Objective To explore the impact of concentrated teaching, self-help training, intensive training, scenario simulation and other systemic training methods on the health teaching level of community health education staff,and the impact of community health education on cultivation of residents' health behavior before and after training. Methods 60 community doctors and nurses involved in systematic training. Taught concentrated 8 hours every week, and continuous for 4 weeks with medicine, psychology, sociology, pedagogy, aesthetics and production of courseware. Trainees who awarded 80 points or more in examination took part in simulated scene training, which completed a 30-minute design of concentrated health lesson and a 15-minute design of one to one health lesson in written form and multimedia teaching. Teaching effect-site was evaluated by the residents of the community lectures. The impact on cultivation of residents' behaviors was evaluated with ruler evaluation method.Results The community health care workers' teaching ability had significant change after training: plan design (2.32 ± 1.41 vs 4.26 ±0.61 ), lectures (2.63 ±0.89 vs 4.09 ±0.93), teaching skills ( 1.97 ± 1.32 vs 3.89 ±1. 13 ), teaching aids configuration ( 1.68 ± 1. 43 vs 3.97 ± 1. 26 ), educational methods ( 2.01 ± 0. 96 vs 4.03 ±0.82), time control (2.83 ±0.26 vs 4.67 ±0.25), the classroom atmosphere (2.78 ± 1. 13 vs 4.12 ±0.67),courseware ( 2.48 ± 1. 08 vs 3.89 ± 1.02 ) , teaching the image ( 2.15 ± 1.15 vs 4.06 ± 0.78 ), overall evaluation (2.36 ± 1.21 vs 4. 16 ± 0.65 )(P ＜ 0. 0 1 ). After training, community residents' knowledge on community health care workers' one to one health education and collective health education training, and positive evaluation of helpful to students' behavior improved significantly ( x2 = 17.19,36.37 ;8.91,20.98 ;34.14,32.29) ,and all had remarkable difference( all P＜0. 01 ). Evaluating the impact of health care workers' teach on cultivating residents'health behavior after one year, it improved significantly (P ＜ 0. 01 ). Conclusion Systemic training can improve health education ability of community medical staff and the impact on cultivating residents' health behavior is remarkable.

Objective To investigate the independent echocardiographic pathogenesis associated with left atrial spontaneous echo contrast(SEC) formation in patients with atrial fibrillation(AF).Methods Twenty-one patients with valvular AF and twenty-three patients with nonvalvular AF undergoing transthoracic and transesophageal echocardiography(TTE/TEE) were studied.Morphological and functional parameters of the heart in patients with AF were detected by TTE,while the sizes of the left atrial appendage(LAA),its Doppler flow patterns,Doppler flow patterns of the left upper pulmonary vein and integrated backscatter(IBS) values of left atrial SEC relative to those of the left ventricle were measured by TEE.Results There were the following 10 variables significantly associated with the left atrial SEC,some of which associated positively with SEC were left atrial diameter(r=(0.40252),P=(0.0061)),diameter of the open mouth of LAA to the left atrium(r=(0.37816),P=(0.0161)),while the others of which associated negatively with SEC were antegrade/retrograde blood flow velocity peak,integrate(RVi) and retrograde blood flow velocity mean(RVm) values,and S/D wave peak,S wave integrate(Is) and D wave mean(Md) values,their r values ranged from(-0.40379) to(-0.32832),their P values between(0.0018) and(0.0386).Collinearity analyses suggested that RVi,RVm,Is,Md represented completely all the blood flow velocity parameters of LAA and the left upper pulmonary vein,respectively.Multivariate analyses demonstrated that RVm and Md were the independent predictors of the left atrial SEC in patients with AF(both P

OBJECTIVETo explore the therapeutic effect and safety of fire needling on rat with rheumatoid arthritis.

METHODSForty female Wistar rats were randomly divided into a normal group, a model group, a methotrexate (MTX) group and a fire needling group, 10 rats in each group. The 0.1 mL of normal saline was subcutaneously injected in rat's right back paw in the normal group, while the other groups received subcutaneous injection of 0.1 mL of complete Freund's adjuvant to establish the model. The pricking method was applied in the fire needling group at "Jiaji" (EX-B 2), "Zusanli" (ST 36) and Ashi points with a depth of 5 mm, once every three days, and totally eight times were required. In the MTX group, with intragastric administration of 2.0 mg/kg per rat, the treatment was given once every seven days, and totally four times were required. The weight, swelling rate of foot, joint pain score and polyarthritis index of rats in each group as well as the pathological change of liver tissue under light microscope were observed.

RESULTSThe weight, swelling rate of foot, joint pain score and polyarthritis index in the model group were significantly higher than those in the normal group (P < 0.05, P < 0.01), after the treatment, the above-mentioned indexes in the two treatment groups were obviouly dereased as componed with those in the model group (all P < 0.01), and there were statistical differences between the fire needling group and MTX group (P < 0.05, P < 0.01). Compared with the normal group, inflammatory cells were appeared with a cluster distribution in the liver cells of rats in the model group. The inflammatory cells were reduced in the MTX group and fire needling group, and liver cells had degenerative edema and cell nucleus were largen and deformed in the MTX group.

CONCLUSIONThe fire needling has significant efficacy for rats with adjuvant arthritis (AA) without any damage to the liver, which coud have a better control of disease progression of rheumatoid arthritis .

Acupuncture Therapy ; adverse effects ; instrumentation ; methods ; Animals ; Arthritis, Rheumatoid ; therapy ; Female ; Humans ; Rats ; Rats, Wistar

Objective To explore the residual undifferentiated mouse embryonic stem cells (ESCs) in embryoid bodies. Methods Mouse R1 and Oct-4-GFP transgenic ESCs were firstly cultured in suspension to form embryoid bodies (EBs). Twenty days later, EBs were digested into single cells and then re-plated in standard ESC culture condition. The morphology of residual undifferentiated cells in EBs was observed, and surface makers and in vitro redifferentiation potency of residual cells were examined by flow cytometry and immunofluoreseent staining. The residual cells were expanded and subcutaneously injected into nude mice, and the specimens were harvested from the injection site for histological analysis 6 weeks after injection. Results There were residual undifferentiated ESCs in EBs differentiated for 20 days, which displayed clonal morphology and expressed undifferentiated cell markers of ESCs, including SSEA1, CD31, CD9 and Oct-4. The cells could be differentiated to form EBs again, and could be re-expanded from secondary EBs. The residual cells were able to form teratoma at the injection site, and mature endoderm, mesoderm and ectoderm tissues could be found in teratoma tissues. Conclusion There are residual undifferentiated ESCs after differentiation of ESCs into EBs. The residual ESCs can differentiate again in vitro and in vivo, and can residue again in the in vitro differentiation.

As a part of the project for the Chinese Pharmacopoeia (2015 edition), the quality standard of Sophora flavescens root extract was investigated and established. According to the methods described in the Appendix of Chinese Pharmacopoeia (2010 edition), the water and ash inspections were carried out. The marker components trifolirhizin, sophoraflavanone G, oxymatrine and oxysophocarpine in the samples were identified by qualitative TLC. The determination of oxymatrine, matrine, oxysophocarpine and sophocarpine was conducted by HPLC and the total flavonoids were measured by ultraviolet spectrophotometry, using sophoraflavanone G as reference substance. The results indicated the spots on the plate were clear with good resolution and the contents of oxymatrine, matrine, oxysophocarpine and sophocarpine in the 13 batches of the samples were 3.87% - 11.1%, 0.970% - 4.33%, 1.30% - 2.59% and 0.260% - 1.14%, respectively. The total flavoids in the 13 batches of the samples were 3.88% - 7.93%. In the study, the validated methods were reproducible and the established quality standard was feasible, which could be used for the quality control of S. flavescens root extract and related preparations.
Chromatography, High Pressure Liquid ; Flavonoids ; analysis ; Plant Extracts ; analysis ; Plant Roots ; chemistry ; Sophora ; chemistry

Objective To observe the coronary vessel lumen diameter and bifurcation angle in subjects with normal CT coronary angiography (CTCA) imaging.Methods64-row CT coronary angiography imaging from 526 adult people with excellent image quality and normal vascular image were analyzed in this study.The lumen diameter from the origin to distal with 2 mm lumen of left main coronary artery (LM),anterior descending branch (LAD),left circumflex branch (LCX) and right coronary artery (RCA) was measured at 1 cm interval in CPR image.The vascular tapered ratio was calculated.The bifurcation angle in the diagonal branch,obtuse marginal branch,posterior descending branch,acute marginal branch as well as the origin diameter was also measured in VR image.Results The LAD average length was 13 cm and lumen diameter was 3.92 mm at origin and 2.10 mm at distal.The average decremented ratio of LAD was 7.7％ ( male 7.0％,female 8.4％ ).The maximal decremented ratio 8.0％ -10.0％ occurred at 3 -5 cm apart from the origin of LAD.The LCX average length was 13 cm and lumen diameter was 3.57 mm at origin and 2.10 mm at distal.The average decremented ratio of LCX was 9.7％( male 9.6％,female 9.7％ ).Lumen decremented ratio was less than 3.0％ between origin and proximal 3 cm and 8.3％ - 10.7％ in the rest portion of the LCX.The RCA average length was 18 cm and lumen diameter was 3.97 mm at origin and 2.15 mm at distal.The average decremented ratio of RCA was 5.1％(male 4.9％,female 5.3％ ).The decremented ratio of RCR was less than 4.0％ between origin and proximal 10 cm and 6.1％ - 15.2％ in the rest portion.The bifurcation angle was 50,55,66 and 76 degree for LAD with diagonal branch,LCX with obtuse marginal branch,RCA with posterior descending branch and RCA with obtuse marginal branch respectively.Conclusion Coronary artery length,lumen diameter and decremented ratio as well as bifurcation angel could be identified in 64 row CTCA image in vivo.This information could help us to understand the in vivo coronary artery anatomy.

OBJECTIVETo determine the incidence and risk factors for in-hospital stroke in patients with acute myocardial infarction (AMI).

METHODSTwo thousand one hundred and thirty-three patients with acute myocardial infarction were studied retrospectively. History, demographic, clinical, thrombolytic and anticoagulant data of AMI were obtained through review of the medical record. The relative risk of in-hospital stroke in patients with AMI was estimated using multiple nonconditional logistic regression to adjust for potential confounding factors.

RESULTSAmong 2,133 consecutive patients admitted with acute myocardial infarction to hospitals in Shandong and Hubei provinces, 98 (4.59%) experienced strokes during hospitalization. In our analysis, anterior infarction was the most important risk factor for in-hospital stroke (ischemic and hemorrhagic) in patients with AMI (RR = 7.04), followed by history of hypertension (RR = 3.41), previous stroke (RR = 1.69), atrial fibrillation (RR = 2.22), advanced age (RR = 1.04), and higher heart rate at enrollment (RR = 1.03).

CONCLUSIONSThe incidence of in-hospital stroke in patients with AMI increased with lower rate of using thrombolytic agents. Thrombolytic therapy was noticed as a protective factor for stroke after AMI. The risk factors for in-hospital stroke with AMI were history of hypertension, previous stroke, atrial fibrillation, advanced age, anterior infarction, and higher heart rate at enrollment.

Adult ; Aged ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Multivariate Analysis ; Myocardial Infarction ; complications ; Risk Factors ; Stroke ; epidemiology ; etiology

BACKGROUND:There is a general consensus that patients undergoing joint arthroplasty surgery wil be in hypercoagulable state and easily to induce deep vein thrombosis. Thromboelastography is a new kind of method to monitor blood coagulation state, but not widely used in orthopaedics. No final conclusion has yet been reached on whether we can guide the clinical prevention of deep vein thrombosis and medication through using thromboelastography to monitor perioperative coagulation state of patients treated with joint arthroplasty. OBJECTIVE:To investigate the correlation between thromboelastography and routine coagulation functional tests, and evaluate the clinical application value of thromboelastography in monitoring the perioperative coagulation state of patients treated with joint arthroplasty.
METHODS:A total of 204 patients who treated with joint arthroplasty at First Affiliated Hospital of Soochow University from November 2014 to August 2015 were retrospectively analyzed. The thromboelastography, routine coagulation, platelet and other data before and after the replacement were respectively col ected. The correlative analysis was conducted between the thromboelastography result and the results of conventional coagulation test, that is, routine coagulation and platelet count. RESULTS AND CONCLUSION:In total knee arthroplasty group, activated partial thromboplastin time and reaction time showed good consistency (φ=0.713, Kappa value=0.647);Prothrombin time had moderate correlation and general consistency with reaction time (φ=0.392, Kappa value=0.362);Coagulation time and fibrinogen had moderate correlation and consistency (φ=0.392, Kappa value=0.488);Aggregates formation rate (αangle) and fibrinogen had moderate correlation and consistency;the remaining parameters had poor correlation and consistency. In total hip arthroplasty group, there was a weak correlation and consistency between the reaction time, activated partial thromboplastin time and prothrombin time;the other correlations were poor. However, there was a higher proportion of consistent clotting trend between some parameters of thrombelastography and routine coagulation. In total hip arthroplasty group, the consistent proportion of coagulation time and fibrinogen accounted for 67.6%;the consistent proportion of aggregates formation rate (αangle) and fibrinogen accounted for 78.3%. These results suggest that thromboelastography and routine coagulation tests have some correlations and consistency. Thromboelastography parameters have more consistent tendency on the data. Thrombelastography can serve as an auxiliary mean to monitor coagulation state of perioperative joint arthroplasty.

Objective To improve the patients' satisfaction to the nursing work through implementing the humanistic concern in nursing work. Methods We held some activities to provide the humanistic concern in nursing work, developed the educations to improve the professional quality of the nurses, constructed the criterion of civilized srvice, and strengthened the construction of nursing culture in the service demonstration ward. Meanwhile, we intensified the service ideas to create the harmonious patient-nurse relationships, the harmonious working settings, the harmonious treatment surroundings and the harmonious humanistic environment. Results The whole quality of the nurses was improved. especially the consciousness of active service. The relationship between nurses and patients was more harmonious, and the nursing quality and the degree of patients' satisfaction were elevated. Conclusions to implement the humanistic concern in nursing work is not only the base of building the harmonious relationships between patients and nurses. but also the guarantee of elevating the nursing quality and the degree of patients' satisfaction.

Objective To investigate the effect of osteoblast-derived exosome(Exo)mediating microRNA(miR)-494 on bone metabolism and bone remodeling balance in osteoporosis(OP)rats and its mechanism.Methods Exosomes was isolated and identified from MC3T3-E1 osteoblast cell line and transferred to Exo by electrical transfer.Forty SD rats were randomly divided into control,model,miR-494 mimic(miR-494),and miR-494 inhibitor group,10 rats in each group.The ovaries were removed to construct the OP model except the control group.After modeling,the miR-494 group and miR-494 inhibitor group received tail vein injections of exosomes containing the corresponding miRNA,at a dose of 3×109 particles.Four weeks later,bone parameters were detected in each group of rats by Micro-CT,serum bone markers were measured by ELISA,pathological changes in bone tissue were observed by HE staining,osteoclast numbers were detected by tartrate-resistant acid phosphatase(TRACP)staining,and the expression levels of bone remodeling-related proteins and toll-like receptor 4(TLR4)pathway-related proteins were determined by Western blotting.Results Typical cup-shaped or round exosomes were successfully isolated with a diameter of about 100 nm from MC3T3-E1 cells,which contained CD63,CD9,tumor susceptibility gene 101(TSG101),heat shock protein 70(HSP70)proteins and can be taken up by MC3T3-E1 cells.Compared with the model group,the bone parameters of the rats in the miR-494 mimic group decreased,serum bone markers bone Gla protein(BGP),TRACP,C-terminal telopeptide of type Ⅰ collagen(CTX-Ⅰ)increased,osteoprotegerin(OPG),procollagen type Ⅰ N-terminal propeptide(PⅠNP)decreased,bone trabeculae structure was disordered,osteoclasts increased,bone morphogenetic protein 2(BMP-2),Runt related transcription factor 2(RUNX2)in bone tissue downregulated,receptor activator of nuclear factor kappa-B ligand(RANKL)upregulated,TLR4,nuclear factor kappa-B p65(NF-κB p65)and myeloid differentiation primary response 88(MyD88)upregulated(all P＜0.05).In contrast,the situation of the miR-494 inhibitor group was opposite,bone parameters and OPG,PⅠNP increased,BGP,TRACP,CTX-Ⅰdecreased,bone structure returned to normal,osteoclasts decreased,BMP-2,RUNX2 in bone tissue upregulated,RANKL downregulated,TLR4,NF-κB p65 and MyD88 downregulated(all P＜0.05).Conclusion The transfer of miRNA-494 by Exo aggravates abnormal bone metabolism in OP rats and inhibits bone remodeling balance,suggesting that the mechanism of action may be related to the regulation of TLR4 pathway.