Objective To investigate the significance of procalcitonin(PCT),C-reactive protein (CRP)and WBC counts in predicting the postoperative jnfections in patients with bone fractures.Methods Clinical data of 49 patients with open fractures were retrospectively analyzed,and the patients were grouped into the infeeted(n=24)and non.infected(n=25).PCT,CRP and WBC values were detected 1,4,7and 10 days after the operations,and the results were compared with those taken from the healthy controls.Areas under the receiver operating characteristic(ROC)curves were used to determine the value in predicting postoperative infections.Results PCT,CRP and WBC values in the infected group and the noninfected group were higher than those in health controls(F=19.84,57.71 and 35.44,P＜0.01).PCT,CRP and WBC values in the infected group were higher than those in the non-infected group 4.7 and 10 days after the operations(tPCT=7.31,7.74 and 4.59;tCRP=2.23,5.75 and 8.01;tWBC=2.34,2.51 and 4.07,P＜0.05).ROC curves suggested that PCT value was more sensitive and had higher specificity than CRP and WBC values in the diagnosis of postoperative infections.Conclusions PCT,CRP and WBC values arise in bone fracture patients with postoperative infections.Detection of PCT has higher sensitivity and specificity.which can be used in early diagnosis of postoperative infections.

Cachexia is a common complication in patients with lung cancer. It aggravates the toxic and side effects of chemotherapy, hinders the treatment plan, weakens the responsiveness of chemotherapy, reduces the quality of life, increases complications and mortality, and seriously endangers the physical and mental health of patients with lung cancer. The causes and pathogenesis of tumor cachexia are extremely complex, which makes its treatment difficult and complex. Controlling cachexia in lung cancer patients requires many means such as anti-tumor therapy, inhibition of inflammatory response, nutritional support, physical exercise, and relief of symptoms to exert the synergistic effect of multimodal therapy against multiple mechanisms of tumor cachexia. To date, there has been a consensus within the discipline that no single therapy can control the development of cachexia. Some therapies have made some progress, but they need to be implemented in combination with multimodal therapy after fully assessing the individual characteristics of lung cancer patients. This article reviews the application of drug therapy and nutritional support in lung cancer patients, and looks forward to the research direction of cachexia control in lung cancer patients.
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Cachexia/therapy* ; Combined Modality Therapy ; Humans ; Lung Neoplasms/drug therapy* ; Neoplasms/complications* ; Nutritional Support/adverse effects* ; Quality of Life

Objective To explore the development trends in community nursing. Methods The current situation of community nursing in Shanghai was analyzed by means of questionnaire surveys and literature review. Subjects A total of 3 173 questionnaires were distributed to community nurses, hospital nurses, community residents, and hospitalized patients and 2 942 of them were retrieved, the rate of retrieval being 93.8%. Results The demand for community nursing was not satisfied, the number of community nurses was insufficient and their general quality was low. Conclusion The scope of services in community nursing needs to be expanded with demand as a guide, more community nurses need to be cultivated, and the quality of the nursing contingent needs to be enhanced.

Objective To investigate the effect of fasting blood glucose control and its influencing factors in patients with type 2 diabetes mellitus (T2DM) in community.Methods 905 cases of patients with T2DM were collected in Rencheng District of Jining city according to the stratified cluster random sampling method.The general demographic characteristics and lifestyle of the subjects were collected by questionnaire survey,and the height,body weight,blood glucose,blood pressure and blood lipids were measured by physical examination.Multivariate Logistic regression analysis was used to analyze the influencing factors of blood glucose control.Results A total of 905 subjects were recruited in the analysis.74.70％ of the subjects were aged 35 years above.The proportion reaching the control criteria of the blood glucose,blood pressure and cholesterol was 71.27％ (645),29.83％ (270) and 26.74％(242) of the subjects respectively.The influencing factors for blood glucose control in the subjects were age,duration of disease,blood pressure,weight,diet condition and psychological states and treatment compliance,and the differences were statistically significant(x2 =7.58,23.18,7.08,5.22,5.46,5.16,5.65,all P＜0.05).Multivariate Logistic regression analysis showed that age and duration of disease were the risk factors of blood glucose control in patients with T2DM.Standard blood pressure control was the protective factor that affects the effect of blood glucose control (OR=1.430,95％ CI=1.015-2.015,P＜0.05).Conclusion The blood glucose control of T2DM patients need to be improved comprehensively in community.By strengthening the control of blood glucose and blood pressure,establishing good habits of life behavior and improving the ability of self management,patients with T2DM can improve their quality of life.

Depression is a common, serious psychiatric disease. Despite a wide range of antidepressants available, only one third of the patients show significant mood improvement in response lo an initial antidepressant treatment. Moreover, there is a time-lag of weeks to months with currently available medications; the suffering of patients could not be relieved quickly. Ketamine was found to produce rapid antidepressant responses in treatment resistant major depressive disorder patients. Molecular and cellular studies in rodent models demonstrated that ketamine stimulates mammalian target of rapamycin (mTOR) signaling and increases the initial translation of mTOR and downstream molecules, these effects of ketamine are accompanied by increasing levels of maturity and quantity of spine synapses in the prefrontal cortex. Ketamine was found to produce rapid antidepressant responses in treatment of depression. These studies identify the characterization of the mTOR signaling pathway in depression and its action in response to antidepressants shows great potential for the identification of new therapeutic targets for the development of antidepressant drugs.

ObjectiveTo systematically review the effect of psychological intervention on anxiety and depression in hearing-impaired children and adolescents. MethodsThe literature was researched from the databases of PubMed, Web of Science, Embase, CNKI, and Wanfang Database on psychological intervention on anxiety and depression for hearing-impaired children and adolescents until July, 2023. After screening, author, country, study object, study design, intervention mode, outcome, and measurement tools were extracted from the literature. ResultsEight articles from three countries were included, including eight randomized controlled trials, involving 404 participants, publishing mainly from 2013 to 2023. The types of psychological intervention included family support education, emotional intelligence training, cognitive behavioral therapy, self-confidence group training, and play therapy, and so on, which improved social phobia, and relieved the levels of anxiety and depression of children and adolescents with hearing impairment. ConclusionPsychological intervention can effectively alleviate the anxiety and depression of children and adolescents with hearing impairment.

Humans ; Neck Injuries/surgery* ; Carotid Artery Injuries/surgery* ; Neck ; Bone Screws/adverse effects* ; Carotid Artery, Common/surgery*

Allergic conjunctivitis is the most common type of allergic eye disease, and the incidence in children and adolescents is increasing year by year. Drug therapy can only relieve some symptoms and only in a short period, while allergen immunotherapy is currently a therapy that can significantly improve the symptoms of chronic allergy and the course of the disease. This method has been used abroad for many years but has yet to be reported in China. The author reviews the effective mechanism and clinical efficiency of allergen immunotherapy and provides a reference for the further clinical application in China.

Objective: To explore the mental health status and influencing factors of medical staff after blood-borne occupational exposure, and to provide scientific basis for effective psychological intervention. Methods: From January 2017 to December 2018, 178 medical staff with blood-borne occupational exposure in three hospitals of Shandong Province were collected as the contact group, and 100 routine medical staff as the control group during the same period. Questionnaires were conducted among medical staff in the two groups, including general information questionnaire, symptom checklist 90 (SCL-90) , post-traumatic stress disorder self-rating scale (PCL-C) , coping style scale (CPS) , social support scale (SSRS) . The basic situation and mental health level of medical staff in the two groups, as well as the coping and social support status of medical staff exposed to hematogenous occupational exposure were analyzed. Relevant influencing factors. Results: The total score of SCL-90 was 1.66+0.33, 45 (38.14%) were positive, and 21 (21.00%) were positive in the control group. The difference was statistically significant (χ²=7.529, P<0.05) . Compared with the control group, the scores of SCL-90 somatization, obsessive-compulsive symptoms, depression, anxiety, hostility, paranoia and total scores of medical staff in the exposure group increased significantly (P<0.05) . The total PCL-C score of exposure group was 36.84+9.50, PTSD positive 47 (39.83%) and control group 13 (13.00%) . The difference was statistically significant (χ²=19.534, P<0.05) . Compared with the control group, PCL-C re-experience, avoidance, vigilance factor scores and total scores of medical staff in the contact group increased significantly (P<0.05) . The problem solving, help seeking and subjective support of the medical staff in the positive mental health group with blood-borne occupational exposure were significantly lower than those in the negative group, while self-blame, fantasy and withdrawal were significantly higher than those in the negative group (P<0.05) . The mental health level of medical staff with occupational exposure was negatively correlated with problem solving, help seeking and subjective support, and positively correlated with self-blame, fantasy and withdrawal (P<0.05) . Problem solving, help seeking and subjective support were protective factors of mental health (OR=2.121, 1.616, 1.371) , and self-blame and withdrawal were risk factors of mental health (OR=0.160, 0.484) . Conclusion Medical personnel exposed to blood-borne occupational exposure are prone to psychological problems and PTSD. Solving problems, seeking help and subjective support are protective factors for mental health, while self-blame and withdrawal are risk factors for mental health.

ObjectiveTo investigate the effect of finasteride on the microvascular density (MVD) and the expression of the vascular endothelial growth factor (VEGF) in the seminal vesicle of rats.

METHODSForty male SD rats were randomly and equally divided into groups A, B, C and D, those in groups A and B fed with normal saline as the control and those in C and D with finasteride at 40 mg per kg of the body weight per day, A and C for 14 days and B and D for 28 days. Then the seminal vesicles of the animals were harvested for HE staining, measurement of MVD, determination of the expressions of CD34 and VEGF by immunohistochemistry, and observation of histomorphological changes in the seminal vesicle.

RESULTSThe expressions of CD34 in groups C and D were decreased by 6.7% and 15.8% as compared with those in A and B (P<0.01), and that in group D decreased by 9.3% in comparison with that in C (P<0.01). The expression indexes of VEGF in groups C and D were decreased by 6.9% and 14.1% as compared with those in A and B (P<0.01), and that in group D decreased by 9.0% in comparison with that in C (P<0.01).

CONCLUSIONSFinasteride can inhibit the expression of VEGF in the seminal vesicle tissue of the rat and hence suppress the angiogenesis of microvessels of the seminal vesicle.

Angiogenesis Inhibitors ; pharmacology ; Animals ; Antigens, CD34 ; metabolism ; Finasteride ; pharmacology ; Immunohistochemistry ; Male ; Neovascularization, Physiologic ; drug effects ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Seminal Vesicles ; blood supply ; drug effects ; metabolism ; Vascular Endothelial Growth Factor A ; metabolism