In order to study the rural elderly chronic patient's seeking healthcare behavior and its influencing factors, the paper uses the 2011 national baseline survey data of the “China Health and Retirement Longitudinal Study ( CHARLS)” and the Multinomial Logit model to conduct an empirical analysis .The study results show that:( 1 ) The rural elderly chronic patients are more likely to choose the county-level and above hospitals and village clin-ics instead of the township health centers .(2) The obvious influencing factors in the healthcare seeking behavior in-clude age , educational background , household per capita annual income , chronic disease severity , self-rated health and region.Therefore, the present study suggests that the treatment of chronic diseases does not transfer to the town -ship health centers .The township health centers should improve their chronic medical service abilities , and actively strengthen their functions in chronic diseases prevention and treatment .

Objective To investigate the low hemoglobin density (low haemoglobin density,LHD) and red blood cell volume distribution width (red blood cell volume distribution width,RDW) in iron deficiency anemia (iron-deficiency anemia,IDA)in children with the value of diagnosis and treatment.Methods From February 2016 to May 2017,in the Second People's Hospital of Longgang District in Shenzhen City,86 cases of children with iron deficiency anemia for IDA group,and 120 cases of healthy children (as the control group) at the same time were confirmed.Blood routine of children with IDA were detected before and after treatment hemoglobin concentration and the results were analyzed statistically.Results 120 cases of healthy children in the peripheral blood LHD value was 2.74 ％ ± 0.90 ％ and the boy was 3.07 ％ ± 0.81％,higher than that of 2.26 ％ ± 0.69 ％ of the girls.Between them,there was statistically significant difference (t=3.815,P＜0.05).The value of RDW was 12.37 ％ ± 2.84 ％,12.09 ％ ± 2.80 ％ for the boys and 12.56 ％ ± 2.87 ％ for the girls,there was no statistically significant difference between the them (t=0.517,P＞0.517).Before treatment,86 cases of children with IDA LHD and RDW values in peripheral blood were 30.67 ％ ± 20.12 ％ and 16.62 ％ ± 3.27 ％,significantly higher than the control group,the difference was statistically significant between (t=4.025 ～ 4.025,P＜0.05 ～ 0.01),and there was no statistically significant difference between male and female children (t =0.761 ～ 0.917,P＞ 0.05).After treatment L HD and RDW values were 10.65 ％ ± 8.92 ％ and 14.02 ％ ± 2.93 ％,significantlylower than before the treatment,between them was statistically significant difference (t=2.912～9.675,P＜0.05).Conclusion Children with iron deficiency anemia treatment before the LHD and RDW values significantly elevated in the blood,significantly decreased after treatment,the LHD and RDW values for diagnosis and treatment of children with iron deficiency anemia dynamic monitoring has certain application value,worthy of popularization and application.

Aim To study the proliferative effect of resveratrol pretreatment on oxygen-glucose deprivation/reoxygenation ( OGD/R ) injury of rat cortical neural stem cells ( NSCs ) in vitro. Methods Isolation and purification of NSCs in neonatal Sprague-Dawley( SD) rats were conducted by suspended cultivation. The third passage NSCs of adherent culture was cultured under oxygen and glucose deprivation for 150 min and reoxygenation for 24 h. The experimental subjects were divided into normal, control, ethanol and resveratrol pretreatment groups. Immunofluorescence was used to identify NSCs. Cell viability was detected with CCK-8 assay. Flow cytometry cell cycle and BrdU assay were used to measure cell proliferation. Results Cells both in suspended and adherent cultivation highly expressed neuroepithelial stem cell protein ( nestin ) . Compared with the control group, NSCs viabilities and prolifera-tion in resveratrol groups (1, 5, 20 μmol·L-1 ) were significantly heightened, and highest in the 5 μmol · L-1 resveratrol group ( P<0. 05 ) . Conclusion Res-veratrol pretreatment can reduce injury and promote proliferation of NSCs after oxygen-glucose deprivation /reoxygenation.

Background The rejection following keratoplasty still is a leading cause of corneal transplantation failure.Studies showed that the interleukin-22 (IL-22) ,one of the effector molecules of T helper cell 17 (Th17) participated on the rejection after heart,liver and bone marrow transplantation.However,the effect of IL-22 on corneal graft rejection is not well understood.Objective This study was to investigate the expression of IL-22 mRNA in the corneal grafts and the role of IL-22 in the immune rejection after corneal transplantation in rats.Methods Seventy-two Wistar rats were randomized into autologous keratoplasty group,allograft keratoplasty group and anti-rejection group,and other 4 normal Wistar rats served as normal control group.Autologous keratoplasty was operated on the Wistar rats of the autologous keratoplasty group,and allograft keratoplasty were carried out with the 24 SD rats as donors and 48 Wistar rats as recipients.Tobramycin and dexamethasone eye drops were topically administrated after autologous keratoplasty for 2 weeks in the anti-rejection group.The experimental eyes were examined by slit lamp microscope after surgery and graft survival was evaluated based on the rejection scoring criteria of Larkin.Intergroup accumulated survival rates of grafts were compared using Kaplan-Meier analysis.Histopathological examination of grafts was carried out in 5 and 14 days after operation respectively,and the related expression levels of IL-22 mRNA and aryl hydrocar-bon receptor (AhR) mRNA were carried out by real-time fluorescence quantitative PCR.The feeding and use of the experimental animals followed the Guangdong provincial regulations on the management of experimental animals.The experimental design was approved by the ethics committee of Southern Medical University.Results The median survival time of grafts in the allograft keratoplasty group was 10 days,and that in the anti-rejection group was 17 days,showing a significant survival extention in the anti-rejection group (x2=16.442,P =0.000).Significant differences were found among the 4 groups in the related expression levels of IL-22 mRNA in both 5 days and 14 days after surgery (postoperative 5 days : F=2.44,P =0.00;postoperative 14 days: F=267.92, P =0.00), and the related expression levels of IL-22 mRNA were remarkably higher in the allograft keratoplasty group than those in the anti-rejection group at different time points (postoperative 5 days :9.70±0.35 vs.0.46±0.21;postoperative 14 days : 23.12 ± 1.89 vs.3.14±0.94) (both at P＜0.05).The related expression levels of AhR mRNA in the grafts were considerably different among the 4 groups (postoperative 5 days : F =395.73, P =0.00;postoperative 14 days : F =942.37, P =0.00) , and the expression levels were significantly elevated in the allograft keratoplasty group compared with the anti-rejection group at various time points (postoperative 5 days:2.52±0.32 vs.1.89±0.10;postoperative 14 days:7.20±0.25 vs.2.60±0.17) (both at P＜0.05).Conclusions The expression level of IL-22 RNA up-regulates in the grafts with immuno-rejection.Topical administration of tobramycin and dexamethasone eye drops inhibits the rejection after keratoplasty.AhR plays a regulative role to the expression of IL-22 in rats after keratoplasty.

Objective To study the relationship between clinicopathological features and central lymph nodes metastasis in patients with papillary thyroid microcarcinoma(PTMC).Methods From Jan.2013 to Jun.2013,400 cases with PTMC in cN0 stage undergoing thyroidectomy and central neck dissection were collected.Results Univariate analysis showed that the rate of central lymph node metastasis in PTMC was 28.0％,nevertheless,the rate of central lymph node metastasis was 32.5％,42.6％,44.1％,33.3％,and 37.4％ respectively in patients aging below 45 years old,in male patients,in patients with extrathyroidal extension,in patients with tumor diameter larger than 5 mm and in patients with multifocality.Gender,age,extrathyroidal extension,tumor diameter,multifocality of patients had correlation with central lymph node metastasis.Multivariate binary logistic regression analysis revealed that the rate of lymph node metastasis significantly increased in cases of male,ageing below 45 years old,with extrathyroidal extension and multifocality(P ＜ 0.05).Conclusions The treatment for central lymph node metastasis of PTMC should be different considering elements including gender,age,multifocality of the tumor,and extrathyroidal extension.Prophylactic central lymphadenectomy should be performed when the primary lesion was resected.

Objective:To explore the related factors of postoperative adjuvant therapy for cervical cancer stagedⅠB1-ⅡA2 [according to 2018 International Federation of Gynecology and Obstetrics (FIGO) staging standard], and to establish a nomogram model to predict the risk of postoperative adjuvant therapy for locally advanced cervical cancer.Methods:A total of 714 patients with cervical squamous cell cancer staged FIGO ⅠB1-ⅡA2 treated by surgery in Anhui Provincial Hospital were selected as the research objects from January 2009 to December 2019, and their clinicopathological data were analyzed. Multiple logistic regression analysis was used to determine the influencing factors, and a nomogram model was established to predict the risk of postoperative adjuvant treatment of cervical cancer. The predictive performance of the model was evaluated with the consistency index (C-index), and the compliance of the model was evaluated with the calibration curve.Results:Univariate analysis suggested that postoperative adjuvant therapy for cervical cancer was associated with gravidity ( χ2=11.506, P=0.001), underlying disease (hypertension or diabetes) ( χ2=7.668, P=0.006), squamous cell cancer antigen (SCC-AG) level ( χ2=19.392, P<0.001), imaging risk factors ( χ2=16.392, P<0.001), FIGO stage ( χ2=25.686, P<0.001), tumor size ( χ2=9.392, P=0.025) and surgical path ( χ2=16.590, P<0.001). Multivariate logistic regression analysis suggested that the number of pregnancy >2 times ( OR=1.951, 95% CI: 1.355-2.808, P<0.001), SCC-Ag ≥1.5 μg/L ( OR=2.021, 95% CI: 1.444-2.829, P<0.001), FIGO stage ⅠB3-ⅡA2 [ⅠB3 ( OR=1.933, 95% CI: 1.139-3.282, P=0.015); ⅡA1 ( OR=2.723, 95% CI: 1.556-4.765, P<0.001); ⅡA2 ( OR=3.159, 95% CI: 1.502-6.646, P=0.002)], with underlying disease (hypertension or diabetes) ( OR=1.867, 95% CI: 1.051-3.318, P=0.033), imaging risk factors ( OR=1.997, 95% CI: 1.127-3.537, P=0.018), without neoadjuvant therapy [preoperative neoadjuvant therapy for 1 cycle ( OR=0.402, 95% CI: 0.207-0.783, P=0.007)] and laparoscopic surgery ( OR=2.177, 95% CI: 1.524-3.112, P<0.001) were independent influencing factors for postoperative adjuvant treatment of cervical cancer. Based on the screened variables, the nomogram model to predict the risk of postoperative adjuvant treatment for cervical cancer has good predictive performance (C-index was 0.702) and compliance. Conclusion:The number of pregnancy >2 times, SCC-Ag ≥1.5 μg/L, FIGO stage ⅠB3-ⅡA2, with underlying disease (hypertension or diabetes), imaging risk factors, without neoadjuvant therapy, and laparoscopic surgery are independent influencing factors for postoperative adjuvant treatment of cervical cancer. A nomogram model has been constructed to predict the risk of postoperative adjuvant therapy for locally advanced cerrical cancer, and it can provide evidence for clinical treatment selection.

OBJECTIVE: To investigate the self-management behaviors of patients with type 2 diabetes mellitus (DM) in a community and to explore the relationship between self-management behaviors and the glycemic control. METHODS: A total of 211 type 2 DM patients in a community were selected by stratified random sampling. Patients were grouped according to the scores of self-management behaviors. The fasting plasma glucose (FPG), 2 h postprandial plasma glucose (2hPG) and glycated hemoglobin (HbA1C) level were tested. The differences between groups and relationship between self-management behaviors and glycemic control were analyzed. RESULTS: Self-management behaviors of most patients were not effective, and 2hPG and HbA1C were affected by different levels of the self-management behaviors (P<0.05). The self-management behaviors were negatively related to FPG (r=-0.277, P=0.015), 2hPG (r=-0.453, P=0.001), and HbA1C (r=-0.435, P=0.001). Glycemic control of the patients whose course of disease was over 5 years was significantly different due to different self-management behaviors. FPG level of the patients was positively related to alimentary control. The 2hPG level of the patients was positively related to alimentary control, medication persistence, and blood glucose self-monitoring. The HbA1C level of the patients was positively related to alimentary control and medication persistence. The times the patients received DM education, the way to use insulin, and the disease course of the patients were important factors to affect self-management behaviors of type 2 DM in the community. CONCLUSION Self-management behaviors of type 2 DM patients in the community are not effective. Satisfactory self-management behaviors, specially the control of 2hPG and HbA1C are beneficial to glycemic control. We can improve the self-management behaviors in type 2 DM patients by paying attention to the disease course, the treatment method, and the contents and effect of DM education.
Adult ; Aged ; Aged, 80 and over ; Attitude to Health ; Blood Glucose ; metabolism ; Blood Glucose Self-Monitoring ; statistics & numerical data ; China ; Community Networks ; Diabetes Mellitus, Type 2 ; blood ; psychology ; therapy ; Diet, Diabetic ; methods ; psychology ; Female ; Glycated Hemoglobin A ; analysis ; Humans ; Male ; Middle Aged ; Patient Education as Topic ; Self Care ; methods ; psychology ; Surveys and Questionnaires ; Young Adult

OBJECTIVE To investigate the causes of fever and risk factors in portal hypertensive patients after combined operation(devascularization+shunt).METHODS Forty five cases of portal hypertension(PHT) after combined operation were retrospectively and prospectively analyzed.RESULTS Complications caused 88% post operational fever.The most common cause was hydrothorax,hematocele or hydrops and infection in splenic recess.Long-term fever was related to liver function(P

Aim To investigate the effect of resveratrol on astrocyte activation after cerebral ischemia/reperfusion injury in rats.Methods 45 male Sprague-Dawley rats were divided into sham,control and resveratrol groups, 15 rats in each group.Resveratrol or solvent was intra-peritoneally perfused into the rats for 7 consecutive days after 3h for MCA I /R.Cerebral infarction volume with TTC,neurological function score with Longa score, and pathological change with HE staining,the protein expressions of Caspase-3 with immunohistochemistry at 24h after MCA I /R were examined.The protein ex-pressions of GFAP and NeuN in penumbra were detec-ted with immunohistochemistry and immunofluores-cence at 14d after MCA I /R.Results Resveratrol treatment significantly improved the neurological func-tion score,decreased the infarct volume,reduced neu-ron loss,and inhibited the activation and proliferation of astrocytes,compared with the control group.Con-clusion Resveratrol can inhibit the excessive activa-tion of astrocytes,protect neurons in penumbra and im-prove neurological function.

Objective To make students at different levels not only learn theoretical knowledge of acupuncture-moxibustion manipulation skills but also achieve full operating training, strengthen the combination of theory and practice and improve the teaching quality of clinical disciplines by applyingmultimedia-subject participationteaching method to acupuncture-moxibustion manipulation techniques in the experimental teaching of acupuncture and moxibustion. Method The students were randomized, according to grade, into experiment (n=114) and control (n=115) groups. The teaching content was the same in the two groups. The experiment group received multimedia-subject participationteaching method. After the multimedia teaching, the students did an independent demonstration and made a self-evaluation, the teachers made a comment and the students did independent practice again in groups. The control group received conventional theory teaching and did practice under demonstration in the experimental lesson. The examination and questionnaire were used as assessment indicators to evaluate the effect ofmultimedia-subject participationteaching method applied to acupuncture-moxibustion technique teaching. Result Statistical analysis was made using the SPSS11.5 statistical software package. The independent samples t-test is used for a between-groups comparison. The statistical result showed that satisfaction was 100%in the experiment group and 75.7%in the control group;there was a statistically significant difference between the two groups (P<0.05). Conclusion Multimedia-subject participationteaching method is an innovation in acupuncture-moxibustion technique teaching and helps the students to better master acupuncture-moxibustion manipulation skills. Mastery of theoretical knowledge before real practice is the key to proficient manipulation. The combination of the two in classroom teaching yields twice the result with half the effort. Carrying out multimedia-subject participation teaching method will help to further deepen the teaching reform and to improve the level and quality of“Acupuncture and Moxibustion”teaching.