Doctor-Patient knowledge transfer plays an important role in clinical service.In an evidence-based investigation on their basic features and preference,patients investigated fall into six categories according four influence factors.These factors comprise,set as the criteria,information preference,decision-making preference,perceived severity of disease and influence of reference group.The six groups are the contradiction group,reactive group,ego group,decision preference group,total equality group,and positive group.Doctor-Patient knowledge transfer stategiea are suggested based on the preference features of the six groups.These strategies serve as references and paramedics for doctors to perform effective doctor-patient communication.

Carcinoembryonic Antigen ; analysis ; Humans ; Luminescence

Objective To investigate the application of structured triglyceride (STG) in malignant obstructive jaundice (MOJ) patients after pancreaticoduodenectomy.Methods The records of 21 MOJ patients received pancreaticoduodenectomy in our hospital were retrospectively analyzed.The patients received parenteral nutrition on the first postoperative day, of whom 7 were given STG (STG group) and 14 were given medium and long chain triglyceride (MCT/LCT group).The changes of liver function, lipid profile, albumin, and postoperative complications were compared between the two groups.Results The triglyceride levels in the STG group on the 3rd and 7th postoperative days were significantly lower than those in the MCT/LCT group [3rd day:(1.85 ±0.90) mmol/L vs.(2.18 ±1.41) mmol/L;7th day: (1.62 ±0.78) mmol/L vs.(2.46± 1.62) mmol/L;both P =0.042];the level of high-density lipoprotein on the 7th postoperative day was significantly higher than that in the MCT/LCT group [(0.67 ±0.64) mmol/L vs.(0.45 ±0.15) mmol/L, P =0.046].The albumin in the STG group returned to normal on the 3rd postoperative day, which was significantly higher than that in the MCT/LCT group [(35.50 ±2.91) g/L vs.(30.66 ±5.08) g/L, P =0.048].There were no significant differences in terms of liver function, length of hospital stay, wound healing, systemic inflammatory response syndrome, and infection between the two groups.Conclusions Parenteral nutrition with structured triglyceride after pancreaticoduodenectomy in MOJ patients is tolerable and safe.STG has less influence on lipid metabolism than MCT/LCT does, and can increase albumin level rapidly.

Objective To observe the short-,mid-and long-term surgical complications of complex acetabular fractures treated by the Kocher-Langenbeck (K-L) approach combined with digastric trochanteric flip osteotomy (DTFO).Methods We reviewed the 40 cases of complex acetabular fracture that were treated at our department from December 2009 through December 2013.They were 34 men and 6 women,from 17 to 73 years of age (average,47.6 years).Of them,19 were treated by K-L approach combined with DTFO,including 17 males and 2 females,with a mean age of 44.7 ± 11.7 years.The other 21 controls were treated simply through the K-L approach,including 17 males and 4 females,with a mean age of 42.8 ± 14.4 years.The 2 groups were compared in terms of intraoperative results,postoperative outcomes and surgical complications like infection,sciatic nerve injury,heterotopic ossification,femoral avascular necrosis,and post-traumatic arthritis.Results The 40 cases were followed up for an average of 29.7 months (range,from 18 to 59 months).The operation time for the DTFO group (248.2 ± 123.2 min) was significantly shorter than that for the control group (276.1 ±50.6 min),the satisfactory reduction rate for the DTFO group (100.0％) was significantly higher than that for the control group (90.5％),the hip intorsion (19.7° ± 3.5°),hip extorsion (26.1° ±4.3°),and hip abduction (40.5° ±4.7°) at one year postoperation in the DTFO group were significantly superior to those in the control group (14.3°± 6.0°,21.0°± 7.2°,31.9°± 10.8°,respectively),and the hospital stay for the for the DTFO group (19.0 ±7.1 d) was significantly longer than that for the control group (13.6 ±4.9 d) (P ＜ 0.05).The intraoperative bleeding and transfusion for the DTFO group were insignificantly greater than those for the control group (P ＞ 0.05).Infection or iatrogenic sciatic nerve injury occurred in none of the patients.There were no significant differences between the 2 groups in terms of positive Trendelenburg test,hip function,heterotopic ossification,femoral avascular necrosis,or post-traumatic arthritis at the last follow-ups(P＞ 0.05).Conclusions In the surgical treatment of complex acetabular fractures,especially those involving the acetabular dome area and the femoral head,K-L approach combined with DTFO can obtain larger surgical exposure field,good fracture reduction and functional recovery,without obviously increasing surgical complications.This technique only slightly increases intraoperative bleeding and transfusion,and results in longer hospital stay.

AIM: To observe the effect of cannabinoid receptor (CB1R) agonist WIN55-212-2 on the expression of brain-derived neurotrophic factor (BDNF), c-Fos and protein kinase A beta-catalytic subunit (PKAC-β) in cerebrum cortex after intracerebral hemorrhage (ICH) in rats. METHODS: The intracerebral hemorrhage model of rat was made by the injection of collagenase Ⅶ, and WIN55-212-2 was intraperitoneally (ip) injected 30 min later. The rats were killed for sampling the brain tissues as specimens 24 h after ICH. The methods of immunohistochemical analysis and Western blotting were adopted to detect the expression of PKAC-β and BDNF. The mRNA expression of PKAC-β, c-Fos and BDNF was determined by RT-PCR. RESULTS: WIN55-212-2 obviously improved some nervous deficit symptoms and increased the expression of BDNF at mRNA and protein levels with upregulating the mRNA expression of c-Fos and downregulating the expression of PKA at mRNA and protein levels in the ipsilateral cerebral cortex. The proteins of PKAC-β, c-Fos and BDNF were expressed on the membrane or nucleus of the neuron or in the cytoplasm of glial cells, respectively. CONCLUSION: The expression of BDNF is induced not only by upregulation of c-Fos, but also by downregulation of PKA in WIN55-212-2 treated rats.

Objectives:To evaluate the clinical significance of different early nutrition support in severe head injured patients. Methods:140 cases(GCS≤8) were randomly divided into 5 groups.From A to E,each one had 28 cases.The patients in group A received early parenteral nutrition(PN) and enteral nutritoin(EN) together;group B received early PN,and EN after 1 week later;group C received PN only for more than 2 weeks;group D received early EN only;group E received traditional delayed EN.The clinical observation and statistical comparison were taken. Results:Severe head injured patients could get nutrition from different ways at early stage.A and B groups had better outcomes,and the blood glucose and nutritional data were superior to those of D,E group( P

Objective: To investigate the mortality and life loss of malignant tumors among residents in Xicheng District, Beijing from 2014 to 2021, so as to provide the evidence for formulating the control strategy for malignant tumors. Methods: Data pertaining to dead cases of malignant tumors in Xicheng District from 2014 to 2021 were collected from Beijing Integrated and Analysis Platform for Health and Disease Prevention Monitoring Information Resources. The crude mortality, standardized mortality, years of potential life lost (YPLL), years of potential life lost rate (YPLLR), rate of standardized years of potential life lost (SYPLLR), average years of life lost (AYLL) and annual percent change (APC) of malignant tumors were measured to analyze the trends in mortality of malignant tumors and life loss. Results: A total of 23 202 residents died from malignant tumors in Xicheng District from 2014 to 2021, and the crude and standardized mortality rates of malignant tumors were 198.09/105 and 101.46/105, respectively. The standardized mortality of malignant tumors was 117.36/105 among men and 85.97/105 among women. The standard mortality of malignant tumors appeared a tendency towards a decline among all cases (APC=-1.515%, t=-4.289, P=0.005) and women (APC=-1.629%, t=-3.046, P=0.023), and the crude mortality of malignant tumors appeared a tendency towards a rise with age (χ2trend=49.324, P<0.001). The five most deadly malignant tumors included lung cancer, colorectal cancer, liver cancer, stomach cancer and pancreatic cancer, and lung cancer, liver cancer and colorectal cancer were the three malignant tumors with the three highest life loss, with YPLL of 18 054 person-years, 9 446 person-years and 8 179 person-years, respectively. Leukemia had the highest AYLL (15.95 years per person). Conclusions The standardized mortality of malignant tumors appeared a tendency towards a decline among residents in Xicheng District from 2014 to 2021, and men and the elderly people were at high risk of malignant tumors. Lung cancer, colorectal cancer and liver cancer were leading causes of death, leukemia was the major cause of life loss.

Aim To explore the effects of cannabinoid (WIN55,212-2) on mRNA and protein expressions of PKAC-β,c-fos and BDNF in cerebral cortex after intracerebral hemorrhage(ICH)in rats.Methods ICH model of rats were made by Ⅶ Collagenase,which were injected by the intraperitoneal route,thirty minutes after the operations.The rats were killed for brain tissue as specimens with 24 hours.The localizations of PKAC-β,c-fos and BDNF were assessed by immunohistochemistry;The expressions of PKAC-β,c-fos and BDNF mRNA were detected by RT-PCR;The expressions of PKAC-β and BDNF protein were revealed by Western blot.Results WIN55,212-2 increased not only the levels of BDNF mRNA and protein,but also c-fos mRNA in ipsilateral cerebral cortex.However,it decreased the levels of PKAC-β mRNA and protein.PKAC-β,c-fos,and BDNF proteins were expressed on membrane of neurons,nucleus of neurons or the cytoplasm of glial cells respectively.Conclusion WIN55,212-2 induces the expression of BDNF in the cerebral cortex,which provides a theoretical basis for the treatment of cerebrovascular disease.

Aim To explore the effects of cannabinoid (WIN55,212-2) on mRNA and protein expressions of PKAC-?,c-fos and BDNF in cerebral cortex after intracerebral hemorrhage(ICH)in rats.Methods ICH model of rats were made by Ⅶ Collagenase,which were injected by the intraperitoneal route,thirty minutes after the operations.The rats were killed for brain tissue as specimens with 24 hours.The localizations of PKAC-?,c-fos and BDNF were assessed by immunohistochemistry;The expressions of PKAC-?,c-fos and BDNF mRNA were detected by RT-PCR;The expressions of PKAC-? and BDNF protein were revealed by Western blot.Results WIN55,212-2 increased not only the levels of BDNF mRNA and protein,but also c-fos mRNA in ipsilateral cerebral cortex.However,it decreased the levels of PKAC-? mRNA and protein.PKAC-?,c-fos,and BDNF proteins were expressed on membrane of neurons,nucleus of neurons or the cytoplasm of glial cells respectively.Conclusion WIN55,212-2 induces the expression of BDNF in the cerebral cortex,which provides a theoretical basis for the treatment of cerebrovascular disease.

Adolescent ; Adult ; Behavior, Addictive ; epidemiology ; Cross-Sectional Studies ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Occupational Health ; statistics & numerical data ; Smoking ; epidemiology ; Surveys and Questionnaires ; Young Adult