Objective To investigate the role of correcting anemia in improving the heart function of chronic heart failure(CHF) with anemia. Methods Sixty-six CHF patients with anemia were randomly assigned to two groups. Thirty cases in the control group received routine treatment including digitalis, diuretics, vasodilator,ACEI or β-blocker,and 36 cases in the observe group received the above routine treatment and EPO,chalybeate and transferring hematid. Results Clinical efficiency ratio and total efficiency ratio were higher in the observe group (63. 9% ,91.7%) than in the control group(33.3% ,56. 7%) (χ2 =6. 73 and 10.91 ,P ＜0.01). After treatment for 3 months,Hb concentration, LVEF, LVDD, LEDV and LESV in the observe group were (125.0 ± 4. 0) g/L,(49.6±8.0)%,(4.9 ±0.7) cm,(130.1 ±24.0) ml and (72.5 ±32.0) ml respectively,which were all significantly improved than those in the control group [(80.0 ± 7.0) g/L, (34. 7 ± 10.0) %, (6. 0 ± 0.4) cm,(148. 3 ± 30.8) ml and (79. 7 ± 25. 0) ml] (P ＜ 0.01). Conclusions Correcting anemia is a safe and effective method in improveing the heart functionin CHF patients with anemia.

Objective To evaluate the clinical efficiency of febuxostat on hyperuricemia and hyperlipidemia,provide evidences for the option of clinical treatment.Methods From Mar.2015 to Mar.2016,80 patients with hyperuricemia and hyperlipidemia were enrolled to this study,and they were randomly divided into observation group and control group by random number table,each group with 40 cases.The observation group received 40 mg of fenbuterol tablets once a day.The control group received 100 mg allopurinol tablets three times a day.The levels of serum uric acid,lipids,endothelium-soluble intercellular adhesion molecule-1 (sICAM-1) and endothelium (ET-1) were measured at the baseline,12 weeks after treatment and 24 weeks after treatment.Meanwhile,the liver and kidney function damage and adverse reactions were recorded.Results After treatment,the levels of uric acid,blood lipid,sICAM-1 and ET-1 were decreased in two groups,and there was significant difference between them (P＜0.05).The adverse effects of the two groups were transient.The incidence of liver or kidney damage,side effect of drug in observation group was lower than that in the control group,and there was no significant difference between the two groups (P＞0.05),except the incidence of rash.Conclusion Febuxostat intervention in treatment of patients with hyperuricemia and hyperlipidemia is safe and efficient.

Objective To examine the expression of miR-210,miR-155 and miR-34a in the peripheral blood of patients with systemic lupus erythematosus (SLE) and to analyze their clinical significance.Methods One hundred and teenty-six SLE patients were divided into the stable group (n=35),mild active group (n=49),medium and severe active group (n =42) based on systemic lupus erythematosus disease activity index (SLEDAI) score.Meanwhile,40 subjects for healthy check-up were selected as controls.The clinical data of patients were collected.Complete blood count,liver and kidney function and immunological indexes were tested in patients and the lupus activity index was assessed.The expression level of miR-210,miR-155 and miR-34a were determined by real-time polymerase chain reaction.Furthermore,the correlation between their levels and clinical parameters such as erythrocyte sedimentation rate (ESR),C-reactive protein (CRP),SLEDAI score,were analyzed.The expression levels of miR-210,miR-155 and miR-34a in each group were compared by one-way analysis of variance (ANOVA).Correlation analysis was performed by non parametric Spearman test.The difference was statistically significant if P＜0.05.The diagnostic value of SLE was evaluated by the subjects characteristic (ROC) curve.Results The levels of miR-210 and miR-155 were no significantly differencet between the stable group (0.017±0.012);(0.150±0.101) and the control group (0.015±0.010);(0.071±0.034),but they were increased in mild active group (0.502±0.166);(1.521±1.138),medium and severe active group(1.237±0.584),(13.589±9.827) (F=124.321,70.065,P＜0.05).The average expression level of miR-34a in the control group,the stable group,the mild active group and the moderate and severe active group were (0.005±0.003),(0.249±0.137),(2.981±1.762) and (9.625±5.873) respectively,and showed a trend of increase in turn (F=75.688,P＜0.05).The expression level of miR-210,miR-155 and miR-34a was not significantly different between the LN group and the non LN group (P＞0.05).The R values of miR-210,miR-155,miR-34a and each index were IgG (0.347;0.518;0.482);IgA (0.463;0.635;0.379);IgM (0.287;0.392;0.336),ESR(0.317;0.428;0.369),C3(0.243;0.429;0.381),C4(0.317;0.513;0.429),ANA titer (0.462;0.594;0.527),Anti-ds-DNA antibodies (0.391;0.586;0.483),SLEDAI scores (-0.412;-0.558;-0.493),and there were significant correlations (P＜0.05).In patients with SLE,there was no significant correlation between hormone therapy alone or hormone plus immunosuppressive therapy (P＞0.05).The sensitivity and specificity of miR-210,miR-155,miR-34a in combination for the diagnosis of SLE reached 75.7％ and 72.3％,respectively.Conclusion The levels of miR-210,miR-155 and miR-34a in combination may be used as bio-markers for the diagnosis of SLE.

High-risk procedures in general surgery usually carry high risks and uncertainties,and patients may face significant changes in their living and health conditions,which can easily lead to doctor-patient disputes.This paper summarized the obstacles to implementing joint decision-making of doctors and patients in high-risk procedures in general surgery,as well as explored the best way to incorporate joint decision-making into clinical practice.In the decision-making process,general surgeons and patients need to work together to overcome ethical dilemmas such as lack of communication and decision-making abilities,inadequate informed consent and cognitive abilities,as well as institutional and cultural issues.To help patients choose the most suitable treatment method and truly make decisions about high-risk procedures,it is recommended that China strengthen communication skills training for general surgeons,develop and utilize decision-making support tools,and simultaneously supported multiple parties,to provide a good incubation soil for the implementation of joint decision-making of doctors and patients in general surgery.

Purpose: To understand the recurrence risk perception of stroke patients and develop a chain mediation model of recurrence risk perception and health behavior. Methods: A cross-sectional study and convenience sampling were used. Stroke survivors were recruited from the neurology departments of three tertiary hospitals. Their recurrence risk perception, behavioral decision-making, social support, self-efficacy, recurrence worry, and health behavior were measured by relevant tools. Data was analyzed through one-way analysis and regression analysis, and the AMOS 21.0 software was used to explore the mediating relationships between variables. Results: Of the 419 participants, 74.7% were aware of stroke recurrence risk. However, only 28.2% could accurately estimate their own recurrence risk. Recurrence risk perception was significantly correlated with behavioral decision-making, social support, self-efficacy, and health behavior (r = .19 ∼ .50, p < .05). Social support and recurrence risk perception could affect health behavior indirectly through self-efficacy, behavioral decision-making, and worry. Behavioral decision-making acted as a main mediator between recurrence risk perception and health behavior, while the path coefficient was .47 and .37, respectively. The chain mediation effect between recurrence risk perception and health behavior was established with a total effect value of .19 (p < .01). Conclusion Most stroke survivors could be aware of recurrence risk but failed to accurately estimate their individual risk. In the mediation model of recurrence risk perception and health behavior, social support seemed to be an important external factor, while self-efficacy, behavioral decision-making, and worry seemed to act as key internal factors.

Purpose: To understand the recurrence risk perception of stroke patients and develop a chain mediation model of recurrence risk perception and health behavior. Methods: A cross-sectional study and convenience sampling were used. Stroke survivors were recruited from the neurology departments of three tertiary hospitals. Their recurrence risk perception, behavioral decision-making, social support, self-efficacy, recurrence worry, and health behavior were measured by relevant tools. Data was analyzed through one-way analysis and regression analysis, and the AMOS 21.0 software was used to explore the mediating relationships between variables. Results: Of the 419 participants, 74.7% were aware of stroke recurrence risk. However, only 28.2% could accurately estimate their own recurrence risk. Recurrence risk perception was significantly correlated with behavioral decision-making, social support, self-efficacy, and health behavior (r = .19 ∼ .50, p < .05). Social support and recurrence risk perception could affect health behavior indirectly through self-efficacy, behavioral decision-making, and worry. Behavioral decision-making acted as a main mediator between recurrence risk perception and health behavior, while the path coefficient was .47 and .37, respectively. The chain mediation effect between recurrence risk perception and health behavior was established with a total effect value of .19 (p < .01). Conclusion Most stroke survivors could be aware of recurrence risk but failed to accurately estimate their individual risk. In the mediation model of recurrence risk perception and health behavior, social support seemed to be an important external factor, while self-efficacy, behavioral decision-making, and worry seemed to act as key internal factors.

Purpose: To understand the recurrence risk perception of stroke patients and develop a chain mediation model of recurrence risk perception and health behavior. Methods: A cross-sectional study and convenience sampling were used. Stroke survivors were recruited from the neurology departments of three tertiary hospitals. Their recurrence risk perception, behavioral decision-making, social support, self-efficacy, recurrence worry, and health behavior were measured by relevant tools. Data was analyzed through one-way analysis and regression analysis, and the AMOS 21.0 software was used to explore the mediating relationships between variables. Results: Of the 419 participants, 74.7% were aware of stroke recurrence risk. However, only 28.2% could accurately estimate their own recurrence risk. Recurrence risk perception was significantly correlated with behavioral decision-making, social support, self-efficacy, and health behavior (r = .19 ∼ .50, p < .05). Social support and recurrence risk perception could affect health behavior indirectly through self-efficacy, behavioral decision-making, and worry. Behavioral decision-making acted as a main mediator between recurrence risk perception and health behavior, while the path coefficient was .47 and .37, respectively. The chain mediation effect between recurrence risk perception and health behavior was established with a total effect value of .19 (p < .01). Conclusion Most stroke survivors could be aware of recurrence risk but failed to accurately estimate their individual risk. In the mediation model of recurrence risk perception and health behavior, social support seemed to be an important external factor, while self-efficacy, behavioral decision-making, and worry seemed to act as key internal factors.

【Objective】 To analyze the metagenomics and microbiology of voluntary blood donors in China, so as to assess the potential threats of emerging infectious diseases to the safety of blood transfusion. 【Methods】 12 300 plasma samples (10 mL each) collected by central blood stations in Chongqing, Liuzhou, Urumqi, Mianyang, Wuhan, Nanjing, Mudanjiang, and Dehong Prefecture area from 2012 to 2018 were subjected to total DNA extraction after ultracentrifugation (32 000 rpm/min, centrifugal radius 91.9 mm) in minipools of 160 donations. The metagenomic library was constructed, and deep sequencing was conducted by Illumina Hiseq 4 500. By comparing with reference sequences of bacteria, fungi, parasites and viruses, metagenomic data were analyzed, classification of microbes were identified, and potentially harmful pathogens were evaluated. 【Results】 A total of 632 GB clean data were obtained by deep sequencing, and the top three pathogens were Pseudomonas(0.561 1%), Burkholderia(0.468 7%) and Serratia(4.242 0%). Pathogens with potential threat which could be transmitted by blood transfusion or blood products were found, such as human parvovirus B19(0.126 6%), Leishmania spp(1.348 5%) and Toxoplasma gondii(0.615 8%). 【Conclusion】 Our study analyzed metagenomics of voluntary blood donors in parts of China and revealed pathogens that may cause potential harm to blood safety, which were helpful for targeted prevention and control of emerging infectious diseases.