ObjectiveTo investigate and analyze the prevalence and risk factors of acute stress disorder (ASD) among survivors of road traffic accidents.MethodsA total of 206 participants ( 168 men,38 women) were administrated with the acute stress disorder scale (ASDS) 2 to 23 days after the traffic accidents.ResultsThere was a total of 61 (29.6％) possible ASD patients among all participants.Women had more serious ASD symptoms than men (male:36.70 ± 11.42; female:41.18 ± 12.58; P＜ 0.05 ),the married's ASD symptom severity was higher than the single's ( married:38.37 ± 11.94 ; single/widowed/divorced:30.86 ± 8.37 ; P ＜ 0.01 ),people with low degree of education had more severe ASD symptoms than the people who had high degree of education (P＜0.05) ; being elder( r=0.43,P＜0.01 ),having fear / helpless / horror experience of accident ( r=0.21,P＜ 0.01 ) were significantly correlated with the severity of ASD symptoms.According to linear regression analysis,age could positively predicted ASD symptoms ( β =0.29,P ＜ 0.01 ) too.ConclusionASD is a common mental problems among Chinese survivors of road traffic accident,and the main predictive factors of ASD include gender,age,marital status,the degree of education,whether there is fear / helpless / horror experience of accident.

In order to understand the resistance against common antibiotics in clinic and macrolide antibiotic-resistant mechanism of Streptococcus pneumoniae (S.pneumoniae) isolates in Zhejiang area,both K-B slip method and E-test were applied to determine the sensitivity of 138 S.pneumoniae isolates to nine antibiotics,and the ermB and mefE genes in those isolates which associated with macrolide antibiotics-resistance closely were detected by PCR.Subsequently,correlation among ermB and mefE genes and the erythromycin resistance were analyzed.For these 138 S.pneumoniae isolates,93.5% (129/138) of the strains were resistant to erythromycin,but only 2.9%～4.3% strains were resistant to cefotaxim,cefuroxime,amoxicillin and levofloxacin.The positive rate of ermB gene in the isolates (91.3%,126/138) was significantly higher than that of mefE gene (33.3%,46/138) (P<0.05).Both of these two genes existed in 27.5 % (38/138) of the strains and all of the strains without ermB and mefE genes were sensitive to erythromycin.The erythromycin resistance rate (62.5%) of mefE gene positive strains was remarkably lower than that of the mefE&ermB gene positive strains (100%) and the ermB gene positive strains (97.7%) (P<0.05).All the data mentioned above demonstrated that erythromycin is not an appropriate antibiotic to treat the infectious diseases caused by S.pneumoniae.Moreover,ermB is the predominant erythromycin resistance gene in S.pneumoniae isolates and ermB gene could inspire stronger erythromycin resistance than mefE gene.

Objective:To explore the application effect of family nursing based on Noddings′ caring education theory in children with bronchopneumonia, so as to provide reference for clinical nursing of children with bronchopneumonia.Methods:A randomized controlled study was conducted, 120 children with bronchopneumonia admitted to Anqing Municipal Hospital from August 2023 to March 2024 were enrolled as the research objects by convenience sampling method. According to random number table method, they were divided into the control group and the experimental group. The control group was given routine nursing, while the experimental group was given family nursing based on Noddings′ caring education theory on the basis of routine nursing. The symptoms remission (disappearance time of cough and wheezing), length of hospital stay, lesion absorption, compliance of aerosol inhalation, treatment compliance, etc in 2 groups were observed.Results:A total of 60 children with bronchopneumonia were included in the control group, including 37 males and 23 females, aged (5.75 ± 1.09) years old, and 60 cases were included in the experimental group, including 36 males and 24 females, aged (5.65 ± 1.06) years old. The disappearance time of cough and wheezing, and length of hospital stay in the experimental group were (5.98 ± 0.61), (4.31 ± 0.45), (5.50 ± 0.65) d, which were shorter than (6.21 ± 0.63), (4.52 ± 0.46), (6.38 ± 0.89) d in the control group, the differences were statistically significant ( t = 2.03, 2.53, 6.19, all P<0.05). The lesion absorption rate and compliance of aerosol inhalation in the experimental group were 95.00% (57/60) and 91.67% (55/60), higher than 83.33% (50/60) and 76.67% (46/60) in the control group, the differences were statistically significant ( χ2 = 4.23, 5.07, both P<0.05). The scores of treatment compliance (medication according to time and dosage, moderate exercise, reasonable diet, self-care) in the experimental groups were (4.02 ± 0.41), (3.39 ± 0.37), (3.87 ± 0.48), (3.13 ± 0.37) points, higher than (3.82 ± 0.39), (3.25 ± 0.35), (3.68 ± 0.45), (2.97 ± 0.34) points in the control group, the differences were statistically significant ( t value were 2.13-2.74, all P<0.05). Conclusions:Family nursing based on Noddings′ caring education theory is beneficial to alleviate clinical symptoms and medical fear, improve compliance of aerosol inhalation and treatment compliance in children with bronchopneumonia.

Objective:To explore the relationship between workplace procrastination and illegitimate tasks in-kindergarten teachersand the role of work disengagement and coworker support in their relationship.Methods:A to-tal of 245 kindergarten teachers were selected from 3 cities in Zhejiang Province.They were assessed with the Workplace Procrastination Scale(WPS),Bern Illegitimate Tasks Scale(BITS),Work Disengagement Scale(WDS),Colleague Support Scale(CSS).The models were tested by using Process macro for SPSS,and non-para-metric percentile bootstrap method was used to analyze the mediating effect and moderating effect.Results:There were significant differences in the total scores of workplace procrastination among kindergarten teachers in different marital status,age,teaching age,education level,teaching gradeand kindergarten level(Ps＜0.05).Work disengage-ment played a significant mediating role between workplace procrastination and illegitimate tasks(indirect effect=0.26,95％CI:0.16-0.37).Coworker support played a significant moderating role in the impact of illegitimate tasks on work disengagement(simple slope=0.72,0.39;P＜0.001).Conclusion:It suggests that workplace pro-crastination is related to illegitimate tasksin kindergarten teachers.Work disengagement plays a mediating role in their relationship,and coworker support plays a moderating role in the first half of this mediating role.

Objective:To observe the effects of acupuncture and moxibustion on interleukin(IL)-9/IL-9 receptor(IL-9R)in the colon tissue of rats with ulcerative colitis(UC)and investigate the protective mechanism of acupuncture and moxibustion on the intestinal mucosal barrier in UC rats. Methods:Male Sprague-Dawley rats were randomly divided into a normal control(NC)group and a modeling group.UC models were prepared by giving 4%dextran sulfate sodium(DSS)water for 7 d.After the successful construction of the UC rat model,the modeling group was randomly divided into a UC group,a herb-insulated moxibustion(HM)group,and an electroacupuncture(EA)group.HM and EA interventions at bilateral Tianshu(ST25)were performed once a day for 7 d.Hematoxylin-eosin(HE)staining was used to observe the histopathological changes in the colon.The serum concentrations of IL-9,IL-6,IL-1β,and hemoglobin-H(HbH)were determined by enzyme-linked immunosorbent assay.The protein expression levels of IL-9,IL-9R,claudin-2,zonula occludens-1(ZO-1),and occludin in the colon tissue were measured by Western blotting or immuno-histochemistry.Immunofluorescence was used to detect the co-expression of PU.1 and CD4 with the IL-9 protein. Results:Compared with the NC group,the colon tissue of UC rats was severely damaged and ulcerated with congestion and edema,and the colonic histopathological score increased significantly(P<0.01).The serum HbH concentration decreased significantly(P<0.01),while the serum concentrations of IL-9,IL-6,and IL-1β increased(P<0.01).The protein expression of colonic ZO-1 and occludin decreased significantly(P<0.01),while the protein expression of colonic IL-9 and IL-9R increased(P<0.05).The positive co-expression levels of IL-9/PU.1 and IL-9/CD4 increased in the colon tissue(P<0.05).Compared with the UC group,the colonic mucosal structures were gradually repaired in both HM group and EA group,and healed ulcers could be observed,the colonic histopathological score decreased significantly(P<0.05).The serum concentration of HbH increased(P<0.01),while the serum concentrations of IL-9,IL-6,and IL-1β decreased(P<0.05).The protein expression levels of ZO-1 and occludin increased(P<0.05),while the protein expression levels of IL-9 and IL-9R decreased(P<0.01).The positive co-expression levels of IL-9/PU.1 and IL-9/CD4 decreased in the colon tissue(P<0.05). Conclusion:Both HM and EA can inhibit the protein expression levels of IL-9 and IL-9R in the UC colon by regulating the transcription factor PU.1,promote the repair of intestinal mucosal barrier,and down-regulate protein contents of proinflammatory factors IL-9,IL-6,and IL-1β in the serum,which may be one of the key mechanisms of acupuncture and moxibustion in reducing the inflammation of UC colonic mucosa and protecting the intestinal mucosal barrier.

Objective:To explore the mechanism of herb-partitioned moxibustion in relieving rat intestinal inflammation by focusing on the neutrophil extracellular traps(NETs)in Crohn disease(CD)development. Methods:Rats were randomly divided into a normal group,a model group,a herb-partitioned moxibustion group,and a mesalazine group.The CD rat model was prepared with 2,4,6-trinitrobenzene sulfonic acid except for rats in the normal group.Rats in the normal group and model group did not receive any treatment but had the same fixation as the other groups.Rats in the herb-partitioned moxibustion group received herb-partitioned moxibustion at Qihai(CV6)and bilateral Tianshu(ST25).Rats in the mesalazine group received intragastric administration of mesalazine enteric-coated tablets.The general situation of rats in each group was recorded,and the histopathological changes in the colon were observed and scored by hematoxylin-eosin staining.The serum concentrations of NETs DNA(NETs-DNA),neutrophil elastase(NE)-DNA,and myeloperoxidase(MPO)-DNA were detected by ABC enzyme-linked immunosorbent assay,and the citrullinated histone 3(citH3),MPO,and NE protein and mRNA expression levels in rat colon tissue were observed by immunofluorescence and real-time quantitative polymerase chain reaction. Results:Compared with the normal group,the mucosal ulcer reached the muscularis,the epithelium was incomplete,the goblet cells decreased obviously with significant inflammatory cell infiltration in the colon;the colonic mucosa damage index(CMDI)score increased significantly(P<0.01);the serum NETs-DNA,NE-DNA,and MPO-DNA concentrations increased(P<0.05);the NE,citH3,and MPO protein and mRNA expression in the colonic tissue increased significantly in the model group(P<0.01 or P<0.05).Compared with the model group,the mucosal epithelium in the herb-partitioned moxibustion group and the mesalazine group was repaired and the goblet cells increased with a few infiltrating inflammatory cells in the colon;the CMDI score decreased(P<0.01);the serum NETs-DNA,NE-DNA,and MPO-DNA concentrations decreased(P<0.05);the NE,citH3,and MPO protein and mRNA expression in the colonic tissue was down-regulated(P<0.01 or P<0.05). Conclusion:Herb-partitioned moxibustion reduced the serum NETs complex and inhibited the protein and mRNA expression of NETs complex in the colon tissue,which may be one mechanism of herb-partitioned moxibustion in relieving colon mucosal inflammation in CD.

Accurate positioning of brackets is a necessary condition for ideal orthodontic treatment. Traditional bracket bonding technology has certain limitations, such as long operation time and poor accuracy. Indirect bonding technology is a method that bonding brackets on the model through intraoral impression or scanning, and then the brackets are accurately bonded to the tooth crowns using a transfer tray. In this article, the progression of transfer trays and adhesive agents, the application of digital technology in indirect bonding technology, indirect bonding for invisible appliances, and the prospect of this technology are reviewed. The literature review results show that indirect bonding technology can locate the bracket accurately, the operation is simple, the patient’s experience is comfortable, and the clinical efficiency can be significantly improved, the photocurable adhesive is an ideal adhesive for indirect bonding technology. With the development of digital technology, indirect bonding technology will be able to locate the brackets with increasing accuracy, thus achieving the "digital precision movement" of the teeth. The bonding technology of invisible appliance accessories is essentially a type of indirect bonding technology, It requires indirect bonding technology and digital technology to highly fit the needs of computer design accessories for the visual tooth movement and the use of indirect bonding technology to accurately bond accessories, ultimately achieving the desired tooth movement. Indirect bonding technology will play an increasingly important role with the development of digital technology and invisible correction technology.