results The number of white blood cell in peripheral blood of the rhesus monkeys after 4 and 8 Gy 60Co γ-ray irradiation were lower than that before irradiation at 3 h after irradiation,as was significant increased at 6 h after irradiation,the highest values were 136.04%.and 221.38% after 9 h(with before irradiation values was 100.00%,the same below),become obviously drooped from 12 h after irradiation,show clearly temporary peak.But the number of white blood cell after 12 Gy 60Co γ-ray irradiation was significant increased at 6 h after irradiation,at the highest of 9 h,become obviously drooped from 12 h after irradiation.Peripheral blood neutrophile count was significant increased at 6 h after irradiation,at the highest of 9 h,become obviously drooped from 12 h after irradiation.Peripheral blood lymphocyte count fell sharply after irradiation,3 h detection value was only 12.02%-25.04% of before irradiation.Sternal bone marrow nucleated cell number decreased sharply after irradiation,the more irradiation dose,the less residual hematopoietic cells.Conclusion In the early stage of BM-ARS,temporary peaktime node of the white blood cell and neutrophil count could be regarded as the best delivery time of hematopoietic cytokine therapy.

Objective To investigate the risky sexual behaviors,associated factors and characteristics of sexual network among clients receiving methadone maintenance treatment (MMT) at the clinics in Taizhou prefecture of Zhejiang province.Methods A cross-sectional survey was conducted.Data was collected through questionnaire and from the national unified MMT system.Urine was collected to test heroin,methamphetamine,3,4-methylenedioxymethamphetamine (MDMA) and ketamine.Blood was collected to test infections on HIV,hepatitis C vims(HCV) and syphilis.Results Totally,362 clients were recruited.Most of the clients were male (88.7％),31--40 year-olds (54.5％),married (61.6％) and having received junior high school education (56.6％).85.1％ of them received urine test with 82(26.6％) positive for heroin,21 (6.8％) positive for methamphetamine,19 (6.2％) positive for MDMA and none for ketamine.77.1％ of them received blood test,and prevalence rates for HIV,HCV and syphilis were 1.1％,36.7％ and 3.6％.19.5％ of the clients who had sex in the past 6 months.Factors as having multiple sexual partners and positive for club drugs were under higher risk.Sexual networking seemed to be loose,linear and acyclic among this population but overlapping with the drug-using network.Conclusion Effective and targeted interventions should be taken among the MMT clients since continuing drug use and HIV/STD related sexual behavior were found common in them,suggesting there was a risk of HIV/STD transmission in this ppulation.

BACKGROUND:Endoplasmic reticulum stress participates in the occurrence and development of many diseases, such as atherosclerosis, diabetes, and Alzheimer’s disease. GRP78 is a marker of endoplasmic reticulum stress. The expression of GRP78 reflects the degree of endoplasmic reticulum stress.
OBJECTIVE:To investigate the effect of cyclic stretch on GRP78 expression of L6 rat myoblasts, and to identify the relationship between cyclic stretch and endoplasmic reticulum stress.
METHODS:In vitro culture-tensile stimulation models of myoblasts of L6 rats were established successful y. The expression of GRP78 of myoblasts exposed to cyclic stretch was determined by reverse transcription-PCR and western blot assay. Stretch groups were subjected to 15%surface elongation at a frequency of 10 cycles per minute, over a period of 1, 6, 12 and 24 hours. cells were simultaneously seeded on a plate in the control and experimental groups with no stimulation.
RESULTS AND CONCLUSION:The expression of GRP78 mRNA was continuously elevated over time after stretched treatment, and significant differences were detected as compared with the control group (P<0.05). GRP78 protein expression began to increase at 1 hour after stretched treatment, was significantly increased at 6 hours, peaked at 24 hours, and significant differences were visible as compared with the control group (P<0.05). In conclusion, cyclic stretch induced the occurrence of endoplasmic reticulum stress, which was enhanced with prolonged time. However, prolonged stretch caused severe endoplasmic reticulum stress and leaded to apoptosis of myoblasts.

BACKGROUND:The adaptive reconstruction of maxil ofacial muscles would happen when functional orthopedic treatment is done to cure micromaxil ary deformity. The myoblast is the main responder in the process of adaptive reconstruction, and cyclic stretch can induce apoptosis of myoblasts. Caspase-9 is an important factor in the mitochondrial apoptosis pathway.
OBJECTIVE:To investigate the expression of Caspase-9 in different cyclic stretch.
METHODS:Based on myoblasts cultured in vitro-mechanical stimulation model, the rat L6 myoblasts were loaded stretch for 1, 6, 12 and 24 hours through multi-channel cellstress loading system, while the control group received no stretch. The morphological change and growth of myoblasts were observed under inverted phase contrast microscope;the expression of the mRNA and protein of Caspase-9 were detected by RT-PCR and western blot analysis, respectively.
RESULTS AND CONCLUSION:Under inverted phase contrast microscope, the rat L6 myoblasts at cyclic stretch maintained a good growth state and biological characteristics;there was no celldegeneration;and the loss rate was extremely low, which could demonstrate that myoblast in vitro-mechanical stimulation model was established successful y. The results of RT-PCR and western blot analysis showed that, the expression of Caspase-9 mRNA and Cleaved Caspase-9 protein was significantly increased as the loading time prolonged, and the expression of Procaspase-9 protein was significantly decreased as the time. We can conclude that Caspase-9 is involved in the mechanical signal transduction of cyclic stretch.

Objective:To carry out a scoping review on feeding decision aids in patients with advanced dementia, clarify the characteristics, functions, and application effects of the tools, so as to provide reference for further clinical research.Methods:The research on feeding decision aids for patients with advanced dementia was systematically searched on China National Knowledge Infrastructure (CNKI) , VIP, WanFang Data, and the China Biomedical Literature Library, PubMed, Web of Science, Embase, and Cochrane Library. The search period was from database establishment to August 2022. Two researchers independently selected literature based on inclusion and exclusion criteria, extracted, summarized and analyzed data from the included literature.Results:A total of 8 decision aids were included. The main types included web-based decision aids, paper text decision support manuals, audio manual form decision aids, and a combination of various forms of decision aids. Decision aids provided dementia feeding related information to patients and surrogate decision-makers, analyzed the advantages and disadvantages of different feeding methods, helped clarify their value preferences, and assisted them in making feeding decisions. The evaluation of application effectiveness mainly included outcome indicators such as knowledge, decision conflict, decision regret, decision satisfaction, frequency of doctor-patient communication, and acceptability and effectiveness of decision aids.Conclusions:Decision aids have played a positive role in selecting feeding methods for dementia patients and surrogate decision-makers. Under the background of "Internet + nursing service", we can learn from the experience of foreign research and make full use of artificial intelligence technology to explore scientific and feasible personalized decision aids, so as to provide demand based decision support for patients and their surrogate decision-makers and improve the quality of decisions.