Objective To study the association between sympathetic skin response(SSR) and diabetic autonomic neuropathy(DAN), and explore its use as the objective base for its early diagnosis. Methods SSR was carried out in 30 patients with DAN and 30 healthy controls. Results The SSR indices of the patient with diabetic mellitus(DM) either with or without DAN were different from those of normal objects. Conclusion The SSR detection and analysis can detect the early dysfunction of the autonomic system in diabetic mellitus and may be a useful testing for early diagnosis of diabetic neuropathy.

BACKGROUND: The real mechanism of systemic sclerosis is still not clear, it is found clinically that there are psychological stress factors of different forms before the attack.OBJECTIVE: To deeply investigate the psychosocial factors in patients with systemic sclerosis, and primarily analyze the role of psychological stress factors by comparing with national norms and controls as well as combining with clinical immunological test.DESIGN: A controlled observation.SETTING: The experiments were carried out in the Department of Geriatrics, the First Hospital Affiliated to Medical College, Zhejiang University and the Department of Surgery, Hangzhou Tongji Hospital.PARTICIPANTS: Between December 2002 and September 2005. 26 patients with systemic sclerosis (systemic sclerosis group), who received thoracic duct lymph drainage therapy, and 30 inpatients with chronic gastritis(control group) were selected from the same disease area of the Department of Internal Medicine, the First Hospital of Medical College, Zhejiang University.METHODS: All the patients filled the general information inventory, the contents included were age, gender, main symptoms, disease course, special examination, diagnosis and drug therapy. The psychosocial scale was used to evaluate the psychosocial factors. Life event scale (LES) was used to assess the life events stress, including profession, learning, marriage and love, family and child, economics, justice, interpersonal relationship and other common life events. The simplified coping style questionnaire (SCSQ)was applied to assess the coping styles, including 8 main components: confrontation, indifference, self-control, seeking help, self-blame, escape, planning and reassessment, and then the habitual coping styles were divided into negative ones and positive ones. The Eysenck personality questionnaire (EPQ) was used to evaluate the personality characters, it consisted of4 subscales: extraversion-introversion scale, neuroticism scale, psychoticism scale, lie and cover up scale. The fasting blood samples (3 mL) were drawn from the patients to detect serum levels of immunoglobulin G (IgG), immunoglobulin A (IgA) immunoglobulin M (IgM) and complement C3 with immunoturbidimetry, and the correlations between IgG and other factors were analyzed.MAIN OUTCOME MEASURES: The evaluative results of psychosocial scale and results of clinical immunological detection were mainly observed.RESULTS: All the 56 patients finished the scale survey and immunological detection, and all were involved in the analysis of results. The total number of life events, number of negative events and LEU value of negative events in LES were all significantly greater in the systemic sclerosis group than in the control group. For the coping style, the dimension of positive coping was less but that of negative coping was more in the systemic sclerosis group than in the control group. For EPQ, the scores of extraversion-introversion were lower but the scores of neuroticism in both males and females in the systemic sclerosis group were higher than in the control group and norms. For the immunological detection, the levels of lgG, lgA and lgM were all higher in the systemic sclerosis group than in the control group, but C3 level had insignificant difference between the two groups.IgG had negative correlations with the number of negative events, dimension of negative coping and the score of extraversion-introversion in EPQ.CONCLUSION: Patients with systemic sclerosis have obvious psychological stress, negative coping style, unstable mood and abnormal humoral immune function. Psychosocial stress has influence on immunology, it is indicated that psychological stress is closely correlated with the attack of systemic sclerosis.

Objective To investigate the QCC application value impacted on the period of chronic recession of nursing quality management in psychotic. Methods A total of 50 cases of chronic deteriorated schizophrenia patients in Wenzhou Kangning Hospital from June 2014 to August 2014 were chosen as control group, while 50 cases of chronic recession of schizophrenia in Wenzhou Kangning Hospital from September 2014 to November 2014 were selected as the intervention group. The patients of control group were given routine nursing, and the patients in nursing intervention group accepted QCC activities, labor and self-care of patients condition, negative symptoms to improve the situation and satisfaction assessment. Results After 3 months intervention in two groups, the scores of positive factors, negative factor scores and total disease assessment scores had significantly improved compared before intervention, and improvement of these scores in the experimental group was better than those of control group. In the intervention group, the negative symptom was obviously lower than that of the control group, but the satisfaction was better than that of the control group (P<0. 05). Conclusions Nursing process QCC application to chronic recession mental patients not only can effectively improve the patient′s ability to work, the self-care ability of patients, and the negative symptoms, but also can improve the satisfaction of patients, which is worthy of clinical promotion.

Cervical cancer has become an important disease that jeopardizes women′s health, causing hundreds of thousands of new cases annually. Human papillomavirus (HPV) is the leading cause for cervical cancer. Since the world′s first HPV vaccine was licensed in 2006, 92 countries around the world have introduced them in national immunization programs. The WHO recommends that scientific economic evaluation should be achieved before the introduction, but this is more difficult for low-and middle-income countries. Therefore, this article introduces a mathematical model recommended by WHO in 2014 to quickly and easily accomplish economic evaluation of HPV vaccine -the PRIME, and take the China′s 2018 data published by International Agency for Research on Cancer (IARC) as an example. The evaluation result shows that the introduction of HPV vaccine in Chinese 12-year-old women is cost-effective.

Objective To investigated job satisfaction and turnover intention of clinical nurses with different educational background in northeastern Sichuan Province and to study the cor-relation between the two factors.Methods A total of 860 clinical nurses were investigated by a questionnaire,including general data,turnover intention and job satisfaction.Results The opti-mistic degree on work in secondary education was better than those of undergraduate nurses and ju-nior education nurses,and the optimistic degree and severity on work of undergraduate nurses were highest.A significant difference was observed in management,work load,work or family balance, personal growth and development of job satisfaction among the 8 factors (P <0.05).Turnover in-tention score and job satisfaction score were significantly lower than the total theoretical score and the difference was statistically significant (P <0.05).Conclusion The higher the education is, the lower optimistic degree on the job and job satisfaction are,and the higher the turnover intention is.Thus,the hospital can improve the wages and welfare of nurses,and provide the support and platform for their development,and strive to improve their professional knowledge,positive nursing team construction,improve their job satisfaction so as to reduce turnover intention and the nursing resources loss.

Objective To investigated job satisfaction and turnover intention of clinical nurses with different educational background in northeastern Sichuan Province and to study the cor-relation between the two factors.Methods A total of 860 clinical nurses were investigated by a questionnaire,including general data,turnover intention and job satisfaction.Results The opti-mistic degree on work in secondary education was better than those of undergraduate nurses and ju-nior education nurses,and the optimistic degree and severity on work of undergraduate nurses were highest.A significant difference was observed in management,work load,work or family balance, personal growth and development of job satisfaction among the 8 factors (P <0.05).Turnover in-tention score and job satisfaction score were significantly lower than the total theoretical score and the difference was statistically significant (P <0.05).Conclusion The higher the education is, the lower optimistic degree on the job and job satisfaction are,and the higher the turnover intention is.Thus,the hospital can improve the wages and welfare of nurses,and provide the support and platform for their development,and strive to improve their professional knowledge,positive nursing team construction,improve their job satisfaction so as to reduce turnover intention and the nursing resources loss.

Mental disorders are characterized by disturbances in behavior,volition,emotion,and cognition and are considered emotional diseases in traditional Chinese medicine.Acupuncture is one of the most widely used complementary alternative therapies for the treatment of mental disorders.Recently,there has been growing interest in the use of the Tong Du Tiao Shen(Dredging Du meridian to regulate the spirit)as a primary treatment.However,a comprehensive summary of the establishment and related acupuncture methods of Tong Du Tiao Shen is lacking.This paper aims to address this gap by exploring the origin and development of Tong Du Tiao Shen,its application in treating mental disorders,and the modern biological mechanisms involved.Ultimately,this paper seeks to expand the clinical application of Tong Du Tiao Shen acupuncture and provide a scientific basis for future research in this field.

Objective To explore the safety and efficacy of endovascular treatment(EVT)in patients with acute posterior circulation ischemic stroke over 24 hours from onset.Methods This retrospective study retrospectively analyzed patients with acute posterior circulation ischemic stroke who received EVT in the Department of Neurology,First Hospital of Jilin University from June 2018 to June 2023.The patient's gender,age and other related demographic information were collected.The related examination results of patients were collected,including admission rapid blood glucose,admission systolic blood pressure,admission diastolic blood pressure.The related risk factors of stroke of patients were collected,including previous transient ischemic attack,hypertension,diabetes,atrial fibrillation,and history of drinking,smoking history,etc.;other related indicators were collected,including intravenous thrombolysis,tandem lesions,awakening stroke,baseline National Institutes of Health stroke scale(NIHSS)score,and baseline posterior circulation Alberta stroke program early CT score(pc-ASPECTS),collateral circulation grade of American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology(ASITN/SIR),onset to EVT puncture time,the trial of org 10172 in acute stroke treatment(TOAST)classification and outcome indicators(efficacy indicators included 90 days Modified Rankin scale[mRS]score≤3 after EVT,successful recanalization[extended cerebral infarction thrombolytic recanalization class 2b-3];security indexes included symptomatic intracranial hemorrhage[sICH]within 24 h after EVT and 90 d mortality after EVT).According to the symptom onset to EVT puncture time,the patients were divided into two groups:≤24h group and＞24h group.The patients with onset time＞24 h and those with onset time≤24 h were matched at a ratio of 1:1 by propensity score matching(PSM).All patients were divided into poor prognosis group(mRS score＞3)and good prognosis group(mRS score ≤ 3)according to mRS score at 90 days after EVT.Using univariate and multivariate Logistic regression was used to analyze the effect of onset time on clinical outcomes at 90 days after EVT.Results A total of 366 patients were enrolled in this study,including 284 males and 82 females.The median age was 61(55,68)years old,ranging from 25 to 91 years old.Before PSM,the＞24h group had lower prevalence of atrial fibrillation(2.02％[2/99]vs.9.74％[26/267],P=0.025)and lower baseline NIHSS score(10.0[5.0,19.0]vs.14.0[10.0,35.0],P＜0.01)and higher ASTIN/SIR collateral grade(P=0.018).After PSM,we did not find statistical difference between the two groups in baseline characteristics except for the onset to EVT puncture time.Before and after PSM,there was no significant difference in efficacy and safety between the onset time＞24 h group and the onset time ≤24h group.Univariate binary Logistic regression analysis showed that hypertension(OR,0.613,95％CI 0.391-0.942,P=0.025),intravenous thrombolysis(OR,3.235,95％CI 1.316-9.237,P=0.010),baseline NIHSS score(OR,0.975,95％CI 0.957-0.988,P＜0.01),baseline pc-ASPECTS(OR,1.281,95％CI 1.101-1.482,P=0.001)and sICH within 24 h after EVT(OR,0.070,95％CI 0.000-0.330,P＜0.01)were significantly correlated with prognosis.Gender,age,hypertension,baseline NIHSS score,intravenous thrombolysis,baseline pc-ASPECTS,ASTIN/SIR collateral grade,onset time＞24 h and sICH within 24 h after EVT were included in the multivariate binary Logistic regression analysis.The multivariate binary Logistic regression analysis showed that the onset time＞24 h was not associated with poor prognosis 90 d after EVT(aOR,1.635,95％CI 0.936-2.893,P=0.087).Conclusion EVT for acute posterior circulation ischemic stroke more than 24 hours after onset is feasible under strict imaging screening,and its safety and efficacy are similar to those in patients with onset under 24 hours.

Objective:To explore the effectiveness and safety of endovascular treatment (EVT) for patients with acute anterior circulation ischemic stroke with symptom onset exceeding 24 h.Methods:In this retrospective cohort study, data were extracted from patients who underwent endovascular treatment for acute anterior circulation ischemic stroke at the First Hospital of Jilin University from February 2019 to April 2022. A total of 569 patients were included, with a mean age of 63 (54-70) years. Among them, 398 (69.9%) were male. The patients were divided into two groups based on symptom onset time:>24 h group and≤24 h group. Propensity score matching (PSM) was used to match the patients in a 1︰1 ratio between the>24 h group and the≤24 h group. Logistic regression was used to evaluate the impact of symptom onset time on outcome events.Results:Before PSM, compared with≤24 h group, the>24 h group had a younger age [56 (48, 64) vs. 64 (55, 70), Z=-3. 60, P<0.001]; lower proportion of prior atrial fibrillation [1.8% (1/57) vs. 21.1% (108/512), χ2=12.39, P<0.001]; lower proportion of wake-up stroke [7.0% (4/57) vs. 27.7% (142/512), χ2=11.54, P<0.001]; lower baseline NIHSS score [11.0 (7.5, 14.0) vs. 13.0 (10.0, 16.0), Z=-3.22, P<0.001]; and a higher American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology(ASITN/SIR) grading ( P<0.001). After PSM, there were no significant differences in baseline characteristics between the two groups. There was no significant difference in the proportion of patients with a modified Rankin Scale (mRS) score≤2 at 90 days after surgery between the two groups (before matching: 42.0% vs. 40.4%, OR=0.745, 95% CI 0.407-1.362, P=0.339; after matching: 51.8% vs. 39.3%, OR=0.511, 95% CI 0.212-1.236, P=0.136). No significant differences were observed in the incidence of any safety outcomes between the>24 h group and the≤24 h group. Conclusion:For patients with acute anterior circulation ischemic stroke with symptom onset exceeding 24 h, EVT is feasible after strict radiological screening and has similar safety and effectiveness as for patients with symptom onset under 24 h.

Cervical cancer has become an important disease that jeopardizes women′s health, causing hundreds of thousands of new cases annually. Human papillomavirus (HPV) is the leading cause for cervical cancer. Since the world′s first HPV vaccine was licensed in 2006, 92 countries around the world have introduced them in national immunization programs. The WHO recommends that scientific economic evaluation should be achieved before the introduction, but this is more difficult for low?and middle?income countries. Therefore, this article introduces a mathematical model recommended by WHO in 2014 to quickly and easily accomplish economic evaluation of HPV vaccine?the PRIME, and take the China′s 2018 data published by International Agency for Research on Cancer (IARC) as an example. The evaluation result shows that the introduction of HPV vaccine in Chinese 12?year?old women is cost?effective.