Objective To evaluate the efficacy of noninvasive positive pressure ventilation (NIPPV) in the treatment of early acute respiratory distress syndrome(ARDS) Methods 12 patients with early ARDS were errolled in the study All the patients pulltiled the criteria of ARDS and no improvement after high flow oxygen therapy via mask NIPPV was used because the patients and their family refused intubation Pressure support ventilation (PSV) and positive end expiratory pressure (PEEP) were used via facial mask with Vison or BiPAP ventilator PEEP were set at 8～12 cm H 2 O with 4～6 PSV level Results The baseline respiratory frequency(RR)was (36?4)bpm,PaO 2 was (55?9)mm Hg and oxygen index (OI)was (127?4)mm Hg At final,8 patients survived (S group) and 4 patients died (F group) After 4～6 h treatment with NIPPV,in S group,RR decreased to (32?1 2)bpm ( P

Objective To explore the application effect of the multidisciplinary collaborations in control of peritoneal dialysis patients with hypertension. Methods A total of 220 cases of peritoneal dialysis patients divided into experimental group and control group (each group had 110 cases) according to the random number table. In which, the control group received routine capacity control and health education with a total of 105 patients finished the study. The experimental group received of multidisciplinary collaborations on the basis of routine capacity control and health education with a total of 107 patients finished the study. Observe changes with knowledge of drugs, medication compliance, self-management behavior and blood pressure of patients before and after the intervention respectively. Results In experimental group,the scores of drug knowledge, medication compliance and self-management behaviors were (0.93 ± 0.49), 0.00 (0.00, 0.25), (2.69 ± 0.25) points before the intervention, 6 months after the intervention were (1.17 ± 0.54), 0.25 (0.00, 0.50), (2.86 ± 0.15) points, the difference between the groups was statistically significant (t=38.60, Z=4.34, t= 2.45, P < 0.01 or 0.05). In control group,the scores of drug knowledge, medication compliance and self-management behaviors were (0.87 ± 0.45), 0.00 (0.00, 0.25), (2.64 ± 0.27) points before the intervention, 6 months after the intervention were (0.89 ± 0.43), 0.00 (0.00, 0.38), (2.73 ± 0.27) points, there was no significant difference between drug knowledge and medication compliance (t=0.44, Z=1.83, P > 0.05), there were statistically significant differences in self-management behavior (t=6.23, P<0.01);there was no difference between the statistical significance between the 2 groups before intervention (t=1.02, Z=1.46, t=1.32, P > 0.05); there was significant difference between the 2 groups after intervention (t=4.11, Z=4.03, t=4.34, P<0.01). Patients in the experimental group with the systolic and diastolic blood pressure were (147.11 ± 14.31), (90.16 ± 13.02) mmHg (1 mmHg=0.133 kPa) respectively, before the intervention; 6 months after the intervention were (139.39 ± 17.05), (83.76 ± 12.52) mmHg respectively, the difference was statistically significant (t=3.59, 2.92, P<0.01). The control group before intervention were (149.56 ± 18.11), (93.56 ± 15.09) mmHg respectively, 6 months after the intervention were (145.14±20.50), (88.14±10.88) mmHg respectively, the difference was statistically significant (t=2.02, 2.72, P<0.05 or 0.01);there was no significant difference between the two groups before intervention (t=1.09, 1.82, P>0.05);6 months after the intervention there was significant difference between the 2 groups (t=2.22, 2.72, P < 0.05 or 0.01). Conclusions Multidisciplinary collaborations have a significant role in patients with peritoneal dialysis, especially in blood pressure control, medication compliance and self-management behavior.

Objective To detect the clinical value of evaluating myocardial viability in patients with old myocardial infaretion(OMI) by measuring myocardial isovolumie contraction motion indices with tissue Doppler imaging(TDI) under the quiescent condition. Methods The myocardial isovolumic contraction motion indices of 30 normal subjects and 30 patients with OMI were examined by TDI. The sample gate was located at left ventricular postero-septal,lateral,anterior,inferior,antero-septal and posterior walls in basal and middle segments separately. The peak positive and negative veiocities(VIVC1 ,VIVC2 ) during myocardial isovohimic contraction phase, and the difference(DIVC) between VIVC1 and VIVC2 were measured, which were analysed combined with the viable fraction(VF) calculated by single photon emission computed tomography (SPECT). Results VIVC1, DIVC were significantly decreased,and VIVC2 was significantly increased in infarct zones of patients with OMI than those of the normal subjects( P <0.05). Compared with normal subjects, myocardial isovolumic contraction motion indices of non-infarct wails in patients with OMI were steady( P >0.05). In OMI group,DIVC of short axis was significantly decreased than that in long axis( P <0.05). Statistic analysis showed that DIVC values on both of short and long axis had significant positive correlations with VF derived from SPECT,and the correlation coefficients were 0. 837 ( P<0. 001) and 0. 797( P<0. 001 ) ,respectively. The sensibility and specificity of evaluating viable myocardium was 75% and 75% separately supposing the cutoff of DIVC on short axis was more than - 1.50,and the sensibility and specificity was 77. 8% and 87.5% separately if the cutoff of DIVC on long axis was more than 0.92. Conclusions Myocardial isovolumic contraction's TDI of infarct zones in patients with OMI had characteristic changes. DIVC on both of short and long axis could be as a new method of evaluating myocardial viability.

Objective To compare the effects of health education on fat intake behavior and its psychology in students with different BMI,provide evidence for improving individual healthy education.Methods A experimental epidemiology was used,Twenty-nine secondary school classes were randomly selected by multi-stage cluster sampling from two cities in Zhejiang province.Overweight or obesity group included all students who were judged overweight or obesity,normal group included students who were judged normal and basic matched by age,grade,sex and stage of baseline.Intervention based on transtheoretical mode was conducted on two groups and intervention results were measured by the adolescent fat intake behavior of psychological measurement scales (Chinese version).Chi-square tests,T-tests,non-parameters tests and binary logistic regression were performed for data analyses.Results Stage of students with overweight or obesity and with normal BMI all moved forward after intervention,while the proportion of stage advance for students with overweight or obesity was further than students with normal BMI.Change strategy(2.60±0.79),pros(3.58±0.90) and self-efficacy(3.01±0.72) of students with overweight or obesity better than students with normal BMI in baseline((2.34±0.86),(3.08±0.91),(2.79±0.81)) while difference was not significant after intervention.Logistic regression analysis discovered that the promotion of change strategy moved stage forward for students with normal BMI(OR=2.168,95％ CI:1.560-3.014)and promotion of self-efficiency moved stage forward for students with overweight or obesity (OR=1.801,95％ CI:1.026-3.159).Conclusion The intensity and duration of psychological intervention is essential to be reinforced for students with normal BMI,while for students with overweight and obesity,psychological intervention should be promoted in combination with social support.

ObjectiveTo explore the characteristics and correlation of intelligence development and socioemotional development in 1~3 years old children with expressive language disorder,and provide a basis for early intervention.Methods125 cases with expressive language disorder(language disorder group) and 126 normal children (normal group) are evaluated in two parts (intelligence and social mood) with 0~6 years old neuropsychological development diagnosis scale and Chinese version of urban infant-toddler social and emotional assessment.Results (1)The scores in language disorder group were lower than normal group in the area of free movements (81.60±10.40 vs 89.62±7.94),adaptability (81.48±10.95 vs 91.25±8.89),language (67.46±7.20 vs 89.13±8.24),social behavior (76.61±9.73 vs 90.12±8.13) and total developmental quotient (80.17±6.39 vs 91.15±6.05) (P<0.05).(2) There were significant differences between language disorder group and normal group in the area of externalizing behavior(56.28±10.15 vs 53.57±7.91),deregulation (56.45±10.61 vs 51.11±9.32) and capabilities(46.79±9.08 vs 51.25±7.47) (P<0.05).The boys' scores in internalizing behavior were lower than the girls' (49.19±10.76 vs 54.71±9.90) (P<0.05).(3) The scores of gross motor had positive correlation with externalizing behavior (r=0.220,P<0.05).The scores of language had negative correlation with externalizing behavior and deregulation(r=-0.650,P<0.05;r=-0.470,P<0.05).The scores of social behavior had negative correlation with externalizing behavior (r=-0.208,P<0.05).There was also a negative correlation between total development and deregulation (r=-0.184,P<0.05).(4) Multiple stepwise linear regression results showed that the externalizing behavior domain and mothers' education could predict 44.1% of variances in the language area.ConclusionThe children with expressive language disorder not only show backward in level of language development,but also in the development of other areas,and also bad social behavior and emotional problems.Individualized parenting interventions should be adopted to promote these children's intelligent development in an all-round way.

Objectives To explore the relationships between the current physical exercise behaviors and psychological factors of middle school students,so as to provide scientific evidence for improving health education and carrying out targeted health intervention measures.Methods The Multi-stage stratified sampling and cluster sampling method was adopted to choose 3600 students from 12 junior and senior middle schools in Hangzhou,Wuhan and Xi'an.The date was collected using the adolescent physical exercise behavior-psychological measurement scale(Chinese version).The structural equation model was built to explore the relationships between psychological factors(including the change of strategy,decision balance positive effect,decision balance negative effect and self-efficiency)and physical exercise.Results The change of strategy has biggest effect on physical exercise behaviors,with the standardized direct effect value of 0.344.The standardized direct effect value of decision balance negative effect,decision balance positive effect and self-efficiency were 0.071,0.093 and 0.169 respectively.The negative correlation among the four dimensions was significant statistically.Conclusion Psychological factors have direct effects on the change of the behaviors,and the change of the strategy has the largest impact on physical exercise behaviors of middle school students.The four psychological factors are closely correlated with one another,which is important in formulating middle school sports programs to promote the physical quality of middle school students.

The oligonucleotide microarray, a high-throughput polymorphism detection technology, holds great promise for the characterization of complex genetic variance. To achieve greater sensitivity and specificity for it to be an effective platform technology we present results and discuss some of the factors influencing signal intensities and single-mismatch discrimination in array-based mutation/SNP detection. Probes with a series of concentrations were spotted onto the slide in order to find the optimal concentration with the identifiable satisfying signals and the stable ratios between matched and mismatched probes. It was found that under our experimental conditions, when the initial probe concentration is higher than the maximum immobilization capability of the slide (7.5 micrometer), the hybridization signal will be saturated and the ratio between matched and mismatched probes will be more stable than at a lower probe concentration. Considering the cost of probes and the systematic stability, a constant spotting concentration of 10 micrometer was selected. The stability of different types of mismatched oligo-DNA duplexes on the glass surface was also confirmed. The results show that the order of stability of mismatched oligo-DNA duplexes on a glass surface is in general agreement with previous reports conducted using liquid and polyacrylamide gel pads. This suggests that the influence of the mismatched base pair on the stability of the duplex in a solid hybridization system is similar to that in the solution hybridization environment.
Nucleic Acid Heteroduplexes/chemistry ; *Nucleic Acid Hybridization ; *Oligonucleotide Array Sequence Analysis ; Oligonucleotide Probes/chemistry ; *Polymorphism, Single Nucleotide ; Research Support, Non-U.S. Gov't

Objective:To develop a simple, practical and repeatable ultrasound method to locate the muscle at the trigger point of female myofascial pelvic pain(MPP), which can provide imaging reference for clinical precision treatment.Methods:A total of 113 patients with suspected MPP who came to the Women′s Hospital School of Medicine Zhejiang University from September 1, 2021 to April 20, 2023 were prospectively selected. The gynecologist performed internal examination with index finger on some pelvic floor muscles (puborectalis, pubococcygeus, iliococcygeus, coccygeus) and pelvic wall muscles (piriformis and obturator internus) respectively, searched for the muscles where the pain trigger point was located, and scored the pain by referring to visual analogue scale (VAS) and numerical rating scale (NRS), and then referred the patients to the ultrasound department. The ultrasound doctor used transvaginal ultrasound to display the above muscle groups in real time for observation and appropriate pressure. The muscle where the painful trigger point was located was found through tenderness and the pain score was performed. The two scores were compared for consistency and difference analysis.Results:The trigger point was clear and of good reproducibility. For the location and score of pain trigger points located in bilateral puborectalis, pubococcygeus and coccygeus, there was a strong consistency between the tenderness guided by vaginal ultrasound probe and clinical palpation (the consistency rate was ≥70%), and there was no significant difference in the pain scores of the trigger points located in the puborectalis muscle and coccygeal muscle between the two methods ( P>0.05), and there was statistically significant difference in the pain scores of the trigger points located in the other pelvic floor and pelvic wall muscles (all P<0.05). At the same time, ultrasonic examination made up for the deficiency of clinical palpation in the evaluation of piriformis muscle. Conclusions:The present method for finding the trigger point of MPP guided by the ultrasound probe is a new non-invasive, safe, simple and practical imaging method, which can provide a new imaging reference for the clinical diagnosis of MPP and the formulation of treatment strategies.