0.05). In comparison to control group (26.5%?14.3%), the fatigue index (FI) decreased remarkably in CMV+PEEP group (12.2%?6.4%, P

Objective To explore the correlation of B-type natriuretic peptide (BNP) with blood lipids and renal function in elderly patients with coronary heart disease (CHD).Methods According to the four quantiles of BNP level,325 subjects aged 65 years and over were divided into four groups:group A (≤32.4 ng/L),group B (32.5 ng/L),group C (62.4 ng/L),group D (＞ 162.5 ng/L).The left ventricular ejection fraction (LVEF),left ventricular end-diastole dimension (LVEDD),levels of blood lipids and renal function were compared among the groups.Results With the increase of BNP level,the LVEF was gradually decreased [(63.3±8.2) ％,(59.6±7.4) ％,(57.9±9.7)％,(55.2±10.6)％,respectively,F=11.54,P＜0.01] and the LVEDD was gradually increased (F=6.76,P＜0.01),the level of triglyceride (TG) was gradually decreased (F=2.73,P ＜0.05) in group A,B,C and D.Creatinine clearance was gradually decreased [(1.24±0.31) ml ·s-1 · 1.73 m-2,(1.21±0.31) ml· s-1 · 1.73 m-2,(1.24±0.29) ml · s-1 · 1.73 m 2,(1.09± 0.33) ml · s-1 · 1.73 m-2,respectively,F=3.62,P＜0.05],and blood urea nitrogen was gradually increased (F=4.43,P＜0.05) in group A,B,C and D.Multi-linear regression analysis showed that levels of total cholesterol,triglyceride,low density lipoprotein-cholesterol,high density lipoproteincholesterol,very low density lipoprotein-cholesterol,creatinine clearance and blood urea nitrogen were influencing factors for BNP (all P＜0.05).Conclusions BNP level can be used as a sensitive indicator for the diagnosis of heart failure and the assessment of its severity.The levels of blood lipids and renal function are associated with BNP.

To develop a handling platform for loading, unloading, fixation, deployment, withdrawal and etc of medical materials in field conditions. Classified handling was performed for different function units with the de-vice developed, which was composed of a trolley, a railroad, a hydraulic handling board, a fixation belt and a vehicle-mounted tractor. The platform could enhance the efficiency of materials handling, which behaved well in the hos-pital without any handling device. The modular handling platform is easy to unload, carry, transport, fix and maintain, and thus is worthy popularizing practically.

Abstract: Objective To investigate the correlation of serum exosomal microRNA (exomiR)-27a with drug resistance and adverse outcomes in pulmonary tuberculosis (PTB), to provide new evidence for the development of anti-tuberculosis treatment. Methods From May 2018 to June 2020, 326 patients with PTB in the Eighth Affiliated Hospital of Xinjiang Medical University were selected and divided into 228 patients with active TB (active group) and 98 patients with latent TB infection (latent group), and 100 healthy subjects were included as controls. The serum exosomes of all subjects were extracted and identified by transmission electron microscopy, nanoparticle particle size analyzer and flow cytometry. The expression level of serum exomiR-27a was detected by real-time quantitative PCR. The diagnostic value of serum exomiR-27a in PTB was analyzed by receiver operating characteristic (ROC) curve. Drug resistance in patients with active PTB was recorded after standard treatment. The effect of serum exomiR-27a on the incidence of adverse outcomes was analyzed. Results The characterization of serum exosomes confirmed that exosomes were successfully isolated from serum. Compared with the control group 0.92(0.63, 1.17), the expression of serum exomiR-27a was up-regulated in the active group 1.55(1.18, 2.09) and the latent group 1.27 (0.96, 1.65), and the expression of exomiR-27a in the active group was higher than that in the latent group (P<0.05). PTB patients with high serum exomiR-27a expression (≥1.50) had poorer chest radiography and a higher proportion of chronic hepatitis comorbidities (P<0.05). ROC curve analysis showed that the area under the curve (AUC) of serum exomiR-27a distinguishing control and active group was 0.838 (95%CI: 0.795-0.880) and the AUC of serum exomiR-27a distinguishing normal and latent group was 0.766 (95%CI: 0.701-0.830). Patients in the active group received standard antituberculosis therapy (≥6 months). The expression level of serum exomiR-27a in drug-resistant patients was higher than that in sensitive patients (P<0.001), and the expression level of serum exomiR-27a in multi-drug resistant tuberculosis patients was higher than that in single-drug resistant tuberculosis patients (P<0.001). Logistic regression analysis showed that elevated serum exomiR-27a was an independent predictor of PTB resistance (P<0.001). High expression of serum exomiR-27a indicated a higher incidence of adverse outcomes (log rank=15.725, P<0.001). Conclusions High expression of serum exomiR-27a is helpful in the diagnosis and prediction of adverse outcomes of PTB.

Objective To observe effects of problem-based learning(PBL) combined with case-based study (CBS)teaching mode in clinical teaching in intensive care unit(ICU). Methods Students from ICU of Fangcun Branch of Guangdong Provincial Hospital of Traditional Chinese Medicine from March 2011 to February 2012 were divided into treatment group (31 cases, with PBL combined with CBS teaching mode) and control group (34 cases, with the traditional teaching mode). Scores of two groups were compared and analyzed and questionnaire survey was conducted in treatment group. Data were processed by SPSS 13.0 statistical software. Measurement data were compared by t-test and data of heterogeneous variance were compared by rank-sum test. Results Treatment group achieved better scores ((85.26 ±5.96) in theory examination and (80.59 ±7.33) in case-analyzing examination) compared with those of control group ((79.17 ±7.31) in theory examination and (76.02 ±9.27) in case-analyzing examination)(P<0.05). PBL combined with CBS teaching mode can stimulate learning interests but it was lack of systematization; most students did not volunteer to speak. Conclusion PBL combined with CBS teaching mode has certain advantages in ICU clinical teaching.

Objective To investigate the reference interval of platelet‐related parameters including mean platelet volume (MPV) ,platelet distribution width (PDW) ,platelet hematocrit (PCT) .Methods Used Sysmex XN‐9000 assembly line and PEN‐TRA 120 hematology analyzer to analysis the venous blood cells for 3 415 cases of 16 to 90 years old physical examination personnel in Mianyang Central Hospital ,the platelet‐related parameters results of 2 718 standard healthy population by screening were statis‐tically analyzed .Results Platelet‐related parameters 95% reference interval (2 .5% -97 .5% ) of XN assembly line :M PV 9 .9-14 . 7 fL ,PDW 11 .2% -24 .3% ,PCT 0 .15% -0 .30% ;Platelet‐related parameters of 95% reference interval of PENTRA 120:MPV 8 .4-12 .7 fL ,PDW 13 .8% -24 .8% ,PCT 0 .12% -0 .26% ;comparison between the instruments :MPV ,PDW ,PCT results showed significant differences (P<0 .05);comparison between men and women :PCT test results of XN assembly line were differ‐ent (P<0 .05) ,MPV ,PDW ,PCT results of PENTRA 120 were different (P<0 .05);comparison between age groups :PCT result of all ages between men and women were different in XN assembly line (P<0 .05) ,in PENTRA 120 ,MPV ,PDW ,PCT results be‐tween ages were different in men (P<0 .05) ,PCT results between ages were different in women (P<0 .05) .Conclusion Each la‐boratory should establish the laboratory supporting biological reference interval of platelet‐related parameters based on different in‐struments ;in practical applications ,should set the reference interval for different gender or age .

Objective:To understand cognition and satisfaction degree of mental health service among residents in Weifang,and provide reference for further development of mental health work.Methods:6174 residents were selected with random sampling method and a cognition survey was conducted using a self-designed questionnaire.Among them,553 residents were selected to investigate their satisfaction with mental health service.Results:The residents have unscientific cognition on mental health service,and they did not understand the delivery of community mental health services.Residents who have received mental health service were more satisfied with informed consent and patient privacy protection,and had low satisfaction with the clinic environment and the charge of inspection items.Conclusions:To improve residents' cognition and satisfaction of mental health service,we should further perfect the professional mental health institutions and personnel recruiting,and forcefully carry out mental health education.

Objective To study the pathological changes and expressions of NO and iNOS mRNA in the lung tissue of traumatic hemorrhagic shock rats under dry heat environment of desert and their relations to the lung injury.Methods A total of 140 male SD rats were randomly (random number) ivided into the room temperature (25 ℃) environment traumatic hemorrhagic shock group (room temperature group) and the dry heat traumatic hemorrhagic shock groups (dry heat group,temperature 40℃,humidity 10％),respectively,and each groups was further randomly divided into 7 subgroups:the control subgroup,post shock subgroups at 0,0.5,1,1.5,2and 3 h (n =10 in each subgroup).The rats of control subgroup were not treated,and rats of dry heat group were placed in dry heat environment for 60 min,then anesthetized,fixed,and insertion of intravenous indwelling needles and catherization of right carotid artery,jugular vein and the right femoral artery were performed.After stabilization for 10 min,2500 g iron wheel was used to be dropped from 30 m height and vertically hit the upper left femoral of SD rats in order to make comminuted fracture,wounds were quickly dressed after injury.Exsanguination from right femoral artery was kept until MAP maintained at (35 ± 5) mmHg,and resuscitation was carried out after continue monitoring for 60 min.After the establishment of traumatic hemorrhagic shock model in each environment,the rats were sacrificed at given intervals,and thoracotomy was performed to take broncho-alveolar lavage fluid (BALF) and lung tissue.Pathological changes of lung tissues were observed by using HE staining and NO concentration of lung tissue was detected by one-step method,and changes of the iNOS mRNA expressions were detected by using fluorescence quantitative PCR.Then t test,ANOVA and Pearson correlation analysis were used for the data analysis.Results The pathological change in dry heat group at each interval was more severe,and pulmonary histopathological injury score was higher,and the protein exudation was more profuse compared with the room temperature group.NO concentration in lung tissue homogenate of dry heat group was higher than that of room temperature group (t =2.472,P ＜ 0.05),and the difference in NO level between different intervals within the dry heat group was statistically significant (F =6.77,P ＜ 0.01).The NO concentration in dry heat group reached its maximum at 2 h (3.35 ± 0.23) μmol / g and the peak value emerged sooner than that in room temperature group.The difference was statistically significant in overall expression of iNOS mRNA between two groups analyzed with t test (t =3.619,P ＜ 0.01),and there was statistically significant difference between intervals within the dry heat group (F =12.34,P ＜0.01).The values of iNOS mRNA in the dry heat group were higher than those in the room temperature group at the same given intervals,and the peak value appears at 1.5 h in dry heat group,and the room temperature group it began to increase at 2 h.The concentration of NO and the expression of iNOS mRNA were positively correlated with each other in two groups (r =0.680,r =0.376).The expression of iNOS mRNA and lung histopathological injury score was positively correlated in two groups (r =0.846,r =0.899).Conclusions When traumatic hemorrhagic shock occurred in the dry heat desert environment,the lung injury was more severe and appeared sooner than that in the room temperature environment.NO and iNOS played important roles in the secondary lung injury in the wake of traumatic hemorrhagic shock in rats under the dry heat environmengt of desert.

Objective To explore the effect of prevention and treatment on steroid-induced osteonecrosis of mice femoral head(ONFH) treated with metformin. Methods Thirty-six Kunming mice were randomly divided into three groups (n = 12):A (Control Group), B (Model Group)and C (Prevention Group). For producing ONFH mice models, did the intraperitoneal injection of horse serum (10 mL/kg) to B and C firstly. After two weeks, continuing the intraperitoneal injection of horse serum (5 mL/kg) again with the prednisolone intramuscularly [45 mL/(kg· day), totally for 5 days]. Meanwhile, feeding normal saline 10 mL/(kg·day) to B and feeding metformin hydrochloride [0.2 g/(kg·day)] to C. For A, mice were only given normal saline intramuscularly and intragastrically in equal quantity at the same time. The contents of serum cholesterol (TC), triglycerid (TG), plasma von willebrand factor (VWF) and plasminogen activator inhibitor 1 (PAI-1) were determined at the 2nd, 4th and 6th week after treatment. The micewere sacrificed at 2nd, 4th, and 6th weekafter treatment, and femoral heads were harvested to do histopathology analysis. Results The appearance and shape of the femoral head and the surface of cartilages were normal. The percentage of empty osteocyte lacunae in B was significantly higher than that in C (P < 0.05), there was no significant difference between A and C (P>0.05). TC and TG contents in C were significantly lower than that in B in 2th、4th、6th weeek(P<0.05), and higher than that in A(P<0.05). VWF and PAI-1 level in C were significantly lower than that in B at 2nd and 4th week (P<0.05), but there were no statistical significance at 6th week. there were no statistical significance for the comparison between A and C. Conclusion Metformin can prevent steroid-induced ONFH by improving hyperlipemia, hypercoagulability and hypofibrinolysis, then effectively prevent osteonecrosis.

Objective:This article is to study the quality of life and the situation of social support for the elderly in Weifang while analyzing the correlation between them.Methods:This study was undertaken among elderly aged over 60 followning the European five D health scale and Social Support Rating Scale.The results were analyzed statistically.Results:On the living quality of elderly in Weifang,the EQ-SD index was (0.78 ±0.12) and the EQ -VAS index was (76.42 ± 14.67).The result from each scale shows a tremendous health issue among the elderly in Weifang.On the other hand,the situation of social support for the elderly in Weifang appeared optimistic.Still,this situation can be improved in practical supports.Also,there was significant negative correlation between EQ-5D and SSRS (r =0.260,P ＜ 0.05).Results of multiple linear regression show that the subjective support and objective support may enter the regression equation.Conclusion:To conclude,the city of Weifang awaits improvements in aged care and social support for the elderly.Only by this chance the quahty of life of the elderly may be improved.