OBJECTIVE:To study the stability of timolol maleate eye drops and predict its storage period at room temperature METHODS:Timolol maleate was determined by UV-spectrophotometry,initial average rate method was used in predicting the expiry term RESULTS:Stability of the 0 5% timolol maleate eye drops was not so good,expiry term predicted at 25℃ was only 70 days,while at 5℃ was as long as 1 2 years CONCLUSIONS:Initial average rate method is rapid,convenient and precise,so it is suitable for stability study of hospital preparations

Objective To investigate the expressions of Smad3 and Smad7 in patients with ulcerative colitis(UC)and their relation with clinicopathology.Methods The expressions of Smad3 and Smad7 were measured by immunohistochemistry with SABC method in 60 UC specimens and 16 normal colonic tissues.The association of expressions of Smad3 and Smad7 proteins with clinical staging,lesion extent and pathologic grading were retrospectively analyzed.Results The expression of Smad3 was significantly lower in UC patients than in normal controls(P＜0.05),however,there was no relation between Smad3 expression and lesion extent(P＞0.05).There was a negative correlation between the expression of Smad3 and histological grade(r=-0.283,P＜0.05).The expression of Smad7 was significantly higher in UC patients than in normal controls,and its expression in active disease was higher than that in clinical remission(Z=2.097,P=0.036).There was a positive correlation between the expression of Smad7 and histological grade(r_s=0.453,P=0.000),and no relation between Smad7 expression and lesion extent(r_s=0.066,P=0.614).The statistical analysis showed a negative correlation between Smad3 expression and Smad7 expression(r=-0.420,P＜0.05).Conclusion The abnormal expressions of Smad3 and Smad7 are correlated with pathogenesis of UC.Furthermore.Smad7 may serve as marker for disease activity of UC.

Objective To study the changes of the myocardial cell apoptosis in myocardial infarction of rabbits. Methods The model of rabbit with myocardial infarction was established.HE staining,TUNEL staining, immunohistro-chemistry staining, ultrathin section for electron microscope and DNA electronic gel phorensis were performed in samples of ischemia or infarction in different times.The position of apoptotic myocytes in different phases of ischemia were observed by light microscope and electronic microscope. Results After 30 minutes to 4 weeks ischemia.there were a few TUNEL positive nucleus of myocytes in the margin area of myocardial infarction;HE staining-found typical expressions of apoptosis,such as chromosome conglomeration,chromosome gathered at the edge or chromosome aggregation,dark-stained nucleus,cell shrinkage,were obvious in 4-8 hours.A lot of positive nucleus of myocytes stained by TUNEL were found in the early stages of myocardial ischemia in myocardial infarction.gradually ascended and then became hardly visible from 8 hours to 3 days.Nucleus swelling,karyorrhexis and karyolysis were found in the area of myocardial infarction.then cells were broken.DNA agarose electrophoresis found DNA fragment of most myocytes in 30 minutes of ischemia,just a few cardiocytes decomposed to the big segments.At 4hours of ischemia the most cardiocytes decomposed to big segments,and there were a blurry"ladder"in DNA strand breaks from 8 hours to 1 day.It showed that apoptotic cardiocytes existed in the margin area of myocadial infarction. Conclusions There are cardiocytes apoptosis in the margin area of infarction from 30 minutes to 4 weeks after myocardial ischemia.Maybe it relates to the reperfusion caused by collateralization establishment or infiltration from circumference.

Objective To compare the rates of major adverse cardiovascular events(MACE)and bleeding events of three different antiplatelet strategies during temporary withdrawal of antiplatelet therapy for non-cardiac surgery within 1 year after drug-eluting stent (DES)implantation.Methods Retrospectively analyzed 42 patients who had accepted non-cardiac surgery and required temporary withdrawal of antiplatelet therapy within 1 year after drug-eluting stent implantation. The patients were divided into three groups according to the bridging antiplatelet strategies they received.All patients discontinued clopidogrel 5 to 7 days before the non-cardiac surgery. The tirofiban group was treated with intravenous tirofiban 0.4ug/kg·min in the first 30 min followed 0.1μg/(kg·min). The dosage was reduced by half for patients whose Creatinine clearance were less than 30 ml/min.The low molecular weight heparin group was treated with subcutaneous enoxaparin (Clexane 4000 AxaIU, once per day) .The asprin group was given only oral asprin(100 mg, once per day) . Tirofiban and low molecular weight heparin were continued until clopidogrel was resured. Perioperative cardiovascular events and serious bleeding were recorded. Results The rates of major adverse cardiac events in the tirofiban and the low molecular weight heparin group were lower than the aspirin group. Acute myocardial infarction caused by confirmed in-stent thrombosis was diagnosed in one patient in the aspirin group. One case of asymptomatic ST-T changes was found in the low molecular weight the aspirin group. 3 cases in the aspirin group presented ST-T changes on ECG and among them 1 case was STEMI due to LAD thrombosis requiring primary and 2 other cases were agina pectoris.There were no significant differences in bleeding events among the three groups.Conclusions Potential for the perioperative management with tirofiban or low molecular weight heparin is safe and feasible for patients who had recently undergone DES implantation and required noncardiac surgery with the interruption of antiplatelet therapies.

Objective To investigate the risk factors and prognosis of perioperative myocardial infarction in the patients undergoing noncardiac surgery. Methods Clinical data of 562 patients who had accepted non-cardiac surgery was collected and retrospectively analyzed. The risk factors, treatments and outcomes of all these patients were recorded and analyzed. Results A total of 19 out of the 562 patients had perioperative myocardial infarction ( PMI) . The incidence was 3. 4% . The mean occurrence time was (43. 5 ± 12. 7)h after operation. Eleven PMI patients (11 ∕ 19) were non-ST-segment elevation myocardial infarction and eight patients (8 ∕ 19) were ST-segment elevation myocardial infarction. Thirteen PMI patients were left coronary artery occlusion and six patients were right coronary artery occlusion. Advanced age, history of myocardial infarction, unstable angina, change of ST-T segment on electrocardiography (ECG), multivessel diseases, diabetes,hypertension,and high risk non-cardiac surgery were the risk factors of PMI and positively correlated to PMI. Sixteen PMI (16 ∕ 19) patients accepted PCI treatment and three patients (3 ∕ 19) accepted drug conservative treatment. Two patients had unstable angina attack after treatment and one patient had arrhythmia. The heart function in two patients decreased by one or more than one class within the follow up of 1 year. No patient had recurrent acute myocardial infarction or deceased during follow-up. Conclusions Many factors could lead to PMI. Making preoperative assessment, recognizing patients of high risks and dealing with patients who had PMI in time was necessary.

Objective To screen for biomarkers in urine from patients with steroid-resistant nephrotic syndrome (SRNS) using surface-enhanced laser desorption ionization time-of-flight mass spectrometry (SELDI-TOF-MS) Proteinchip technology. Methods Urine samples from 9 SRNS patients, 32 steroid-sensitive nephrotie syndrome (SSNS) patients and 45 normal controls were analyzed using UA gold chip. Proteomic spectra were generated by mass spectrometry. Results Four differentially expressed biomarkers were identified with relative molecular weight of 6 703, 7 212, 11 820, 14 356. It was found that these protein peaks with relative molecular weigh of 7 212, 11 820, 14 356 were highly expressed in SRNS and 6 703 were lowly expressed in SRNS. The diagnostic cast that is constructed with these four protein to differentiate SRNS from SSNS with sensitivity of 88.89% and specificity of 93.75%. Conclusions SELDI-TOF-MS Proteinchip technology is a non-invasive, quick, easy, and convenient, and high-throughput analyzing method capable of screening several biomarkers from the urines of SRNS patients and has better clinical value.

Objective To compare the Roussouly classification of old thoracolumbar fractures combined with post-traumatic kyphosis with that of normal adults, evaluate the effect of different kyphosis angles on sagittal curvature of the thoracolumbar spine so as to provide a theoretical basis for the clinical status and clinical treatment plan of old thoracolumbar fractures combined with post-traumatic kyphosis.Methods A retrospective case control study was made on 49 cases of old thoracolumbar fractures with post-traumatic kyphosis treated from January 2014 to December 2015 (fracture group).Damaged segments of the spine were T11 in four cases, T12 in 14, L1 in 25 and L2 in six.Another 52 normal adult volunteers were chosen as controls.Whole spine X-ray film of the two groups was taken, and the difference in Roussouly classification of the sagittal spine curvature was compared between the two groups.Patients in fracture group were separated into subgroups depending on the Cobb angle (0°-10°, 10°-20°, 20°-30°, 30°-40°, respectively), and the difference in Roussouly classification was compared among subgroups.Results Roussouly classification in control group was five cases of type 1, 12 tpye 2, 25 type 3 and 10 type 4.Results in fracture group was 14 cases of type 1, 11 type 2, eight type 3 and 16 type 4.There were significant differences in Roussouly types between the two groups (P<0.05).According to Roussouly classification, there were two cases of types 1 and 2 and seven cases of types 3 and 4 in subgroup of Cobb angle between 0°-10°;four cases of types 1 and 2 and 10 cases of types 3 and 4 in subgroup of Cobb angle between 10°-20°;12 cases of types 1 and 2 and four cases of types 3 and 4 in subgroup of Cobb angle between 20°-30°;seven cases of types 1 and 2 and three cases of types 3 and 4 in subgroup of Cobb angle between 30°-40°.There were significant differences in Roussouly types among subgroups (P<0.05).Further, Roussouly types 1 and 2 were significantly increased when the Cobb angle was >20° (P<0.05).Conclusions Post-traumatic kyphosis in old thoracolumbar fractures affects spine sagittal curvature.Patients with sagittal spinal imbalance (Roussouly types 1 and 2) are more with increased Cobb angle.Moreover, Cobb angle >20°may be the reference basis for clinical intervention.

Objective:To quantitatively analyze the clinical and drug resistance feature of diarrhea of adults patients in 2016 and 2019 induced by the Escherichia coli (diarrheagenic Escherichia coli, DEC), and to reveal the difference of DEC′s epidemiological features of before and after measuring to strengthen food hygiene and safety in Beijing. Methods:A total number of 3 408 patients with food-borne adult diarrhea were received diagnosis and treatment in the intestinal clinic department of Beijing Tongren Hospital in 2016 and 2019.There were 1 926 patients in 2016 and 1 482 in 2019, respectively. The clinical information of patient were entered into the intestinal early warning system and were carefully preserved. The clinical specimens (the stool samples) were isolated and the DECs were identified by culturing. The colony of DECs was identified by matrix assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry. Five pathogenic types of Escherichia coli were classified by multiplex PCR methods. The drug-susceptibility test was performed according to the standards of the American Society for Clinical and Laboratory Standardization in 2019. The categorical data were analyzed by χ 2 test or Fisher′s exact test to verify the statistical difference. Results:A total number of 581 DECs strains were detected in 3 408 specimens. Among the subtypes of E Coli, the Enterotoxigenic Escherichia coli (ETEC) accounted for 53.36% (310/581), and Enterohemorrhagic Escherichia coli (EHEC) was detected. In 2016, the total detection rate of DEC was 14.54% (280/1 926), enteroaggregative Escherichia coli (EAEC) accounted for 18.21% (51/280), and ETEC accounted for 71.79% (173/280). In 2019, the total detection rate of DEC was 20.31% (301/1 482), EAEC accounted for 41.23% (116/301), and ETEC accounted for 48.93% (137/301). Compared with 2016, the detection rate of EAEC in 2019 increased significantly (χ2=29.26, P<0.001), followed by EPEC (χ2=9.37, P=0.002), and ETEC decreased (χ2=15.43, P<0.001). Compared with other pathogenic types, EAEC can easily cause nausea(χ2=32.72, P<0.001).The red blood cells(χ2=16.44, P=0.001) or the white blood cells (χ2=26.82, P<0.001) could be easily observed in stool specimens of patients infected with enteroinvasive Escherichia coli (EIEC). The resistance rates of EIEC to ampicillin, ampicillin/sulbactam and gentamicin were 80.95% (17/21), 66.67% (14/21) and 57.14% (12/21), respectively. Three strains of EAEC resistant to carbapenem antimicrobials were discovered in 2019 and of which two strains were resistant to ertapenem and imipenem, and the other one strain was only resistant to ertapenem. The whole genomic sequencing showed that there are multiple resistance mechanisms: including the mainly drug-resistant nodular cell differentiation family efflux pump, penicillin binding site mutation, and New Delhi metal-β-lactamase 5 production. Conclusions:The detection rate of DECs in adult patients with food-borne diarrhea is high, and the foremost subtype of DECs is ETEC. Compared with 2016, the detection rates of ETEC in clinical specimens decreased in 2019, and the detection rate of EAEC increased significantly, respectively. In 2019, a carbapenem-resistant antibacterial drug-resistant Escherichia coli strain was isolated. It is of great significance to focus on the biological characteristics and epidemiological changes of DEC.

Objective: To examine the mediating effects of mindfulness level on resilience and symptoms of anxiety and depression among healthcare workers, so as to provide the reference for developing effective psychological intervention. Methods: The clinical doctors, nurses and public health professionals were selected using the stratified random cluster sampling method from hospitals, disease prevention and control centers, and health departments in five cities in Shandong Province, including Qingdao, Jinan, Rizhao, Jining and Liaocheng in January 2023. Basic information, mindfulness level, resilience and symptoms of anxiety and depression among healthcare workers were collected using general demographic questionnaires, the 5-item Mindful Attention Awareness Scale, 10-item Connor-Davidson Resilience Scale, Generalized Anxiety Disorder Scale and Patient Health Questionnaire, respectively. The Process program was used to analyze the mediating effects of mindfulness level on resilience and symptoms of anxiety and depression. Results: A total of 1 836 healthcare workers were investigated, including 472 males (25.71%) and 1 364 females (74.29%), and the median age was 39 (interquartile range, 12) years. There were 629 clinical doctors (34.26%), 963 nurses (52.45%) and 244 public health professionals (13.29%). The median scores of mindfulness level and resilience were 22 (interquartile range, 7) and 20 (interquartile range, 4) points, respectively. The detection rates of anxiety and depression symptoms were 49.78% and 72.28%, respectively. The mediation analysis showed that mindfulness level exerted a partial mediating effect between resilience and anxiety symptoms (β=-0.510, P<0.001), with a direct effect value of -0.130 and a mediating effect value of -0.046, and the mediating effect accounted for 26.14% of the total effect; mindfulness level also exerted a partial mediating effect between resilience and depression symptoms (β=-0.575, P<0.001), with a direct effect value of -0.120 and a mediating effect value of -0.052, and the mediating effect accounted for 30.23% of the total effect. Conclusion Mindfulness level plays a mediating effect between resilience and symptoms of anxiety and depression among healthcare workers.

Emergency Medical Services ; Health Promotion ; Humans ; Life Style ; Nurses ; psychology