Objective Applying color Doppler ultrasonic test on the first dorsal metatarsal arteries,to acquire relevant Doppler bloodstream parameters,and in the end,to explore the clinical value of this approach.Methods Applying GE-LOGIQ-400 color Doppler high-frequency ultrasonic test on the first dorsal metatarsal arteries of 100 diabetes patients,contrasting to those of 60 normal persons,observing the origination,trend,smooth of bloodstream,angioplerosis Status,analyzing bloodstream spectrum(including the interior diameter of blood vessel,spectrum status,bloodstream speed,drag index,erc.),and contrasting the resuits.Results The first dorsal metatarsal arteries of diabetes patients have narrower interior diameter,faster bloodstream speed,higher drag index than those of non-diabetes patients.Conclusion The high-frequency color Doppler ultrasonography can provide objective clinical evidence on the test of the first dorsal metatarsal arteries diseases.

Objective To construct a model for persistent genital tract infection with Chlamydia trachomatis in mice with low serum iron. Methods Iron deficiency was induced in female BALB/c mice by lowiron diet. Mice with or without iron-deficency were inoculated intravaginally with direct instillation of 50 μl of bacterial suspension containing 3.4344 × 107 IFU/ml of C. trachomatis serovar E elementary body 1 week after intramuscular injection of progesterone. Moxifloxacin and ferrous sulfate, alone or in combination were given to inoculated mice with iron deficiency daily for 1 week. Subsequently, vaginal discharge was obtained from mice and observed under an immunofluorescence microscope, and tissue specimens were resected from the uterus,uterine tube and ovary of mice and subjected to pathological examination at various time points. Results Compared with normal-iron mice, iron-deficient mice were infected with C. trachomatis for a longer duration (more than 18 weeks). After 18-week infection with C. trachomatis, there was an obvious chronic inflammation and lymphocytic infiltration in tissues specimens from the uterus,uterine tube and ovary of mice. Immunofluorescent examination of vaginal discharge for C. trachomatis turned negative in 60% of iron-deficient mice treated with both moxifloxacin and ferrous sulfate, but not in any of those receiving moxifloxacin or ferrous sulfate alone. Conclusion As animal models show, low serum iron may contribute to the persistent genital tract infection with C. trachomatis.

Heavy metal residue in vegetables is a big concern in the whole world.The aim of this work is to explore the effect of multivariable selection on analyzing Cd in Chinese cabbage polluted in lab by collecting the spectra of laser induced breakdown spectroscopy (LIBS) from the samples.At the same time,the actual Cd content in samples was obtained by anodic stripping voltammetry (ASV).The LIBS spectral range in partial least square (PLS) model was screened by standard normal variable transformation (SNV),first derivative (FD),second derivative (SD) and center treatment (CT) for preprocessing spectra and the optimized method was used for the analysis of interval partial least square (iPLS) and synergy interval partial least square (SiPLS).The results indicated that the method of CT was the best as a comparison with PLS,iPLS and SiPLS.And the intervals of wavelength were 214.72-215.82 nm,215.88-216.97 nm and 225.08 -226.35 nm by utilizing the optimized SiPLS.Here the root mean square error of cross validation (RMSECV) between real content and predicted ones was 1.487,the root mean squared error of prediction (RMSEP) was 1.094,the correlation coefficient (R) was 0.9942,and the average relative error (ARE) was 11.60％.The results displayed that LIBS could predict Cd in vegetables by multivariable selection of SiPLS and the accuracy could meet the requirement of rapid and green analysis of Cd in vegetables.

Objective To observe the effects of a lower-limb rehabilitation robot plus psychological intervention on depression and lower limb motor function of the stroke patients.Methods Sixty stroke patients were randomly divided into a treatment group (n =30) and a control group (n =30).The patients of control group were treated with routine rehabilitation and psychological intervention,while the treatment group were treated with lowerlimb rehabilitation robot,in addition to the interventions of the control group,for 10-20 minutes daily,6 days per week for 8 weeks.Both groups were assessed with Hamilton Depression Scale (HAMD),Simplified Fugl-Meyer assessment (FMA) and Functional Ambulation Category (FAC) before and at the end of 2,4 and 8 weeks of treatment.Results There was no significant difference between the 2 groups in all the assessment parameters before and after 2 weeks of treatment.At the end of 4 weeks of treatment,both groups improved significantly with regard to the scores of HAMD,FMA and FAC classification,and the treatment group improved to a significantly greater extent than the control group (P ＜ 0.05).At the end of 8 weeks of treatment the scores of HAMD,FMA and FAC classification were further improved significantly in treatment groups when compared with values obtained at the end of 4 weeks after treatment,but the scores of the control group was not significantly improved at the end of 8 weeks when compared with those at the end of 4 weeks of treatment.Conclusion Lower-limb rehabilitation robot plus psychological intervention can significantly help relieve the post-stroke depression and improve lower motor function of stroke patients.

Objective To observe the influence of psychology intervention and family rehabilitation guides on psychological status and quality of life of patients with spinal cord injury(SCI). Methods 24 SCI patients were divided randomly into treatment(n=12) and control(n=12) groups. The treatment group was given to psychology intervention and family rehabilitation, the psychological status and ADL were evaluated individually by SCL-90 and Barthel index on pre-guide and post-guide of six months.Results The discrepancy got statistic meaning on degree of SCL-90 and Barthel index on pre-guide and post-guide（P<0.05）. Conclusion Effective psychology intervention and family rehabilitation guides could impove psychological status and enhance quality of life of patients.

Objective: To explore the effect of DMAIC(Define, Measure, Analyze, Improve, Control) in reducing catheter-related urinary tract infection. Methods: A retrospective case control method was used to select 578 patients admitted and treated in comprehensive ICU of Tianjin First Central Hospital from January to December 2018 with catheters as research objects.The 283 patients from January to June 2018 were the control group, and 295 patients from July to December 2018 were the observation group.Routine methods were used in the control group, and DMAIC method with 6 sigma management was used in the observation group. The correct rate of implementation of each measure, the utilization rate of urinary catheter and the infection rate between the two groups were compared. Results: Implementation rate of early extubation assessment, urine collection accuracy, urine tube fixed correctly, urine tube cleaning time, urine collection bags location accuracy were 60.42%(171/283), 69.61%(197/283), 79.86%(226/283), 89.40%(253/283), 92.58%(262/283)in the control group, 80.34%(237/295), 90.85%(268/295), 94.92%(280/295), 96.27%(284/295), 97.97%(289/295) in the observation group, the differences were statistically significant (χ²= 9.411-41.415, P < 0.01). The rate of urinary catheter usage was 75.31%(3 856/5 120) in the observation group and 82.60%(4 098/4 961) in the control group, the differences was statistically significant (χ²=80.475, P < 0.01). The rate of catheter associated urinary tract infection was 0.26‰ (1/3 856) in the observation group and 1.95 ‰ (8/4 098) in the control group, the differences was statistically significant (χ²=5.832, P< 0.05). Conclusions DMAIC can improve the accuracy of nursing measures, optimize the catheter care process, and reduce catheter-related urinary tract infections.

Objective: To elucidate the mechanism of melatonin combined with cisplatin in promoting cell apoptosis of rat pancreatic cancer AR42J cells. Methods: Rat pancreatic cancer AR42J cells were divided into control group, 1 mmol/L cisplatin treated group (cisplatin group), 1 mmol/L melatonin treated group (melatonin group), 1 mmol/L cisplatin combined with 1 mmol/L melatonin treated group (combined group), 1 μmol/L cisplatin combined with melatonin treated group after 1 μmol/L PBN pretreatment for an hour (PBN+ combined group) and 1 μmol/L cisplatin combined with melatonin treated group after PBN solvent pretreatment for an hour (solvent+ combined group). MTT and annexin V-FITC/PI were used to detect the cell proliferation rate and cell apoptosis rate, respectively. The protein expression of caspase-3 was detected by Western blot. DCFH-DA was used to detect the level of ROS. ROS level and caspase-3 expression in AR42J cells pretreated with ROS antagonist PBN for 24 hours were detected. Results: The cell proliferation rate of control group, cisplatin group, melatonin group and combination group after 24-hour culture was (96.29±3.49)%, (81.38±6.01)%, (80.72±3.68)% and (42.26±6.35)%, respectively. The cell apoptosis rate was (16.42±4.15)%, (56.47±9.06)%, (52.94±6.57)% and (87.36±6.48)%, respectively. The percentage of ROS positive cells was (1.33±1.53)%, (46.67±7.64)%, (45.67±5.13)% and (83.33±7.64)%, respectively. The expression of cspase-3 was 100%, (150.64±7.70)%, (147.00±7.27)% and (190.04±5.07)%, respectively. The cell proliferation rate of cisplatin group and melatonin group was significantly lower than that of the control group. The apoptotic rate, the proportion of ROS positive cells and the expression of caspase-3 were significantly higher than those in control group. The changes in the combined group were more obvious than those in the single drug treatment group, and the differences were all statistically significant (all Pvalues <0.05). The percentage of ROS positive AR42J cells [(45.24±4.64)% vs (84.90±6.13)%)] induced by melatonin combined with cisplatin could be significantly reversed by PBN pretreatment for 1 hour, and the expression of caspase-3 in AR42J cells could be down regulated (124.92±9.72 vs 184.69±7.76) with statistically significant difference (all P values<0.05). Conclusions Melatonin combined with cisplatin may promote cell apoptosis of pancreatic cancer AR42J cells through ROS/caspase-3 pathway.

Objective To explore the effect of prevention intraoperative hypothermia of different heat preservation measures during craniotomy cerebroma resection surgery in the department of neurosurgery. Methods According to the inclusion criteria, a total of 90 patients with craniocerebral surgery were recruited and randomly divided into A, B, C groups with random number table method, and 30 patients in each group. And the three groups were respectively given different heat preservation measures of regular cover, regular cover with infusion heating, regular cover with force-air warming. Meanwhile the rectal temperatures of just entered into the operating room, immediately after anesthesia induction and every 30 minutes after induction of anesthesia, as well as the HR, BP, the amount of infusion and flushing liquor, operation time, incidence of chills during operation, the condition of surgical site infection and hospitalization days were recorded and analyzed statistically by means of the software of SPSS 13.0. Results Rectal temperatures of the three groups were no statistically significant difference (P>0.05) ,when the patients just were moved into the operating room, immediately after anesthesia induction and 0.5 h、1 h after anesthesia induction. The rectal temperatures of the three groups had statistically significant difference (P<0.05) from the 1.5h after anesthesia induction to the end of the surgery.The incidence rates of introperative hypothermia and chill of group C were 26.7%(8/30)and10.0% (3/30),lower than group A and group B:60.0%(18/30), 33.3%(10/30)and 53.3%(16/30), 13.3%(4/30), meanwhile the statistically significant difference was found in these three groups (χ2=7.500, P=0.024;χ2=6.237, P=0.044).The volume of intraoperative blood loss and transfusion were 200(100, 300), 45(0, 60) ml, which lower than group A and group B:300(200, 525), 215(0, 400) ml and 250(150, 500), 120(0, 200) ml, and statistically significant difference was also found in these three groups(H=7.612, P=0.022;H=6.194, P=0.045). Conclusions Regular cover with force-air warming can effectively reduce the incidence of intraoperative hypothermia and chills of craniotomy cerebroma resection patients in the department of neurosurgery and reduce intraoperative bleeding and transfusion volume, as well as ensure the effect of surgical treatment. So it′s worth popularizing in clinic.

Objective:To establish early warning indicators for Chinese nurses to recognize in-hospital cardiac arrest (IHCA) of adult inpatients.Methods:Computer retrieval of Chinese and English databases such as CNKI, Wanfang Database, VIP, National Medical Library of the United States PubMed Database, Web of Science, Embase Database of the Netherlands Medical Abstracts, Cochrane Library Database and other international guidelines collaboration network (GIN), National Institute for Health and Clinical Optimization (NICE), Scottish Intercollegiate Guidelines Network (SIGN), BMJ best clinical practice and other guidelines was performed. The retrieval time limit for respiratory and cardiac arrest early warning indicators or risk identification related content of the adult inpatient in the professional website was until June 30, 2020. After literature research and expert group analysis, the research group drew up an expert correspondence questionnaire, and selected 32 medical and nursing experts from Beijing, Tianjin, Jilin, Shandong, Shaanxi, Sichuan, Zhejiang and other grade three first-class general hospitals from July to September 2022. The Delphi method was used to conduct two rounds of expert correspondence, forming the final version of the early warning index of cardiac arrest in adult inpatients.Results:Five first-level indicators, 23 second-level indicators and 41 third-level indicators including vital signs, consciousness and pupils, postoperative blood drainage volume, lab results and other five aspects were initially formed. The effective response rates of the two rounds of expert correspondence were 100% (32/32) and 93.75% (30/32), respectively, the Kendall coordination coefficients W of the first round and the second round were 0.340 and 0.462, respectively, the expert authority coefficients Cr were 0.88 and 0.89, respectively, the mean value of importance assignment was 3.94-5.00, 4.07-5.00, and the coefficient of variation was 0-0.16, 0-0.14, with statistically significant differences (all P < 0.05). Finally, 5 primary indicators, 23 secondary indicators and 43 tertiary indicators were formed, including five aspects of vital signs, consciousness and pupils, postoperative blood drainage, lab results, symptoms and chief complaints. Conclusion:The expert consultation on the early warning indicators of IHCA for adult patients tends to be consistent and scientific, which is applicable to help nurses detect the changes of patients' condition as early as possible.

Objective To study the expression and significance of Nrf2 and caspase-3 in non-small cell lung cancer (NSCLC).Methods The specimens from 82 cases of NSCLC in our hospital from September 2015 to December 2017 were selected for observation.All patients were surgically resected to obtain NSCLC specimens.The expression of Nrf2 and caspase-3 in NSCLC was detected by immunohistochemistry and its clinical significance was analyzed.Results The positive expression rate of Nrf2 in NSCLC (63.4％) was significantly higher than that in normal tissue (30.0％),with statistically significant difference (P ＜ 0.05).The analysis of clinical characteristics showed that the expression of Nrf2 in NSCLC was related to tumor diameter,tumor node metastasis (TNM) stage,lymph node metastasis and distant metastasis (P ＜ 0.05).The expression of Nrf2 in NSCLC was not significantly associated with gender,age,smoking history,case classification,and histological differentiation (P ＞ 0.05).The positive rate of caspase-3 in NSCLC (40.2％) and the positive rate of caspase-3 in normal tissues (40.0％) were not statistically different (P ＞ 0.05).Analysis of clinical characteristics showed that the expression of caspase-3 in NSCLC was related to TNM stage,lymph node metastasis,distant metastasis,and the difference was statistically significant (P ＜ 0.05);the expression of Nrf2 in NSCLC was not significantly associated with gender,age,smoking history,case classification,tissue differentiation,and tumor diameter (P ＞ 0.05).Conclusions The abnormal expression of Nrf2 and caspase-3 is correlated with the progression of NSCLC and the malignant biological behavior.Active detection of Nrf2 and caspase-3 levels can clinically determine the clinical stage,lymph node metastasis and distant metastasis of NSCLC,providing information to facilitate clinical development of relevant interventions.