Objective: To investigate the hepatitis C prevention and control knowledge among clinicians in Jiaxing City, Zhejiang Province, so as to provide the evidence for intensified training and improved diagnosis and treatment of hepatitis C among clinicians. Methods: In November, 2021, clinicians were sampled using a stratified random sampling method from a city-level and a county (district)-level hepatitis C designated hospital in Jiaxing City. A questionnaire survey was performed using the Questionnaire for Hepatitis C Prevention and Control Knowledge among Clinicians, and the awareness of basic knowledge, professional knowledge and related knowledge about hepatitis C prevention and control among clinicians were descriptively analyzed. Results: A total of 186 questionnaires were allocated and 179 valid questionnaires were recovered, with an effective recovery rate was 96.24%. The respondents included 107 men (59.78%) and 72 women (40.22%) and had a mean age of (37.06±9.46) years. There were 107 respondents with a bachelor degree (59.78%), 56 with junior professional titles (31.28%), and 170 from non-infectious disease departments (94.97%). The awareness of basic hepatitis C prevention and control knowledge was 96.09%, and the awareness of “Transfusion of blood containing hepatitis C virus may acquire hepatitis C” was high (98.88%), and the awareness of “Hepatitis C can be cured” was low (77.09%). The awareness of professional hepatitis C prevention and control knowledge was 3.91% to 100.00%, and the awareness of “Pathogens of hepatitis C” (100.00%) and “Recommended screening populations for hepatitis C” (86.59%) was high, while the awareness of “There are two categories of hepatitis C cases: clinically diagnosed cases and confirmed cases” (3.91%) and “Clinical diagnosis of hepatitis C: positive anti-HCV antibody + any one of abnormal liver function or epidemiological history or clinical symptoms” (3.91%) was low. The awareness rates of “The state has included antiviral agents against hepatitis C into medical insurance” was and “Antiviral agents against hepatitis C are reimbursed in outpatient and inpatient departments of our hospital” were 81.56% and 59.78%, respectively. There were 69 clinicians participating hepatitis C-related training within one year (38.55%), and the awareness of clinicians that had participated in hepatitis C-related training had a higher awareness rate of basic hepatitis C prevention and control knowledge than those without participation (100.00% vs. 93.64%, P<0.05). Conclusion The awareness of basic hepatitis C prevention and control knowledge is high among clinicians in Jiaxing City; however, the training on diagnosis and classification criteria of hepatitis C and related medical insurance policy require to be improved.

Objective:To evaluate the clinical efficacy of 1 064 nm/755 nm dual wavelength laser on hair removal.Methods:A total of 60 patients aged 18-52 (30±7) years in our hospital from January 2017 to December 2017 were collected. 1 064 nm and 755 nm laser hair removal was performed at the same symmetrical areas or two different areas in the same patient. We performed 6 sessions of laser treatment at 6-week intervals and the effect was evaluated 6 weeks after the last session.Results:The hair removal efficacy was 96.7% (58 cases) at 1 064 nm, 96.7% (58 cases) at 755 nm laser treatment. There was no significant difference in the effective rate between two wavelengths laser hair removal methods ( P>0.05). The incidence of pigmentation was 1.7% (1 case) at 1 064 nm laser and was 3.3% (2 cases) at 755 nm laser without significant difference ( P>0.05). No hypopigmentation, blister or scar appeared in all patients. The total satisfactory rate was 95.0% (57 cases) at 1 064 nm, 98.3% (59 cases) at 755 nm laser treatment, respectively. Conclusions:1 064 nm/755 nm dual wavelength laser has definite therapeutic effect and safety on hair removal.

Objective To investigate clinical and epidemiological features of pneumocystis jirovecii pneumonia (PJP) in kidney transplant recipients. Methods Clinical data of 68 kidney transplant recipients admitted from July, 2021 to December, 2021 were collected. All patients were divided into the PJP group (n=11), common pulmonary infection group (n=24) and non-pneumonia group (n=33) according to the status of pulmonary infection. The incidence and treatment of PJP after kidney transplantation were analyzed. Basic characteristics and laboratory parameters of the recipients were compared among all groups. The genotyping and transmission map of PJP patients were evaluated. Results Among 64 kidney transplant recipients, 11 cases were definitely diagnosed with PJP. The most common clinical manifestations included elevated body temperature, and dry cough complicated with progressive dyspnea. Chest CT scan showed diffuse interstitial inflammation and ground glass-like lesions of bilateral lungs in all patients. After diagnosis, all patients were orally given with compound sulfamethoxazole for 3-4 weeks. Two patients received non-invasive ventilator-assisted ventilation due to severe lung infection and dyspnea, and the remaining patients were given with nasal cannula oxygenation. One patient experienced elevated serum creatinine level upon discharge, and developed renal allograft failure. The remaining 10 recipients with PJP obtained normal renal allograft function, and no recipient died. Compared with the non-pneumonia group, the rejection rate was higher, the length of hospital stay was longer, the lymphocyte count was less, the lymphocyte proportion was lower, the levels of C-reactive protein, serum creatinine and lactate dehydrogenase were higher, and the levels of serum albumin was lower and CD4⁺T cell count was less in the PJP group (all P < 0.05). Compared with common pulmonary infection group, the lymphocyte count was less, the lymphocyte proportion was lower, the CD4⁺T cell count was less and 1, 3-β-D- glucan (BDG) level was higher in the PJP group (all P < 0.05). No new genotype was detected in 10 of the 12 testing samples. It was considered that PJP mainly depended on two transmission chains and two independent transmission individuals. Conclusions Kidney transplant recipients are prone to pneumocystis jirovecii (PJ) infection due to impaired cellular immune function. The most common clinical manifestations consist of elevated body temperature and dry cough complicated with progressive dyspnea, accompanied by headache and fatigue in partial patients. Chest CT scan shows diffuse interstitial inflammation and ground glass-like lesion of bilateral lungs. PJ may be transmitted through respiratory tract. Small-scale PJP might occur in the follow-up outpatient of kidney transplant recipients. Preventive measures should be delivered in a timely manner.

Narrative medicine emphasizes the cultivation of narrative ability,providing an important pathway to promote clinical discipline teaching and guide the transformation of medical students into the role of doctors.Based on the theory of narrative medicine,the Warm Medicine course is designed with a two-layer advanced practical teaching system covering the entire life cycle of"birth,aging,illness,and death".It can train the ability of medical students to absorb,interpret,and respond to patients'stories and difficulties in actual medical scenarios.Taking the"birth"theme practice as an example,the paper presentes the specific implementation and development of the course.The practical teaching of the"birth"theme enhanced students'understanding of medical themes and their perception of the essence of life,as well as promoting the establishment of the subjectivity of doctor-patient relationships and the formation of medical students'holistic medical diagnosis and treatment thinking.

Objective To explore the role of serum Irisin,Nesfatin-1 and chitinase like protein 40(YKL-40)levels detection in evaluating the condition of patients with multiple sclerosis(MS).Methods A total of 160 MS patients who visited the First Hospital of Handan City from August 2017 to November 2023 were selected as the study subjects.According to clinical classification,they were separated into a remission group(n=115)and a progression group(n=45),and according to the severity of condition,they were separated into a mild group(n=109)and a severe group(n=51).ELISA method was applied to detect the levels of Irisin,Nesfatin-1 and YKL-40 in serum.Pearson was applied to analyze the correlation between serum Irisin,Nesfatin-1,YKL-40 levels and expanded disability status scale(EDSS)score in MS patients.Multivariate Logistic regression was applied to analyze the influencing factors of Ms Necerity.ROC curve was applied to analyze the evaluation value of serum Irisin,Nesfatin-1 and YKL-40 levels for the progression of MS patients.Results In the advanced stage group,the serum levels of Irisin(8.25±2.17 ng/ml)and Nesfatin-1(5.94±1.76 ng/ml)in MS patients were lower than those in the remission stage group(14.94±3.58 ng/ml,9.92±2.15 ng/ml),while the YKL-40(42.98±10.89 ng/ml)level was higher than that in the remission stage group(22.78±7.95 ng/ml),and the differences were statistically significant(t=11.709,11.048,12.956,all P<0.05).In the severe group,the serum levels of Irisin(8.86±2.21 ng/ml)and Nesfatin-1(6.32±1.91 ng/ml)in MS patients were lower than those in the mild group(15.02±4.42 ng/ml,9.96±2.30 ng/ml),while the disease course(5.84±1.65 years)and YKL-40(37.28±10.15 ng/ml)levels were higher than those in the mild group(3.65±1.45 years,24.34±7.62 ng/ml),and the differences were statistically significant(t=8.514,9.407,9.823,8.971,all P<0.05).Serum Irisin and Nesfatin-1 levels in MS patients were negatively correlated with EDSS scores(r=-0.504,-0.517,all P<0.05),while YKL-40 levels were positively correlated with EDSS scores(r=0.509,P<0.05).Irisin(OR=0.724,95%CI:0.589～0.889)and Nesfatin-1(OR=0.813,95%CI:0.669～0.945)were protective factors for disease progression in MS patients,while YKL-40(OR=2.964,95%CI:1.795～4.894)was a risk factor for disease progression in MS patients(all P<0.05).The AUCs of serum Irisin,Nesfatin-1 and YKL-40 levels in evaluating the progression of MS patients were 0.844,0.849 and 0.823,respectively,which were lower than the AUC(0.957)of their combination(Z=3.158,3.096,3.324,all P<0.05).Conclusion Serum Irisin,Nesfatin-1 and YKL-40 detection levels can effectively evaluate the progression of MS patient condition.

Objective To explore nursing intervention management mode that are suitable for medical environment and resources in outpatient department of stomatology in comprehensive hospitals in China, that are effect in relieving anxiety of patients, and that are with strong operability.Methods According to randomized controlled clinical trial, 208 patients, treated in Department of Stomatology from September to October in 2015, were chosen and were randomly divided into research group and control group, each with 104 cases. Routine nursing was conducted to patients in the control group, while besides that, extra multi-dimensional cognitive intervention was implemented to patients in the research group. Before and after treatment, anxiety of the patients in the two groups was evaluated by dental fear scale (DFS), and their satisfaction towards nursing was evaluated by visual analogue scale (VAS).Results Before treatment, DFS scores of patients in the research group were (50.07±10.35), and (49.18±11.67) in the control group (t=0.696,P=0.891). After treatment, DFS scores of patients in the research group were (31.27±7.02), significantly lower than before the treatment; while DFS scores of patients in the control group were (55.67±16.93), significantly higher than before the treatment; besides, DFS scores of patients in the research group were significantly lower than that in the control group (t=12.447,P<0.001). Satisfaction towards nursing of patients in the research group was 96.2%, significantly higher than 84.6% in the control group (χ2=137.692,P<0.001).Conclusions The multi-dimensional cognitive intervention can relieve anxiety of patients during dental treatment and improve patients' satisfaction towards nursing.

OBJECTIVE: To investigate the bone mineral density (BMD) of cervical vertebrae in a population-stratified manner and correlate with that of the lumbar vertebrae. MATERIALS AND METHODS: Five hundred and ninety-eight healthy volunteers (254 males, 344 females), ranging from 20 to 64 years of age, were recruited for volumetric BMD (vBMD) measurements by quantitative computed tomography. Basic information (age, height, weight, waistline, and hipline), and vBMD of the cervical and lumbar vertebrae (C2-7 and L2-4) were recorded. Comparisons among sex, age groups and different levels of vertebrae were analyzed using analysis of variance. Linear regression was performed for relevance of different vertebral levels. RESULTS: The vBMD of cervical and lumbar vertebrae was higher in females than males in each age group. The vBMD of the cervical and lumbar vertebrae in males and the vBMD of lumbar vertebrae in females decreased with aging. In each age group, the vBMD of the cervical vertebrae was higher than that of the lumbar vertebrae with gradual decreases from C2 to C7 except for C3; moreover, the vBMD of C6 and C7 was significantly different from that of C2-5. Correlations of vBMD among different cervical vertebrae (females: r = 0.62-0.94; males: r = 0.63-0.94) and lumbar vertebrae (males: r = 0.93-0.98; females: r = 0.82-0.97) were statistically significant at each age group. CONCLUSION: The present study provided normative data of cervical vertebrae in an age- and sex-stratified manner. Sex differences in vBMD prominently vary with age, which can be helpful to design a more comprehensive pre-operative surgical plan.
Aging ; Asian Continental Ancestry Group* ; Bone Density* ; Cervical Vertebrae ; Female ; Healthy Volunteers ; Humans ; Linear Models ; Lumbar Vertebrae* ; Male ; Sex Characteristics ; Spine

Objective To Pulse oximetry saturation has been wildly used clinically.It has been reported that pulse oximetry plethysmographic waveform (POP) reflected the peripheral tissue perfusion.In this study,we parameterized POP,observed the value of POP parameters in normal adults,and established the normal reference value range.Methods A multi-center prospective descriptive study.Total of 1 019 adult volunteers with normovolemia from 7 cities were enrolled in this study.Sex,age,height,weight and pulse oximetry data in awake and spontaneous breathing under in quiet conditions in the room temperature were collected.POP parameters and perfusion index were analyzed using MATLAB 2012a software.The normal reference value ranges of POP parameters,including the amplitude of POP (Amp) and the area under the curve of POP (AUC),were formulated.Results Statistical differences of POP parameters were detected between men and women in the normal adult.The 95％ confidence reference value of POP parameters in normal population was as follows:Amp (104.8-2298.7) PVA and AUC (3265.8-6028.5) PVPGin total,Amp (129.4-2433.6) PVA and AUC (3319.0-5862.2) PVPG in male;Amp (89.5-2138.2) PVA and AUC (3163.9-5929.9) PVPG in female.Conclusions POP,including the amplitude of POP (Amp) and the area under the curve of POP (AUC),had normal reference value ranges in normal adults.

Objective To assess right ventricular systolic function using real-time three-dimensional right ventricular quantitative analysis (RT-3DRVQ) in patients with coronary artery disease (CAD) complicating left heart failure. Methods Sixty-eight patients diagnosed with CAD and left heart failure were selected as the case group.Among them,38 individuals were associated with pulmonary hypertension (PH) and 30 were without. Another 30 healthy people were recruited as control group. Conventional echocardiographic parameters,as well free wall and septum longitudinal strains of right ventricle were evaluated in all subjects. Results Patients with left heart failure had significant lower strain values than control group( P <0.001).In case group,three-dimensional derived right ventricular free wall longitudinal strain (3D-FWLS) had strongly correlation with right ventricular ejection fraction ( r = -0.877, P <0.001). The patients with PH had also significantly reduced 3D-FWLS values compared with patients without PH ( P < 0.01),and the area under the curve was 0.726 using ROC method to predict patients with PH.Conclusions RT-3DRVQ could be recognized as a good technology to evaluate right ventricular systolic function,which would provide valuable information for clinical decision-making.

Cellular dysfunction caused by vesicle transport is associated with a variety of diseases.The trans-Golgi network(TGN)to endosome transport is an important pathway of vesicle transport,and its defects leading to protein balance disorders has been linked to many diseases such as cancer,neurodegenerative diseases and diabetes mellitus.Gol-gi-associated gamma-adaptin ear-containing ADP-ribosylation factor-binding protein 2(GGA2)is a crucial protein in-volved in TGN-endosomal transport.It plays a significant role in the regulation of several diseases,including cancer,Al-zheimer disease,type 2 diabetes mellitus and cerebral ischemia,by mediating protein transport with important biological significance.This article provides an overview of the molecular structure of GGA2,its role in regulating clathrin-mediated protein transport between TGN and endosomes,and its potential implications for a variety of diseases.