Objective: To analysis the relationship between glucocorticosteroids (GCS) usage and side effects in the treatment of severe acute respiratory syndrome (SARS). Methods: All clinical records of probable SARS patients in Beijing were collected and input into an Epi6 database, in which 1 291 patients had entire information and met the clinical criteria of SARS. The usage of GCS and GCS associated side effects were analyzed retrospectively. Results: Patients accepted GCS therapy were 83.96% (n= 1 084), whereas 16.04%(n=207) did not take GCS. The average dosage of GCS was 160 mg/d in the first week, and then reduced to 80 mg/d and 40 mg/d in the second and the third weeks, respectively. Initial blood glucose, systolic pressure (SBP), and diastolic pressure (DBP) were no significant difference between GCS group and non-GCS group. The highest blood glucose during the treatment in GCS group was markedly higher than that in non-GCS group [(8.68? 4.80 ) mmol/L vs (6.39?3.71) mmol/L, P05). After GCS administration, SBP and DBP were increased gradually, and reached their peaks in the fourth week [SBP (117.2?14.0) mm Hg and DBP (72.5?9.1) mm Hg vs SBP (120.0?12.5) mm Hg and DBP (74.5?8.7) mm Hg, P

Objective To investigate the effects ofShipi-Gushen-Huayu Recipe on the expressions of collagen I, laminin(LN), transforming growth factor-β1(TGF-β1)andα-smooth muscle actin(α-SMA)in adriamycin-induced renal fibrosis in rats.Methods A total of male SD rats were randomly divided into four groups, with 10 rats in each group: a normal group, a model group, a treatment group and a fosinopril sodium group. Except the rats in the normal group, the rest rats were subjected to renal fibrosisvia tail intravenous injection of adriamycin(4 mg/kg). Two weeks after modeling, the rats in the rreatment group and in the fosinopril sodium group were intragastrically administrated daily withShipi-Gushen-Huayu Recipe extract(43 g/kg)and fosinopril solution(2 mg/kg), respectively,both in the normal group and model group with saline. After 30 days, 24-hours urine protein were determined, and the expressions of collagen I, LN, TGF-β1 andα-SMA in kidney tissue were detected with immunohistochemistry staining.Results The expressions of collagen I(24.64±0.67vs. 32.86±0.88), LN(18.71±0.72vs. 28.35±0.87), TGF-β1(14.71±0.68vs. 18.35±0.96)andα-SMA(17.64±0.74vs. 25.86±0.85)in the treatment group were significantly lower than those in the model group(allP<0.01). The expressions of collagen I, LN, TGF-β1 andα-SMA in the fosinopril sodium group were 27.33±0.73, 20.44±0.81, 15.44±0.85 and 19.33±0.77, respectively. There was no statistically significant difference between the expressions of collagen I, LN, TGF-β1 andα-SMA in the treatment group and in the fosinopril sodium group.ConclusionShipi-Gushen-Huayu Recipe can significantly down regulate the expressions of collagen I, LN, TGF-β1 andα-SMA in adriamycin-induced renal fibrosis in rats.

Objective? To investigate the status and influencing factors of nurses' evidence-based nursing ability in a tertiary general hospital in Beijing. Methods? A total of 463 nurses from a tertiary hospital in Beijing were selected for research by convenience sampling method. Evidence-based nursing practice ability rating scale was used to evaluate nurses' evidence-based nursing ability, and a self-designed influencing factor questionnaire was used to investigate and analyze the influencing factors. 463 questionnaires were collected and 463 were valid. Results? The total score of 463 nurses with evidence-based nursing ability was (43.05±24.25). The average score was (1.87±1.05). The score of the evidence retrieval and evaluation ability dimension was (1.72±1.18), the score of the evidence integration ability dimension was (1.54±1.21), the score of the evidence dissemination ability dimension was (1.89±1.22), and the score of situational evaluation and evidence application dimension was (2.20±1.04). Univariate analysis showed the scores of nurses' evidence- based nursing ability were different with 10 different characteristics:initial education, final education, working years, English level, whether received evidence-based training, knowledge of evidence-based nursing, and whether considered evidence-based nursing is helpful for clinical work, considered whether it is necessary to carry out evidence-based practice projects, whether to consult the literature, whether you have tried evidence-based nursing practice, the differences were statistically significant (P＜ 0.05). Multiple linear regression analysis showed years of work, whether to consult the literature, and considered whether it is necessary to carry out evidence-based practice projects, whether you have tried evidence-based nursing practice were the factors affecting the nurse's evidence-based ability score. Conclusions? In this study, the level of evidence-based nursing ability of nurses needs to be improved. The nurses, who are with longer working years, limited literature consulting, consider no need to carry out evidence-based practice, and have no evidence-based practice experience, have lower ability in evidence-based practice. It is suggested that nursing managers should pay attention to the cultivation of evidence-based nursing ability of senior nurses, organize literature review and evidence-based nursing training to increase knowledge, create an organizational environment for evidence-based nursing to change attitudes, give full play to leadership to support evidence-based nursing behaviors of nurses, and improve their evidence-based nursing ability.

Objective? To evaluate and summarize the best evidence for management of peristomal irritant dermatitis in patients with a urostomy. Methods? Clinical practice guidelines, evidence summary and systematic review related to peristomal irritant dermatitis were retrieved and screened from various guideline websites and databases (from their founding to July 2018). The quality of these literatures were evaluated with the Appraisal of Guidelines for Research & Evaluation Ⅱ (AGREE Ⅱ) and the Joanna Briggs Institute Critical Appraisal Tools. Evidence was extracted and summarized from high-quality literatures. Results? Totally 7 literatures were included, including 5 clinical practice guidelines, 1 evidence summary and 1 systematic review. Evidence for recognition, evaluation, prevention, treatment, health education and follow-up visits of peristomal irritant dermatitis was summarized. Conclusions? It is recommended that medical institutions refer to the content of evidence summary, make evidence-based practice plans based on the conditions of clinical departments, use the evidence efficiently, and bridge the gap between evidence and practice.

Objective: To understand the gender disparity and influencing factors for in-hospital mortality in patients with ST-segment elevation myocardial infarction (STEMI) at secondary hospitals in China. Methods: A total of 5525 in-hospital STEMI patients from 99 secondary hospitals of 15 provinces or autonomous regions between 2011-09 to 2014-06 were recruited including 1649 female and 3876 male. The in-hospital mortalities were compared between 2 genders and the relevant inlfuencing factors were studied by multiple Logistic regression analysis. Results: There were about 29.8% female and 70.2% male STEMI patients were studied. The in-hospital mortalities in female and male were 13.2% and 5.9%,P<0.01; gender disparity was obviously existing regardless of age, history of MI, hypertension and diabetes mellitus. The mortality in female was higher than male even without diseases history and cardiovascular risk factors. Compared with male gender, female patients were usually having elder age and likely complicated with cardiovascular risk factors; they were with lower incidence to receive ECG, drug therapy and thrombolysis within 10 minutes of admission. With adjusted confounding factors, multiple regression analysis presented that female STEMI patients had the higher mortality than male (OR:1.7, 95% CI:1.4-2.0). Conclusion: The in-hospital mortality for STEMI patients was higher in female than male at secondary hospitals in China. Female patients were usually having elder age, complicated with more cardiovascular risk factors, while with less chances to receive ECG, drug therapy and thrombolysis within 10 minutes of admission.

ObjectiveTo search, appraise and summarize the best evidence of the diabetic foot assessment and provide a reference for the standardization of the clinical diabetic foot evaluation in China. MethodsOn the computer, the following websites as well as databases were searched: National Guideline Clearinghouse(NGC) of the USA, Registered Nurses' Association of Ontario(RNAO), National Institute for Health and Care Excellence(NICE) of UK, the Scottish Intercollegiate Guidelines Network(SIGN), New England Guidelines Group(NEGG), International Guidelines Network(IGN), American Center for Disease Control and Prevention(ACDC), World Council of Enterostomal therapists(WCET), Wound Ostomy Continence Nurses Society(WOCN), the International Working Group on Diabetic Foot(IWGDF), American Society for Wound Healing, American Diabetes Association(ADA), American Society for Vascular Surgery(ASVS), Society of Endocrinology of Chinese Medical Association, Clinical evidence, PubMed, ProQuest, Web of Science, Clinical Key, CINAHL, Best Practice, CNKI, VIP, Wanfang Data, Medlive from January of 2010 to July of 2018 about all evidence-based clinical practice guidelines and systematic reviews on assessment of diabetic foot. Two researchers evaluated the quality of the articles and performed materials extraction, and extracted the evidence from the qualified articles. ResultsA total of 7 articles were included among which 6 were guidelines and 1 was systemic review. After analyzing them, 9 categories and 32 items of the best evidence contents about diabetic foot assessment were concluded. ConclusionsThis study summarizes the best evidence for assessment of diabetic foot and provide evidence basis for medical institutions to improve clinical practice of diabetic foot assessment. When applying the evidence into clinical practice, it is necessary to evaluate specific situations, consider patients' values and willingness and select targeted evidence accordingly.

Objective:To investigate the epidemiology, evolution and transmission characteristics of HIV-1 CRF07_BC in Nanjing between 2015 and 2019 to provide scientific basis for precise prevention and control of HIV-1 transmission.Methods:Pol gene sequences of 319 patients with HIV-1 CRF07_BC infection in Nanjing were amplified and sequenced and a maximum likelihood phylogenetic tree was then constructed. Markov Chain Monte Carlo sampling method was used to generate Maximum Clade Credibility Tree. Bayesian Skyline Plot was used to reconstruct the changing trend of the effective population size. Pairwise gene distance method was used to construct molecular network to investigate the transmission features. Results:Among the 319 patients, 303 (95.0%) were male; 264 (82.8%) had multiple sexual partners; only 14 (4.4%) had been using condoms. Most of the infections were occurred in men who have sex with men (MSM), accounting for 77.4%. The maximum likelihood phylogenetic analysis of HIV-1 CRF07_BC revealed two clusters: Cluster1 and Cluster2. Cluster1 mainly contained the strains isolated from MSM and Cluster2 mainly consisted of the strains isolated from heterosexual patients. The most recent common ancestor was 2002.47(1999.91, 2005.43) year for Cluster1 and 1996.38(1992.55, 1999.76) year for Cluster2. The evolutionary rates (95% highest posterior density, 95%HPD) of Cluster1 and Cluster2 were 1.73×10 -3 (1.36×10 -3-2.16×10 -3) substitutions·site -1·year -1 and 2.09×10 -3 (1.50×10 -3 -2.79×10 -3 ) substitutions·site -1·year -1, respectively. The effective population sizes of Cluster1 and Cluster2 tended to be stable after 2002 and 2003, respectively. In addition, Cluster1 and Cluster2 formed eleven and eight unique branches, respectively, suggesting the possibility of divergent epidemics of this genotype. A total of 35 propagation clusters were formed in the molecular propagation network, including 92 Nanjing sequences with an average degree of 4.3. Males, MSM and people with multiple sexual partners were more likely to be connected to the network. Students and young patients were more likely to be connected to the network. Conclusions:HIV-1 CRF07_BC infection was characterized by low age, multiple sexual partners, unprotected behaviors and transmission among MSM in Nanjing from 2015 to 2019. It was recommended to pay more attention to students and young people, to formulate more effective prevention and control measures for high-risk sexual behaviors, and to carry out continuous molecular monitoring of CRF07_BC strain, so as to provide scientific basis for the prevention and control of HIV CRF07_BC.

OBJECTIVETo understand the current status on prevalence of overweight and obesity in Chinese middle-aged population, and to quantify the magnitude of the trends of development in the past two decades.

METHODSBody mass index (BMI) was measured on 15 389 middle-aged men and women from 15 natural populations all over China with different geographical, economical (urban/rural) and occupational status. Overweight was defined as BMI >/= 25 while obesity as BMI >/= 30.

RESULTS1) The rates of prevalence on overweight and obesity varied dramatically between populations. 2) In general, the prevalence rates were higher in the northern areas, in urban areas, and in women. 3) The current problem of obesity was related to 'pre-obese' stage, with less than 10% in most populations. 4) The prevalence of overweight and obesity started to show significantly increase from early 80's to early 90's but more prominant in the late 90's.

CONCLUSIONPrevention and intervention of overweight and obesity are in urgent need in the Chinese populations, especially in those economically fast developing areas.

Adult ; Body Height ; Body Mass Index ; Body Weight ; China ; epidemiology ; Female ; Humans ; Male ; Mass Screening ; statistics & numerical data ; trends ; Middle Aged ; Obesity ; epidemiology ; physiopathology ; Prevalence

Objective: To explore cyberbullying and risk factors of middle school students, and to provide a reference for cyberbullying prevention in school settings. Methods: A stratified cluster random sampling method was used to select 12 940 students from three junior high schools and four senior high schools in Yixing City of Jiangsu Province, China, to conduct a questionnaire survey from March 1 to May 31, 2019. The Chi -square test was performed to compare differences in the prevalence of cyberbullying among groups with different sociodemographic characteristics, and the multivariate Logistic regression model was employed to analyze the risk factors. A risk predictive nomogram model was constructed and then verified. Results: Middle school students were found to be victims of cyberbullying at a rate of 12.3%. The Logistic regression results showed that alcohol use ( OR =1.93), lack of emotional management ( OR =1.30), feeling unsafe ( OR =1.70), not trusting people ( OR =1.66), increased daily online time ( OR =1.39), higher frequency of using social software or websites ( OR =2.24), poor relationships with family members ( OR =1.46), parental neglect ( OR =1.50), class leadership ( OR =1.30) and poor relationships with classmates ( OR =1.34) were risk factors for middle school students who were victims of cyberbullying ( P <0.05). Based on these 10 independent risk factors, the nomogram prediction model, had good discrimination ( AUC =0.73). Conclusion Cyberbullying is common among middle school students. Internet use, parental neglect and class leadership all have an impact on cyberbullying.

Objective To investigate the knowledge and behavioral status of foot care among pa-tients with type 2 diabetes in Xinjiekou Community in Beijing and analyze its influencing factors.Methods A convenient sampling method was used to select 278 diabetes patients from Xinjiekou Community in Beijing for questionnaire surveys,which included general information,foot care knowl-edge,and behaviors of the patients.Results The average score of foot care knowledge among the 278 patients was(71.65±14.59),indicating a moderate level overall.The average score of foot care be-havior was(48.83±8.83),indicating a poor level overall.Multivariate stepwise regression analysis showed that gender,duration of diabetes,and whether the patients had received foot care education or not were independent influencing factors for both the foot care knowledge score and the foot care behav-ior score among community diabetes patients(P＜0.05).Pearson correlation analysis showed that a positive correlation between foot care knowledge and foot care behavior among community diabetes patients was observed(r=0.593,P＜0.001).Conclusion The level of foocare knowledge among diabetes patients in this community in Beijing is moderate,while the status of foot care behaviors is not optimistic.Community healthcare professionals should strengthen health education on foot care,improve patients'knowledge of foot care and compliance with foot care behaviors,and pay attention to male patients and those with a shorter duration of diabetes to reduce the occurrence of diabetic foot.