Objective:To investigate the early warning value of transcutaneous oxygen pressure and transcutaneous carbon dioxide pressure (TcPO 2/TcPCO 2) monitoring in patients with pressure injury in ICU. Methods:A prospective clinical observation study was conducted. Patients were selected in the department of critical care medicine of Shenzhen Hospital Affiliated to University of Chinese Academy of Sciences from December 2020 to June 2022. The general information of all patients were recorded. The data of TcPO 2 and TcPCO 2 were monitored respectively in left lying position, supine position and right lying position. According to the Braden score of patients, they were divided into low risk group and high risk group, and the monitoring results of TcPO 2/TcPCO 2 were analyzed. Results:The study included a total of 80 patients, with 46 patients in the low risk group and 34 patients in the high risk group. There were no significant differences in gender and age between the two groups (both P>0.05). There were significant differences in the Braden score and the incidence of pressure injury between the two groups (both P<0.05). There were statistically significant differences in TcPO 2 at various time points in the left lying position, supine position and right lying position between the low risk and the high risk groups (all P<0.001). Except for the 15th minute of the left lying position and right lying position, there were statistically significant differences in TcPCO2 at all other time points in the supine and right lying positions between two groups (all P<0.05). There were statistically significant differences in TcPO 2/TcPCO 2 values at various time points in different positions between two groups (all P<0.001). In supine position, TcPO 2 and TcPO 2/TcPCO 2 were positively correlated with the Braden score ( r=0.680, 0.741). TcPCO 2 was negatively correlated with the Braden score ( r=-0.771). The Braden score, TcPO 2, TcPCO 2 and TcPO 2/TcPCO 2 all have moderate diagnostic value. The cut-off values were 12.50, 41.48 mmHg, 52.29 mmHg and 0.91, respectively. And the AUC were 0.899, 0.727, 0.816 and 0.719, respectively. However, there were no significant differences in AUC between the TcPO 2, TcPCO 2, TcPO 2/TcPCO 2 and Braden score (all P>0.05). Conclusions:TcPO 2, TcPCO 2 and TcPO 2/TcPCO 2 values all have higher diagnostic value about pressure injury for patients in ICU. TcPO 2/TcPCO 2 monitoring has early risk warning value for the occurrence of pressure injury in ICU, which is worthy of clinical promotion.

OBJECTIVE To study the moderation effect of water extract of Farfarae Flos on blood lipid and glucose regulation in obese mice. METHODS Chemical method was used to identify the components of the water extract of Farfarae Flos. The contents of total terpenes in the water extract of the Farfarae Flos were determined by UV-VIS spectrophotometry. The mice were randomly divided into blank group, model group, orlistat group, and low-dose, medium-dose, and high-dose groups of water extract of Farfarae Flos. The blank group was fed with ordinary diet, while the other groups were fed with high-fat and high-sugar diet to establish an obese animal model, and they were administration while molding for 45 d. At the end of the experiment, the contents of serum triglyceride(TG), cholesterol(CHO), high-density lipoprotein-C(HDL-C), low-density lipoprotein-C(LDL-C), glucose(GLU), and glycosylated serum protein(GSP) were detected. Hematoxylin-eosin(HE) and oil red O staining were used to observe the morphological changes and lipid droplet distribution of liver tissue in mice. RESULTS There were flavonoids and terpenoids in the water extract of the flower. Compared with the blank group, the levels of TG, CHO, LDL-C, GLU and GSP in the model group were significantly increased(P<0.05 or P<0.01), HDL-C was significantly decreased(P<0.05), and the area of lipid droplets in the liver was significantly increased(P<0.01). Compared with the model group, TG, LDL-C, CHO, GLU and GSP levels in the Farfarae Flos water extract groups were significantly decreased, HDL-C was increased, and lipid droplet accumulation were reduced. Compared with the model group, the blood lipid and blood glucose levels in the treatment groups were significantly decreased, among them, the high-dose group of the water extract of Farfarae Flos had the best effect. CONCLUSION The water extract of farfara can improve glucose and lipid metabolism in obese mice by reducing blood lipids, CHO, and improving the pathological morphology of liver tissue.

[Abstact] Objective To investigate the characteristics of heart rate variability (HRV) of ambulatory electrocardiogram in patients with acute stroke, and evaluate the predictive value of HRV in stroke prognosis. Methods Eighty-three patients acute stroke (study group) and 83 cases of healthy subjects (control group) from October 2016 to October 2017 in Dalian Municipal Central Hospital Affiliated of Dalian Medical University were selected. The 24 h ambulatory electrocardiogram was performed to determine HRV in 2 groups, including standard deviation of NN intervals (SDNN), standard deviation of the 5 min mean cycle lengths (SDANN), root-mean-square successive difference (RMSSD) and percentage value of NN50 count (PNN50). Results The SDNN, SDANN, RMSSD and PNN50 in study group were significantly lower than those in control group: (80.83 ± 10.52) ms vs. (148.11 ± 22.59) ms, (79.98 ± 8.89) ms vs. (129.35 ± 5.34) ms, (19.28 ± 4.25) ms vs. (39.57 ± 2.38) ms and (5.91 ± 2.12) % vs. (19.35 ± 12.15) %, and there were statistical differences (P＜0.05). Among the 83 patients with acute stroke, there were no statistical differences in SDNN, SDANN, RMSSD and PNN50 between ischemic stroke (54 cases) and hemorrhagic stroke (29 cases) (P＞0.05). The SDNN, SDANN, RMSSD and PNN50 in right stroke (43 cases) were significantly lower than those in left stroke (40 cases): (75.18 ± 2.32) ms vs. (88.12 ± 3.58) ms, (73.36 ± 2.18) ms vs. (85.69 ± 7.29) ms, (17.57 ± 1.67) ms vs. (20.58 ± 4.23) ms and (4.39 ± 1.57) % vs. (8.61 ± 1.12) %, and there were statistical differences (P＜0.05). Patients were followed up for 1 year, 24 died and 59 survived. The SDNN, SDANN, RMSSD and PNN50 in dead patients were significantly lower than those in survived patients: (92.35 ± 4.58) ms vs. (154.37 ± 4.65) ms, (76.23 ± 4.03) ms vs. (143.95 ± 4.34) ms, (7.43 ± 2.12) ms vs. (31.65 ± 1.52) ms and (2.35 ± 0.46) % vs. (11.65 ± 0.48) % , and there were statistical differences (P＜0.05). Conclusions The autonomic nervous function of patients with acute stroke is seriously unbalanced, with increased sympathetic excitability and decreased vagus excitability. The decrease of HRV can easily induce cardiac events and seriously affect the prognosis.

Objective To investigate the risk factors and appropriate screening methods for diabetic peripheral neuropathy (DPN ). Methods This research is a multicenter ,randomized ,cross-sectional study. Questionnaires ,physical examinations and laboratory tests were performed on 1054 elderly diabetic outpatients at 13 hospitals in urban and rural areas of Beijing. Patients were screened for DPN with the five physical examinations recommended by the Diabetes Branch of the Chinese Medical Association. They were divided into a confirmed DPN group(n=449 ,42.6％ ) ,a suspected DPN group(n=276 ,26.2％ ) ,and a non-DPN group(n=329 ,31.2％ ).Multivariate logistic regression was used to analyze risk factors for DPN.The sensitivity ,specificity ,Youden index ,and area under the receiver operating characteristic (ROC)curve were calculated and used for evaluating each test and their combinations in screening DPN and for choosing the opitmal test combination. Results The differences in age ,family income ,duration of diabetes ,glycated hemoglobin(HbA1c) ,hypoglycemia ,and dyslipidemia among three groups were statistically significant (all P<0.01). The decision whether or not to initiate metformin therapy ,metformin doses and DPN prevalence in patients on long-term metformin therapy showed statistically significant differences among three groups (all P<0.01). The differences in the prevalences of cerebral infarction ,diabetic retinopathy ,and peripheral vascular disease among three groups were statistically significant (all P< 0.05).Multivariate Logistic regression analysis suggested that levels of HbA1c ,hypoglycemia ,LDL cholesterol ,whether or not metformin use , metformin dose ,and duration of metformin use were risk factors for DPN in elderly diabetics (all P<0.05) . The combined methods of ankle reflex ,vibratory sensation and temperature sensation used for screening DPN showed the best results with a sensitivity of 94.1％ ,specificity of 75.3％ ,an area under the ROC curve of 0.847 ,and a Yoden index of 0.6945. Conclusions The prevalence of DPN in elderly diabetic outpatients at third-level referral hospitals in Beijing is high. Poor glycaemic control ,repeated episodes of hypoglycemia , metformin use and its daily dose and duration are risk factors for DPN in elderly diabetics.We should focus on strengthening the DPN screening and management of high-risk population.Symptoms of peripheral neuropathy plus ankle reflex ,vibratory and temperature sensations are simple ,rapid and reliable DPN-screening methods ,and can be promoted in outpatient department and primary hospitals.

Objective To explore mediating effect of coping style on the relationship between self-esteem and negative emotions among college students with left-behind experience. Methods The investiga-tion was carried out among 663 college students with left-behind experience by multistage sampling method, using coping style scale, self-esteem scale, self-rating anxiety scale and Beck depression inventory. Re-sults Scores of all scales were shown as follows: self-esteem (3. 09±0. 51),anxiety (34. 94±7. 90),de-pression (8. 80±8. 72),solving problem coping (9. 03±2. 57),help-seeking coping (5. 70±2. 24),self-bla-ming coping (3. 54±2. 24),fantasy coping (4. 56±2. 35),avoidance coping (4. 74±2. 02),rationalizing coping (4. 67±2. 32). Anxiety and depression had significantly negative correlations with self-esteem(r=-0. 46,-0. 50,P<0. 01) ,solving problem coping( r=-0. 29,-0. 30,P<0. 01) and help-seeking coping( r=-0. 08,-0. 18,P<0. 01) ,and significantly positive correlations with rationalizing coping( r=0. 32,0. 28,P<0. 01),self-blaming coping(r=0. 45,0. 43,P<0. 01),fantasy coping(r=0. 33,0. 23,P<0. 01) and avoid-ance coping(r=0. 26,0. 23,P<0. 01). There were partially significant mediating effects of solving problem coping(-0. 09,95％CI:-0. 06--0. 13),rationalizing coping(-0. 03,95％CI:-0. 01--0. 05),self-blaming coping(-0. 11,95％CI:-0. 06--0. 15) ,fantasy coping(-0. 02,95％CI:-0. 01--0. 04) ,and non-significant effects of help-seeking coping and avoidance coping in the relationship between self-esteem and negative e-motions. Conclusion Solving problem coping,rationalizing coping,self-blaming coping and fantasy coping play a partial mediating role in the relationship between self-esteem and negative emotions,while the media-ting effect of help-seeking coping and avoidance coping are not significant.

Objective To isolate bacteriophages against extensively-drug resistant Acinetobacter baumannii from hospital sewage and analyze their biological characteristics.Methods Extensively-drug resistant Acinetobacter baumannii isolated from several hospitals in Shanghai during December, 2013 to July, 2014 were used as host bacteria, adopting double-layer agar method to isolate bacteriophages from raw sewage of these hospitals.The phage with broad host range was selected for further study, including observation of electron microscopic morphology, examination of thermal stability, pH stability and the optimal MOI, drawing of the adsorption, one-step-growth and infection curves, as well as sequencing of the phage genome DNA. Results An extensively-drug resistant Acinetobacter baumannii bacteriophage vB_AbaP_PD-AB9 ( PD-AB9 for short) with broad host range was isolated, and electron microscopy revealed it belonged to Podoviridae family.The optimal MOI of PD-AB9 was 0.001.PD-AB9 remained stable among 4 ℃to 50 ℃and pH 4 to 11.In the adsorption experiment, the adsorption rate of PD-AB9 reached above 95%within 5 min.PD-AB9 had a latent period of 4 min and a burst size of 213.PD-AB9 could obviously restrain the host growth, with faster effect at the higher MOIs (MOI=1, 0.1, 0.01) than at the lower ones (MOI=0.001, 0.000 1).Furthermore, genome of PD-AB9 proved to be a double-stranded linear DNA with size of 40 938 bp and GC content of 39.34%.Conclusions PD-AB9 exhibits good thermal stability, wide pH tolerance range, very fast adsorption, a short latent period, a large burst size and it could quickly cause effective host lysis after infection.Therefore, PD-AB9 is promised to act as a new antimicrobial agent to control drug-resistant Acinetobacter baumannii infections and its bio information remains to be further studied.

Objective To investigate the differences in position and volume between planning target volumes (PTV) based on positron emission tomography?computed tomography (PET?CT) images with an standardized uptake value ( SUV) no less than 2?5, 20% of the maximum SUV ( SUVmax ), or 25% of SUVmax , three?dimensional ( 3D ) CT, and four?dimensional ( 4D ) CT in thoracic esophageal cancer. Methods Eighteen patients with thoracic esophageal cancer sequentially received chest 3DCT, 4DCT, and [18F]fluoro?2?deoxy?D?glucose (FDG) PET?CT scans. PTV3D was obtained by conventional expansion of 3DCT images;PTV4D was obtained by fusion of target volumes from 10 phases of 4DCT images. The internal gross tumor volumes ( IGTV) , IGTVPET2.5 , IGTVPET20%, and IGTVPET25%, were generated based on PET?CT images with an SUV no less than 2?5, 20% of SUVmax , and 25% of SUVmax , respectively. These IGTVs were expanded longitudinally by 3?5 cm and radically by 1 cm to make PTVPET2.5 , PTVPET20%, and PTVPET25%, respectively. Results PTV3D was significantly larger than both PTV4D and PTVPET(P=0?000 -0?044), while there was no significant difference between PTV4D and PTVPET ( P= 0?216 -0?633 ) . The mutual degrees of inclusion ( DIs ) between PTV3D and PTV4D were 0?70 and 0?95, respectively, which were negatively correlated with 3D?Vector ( P=0?039). The mutual DIs between PTVPET2.5, PTVPET20%, and PTVPET25% were 0?74, 0?72, 0?78, 0?73, 0?77, and 0?70, respectively, which showed no correlation with 3D?Vector (P=0?150 -0?822). The mutual DIs between PTV3D and PTVPET were 0?86, 0?84, 0?88, 0?63, 0?67, and 0?59, respectively. Conclusions It is difficult to achieve complete volumetric overlap of PTVs based on 3DCT, 4DCT and PET?CT in thoracic esophageal cancer due to different target volume information. PET scan during free breathing should be used with caution to generate PTVs in thoracic esophageal cancer.

Objective To investigate the correlations in target volumes based on positron emission tomography CT (PET/CT) and the end-expiration phase of four-dimensional CT (4D-CT) images for non-small cell lung cancer (NSCLC).Methods Seventeen patients with NSCLC sequentially underwent three-dimensional CT (3DCT),4D-CT and 18F-FDG PET/CT thoracic simulation scans.The gross target volume (GTV) was contoured on the end-expiration phase (50％) of 4D-CT and defined as GTV50％.The internal gross target volumes (IGTV) based on PET/CT images (IGTVPET) were determined by the standardized uptake value (SUV) 2.0 (IGTVPET2.0) and 20％ percentage of the maximal standardized uptake value (SUVmax) (IGTVPET20％).The following parameters were calculated to analyze the correlation between IGTVPET and GTV50％ in volume ratio (VR) and conformity index (CI):maximum transverse diameter of GTV50％,volume of GTV50％,the displacement of GTV in the cranial-caudal direction and 3D Vector calculated from 4D-CT dataset as well as the SUVmax.Results There was no significant correlation between the VR of IGTVPET2.0 to GTV50％ and the maximum transverse diameter of GTV50％,volume of GTV50％,the displacement of GTV in the cranial-caudal direction,3D Vector and the SUVmax (P ＞ 0.05).The VR between IGTVPET20％ and GTV50％ inversely related to maximum transverse diameter of GTV50％,volume of GTV50％ and SUVmax (r =-0.663,-0.669,-0.752,P ＜0.05).The CI between IGTVPET2.0 and GTV50％ positively related to volume of GTV50％ and maximum transverse diameter of GTV50％ (r =0.613,0.483,P ＜ 0.05).Conclusions 3D PET images provide a time-averaged image of the tumor during the numerous breathing cycle.They fail to include the full information of moving tumor.The target volumes based on 3D PET might not reflect the real IGTV of NSCLC.

Objective:To analyze survival in patients with advanced oral cancer from prospective clinical trials. Methods:From 2008 to 2010, 256 patients with oral cancer at clinical stage III/IVA were randomly categorized into two groups. Patients in the experi-mental group received neo-adjuvant chemotherapy, surgery, and post-operative radiation, and patients in the control group underwent surgery and post-operative radiation. All patients were routinely followed-up after treatments. Survival was analyzed using Kaplan–Meier method and log-rank test, and differences were considered statistically significant at P value lower than 0.05. Results: Each group was composed of 128 patients. With the median follow-up period of 60 months, the 5-year overall survival rate was 61.7%and the disease-free survival rate was 53.9%. The overall survival rate (P=0.350) and the disease-free survival rate (P=0.160) were not sig-nificantly different between the experimental and control groups. Patients with positive pathological response to neo-adjuvant chemo-therapy exhibited significantly improved overall survival (P＜0.05). Conclusion:Radical surgery should be emphasized to improve the prognosis of oral cancer. Functional reconstruction could also improve the quality of life and survival of patients. Despite that neo-adju-vant chemotherapy could not improve the survival of patients with advanced oral cancer in entirety, it could benefit patients exhibiting positive treatment responses.