Objective:To evaluate the clinical value of percutaneous transhepatic cholangial drainage (PTCD) and percutaneous transhepatic cholangial stent(PTCS)implantation therapy for malignant biliary obstruction in the elderly patients.Methods:Fifty three patients over 60 years-old were treated with PTCS implantation (n=35),PTCD for internal-external drainage(n=11),or single external drainage(n=7). The imaging examination was performed for all the patients one week after surgery. The serum levels of total bilirubin (TBIL) and alanine aminotransferase (ALT) were detected before and after surgery.Rusults:Metallic stents were successfully implanted in 32 patients during the surgery, and 3 patients were implanted 5 to 7 days later after PTCS. Both total serum levels of TBIL and ALT were significantly decreased at one week after surgery (P<0.05). The mean survival periods were 11.5 months for stent implantation patients and 5.5 months for PTCD patients. Conclusion:PTCD and PTCS are easy to perform and safe and effective in the treatment of malignant biliary obstruction of elderly patients.

Objective? To investigate the correlation between self-efficacy, discharge readiness and self-management in readmitted patients with myocardial infarction, to explore the influencing factors to self-management and to provide a basis for intervention strategies in clinical practice. Methods? Totally 198 readmitted patients with myocardial infarction from First Hospital of Shanxi Medical University were selected using convenient sampling from December 2017 to May 2018 and investigated with the general informational questionnaire, Coronary Heart Disease Self-Efficacy Questionnaire (CHDSEQ), Discharge Readiness Scale (DRS), and Coronary Heart Disease Self-Management Scale (CHDSMS). Pearson correlation analysis and multivariate linear multilayer regression analysis were used to explore the influencing factors to self-management behavior. Results? The CHDSMS score of the 198 patients was (75.21±9.31), with a 63.12% scoring metrics;the CHDSEQ score was (50.91±10.43); the DRS score was (161.53±26.76). Correlation analysis showed that self-efficacy was positively correlated with self-management (r=0.537, P＜0.01), and that discharge readiness was positively correlated with self-management (r=0.416, P＜ 0.01). Multilayer correlation analysis revealed that the two factors could account for 14.1% of the variance of self-management. Conclusions? Medical and nursing workers should evaluate the discharge readiness of readmitted patients with myocardial infarction accurately, improve patients' self-efficacy, and provide effective discharge guidance for different groups according to relevant influencing factors, thus improving patients' self-management.

Objective:To summarize the best evidence for the evaluation and management strategies of adolescent non-suicidal self-injury, and provide a basis for medical staff to carry out standardized evaluation and management of adolescent non suicidal self injury.Methods:According to evidence-based nursing methods and the "6S"evidence pyramid model, the evidences of non-suicidal self-injury in adolescents, including guidelines, standards, case report, evidence summary, randomized controlled trial (RCT) , systematic review, clinical practice and other evidences were searched in BMJ Best Practice, UpToDate, World Health Organization, National Institute for Health and Care Excellence, National Guidelines Clearinghouse, Registered Nurses ' Association of Ontario, Scottish Intercollegiate Guidelines Network, American College of Physicians Club, Australian Joanna Briggs Institute (JBI) Evidence-based Health Care Center Library, Cochrane Library, PubMed, Embase, PsycINFO, China Biology Medicine disc, China National Knowledge Infrastructure, Wanfang Database, Medlive and other databases. The retrieval period was from the establishment of the databases to June 30, 2022. The quality evaluation of the articles was evaluated by two researchers trained in the evidence-based curriculum. Included studies were pre-graded using the Australian JBI Evidence-based Health Centre Evidence pre-grading system and the Evidence Recommendation Level System (2014 edition) . Results:Finally, a total of 18 articles were included, including 5 guidelines, 2 standards, 1 case report, 1 evidence summary, 3 systematic reviews, 1 Meta-analysis, 2 clinical practices and 3 RCT studies. A total of 22 pieces of best evidence were summarized from 6 dimensions, such as screening and assessment, multi-professional and multi-form intervention strategies, training and education, self-management strategies, disposal after self-injury treatment and follow-up.Conclusions:The best evidence based on evidence-based assessment and management strategies of adolescent non-suicidal self-injury is scientific and practical, which can provide reference for the clinical practice of adolescent non-suicidal self-injury.

OBJECTIVETo investigate the relationship between polymorphisms of the growth arrest specific 6 (GAS6) gene and severe preeclampsia in a South West Han Chinese population.

METHODSBlood samples from 167 patients with severe preeclampsia and 312 normal pregnant women as controls from Han Chinese in Chengdu area were analyzed by polymerase chain reaction-restriction fragment length polymorphisms.

RESULTSC and T allele frequencies for +1332C/T site were 85.63% and 14.37% in the patient group, respectively, and 78.04% and 21.96% in control group, respectively. The TT genotype and variant T allelic frequencies of the +1332C/T polymorphism were significantly lower in patients with severe preeclampsia than in the control group (both P<0.05), and the odds ratio for the risk of severe preeclampsia was 0.602 (95%CI: 0.401-0.904) in carriers for the variant T allele (χ=6.045, P=0.014). G and A allele frequencies for 834+7G/A site were 72.75% and 27.25% in case group, respectively, and 74.36% and 25.64% in control group, respectively. The genotype and allele frequencies of the 834+7G/A polymorphism in patients with severe preeclampsia and controls showed no significant differences (both P>0.05). In addition, there was no significant association between the polymorphisms and blood pressure levels in the patient or control groups.

CONCLUSIONThe variant GAS6+1332 T allele is associated with a decreased risk for severe preeclampsia in a South West Han Chinese population. On the other hand, the 834+7G/A polymorphism has no effect on the severe preeclampsia.

Adult ; Alleles ; Asian Continental Ancestry Group ; genetics ; China ; Female ; Gene Frequency ; Genetic Predisposition to Disease ; ethnology ; genetics ; Genotype ; Humans ; Intercellular Signaling Peptides and Proteins ; genetics ; Polymerase Chain Reaction ; Polymorphism, Single Nucleotide ; Pre-Eclampsia ; ethnology ; genetics ; pathology ; Pregnancy ; Risk Factors ; Severity of Illness Index ; Young Adult

OBJECTIVETo investigate effects of GSTM1 and GSTT1 gene polymorphisms on serum lipid and apopoprotein levels in healthy normolipidemic and endogenous hypertriglyceridemic subjects.

METHODSTwo hundred and thirty-seven healthy normolipidemic and 102 endogenous hypertriglyceridemic subjects from a population of Chinese Han nationality in Chengdu area were studied using the multiplex polymerase chain reaction (PCR). Serum lipids were measured by enzymatic kits and apolipoproteins AⅠ, AⅡ, B100, CⅡ, CⅢ and E were measured by the RID kits.

RESULTSThe non-null and null genotype frequencies for GSTM1 site were 39.2% and 60.8% in the control group, respectively, and 47.6% and 52.4% in the HTG group, respectively. The non-null and null genotype frequencies for GSTT1 site were 51.5% and 48.5% in the control group, respectively, and 57.3% and 42.7% in the HTG group, respectively. The GSTM1 and GSTT1 genotype frequencies in HTG subjects were not different from those in the controls, respectively (P>0.05). However, in control group subjects with both null genotypes (GSTT1- and GSTM1-) showed the lowest plasma HDL-C levels (1.29±0.30 mmol/L), whereas those with each of the other three genotype combinations showed relatively higher HDL-C levels. There was significant difference of HDL-C levels between subjects with GSTT1-/GSTM1-and those with GSTT1+/GSTM1-(P<0.05). Similar result was not observed in HTG group. No significant changes of lipid and lipoprotein levels were observed in either GSTM1 or GSTT1 polymorphism alone in control or HTG group.

CONCLUSIONThe present study provides an evidence that the presence of double deletion genotypes is associated with low HDL-cholesterol levels in normal Chinese subjects. However, these polymorphisms are not associated with lipid levels in endogenous hypertriglyceridemia in Chinese population of Chengdu area.

OBJECTIVE: To assess the association of apolipoprotein (apo) C1 (APOC1) gene rs4420638A/G and -317H1/H2 polymorphisms with the risk of pre-eclampsia (PE) and the influence of their genotypes on the clinical and metabolic indexes among Chinese women. METHODS: In total 289 PE patients and 824 women with uncomplicated pregnancies were included. The rs4420638A/G genotype was determined by a Taqman real-time PCR allelic discrimination assay. The -317H1/H2 genotype was measured through PCR and restriction fragment length polymorphism analysis. Serum lipid and apo levels were measured by an enzymatic kit and a PEG-enhanced immunoturbidimetric assay. RESULTS: Allelic and genotypic frequencies of the APOC1 gene rs4420638A/G and -317H1/H2 were not significantly different between the two groups (all P> 0.05). However, patients carrying the G allele of the rs4420638A/G locus had higher serum levels of triglyceride, non-HDL-C and apoB, and a higher apoB/apoA1 ratio compared with those with an AA genotype (all P< 0.05). Patients carrying the H2 allele of the -317H1/H2 polymorphism had smaller delivery gestational weeks compared with those with the H1H1 genotype (P< 0.05). CONCLUSION Polymorphisms of the APOC1 gene rs4420638 and -317H1/H2 sites may be associated with abnormal lipoprotein metabolism among Chinese patients with PE, though no association was found between variants of the APOC1 gene and the risk of PE among them.

Objective? To design a Seminar curriculum model for graduate nursing students based on the discussion of SCI papers and evaluate its effect on students' scientific research ability. Methods? Using the cluster sampling method, 57 graduate nursing students from a medical university were selected as the control group, and 58 graduate nursing students were selected as the experimental group. Using SCI nursing papers as the subject of discussion, the control group implemented the empirical Seminar curriculum model. The experimental group constructed and implemented the curriculum model based on the research capability structure model and the Seminar learning objectives. The effects of the intervention were evaluated using the Research Motivation Scale (RMS), the Nursing Research Self-Efficacy Scale (NURSES), the Nursing Staff Scientific Research Self-Assessment Scale (SRASES), and the Seminar Survey Questionnaire. Results? After the course, the scores of RMS total score, intrinsic motivation and extrinsic motivation of the nursing students in the experimental group were higher than those in the control group, and the differences were statistically significant (P＜0.05). At the end of the course, the scores of the NURSES total scores, scientific knowledge resources of the nursing students and "effect of collective research" in the experimental group were higher than those in the control group, and the differences were statistically significant (P＜0.05). At the end of the course, the scores of the total scores and dimensions of the SRASES in the experimental group were higher than those in the control group, and the differences were statistically significant (P＜0.05). Conclusions? The Seminar curriculum model based on SCI papers can improve the motivation, scientific research efficacy and scientific research ability of graduate nursing students to a certain extent. However, it is still necessary to further explore the curriculum model to help students avoid the motivation of scientific research failure and the understanding and application of theory.

OBJECTIVE: To analyze the quality of life(QOL) of peasant workers with pneumoconiosis and its main influencing factors. METHODS: A typical sampling method was used to select 83 peasant workers with pneumoconiosis in two villages in Zhaotong City, Yunnan Province as the pneumoconiosis group, and 85 non-pneumoconiosis peasant workers in the same village selected as the control group. The QOL of the two groups was investigated using the Quality of Life Measurement Scale. RESULTS: The average annual family income of pneumoconiosis group was much lower and average annual expenditure of the family for disease treatment increased in 2015(P<0.01) compared with the control group. The total score of QOL and its average scores in the physical, psychological, environmental and social fields of pneumoconiosis group were lower than that of the control group(P<0.01). The multiple stepwise regression analysis results showed significant factors related to all functional domain scores of QOL in the pneumoconiosis group. For the total score of QOL, complication and ability to do housework were the significant factors. In the physical domain of QOL, only doing housework was the significant factor. In the psychological domain of QOL, complications and average annual family income were the significant factors. Marital status, doing housework and educational level were the significant factors for the social domain of QOL. The significant factors for the environmental domain of QOL were average annual family income and doing housework. CONCLUSION: The QOL of migrant workers with pneumoconiosis was poor. Complications, divorcement or widowhood reduced the quality of their lives. Higher education degree, higher average annual family income and higher ability to do housework played a positive role in promoting the QOL of peasant workers with pneumoconiosis.

Background The adverse effects of long working hours, shift rotation, and job stress on the physical and mental health of occupational populations require urgent attention. Objective To investigate and compare the positive rates of WMSDs between different industries, analyze the exposure status of long working hours, shift rotation, and job stress among key occupational groups, and evaluate the impacts of these factors on WMSDs in the manufacturing and service industries. Methods The study subjects were derived from key occupational populations in Yunnan Province, recruited by the Chinese National Occupational Health Literacy Monitoring Survey in 2022. A cross-sectional design was used for this survey. The key occupational populations were recruited from the secondary industry (manufacturing industry, metal mining and beneficiation industry, and non-metal mining and beneficiation industry) by stratified random sampling and from the tertiary industry (medical and healthcare industry, education industry, environmental sanitation industry, transportation industry, and express/takeaway delivery industry) by proportional probability sampling, and 12014 front-line workers were finally included as survey participants. General information, work-related factors (shift rotation, weekly working hours, job stress, etc.) and WMSDs assessment results were obtained through a web-based self-reported questionnaire, and the associations of long working hours, shift rotation, and job stress with WMSDs were analyzed using χ² test and logistic regression. Results The average positive rate of WMSDs among the key occupational groups in Yunnan Province was 77.2%. The positive rate of WMSDs in the secondary industry group was 69.4%, while it was 81.6% in the tertiary industry group, with a statistically significant difference (P<0.001). Among the eight surveyed sectors, the education sector had the highest positive rate of WMSDs (94.2%). The single-site WMSDs mainly involved the neck, shoulders, and low back. In the secondary industry, WMSDs was reported in 1−2 body parts, while in the tertiary industry, WMSDs was mainly reported in multiple (≥5) body parts. Long working hours (OR: 1.119, 1.165, 1.163, respectively), shift rotation (OR: 1.094, 1.199, 1.230, respectively), and job stress (OR: 1.795, 1.854, 2.006, respectively) were risk factors for WMSDs in the neck, shoulder, or low back, and all three were also risk factors for multi-site WMSDs. Moreover, as the number of involved body parts increased, the effects of long working hours and job stress became more pronounced. For 1-2, 3-4, and 5 or more body parts compared to no pain reported, their OR values were 0.971 (95%CI: 0.871, 1.082), 1.133 (95%CI: 1.004, 1.279), and 1.285 (95%CI: 1.155, 1.429) for long working hours, respectively, and the OR values were 1.009 (95%CI: 0.878, 1.160), 1.360 (95%CI: 1.174, 1.575), and 2.797 (95%CI: 2.471, 3.166) for job stress, respectively. Conclusion The positive rate of WMSDs is higher in the tertiary industry than that in the secondary industry among the key occupational groups in Yunnan Province. Long working hours, rotating shift work, and job stress could significantly increase the risk of WMSDs.

To improve collagen production by recombinant Pichia pastoris, we applied Placket-Burman and Box-Behnken design to optimize the fermentation medium. Through Placket-Burman design, three variables in the medium (concentration of yeast extract, peptone and glycerol) were selected for having significant effect on cell dry weight. Through Box-Behnken design regression coefficients analysis, a secondary degree polynomial equation was established, and the optimum levels of the three variables were yeast extract 1.13%, peptone 1.61% and glycerol 0.86%. During the growth period, an average cell dry weight of 4.41 g/L was obtained after 12 h fermentation, increased by 26%. Through high density fermentation, the production of recombinant human collagen (Ⅲ) was up to 4.71 g/L in 22 L fermentor. The recombinant human collagen (Ⅲ) exhibited good results to repair acetic acid induced gastric ulcer in rats.