Objective:To understand the relationship between pain, negative emotions (anxiety and depression), insomnia and fatigue in patients with rheumatoid arthritis, and explore the multiple mediating effects of negative emotions and insomnia on pain and fatigue.Methods:A total of 240 patients with rheumatoid arthritis were selected from Northern Theater General Hospital from October 2018 to January 2019. The general questionnaire, Bristol Rheumatoid Arthritis Fatigue Multi-Dimensional Questionnaire,Visual Analogue Scale,The Hospital Anxiety and Depression Scale and the Asens Insomnia Scale were used to investigate the demographic data, fatigue, pain, anxiety, depression, and insomnia, respectively. SPSS 20.0 was used for correlation analysis, and Mplus 7.0 was used for mediation analysis.Results:The fatigue score of patients with rheumatoid arthritis was (28.88±14.89), which was moderate. The score of Visual Analogue Scale was 4(2-7), the score of insomnia was 7(3-11), the score of anxiety was 5(3-8), the score of depression was 7(4-11). There was a positive correlation between fatigue and pain, negative emotion and insomnia ( r values were 0.432-0.950, P<0.01). Negative emotions and insomnia had a partial mediating effect between pain and fatigue, with mediating effects accounting for 56.44% of the total effect. Conclusions:The fatigue of patients with rheumatoid arthritis is moderate; fatigue is associated with pain, negative emotions, and insomnia; negative emotions and insomnia have multiple mediating effects between pain and fatigue.

Objective To explore the clinical effects of Xueshuantong injection in the treatment of acute cerebral infarction(ACI).Methods 70 patients with ACI were divided into Xueshuantong injection treatment group and Fufangdanshen control group,The two groups were all treated with routine way.The treatment group were treated with routine way and the Xueshuantong injection for 14 days,The two groups before and after evaluation for neural function defect scale was evaluated,and hemorheology indices were detected.Results The treatment group basic recovery rate was 25.0％,Significant progress rate was 37.5％,progress rate was 27.5％,overall response rate was 90.0％.The control group were 16.7％,30.0％,23.3 ％,70.0％,the difference was significant (x2 =4.534,P ＜ 0.05),the hemorrheologic indices of the treatment group after drug use are statistically significant differences,compared with before drug use(all P ＜ 0.05).Conclusion Xueshuantong injection in treatment of acute cerebral infarction is safe and effective.

Torque teno virus(TTV)is a nonenveloped virus containing a single-stranded,circular DNA genome of approximately 3.8kb.We completely synthesized the 3808 nucleotides of the TTV(SANBAN isolate)genome,which contains a hairpin structure and a GC-rich region.More than 100 overlapping oligonucleotides were chemically synthesized and assembled by polymerise chain assembly reaction(PCA),and the synthesis was completed with splicing by overlap extension(SOEing).This study establishes the methodological basis of the chemical synthesis of a viral genome for use as a live attenuated vaccine or gene therapy vector.

Objective: To evaluate effect of the morphology of simulated S-shaped root canals with Reciproc or Mtwo instruments on root canal irrigation. Methods: A total of 40 simulated S-shaped resin blocks were randomly divided into 2 groups (n=20), which was prepared by Reciproc or Mtwo. Blue ink was injected with constant speed and volume into the canals using 30G lateral opening syringe. hTe distance from needle tip to apex and vapor lock length were measured. A type of 25# 0.04 gutta-percha point was used to stir and remove the vapor lock. hTe time for removal of the vapor lock was recorded. Another syringe was used to inject saline into the canals and to measure the length of stagnant water. Results: hTe distance from needle tip to apex in the Reciproc group was signiifcantly longer than that in the Mtwo group [(4.276 ± 0.221) mm vs (3.459 ± 0.205) mm,P<0.05]. The vapor lock length in the Reciproc group was signiifcantly longer than that in the Mtwo group [(4.472 ± 0.230) mm vs (3.668±0.217) mm,P<0.05]. hTe time to remove vapor lock was signiifcantly shorter in the Reciproc group than that in the Mtwo group [(10.13 ± 1.79) s vs (15.29 ± 2.15) s,P<0.05]. The length of stagnant water was also shorter in the Reciproc group than that in the Mtwo group[(1.351 ± 0.142) mm vs (2.245 ± 0.206) mm,P<0.05]. Conclusion: hTe morphology of S-shaped root canal affects the root canal irrigation. hTe effect of root canal irrigated by Reciproc is better than that by Mtwo.

OBJECTIVETo report our therapeutic effect of double adipofascial turnover flaps in repairing stage IV ischial pressure scores.

METHODSDuring the period of May 2009 to February 2013, we treated 11 cases of stage IV ischial pressure scores with double adipofascial turnover flaps and proper drainage. Based on the conditions of pressure scores and abundant blood supply of adipofascial flaps, we designed two adipofascial flaps on each side of lesion. The two flaps were overlaped to cover the pressure score, following with negative pressure drainage.

RESULTSAll pressure scores healed primarily. The follow-up period ranged from 11 to 36 months with satisfactory results and no recurrence.

CONCLUSIONSDouble adipofascial turnover flaps and proper drainage is a safe and simple method for the treatment of stage IV ischial pressure scores with satisfactory results.

Adipose Tissue ; transplantation ; Drainage ; methods ; Fascia ; transplantation ; Female ; Follow-Up Studies ; Humans ; Ischium ; Male ; Negative-Pressure Wound Therapy ; Pressure ; Pressure Ulcer ; pathology ; surgery ; Recurrence ; Surgical Flaps ; blood supply ; transplantation ; Wound Healing

[Objective]To discuss the anatomy and etiology of cubital tunnel syndrome.[Method]The clinical data and surgical findings of sixty five cubital tunnel syndrome cases were analyzed,and the per-operative electromyogram results of twenty five cases were studied.[Result]Hypertrophy of arcuate ligament resulted in compression and abrasion of ulnar nerve in sixty patients;we found that the ulnar nerve conduct velocity decreased(the average speed was 27.97 m/s),motional amplitude also decreased(the average voltage was 1.95 mv),and latent period prolonged(the average time was 5.41 ms)after pre-operative electromyogram.[Conclusion]The major etiology of cubital tunnel syndrome is chronic injury with sustained compression of ulnar nerve around elbow joint.Careful physical examination of ulnar nerve function and pre-operative electromyogram will help us to diagnose the cubital tunnel syndrome.Cubital tunnel syndrome should be differentiated from tardy ulnar nerve palsy of other sites.

Objective To investigate the effects of clonidine on the visceral pain induced by acute myocardial ischemia. Methods Male SD rats weighing 250-280 g were operated upon under general anesthesia with intraperitoneal methane 1.2 g/kg and local infiltration of the skin incision. After tracheal intubation, the animals were mechanically ventilated (VT = 5-7 ml/kg, RR = 75 bpm). The anterior descending branch of left coronary artery was occluded with a snare through the left 4 th intercostal space. The animals were then fastened to a brain stereotaxic instrument and a burr hole was made in the skull. A glass micro-electrode was inserted into the brain. The discharges of noxious stimulation responding neuron (NSRN) in parafascicular nucleus were recorded. Twenty-four rats detected NSRN showed response to coronary artery occlusion (CAO) were randomly divided into 4 groups (n =6 each): group Ⅰ CAO + normal saline 0.1 ml; group Ⅱ CAO + elonidine 30 μg; group Ⅲ CAO + clanidine 100 μg; group Ⅳ CAO + clonidine 100 μg + yohimbine (an α2-adrenergic receptor antagonist) 200 μg. In group Ⅳ , clonidine was administered intravenously 15 min after CAO, and then yohimbine was injected intravenously 15 min later. The discharges of NSRN were recorded every 5 min for 60 min from the beginning of CAO. Results Clonidine 100 μg significantly inhibited the increased frequency of nociceptive discharge rate of NSRN after CAO. However, this effect could be blocked by the α2-adrenergic receptor antagonist yohimbine.Conclusion Clonidine 100 μg can reduce the visceral pain induced by acute myocardial ischemia through activiting α2-adrenergic receptor.

Objective To evaluate the efficacy of PTCRA+ PTCA in patients with complicated coronary disease Methods PTCRA+PTCA were performed on 16 lesions in 14 patients in our hospital Results In 14 lesions, PTCA was performed after direct PTCRA in order to achieve opital angigraphic result; PTCRA was performed in 5 coronary artery lesions after failed PTCA 14 patients (100%) had successful result Conclusion The combined use of PTCRA+PTCA can improve the success rate during revasculrization for patients with complicated coronary artery disease

Objective To explore the correlation between the psychological resilience levelwith the emotional regulation modeand personality characteristicin the patientwith gastricarcinomto provide the theoretical reference fothe intervention measure.MethodOne hundred and forty-seven patientwith gastricancewere selected athe research subject(gastricancegroup) and contemporaneou150 individualwith healthy physical examination in the outpatiendepartmenwere selected athe control group .The Connoand Davidson Resilience Scale(CD-RISC) ,Eysenck Personality Questionnaire(EPQ) and Emotion Regu-lation Scale were adopted to perform the investigation .The correlation between the psychological resilience levelwith the emotional regulation modeand personality characteristicwaanalyzed .ResultThe overall CD-RISscore in the gastricancegroup wa(59 .12 ± 9 .19) point,which belonged to the poorescope ;the personality characteristic,emotional regulation modeand psycho-logical resilience had statistical differencebetween the gastricancegroup and the control group (P＜0 .05);the multivariate Lo-gistiregression analysiresultshowed thathe introversion ,extroversion ,neuroticism ,catharsiregulation and depression regula-tion had largeinfluence on the lowepsychological resilience level in the patientwith gastricance(P＜0 .05);the psychological resilience in the patientwith gastricancewapositively correlated with the catharsiregulation and the depression regulation (r=0 .287 ,0 .136 ,P＜0 .05) and negatively correlated with the introversion ,extroversion and neuroticism (r= -0 .232 ,-0 .789 , P＜0 .05) .Conclusion The introversion ,extroversion ,neuroticism ,catharsiregulation and depression regulation are the importanfactorinfluencing the psychological resilience level .The multi-angle interventional measureshould be taken to improve the psy-chological resilience level in the patientwith gastricance.

Background Integrated transepithelial photorefractive keratectomy (TransPRK) is a new kind of surface ablation and has a fast reepithelialization and uncorrective visual acuity (UCVA) recovery as well as slighter postoperative pain,and epipolis laser in situ keratomileusis (Epi-LASIK) has been recognized to be an effective method for myopia.But there have been few studies to evaluate the dynamic change of the corneal biomechanical properties and posterior corneal elevation after TransPRK.Objective This study was to assess and compare the effectiveness and safety between TransPRK and Epi-LASIK for myopia with thin cornea.MethodsThis study was approved by Ethic Committee of Jinan Mingshui Eye Hospital,and written informed consent was obtained from each patient.In this prospective non-randomized controlled study,93 right eyes of 93 myopic patients with the central corneal thickness 460 to 500 μm were included in Jinan Mingshui Eye Hospital from June to December 2013 under the informed consent.The eyes were divided into TransPRK group for 46 eyes and Epi-LASIK group for 47 eyes.UCVA,manifest refraction,haze,corneal biomechanical properties,posterior corneal elevation,Qvalue and corneal high order wavefront aberration were analyzed before and 1 week,1 month,3 months and 6 months after operation,respectively,and the examination results were compared between the two groups.Results There was no statistically significant difference in the eyes of postoperative UCVA and manifest refraction between the TransPRK group and the Epi-LASIK group at various time points (all at P＞0.05).Six months after surgery,the percentage of eyes with UCVA of 1.0 or better was 93.9％,and 90.9％ eyes exhibited the targeted refraction in ± 1.00 D in the TransPRK group.Corneal haze was most obvious 1 month after surgery in both groups,with the incidence of 32.6％ (15/46) in the TransPRK group and 17.4％ (8/47) in the Epi-LASIK group,but no significant difference was found in the eye numbers with haze between the two groups (x2 =2.841,P =0.092).No significant differences were seen in the corneal hysteresis(CH) values and corneal resistance factor(CRF) values between the two groups (CH:Fgroup =0.000,P =0.999;CRF:Fgroup =0.110,P =0.741),however,the postoperative CH values and CRF values were significantly declined in comparison with preoperative ones,with significant differences among various time points (CH:Ftime =103.658,P =0.000;CRF:Ftime =132.008,P =0.000),while there were no remarkable differences between any two time points in postoperation (all at P＞0.05).Posterior corneal surface height shifted rearward 1 week,1 month,3 months and 6 months after surgery,showing remarkable differences in comparison with before surgery in both groups (Ftime =12.868,P =0.001),but no significant differences between the two groups (Fgroup =1.923,P=0.169).No significant differences were found in Q-value between the two groups (Fgroup =0.191,P=0.663).Root mean square (RMS) and spherical aberration values elevated in postoperation compared with preoperation,with significant differences between them(all at P＜0.01),but the comparison between intergroup was insignificant (RMS:Fgroup =0.299,P =0.586;Spherical aberration:Fgroup =1.290,P =0.259).Conclusions TransPRK for myopia with thin cornea is safe and stably effective like Epi-LASIK.TransPRK affects corneal biomecbanical properties early after surgery but the effect gradually lessens over time.The posterior corneal elevation shows a tiny backward displacement,while posterior corneal asphericity has no change.