OBJECTIVE To investigate the changes in high performance liquid chromatography （HPLC） fingerprint spectra and nucleoside components between Pinelliae Rhizoma Praeparatum cum Zingibere et Alumine and its processed product Succus bambusae pinella preparata， providing a reference for the quality evaluation of the latter. METHODS HPLC fingerprint was established for 10 batches of Pinelliae Rhizoma Praeparatum cum Zingibere et Alumine and its processed product Succus bambusae pinella preparata following the Similarity Evaluation System of TCM Chromatographic Fingerprints （2012 Edition）. Hierarchical cluster analysis （HCA）， principal component analysis （PCA）， and orthogonal partial least squares-discriminant analysis （OPLS- DA） were conducted on their common peaks. The contents of four nucleoside components， hypoxanthine， uridine， adenine， and guanosine， in both Pinelliae Rhizoma Praeparatum cum Zingibere et Alumine and Succus bambusae pinella preparata were determined. RESULTS The similarity between the fingerprints of the 10 batches of Pinelliae Rhizoma Praeparatum cum Zingibere et Alumine， Succus bambusae pinella preparata， and their corresponding reference fingerprints ranged from 0.851 to 0.990. A total of 10 common peaks were obtained for both samples， and 4 components were identified as hypoxanthine， uridine， adenine， and guanosine. The results of HCA， PCA and OPLS-DA showed that the samples of Pinelliae Rhizoma Praeparatum cum Zingibere et Alumine and Succus bambusae pinella preparata were clustered into separate categories， with OPLS-DA selecting 4 differential components between them， ranked by variable importance projection values as peak 8， peak 1， peak 6 （adenine） and peak 10. The content determination results showed that the average contents of hypoxanthine， uridine， adenine and guanosine in Succus bambusae pinella preparata declined by 15.90%， 12.00%， 26.04% and 22.18% compared to Pinelliae Rhizoma Praeparatum cum Zingibere et Alumine， respectively， with statistically significant differences in the contents of hypoxanthine， adenine and guanosine （P＜0.05 or P＜0.01）. CONCLUSIONS The established fingerprint and content determination methods are simple to operate and have good repeatability， which are suitable for qualitative and quantitative analysis of Pinelliae Rhizoma Praeparatum cum Zingibere et Alumine and Succus bambusae pinella preparata. The average contents of the four nucleoside components decreased after the processing of Succus bambusae pinella preparata.

Objective To investigate the interventional effect and mechanism of a novel ampelopsis hydrogel on dampness-heat accumulation syndrome of gouty arthritis. Methods A total of 90 patients with gouty arthritis who met the diagnostic criteria of western medicine and were differentiated as damp-heat accumulation syndrome of traditional Chinese medicine(TCM) were randomly divided into treatment group, control group and blank group, with 30 patients in each group. The blank group was treated with etoricoxib only, the control group was treated with etoricoxib combined with ampelopsis hydrogel, and the treatment group was treated with etoricoxib combined with external application of ampelopsis hydrogel. The clinical efficacy, time to symptom improvement, safety, comfort, changes in syndrome scores of TCM, serum inflammatory factors[C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), erythrocyte sedimentation rate (ESR)], NF-κB signaling pathway-related proteins, Visual Analogue Scale (VAS) scores for pain, and joint mobility were compared among the three groups before and after treatment. Results The total effective rates in the treatment group and control group were 93.33% and 90.00%, respectively, which were higher than 70.00% in the blank group (P < 0.05). The time for improvement of pain, redness, tenderness, and limited joint mobility in the treatment group was shorter than that in the control group and blank group (P < 0.05). After 7 days of treatment, the TCM syndrome score in the treatment group was lower than that in the control group and blank group, and the levels of serum CRP, TNF-α, and ESR and the expressions of NF-κB signalingpathway-related proteins P50 and P65 in the treatment group and control group were lower than those in the blank group (P < 0.05). After 7 days of treatment, the VAS score in the treatment group was lower than that in the control group and blank group, and the comfort score in the treatment group was higher than that in the control group (P < 0.05). There was no significant difference in the incidence of adverse reactions among the three groups (P>0.05). Conclusion The effect of ampelopsis hydrogel in treating gouty arthritis is better than that of ampelopsis paste, and its mechanism may be related to the regulation of the NF-κB pathway and inhibition of inflammatory factor expression. The hydrogel is easy to use, hygienic, and comfortable, and is expected to become a safe, effective, and convenient external medicine for gouty arthritis.

Objective:To investigate and analyze on the basic skills level of health literacy and its influencing factors in permanent residents in Fujian province in 2020.Methods:In this cross-sectional study, from April to November in 2020, 3 304 urban and rural permanent residents aged 15-69 years in 13 counties (cities or districts) in Fujian province were selected by stratified multistage cluster sampling and random sampling for household questionnaire survey. Based on “Health literacy of Chinese citizens—basic knowledge and skills”, the questionnaire included three aspects: basic knowledge and concept, healthy lifestyle and behavior and basic skills. There were 50 questions in total, including 12 questions about basic skills with a total score of 16 points. A score of 13 points and above was considered as having basic skills. A total of 3 304 questionnaires were issued and reclaimed, and among which 3 250 questionnaires were valid. According to the data of the Sixth National Census in 2010 in Fujian province and the basic data collected in the monitoring process, the basic weight, no response and post-stratification adjustment of the samples were made to obtain the representative data of the province. The χ2 test and multivariate logistic regression were applied to analyze the influencing factors of basic skill level of health literacy in permanent residents in Fujian province in 2020. Results:According to the weighted data, the basic skill level of health literacy in permanent residents in Fujian province in 2020 was 26.02%, and it was higher in urban area than that in rural area (35.00% vs 20.15%). It was higher in people aged 25-34 years (35.36%), people with high education level (college/undergraduate and above 47.20%), civil servants (47.49%), medical personnel (44.00%), people with chronic diseases (27.04%) and people with good health condition (31.31%), respectively (all P<0.05). Among the 12 questions on basic skills, the correct rate in 6 questions was ≥50%. The question with the highest correct rate was “The correct practices after the occurrence of severe infectious diseases in the local area” (88.2%), and the question with the lowest correct rate was “Correctly identify drugs with‘OTC’ printed on the label”(28.7%). Education level (illiterate/less literate, OR=0.036, 95% CI: 0.018-0.073; primary school, OR=0.091, 95% CI: 0.053-0.155; junior high school, OR=0.230, 95% CI: 0.148-0.357; senior high school/vocational high school/technical secondary school, OR=0.351, 95% CI: 0.232-0.532; college/undergraduate and above, OR=1.000) was positively correlated with the basic skill level of residents′ health literacy ( P<0.001). Conclusions:The overall level of basic health skills in permanent residents in Fujian province in 2020 is relatively high, educational level is a positive correlation factor.

Objective:To investigate the effectiveness of case-based learning (CBL) combined with online teaching in standardized residency training of rheumatology and immunology.Methods:A total of 78 individuals who participated in standardized residency training in Department of Rheumatology and Immunology in our hospital from June 2019 to August 2020 were included and divided into observation group and control group. The individuals in the control group received traditional teaching, and those in the observation group received CBL combined with online teaching. The physicians receiving standardized residency training were evaluated by theoretical examination, clinical operation skill assessment, and instructor rating, and the degree of satisfaction with teaching, degree of satisfaction with teaching methods, and classroom learning atmosphere were also evaluated.Results:The observation group had a theoretical examination score of (94.10±2.01) and a clinical operation skill assessment score of (90.44±1.57), which were significantly higher than those of the control group ( P<0.05), and the observation group had a significantly better instructor rating (89.36±1.33) than the control group ( P<0.05). Compared with the control group, the observation group had significantly higher degree of satisfaction with teaching (3.79±0.41), degree of satisfaction with teaching methods (3.92±0.27), and evaluation of classroom learning atmosphere (3.90±0.31) ( P<0.05). Conclusion:CBL combined with online teaching can help to improve learning efficiency, stimulate the enthusiasm for learning, expand clinical thinking, promote the growth of teaching and learning, and form a virtuous cycle among trainees receiving standardized residency training, which holds promise for further exploration.

Objective:To evaluate the effect of self-made lithotomy heating mask on intraoperative and postoperative body temperature and short-term postoperative outcome indicators in patients undergoing radical resection of rectal cancer.Methods:Using the method of quasi experimental research design, 100 patients with open rectal cancer in Ningbo Huamei Hospital of the University of Chinese Academy of Sciences from February to July 2021 were selected as the research objects. The patients were divided into experimental group and control group with 50 cases in each group. The control group was kept warm by routine methods, and the experimental group was kept warm by self-made lithotomy heating hood. The changes of core temperature at different time points before, during and after operation were compared between the two groups. The incidence of accidental hypothermia and shivering, the recovery time of anesthesia, and the incidence of various complications within 48 hours after operation were compared between the two groups after operation from the beginning of the operation to 6 hours after returning to the ward.Results:From 30 minutes after anesthesia to 3 hours after entering the ward, the core temperatures of the experimental group at 10 time points were higher than that of the control group, and the differences were statistically significant ( t values were 3.48-37.30, all P<0.01). From the beginning of surgery to 6 h after returning to the ward, the incidence of perioperative accidental hypothermia in the experimental group was 2% (1/50), lower than 24% (12/50) in the control group, and the difference was statistically significant ( χ2=11.06, P<0.05) . The number of cases of shivering in the experimental group was 10, lower than that in the control group of 22, the difference was statistically significant ( χ2=6.62, P<0.05) . The recovery time, extubation time and stay time in anesthesia recovery room of the experimental group were (8.44 ± 2.83), (13.05 ± 4.72), (74.51 ± 11.82) min, which were shorter than those of the control group (15.35 ± 2.09), (17.62 ± 3.28), (89.14 ± 9.19) min, and the difference was statistically significant ( t=-13.89, -5.62, -6.91, all P<0.01). The number of cases of agitation, delirium and nausea and vomiting in the experimental group was 3, 1 and 2 respectively, which was lower than 13, 7 and 8 in the control group, and the difference were statistically significant ( χ2=7.44, 4.89, 4.00, all P<0.05). There was no significant difference in the incidence of adverse cardiac events between the two groups ( P>0.05). Conclusions:The application of self-made lithotomy heating mask in open rectal cancer surgery can effectively improve the risk of hypothermia at different time points during and after surgery, reduce the incidence of shivering, restlessness, postoperative nausea, vomiting and delirium, shorten the time of awakening and extubation, and prevent postoperative complications. It has practical value in clinic.

Objective:To assess the practical value of visual scores of magnetic resonance imaging(MRI)features in the diagnosis and classification of dementia with Lewy bodies(DLB).Methods:In this study, 102 DLB patients were prospectively recruited, with 102 cognitively normal elderly people as the normal control group(NC).All included subjects underwent MRI examinations and neuropsychological assessments.Based on the clinical dementia rating(CDR)scale, DLB patients were divided into a mild(CDR=1.0), a moderate(CDR=2.0)and a severe(CDR=3.0)group.The results of MRI were scored visually and the rating scales included medial temporal lobe atrophy(MTA), global cortical atrophy-frontal subscale(GCA-F), posterior cortical atrophy(PCA), white matter lesions(the Fazekas scale), cerebral microbleeds(CMBs), and the Evans Index(EI).Statistical differences were compared between the DLB and NC groups and between DLB patients with different degrees of cognitive impairment.Results:In terms of neuropsychology, the Mini-Mental State Examination(MMSE) score of the DLB group[16.0(11.0, 21.0)]was statistically significantly lower than that of the NC group[29.0(28.0, 30.0)]( Z=-12.31, P<0.001), the Montreal Cognitive Assessment(MoCA)score of the DLB group[9.5(6.0, 15.0)]was statistically significantly lower than that of the NC group[28.0(27.0, 29.0)]( Z=-12.40, P<0.001), and the Activities of Daily Living(ADL)score of the DLB group[32.0(23.8, 40.0)]was statistically significantly higher than that of the NC group[20.0(20.0, 20.0)]( Z=-11.98, P<0.001).The scores of all MRI visual assessment scales in DLB patients were statistically significantly higher than those in the NC group( P<0.001).There were significant differences in MTA scores between DLB patients with different degrees of cognitive impairment( P0<0.001).The MTA score of the mild group[1.0(1.0, 1.0)]was statistically significantly lower than that of the moderate group[2.0(1.0, 2.0)]( P1<0.001, P2<0.001); The MTA score of the moderate group[2.0(1.0, 2.0)]was statistically significantly lower than that of the severe group[2.0(2.0, 3.0)]( P1=0.003, P2=0.010). Conclusions:This study has for the first time after comprehensively evaluated the value of various visual scores in DLB diagnosis, MTA can be used to help diagnose DLB and distinguish the severity of DLB, providing a new supplemental tool for clinical diagnosis.

Heart failure, as a progressive and irreversible clinical syndrome, is an important part of the global prevention and treatment of chronic cardiovascular diseases. The management of its complex symptoms and risk factors cannot completely rely on medical and nursing staff and short-term clinical treatment. Self-care is an effective way to reduce the readmission rate and fatality rate of patients. Symptom perception is a new dimension in the situation-specific theory of self-care in heart failure, and that is a comprehensive process by which patients conduct self-monitoring of symptoms and signs and identify, interpret, and label the meaning of symptoms. Symptom perception of heart failure is crucial to achieve effective self-care, however, there are few studies in China. This article reviews the definition, influencing factors and evaluation tools of symptom perception in patients with heart failure, so as to provide evidence for the intervention and promotion of symptom perception in patients with heart failure.

Objective:To investigate the molecular characteristics, drug resistance rate and virulence genes harboring status of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) associated with skin and soft tissue infections (SSTIs), and provide epidemiological basis for clinical antibiotic usage and infection prevention and control. Methods:The Staphylococcus aureus associated with SSTIs in Quzhou People′s Hospital from 2014 to 2018 were retrospectively analyzed. A total of 72 CA-MRSA isolates were screened, and molecular typing was performed by multilocus sequence typing (MLST). K-B method and micro broth dilution method were used to analyze the antibiotic susceptibilities of those strains. The virulence genes screened including fibronectin binding protein genes (fnbA, fnbB),hemolysin genes (hla, hlb), enterotoxin genes (sec, seh) and leukocidin gene (PVL) were detected by polymerase chain reaction (PCR).Statistical analysis of differences between drug resistance rates and virulence genes carrier rates between ST59 and non-ST59 groups used were Chi-square test or Fisher exact test. Results:ST59 type was the main epidemic clone in skin and soft tissue infection CA-MRSA in Quzhou area with account for 55.56% (40/72). All isolates had higher resistance rates to erythromycin (90.28%, 65/72), clindamycin (68.06%, 49/72) and tetracycline (41.67%, 30/72). The nitrofurantoin, daptomycin and linezolid were all sensitive. The resistance rate to clindamycin of sequence type 59 (ST59) was (85.00%, 34/40). The resistance rate of ST59 to clindamycin was significantly higher than that of other clone types (χ 2=11.886, P<0.01). There was no significant difference in the resistance rates of other antibiotics. All 72 isolates exhibited carriage of virulence genes as follows, hla (97.22%, 70/72) , hlb (33.33%, 24/72) , fnbA (50.00%, 36/72) , fnbB (48.61%, 35/72) , PVL (63.89%, 46/72) , sec (4.17%, 3/72) , seh (4.17%, 3/72) . The carrier rate of PVL gene in ST59 type was (77.50%, 31/40). ST59 showed higher rates of PVL genes compared with other clone types (χ 2=7.227, P<0.01). Conclusions:The main clone of CA-MRSA associated with SSTIs in Quzhou was ST59, which was similar to other parts of the Country. The carrying rate of PVL gene of ST59 isolate was significantly higher than that of other isolates. CA-MRSA associated with SSTIs has a high resistance rate to erythromycin and clindamycin, which should not be used as the first choice in treatment.

Objective: To explore the effect of DMAIC(Define, Measure, Analyze, Improve, Control) in reducing catheter-related urinary tract infection. Methods: A retrospective case control method was used to select 578 patients admitted and treated in comprehensive ICU of Tianjin First Central Hospital from January to December 2018 with catheters as research objects.The 283 patients from January to June 2018 were the control group, and 295 patients from July to December 2018 were the observation group.Routine methods were used in the control group, and DMAIC method with 6 sigma management was used in the observation group. The correct rate of implementation of each measure, the utilization rate of urinary catheter and the infection rate between the two groups were compared. Results: Implementation rate of early extubation assessment, urine collection accuracy, urine tube fixed correctly, urine tube cleaning time, urine collection bags location accuracy were 60.42%(171/283), 69.61%(197/283), 79.86%(226/283), 89.40%(253/283), 92.58%(262/283)in the control group, 80.34%(237/295), 90.85%(268/295), 94.92%(280/295), 96.27%(284/295), 97.97%(289/295) in the observation group, the differences were statistically significant (χ²= 9.411-41.415, P < 0.01). The rate of urinary catheter usage was 75.31%(3 856/5 120) in the observation group and 82.60%(4 098/4 961) in the control group, the differences was statistically significant (χ²=80.475, P < 0.01). The rate of catheter associated urinary tract infection was 0.26‰ (1/3 856) in the observation group and 1.95 ‰ (8/4 098) in the control group, the differences was statistically significant (χ²=5.832, P< 0.05). Conclusions DMAIC can improve the accuracy of nursing measures, optimize the catheter care process, and reduce catheter-related urinary tract infections.

Objective To evaluate the feasibility of quantitative evaluation of fallopian tubes patency by the rising slope of pressure curve produced by bolus injection using a liquid diagnostic apparatus in the four-dimen-sional hysterosalpingo-contrast sonography. Methods A total of 205 patients with infertility were collected for four-dimensional hysterosalpingo-contrast sonography. In the examination,the contrast medium concentration,the liquid volume of the liquid diagnostic apparatus and the speed of the liquid were stationary calculated. The rising slope of the curve was calculated according to the real-time pressure curve produced by the contrast agent injection process. According to the hysterosalpingo-contrast sonography examination's results ,patients were divided into one side patency group,one side partial obstruction group and one side obstruction group. The correlation between the slope and the patency of the fallopian tube was analyzed by binary logistic regression. Results Binary logistic regression showed that the slope and fallopian tube patency had good correlation(all P < 0.05)between one side patency group and one side obstruction group,and also between one side partial obstruction group and one side obstruction group;but had no correlation between one side patency group and one side partial obstruction group(regression coefficient P>0.05,regression constant P=0.000). Conclusion The slope of pressure curve produced by four-dimensional hysterosalpingo-contrast sonography can be used to assess the patency of fallopian tubes quantitatively. It is a new auxiliary index for evaluating the patency of fallopian tubes.