Objective We observed influence of different handgrip exercise on the changes of blood flow velocity and blood vessel diameter of basilic vein before and after the PICC placement and discuss the best model for handgrip exercise.Methods 60 patients with PICC were chosen and divided into group A,B and C with 20 patients in each groups.Group A received routine guidance on unarmed handgrip exercise,group B used electronic handgrip,the frequency was 25 times/min,the time period was 2 min with 4 times a day,once every 4 hours,group C adopted the same model as that of group B and 6 times a day,once every 3 hours.The venous blood flow velocity and blood vessel diameter was measured by pulsed Doppler ultrasound one hour before the PICC placement and one hour,1 day,3 days,7 days,10 days,14 days,21 days after placement.Results The venous blood flow velocity before and after PICC placement had statistically significant differences at different time points (F=2.934,P ＜ 0.05).The effect of group B and C was better than that of the group A and group C showed the best effect.The blood vessel diameter before and after PICC placement had significant differences at different time points(F=3.940,P ＜ 0.05).There was significant differences in the blood vessel diameter 1h before and 1h after PICC placement.Conclusions Handgrip exercise can effectively promote the upper limb venous blood flow velocity in patients with PICC,but shows little effect on the blood vessel diameter.Using the electronic hand grip in weak tap position,25 times/min,2 min every time,and 6 times a day (once every 3 hours),can obviously promote the upper limb venous blood flow velocity.

Objective To evaluate the effect of dexmedetomidine on synaptic transmission in the spinal dorsal horn of rats.Methods Male Sprague-Dawley rats,aged 4-6 weeks,weighing 150-200 g,were used in the study.The lumbar enlargemnent segments of the spinal cord were harvested,and the parasagittal lumbosacral spinal cord slices with attached dorsal roots were prepared and incubated in artificial cerebro-spinal fluid.The whole-cell patch-clamp technique was used to record each index,and 4 spinal cord slices were selected and used for each index records.Experiment Ⅰ Dexmedetomidine was added cumulatively in concentration increments.Aδ and C fibers-mediated evoked excitatory postsynaptic currents (eEPSCs) were recorded before administration (baseline) and during perfusion with dexmedetomidine 4 and 10 μg/ml.Experiment Ⅱ The neurons innervated by Aδ and C fibers were selected,and Aδ and C fibers-mediated eEPSCs were recorded before administration (baseline),at 5 min of perfusion with yohimbine (alpha 2 adrenergic receptor antagonist) 2 μmol/L,and during continuous perfusion with yohimbine 2 μmol/L plus dexmedetomidine 4 μg/ml.Experiment Ⅲ The evoked excitatory postsynaptic potentials (eE-PSPs) and evoked inhibitory postsynaptic potentials (eIPSPs) were recorded before administration (baseline) and during perfusion with dexmedetomidine 4 μg/ml.Results Dexmedetomidine could dose-dependently inhibit Aδ and C fibers-mediated eEPSCs,dexmedetomidine could inhibit Aδ and C fibers-mediated eEPSPs and produced no effect on eIPSPs,and yohimbine could inhibit dexmedetomidine-induced inhibitory effect on eEPSCs.Conclusion The mechanism by which dexmedetomidine inhibits nociceptive information transmission in the spinal dorsal horn is related to inhibition of excitatory synaptic transmission through activating α2-adrenergic receptors,but not related to activation of inhibitory synaptic transmission in rats.

Objective:To investigate the impact of Bayesian penalized likelihood (BPL) PET reconstruction method on the uptake of 18F-fluorodeoxyglucose (FDG) and signal to noise ratio (SNR) of lungs, liver, aorta and bones. Methods:From March 2019 to June 2019, the 18F-FDG PET/CT images of 60 patients with clinical diagnosed tumors (29 males, 31 females, age: 24-89 (60.4±15.2) years) in Yuhuangding Hospital were retrospectively analyzed. PET images were reconstructed with ordered subset expectation maximization (OSEM), time of flight (TOF)+ point spread function (PSF) and BPL (β=350) algorithms. Volumes of interest (VOIs) were delineated on the right upper lung lobe, the right liver, aortic root and lumbar vertebra. The mean standardized uptake value (SUV mean), maximum standardized uptake value (SUV max), peak of lean body standardized uptake value (SUL peak), standard deviation of standardized uptake value (SUV SD) and the SNR were measured. The percentage of SNR change (%ΔSNR) between the BPL method and non-BPL methods were calculated. The correlations between body mass index (BMI) and %ΔSNR were analyzed by Pearson correlation analysis. One-way analysis of variance and the least significant difference (LSD) t test were used to analyze the data. Results:There were no significant differences of SUV mean and SUL peak in lung, aorta, liver and lumbar vertebra among 3 methods ( F values: 0.04-1.95, all P>0.05). The SUV max in lung, aorta, liver and lumbar vertebra of BPL reconstruction (1.14±0.82, 2.13±0.37, 2.95±0.50 and 2.76±0.87) was significantly lower than those of TOF+ PSF (1.56±0.61, 2.99±0.75, 4.32±0.94 and 4.05±1.48) and OSEM (1.51±0.67, 3.00±0.70, 4.45±1.12 and 3.81±1.06) reconstructions ( F values: 20.59-52.24, all P<0.001) and SUV SD (0.13±0.07, 0.20±0.05, 0.26±0.06, 0.38±0.17) was also significantly lower than those of TOF+ PSF (0.24±0.11, 0.43±0.11, 0.58±0.15, 0.67±0.21) and OSEM (0.21±0.09, 0.42±0.10, 0.58±0.14, 0.63±0.20) reconstructions ( F values: 24.46-124.95, all P<0.001), while the SNR (4.67±1.34, 7.74±2.22, 8.17±1.77, 4.45±1.22) was significantly higher than those of TOF+ PSF (2.54±0.72, 3.55±0.82, 3.77±0.91, 2.49±0.69) and OSEM (2.65±0.64, 3.67±0.80, 3.75±0.87, 2.60±0.67) reconstructions ( F values: 83.04-247.73, all P<0.001). However, there were no significant differences between OSEM and TOF+ PSF reconstructed images in SUL peak, SUV mean, SUV SD and SNR (all P>0.05). In BPL group, SNR increased with the increase of BMI, and there were statistically differences of aortic SNR (7.07±2.21 vs 9.67±2.26) and liver SNR (7.75±1.85 vs 9.32±0.70) between BMI<25 kg/m 2 and BMI≥30 kg/m 2 ( F values: 3.46 and 4.19, both P<0.05). Positive correlations were found between %ΔSNR of lung, aorta, liver and lumbar vertebra in OSEM and TOF+ PSF and BMI ( r value: 0.042-0.354, all P<0.05). Conclusion:In background tissues, BPL algorithm has no significant impact on absolute quantification compared with OSEM and TOF + PSF reconstruction methods but it can significantly improve SNR, especially for the patients with large body weight.

Objective: To confirm early (6 hours) exercise in patients with partial hepatectomy is safe and feasible. Methods: The control group included 211 patients who qualified for partial liver resection before the accelerated rehabilitation surgery (ERAS), 218 patients with partial hepatectomy who met the entry criteria after the implementation of ERAS were taken as test group, get out of bed 24 hours after routine mission in control group, activity of 6 hours after operation in ERAS group. To observe the time of getting out of bed and the incidence of postoperative complications in 2 groups. Results: Comparison with control group, early exercise time of patients in ERAS group after surgery. The incidence of postoperative complications decreased was 14.3% (31/218) while 34.6%(73/211) of the control group. The difference was statistically significant (χ²=299.3, 18.270, P < 0.01). And did not increase the risk of falls, incision pain, postoperative bleeding. Conclusion Liver partial resection is safe and effective for patients with 6 hours post-operative exercise, worth clinical application.

Objective: To evaluate the influence of happiness therapy intervention on the medication compliance and quality of life of acquired immune deficiency syndrome (AIDS) patients after discharge. Methods: A total of 106 adult AIDS patients discharged from hospital from July 2016 to July 2017 were randomly divided into control group (52 cases), observation group (54 cases). The control group was given routine health education and instruction, and three times of happiness therapy intervention were performed during the hospitalization. The observation group increased the number of happiness therapy intervention after discharge according to the patient′s medication compliance. The medication compliance scale and quality of life scale were used to evaluate the compliance rate and quality of life of patients in 2 groups at discharge, 3 months after discharge, 6 months after discharge, and 12 months after discharge. Results: There was no significant difference in medication compliance and quality of life at discharge and 3 months after discharge between the two groups (P>0.05). At 6 months and 12 months after discharge, the compliance rate and quality of life scores in the observation group was 90.74%(49/54), 88.89%(46/54) and (69.62 ± 5.82) points, (68.76 ± 5.63) points, respectively, 61.54% (32/52), 59.62% (31/52) and (52.12 ± 4.30) points, (52.05 ± 4.25) points in the control group, the difference was statistically significant (χ²=9.684, 9.035, t=8.638, 8.963, P<0.01). Conclusions The happiness therapy intervention during hospitalization can effectively improve the medication compliance and quality of life of AIDS patients. After the discharge, the happiness therapy intervention can provide the patients with long-term nursing programs, which can improve the adherence and quality of life of AIDS patients compared with the control group Have a better long-term effect.

Hemostatic materials are essential for the treatment of trauma patients with massive blood loss in battlefields and disaster environments. According to the site and severity of trauma, different types of hemostatic materials need to be used to stop bleeding urgently. At present, first-aid hemostatic materials for bleeding on body surface wounds, extremities and junctions have been well applied. However, in the case of deep bleeding wounds in the thoracic and abdominal cavity and internal organs and even non-compressible hemostasis, there are still no ideal hemostatic materials in early emergency treatment. In this review, the authors elaborate the classification and mechanism of hemostatic materials and their application in trauma first aid, so as to provide references for the use of hemostatic materials in first aid.

OBJECTIVETo develop a rapid, simple, cost-effective, accurate and sensitive method for quantitative detection of mitochondrial DNA (mtDNA) 3243A→G mutation in order to provide reference for selecting the best detection method under different conditions.

METHODSGenomic DNA was extracted from peripheral leucocytes of 17 individuals from a Wenzhou family featuring maternally inherited diabetes and deafness (MIDD). Heteroplasmic level of mtDNA 3243A→G mutation was determined respectively with polymerase chain reaction-restriction fragment length polymorphism (PCR-RLFP), real time-amplification refractory mutation system-quantitative PCR (RT-ARMS-qPCR) and pyrosquencing. Eleven plasmids with various heteroplasmic levels of the 3243A→G mutation (ranging from 0 to 100%)were constructed as the standards. The reliability of above methods was compared by correlation coefficient based on observed and expected values.

RESULTSFor all three methods, measurement of the standards showed a linear correlation between the expected and detected values, i.e., PCR-RFLP (R(2)=0.828), RT-ARMS-qPCR (R(2)=0.998) and pyrosquencing (R(2)=0.997). For the MIDD family, it was consistent that there are 13 members carrying the A3243G mutation with different heteroplasmic levels. And there was no significant difference between the results by RT-ARMS-qPCR and pyrosquencing.

CONCLUSIONPCR-RFLP is not appropriate for the quantitative detection but could be used for early clinical screening. Both RT-ARMS-qPCR and pyrosquencing are suitable for the detection of low heteroplasmic level of A3243G mutation. Compared with pyrosquencing, RT-ARMS-qPCR is rapid, reliable and cost-effective, and is the best choice for detecting low mutation loads.

Adolescent ; Adult ; Base Sequence ; Child ; DNA, Mitochondrial ; genetics ; Deafness ; diagnosis ; genetics ; Diabetes Mellitus ; diagnosis ; genetics ; Female ; Genetic Testing ; methods ; High-Throughput Nucleotide Sequencing ; methods ; Humans ; Male ; Molecular Sequence Data ; Pedigree ; Point Mutation ; Polymerase Chain Reaction ; methods ; Polymorphism, Restriction Fragment Length ; Young Adult

Objective Based on mosq-ovitrap monitoring method of Aedes albopictus， to determine the spatial and temporal distribution of Aedes albopictus in Songjiang District and provide scientific evidence for prevention and control of mosquito-borne diseases. Methods From May to October， 2018‒2020， density of Aedes albopictus was monitored by using the mosq-ovitrap method. Sub-districts and towns were used as the monitoring units and the difference in mosquito ovitrap index （MOI） was compared by seasons， years and habitats. Results The total number of positive mosquito ovitraps was 1049 in 2018‒2020， and the average MOI was 8.10. Four sub-districts/towns in the urban area and the northern area had the relatively high MOIs. Moreover， MOIs in residential and external environments were higher than other habitats. In addition， MOI of Aedes albopictus decreased over years from 2018 to 2020. Conclusion Aedes albopictus is widely distributed in Songjiang District. Although the number of mosquito decreased over years after the implementation of mosquito control measures， reproduction of mosquito remains excessive in some areas and seasons. It is necessary to perform targeted control measures based on comprehensive monitoring methods.

In recent years, the clinical experts consensuses or guidelines of ankylosing spondylitis (AS)/spondyloarthritis (SpA) have been constantly updated, but to better understand and practice, patient self-participation management is one of the key points to improve the level of diagnosis and treatment. Through questionnaire survey of these patients, we screened out the most concerned issues, and established the AS/SpA patient practice guideline working group with multidisciplinary physicians and patients. Fifteen opinions, as the AS/SpA patient practice guidelines, are proposed in accordance with the relevant principles of the "WHO guidelines development manual" , and with the international normative process.

Objective: To summarize the clinical manifestations and treatment of retinal artery occlusion and cerebral infarction caused by facial injection of hyaluronic acid. Methods: Fifteen cases (15 eyes) with vision lose caused by facial cosmetic injection of hyaluronic acid visited Xi＇an No.4 Hospital from December 2010 to January 2017. The clinical data were collected such as general medical history and treatment methods, and follow-up for 1 year. Results: All patients were female, 22-41 years old, with average age of 33. All patients were injected with hyaluronic acid. For 8 patients the fillers were injected in the forehead, 3 patients were in the glabellar region, 3 patients were in the nasolabial fold, and 1 patient was in the temporal of left eye. All patients had vision lose after injection, the visiting time was 1 to 6 hours. 13 patients were central retinal artery occlusion (CRAO). 1 patient was retinal branch artery occlusion (BRAO), 1 patient was ischemic optic neuropathy (ION), 13 patients manifested as no light perception (NLP), 1 patient was 0.6, 1 patient was CF/30 cm, and 14 patients with cerebral infarction, manifested as headache, dizziness. All patients were given emergency treatment, and 9 patients had treated with interventional thrombolysis therapy. After treatment 11 patients, visual acuity had no significant improvement, but 4 patients improved. Headache, dizziness symptoms disappeared, but cerebral infarction lesions still existed on MRI. Conclusions Human face is a rich blood supply; vision loss and cerebral infarction could occur after injection of hyaluronic acid. After urgent treatment visual acuity is not improved obviously, eventually leading to irreversible visual impairment or even loss.