Objective:To construct a comprehensive community management platform for prevention and treatment of chronic obstructive pulmonary disease (COPD) and evaluate its effectiveness and feasibility in the prevention and treatment of COPD.Methods:A comprehensive community management platform for prevention and treatment of COPD was established based on the information network. The platform mainly includes COPD screening, establishment of electronic health files of COPD patients living in the community, and hierarchical management of COPD patients. Patients who met COPD criteria were admitted by two community health centers (control and study groups, n = 1 000/group) with similar environments. In the control group, comprehensive community management platform for prevention and treatment of COPD was not established, and only diagnosis and conventional treatment were performed. In the study group, comprehensive community management platform was established to screen COPD patients, establish electronic health files of COPD patients, and hierarchically manage the COPD patients. All patients were followed up for 1 year. The number of acute exacerbations of COPD, treatment cost, the improvement in pulmonary function, dyspnea, and quality of life were compared between the two groups. The effects of the established comprehensive community management platform on prevention and treatment of COPD were analyzed. Results:One-year follow-up results revealed that an acute exacerbation of COPD occurred in 578 patients from the control group and 326 patients from the study group. The proportion of an exacerbation of COPD, the number of exacerbations of COPD, treatment cost in the study group were 32.60% (326/1 000), (1.52 ± 0.58), (2 014.21 ± 122.29) yuan, respectively, which were significantly lower than those in the control group [57.80% (578/1 000), (2.28 ± 2.15), and (4 201.34 ± 210.25) yuan, t = 12.34, 3.19, 21.24, all P < 0.05]. Before establishment of the comprehensive community management platform, there were no significant differences in pulmonary function, modified Medical Research Council (mMRC) dyspnea score, COPD assessment test (CAT) score between the two groups (all P > 0.05). In the control group, the ratio of forced expiratory volume in 1 second (FEV 1)/forced vital capacity (FVC), predicted FEV 1 value, mMRC dyspnea score, and CAT score were (60.32 ± 12.31)%, (63.65 ± 9.37)%, (1.89 ± 1.01) points, (18.82 ± 5.35) points, respectively after 1 year of treatment. There were no significant differences in these indexes between before and after 1 year of treatment ( t = 0.79, 0.87, 1.05, 0.83, all P > 0.05). In the study group, FEV 1/FVC ratio, predicted FEV 1 value, mMRC dyspnea score, and CAT score were (65.27 ± 13.59)%, (68.92 ± 10.67)%, (1.41 ± 0.72) points, (13.24 ± 5.21) points, respectively after 1 year of treatment. Significant differences in these indexes were found between before and after 1 year of treatment ( t = 3.28, 3.39, 4.17, 5.71, all P < 0.05). Conclusion:The established comprehensive community management platform is highly effective for prevention and treatment of COPD. It can effectively reduce the frequency of acute exacerbations of COPD, reduce treatment cost, improve pulmonary function, alleviate dyspnea, and improve quality of life.

OBJECTIVE:To prepare core-shell nanocapsules loading nicardipine hydrochloride and to investigate its pharmaceutical characteristics. METHODS: Core-shell nanocapsules were prepared using layer-by-layer electrostatic self-assembly technique. The indexes including the shape and particle size and the loaded drug amount of the nanocapsules were evaluated, and its accumulative release rates in artificial gastric juice and intestinal juice were computed and compared with those of its crude drug. RESULTS: The results showed that the nanocapsules were spherical with a mean particle size of 200 nm and a maximum loaded drug amount of 2.512%. The drug release rate within 12 h reached 18.64% in artificial gastric juice and 70% in artificial intestinal juice, whereas within 3 h the drug release rate of its crude drug in artificial intestinal juice reached 87%. CONCLUSIONS: The prepared core-shell nanocapsules containing nicardipine hydrochloride had a good pharmaceutical property.

Objective To explore of the color Doppler ultrasound diagnosed choledocholithiasis.Methods 100 cases with choledocholithiasis diagnosed by color ultrasonography and cholangiography were analysed retrospectively.The sensitivity,specificity,accuracy and the inspection time of two methods were compared.Results 90 cases were diagnosed after operation,90％ in 100 patients.The diagnostic accuracy of Doppler ultrasound was 88 cases,2 false negative cases,no false positive.The diagnostic accuracy of cholangiography was 87 cases,3 false negative cases,2 false positive cases.The sensitivity,specificity and accuracy of two groups were not statistically significant (x2 =0.23,1.25,0.57,P ＞ 0.05).The inspection time of color ultrasound was 12 ～ 28 min,the average inspection time was (16.57 ±4.12)min.The inspection time of cholangiography was 12 ～37min,the average inspection time was (21.09 ± 6.24) min.The inspection times of two ways were statistically significant (t =6.53,P ＜ 0.05).Followed up between 5 months and 2 years,there was no residual gallstone patients.Conclusion Color Doppler ultrasound is a noninvasive,safe,time-saving,simple,good repeatability,high successful rate,for common bile duct stones in the main examination methods.

Objective To detect the levels of retinol binding protein(RBP)and adiponectin during the second trimester in the serum of women in normal pregnancy and women who subsequently develop gestational diabetes mellitus(GDM )and to evaluate their role in predicting GDM .Methods A case‐control study was performed to detect and compare the levels of RBP and adiponec‐tin between women who subsequently develop GDM (n= 88)and normal control from 16 to 20 pregnancy weeks (n= 88) . Results Maternal serum RBP levels and the RBP/adiponectin ratio were significantly higher in GDM women than that in normal controls(P<0 .01) .The levels of maternal serum adiponectin were significantly lower in GDM women than that in normal controls (P<0 .01) .The levels of RBP≥30 .45 mg/L ,adiponectin≤9 .93 mg/L and the ratio of RBP/adiponetin≥3 .18 as early markers for predicating development of GDM ,their sensitivities were 63 .6% ,80 .7% and 81 .8% ,and specificities were 75 .0% ,65 .1% and 79 .7% ,respectively .Conclusion The combination of RBP and adiponetin as early marker for predicating development of GDM from 16 to 20 pregnancy weeks was more valuable than single use of them .

Objective To study the operative technique and effect of temporary balloon occlusion of the abdominal aorta for preventing intraoperative bleeding during cesarean for patients with pernicious placenta previa and placenta accreta. Methods Retrospective analysis was conducted on the intraoperative situation of forty-one cases and information of follow-up twenty-nine cases, which were pernicious placenta previa and placenta accreta and delivered in the First Affiliated Hospital of Zhengzhou University from May 1, 2013 to June 30, 2014. Diagnosis was confirmed by line of color Doppler ultrasound and MRI for all patients before operations. An interventional physician performed right femoral artery puncture and preset the abdominal aortic balloon catheter in the digital subtraction angiography operation room before cesarean. At the same time of fetal delivery, 10 ml normal saline was injected into the balloon immediately, which results in filling of the balloon and blocking of the aorta. According to the area and depth of placenta implantation and implantation or penetration of the posterior bladder wall, placenta separation, partial resection of the uterine wall and partial bladder resection and repair were performed correspondingly. Meanwhile, saline in the balloon was pumped out gradually until empty. Condition of placenta implantation, blood loss and blood transfusion volume during the operation, intraoperative and postoperative complications, the duration and dose of fetal radiation exposure, and Apgar score of neonates were analyzed. Results Among the 41 cases, penetrative placenta and implanted placenta were observed in five cases and 36 cases, respectively. The latter 36 cases including 28 cases of bladder posterior wall accreta and eight cases of bladder posterior wall penetration. For all cases, the average operation time was (68.5±15.3) min, the mean blood loss in the operation was (1 058±960) ml, among which eight received blood transfusion with an average of (600±400) ml, and the mean hospital stay was (8.2±2.3) d. Uteruses were reserved in all cases. The mean duration and dose of fetal radiation exposure was (8.1±3.6) s and (5.2±2.9) mGy, and the Apgar score of neonates was 8.7±0.5 at 1 min and 9.5±0.3 at 5 min, respectively. The patients were followed up until October 31, 2014. Among them, six were lost, six were still in puerperium, 18 were breast-feeding, and the menses of 11 had returned. Conclusion Preset abdominal aortic balloon catheter in pernicious placenta previa and placenta accrete patients might effectively reduce the blood loss during cesarean section as well as the risk of hysterectomy through temporary occlusion of the abdominal aorta.

Objective To investigate the clinical efficacy and safety of transcatheter arterial chemoemblization (TACE) using raltitrexed and lobaplatin in treating advanced hepatocellular carcinoma (HCC).Methods From March 2009 to November 2014,95 cases were treated by raltitrexed combined with lobaplatin (raltitrexed group) through TACE and 124 cases by fluorouracil combined with oxaliplatin (fluorouracil group) through TACE.Disease control rate (DCR),median progression-free survival (mPFS) time and median overall survival (mOS) time were compared between the two groups.Survival rate were analyzed using Kaplan-Meier method and Log-rank analysis in SPSS 16.0.Results The disease control rate of raltitrexed group was 91.6％ (87/95),compared with fluorouracil group of 84.6％ (105/124) in fluorouracil group (x2 =2.505,P =0.474).The mPFS of raltitrexed group was 6.8 months and that of fluorouracil group was 5.9 months (x2 =5.542,P =0.019);mOS of raltitrexed group was 13.6 months and fluorouracil group was 11.4 months (x2 =5.953,P =0.015).The main adverse reactions in the two groups were not statistically significant (P ＞ 0.05).Conclusions TACE using rahitrexed and oxaliplatin prolongs the progression free survival and overall survival time of patients with advanced hepatic carcinoma.

Objective:To explore the potential categories of return-to-work self-efficacy of postoperative patients with thyroid cancer and analyze the influencing factors, so as to provide theoretical basis for implementing precise interventions of occupational rehabilitation.Methods:This was a cross-sectional study. A convenient sampling method was used to select 257 postoperative patients with thyroid cancer in Zhujiang Hospital of Southern Medical University from May 2022 to July 2023. The General Information Questionnaire, Return-To-Work Self-Efficacy Questionnaire and Cancer Fatigue Scale were used for investigation. Latent profile analysis was used to explore the potential categories of return-to-work self-efficacy of postoperative patients with thyroid cancer. Logistic regression and decision tree were used to analyze the influencing factors of different potential categories.Results:Finally, 250 postoperative patients with thyroid cancer were included. There were 76 males and 174 females, aged (37.91 ± 8.04) years old. The return-to-work self-efficacy of postoperative patients with thyroid cancer was divided into 2 potential categories: low return-to-work self-efficacy group (72.0%, 180/250) and high return-to-work self-efficacy group (28.0%, 70/250). Logistic regression showed education, thyrotropin suppressive therapy, cancer-related fatigue and age were factors influencing the potential categories of return-to-work self-efficacy of postoperative patients with thyroid cancer ( OR values were 0.951 - 19.820, all P<0.05). Decision tree model showed education level and cancer-related fatigue were the most important factors ( χ2 = 31.40, 16.95, both P<0.05). Conclusions:There were two potential categories of return-to-work self-efficacy of postoperative patients with thyroid cancer. Most of them had low levels of return-to-work self-efficacy. Health care professionals should focus on patients who are less educated and having cancer-related fatigue, meanwhile, should not ignore patients who are substandard thyrotropin suppressive therapy, and older. Implement precise interventions of occupational rehabilitation to improve the return-to-work self-efficacy of postoperative patients with thyroid cancer so as to help them reintegrate into society.

Aging associated cognitive decline has been linked to dampened neural stem/progenitor cells (NSC/NPCs) activities manifested by decreased proliferation, reduced propensity to produce neurons, and increased differentiation into astrocytes. While gene transcription changes objectively reveal molecular alterations of cells undergoing various biological processes, the search for molecular mechanisms underlying aging of NSC/NPCs has been confronted by the enormous heterogeneity in cellular compositions of the brain and the complex cellular microenvironment where NSC/NPCs reside. Moreover, brain NSC/NPCs themselves are not a homogenous population, making it even more difficult to uncover NSC/NPC sub-type specific aging mechanisms. Here, using both population-based and single cell transcriptome analyses of young and aged mouse forebrain ependymal and subependymal regions and comprehensive "big-data" processing, we report that NSC/NPCs reside in a rather inflammatory environment in aged brain, which likely contributes to the differentiation bias towards astrocytes versus neurons. Moreover, single cell transcriptome analyses revealed that different aged NSC/NPC subpopulations, while all have reduced cell proliferation, use different gene transcription programs to regulate age-dependent decline in cell cycle. Interestingly, changes in cell proliferation capacity are not influenced by inflammatory cytokines, but likely result from cell intrinsic mechanisms. The Erk/Mapk pathway appears to be critically involved in regulating age-dependent changes in the capacity for NSC/NPCs to undergo clonal expansion. Together this study is the first example of using population and single cell based transcriptome analyses to unveil the molecular interplay between different NSC/NPCs and their microenvironment in the context of the aging brain.
Aging ; genetics ; Animals ; Astrocytes ; cytology ; metabolism ; Brain ; cytology ; metabolism ; Cell Differentiation ; genetics ; Cell Division ; genetics ; Cell Proliferation ; genetics ; Gene Expression Regulation ; genetics ; Mice ; Neural Stem Cells ; metabolism ; Single-Cell Analysis ; Stem Cells ; cytology ; metabolism ; Transcriptome ; genetics