0 05). NSAIDs users were older than nonusers by a mean of 12 years, and more likely to have a history of upper gastrointestinal bleeding ( P =0 010) and cardiac vessel disease( P =0 000). NSAIDs users have higher number of ulcers ( P =0 002), fewer dyspeptic symptoms ( P =0 000) and shorter hospital stay( P =0 017).

BACKGROUND:Researches about sub-health status in general community population are rare,especially in minor nationalities.OBJECTIVE:To explore the sub-health status and its risk factors with logistic regression model and negative binomial regression model in Tibetan people.DESIGN,TIME AND SETTING:A cross-sectional study was performed among subjects selected from Songpan county in the Aba Tibetan and Qiang Autonomous Prefecture of Sichuan Province on September 2007.PARTICIPANTS:A total of 1791 Tibetan subjects from were recruited from Songpan county in the Aba Tibetan and Qiang Autonomous Prefecture of Sichuan Province and were involved in this study,among which 1763 subjects completed the sub-health questionnaire.Their average age was 27 years,ranging from 10 to 80.There were 731 male subjects (41.5%)and 1032 female ones (58.5%).All subjects were informed of the survey regimen.METHODS:The sub-health rating scale framed by Chen Qingshan et al was used to assess the sub-health status of subjects with stratified and cluster sampling,including the prevalence rate of sub-health status,the number of sub-health symptoms and various dimensional prevalence.MAIN OUTCOME MEASURES:Risk factors of sub-health status with logistic regression model and negative binomial regression model.RESULTS:There were 1038 subjects suffering from one or more sub-health symptoms,and they were considered as being in the sub-health status with the prevalence of sub-health 58.9%.The split-half reliability and internal consistency of the scale were separately 0.7658 and 0.8154.Logistic regression results indicated that the seniors (P=0.0004),female (P＜0.0001),marriage status (P=0.0008),mental labor (P=0.0021)and smoking (P＜0.0001)were main contributing factors of sub-health status.However,marriage status (P=0.0689)and occupation (P=0.1398)weren't statistically significant in negative binomial regression analyses.CONCLUSION:Tibetan populations living in high altitude are also suffering from sub-health status and should be given more attention.Further more negative binomial regression model could be popularized to analyze sub-health and its influencing factors.

Objective Through the analysis of misdiagnosis left renal vein entrapment syndrome,to improve the understanding and reduce the misdiagnosis of this disease.Methods 82 cases of left renal vein compression syn-drome were diagnosed with ultrasound,65 cases were misdiagnosed.Clinical data of these 65 patients were analyzed.Results In 82 cases,only 11 doctors from renal department of internal medicine,pediatrics,department of urology wrote application for it.Among the 65 misdiagnosed cases,30 cases of male,female 35 cases.The age ranged from 6 to 37 years old,the average age was 16.1 years.The misdiagnosis duration ranged from 2 months to 42 months,the median time was 7 months.43 cases of low back pain or backache,urinary tract irritation in 5 cases,60 cases of abnor-mal urinalysis:a simple urinary protein in 15 cases,21 cases of simple hematuria,proteinuria,hematuria 24 cases. 31 cases were misdiagnosed as chronic glomerulonephritis,occult nephritis(asymptomatic proteinuria and hematuria syndrome)in 11 cases,acute nephritis comprehensive sign in 9 cases,7 cases of lumbar muscle strain,urinary tract infection in 4 cases,1 case of urinary tract stones,pelvic inflammatory disease in 2 cases.In the 16 cases complicated with glomerular nephritis,were treated as the glomerular nephritis before (11 cases of chronic nephritis,5 cases of asymptomatic proteinuria and hematuria syndrome).12 cases of abnormal urine fluctuation,after a delay of 3 -16 months referral doctor was diagnosed with left renal vein entrapment syndrome.Conclusion The disease has no char-acteristic clinical manifestations,and most clinicians were short in understanding of the disease,so the misdiagnosis rate is high.The clinicians should improve the understanding of the disease,in order to reduce the misdiagnosis rate.

Objective:To evaluate the test-retest reliability and validity of Chinese version of World Health Organization Composite International Diagnostic Interview version 3.0(CIDI-3.0)by community-based study.Methods:Among 202 subjects from Dalian city,with the clinician-administered Structured Clinical Interview for DSM-IV(SCID),102 patents were diagnostic as mood disorder,anxiety disorder,schizophrenia or psychotic disorder and so on.All of the patients and the other 100 subjects without mental disorders as the control group were interviewed blindly by CIDI-3.0 to test the validity of CIDI-3.0.Ten patients among them were interviewed twice independently in a 7-day interval to evaluate the reliability of CIDI-3.0.Results:(1)For the screen section,the sensitivity values of different mental disorders ranged from 60.4% to 93.1%,while the specificity values from 33.6% to 92.7%.The positive predictive values were from 60.1% to 95.1%,and the negative predictive values were from 68.1% to 93.7%.(2)For different mental disorders,the specificity values ranged from 97.1% to 98.9%,while the sensitivity values were from 33.3% to 70.3%.Positive predict values were from 66.7% to 95.7%,and negative predictive values were from 87.7% to 95.4%.(3)The consistency was 0.78 in any mental disorder.(4)For test-retest reliability,kappa values ranged from 0.737 to 1.0.Conclusion:By clinical reappraisal,the Chinese version of CIDI-3.0 has satisfied validity and reliability.The screen section has high sensitivity,while the diagnostic sections have high specificities.That indicates that CIDI-3.0 is acceptable as a validated instrument for community survey on mental disorders.

ObjectiveTo analyze the serum creatinine level among apparently healthy primary and secondary school students in Inner Mongolia and explore the distribution of serum creatinine by ethnic,regional,gender and age,and establish the reference interval of serum creatinine in different gender and different age groups of primary and secondary school students.MethodsLargesample clinical epidemiological investigation was applied by two-stage clustering sampling method.Random sample of 2630 primary and secondary school students from 9 to 18-year-old was selected from four district in Inner Mongolia including Hohhot,Wulanchabu,Xilin Gol and Bayan Drow from July 2009 to June 2010.After screening outlier individual,the total of 2614 subjects were enrolled,involving 1288 male and 1326 female subjects,1584 Han and1030 Mongolian.The venous blood was collected and serum was separated.The serum creatinine concentration was measured as soon as possible.Furthermore, creatinine levels of different regions,ethnic,gender and age group were compared by analysis of variance or t-test and that of different group were compared by SNK method.Percentile was used to describe the distribution of serum Cr level of different age groups.The reference interval of serum Cr for primary and secondary school students were established by gender and age (P2.5 -P97.5 ).The curve was smoothed using age-specific percentile ( LMS )curve smoothing method.ResultsThe differences of Cr levels were statistically significant between different regions,ethnic,gender and age groups.The reference intervals of creatinine for 9 - 11,12,13 - 14,15,and 16 - 18 year-old males were 35 - 66,37 - 73,39 - 78,47 - 87 and 49 - 91 μmol/L,respectively.The intervals for 9 - 10,11 - 12,13 - 15,and 16 - 18 year-old females were 32 - 60,34 - 63,38 -73 and 40 -74 μmol/L,respectively.Conclusion The reference intervals of serum creatinine for health primary and secondary school students in the Inner Mongolia is established,which is useful for clinicians,especially pediatricians to judge and assess renal function for 9 to 18 year-old patients.( Chin J Lab Med,2012,35:805-809 )

OBJECTIVETo evaluate the reliability and validity of Professional Quality of Life Scale (ProQOL-30, 4th version, 30 items) among government staff in the Wenchuan earthquake-stricken areas

METHODSA total of 1,175 members of government staff in the Wenchuan earthquake-stricken areas were selected by convenience sampling and required to complete the ProQOL and Self-Reporting Questionnair (SRQ). The reliability and validity of the scale was evaluated by correlation analysis, t-test, and confirmatory factor analysis.

RESULTSItem-total correlation coefficients of the three subscales were 0.590 - 0.752, 0.389 - 0.603, and 0.340 - 0.647, respectively (P<0.05), and the average coefficients were 0.672, 0.482, and 0.555 respectively (P<0.05). The Cronbach's α coefficients of the three subscales were 0.864, 0.569, and 0.742 respectively, and the split-half reliabilities were 0.829, 0.490, and 0.677, respectively. P value was 0.88 in thE chi-square test of confirmatory factor analysis model. Goodness-of-fit indices of ProQOL-30 included GFI=0.895 NFI=0.856, CFI=0.895, RMSEA=0.063, and AGFI=0.912. For the ProQOL-28 as an optimized version o ProQOL-30, the Cronbach's a coefficients for burnout and trauma/compassion fatigue increased to 0.616 and 0.757, respectively. P value was 0.91 in the chi-square test of confirmatory factor analysis model test. Goodness-of-fit indices of ProQOL-28 were GFI =0.913, AGFI =0.924, NFI =0.900, CFI =0.913, and RMSEA =0.031 CONCLUSION: ProQOL-28 has good reliability and validity among government staff in the earthquake-stricker areas in China.

Objective To investigate the effects of 5-hydroxy-1-methylhydantoin (HMH) on kidney injury induced by paraquat (PQ). Methods Fifteen SPF healthy Kunming mice were randomly divided into normal saline (NS) control group, PQ poisoning model group and HMH intervention group, with 5 mice in each group. PQ poisoning model was challenged by one-time gavage of 30 mg/kg PQ solution. The NS group received the same amount of NS by gavage. The HMH group was given 100 mg/kg of HMH immediately after the model was made and continued to be gavaged. Mice in each group were sacrificed 1 day after HMH gavage and heart blood and renal tissue were harvested for examination. The morphological changes of renal tissue were observed under light microscope by hematoxylin-eosin (HE) staining. The content of malondialdehyde (MDA) and the activity of superoxide dismutase (SOD) in renal tissue were detected according to the instructions of the kit. The expression of heme oxygenase-1 (HO-1) and interleukin-1β (IL-1β) in renal tissues were detected by Western Blot. The serum metabolites were detected by gas chromatography time-of-flight mass spectrometry (GC-TOF-MS), the overall distribution of each sample was observed by principal component analysis (PCA), the accuracy of the model was evaluated by multidimensional analysis orthogonal partial least squares-discriminant analysis (OPLS-DA), and the difference metabolites were screened by variable importance in the projection (VIP) value > 1. Results Light microscopic observation showed that: glomerular structure in NS group was clear, there was no hyperemia and inflammatory cell infiltration in renal interstitium and blood vessels. In PQ group, some glomeruli atrophy and necrosis, capillary congestion in glomeruli, infiltration of inflammatory cells around glomeruli, swelling of renal tubular epithelial cells, slight stenosis of lumen, and occasional necrosis and exfoliation of epithelial cells occurred. The degree of kidney injury in HMH group was significantly less than that in PQ group. Compared with the NS group, the content of MDA in the PQ group was significantly increased (nmol/g: 6.70±0.84 vs. 2.70±0.43, P < 0.01) and the activity of SOD was significantly decreased (kU/L: 33.30±4.66 vs. 50.20±3.23, P < 0.05), the protein expression of HO-1 and IL-1β were significantly increased (HO-1/β-actin: 1.11±0.12 vs. 0.61±0.13, IL-1β/β-actin: 0.93±0.13 vs. 0.32±0.06, both P < 0.05). Compared with the PQ group, the content of MDA in the HMH group was significantly decreased (nmol/g: 5.10±0.93 vs. 6.70±0.84, P < 0.05) and the activity of SOD was significantly increased (kU/L:61.00±9.02 vs. 33.30±4.66, P < 0.05), the protein expression of HO-1 was significantly decreased (HO-1/β-actin:0.77±0.07 vs. 1.11±0.12, P < 0.05), however, there was no significant difference in the protein expression of IL-1β (IL-1β/β-actin: 0.87±0.13 vs. 0.93±0.13, P > 0.05). Metabolite detection results showed that: compared with NS group, the levels of creatinine, glycine, succinic acid, fumaric acid and citric acid were significantly increased in the PQ group (VIP value was 1.50, 1.58, 1.64, 1.74 and 1.95 respectively, all P < 0.05), while the levels of palmitic acid, α-tocopherol and 6-phosphogluconic acid were significantly decreased (VIP value was 1.10, 1.55 and 1.56 respectively, all P < 0.05). Compared with the PQ group, the levels of creatinine and citric acid were significantly decreased in the HMH group (VIP value was 1.50 and 1.86, both P < 0.05), while trans-4-hydroxy-proline, D-glyceric acid, 2, 6-fructose phosphate, 6-phosphate gluconic acid and aminomalonic acid were significantly increased (VIP value was 1.36, 1.55, 1.63, 1.68 and 1.76 respectively, all P < 0.05). Conclusions HMH protects kidney injury caused by PQ poisoning by correcting tricarboxylic acids cycle disturbance, lipid peroxidation and energy metabolism disturbance, and its mechanism is related to the regulation of HO-1 protein expression through Nrf2 pathway.

Objective To establish a HPLC-MS method for determination of aconitum alkaloids in biological samples. Methods The aconitum alkaloids were extracted from the whole blood by using acetonitrile-methanol (5:1 v/v) and then analyzed using HPLC-MS in multiple reaction monitoring (MRM) mode with positive ionization. The analytical column was Agilent Zorbax SB C18 (2.1mm×50mm, 1.8μm)and the mobile phase were water containing 0. 1 % formic acid : acetonitrile (60 : 40 v/v) in isocratic elution. Results The retention time of detection of the aconitine, hypaconitine and mesaconitine were 0.73 min, 0.77 min and 0.63 min, and the precursor product ion combinations of m/z 646.4 → 586.4, 616.1 → 556.5 and 632.4 → 572.1 were used for quantitative analysis, respectively. Calibration curve was linear within the range of 0.1-250 ng/mL with the LOD was 0.1ng/mL, and the coefficient of variation (CV) less than 5.42 % (n=6). The extraction recoveries of aconitine in blood were more than 90 %.Conclusion The results demonstrated that the present method was reliable and robust for natural drugs.

The global incidence rate of cancer continues to rise,and shows an obvious trend of youth.Implementing digital health interventions can improve the accessibility and quality of palliative care for adolescent cancer patients.At present,there is a gradual increase in related research,but foreign research is the main focus,and domestic research is relatively small,which has not yet attracted the attention of medical staff.Starting from the needs of palliative care for adolescent cancer patients,this article reviews the forms of digital health interventions and their applications in health education,symptom assessment,psychological support and grief counseling,and the development of advance care planning.It analyzes existing problems and proposes nursing strategies,aiming to provide references for clinical nursing practice.

Objective:To explore the effect of preoperative visit with Child Life mode in the management of preschool children′s anxiety.Methods:A total of 80 cases of children of pre-school age who were operated from September 2018 to February 2019 were selected by cluster sampling method. The children from September to November 2018 who were given the traditional mode of preoperative visit were set as the control group. Children from December 2018 to February 2019 who were given preoperative visit with Child Life mode were set as the experimental group. The Modified Yale Perioperative Anxiety Scale (m-YPAS) scores, Induction Compliance Checklist (ICC) scores and Pediatric Anesthesia Emergence Delirium (PAED) scores were compared between the two groups at 4 different perioperative time points (6 hours after admission, waiting for surgery, induction of anesthesia, and 6 hours after surgery).Results:Totally three patients were suspended from the study due to surgery. A total of 77 children were studied, 38 in the experimental group and 39 in the control group. The score of m-YPAS in the experimental group was significantly lower than that of the control group(17.57±16.64 vs. 42.04±27.46, t value was 3.85, P<0.01) while waiting for surgery. The score of m-YPAS in the experimental group was significantly lower than control group (31.64±27.95 vs. 62.22±25.13, t value was 4.26, P<0.01) at the anesthesia induction. Compare with the control group, the score of m-YPAS in the experimental group showed no significant difference at both time of 6 hours after admission (18.19±17.83 vs.19.85±17.92, t value was 0.87, P>0.05) and 6 hours after surgery(35.61±15.70 vs. 41.81±17.97, t value was 1.37, P>0.05). Compare with the control group the score of ICC in the experimental group was significantly decreased (1.40±1.39 vs. 3.78±2.60, t value was 4.88, P<0.01) at the anesthesia induction. The score of PEAD in the experimental group and control group, there was no significant difference between the two groups (7.18±2.45 vs. 7.85±3.05, t value was 0.91, P>0.05). Conclusions:Compared with the traditional preoperative visit mode, the preoperative visit mode of Child Life can effectively relieve the anxiety of preschool children undergoing general anesthesia surgery while they are waiting for surgery and during anesthesia induction, and can improve the degree of cooperation during anesthesia induction.