Objective:To observe expression and diversity of glycogen synthase (GSK)-3 and ribosome S6 protein kinase (P70S6K) in skeletal muscle of insulin resistance (IR) rat induced by high fat food and to approach the effect and significance of GSK-3 and P70S6K in IR occurrence.Methods:Forty Wistar rats aged four-week were randomly divided into normal control, high-glucose, high-fat and high-fat high-glucose groups. 8 weeks after feeding, insulin sensitivity of the rats was evaluated by hyperinsulinism euglycaemic clamps technique (ring clamp experiment), GSK-3 and P70S6K in rat skeletal muscle were measured by Western blot and epididymis fat pad weight, blood glucose, insulin, triglyceride (TG), cholesterin (TC), free fatty acids (FFAs) and hsCRP levels were also determined.Results:IR was induced, body weight (P

Advances in modern science and technology bring the potential for human performance modification(HPM) which could be a golden opportunity for military medicine.HPM technologies can deepen the extension of military medicine research, provide frontier research achievements, and such innovations will fulfill increasingly sophisticated requirements coming from the military.The pull factor of HPM oriented military medicine is the capacity needs of military personnel to execute military operations.Through the bridge of science and technology, it will meet the demands of maintaining, regener-ating and improving fighting force.

ObjectiveTo identify the status of quality of life in breast cancer patients and explore the impact of environmental factors on quality of life in breast cancer patients receiving chemotherapy. MethodsTotally 201 primary breast cancer patients undergoing chemotherapy after surgery were investigated.Self-developed demographic and clinical character investigation questionnaire,WHO Disability Assessment Schedule Ⅱ(WHODAS Ⅱ),and environmental factors in International Classification of Functioning Disability and Health(ICF)core sets for breast cancer patients were adopted to collect relevant data. ResultsBreast cancer patients had different levels of difficulties on each domain of WHODAS Ⅱ.Multiple stepwise regression analysis demonstrated that“material and emotional support and interrelationship with friends”, “social security service,system and policies” and“social norms,practices and ideologies” were factors influencing quality of life of breast cancer patients. ConclusionsIn addition to the strengthen of rehabilitation exercise training,nurses should advocate more services from society through policy making,prompt public awareness and scientific cognition,as well as construct effective nursing interventions to help enlarge social support resources and improve social support level.

Objective To evaluate the prevalence of extraosseous findings on integrated CT images of routine SPECT/CT bone imaging and its clinical incremental values. Methods A total of 843 patients (470 males, 373 females, age range: 26-92 years) who underwent SPECT/CT bone imaging during May 2013 to December 2015 were enrolled in this retrospective study. A modified C-RADS was used to classify the extraosseous findings to E1, E2, E3 and E4. χ2 test was used for data analysis. Results The CT images in 78.6%(663/843) of patients were normal or with no additional clinical significance (E1 and E2), and those in 21.4%(180/843) of patients might need further assessment (E3 and E4). The rate of E4 extraosseous findings in patients with malignancy was higher than that in patients without malignancy: 9.5%(59/622) vs 5.0%(11/221); χ2=4.352, P<0.05. There was no significant difference of the rate between genders: 8.5%(40/470) in males vs 8.0%(30/373) in females; χ2=0.510, P>0.05. With age increasing, the prevalence of E4 finding increased and the rate was the highest in the patients over 80 years old (125%, 16/128). Seventy patients had E4 findings and chest masses and nodules were the most common, followed by the abdominal or pelvis lymph node enlargements. Conclusions Potentially important extraosseous findings are common on SPECT/CT. Systematic reviewing CT images and communicating the important unexpected findings to clinical physicians could enhance its clinical incremental values.

ObjectiveTo study the value of quantitive scoring methodby ultrasound in differential diagnosis of thyroid nodule.MethodsTotally 1 360 patients with thyroid carcinoma or nodular goiter were given preoperative ultrasound examination of thyroid. The features of thyroid nodule and their signiifcances in diagnosing thyroid carcinoma were evaluated by logistic regression analysis. Surgical pathology was taken as golden standard. Signiifcant feature was scored as 1 point, and insigniifcant feature was scored as 0 point. In two groups, the data were analyzed statistically.ResultsLow echo, obscure boundary, incomplete or no capsule, incomplete or no halo, aspect ratio≥1, internal lfow, posterior acoustic attenuation, no cystic echo, microcalciifcation and background Hashimoto′s thyroiditis showed correlation with malignancy. There were statistically significant difference between thyroid cancer and nodular goiter in thyroid nodules scores (χ2=802.08,P<0.05). Of 768 thyroid nodules with<6 points, 742 were benign and 24 were malignant. Of 60 thyroid nodules≥10 points, 2 were benign and 58 were malignant. Of 314 thyroid nodules with 8-9 points, 60 were benign and 254 were malignant. Of 368 thyroid nodules with 6-7 points, 155 benign and 213 were malignant.ConclusionsQuantitive scoring of thyroid nodule had clinic signiifcance in differential diagnosis. Thyroid nodule with>8 points accounted for the majority of malignancy and should be considered for surgery.

Objective To study the changes of the thyroid hormones leval of human fetus and newborans Methods More than 71 cases of medically indicated cordocentesis have been done in 16 36 gestational weeks in our hospital during last three years. Among them, 71 fetus who were free of diseases and their maternal thyroid function were normal were included into the study group. The blood samples were sent to analysis of thyroxine (T 4), triiodothyroxine (T 3), free thyroxine (FT 4), free triiodothyroxine (FT 3) and thyrotropin (TSH). 140 umbilical cord blood samples taken at the time of term delivery were sent to analysis of FT 4,FT 3 and TSH as a control. Normal range of different gestational weeks was calculated. Statistical analysis was done for the changes of all these thyroid hormones before 28 weeks and after Results All the thyroid hormones can be detected in 16 weeks of pregnancy,FT 4 already reaches the top level of adults (5.8?2.6) pmol/L and will continually increase with the increase of gestational age. There was a parallel increment of all the fetal thyroid hormone concentrations with the gestational age. The concentrations of T 4,T 3 and FT 4 have a rapidly increase after 28 weeks and have a statistically significant difference from (2.8 ?1.8) nmol/L, (37.2?27.2) nmol/L and (10.6?3.1) pmol/L,respectively to (5.8?2.6) nmol/L, (55.9?33.3) nmol/L,( 13.0?4.5) pmol/L, respectively. TSH level of fetus was increased gradually along the gestation, reaching the up level of the adults at the 20 weeks and peaking at the birth time. While the T 3 and FT 3 keep in a lower level in gestation Conclusions Fetal thyroid hormones increase with the gestational age.The diagnosis of congenital fetal thyroid hormone malfunction in the second half of the pregnancy should be monitored mainly by the T 4, FT 4 and TSH levels in different gestational age. For this consideration, to set up a reliable data for normal human fetus thyroid hormone concentrations is a very important and essential step to provide a practical guide for doctors to do intra uterine diagnosis and treatment of associated high risk groups. The peaking level of TSH at the birth time will surely company the changing of other thyroid hormones, so it might not be the best time to screening the congenital thyroid malfunction at the 72 hours after birth.

Objective:To explore the influence of mindfulness on perceived stress in psychiatric nurses and the mediating effect of resilience.Methods:A total of 427 psychiatric nurses from a psychiatric hospital in Beijing were selected.Five-facet mindfulness questionnaire(FFMQ), Chinese-version perceived stress scale (CPSS) and Connor-Davidson resilience scale (CD-RISC) were used in this survey.Pearson correlation analysis and multiple stepwise regression analysis were performed using SPSS 24.0.And mediating effect was performed using AMOS 24.0.Results:The total score of psychiatric nurses' perceived stress was (37.89±7.16). Among all psychiatric nurses, 66.74% were under high pressure and 20.84% were under great pressure.The perceived stress was negatively correlated with mindfulness(123.69±10.82, r=-0.65, P<0.01) and resilience(85.40±17.87, r=-0.67, P<0.01), and mindfulness was positively correlated with resilience ( r=0.50, P<0.01). The direct effect of mindfulness on perceived stress was -0.15, the indirect effect was -0.34, and the total effect was -0.49. Conclusion:Resilience plays a partial mediating role between mindfulness and perceived stress psychiatric nurses.

Objective To investigate whether echocardiography left ventricular ejection fraction (LVEF) and NT-proBNP could be an early detective marker for patients with untypical NSTE-ACS. Methods A total of 248 ACS cases admitted to the emergency department of our hospital from January 1,2015 to June 31,2016 were retrospectively reviewed. The data included age,gender,past medical history,D-dimer,MB isoenzyme of creatine kinase(CK-MB),cardiac troponin I(cTnI),the precursor of the N-terminal pro-brain natriuretic peptide(NT-proBNP),electrocardiogram(ECG)before treatment,and the CK-MB,cTnI and LVEF,the treatment of percuta-neous coronary intervention(PCI)or thrombolytic by drugs. Survival condition and time from onset to death were recorded. According to the results of multivariate logistic regression analysis ,receiver operating characteristic curve(ROC curve)and fitting curve were drawn. The association between the LVEF and NT-proBNP before the treatment and prognosis of ACS was analyzed. Results NSTE-ACS patients with chief complaint of chest pain were less than those of STE-ACS(33.6% vs. 70.1%,P=0.003). Pre-hospital time was longer than that of STE-ACS group(67.92 ± 116.89 vs. 30.65 ± 55.59,P = 0.006). CTNI(4.37 ± 12.53 vs. 9.62 ± 18.00,P=0.011)and LVEF(53.51 ± 14.51 vs. 56.26 ± 12.30,P=0.019)were less than that of the STE-ACS group. NT-proBNP was higher than that of the STE-ACS group(2288.37 ± 4612.10 vs. 1506.84 ± 1722.51,P=0.038). mortality rates was higher than the STE-ACS group((15.3%vs. 6.8%,P=0.036). Multivariate logistic regression analysis showed that LVEF values was correlated to 28-day death(B =-0.097 ,P=0.022). The ROC curves showed that LVEF values was negative correlated with the 28-day death. However,combination of LVEF and NT-proBNP was better than single LVEF values. LVEF values was negative correlated with the NT-proBNP(r =-0.263,P=0.001), LVEF values had greater and longer survival time(B=0.401,P=0.045)but NT-proBNP was not related to surviv-al time.(B=0.00,P=0.931). Conclusion LVEF and NT-proBNP are correlated with the early risk assessment of patients with ACS,but was not correlated with the time from onset to death. The decrease in LVEF values at the early stage of NSTE-ACS may be helpful to indicate the critical condition of the ACS patients.