ObjectiveTo explore the effects of insomnia on heart rate variety(HRV) in aged hypertension patients. Methods259 subjects were divided into healthy group (74 cases),simple hypertension group (71 cases),coexisting hypertension and insomnia group (114 cases) which was sub-grouped to ＜5 years,5-9 years and ≥-10 years according to the duration of insomnia.All subjects had 24 h recordings of ECG.The data of HRV time domain (SDNN,SDANN and ASDNN) were collected and compared.ResultsHRV time domain was lower in healthy group than in the other two groups (F=12.02,10.54 and 4.27,P＜0.01),and decreased more significantly in coexisting hypertension and insomnia group compared with simple hypertension group(P＜0.01).The values of SDNN and SDANN in 5-9 years and ≥ 10 years subgroups decreased as compared with ＜ 5 years subgroup (F=8.63 and 4.54,P＜0.01),and these values further lower in ≥10 years subgroup than in 5-9 years subgroup (P＜ 0.01 ). ConclusionsInsomnia may lead to more serious disorder of automatic nervous system and further aggravated disorders appear in the elderly with hypertension along with increasing years of insomnia.

Objective To investigate behavioral and endocrinal changes following the conflict-related stress. Method Male SpragueDawley rats were exposed to stressors using Vogel conflict test. Body weight and behavioral responses in open field test were investigated during the whole procedure. Serum corticosterone level was analyzed using immunoassay. Results Compared with the control, the rats of the 1-week, 2-week and 4-week stressed group showed significantly decreased body weight. There was increasing tendency or significant difference in locomotion between the 1 -week, 2-week and 4-week stressed group and their control. And the hormone levels for the stressed animal were reliably high. Conclusions The increased locomotion, and high corticosterone level and reduced body weight in stress animal,was consistent with the features of anxiety-like disorders. Furthermore, the behavioral and endocrine changes produced by conflict-related stress could maintain a long time. The conflictrelated stress paradigm may be used as psychological stress animal mode in the future.

Objective:To investigate the role of endogenous hydrogen sulfide(H2S)in patients with asthma.Methods:Levels of serum H2S,lung function and cell differential count in induced sputum were studied in 44 patients with acute exacerbation of asthma,33 patients with stable asthma and 12 health subjects.Of the 33 patients with stable asthma,3 failed to achieve induced sputum.Results:The serum H2S level was(75.2?13.0)?mol/L in controls(12 cases),(55.8?13.6)?mol/L in patients with stable asthma(33 cases),(57.8?6.3)?mol/L in patients with mild of acute exacerbation asthma(9 cases),(40.8?5.1)?mol/L in that with moderate of acute exacerbation asthma(13 cases),and(31.3?2.9)?mol/L in that with severe of acute exacerbation asthma(22 cases,F=44.592,P

Objective:To investigate the effects of pulmonary rehabilitation on anxiety/depression and subjective/objective sleep quality of elderly patients with stable chronic obstructive pulmonary disease(COPD).Methods:From February 2018 to February 2019, 120 elderly patients with stable COPD were selected and randomly divided into the experimental group (pulmonary rehabilitation exercise combined with conventional COPD treatment) and the control group (simple COPD conventional treatment). Sixty cases in each group were intervened for 8 weeks. Before and after treatment, Hamilton anxiety scale (HAMA) was used to evaluate anxiety, Hamilton depression scale(HAMD)was used to evaluate depression, Pittsburgh sleep quality index(PSQI)and sleep log were used to evaluate subjective sleep quality, and objective sleep quality was monitored by multi-channel sleep monitor.SPSS 21.0 software was used to analyze and process the data. Chi square test, independent sample t test and paired t test were used for statistical analysis. Results:After 8 weeks of intervention, the HAMA and HAMD scores of the experimental group were lower than those of the control group (HAMA: (7.57±3.19) vs (10.15±4.89), t=-3.428, P=0.001; HAMD: (8.22±4.73) vs (10.60±6.49), t=-2.300, P=0.023). COPD patients with anxiety decreased (χ 2=7.566, P=0.006). After treatment, the subjective sleep latency of the experimental group was shorter than that of the control group ((42.00±9.88)min vs (47.25±10.27)min, t=-2.854, P=0.005). The subjective sleep efficiency was higher than that of the control group ((76.00±4.50)% vs (74.00±5.20)%, t=2.272, P=0.025), and the objective sleep latency was shorter than that of the control group ((28.02±5.59)min vs (32.95±6.21)min, t=-4.575, P<0.05). Conclusion:Pulmonary rehabilitation exercise can improve the anxiety and depression of elderly patients with stable COPD, and improve the subjective and objective sleep quality.

Objective To investigate the relationship between proinflammatory cytokines and cognitive function in patients with mild cognitive impairment (MCI).Methods From May 2007 to May 2009,70 patients (aged ≥ 60 years) with MCI were collected.Among them,50 cases were amnestic MCI,and 19 cases developed into AD.The cognitive function was assessed,and all patients were followed up.The venous blood samples were obtained and proinflammatory cytokines (IL-1α,IL 1β,IL-6,TNF-α) were detected by using enzyme linked immunosorbent assay.Results There were differences in the levels of proinflammatory cytokines between patients with aMCI and patients with Alzheimer's disease (AD) [IL-1β,(40.5 ± 7.7) μg/L vs.(38.6 ± 7.3) μg/L ; IL 6,(70.4 ±24.3) μg/'L vs.(53.6±20.5) μg/L;TNF-α,(58.6±13.5) μg/'L vs.(50.3±-17.1) μg/'L;t=3.537,2.229,2.226,P=0.002,0.039,0.039,respectively].Conclusions MCI is a preclinical state of AD.The cognitive function damage of MCI patients are different from that of AD patients,and the immune status of MCI patients is also changed.

Objective To explore the changes of pathogens and antibiotic susceptibility in a respiratory ward.Methods All pathogens isolated from patients in a respiratory ward from 2001 to 2005 and the drug susceptibility results were retrospectively analyzed.For patients with more than 1 isolates of the same species, only the first strain of pathogen was included for analysis. The isolation and identification procedure was based on guidelines for national clinical laboratories.The susceptibility test was performed by disk diffusion method.WHONET 5.3 software was used for statistical analysis.Results A total of 876 strains were analyzed.The majority was gram negative bacteria.MRSA prevalence was 72.4% and showed a trend of increase.No vancomycin resistant Staphylococcus aureus or Enterococcus was detected.Streptococcus pneumoniae was highly resistant to macrolides.The non-sensitivity rate to penicillin was 25.5%-66.7% over years.The resistance rate to levofloxacin was 22.2%-27.3%.Enterobacter and Acinetobacter baumannii showed stable susceptibility to imipenem.ESBLs-producing Esche- richia coli and Klebsiella pneumoniae accounted for 33.3%-38.9% and 14.3%-19.2% respectively.P.aeruginosa strains were relatively susceptible to ceftazidime, amikaein, cefoperazone-sulbactam, imipenem, piperacillin-tazobactam and cefepime. The sensitivity rate was 87%, 82.6%, 78.3%, 73.9%, 73.9% and 71.4% respectively in 2005.Conclusions The changes of pathogens and antibiotic resistance in the respiratory ward were consistent with the surveillance data in this country, which were influenced by underlying diseases, severity of illness and antibiotic use.Our data are useful for the guidance of rational use of antibiotics.

Objective:To explore the effect of implementing group empowerment management model based on Myers-Briggs Type Indicator (MBTI) Scale on the quality of orthopedic nursing management.Methods:From January 2018 to December 2019, MBTI Scale was used to test the personality types of 46 nurses in Department of Orthopedics in Zhejiang Hospital. Test results were analyzed and nurses were grouped and given empowerment management measures. Score of orthopedic nurses on the leaders, score of psychological empowerment of nurses and score of nursing quality were compared before and after the improvement of management.Results:MBTI Scale was used to classify personality types of 46 orthopedic nurses, among which ISFJ, ISTJ, ENFP and ESFJ were the most common personality types. After the implementation of empowerment management, score of nurses on the leaders, score of psychological empowerment of nurses and score of nursing quality were all improved than before, and the differences were statistically significant ( P<0.05) . Conclusions:Based on MBTI Scale, the group empowerment management of orthopedic nurses can give full play to the core advantages of nurses, improve self-management ability of nurses and nursing quality.

Objective:To investigate the surgical strategy for chronic pancreatitis complicated with suspected malignant lesions in the pancreatic head and pancreatolithiasis in the distal pancreas.Methods:This is a retrospective cohort study. Clinical data from 11 patients with chronic pancreatitis who underwent pancreaticoduodenectomy combined with longitudinal pancreaticojejunostomy(PD-L) were retrospectively collected(PD-L group) from the Department of Hepatobiliary Surgery of the First Affiliated Hospital of Xi′an Jiaotong University between December 2021 and September 2023. All patients were male with an age of (49.0±11.2) years(range:32 to 70 years). Their primary preoperative diagnoses included pancreatic lesions, chronic pancreatitis, pancreatolithiasis, and dilatation of the pancreatic duct. Data from 248 patients who underwent pancreaticoduodenectomy(PD) during the same period were retrospectively collected(PD group). There were 157 males and 91 females in the PD group, with an age of (61.5±10.8) years(range:27 to 82 years). Among them, 87 cases were diagnosed as pancreatic cancer or chronic pancreatitis. The propensity score matching method was used to reduce confounding bias between the two groups. The caliper value of 0.1 was used and the 1∶4 nearest neighbor matching method was used for the matching. Comparisons between the two groups were made using the independent sample t test, Mann-Whitney U test or χ2 test,respectively. Results:After complete excision of the specimen during pancreaticoduodenectomy, the key surgical step of PD-L was longitudinal pancreaticojejunostomy in the remaining pancreas. Intraoperative blood loss in the PD-L group was lower than that in the PD group [ M(IQR)](300(200)ml vs. 500(500)ml, respectively; P<0.05). Similarly, hospitalization days(21.0(7.0)days vs. 25.0(8.5)days) and postoperative hospitalization days(13.0(8.0)days vs. 17.0(5.0) days) were also lower in the PD-L group compared to the PD group ( P<0.05). There were no significant differences in the operation time and postoperative complication rate between the two groups( P>0.05). In the PD-L group, the postoperative follow-up time was 5(5)months(range: 3 to 21 months). One case was lost for follow-up. Abdominal pain was relieved in 10 patients. Additionally, abdominal distension and steatosis were alleviated in 8 cases. Furthermore, 5 cases of diabetes mellitus showed improved control of HbA1c and fasting blood glucose levels after surgery. Conclusions:PD-L treatment can be used to treat chronic pancreatitis complicated by suspected malignant lesions in the pancreatic head and pancreatolithiasis in the distal pancreas. PD-L also has advantages in removing stones from the pancreatic duct and evaporation of pancreatic fluid. However, due to the single-center design and the small sample size of this study, further practice and long-term follow-up are still necessary.

Objective:To investigate the surgical strategy for chronic pancreatitis complicated with suspected malignant lesions in the pancreatic head and pancreatolithiasis in the distal pancreas.Methods:This is a retrospective cohort study. Clinical data from 11 patients with chronic pancreatitis who underwent pancreaticoduodenectomy combined with longitudinal pancreaticojejunostomy(PD-L) were retrospectively collected(PD-L group) from the Department of Hepatobiliary Surgery of the First Affiliated Hospital of Xi′an Jiaotong University between December 2021 and September 2023. All patients were male with an age of (49.0±11.2) years(range:32 to 70 years). Their primary preoperative diagnoses included pancreatic lesions, chronic pancreatitis, pancreatolithiasis, and dilatation of the pancreatic duct. Data from 248 patients who underwent pancreaticoduodenectomy(PD) during the same period were retrospectively collected(PD group). There were 157 males and 91 females in the PD group, with an age of (61.5±10.8) years(range:27 to 82 years). Among them, 87 cases were diagnosed as pancreatic cancer or chronic pancreatitis. The propensity score matching method was used to reduce confounding bias between the two groups. The caliper value of 0.1 was used and the 1∶4 nearest neighbor matching method was used for the matching. Comparisons between the two groups were made using the independent sample t test, Mann-Whitney U test or χ2 test,respectively. Results:After complete excision of the specimen during pancreaticoduodenectomy, the key surgical step of PD-L was longitudinal pancreaticojejunostomy in the remaining pancreas. Intraoperative blood loss in the PD-L group was lower than that in the PD group [ M(IQR)](300(200)ml vs. 500(500)ml, respectively; P<0.05). Similarly, hospitalization days(21.0(7.0)days vs. 25.0(8.5)days) and postoperative hospitalization days(13.0(8.0)days vs. 17.0(5.0) days) were also lower in the PD-L group compared to the PD group ( P<0.05). There were no significant differences in the operation time and postoperative complication rate between the two groups( P>0.05). In the PD-L group, the postoperative follow-up time was 5(5)months(range: 3 to 21 months). One case was lost for follow-up. Abdominal pain was relieved in 10 patients. Additionally, abdominal distension and steatosis were alleviated in 8 cases. Furthermore, 5 cases of diabetes mellitus showed improved control of HbA1c and fasting blood glucose levels after surgery. Conclusions:PD-L treatment can be used to treat chronic pancreatitis complicated by suspected malignant lesions in the pancreatic head and pancreatolithiasis in the distal pancreas. PD-L also has advantages in removing stones from the pancreatic duct and evaporation of pancreatic fluid. However, due to the single-center design and the small sample size of this study, further practice and long-term follow-up are still necessary.

Objective:To observe the relationship between inducible carbon monoxide synthase (iNOS) and delayed encephalopathy after acute carbon monoxide poisoning (DEACMP), and explore its mechanism of action in DEACMP.Methods:This study was designed as prospective cohort study. Patients with acute carbon monoxide poisoning who met the diagnostic criteria and were admitted to Emergency Intensive Care Unit(EICU) of our hospital from June 2019 to June 2021 were selected as subjects. Patients were divided into the DEACMP group and non-DEACMP group according to the occurrence of DEACMP. Serum samples were collected on the first 24 h after admission and on day 7 and 14 after admission, and the serum nitric oxide (NO), neuronal nitric oxide synthase (nNOS), inducible carbon monoxide synthase (iNOS), and endothelial nitric oxide synthase (eNOS) level were measured by enzyme-linked immunosorbent assay. The generalized estimating equation was used to estimate the difference of NO, nNOS, iNOS and eNOS between DEACMP and non-DEACMP patients.Results:A total of 78 patients with carbon monoxide poisoning were included in our study finally, including 49 (62.82%) males and 29 (37.18%) females, with an average age of (53.96±14.95) years, 20 (25.64%) patients with DEACMP, and 1 (1.28%) death. Univariate analysis showed that patients with DEACMP had an average increase of 3 h (95% CI: 1.00, 5.00) in carbon monoxide exposure time and a 5-point decrease in GCS score (95% CI: 1.00, 6.00) than the patients without DEACMP, and the proportion of patients with severe carbon monoxide poisoning in the DEACMP group was higher than that of the non-DEACMP group (90.00% vs. 32.76%). According to the analysis of generalized estimation equation, on day 7 and 14 after admission, Compared with non-DEACMP patients, neither by performing unadjusted nor adjusted analysis with the iNOS of DEACMP patients was significantly higher than that in non-DEACMP patients regardless of whether exposure time, GCS score, coma time or severity of carbon monoxide poisoning were adjusted or not ( P <0.01 or P <0.05). Except for the level of nNOS in the GEE model adjusted with carbon monoxide exposure time, the levels of NO, nNOS and eNOS showed no significant difference between DEACMP and non-DEACMP patients ( P >0.05). Conclusions:The expression of iNOS level is increased in DEACMP patients, and its continuous expression may be involved in the pathogenesis of DEACMP.