Microglia can be activated immediately after acute cerebral ischemia and play a role of double-edged sword of nerve repair and neurotoxicity.Studies in recent years have suggested that this dual role of microglia can be achieved by a Toll-like receptor 2 (TLR2) signal transduction pathway.Therefore,reasonable regulation of TLR2 expression of microglia may improve the therapeutic effect of cerebral ischemia to a certain extent.This article reviews the mechanisms of TLR2 in cerebral ischemia and the possible interventions.

Objective:To forecast the indicators on maternal and child health of China in 2020.Methods: Based on Surveillance data of the indicators on the maternal and child health in China since the 1990s,forecasting models were found using auto-regressive method,and the indicators on maternal and child health in China in 2020 were forecasted using the models after they had been tested and valued.Results: Auto-regressive models on infant mortality rate(IMR),under-5 mortality rate(U5MR) and maternal mortality(MMR) were found.The models and their parameters passed statistical tests,and their mean absolute error was 5% or so and determination coefficients were all more than 90%.Conclusion: The IMR of China in 2020 was forecasted to be 6.35‰,the U5MR 7.37‰ and the MMR 22.21/100 000.

Objective To investigate the association between diabetes mellitus and risks of kidney cancer.Methods The cohort and case-control studies on the association between diabetes mellitus and risk of kidney cancer were analyzed by searching PubMed database within the time limit of Jan.1990 to Oct.2011.Data were selected according to the inclusion and exclusion criteria,and the meta-analysis was performed by using the Cochrane Collaboration's RevMan 5.0 software.Results A total of 14 studies(8 cohort studies and 6 case-control studies) involving 6,645,516 participants met the inclusion criteria.Meta analysis showed that patients with diabetes had a higher risk of kidney cancer compared with the control group without diabetes(OR =1.28,95％ CI 1.10 ～ 1.48,P ＜ 0.05).Stratification study showed that diabetes was associated with an increased risk of kidney cancer in cohort studies(OR =1.32,95％ CI 1.14-1.53,P ＜0.05),but this association was not found in casecontrol studies (OR =1.21,95 ％ CI 0.79-1.84,P ＞ 0.05).Conclusion This meta-analysis indicates a positive association between diabetes and risk of kidney cancer,however,future researches are needed to identify whether diabetes mellitus is an independent risk factor for kidney cancer.

Objective To explore job satisfaction degrees and the influencing factors among community nurses. Method General information questionnaire and the revised job satisfaction questionnaire were adopted in the investigation among 124 nurses from 28 community health service centers in Nanchong City between February to October 2016. Results The total score was (119.62 ± 15.37), at the moderate to high level. Of the eight dimensions, relationship with colleagues was scored the highest, and personal growth was the lowest. The influencing factors of the nurse's job satisfaction were found to be employment type, work positions, service duration in the community and whether they have been trained on community nursing position (all P<0.05). Conclusions The job satisfaction degree of community nurses is generally at middle level. Therefore, measures should be taken to improve the job satisfaction for the development of community nursing services.

Objective To evaluate the efficacy of metformin(MTF) in treatment of clomiphene (CC)-resistant patients with polycystic ovary syndrome (PCOS).Methods The published articles of randomized controlled trial (RCT) of comparison of MTF combined with CC and CC alone in treatment of CC-resistant PCOS were searched in PubMed,EMBASE,OVID,EBSCO databases and Cochrane Library,and these studies were screened under inclusion and exclusion criteria.The quality of included studies and extract data of comparison of ovulation rates and pregnancy rates were evaluated.And the Meta-analysis using statistic software RevMan 5.0 was completed.ResultTotal of 333 patients in total 8 trials were included.Meta analysis showed that MTF plus CC led to a significantly higher clinical ovulation rate ( OR =7.31,95 ％ CI:2.57 - 20.76,P ＜ 0.05 ) and pregnancy rate ( OR =7.93,95 ％ CI:2.45 - 25.63,P ＜ 0.05 ) than that of CC alone.Conclusion MTF can increase ovulation and pregnancy rates of CC-resistant PCOS women.

Objective To estimate the acceptability of nurses for division of labor pattern in China.Methods A total of 1 609 nurses in 3 provinces were investigated by self-made questionnaires.The contents of questionnaires included assignment distribution,the acceptability of current division pattern,and whether current division pattern can arouse working enthusiasm of nurses.Results The proportion of those engaged in not only life nursing but also technical nursing was more than 40％,and those only engaged in life nursing was lower than 5％ in nurses with junior college,college or bachelor education degree.The nurses' acceptability of current division pattern of nursing work was poor,most fairly reasonable and very general.The improvement of working enthusiasm for division of labor pattern at present was also poor.The higher educational background except master,the lower improvement of working enthusiasm.Conclusions The poor nurses' acceptability of division of labor pattern was low and impacted working enthusiasm.It suggested to establish a scientific and reasonable division of labor pattern for improvement of nurse working enthusiasm,and promote the overall development of clinical nursing,nursing management,nursing education and nursing scientific research.

Objective To explore the influence of continuity care model on how to deal with medical waste of insulin injections among domestic patients Methods Consecutive diabetes patients using the home insulin injections were recruited as the the members of our Diabetes Education Classfrom September 2014 to March 2015. The home medical waste disposal was brought into the content of diabetes education;problems were intervened through the continuity care model. Using the questionnaire survey to investigate the cognitive and disposal of patients on medical waste, to compare the difference of results of questionnaire before and after the intervention. Results The cognitive rate of medical waste after intervention was 97.70%(212/217),while the cognitive rate before intervention was 3.69%(8/217), the difference was significant (χ2=383.63,P<0.01). Disposal of diabetes patients using the home insulin injections had improved after the continuity care, the rate of dealing with medical waste according to specification after the intervention was 91.24% (198/217),while the rate before the intervention was 3.23%(7/217), the difference was significant (χ2=337.26,P<0.01). Conclusions The continuity care model standardized the behavior of patients for disposal of medical waste, reduced the environment pollution of medical waste and decreased the spread of disease.

Objective To investigate the situation of the activities of daily living(ADL)for elderly people in Changsha,and analyze the influencing factors. Methods Questionnaire survey on ADL was held in 2239 elderly people(ranging from 60 to 91 years old),and the influencing factors including age,sex,family structure,marital status,education level,occupation,common chronic diseases and medical care consciousness were analyzed. Results Going to the toilet irregularly hadthe highest injury rate in physical self-maintenance viability(18.2%).But in instrumental ADL,the highest injury rate occurred while shopping(26.3%).Advanced age,living alone,losing spouse,sickness and the lack of medical care awareness were the major factors that influenced the ADL of the elderly people. Conclusions The ADL is an important indicator which reflects the health condition of elderly people.Advanced age,living alone,losing spouse,having many chronic diseases and lacking in medical care awareness are risk factors.

Abstract: Objective To investigate the impact of SARS-CoV-2 virus infection on the risk of thrombosis in COVID-19 outpatient patients with mild and regular symptoms. Methods Outpatient patients during the SARS-CoV-2 large-scale infection period after the policy adjustment for COVID-19 in Beijing in 2022 were selected as the observation group, and the dynamic zero-clearing period before the policy adjustment and outpatient patients during the 2022/2021/2020 period were taken as the three control groups. The patients with physiological factors that may increase the risk of coagulation, such as thrombotic diseases, malignant tumors, female pregnancy and other physiological factors, were excluded. Pediatric patients under 14 years old were also excluded. Age was expressed as median (interquartile). The changes in blood routine, fibrin/fibrinogen degradation products, and D-Dimer in Beijing outpatient patients were studied with statistical method and data analysis techniques. Results Compared with the control groups, the observation group showed a statistically significant decrease in red blood cells (RBC), hemoglobin (Hb), and hematocrit (HCT) levels, and an increase in monocytes (MONO) and platelet (PLT) counts, all showed statistically significant differences (P<0.0001). The proportion of fibrinogen degradation product (FDP) and D-Dimer of observation group exceeding the range increased significantly. Compared with the three control groups, the number of outpatient fibrinogen degradation products (FDP) in the observation group of patients aged 50 years and verage number of patients under 50 years old in the observation group with D-Dimer exceeding the threshold increased by more than 48.98%, and the monthly average number of patients with D-Dimer exceeding the threshold in patients aged 50 or older increased by 346%-998%. Conclusions The results of this study suggest that outpatient patients with mild or regular SARS-CoV-2 infection are also at risk for thrombotic events, and monitoring blood coagulation indicators such as D-dimer is recommended to avoid the sudden onset of thrombosis-related fatal complications .

Objective:To explore the application effect of perforator pedicle flap in the wound repair after resection of the medium and large-sized keloids in the trunk.Methods:From January 2018 to January 2019, 10 patients, aged from 20 to 53 years old, with medium and large-sized keloids in the trunk were treated, including 3 cases in the anterior chest, 3 cases in the umbilical region, 4 cases in the lower abdomen, 8 cases were women and 2 cases were men. The size of keloids were 2.0 cm×3.0 cm to 5.0 cm×9.0 cm, and all keloids were accompanied with infection. Scars and infected tissues were removed and contracture was released completely. Pedicled flaps with intercostal perforator artery(3 cases), paraumbilical perforator artery(3 cases) or groin perforator artery(4 cases) were elevated and advanced or rotated to cover the wound. Early radiotherapy was delivered to the scar bed 5-10 Gy each time with a total dose of 15 to 20 Gy over 3 daily fractions after surgery. And other treatments, such as topical silicone gel, corticosteroid intralesional injection and elastic clothing compression were taken as adjuvant therapy. The scars were assessed by the Vancouver Scar Scale, and local morphology, hair distribution, itching, pain and patient satisfaction were analyzed and evaluated after 12 months to 24 months follow-up.Results:All flaps survived and the incisions healed primarily. The local morphology and hair distribution were normal, and the itching and pain were relieved obviously. The Vancouver Scar Scale scores vary from 1 to 6 in 9 patients. Incision hypertrophic scar with the Vancouver Scar Scale score of 9 occurred in one noncompliance patient who didn’t follow up on time and refuse to take the adjuvant treatments. 8 patients were extremely satisfied with the treatment effect, and 2 patients were satisfied with the treatment effect.Conclusions:For medium and large-sized keloids in the trunk, combined modality therapy, including local perforator pedicled flaps transplantation, early radiotherapy, topical silicone gel, elastic compression and etc, will achieve satisfied clinical effects.