Objective To evaluate the factors influencing the 5-year all-cause death in acute myocarclial infarction with ST segment elevation.Methods Five hundred and ten patients(

The article summarized relevant theories and successful practical experience about medical resource integration, analyzed the background of regional medical-trust in Shanghai, and discussed three different model of regional medical-trust building, and their own advantages and disadvantages. Furthermore it discussed the main framework of regional medical-trust pilot reform,including administrative and operational model, insurance-payment model and visiting-doctor model. Then, it introduced the reform strategies of regional medical-trust pilot and present progress.

The case is the cornerstone of case teaching. The construction of case database can support case teaching and its orderly development. The clinical cases of gynecology of Chinese medicine were collected, sorted and processed in combination with the teaching syllabus and teaching objective. Operating platform was based on the Excelltable. The column was divided into overview, menstrual disorders, leukorrhoeal diseases, pregnancy disease, postpartum disease and miscellaneous diseases of gynecology with hierarchical set of 15 modules per column, including basic information, complaints, history, symptoms, physical examination, diagnosis, application purpose and context and so on. And the corresponding search term was also selected. Cases can be divided into introduction cases and improvement ones according to their easiness and difficulty , into typical cases and atypical ones according to their feature types. Case database content also needs to be constantly revised by teaching activities to make it more suitable for clinical teaching.

9-nitro camptothecin (9-NC) loaded amphiphilic copolymer micelles were prepared with solvent evaporation method. The effects of temperature, distilled water volume, stirring rate, and drug input amount on the size and drug content of micelles were further discussed. As a result, well dispersed spherical micelles with drug content of 4.9 percent and 50 -70 nanometers in diameter were achieved with the following preparation conditions: water bath temperature 60 degrees C , distilled water amount 16 ml, stirring rate 6 500 r/min, and drug input amount 1.2 mg. 9-NC release profiles in vitro illustrated that drug release from micelles included initial burst release and following controlled release. The release rate was decreased with the increase of drug content.
Antineoplastic Agents ; administration & dosage ; chemistry ; Camptothecin ; administration & dosage ; analogs & derivatives ; chemistry ; Delayed-Action Preparations ; chemical synthesis ; chemistry ; Drug Carriers ; chemistry ; Drug Compounding ; Humans ; Micelles ; Nanoparticles ; Particle Size ; Polymers ; Solubility

Objective : To explore the positive rates and influencing factors of depression and anxiety among managed diabetic patients in community and to provide evidence for the future mental health intervention. Methods: Random sampling method was used to select the diabetic patients from the local health information platform in Ningbo. The anxiety and depression symptoms of the diabetic patients were evaluated by 9-Item Patient Health Questionnaire（PHQ-9）and 7-Item Generalized Anxiety Disorder Scale（GAD-7）. Logistic regression model was applied to analyzing the influencing factors for anxiety and depression in diabetic patients. Results: A total of 1 032 diabetic patients were enrolled,with a response rate of 91.98%. The positive rate of depression was 9.01% and the positive rate of anxiety was 3.78%. The results of multivariate logistic regression analysis showed that divorced/widowed（OR=3.046,95%CI：1.522-6.100）,having two comorbidities or more（OR=6.723,95%CI：2.495-18.120）and suffering diabetes for more than ten years（OR=2.668,95%CI：1.406-5.062）were the risk factors for depression in diabetic patients,while having a college education or above（OR=0.288,95%CI：0.093-0.893）was the protective factor for depression in diabetic patients;unmarried（OR=13.244,95%CI：1.268-138.377）,having two comorbidities or more（OR=6.979,95%CI：2.164-22.503） and suffering diabetes for more than ten years（OR=3.109,95%CI：1.241-7.787）were the risk factors for anxiety in diabetic patients. Conclusion Marital status,the number of comorbidity,course of diabetes and education level could affect the occurrence of depression in diabetic patients;marital status,the number of comorbidity and course of diabetes could affect the occurrence of anxiety in diabetic patients.

BACKGROUND:Kinesio taping has been widely used as a means of sports protection,but its role as a means to correct abnormal biomechanical changes of the lower limbs during side-step cutting remains unclear. OBJECTIVE:To analyze and compare the changes in lower limb kinematics and dynamics when the subjects complete the side-step cutting of the knee joint under the conditions of kinesio taping,placebo taping and blank control. METHODS:Thirty-nine male college students majoring in basketball were recruited as subjects.Each subject was tested with kinesio taping,placebo taping or no taping.The mechanical correction method was used to patch the dominant knee joint of each subject.The run-up speed of 4.5-5.5 m/s was selected to complete the 45° side-step cutting motion,and the kinematics and kinetics data were collected synchronously by the three-dimensional dynamic capture system and the force measuring platform.The kinematics and kinetics parameters at the moment of initial touchdown and peak ground reaction force were selected for data analysis.SPSS 27.0 software was used for statistical analysis of the test data. RESULTS AND CONCLUSION:Kinematic indexes:compared with no taping and placebo taping,the hip abduction and knee valgus angles at the initial touchdown moment were significantly decreased when kinesio taping was used(P<0.05);at the moment of peak lateral ground reaction force,the angles of hip abduction,knee valgus and ankle plantar flexion decreased significantly(P<0.05),and the knee flexion angle was significantly increased(P<0.05).Kinetic indexes:Compared with no taping,both kinesio taping and placebo taping significantly reduced hip abduction and external rotation torque,knee valgus and external rotation torque at the moment of initial touchdown(P<0.05),and significantly reduced peak vertical ground reaction force and peak horizontal backward ground reaction force(P<0.05);in addition,kinesio taping significantly reduced peak lateral ground reaction force compared with no taping and placebo taping(P<0.05).These results indicate that kinesio taping of the knee joint may improve some kinematic and kinetic indexes associated with lower limb injury risk factors during the completion of the side-step cutting in basketball specialized college students to some extent,and may have a positive effect on the prevention of injury during the side-step cutting.In addition,the trends in the effects of placebo taping and kinesio taping on the knee joint are more consistent in terms of changes in some indexes,suggesting that there may be a placebo effect on the mechanism of action of kinesio taping.

Objective To observe the clinical efficacy of surgeries on treatment of children with obstructive sleep apnea hypopnea syndrome (OSAHS)so as to explore the main pathogenic fac-tors and the primary causes influencing surgical efficacy.Methods A total of 85 children with OS-AHS were selected and given surgical therapies to observe the comprehensive efficacy and analyze the relevance between hypertrophy degrees of tonsils and adenoids with apnea index (AI),apnea hy-popnea index (AHI)and the lowest arterial oxygen saturation (LSaO2)before and after treatment. Results After operation,the recovery rate of all children was 90.59%,and the mean values of AI, AHI and LSaO2 were evidently better than treatment before (P <0.01).There was no significant difference in AI before treatment while AHI was in positive relation but LSaO2 in negative associa-tion with hypertrophy degree of tonsils,and AI,AHI and LSaO2 were improved markedly 2 months after treatment than treatment before (P <0.05 or P <0.01).Before operation,adenoid group in degree Ⅱ was obviously lower in AI and AHI but apparently higher in than adenoid group in degreeⅢ (P <0.01);after treatment,AI,AHI and LSaO2 were evidently better than treatment before (P < 0 .0 1 ),and better in adenoid group in degree Ⅱ than in adenoid group in degree Ⅲ (P <0.01).Conclusion The main cause of children with OSAHS is nasopharynx airway stenosis, whose severity is in close association with airway stenosis degree ,for which the surgeries can effectively remiss the condition,improve respiratory function and eliminate or even resolve the clinical symptoms.

Objective To observe the clinical efficacy of surgeries on treatment of children with obstructive sleep apnea hypopnea syndrome (OSAHS)so as to explore the main pathogenic fac-tors and the primary causes influencing surgical efficacy.Methods A total of 85 children with OS-AHS were selected and given surgical therapies to observe the comprehensive efficacy and analyze the relevance between hypertrophy degrees of tonsils and adenoids with apnea index (AI),apnea hy-popnea index (AHI)and the lowest arterial oxygen saturation (LSaO2)before and after treatment. Results After operation,the recovery rate of all children was 90.59%,and the mean values of AI, AHI and LSaO2 were evidently better than treatment before (P <0.01).There was no significant difference in AI before treatment while AHI was in positive relation but LSaO2 in negative associa-tion with hypertrophy degree of tonsils,and AI,AHI and LSaO2 were improved markedly 2 months after treatment than treatment before (P <0.05 or P <0.01).Before operation,adenoid group in degree Ⅱ was obviously lower in AI and AHI but apparently higher in than adenoid group in degreeⅢ (P <0.01);after treatment,AI,AHI and LSaO2 were evidently better than treatment before (P < 0 .0 1 ),and better in adenoid group in degree Ⅱ than in adenoid group in degree Ⅲ (P <0.01).Conclusion The main cause of children with OSAHS is nasopharynx airway stenosis, whose severity is in close association with airway stenosis degree ,for which the surgeries can effectively remiss the condition,improve respiratory function and eliminate or even resolve the clinical symptoms.

Objective:To determine the risk profile of venous thromboembolism (VTE) and evaluate VTE prophylaxis implementation of the hospitalized cancer patients in the DissolVE 2 study.Methods:The data of hospitalized cancer patients in the DissolVE 2 study were analyzed. The risk distribution of VTE, preventive measures and in-hospital VTE events of hospitalized patients with tumors were described by percentage and 95% confident interval (CI).Results:A total of 1 535 cancer patients were included. According to the Padua score, 826 (53.8%) patients were at low risk of VTE, while 709 (46.2%) patients were at high VTE risk. VTE events occurred in 4 low-risk patients (0.5%; 95% CI: 0.1%, 1.2%) and 5 high-risk patients (0.7%; 95% CI: 0.2%, 1.6%). The overall incidence was 0.6% (9/1 535, 95% CI: 0.3%, 1.1%). Among patients with high VTE risk, 666 (93.9%) did not receive any VTE prophylaxis, and only 11 (1.6%) patients received appropriate VTE prophylaxis. Among patients who received VTE prevention, no VTE event was observed. Conclusions:Nearly half of the hospitalized cancer patients are at high risk of VTE, but most of them don′t receive VTE prophylaxis. The results reflect the insufficient management of VTE risk for hospitalized cancer patients in China, and improvement of awareness and practice of VTE prophylaxis is urgently needed.

Objective:To determine the risk profile of venous thromboembolism (VTE) and evaluate VTE prophylaxis implementation of the hospitalized cancer patients in the DissolVE 2 study.Methods:The data of hospitalized cancer patients in the DissolVE 2 study were analyzed. The risk distribution of VTE, preventive measures and in-hospital VTE events of hospitalized patients with tumors were described by percentage and 95% confident interval (CI).Results:A total of 1 535 cancer patients were included. According to the Padua score, 826 (53.8%) patients were at low risk of VTE, while 709 (46.2%) patients were at high VTE risk. VTE events occurred in 4 low-risk patients (0.5%; 95% CI: 0.1%, 1.2%) and 5 high-risk patients (0.7%; 95% CI: 0.2%, 1.6%). The overall incidence was 0.6% (9/1 535, 95% CI: 0.3%, 1.1%). Among patients with high VTE risk, 666 (93.9%) did not receive any VTE prophylaxis, and only 11 (1.6%) patients received appropriate VTE prophylaxis. Among patients who received VTE prevention, no VTE event was observed. Conclusions:Nearly half of the hospitalized cancer patients are at high risk of VTE, but most of them don′t receive VTE prophylaxis. The results reflect the insufficient management of VTE risk for hospitalized cancer patients in China, and improvement of awareness and practice of VTE prophylaxis is urgently needed.