Objective Our aim was to study the influence of integration courses combining the death education and resilience cultivation on nursing students.Methods 290 nursing students were randomly divided into the control group and the intervention group with 145 students in each group.The students in the intervention group was provided with the integration courses for 20 class hours based on the curricula of the control group.The influence on the resilience,death anxiety,feeling of sense of life,coping style of students was observed.Results Measurement results showed that the students of two groups had no differences in the four aspects before education,but after education the two groups students showed significant difference,including the average score of resilience and death anxiety,total score of feeling of sense of life as well as the dimensions score of life goals and life value t value was 5.703,3.294,3.649,4.130 and 2.129,P ＜ 0.05.In addition,the mean effectiveness of positive coping styles,problem solving and seeking social support of the two groups showed significant difference too,and all the difference had statistical sense,t value was 1.992,1.977 and 3.344,P ＜ 0.05.Conclusions The integration course can reduce death anxiety as well as improve the resilience of nursing students.

Objective To assess the value of two-dimensional and color Doppler ultrasonography in diagnosis of Hashimoto thyroiditis (HT) .Methods Sixty-five patients with HT (HT group) confirmed histologically underwent two-dimensional and color Doppler ultrasonography.Sixty volunteers with normal thyroid ultrasonogram were enrolled as control group.Ultrasonic characteristics (size,echo,blood flow distribution,peak systolic velocity of the superior thyroid artery,accompanied nodules) ,pathological finding and laboratory parameters were recorded.Results The volume of thyroid increased in HT group than that of control group (t=10.748,P＜0.001) .Ultrasonic characteristics of HT were as followed:hypoechoic parenchyma (51/65,78.46%) ,multiple liner bright echoes throughout the parenchyma (46/65,70.77%) ,single or multiple macronodules in the parenchyma (6/65,9.23%) .Color Doppler flow imaging (CDFI) showed obviously increased blood flow (36/65,55.38%) ,slightly increased blood flow (25/65,38.46%) ,decreased or normal blood flow (4/65,6.15%) ,among which statistical differences of T3,T4,TSH,V_(max) were detected (P＜0.001) .Conclusion There is close relationship among ultrasonic characteristics.pathological and laboratory parameters of HT.Ultrasonography has high value in diagnosis and differential diagnosis of HT.

Objective: To optimize extraction conditions to completely separate ginkgolic acids off ginkgolic flavonone glycosides and terpene lactones. Methods: A liquid liquid equilibrium model was used to simulate extracting process of active components in ginkgo biloba leaves. Results of calculation and experiment were compared to value the extraction system, and the best extracting condition was established. Results: when pH=2.5, extractant consists of 20% ethanol water solution and cyclo hexane, the best extraction efficient can be obtained. Conclusion: There is a great difference between theoretical simulating distribution ratio and experiment value in order of magnitude. However, their relative relationship is consistent.

Objective? To investigate the incidence of post-stroke depression(PSD) and its risk factors, so as to provide the theoretical reference for the prevention of community PSD. Methods? A total of 300 stroke patients hospitalized in the department of neurology in the First Bethune Hospital of Jilin University from July 2016 to May 2017 were selected and assessed by Self-rating Depression Scale(SDS) and Hamilton Depression Scale(HAMD) on their depression. The incidence of PSD was analyzed and after controlling the confounding factors, the relation between PSD and relevant influencing factors were indicated by the Odds Ratio(OR) and 95% Confidence Interval (CI). Results? The incidence of PSD was 31.6% (95/300) in the 300 stroke patients. After controlling the confounding factors, it was found that marital status, occupational status, decreased activity ability, muscle strength, neurological impairment and diabetes were closely related to PSD (P＜0.05). Conclusions? The prevalence of PSD is high and closely related to marital status, occupational status, decreased activity ability, muscle strength, neurological impairment and diabetes. Understanding the risk factors of PSD is necessary to provide intervention for the prevention and treatment of PSD, which has a certain effects in reducing PSD and improving the PSD patients' physical function.

Caspases are a group of structurally related cysteine proteases present in cytosol. One of their important common points is that the active sites contain cysteine and can specifically break the peptide bonds after the aspartic acid residues. Caspases are broadly divided into two groups based on their functions, including inflammatory Caspases and apoptotic Caspases. Inflammatory Caspases include Caspase-1, Caspase-4, Caspase-5, Caspase-11 and Caspase-12, which play important roles in the process of innate immune defense. Unlike inflammatory Caspases, apoptotic Caspases(2/3/6/7/8/910)initiate and execute an immunologically silent form of programmed cell death known as apoptosis. However, ongoing investigations have uncovered essential functions of Caspase-8 in the regulation of immunity in cells and organisms. Accumulated studies have shown that Caspases play important roles in the occurrence and development of various immunity-related diseases. In order to comprehensively elucidate the relationship between Caspases and innate immunity, and to provide some scientific basis and theoretical reference for the treatment of various diseases, this article reviews the regulation of activity and inflammation mechanism of innate immunity-related Caspase-1/4/5/11/8/12.

To assess the positive predictive value (PPV) of extended noninvasive prenatal testing (NIPT-plus) for fetal chromosomal abnormalities. This retrospective research enrolled 511 cases of pregnant women with positive NIPT-plus results at the Obstetrics and Gynecology Hospital of Fudan University from May 2017 to January 2021. Karyotype analysis and chromosome microarray analysis (CMA) techniques was applied for verification. All cases were followed to determine their pregnancy outcome. The Chi-square test was used in PPV. 63 out of 511 refused prenatal diagnosis after counseling, 448 pregnant women with prenatal diagnosis showed that the PPVs of NIPT-plus test for fetal trisomy 21, 18 and 13 (T21, T18, T13), sex chromosome aneuploidy (SCAs) and chromosome microdeletion/microduplication syndrome (MMS) were 86.0% (92/107), 79.5% (35/44), 54.5% (12/22), 39.5% (75/190), and 41.7% (30/72), respectively. The results revealed that the PPV was higher among older pregnant women compared to young pregnant women (77.8% vs. 51.9%, P<0.01). With increasing maternal age, the PPV of NIPT-plus presented increasing trends for T21, T13, and composite PPV except for T18 or SCAs. In addition, the termination rates for confirmed SCAs fetal karyotypes 45, X; 47, XXX; 47, XXY and 47, XYY were 11/11, 3/15, 91.7% (22/24) and 1/14, respectively. NIPT-plus can safely and effectively detect fetal chromosomal abnormalities and can be extended to MMS screening, significantly reducing the proportion of interventional prenatal diagnoses, and those with positive screening still require further confirmation.

To assess the positive predictive value (PPV) of extended noninvasive prenatal testing (NIPT-plus) for fetal chromosomal abnormalities. This retrospective research enrolled 511 cases of pregnant women with positive NIPT-plus results at the Obstetrics and Gynecology Hospital of Fudan University from May 2017 to January 2021. Karyotype analysis and chromosome microarray analysis (CMA) techniques was applied for verification. All cases were followed to determine their pregnancy outcome. The Chi-square test was used in PPV. 63 out of 511 refused prenatal diagnosis after counseling, 448 pregnant women with prenatal diagnosis showed that the PPVs of NIPT-plus test for fetal trisomy 21, 18 and 13 (T21, T18, T13), sex chromosome aneuploidy (SCAs) and chromosome microdeletion/microduplication syndrome (MMS) were 86.0% (92/107), 79.5% (35/44), 54.5% (12/22), 39.5% (75/190), and 41.7% (30/72), respectively. The results revealed that the PPV was higher among older pregnant women compared to young pregnant women (77.8% vs. 51.9%, P<0.01). With increasing maternal age, the PPV of NIPT-plus presented increasing trends for T21, T13, and composite PPV except for T18 or SCAs. In addition, the termination rates for confirmed SCAs fetal karyotypes 45, X; 47, XXX; 47, XXY and 47, XYY were 11/11, 3/15, 91.7% (22/24) and 1/14, respectively. NIPT-plus can safely and effectively detect fetal chromosomal abnormalities and can be extended to MMS screening, significantly reducing the proportion of interventional prenatal diagnoses, and those with positive screening still require further confirmation.

Objective:To investigate the application of multiscale low-rank plus sparsity (MLRS) modeling in fast ultra-high-field intracranial 4D Flow imaging.Methods:Ten healthy volunteers, 5 males and 5 females, aged 23-35 (29±4) years old, recruited from October 2022 to January 2023 at Huashan Hospital of Fudan University, were prospectively collected. A MLRS model acceleration algorithm was proposed according to the characteristics of 4D Flow data based on the multiscale low-rank (MLR) model. Firstly, full sampling brain 4D Flow scans were performed on healthy volunteers using 7.0 T MR, and the acquired data were under-sampled with Gaussian distributions at different acceleration rates (R of 4, 8, 12, and 16, respectively). The root mean square error (RMSE) and peak signal-to-noise ratio (PSNR) of the compressed sensing algorithm (CS), low-rank plus sparse algorithm (L+S), MLR, and MLRS model were calculated at different acceleration rates, with fully sampled data as reference. And the comparison of models was performed using the paired-samples t-test or Wilcoxon signed rank test. Pearson′s test was used to assess the correlation between hemodynamic parameters of the 4 algorithms and the fully sampled reference values at different acceleration rates, and the correlation coefficients were compared using Wilcoxon signed rank test. Results:The RMSE under the same acceleration rates was MLRS, MLR, L+S, and CS models in ascending order, and the RMSE of the MLRS model was significantly lower than that of the MLR, L+S, and CS models ( P<0.05); the PSNR was MLRS, MLR, L+S, and CS models in descending order, and the PSNR of the MLRS model was significantly higher than that of the MLR, L+S, and CS model ( P<0.05). The correlation coefficients between the blood flow velocity measured by the MLRS model and the reference value were significantly higher than those of the MLR, L+S, and CS models for different acceleration rates ( P<0.05). Conclusion:The proposed MLRS algorithm is capable of accelerating ultra-high-field 4D Flow MR imaging of the brain while guaranteeing the image quality, and the MLRS model has higher reconstruction accuracy compared with conventional acceleration models at the same acceleration rate.

Objective:To evaluate the effectiveness of oral-nasal oxygen supply mouth guard in painless gastroscopy for snoring patients.Methods:The snoring patients who underwent painless gastroscopy at two Endoscopy Centers of Shanghai East Hospital, Tongji University in July 2022 were randomly divided into the observation group (using oral-nasal oxygen supply mouth guard) and the control group (using ordinary nasal oxygen tube and mouth guard). Parameters such as the wearing time and the removal time of the mouth guard, lowest pulse oxygen saturation (SpO 2), incidence of hypoxemia, and the satisfaction of medical staff were compared between the two groups. Results:The wearing time of mouth guard was 11.63±0.84 seconds and the removal time was 5.33±0.76 seconds in the observation group ( n=40), which were lower than those in the control group ( n=47) (14.91±1.21 seconds, t=-14.463, P<0.001; 10.38±0.80 seconds, t=-30.095, P<0.001). The wearing satisfaction score was 9.80±0.61, the lowest SpO 2 was (96.70±3.42)%, the removal satisfaction score was 9.75±0.67, and the anesthesiologists' satisfaction score was 9.20±1.42 in the observation group, which were higher than those in the control group [7.70±0.93, t=12.209, P<0.001; (94.06±3.72)%, t=3.417, P=0.001; 7.96±0.98, t=9.803, P<0.001; 8.13±1.35, t=3.615, P=0.001] with significant difference. There was no significant difference in the incidence of hypoxemia [10.00% (4/40) VS 14.89% (7/47), χ2=0.130, P=0.718] and endoscopic physician satisfaction score (9.30±0.97 VS 9.02±1.31, t=1.112, P=0.269) between the two groups. Conclusion:The oral-nasal oxygen supply mouth guard is easy to wear and remove, effectively reducing SpO 2 fluctuations during painless gastroscopy for snoring patients. It can enhance medical staff satisfaction with high clinical value.

ABSTRACT The Association Standard of Practice Specification for Manipulation of Drugs was released by Zhejiang Council for Health Services Promotion in 2023. This standard contains the basic conditions, operating procedures, quality control, storage and validity management, in particular, it provides a detailed and operable process in various dose division modes, which provides a working basis for its work. In this paper, the development background of the group standard and the main technical content of the group standard are interpreted in detail, aiming to provide guidance and reference for the publicity and implementation of the standard.