Objective:To evaluate the effects of left ventricular remodeling on systolic synchronization in patients with severe preeclampsia(SPE) by full-volume imaging technology.Methods:One hundred and nine patients with SPE were randomly selected as SPE group in the First Hospital of Shanxi Medical University from December 2016 to December 2019, which were further divided into systolic synchrony(SS) group ( n=35) and systolic dyssynchrony(SD) group( n=74). And 34 healthy pregnant women during the same period were selected as normal pregnancy(NP) group. The clinical datas were collected. Parameters including left ventricular end diastolic volume(LVEDV), left ventricular end systolic volume(LVESV), left ventricular ejection fraction(LVEF), spherical index(SpI), left ventricular mass index(LVMI) and systolic dyssynchrony index(SDI) were obtained by full-volume imaging technology. The effects of left ventricular remodeling on systolic synchronization in patients with SPE were analyzed by bivariate correlation, multiple linear stepwise regression analysis and binary Logistic regression analysis, respectively. Results:①Bivariate correlation analysis showed that LVEDV, LVESV, SpI and LVMI were positively correlated with SDI( r=0.335, 0.361, 0.635, 0.680; all P<0.01). ②After adjustment for age, body mass index, systolic blood pressure, course of hypertension, antihypertensive and antispasmodic treatments, gestational diabetes mellitus, subclinical hypothyroidism, LVEF, multiple linear regression analysis showed that SpI and LVMI were independent predictors of SDI (β=0.228, 0.319; all P<0.01). ③Binary Logistic regression analysis showed that SpI and LVMI were independently correlated with left ventricular systolic dyssynchrony [ OR(95% CI)=1.288(1.039-1.598), 1.102(1.019-1.192); all P<0.05]. Conclusions:Left ventricular remodeling in patients with SPE leads to the decrease of left ventricular systolic synchronization, which can reflect subclinical myocardial dysfunction early. Full volume imaging technology can accurately evaluate left ventricular systolic synchronization in patients with SPE.

Objective To evaluate the efficacy of a new pelvic muscle gymnastic exercise in the treatment of stress urinary incontinence (SUI).Methods Prospectively,we randomly recruited 60 cases with mild and moderate SUI.We use ICI-Q-SF,pad Test and urodynamics to assess the degree of incontinence,volume of leakage,maximum urethral pressure and functional urethral length before and after intervention.Results The ICI-Q-SF score,volume of leakage,maximum urethral closure pressure and functional urethral length in study group before treatment were 11.6 ±4.2,(5.9 ±2.2) ml,(39.4 ± 12.5) cm H2O and (2.5 ±1.2) cm.The indicators in control group were 10.3 ±2.2,(5.8 ±1.3) ml,(41.3 ±8.9) cm H2O and (2.1 ± 0.5) cm respectively.There was no significant difference between the 2 groups (P ＞ 0.05).The ICI-Q-SF score,volune of leakage and maximum urethral closure pressure in study group after treatment were 7.7 ± 2.7,(1.8 ± 1.2) ml and (65.9 ± 8.9) cm H2O,which were significantly improved than the values of10.1 ±2.1,(5.7 ± 1.1) ml and (44.6 ±9.5) cm H2O in control group (P ＜0.05).Conclusions The new pelvic muscle exercise may play an important role in the treatment of mild and moderate SUI.Therefore,it could be recommended to the patients with mild and moderate SUI.

Background The senescence of alveolar type II epithelial cells is an important driving factor for the progression of silicotic fibrosis, and the regulatory effects of oxamate on the senescence of alveolar type II epithelial cells is still unclear. Objective To explore whether lactate dehydrogenase inhibitor oxamate can alleviate silicotic fibrosis in mice by inhibiting senescence of alveolar type II epithelial cellsMethods This study was divided into two parts: in vivo experiments and in vitro experiments. In the first part, forty SPF C57BL/6J male mice were randomly divided into four groups with 10 in each group: control group, silicosis model group, low-dose oxamate treatment group, and high-dose oxamate treatment group. The silicotic mouse model was established by intratracheal instillation of 50 μL SiO₂ suspension (100 mg·mL⁻¹). The treatment models were prepared by intraperitoneal injection of 100 μL oxamate (225 mmol·L⁻¹ and 1125 mmol·L⁻¹). In the second part, induction of MLE-12 mouse alveolar type II epithelial cells was conducted with SiO₂. The in vitro experimental groups were ① SiO₂ induction groups: control group, 50 μg·mL⁻¹ SiO₂ group, 100 μg·mL⁻¹ SiO₂ group, and 200 μg·mL⁻¹ SiO₂ group, and ② oxamate treatment groups: control group, SiO₂ group (100 μg·mL⁻¹), low-dose oxamate (25 mmol·L⁻¹) treatment group, and high-dose oxamate (50 mmol·L⁻¹) treatment group. Pathological morphology of lung tissues was evaluated after hematoxylin-eosin (HE) staining; deposition of collagen in lung tissues was evaluated after sirius red staining; positive co-expression of prosurfactant protein C (Pro-SPC) and β-galactosidase was detected by immunofluorescence staining; positive expression of β-galactosidase in MLE-12 cells was detected by immunofluorescence staining. The protein expression levels of collagen type I (CoL I), fibronectin1 (FN1), hexokinase 2 (HK2), pyruvate kinase isozyme type M2 (PKM2), lactate dehydrogenase A (LDHA), p-ataxia telangiectasia and Rad3-related kinase (ATR), and cyclin-dependent kinase inhibitors p21, and p16 were detected by Western blotting. Results Compared with the control group, the protein expression levels of HK2, PKM2, LDHA, p-ATR, p21, and p16 were significantly upregulated in the silicosis model group and the SiO₂-induced MLE-12 cells (P＜0.05). The in vivo studies showed that, compared with the control group, the silicon nodule area, the collagen deposition area, the proportion of β-galactosidase positive cells, and the protein expression levels of CoL I, FN1, LDHA, p-ATR, p21, and p16 were significantly upregulated in the silicosis model group (P＜0.05). Compared with the silicosis model group, the oxamate treatment groups showed significant downregulation of the silicon nodule area, the collagen deposition area, the proportion of β-galactosidase positive cells, and the the CoL I, FN1, LDHA, p-ATR, p21, and p16 protein expression levels, and the high-dose oxamate treatment group showed a higher efficacy on these indicators than the low-dose oxamate treatment group (P＜0.05). The in vitro studies showed that, compared with the control group, the proportion of β-galactosidase positive cells and the protein expression levels of p-ATR, p21, and p16 were significantly upregulated in the SiO₂-induced group (P＜0.05). Compared with the SiO₂ group, the proportion of β-galactosidase positive cells and the LDHA, p-ATR, p21 and p16 protein expression levels were significantly downregulated in the oxamate treatment groups, and the high-dose oxamate treatment group showed a higher efficacy on these indicators than the low-dose oxamate treatment group (P＜0.05). Conclusion Lactate dehydrogenase inhibitor oxamate can alleviate silicotic fibrosis in mice by inhibiting the senescence of alveolar type II epithelial cells.

Objective·To establish a reliable alcoholic liver disease mouse model (ALDNM) that mimics the drinking pattern of alcoholic liver disease (ALD) patients.Methods·Using the self-designed feeding tubes and liquid diet,ALDNM model was developed through chronic feeding combined with acute gavage of ethanol based on Lieber-DeCarli model and Gao-Binge model.C57BL/6 mice were administered with control liquid diet for adaptation for first 5 d,and then divided into pair-fed group and ethanol-fed group (10 mice each group).Ethanol-fed mice were fed with the liquid diet in which ethanol accounts for 30％ of total energy,while the pair-fed mice were fed with the control diet for 10 d.At the 16th day,ethanol-fed mice and pair-fed mice were respectively gavaged a single dose of 31.5％ ethanol or isocaloric maltose dextrin,and euthanized 9 h later.Sera and livers were collected.The general physiological condition,hepatic tissue pathological changes and serum indexes between Lieber-DeCarli models and ALDNM models were compared.The liver lipids of ALDNM mice were determined by Oil red O (ORO) staining and hepatic triacylglyceride (TAG) test.Meanwhile,the mRNA levels of interleukin-6 (IL-6),tumor necrosis factor α (TNF-α),fatty acid synthase (Fas),long chain fatty acid elongase 6 (Elovl6) and stearyl-CoA desaturase (Scdl) were detected by real-time PCR in ALDNM models.Western blotting was used to detect the changes of phosphorylated signal transduction and transcriptional activator (p-STAT3) in the livers.Results·Lieber-DeCarli model mice were generally in poor condition,and there was no significant change in serum glutamic-pyruvic transaminase (GPT) and glutamic-oxaloacetic transaminase (GOT) compared to pair-fed group.However,in ALDNM models,H-E staining showed that the hepatocytes of ethanol-fed mice were extremely swollen with round volume,increased cytoplasm and filled with large amounts of fat vacuoles.ORO staining analyses showed obvious microsteatosis in the liver cells from all ethanol-fed mice.The hepatosomatic index,liver TAG content,serum GPT and GOT of ALDNM models were significantly higher than those in the pair-fed group,while the serum HDL significantly decreased compared to the pair-fed group.Moreover,the expression levels of both lipid synthesis pathways and inflammatory signaling pathways related genes in livers significantly increased in the ethanol-fed mice of ALDNM model.Conclusion·ALDNM model was successfully constructed.This model is cost-and time-efficient.Moreover,ALDNM model mimics the drinking pattern and pathogenesis of ALD patients with the advantages of stable food intake,good repeatability,and obvious liver damage.

Objective To observe the clinical safety and efficacy of foscarnet prophylaxis and pre-emptive therapy for cytomegalovirus (CMV) infection in allogeneic hematopoietic stem cell transplantation (allo-HSCT). Methods Ninety-six patients undergoing allo-HSCT from October 2014 to December 2016 were retrospectively analyzed. Plasma CMV-DNA was monitored with real-time quantitative polymerase chain reaction (RQ-PCR) from beginning to 180 days after transplantation. Foscarnet was used not only for prophylaxis but also for first-line pre-emptive therapy when plasma CMV-DNA turned to positive. Foscarnet was given 60 mg·kg-1·d-1 and 120 mg·kg-1·d-1 respectively in prevention and pre-emptive therapy. Incidences of CMV infection and CMV disease were observed, influencing factors on CMV in faction and the efficacy and safety of foscarnet prophylaxis were analyzed, and survival of patients treated by all-HSCT was evaluated. Results Of the total 96 patients, 42 cases (43.8%) had CMV infection with the median time of 42 days after allo-HSCT. CMV-DNA became negative in 36 patients (85.7%, 36/42) after pre-emptive therapy. Six patients (14.3 %, 6/42) developed CMV disease, including 5 patients with CMV negative and 1 patient died for CMV pneumonia. Haploidentical donor and grade Ⅱ-Ⅳacute graft versus host disease (GVHD) were the risk factors for CMV reactivation (χ2 = 3.834, P< 0.05; χ2 = 16.807, P< 0.001). The side effects of foscarnet prophylaxis were mild without hematologic toxicities. 12 patients (28.6 %) died in 42 patients with CMV infection, and 6 patients (11.1 %) died in 54 patients without CMV infection. The difference of survival rates between both groups was not statistically significant. Conclusion Foscarnet is an effective agent for prophylaxis and pre-emptive therapy in CMV infection after allo-HSCT with mild adverse reactions, especially for patients following with hematopoietic recovering.

Purpose: This study compared the diagnostic performance of the Ovarian-Adnexal Reporting and Data System (O-RADS), the Risk of Malignancy Index 4 (RMI4), the International Ovarian of Tumor Analysis Logistic Regression Model 2 (IOTA LR2), and the IOTA Simple Rules (IOTA SR) in predicting the malignancy of adnexal masses (AMs). Methods: This retrospective study included 575 women with AMs between 2017 and 2020. All clinical messages, ultrasound images, and pathological findings were collected. Two senior doctors (group I) and two junior doctors (group II) used the four systems to classify AMs. The postoperative pathological diagnosis was used as the gold standard to evaluate the diagnostic efficiency. A receiver operating characteristic curve was used to test the diagnostic performance. The interrater agreement between the two groups was tested using kappa values. Results: Of all 592 AMs, 447 (75.5%) were benign, 123 (20.8%) were malignant, and 22 (3.7%) were borderline. The intergroup consistency test yielded kappa values of 0.71, 0.92, 0.68, and 0.77 for the O-RADS, RMI4, IOTA LR2, and IOTA SR, respectively. To predict malignant lesions, the areas under the curve of the O-RADS, RMI4, IOTA LR2, and IOTA SR systems were 0.90, 0.89, 0.90, and 0.86 for group I and 0.89, 0.87, 0.88, and 0.84 for group II, respectively. The O-RADS had the highest sensitivity (91.0% in group I and 84.8% in group II). Conclusion The four diagnostic systems could compensate for junior doctors’ inexperience in predicting malignant adnexal lesions. The O-RADS performed best and showed the highest sensitivity.

Objective:To investigate the effect of small molecule antibacterial agent Halicin against Staphylococcus aureus. Methods:The minimum inhibitory concentration (MIC) and minimum bactericidal concentration of Halicin against S. aureus were detected by the microbroth dilution method. The time-kill assay of Halicin against S. aureus was detected by agar plate dilution method. Micro checkerboard dilution method was used to determine the synergistic antibacterial activity between Halicin and conventional antibiotics. Crystal violet staining method was used to assess the biofilm inhibitory and eradicating activity of Halicin. Hemolysis rate was used to detect the mammal cell toxicity of Halicin. Through the mouse skin abscess model, take the skin tissue around the abscess to grind and dilute the colony to detect the antibacterial effect of Halicin in vivo. Results:Halicin showed significant bacteriostasis effects against S. aureus with the minimum inhibitory concentration of 2-4 mg/L. Halicin could significantly reduce the average CFU counts of S. aureus about 5.5×10 6 CFU/ml in a concentration-dependent manner after 8 h treatment at the concentration of 16 mg/L. The fractional inhibitory concentration value between Halicin and ampicillin was 0.5, showing a synergistic antibacterial efficacy. Halicin effectively inhibited the formation of biofilms at the concentration of 4 × MIC, reducing the total biofilm biomass ( A570) from (2.89±0.09) to (1.35±0.17) ( t=11.12, P<0.05). However, there was no eradication effect against preformed biofilms. In addition, Halicin had almost no hemolytic activity on red blood cells even at the concentration up to 128 mg/L. It showed that 20 mg/kg Halicin reduced bacterial burden about 3.0×10 7 CFU/ml in vivo. Conclusion:Halicin had a strong antimicrobial activity against S. aureus with no hemolytic activity.

Objective:To explore the mediating effect of nurses′ self-efficacy in palliative care between the past behavioral experience of end-of-life care and core competence, and provide theoretical reference for improving the core competence of clinical nurses in palliative care.Methods:579 clinical nurses from 2 tertiary general hospitals in Shandong Province were investigated by convenience sampling method using general information questionnaire, nurses′ self-efficacy questionnaire for palliative care and palliative care nurses′ core competency questionnaire. The data were analyzed by SPSS 25.0.Results:The total score of core competence of hospice care of 579 nurses was (71.41 ± 22.74), nurses′ self-efficacy of palliative care was positively correlated with their core competence ( r = 0.648, P<0.01), past behavior experience was positively correlated with self-efficacy ( r = 0.479, P<0.01), positively correlated with core competence ( r = 0.427, P<0.01). Nurses′ self-efficacy of palliative care played a partial mediating role between the pastbehavioral experience and core competence, which accounted for 64.67% of the total effect. Conclusions:The past behavioral experience of end-stage nursing can directly or indirectly affect the core competence of nurses in palliative care through self-efficacy. It can improve the core competence of palliative care by taking active measures to enrich the past behavioral experience of end-of-life care and improve self-efficacy.

Objective: To observe the short-term changes of Body Mass Index (BMI) and Waist Circumference (WC) in junior high school students in Harbin, and to explore its association with the changes of high-sensitivity C-reactive protein (hs-CRP) in the same period. Furthermore, to analyze the value of hs-CRP to predict the BMI and WC changes in children and adolescents. Methods: Convenient sampling method was used,and the students in grades 6 and 7 in junior high school in Harbin were selected by stratified clicstering. Physical examination and serum hs-CRP were performed for two consecutive years. According to the results of the two surveys, the subjects were divided into control group (normal → normal), case group (abnormal → abnormal), improved group (abnormal → normal) and progression group (normal → abnormal). The multinomial logistic regression was used to analyze the predictive value of hs-CRP changes for BMI and WC changes. Results: The rate of overweight and obesity among samples from junior high school was 30.6%. The increment of BMI in female was more obvious than that in male(U=17 358.0，P<0.05). Both increments in BMI and WC were positively correlated with increments in hs-CRP(P<0.05). The risk of occurrence of "BMI always abnormal" and "WC always abnormal" increased sequentially in hs-CRP "normal → abnormal", "abnormal → normal" and "abnormal → abnormal", were 3.45 times, 5.98 times and 38.84 times of "BMI is always normal", respectively; and were 3.45 times, 4.26 times and 28.50 times of "WC is always normal", respectively. The risk of "BMI improvement" was 7.70 times more than that of BMI "always normal" when hs-CRP "abnormal → normal". Conclusion The prevalence of overweight and obesity in junior high school students in Harbin is high. The BMI increases faster in female from junior high school. The trends of change of BMI and WC are consistent with the trend of change of hs-CRP. The “hs-CRP change” has a good predictive value for BMI and WC development.

Objective: To investigate the relationship between dietary polyunsaturated fatty acid (PUFA) intake and blood lipid, C-reactive protein (CRP) and homocysteine (Hcy) in patients with acute ischemic stroke or transient ischemic attack (TIA). Methods: Patients with acute ischemic stroke or TIA were enrolled consecutively from Nanjing Stroke Registry Program. The total dietary PUFA intake level was assessed by the food semi-quantitative frequency questionnaire. Venous blood samples were collected in the morning of the day after admission to the hospital to detect the levels of serum total cholesterol, triacylglycerol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, Hcy, and CRP. According to the median level of total PUFA intake, the patients were divided into low PUFA group and high PUFA group. The relationship between PUFA intake and blood lipid, CRP and Hcy was analyzed by Spearman correlation analysis, and multiple linear regression analysis was used to determine the independent correlation. Results: A total of 170 patients (85.1%) with acute ischemic stroke and 31 patients with TIA (14.9%) were enrolled. Their age was 62.9±14.1 years, 143 were males (71.1%), and the median PUFA daily intake was 12.8 g (interquartile range: 8.05-17.5 g). Compared with the high PUFA group (n=100), patients in the low PUFA group (n=101) were older, serum high-density lipoprotein cholesterol levels were lower, and CRP and Hcy levels were higher. The above differences were statistically significant (all P<0.05). Spearman correlation analysis showed that total dietary PUFA intake was significantly negatively correlated with the serum CRP (r=-0.24, P=0.001) and Hcy (r=-0.17, P=0.013) levels, and there was no significant correlation with the blood lipid levels. Multiple linear regression analysis showed that CRP was significantly negatively correlated with PUFA intake after adjusting for confounding factors (B=-0.28, P=0.012). Conclusions Dietary PUFA intake in patients with acute ischemic stroke or TIA may affect blood metabolism index and oxidative stress index. It is necessary to adjust the dietary structure of patients with low PUFA intake to reduce the risk of stroke recurrence.