Objective To investigate the spiritual well-being (SWB) and perceived control (PC) in adult patients with heart failure (HF),and analyze the relationship between spiritual well-being and perceived control. Methods 125 patients with heart failure were surveyed with questionnaires by convenience sampling, including Control Attitudes Scale-Revised (CAS-R) and Memorial University of Newforndland Scale of Happiness (MUNSH). Results The mean score of the spiritual well-being was(6.34± 2.92), and the mean score of perceived control was (18.40±4.39). The patients’spiritual well-being was closely related to perceived control (P < 0.05). There was a positive correlation between the self-efficacy and the positive indicator of subjective well-being, r=0.46, negative correlation was between the self-efficacy and the negative indicator of subjective well-being, r=-0.17. There was a positive correlation between the locus of control and the positive indicator, r=0.38,while the negative correlation was between the locus of control and the negative indicator, r=-0.05. There was a negative correlation between the learned helpless and the positive indicator, r=-0.43, while the positive correlation was between the learned helpless and the negative indicator, r=0.06. Conclusions The spiritual well-being of patients is at a low level, as well as perceived control. The spiritual well-being of patients can be enhanced by means of improving the ability of perceived control.

Objective:To explore the effect of multi-channel health education model by professional team on drug compliance, disease knowledge and recurrence in rate of inflammatory bowel disease (IBD) patients, so as to provide basis for formulating scientific health education measures.Methods:From February 2016 to February 2019, IBD patients visited First Affiliated Hospital of Kunming Medical University were selected. According to whether they received health education, the patients were divided into intervention group (100 cases) and control group (138 cases). Morisky medication adherence scale-8 (MMAS-8) and Chinese version of Crohn′s and colitis knowledge score (CCKNOW) were used to evaluate treatment compliance and disease knowledge. The score of MMAS-8, the proportion of poor drug compliance, CCKNOW score and recurrence rate at 48 weeks of follow-up were compared between the intervention group and control group. Two sample t test and chi-square test were used for statistical analysis. Results:The total scores of MMAS-8 and CCKNOW of the intervention group were both higher than those of the control group (5.58±1.96 vs. 4.47±1.44, 10.87±4.21 vs. 9.23±4.65), and the differences were statistically significant ( t=-5.06 and -2.79, both P<0.05). The proportion of patients with poor drug compliance and recurrence rate at 48 weeks of follow up of the intervention group were both lower than those of the control group (56.0%, 56/100 vs. 86.2%, 119/138; 20.0%, 20/100 vs. 31.9%, 44/138), and the differences were statistically significant ( χ2=38.18 and 4.17, both P<0.05). Conclusions:Multi-channel health education by professional team can effectively improve the drug compliance and disease knowledge in IBD patients, improve patient self-management ability, and reduce the recurrence rate.

Objective:To know the amount of literacy and scores of behavior problems of the grade 2-5 pupils in the primary school,and explore the correlation between them.Methods:A total of 673 pupils from grade 2 to 5 in primary school of Nanhai distric,Foshan City were enrolled.Their amount of literacy was assessed with the Primary School Literacy Assessment Scale,and their teachers were assessed with the Conners Teacher Rating Scale.Results:The amount of literacy in different grades,genders and parents' education levels were significantly different among the primary school students (P ＜0.05),girls's scores were higher than boys's [(2312 ±719) vs.(2184 ±734),P ＜ 0.05],students whose parents of high education level were higher than those of low education level (P ＜ 0.05).Scores of hyperactivity,inattentive-passive behaviors and conduct problems in different grades and genders were significantly different.Scores of Grade 2 pupils were higher than others,and boys's scores were higher than girls' s (P ＜ 0.05).Three factors of CTRS,including conduct problems (r =-0.31),hyperactivity (r =-0.43) and inattentive-passive behaviors (r =-0.36) and hyperactivity index(r =-0.38) had significantly negative correlation with the amount of literacy (P ＜ 0.001).Regression analysis showed that hyperactivity (β =-22.27,P ＜ 0.01) and conduct problems (β =-17.69,P ＜ 0.01) could significantly explain the amount of literacy (R2 =0.81).Conclusion:It suggests that hyperactivity and conduct problems are moderately associated with the amount of literacy in primary pupils.

Objective To evaluate the therapeutic value of alpha-fetoprotein (AFP) and cholinesterase (ChE) in patients with hepatitis B virus related acute onset chronic liver failure (HBV-ACLF). Methods A case-control observation was conducted. Sixty-seven patients with HBV-ACLF admitted to Tianjin Second People's Hospital from January 2009 to October 2015 were enrolled. According to the diagnostic criteria of ACLF, the patients were divided into early, middle, and late groups, and alternatively, according to the outcome, they were divided into survival group and death group. Serum samples were collected after 0, 2, 4, 8 weeks to determine the value of AFP and ChE and analyze the value of AFP and ChE in reflecting the changes during HBV-ACLF progression. The differences in AFP and ChE between the survival group and the death group were compared. The prognostic values of AFP and ChE for HBV-ACLF patients were evaluated. Results Among 67 patients, there were 24, 24, and 19 patients in the early, middle and late stage, respectively, and there were 0, 9, 18 deaths at 8 week. With the advance of HBV-ACLF, the levels of both AFP and ChE were decreased in the early, middle, and late stage, with the AFP value of 40.205 (14.663, 90.550), 23.445 (8.233, 64.213), 8.990 (6.120, 14.340) μg/L (F = 36.149, P = 0.000) and the ChE value of (4.217±1.408), (3.619±1.200), (2.503±1.248) kU/L, respectively (F = 19.575, P = 0.000). In the death group, the levels of serum AFP at 0, 2, 4, 8 weeks were significantly lower than those in survival group [μg/L: 21.540 (7.670, 50.470) vs. 60.680 (16.383, 146.100), 10.560 (6.170, 20.100) vs. 60.090 (27.662, 100.700), 8.750 (3.045, 10.105) vs. 51.875 (16.778, 88.833), 3.900 (2.120, 7.660) vs. 20.400 (12.950, 50.430), P < 0.05 or P < 0.01]. The levels of serum ChE at 2, 4, 8 weeks in the death group were significantly lower than those in the survival group (kU/L: 3.206±1.480 vs. 4.008±1.227, 2.893±1.478 vs. 4.140±1.236, 2.948±1.355 vs. 4.329±1.390, P < 0.05 or P < 0.01). The levels of AFP in 67 patients were 30.100 (10.100, 90.100) μg/L, and ChE was (3.685±1.382) kU/L at 2 weeks, and they showed no correlation between AFP and ChE according to the linear correlation analysis (r = 0.082, P = 0.508), suggesting that AFP and ChE could be used as two independent prognostic factors for HBV-ACLF patients. It was showed by receiver operating characteristic curve (ROC) analysis that the area under the curve of AFP (AUC) was 0.847 (P = 0.000), while the AUC of ChE was 0.681 (P = 0.012). The highest values of Youden index and the maximum effectiveness of testing were obtained when AFP and ChE reached 20.520 μg/L and 2.924 kU/L, respectively, with the sensitivity and the specificity of AFP being 85.0% and 77.8%, respectively, and of ChE being 77.5% and 59.3%, respectively. When using the value of AFP ≥ 20.520 μg/L combined with the value of ChE ≥ 2.924 kU/L, the sensitivity for predicting HBV-ACLF outcome was 65.9%, and its specificity was 91.0%. Conclusion Both AFP and ChE were helpful in providing accurate information for the progression and prognosis of HBV-ACLF patients due to the facts that their values were less interfered by the clinical treatment and that they have higher specificity.

OBJECTIVETo compare the clinical effects and safety of dynamic external fixtor combined with limited internal fixation and cross K-wires fixation for the treatment of close Pilon fractures of the proximal interphalangeal joint.

METHODSFrom June 2012 to June 2014, totally 41 patients (45 fingers) with close interphalangeal joint Pilon fracture were treated by dynamic external fixtor combined with limited internal fixation or cross K-wires fixation, and all the patients were followed up. In the dynamic external fixtor combined with limited internal fixation group (group A), there were 21 patients with 22 fingers, including 12 males and 9 females, with an average of (30.6±5.6) years old. In the cross K-wires fixation group (group B), there were 20 patients with 23 fingers, including 11 males and 9 females, with an average of (30.1±5.3) years old. Regular re-examination of X-ray was performed to evaluate the active range of joint motion, fracture healing time, infection rate and postoperative joint motion pain.

RESULTSAccording to the evaluation criteria of upper extremity function issued by the Hand Surgery Society of Chinese Medical Association, the excellent and good cases of group A was up to 19 and 13 for group B. The evaluation results has significant differences (Z=2.558, P=0.011). The excellent and good rate of group A was obviously higher than that of group B. The average bone union time of group A was (7.9±2.1) weeks, and (8.1±2.3) weeks for group B. There was no significant difference on the mean healing time (t=-0.304, P=0.762). The infection fingers of group A was 5, and 1 for group B. The difference between the results was statistically significant (χ2=3.287, P<0.05). The infection rate of group A was higher than that of group B. The postoperative joint motion pain was evaluated by VAS score, the mean score was 0.18±0.50 in group A, and 0.65±0.88 in group B. The difference between the results was statistically significant (t=-2.207, P<0.05). The postoperative joint motion pain was lower than that of group B.

CONCLUSIONDynamic external fixtor combined with limited internal fixation is a reliable and effective method to treat Pilon fractures of the proximal interphalangeal joint. It allows early postoperative functional rehabilitation and restores the joint function.

Adolescent ; Adult ; Bone Wires ; Case-Control Studies ; External Fixators ; Female ; Finger Joint ; surgery ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Tibial Fractures ; surgery

BACKGROUND: As for the treatment of chylous fistula concurrent in oral-maxillofacial tumor resection simultaneously undergoing neck lymph node dissection, many different approaches have been put forward. A simple surgical ligation, strong negative pressure drainage, filling the muscle tissue alone or a combination of the above methods are all unsatisfactory regarding the prognosis and curative effect.OBJECTIVE: To evaluate the validity of medical biological adhesive cohering peripheral autologous muscle tissues to block thoracic duct fistula in order to prevent chylous fistula following neck lymph node dissection.METHODS: All of the 12 patients were detected and diagnosed as chylous fistula in neck lymph node dissection surgery, the wounds were immediately sutured and treated with medical biological adhesive cohering peripheral autologous muscle tissues to block thoracic duct fistula. RESULTS AND CONCLUTION: Of all the 12 patients, 10 recovered without chylous fistula or severe complications, and reoperations were adopted to cure the failed 2 cases. All patients were visited 3 months postoperatively, no recurrence of chylous fistula, local stimulus response or allergy was found. It is suggested medical adhesive to block thoracic duct fistula may be an effective and safe way for prevent chylous fistula following neck lymph node dissection.

Objective To evaluate whether low carbohydrate diet before 18F-FDG tumor imaging could reduce myocardial 18F-FDG uptake.Methods From April 2011 to January 2012,70 patients were enrolled in this study.They were randomly divided into control group (34 cases) and test group (36 cases).Patients in control group were on regular diet,while those in test group had low carbohydrate diet in the evening before imaging.Blood samples were taken before injection of 18F-FDG for the measurement of serum glucose,free fatty acid,insulin and ketone body.Whole body 18F-FDG tomography was performed with dualhead coincidence SPECT.The myocardial uptake of FDG was assessed visually and scored as 0 for no uptake,1 for uptake lower than liver,2 for uptake similar to liver,3 for uptake higher than liver,and 4 for remarkable uptake.The ratio of myocardium to liver (H/L) was calculated.Two-sample t test,Wilcoxon rank sum test and linear correlation analysis were performed.Results The myocardial uptake in test group was significantly lower than that in control group with H/L ratios of 0.94±0.57 and 1.50±1.04,respectively(t=-2.75,P＜0.05).The concentrations of serum free fatty acid and ketone body in test group were significantly higher than those in control group: (0.671±0.229) mmol/L vs (0.547±0.207) mmol/L and (0.88±0.60) mmol/L vs (0.57±0.32) mmol/L,t=2.38 and 2.67,both P＜0.05.The concentrations of glucose and insulin were (5.28±1.06) mmol/L and (35.16±33.70) pmol/L in test group,which showed no significant difference with those in control group ((5.19±0.78) mmol/L and (41.64±35.13) pmol/L,t=0.39 and-0.79,both P＞0.05).A negative correlation was found between the myocardial uptake of 18F-FDG and serum free fatty acid/ketone body concentration (r=-0.40,-0.33,both P＜0.01),respectively.There was no correlation between the myocardial uptake of 18 F-FDG and glucose/insulin (r =-0.02,0.13,both P＞0.05),respectively.Conclusion Low carbohydrate diet before 18F-FDG tumor imaging can reduce myocardial uptake,thus facilitating detection of lesions near the heart.

Objective To investigate clinical value of pubococcygeal line (PCL) determined by dynamic magnetic resonance imaging (MRI) used in evaluating pelvic organ prolapse (POP), and investigate the relationship of pelvic organ prolapse quantitation (POP-Q) stage and pubococcygeal line (PCL) for the patient with POP. Methods Twenty patients with POP were evaluated by POP-Q stage and pelvic dynamic MRI examination simultaneously. Sagittal MRI images were acquired at rest and during maximal Valsalva using a fast gradient echo sequence two-dimensional fast low angle shot (FLASH) T1weighted image. The degree of prolapsed anterior vaginal wall, uterus and posterior vaginal wall were measured by PCL and compared with POP-Q system. Results There were 20 cases with cystocel diagnosed by POP-Q staging system, in which bladder neck or bladder base of 17 patients were under the PCL during maximum Valsalva. The concordance rate was 85% (17/20) between PCL and POP-Q stage. There were 19cases with rectocele diagnosed by POP-Q, in which the anorectal junction of 4 patients' PCL descent below more than 2. 5 cm. The concordance rate was 4/19 between PCL and POP-Q stage. There were 14 cases with uterine prolapse diagnosed by POP-Q staging system, in which uterine cervix of all descent below PCL. The concordance rate was 14/14 between PCL and POP-Q stage. However, it was noted that 5 cases did not reach POP-Q staging and their lowest uteri cervix were below or above PCL but less than 1 cm at maximal Valsalva. Conclusions Compared with POP-Q staging system, the reference line of PCL determined by dynamic MRI could diagnose uterine prolapse accurately and anterior vaginal wall with greater clinical value,however it was limited in diagnosing posterior vaginal wall prolapse effectively. Therefore, the clinical value of PCL should be further studied for evaluating POP.

Objective To establish and validate an ultra performance liquid chromatography-tandem mass spectrometric (UPLC-MS/MS)method for quantification of MRX-I,a new oxazolidinone antibacterial agent,in human plasma and urine.Methods Chromatographic separation was performed on a Waters ACQUITY UPLC BEH C8 column using an isocratic elution.The mo-bile phase consisted of acetonitrile and water (40∶60,v/v).Quantitative analysis was conducted in the multiple reaction moni-toring mode.Linezolid was used as an internal standard.Liquid-liquid extraction with ethyl acetate was used to remove impuri-ties in the plasma and urine samples.The method was validated in terms of matrix effect,recovery,precision,accuracy and stability.Results The calibration curves were linear within the range of 0.005 00-1 .00 mg/L.The lower limit of quantification was 0.005 00 mg/L for both plasma and urine samples.Retention time was less than 1 .5 min for both MRX-I and internal standard in plasma and urine.The ma-trix effect factors of plasma and urine for MRX-I was 90.4%±8.2% and 82.7%±7.9%,respectively.The recovery of MRX-I was 112.8% ± 13.4% from plasma and 105.6% ± 13.4% from urine samples,respectively.The inter- and intra-day accuracy of MRX-I was 98.9%-105.0% and 96.5%-102.6% in plasma samples,and 92.7%-98.6% and 95.1 %-105.7% in urine samples.MRX-I was stable for 24 h at room tem-perature,48 h in automatic sampler after pretreatment,and stable after 3 freeze-thaw cycles in plasma and urine.MRX-I was also stable at-40℃for eight months in plasma and six months in urine,respectively.Conclusions The UPLC-MS/MS method established in this study shows high sensitivity and specificity for determination of MRX-I in human plasma and urine.The re-sults of validation are consistent with the requirement of bioanalytical method validation.

Objective:To differentiate the methamphetamine users according to the developmental stages of addictive behavior, and explore the characteristics of different stages in order to provid a theoretical reference for our clinical intervention.Methods:Take the male methamphetamine users in compulsory detoxification institute whom were admitted from September 2018 to December 2019 as research objects.All the objects were asked to complete clinical diagnosis, interview and questionnaire evaluation in one week.According to the developmental stages of addictive behavior, the subjects were divided into occasional use group ( n=51), regular use group ( n=95) and compulsive use group ( n=157).All subjects were evaluated using visual analogue scale(VAS), Barrett impulsiveness scale(BIS)and CogState scale.SPSS 20.0 software was used for statistical analysis, AVOVA or Kruskal-Wallis H test was used for group comparison.Multiple Logistic regression analysis was used to explore the factors associated with the development of addictive behavior. Results:(1)The compulsive use group had higher cumulative duration(24(8, 48), 12(4, 24), 22(10, 36)), average dose(6.6±3.8, 2.8±1.4, 4.5±3.4) and craving score(1(0, 5), 0(0, 1), 1(0, 3)) than the other two groups(all P<0.05).And individuals in compulsive use group had more previous heroin use experience(20.4%, 9.8%, 14.8%, P<0.05).The regular use group had more withdrawal times than the other two groups(1(1, 3), 1(0, 1), 1(1, 2), P<0.05).The total scores of Barrett impulsiveness scale(42.8±13.3, 34.5±13.6, 36.1±14.9) and the scores in all dimensions in the compulsive use group were significantly higher than those in the other two groups(motor impulsiveness: 37.5±15.8, 27.8±13.4, 29.2±17.8; attentional impulsiveness: 43.2±18.0, 39.4±17.0, 37.2±18.1; non-planning impulsiveness: 47.2±19.8, 38.8±18.7, 40.7±20.8; P<0.05) .In the compulsive use users, the ISL(16.50±4.87, 19.30±4.78, 18.33±4.91) and SEC(0.76±0.21, 0.89±0.22, 0.81±0.21) scores about cognitive assessment were significantly lower than other two groups(both P<0.05).(2)The results of multiple Logistic regression analysis showed that cumulative duration ( β=0.022, OR=1.022, 95% CI: 1.003-1.042), dosage( β=0.625, OR=1.869, 95% CI: 1.196-2.921), craving ( β=0.194, OR=1.214, 95% CI: 1.002-1.215), the total scores of Barrett impulse scale( β=0.036, OR=1.037, 95% CI: 1.013-1.061), scores of non-planning impulsiveness( β=0.040, OR=1.041, 95% CI: 1.004-1.038), scores of motor impulsiveness( β=0.033, OR=1.214, 95% CI: 1.001-1.068) were associated with the periodic grouping of addictions. Conclusions:Addictive behavior is a progressive process and methamphetamine users at different stages have different characteristics in substance use, impulsiveness and cognitive function.The development of addictive behavior is associated with the time, dosage and craving of substance use, as well as the personality impulsivity of users.And the compulsive users suffered more cognitive impairment than the other two groups. The methamphetamine users should be identified dynamically and targeted therapeutic intervention measures should be carried out to block the addictive process to achieve the goal of harm reduction.