Objective To investigate the clinical value of ABCD score combined widl diffuse weighing imaging(DWI)for the estimation of transient ischemic attack(TIA)advancing to cerebral infarction in 7 days.Method The clinical dataincludingABCD score and DWI of 105 cases with TIA were analyzed.Results None of TIA patients with ABCD scores＜3 advanced to cerebral infarction.There were 83 cases with ABCD scores≥3,among whom 24 cases(28.9%)advanced to cerebral infarction.The higher ABCD scores,the higher incidence of cerebral infarction(P＜0.01).Nine of 42 cases(21-4%)with DWI abnrmal advanced to cerebral infarction,while 2 of 50 cases(4.0%)with normal DWI advanced to cerebml infarction (P＜0.05).Conclusion ABCD score is alleffective method for the estimation of TIA advancing to cerebral infarction,and when combined with DWI it is more efficient

Objective To investigate the CT diagnostic value of broad ligament leiomyoma.Methods CT appearances of 21 cases with broad ligament leiomyoma confirmed by operation and pathology were analyzed retrospectively.Results CT showed that the tumors were pelvic and extrauterine masses in all cases,the tumors were solid in 19 cases and was cystic-solid in one case. The tumors had clear border in 16 cases and unclear border in 3 cases. The density of tumor in 6 cases were homogeneous, which was similar to that of myometrium on precontrast scanning. There was obviously uptake on postcontrast enhancement, as in myometrium. In heterogeneous tumors, low density areas of light flakes or streaks were observed, and the density of tumor solid part was somewhat lower than that of the uterus muscles on postcontrast enhancement. The tumors grew near the uterus. The shape of tumors appeared multitudinous, which was multilobular or irregular in 11 cases, flat round in 4 cases, and round or elliptic in 6 cases. Conclusion CT is a useful tool in diagnosis of the broad ligament leiomyoma.

Objective To investigate the effects of curcumin on UVB-induced elevation of cellular ROS level and cell death and to explore the involvement of transcription factor Nrf2.Methods Mouse embryonic fibroblasts (MEFs) were pretreated with or without curcumin then irradiated with UVB.The cell viability,cellular ROS level and protein levels of Nrf2 and HO1 were determined by MTT assay,DCFH fluorescence and Western blotting,respectively.These measurements were also performed in Nrf2 (-/-) MEFs.Results UVB irradiation elevated cellular ROS level and decreased cell viability of MEFs(t =16.65,15.89,P ＜ 0.05),while the curcumin pretreatment significantly attenuated the deleterious effects of UVB(t =11.88,3.77,P ＜ 0.05).UVB irradiation moderately increased the protein levels of Nrf2 and HO1 and activated JNK and ERK.The curcumin pretreatment led to more remarked elevation of Nrf2 and HO1 proteins,while inhibited UVB-activated JNK and ERK,but it had little effect on p38MAPK.In contrast,Nrf2 (-/-) MEFs showed significantly decrease in Nrf2 and HO1 expressions and were more susceptible to UVB-induced damages.Interestingly,the protective effects of curcumin were also greatly compromised in Nrf2 (-/-) MEFs (t =16.73,-8.23,P ＜ 0.05).Conclusions Curcumin can attenuate UVB-induced oxidative damages in MEFs by activating Nrf2 signaling.

Objective To analyze the continuous midwifery care services on the natural birth rate and choices of non-pharmacological analgesic delivery for primiparae.Methods A total of 504 primiparae were randomly selected in our hospital and were divided into routine group and experimental group, with 252 cases in each group.The routine group underwent routine obstetric examination, while the experimental group received continuous midwifery nursing services.The natural birth rate, choices of non-pharmacological analgesic delivery and Self-rating Anxiety Scale scores were compared between the two groups.Results The SAS score in the experimental group after nursing care was lower, natural birth rate and the choices rate of non-pharmacological analgesic delivery were higher than that of the routine group (P<0.05).Conclusion The continuous midwifery care services can significantly alleviate anxiety of primiparae, enhance the natural birth confidence, and improve the natural birth rate and the choices rate of non-pharmacological analgesic delivery, and enhance improve the delivery outcomes, so it is worthy of clinical promotion.

Objective To analyze the continuous midwifery care services on the natural birth rate and choices of non-pharmacological analgesic delivery for primiparae.Methods A total of 504 primiparae were randomly selected in our hospital and were divided into routine group and experimental group, with 252 cases in each group.The routine group underwent routine obstetric examination, while the experimental group received continuous midwifery nursing services.The natural birth rate, choices of non-pharmacological analgesic delivery and Self-rating Anxiety Scale scores were compared between the two groups.Results The SAS score in the experimental group after nursing care was lower, natural birth rate and the choices rate of non-pharmacological analgesic delivery were higher than that of the routine group (P<0.05).Conclusion The continuous midwifery care services can significantly alleviate anxiety of primiparae, enhance the natural birth confidence, and improve the natural birth rate and the choices rate of non-pharmacological analgesic delivery, and enhance improve the delivery outcomes, so it is worthy of clinical promotion.

Objective : To investigate the awareness of human papillomavirus ( HPV ) vaccine and willingness to vaccinate daughters among parents of primary and middle school students, so as to provide the reference for the promotion of HPV vaccine in primary and middle school girls. Methods : Using multi-stage stratified cluster sampling method, the parents of girls in in Grade Four to Nine from schools in Gongshu District of Hangzhou, Xiuzhou District of Jiaxing and Wuxing District of Huzhou were selected. A questionnaire survey was conducted to collect demographic information, HPV vaccine related knowledge and willingness to vaccinate daughters with HPV vaccines. The multivariate logistic regression model was used to analyze the influencing factors for the willingness to vaccinate daughters with HPV vaccines among parents. Results : Totally 1 500 questionnaires were sent out, and 1 466 were effectively collected, with an effective rate of 97.73%. There were 313 fathers responded, accounting for 21.35%; and 1 153 mothers responded, accounting for 78.65%. The awareness rate of HPV vaccine was 16.81%. The rate of willing to vaccinate daughters with HPV vaccines was 49.86%. The multivariate logistic regression analysis showed that the patients who ever vaccinated daughters with self-paid vaccines ( OR=1.935, 95%CI: 1.473-2.541 ), knew cervical cancer ( OR=1.424, 95%CI: 1.065-1.904 ), knew HPV vaccine dose ( OR=1.672, 95%CI:1.216-2.301 ), knew the best vaccination period ( OR=1.392, 95%CI: 1.032-1.876 ), knew the need of cervical cancer screening even after vaccination ( OR=1.596, 95%CI:1.227-2.075) were more willing to vaccinate daughters with HPV vaccines, while the parents who thought HPV vaccine expensive ( OR=0.154, 95%CI: 0.099-0.240 ) were less willing to vaccinate daughters with HPV vaccines. Conclusions The rates of HPV vaccine awareness and willingness to vaccinate daughters are 16.81% and 49.86% among parents of primary and middle school students. Their knowledge of HPV vaccine and the price of the vaccine may affect their willingness to vaccinate daughters.

Objective:To evaluate the dose-response relationship of alfentanil inhibiting gag reflex when combined with propofol in elderly patients undergoing painless gastroscopy.Methods:Patients of American Society of Anesthesiologists physical statusⅠor Ⅱ, aged ≥60 yr, scheduled for elective painless gastroscopy, were selected. Propofol 1.5 mg/kg combined with alfentanil was given intravenously in all the patients. The dose of alfentanil was determined by the Dixon up-and-down method. The initial dose of alfentanil was set at 5 μg/kg. The dose of alfentanil in the next patient was determined according to the development of gag reflex, and the ratio between the two successive doses was 1.1. The median effective dose (ED 50) and 95% confidence interval of alfentanil-induced inhibition of gag reflex when combined with propofol in elderly patients undergoing painless gastroscopy were calculated using the by up-and-down sequential allocation. Results:The ED 50 (95% confidence interval) of alfentanil-induced inhibition of gag reflex when combined with propofol 1.5 mg/kg was 2.8 (2.4-3.2) μg/kg in elderly patients undergoing painless gastroscopy. Conclusion:When combined with propofol 1.5 mg/kg, the ED 50 of alfentanil inhibiting gag reflex is 2.8 μg/kg in elderly patients undergoing painless gastroscopy.

Objective:To explore the effect of staged rehabilitation nursing in patients undergoing arthroscopic rotator cuff repair.Methods:From January 2021 to December 2022, convenience sampling was used to select 73 patients who underwent arthroscopic rotator cuff repair in the Department of Hand Surgery at Affiliated Hospital of Nantong University as participants. According to the random number table method, patients were divided into a control group ( n=36) and an observation group ( n=37). Control group received routine rehabilitation nursing, while observation group received staged rehabilitation nursing. The University of California, Los Angeles (UCLA) Shoulder Rating Scale score, American Shoulder and Elbow Surgeons (ASES) Rating Scale score, Constant-Murley Shoulder Scale score, and complications during rehabilitation were compared between two groups of patients before and six months after intervention. Results:Six months after surgery, both groups showed an increase in UCLA scores and ASES scores compared to before the intervention ( P<0.05), and the scores of observation group were higher than those of control group, with statistical differences ( P<0.05). Six months after surgery, the Constant-Murley Shoulder Scale scores for daily life and shoulder range of motion in observation group were higher than those in control group, and the differences were statistically significant ( P<0.05). During the rehabilitation period, the incidence of complications in observation group was lower than that in control group with a statistical difference ( P<0.05) . Conclusions:Staged rehabilitation nursing in patients undergoing arthroscopic rotator cuff repair shows significant effects and can effectively promote patient recovery.

Objective To investigate the clinical significance of serum citrulline levels in evaluating the remnant bowel absorptive function with enterostomy in the neonatal period by means of tandem mass spectrum so as to guide clinical treatment with parenteral nutrition(PN) or not.Methods The serum amino acid profiles of 30 enterostomy infants including small intestinal enterostomy 17 cases of enterostomy and 13 cases of colon enterostomy and 20 cases of control infants in Wuhan Children's Hospital,Tongji Medical College University of Science & Technology from January 2016 to June 2018 were performed by using tandem mass spectrum,and the related amino acid with the bowel absorbing ability-citrulline was screened out.The Pearson correlation of the serum citrulline levels with the gain weight of the infants was studied.Results The weight of small intestinal enterostomy was significantly lower than colon enterostomy and control infants [(3.22 ± 1.00) kg vs.(5.63 ± 0.66) kg and (6.09 ± 0.85) kg],and there was statistical significance (F =57.23,P ＜ 0.05).Serum citrulline levels were significantly lower in small intestinal enterostomy compared with colon enterostomy and controls [(10.65 ± 5.82) μmol/L vs.(16.57 ± 4.33) μmol/L and (16.52 ± 4.20) μmol/L],and there was statistical significance (F =8.29,P ＜ 0.05).In enterostomy infants serum citrulline was positively correlated with gain weight everyday(r =0.65,P ＜ 0.05).Serum citrulline level ＜ 12 μmol/L had 81.3％ sensitivity and 71.4％ specificity for underweight.Conclusions Serum citrulline is a simple and accurate biomarker for evaluation of the absorptive function and adaptation of the enterostomy infants.Serum citrulline level ＜ 12 μmol/L is a strong predictor of PN-dependence in infants with temporary enterostomy.

Objective To explore the effect of bilateral hand function training on the hand function of stroke survivors.Methods Thirty-one patients with unilateral hand dysfunction after stroke were randomly divided into an experimental group of 16 and a control group of 15.Both groups were given 60 minutes of hand function training of their affected hands daily,five days a week for 4 weeks.The experimental group was additionally provided with 40 minutes of bilateral hand training on the basis of the aforementioned intervention.Before the treatment and after the 4 weeks,integrated surface electromyography (iEMG) signals were recorded from both hands' flexor and extensor muscles.Both groups were also assessed using the Fugl-Meyer motor assessment for the upper extremities (FMA-UE).Results After the treatment,the average iEMG of the flexor and extensor muscles during flexion and extension were significantly better than before the treatment in both groups.There was no significant difference between the two groups in their average iEMGs before the treatment,but afterward significant differences were observed in all the iEMG measurements.After the treatment the average total FMA-UE score of the experimental group was significantly higher than that of the control group.Conclusion Bilateral hand function training is significantly more effective than unilateral training in promoting the recovery of flexor and extensor muscle function after a stroke.