OBJECTIVE To explore the suitable hospital infection control measures in health centers of poverty-striken villages,in order to improve the management of hospital infection,decrease hospital infection rate and protect the health of medical staff and patients.METHODS The status quo of hospital infection in health centers of poverty-striken villages,was investigated in 20 small towns health centers with were randomly divided into two groups:test group(n=15)and control group(n=5).The suitable hospital infection control measures were explored from 5 points.The effect of infection control by before-after controlled study of experimental group and randomized controlled study of control group was anal yzed.RESULTS The rate of hospital infection in test group was decreased from 7.60% to 1.98% and at in control group didn't change,the difference was significant.CONCLUSIONS The managements of establishment of the suitable hospital infection control measures in health centers of poverty-striken villages have been put into practice and gained good result.

Objective To explore the medication rules of Professor Gao Zhongying in treatment of chronic atrophic gastritis on basis of his curative prescriptions.Method Prof.Gao Zhongying clinic medical records were used as data resource.Database was built by using Traditional Chinese Medicine Inheritance Support System (Version 2.5).The core combination and assocical rules among the drugs were confirmed by frequency analysis and assocical rules analysis methods.Results We collected 60 clinical formulas including 83 kinds of Chinese herbs.The bighest frequency used simply drugs were Fritilariae Thunbergh Bulbus,Trichosanthis radix,Galli Gigerii Endothelium Corneum and so on.The most frequency drug combination were Fritilariae Thunbergh Bulbus,Trichosanthis radix,Fritilariae Thunbergh Bulbus,Galli Gigerii Endothelium Corneum,Trichosanthis radix,Galli Gigerii Endothelium Corneum,Fritilariae Thunbergh Bulbus,Curcumae Rhizoma and so on.The drug association rules of drug combination were 447 items.Conclusions The medication rules embodied the thoughts of Professor Gao Zhongying of replenishing qi to invigorate the spleen and regulating the stomach to moisten dryness was the main method in treatment of chronic atrophic gastritis and deficiency of spleen and dryness of stomach,which was the key pathogenesis in occurrence and development of chronic atrophic gastritis.

Harmful substances are produced during the metabolism of alcohol in the human body, which causes liver disease.The mechanism of oxidative stress is the main pathogenesis of alcoholic liver disease, which plays a major role in the occurrence and development of alcoholic liver disease.Alcohol-induced oxidative stress mediated by reactive oxygen species(ROS)/reactive nitrogen species(RNS) brings about liver disease via apoptotic signaling pathway and MAPK signaling pathway, and alleviates liver disease through Nrf2 signaling pathway.In this paper, the studies on the mechanism of oxidative stress in alcoholic liver disease are reviewed.

Objective: To explore aspirin resistance (AR) phenomenon in patients with coronary artery disease (CAD) for secondary prevention and to study the relationships between AR and COX1, COX2, TBXA2R gene polymorphisms. Methods: A total of 2881 CAD patients taken aspirin (100 mg/day) in 7 consecutive days were enrolled. Among them, 2 groups were established as AR group, n=166 and Control group, n=200 aspirin sensitive patients. Platelet aggregation function was induced by arachidonic acid (AA), COX1, COX2 and TBXA2R gene polymorphisms were examined by polymerase chain reaction-restricted fragment length polymorphisms (PCR-RFLP) method. Results: The occurrence rate of AR was 5.76% (166/2881). There were 8 tagSNPs locus in 3 genes as in COX1:(rs3842788), (rs4273915), (rs7866582); in: COX2 (rs3218625); in TBXA2R: (rs2238630), (rs2238631), (rs2238633), (rs3786989). The frequencies of wild type, heterozygous genotype and homozygous genotype were similar between 2 groups. Conclusion: The incidence rate of AR is not high in CHD patients with regular aspirin medication; single nucleotide gene polymorphisms of COX1, COX2 and TBXA2R have no obvious correlation to AR.

This paper summarized the development of "Internet + nursing service" in the first six provinces and cities, analyzed its characteristics and advantages, combed the existing problems, so as to further promote and develop "Internet + nursing service", so that the service can truly benefit the people.

Objective:To explore the status and influencing factors of physical activity, sedentary behavior in middle-aged and elderly patients with stable coronary heart disease, and to provide reference for clinical medical staff to formulate targeted intervention measures.Methods:This was a cross-sectional survey. From March to June 2022, a convenience sampling was used to select 378 middle-aged and elderly patients with stable coronary heart disease in the ward and clinic of Department of Cardiology, Jinshan Hospital, Fudan University. The general information questionnaire, the International Physical Activity Questionnaire, the Adult Sedentary Behavior Questionnaire, the Tampa Scale for Kinesiophobia Heart, the Self-efficacy for Chronic Disease Scale and the Social Support Rating Scale were used for investigation.Results:The total metabolic equivalent of physical activity and sedentary time in middle-aged and elderly patients with stable coronary heart disease were 31.40 (21.73, 49.67) MET-h/w and 8(7, 9) h/d respectively. The 39.7% (150/378) patients reached physical activity guidelines recommendations and 61.4% (232/378) patients had a sedentary time ≥ 8 h/d. The 19.0% (72/378) patients were identified as physically active/low sedentary group, 20.6% (78/378) patients were identified as physically active/high sedentary group, 19.6% (74/378) patients were in physically inactive/low sedentary group and 40.7% (154/378) patients were in physically inactive/high sedentary group. The stepwise multiple regression analysis showed that sedentary behavior, working status, kinesiophobia, objective support and disease duration had significant impacts on physical activity ( t values were -9.81-2.67, all P<0.05). The influencing factors of sedentary behavior were physical activity, objective support, support utilization, gender, educational level and kinesiophobia ( t values were -10.77-4.63, all P<0.05). Conclusions:The status of physical activity, sedentary behavior in middle-aged and elderly patients with stable coronary heart disease is not good. Medical staff should intervene corresponding influencing factors to reduce the risk of physical inactivity and high sedentary behavior in this group.

Objective:To evaluate the role of nuclear factor E2-related factor 2 (Nrf2)/heme oxidase-1 (HO-1) in reduction of renal ischemia-reperfusion (I/R) injury by the human umbilical cord mesenchymal stem cells (hucMSCs)-derived exosomes (hucMSCs-exo) in mice.Methods:The hucMSCs were cultured, and exosomes were extracted and identified by transmission electron microscopy, nanoparticle tracking analysis and Western blot. Thirty-six male SPF-grade C57BL/6 mice, weighing 20-25 g, were used. Thirty mice were selected and divided into 5 groups ( n=6 each) by a random number table method: sham operation group (Sham group), sham operation + Nrf2 inhibitor ML385 group (Sham + ML385 group), renal I/R group (I/R group), renal I/R + exosome group (I/R+ EXO group), and renal I/R + exosome + Nrf2 inhibitor ML385 group (I/R+ EXO+ ML385 group). A model of renal I/R injury was prepared by clamping the bilateral renal pedicles for 45 min followed by perfusion in anesthetized animals. ML385 30 mg/kg was intraperitoneally injected at 45 min before preparing the model in Sham+ ML385 group and I/R+ EXO+ ML385 group, and hucMSCs-exo 100 μg was injected via the tail vein at 15 min before reperfusion in I/R+ EXO group and I/R+ EXO+ ML385 group. Serum blood urea nitrogen (BUN) and creatinine (Cr) concentrations were detected at 24 h of reperfusion. The renal tissues were obtained for examination of the pathological changes and for determination of contents of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α) and malondialdehyde (MDA), superoxide dismutase (SOD) activity and reactive oxygen species (ROS) levels and expression of Nrf2 and HO-1 protein and mRNA (by Western blot and quantitative real-time polymerase chain reaction). The left 6 mice were allocated to sham operation group (Sham-IM group, n=3) and renal I/R group (I/R-IM group, n=3) by a random number table method for VISQUE in living imaging observation. Results:The exosomes showed a typical cup-shaped morphology with a transmission electron microscope, the nanoparticles tracked and analyzed the average diameter of the exosome, with an average diameter of 96.7 nm, and the positive expression of surface markers CD9, CD63 and TSG101 was detected using Western blot. The renal fluorescence intensity value was significantly increased in I/R-IM group as compared with Sham-IM group ( P<0.05). Compared with Sham group, the serum BUN and Cr concentrations were significantly increased, the contents of IL-6, TNF-α and MDA and ROS levels were increased, the activity of SOD was decreased, the expression of Nrf2 and HO-1 protein and mRNA was down-regulated ( P<0.05), and the pathological changes of renal tissues were aggravated in I/R group, and no significant change was found in serum BUN and Cr concentrations in Sham+ ML385 group ( P>0.05). Compared with I/R group, the serum BUN and Cr concentrations were significantly decreased, the contents of IL-6, TNF-α and MDA and ROS levels were decreased, the activity of SOD was increased, the expression of Nrf2 and HO-1 protein and mRNA was up-regulated ( P<0.05), and the pathological changes of renal tissues were significantly attenuated in I/R+ EXO group. Compared with I/R+ EXO group, the serum BUN and Cr concentrations were significantly increased, the contents of IL-6, TNF-α and MDA and ROS levels were increased, the activity of SOD was decreased, the expression of Nrf2 and HO-1 protein and mRNA was down-regulated ( P<0.05), and the pathological changes of renal tissues were aggravated in I/R+ EXO+ ML385 group. Conclusions:The mechanism by which hucMSCs-exo reduces renal I/R injury may be related to activation of the Nrf2/HO-1 signaling pathway in mice.

OBJECTIVETo explore if CHA2DS2 VASc score can predict substrate for persistent atrial fibrillation ( AF) and outcome post catheter ablation of AF.

METHODSFrom January 2011 to December 2012,116 patients underwent catheter ablation of persistent AF in our department and were enrolled in this study. CHA2DS2VASc score was calculated as follows: two points were assigned for a history of stroke or transient ischemic attack and age ≥ 75 and 1 point each was assigned for age ≥ 65, a history of hypertension, diabetes,recent cardiac failure, vessel disease, female. Left atrial geometry ( LA) was reconstructed with a 3.5 mm tip ablation catheter with fill-in threshold 10 in CARTO system. The mapping catheter was stabled at each endocardial location for at least 3 seconds for recording. The electrogram recordings at each endocardial location were analyzed with a custom software embedded in the CARTO mapping system. Interval confidence level (ICL) was used to characterize complex fractionated atrial electrograms (CFAEs) . As the default setting of the software, ICL more than or equal to 7 was considered sites with a highly repetitive CFAEs complex. CFAEs index was defined as the fraction of area of ICL more than or equal to 7 to the left atrial surface. The CFAEs index and outcome of catheter ablation among different CHA2DS2VASc groups were compared.

RESULTSOf the 116 patients, CHA2DS2VASc was 0 in 33 patients, 1 in 31 patients and ≥ 2 in 52 patients. Left atrial surface ((121.2 ± 18.9) cm2, (133.6 ± 23.8) cm2, (133.9 ± 16.1) cm2, P = 0.008), left atrial volume ((103.6 ± 24.8) ml, (118.3 ± 27.8) ml, (120.9 ± 20.9) ml, P = 0.005) and CFAEs index (44.6% ± 22.4%, 54.2% ± 22.2%, 58.7% ± 23.1%, P = 0.023) increased in proportion with increasing CHA2DS2VASc. ICLmax, ICLmin and CFAEs spatial distribution were similar among the three groups. During the mean follow-up of (13 ± 8) months, the recurrence rate were 36.4%, 35.5%, 55.8% among the three groups (P = 0.025).

CONCLUSIONA high CHA2DS2VASc score is associated with extensive AF substrate and higher recurrence rate post catheter ablation of persistent AF.

Aged ; Atrial Fibrillation ; Catheter Ablation ; Electrophysiologic Techniques, Cardiac ; Female ; Heart Atria ; Heart Failure ; Humans ; Hypertension ; Recurrence ; Stroke ; Treatment Outcome

Objective To understand the current situation of health education contents as well as the differences in their requirements between clinical medical students and clinicians,and to provide reference for the optimization of health education curricula for medical students.Methods A stratified sampling method was adopted to select 511 medical students (303 females and 208 males) from a medical university,and the survey results of 436 clinicians (144 females and 292 males) were taken as reference.Differences in the degrees of need between clinical medical students and clinicians were compared by chi-square tests.Results There were statistical differences in needs between clinical medical students and clinicians regarding drug compliance,smoking cessation intervention,balanced diet,application of Chinese traditional rehabilitation medicine,mobile health technology education,exercise rehabilitation guidance,and theory of health promotion (P＜0.01).With regard to drug compliance,smoking cessation intervention,and exercise rehabilitation guidance,the proportions of clinical medical students' needs were just 87.1％,82.2％,and 81.2％,respectively,but for clinicians the proportions reached up to 96.3％,93.8％,and 92.8％,respectively.Whereas,there were no statistical differences for mental stress management,chronic infectious disease health education,and acute infectious disease health education (P＞0.05).Conclusion There is still a big gap between medical students and clinical doctors when it comes to the knowledge of chronic disease management and healthy lifestyles;clinical medical students have not yet realized the importance of such knowledge and skills.Therefore,the strengthening of course construction for clinical medical students is suggested.