ObjectiveTo explore the effects of hyperbaric oxygen (HBO) on severe brain injury. Methods60 patients with severe brain injury were divided into control group and treatment group. They were treated with neurosurgical conventional therapy, and HBO for treatment group in addition. They were assessed with Glasgow Coma Scale (GCS) before and after treatment, and Glasgow Outcome Scale (GOS) 3 and 6 months after treatment. ResultsCompared with control group, there is significant improvement in GCS (P<0.05) and GOS (P<0.05) in treatment group. ConclusionHBO has immediate and long-term efficiency on severe brain injury.

Objective To explore the change of cerebral microcirculation before and after clipping of intracranial aneurysm using CT perfusion (CTP)imaging.Methods CTP images of 70 patients diagnosed intracranial aneurysm by CTA were retrospectively an-alysed.They were divided into four groups according to have or not intracranial arterial spasm:A group:Preoperative CVS,postop-erative CVS (4 cases),B group:Preoperative CVS,postoperative nCVS (13 cases),C group:Preoperative nCVS,postoperative CVS (20 cases),D group:Preoperative nCVS,postoperative nCVS (33 cases).CBV/CBF/MTT were measured in four groups be-fore and after surgery,and analyzed statistically.Results (1)The postoperative CBV/CBF/MTT was compared with the preopera-tive data.There were statistically significant in CBVA/B/C/D/CBFA/B/D/MTTA/B during the surgery (P <0.05 ).There were no statistically significant in the CBFC and MTTC/D during the surgery (P >0.05).(2)There were statistically significant in the△CBVBC/BD/△CBFAB/BC/BD/△MTTAB/BD (P < 0.05 ).△CBVAB/AC/AD/CD/△CBFAC/AD/CD/△MTTAC/AD/BC/CD were no statistically significant (P >0.05).Conclusion CTP can early and accurately predict the change of cerebral microcircu-lation after surgery.

Objective To develop and validate the Knowledge-Attitude-Practice Scale for Prevention of Occupational Low Back Pain for Nurses (hereinafter referred to as KAP). Methods Based on the knowledge, attitudes and practice theory, a list of 48 potential items were developed by reviewing literatures related to the prevention of occupational low back pain in nurses. The Delphi expert consultation method was used to conduct two rounds of consultation on the items, and the KAP (draft) with 31 items was formed. A total of 269 nurses in a hospital in Guangdong Province were selected as study subjects by convenience sampling method and investigated with the KAP (draft). The list was selected and its validity tested using SPSS 25.0 software. Results The authority degrees of two rounds of expert consultation were 0.919 and 0.922. All of the recovery rates of valid questionnaires were >80.0%, with the coefficients of variation ranged from 0.07 to 0.40 and 0.05 to 0.28. The Kendall's concordance coefficients were 0.198 and 0.274, respectively (all P<0.05). After item selection, five items were removed, resulting in the KAP with 28-item including three dimensions： knowledge, attitude and behavior. The scale-level content validity index/average was 0.976, and the item-level content validity index ranged from 0.833 to 1.000, as assessed by experts. The scale demonstrated 100.0% for convergent and discriminative validity of the three dimensions. The exploratory factor analysis revealed three factors with a cumulative variance contribution rate of 51.0%. Cronbach's alpha coefficients for the overall scale and knowledge, attitude, and behavior dimensions were 0.880, 0.878, 0.895, and 0.877, respectively. Split-half reliability coefficients were 0.922, 0.863, 0.852, and 0.820, respectively. Conclusion The KAP shows good reliability and validity and can be used to assess knowledge, attitude and practice levels related to occupational low back pain prevention among nurses.

Objective:To evaluate the effect of regulation of zinc finger protein 281 (ZNF281) expression by miR-203 on the proliferation and migration of melanoma cell lines.Methods:The human vascular endothelial cell line ECV304, as well as human melanoma cell lines A375, M14, SK-MEL-28 and SK-MEL-2 were subjected to conventional culture. Real-time fluorescence-based quantitative PCR was performed to measure the miR-203 expression, and Western blot analysis to determine the ZNF281 protein expression in the above cell lines. Both A375 and M14 cells were divided into 5 groups: control group (normally cultured) , miR-203 mimic control group transfected with the miR-203 mimic negative control, miR-203 inhibitor control group transfected with the miR-203 inhibitor negative control, miR-203 mimic group transfected with a miR-203 mimic, miR-203 inhibitor group transfected with a miR-203 inhibitor. Real-time fluorescence-based quantitative PCR was conducted to measure intracellular miR-203 expression, cell counting kit (CCK) -8 assay to assess cellular proliferation activity, Transwell assay to determine the number of migratory cells, and Western blot analysis to measure the protein expression of ZNF281 in A375 and M14 cells in the above groups. Dual-luciferase reporter assay was conducted to verify the targeting relationship between miR-203 and ZNF281. One-way analysis of variance was used for comparison of multiple groups, and the Student-Newman-Keuls- q (SNK- q) test for multiple comparisons. Results:Lower miR-203 expression and higher ZNF281 protein expression were observed in the melanoma cell lines A375, M14, SK-MEL-28, SK-MEL-2 compared with the vascular endothelial cell line ECV304 (all P < 0.05) . Compared with the control group, miR-203 mimic control group and miR-203 inhibitor control group, the miR-203 mimic group showed significantly increased miR-203 expression in A375 and M14 cells ( F = 487.632, 68.454, respectively, both P < 0.05) , significantly decreased number of migratory A375 and M14 cells (both P < 0.05) , and significantly decreased ZNF281 protein expression (both P < 0.05) , while the miR-203 inhibitor group showed significantly decreased miR-203 expression in A375 and M14 cells (both P < 0.05) , significantly increased number of migratory A375 and M14 cells (both P < 0.05) , significantly increased ZNF281 protein expression in A375 cells ( P < 0.05) , significantly increased proliferative activity of A375 cells at 36, 48, 60 and 72 hours (all P < 0.05) , and significantly increased proliferative activity of M14 cells at 24, 36, 48, 60 and 72 hours (all P < 0.05) . Dual-luciferase reporter assay showed interaction sites between miR-203 and ZNF281. Conclusion:Up-regulating the miR-203 expression can inhibit the proliferation and migration of melanoma cell lines, and vice versa, likely by regulating the expression of ZNF281.

ObjectiveToinvestigate the prevalence, awareness and risk factors of chronic kidney disease (CKD) among community adult population in Shanghai, China, in order to provide early diagnosis and treatment of CKD, and informations for national health policy makers.MethodsTwo thousand five hundred and ninety six residents (≥ 18 years old) were randomly selected from community population in Changning district of Shanghai, China. They were interviewed and tested for albuminuria -morning spot urine albumin to creatinine ratio [ACR, abnormal: ≥ 17 mg/g (male), ≥25 mg/g (female)], reduced renal function-estimated GFR by abbreviated MDRD equation [abnormal: <60 ml ·rain-1 (1.73 m2)-1] and hematuria-morning spot urine dipstick confirmed by urine microscopy. The associations among demographic characteristics, healthy characteristics (e.g. diabetes and hypertension) and indicators of kidney damage were examined. The investigators and neighborhood committee were well trained. Those who had semiquantitative positive were detected again by albuminuria-morniag spot urine albumin to creatinine ratio after three months. ResultsTwo thousand five hundred and fifty four residents with complete data were enrolled in the study. Albuminuria was detected in 6.3% of subjects, reduced renal function in 5.8%, hematuria in 1.2%. Approximately 11.8% of these subjects had at least one indicator of kidney damage. The awareness rate of CKD was 8.2%. The Logistic regression model showed that hyperuricemia, nephrolithiasis, anemia, diabetes, central obesity, hypertension and age contributed to the development of CKD. ConclusionsThe prevalence of CKD in community adult population in Shanghai is 11.8%, And the awareness rate of CKD is 8.2%. Hyperuricemia, nephrolithiasis, anemia, diabetes, central obesity, hypertension and age are risk factors of CKD.

Objective To investigate the application effect of the sandwich teaching method in the course of Surgical Nursing . Methods Two classes of the students majoring in nursing were randomly divided into control group and observation group, with 36 students in each group. The students in the control group received the traditional teaching method, and those in the observation group received the sandwich teaching method . The teaching effect was compared between the two groups by theoretical assessment and questionnaire survey. SPSS 24.0 was used for analysis of variance and the t-test. Results Compared with the control group, the observation group had significantly higher scores of course assessment, learning atmosphere, and learning initiative. The observation group also had significantly higher good rates of learning atmosphere and learning initiative than the control group(P<0.05). Conclusion The sandwich teaching method can significantly improve students' abilities of communication and problem solving, arouse their enthusiasm of learning, and increase the interestingness of classroom, and therefore, it has a practical value in teaching.

Objective:To investigate the clinical efficacy of ear acupoint pressing beans combined with escitalopram tablets in the treatment of depression.Methods:A total of 100 patients with depression who received treatment in the Department of Psychiatrics, The Third People's Hospital of Yongkang from October 2021 to February 2023 were included in this randomized controlled study. These patients were randomly divided into a control group and an observation group, with 50 patients in each group, using a random number table method. The control group was treated with escitalopram tablets, while the observation group was treated with ear acupoint pressing beans combined with escitalopram tablets. The two groups were treated for 8 weeks. Hamilton Depression Scale (HAMD), traditional Chinese medicine syndrome scores, Pittsburgh Sleep Quality Index (PSQI), serotonin levels, clinical efficacy, and adverse reactions were recorded in each group.Results:After treatment, the HAMD scores in each group were significantly decreased compared with those before treatment (both P < 0.001). After treatment, the HAMD scores in the observation group were significantly lower than those in the control group [(15.89 ± 1.08) points vs. (19.24 ± 1.27) points, t = 14.21, P < 0.001]. After treatment, the traditional Chinese medicine syndrome scores in each group were significantly lower than those before treatment (both P < 0.001). After treatment, the traditional Chinese medicine syndrome scores in the observation group were significantly lower than those in the control group [(6.83 ± 1.24) points vs. (9.78 ± 1.80) points, t = 9.54, P < 0.001]. After treatment, the PSQI scores in each group were significantly decreased compared with those before treatment (both P < 0.001). After treatment, the PSQI scores in the observation group were significantly lower than those in the control group [(7.00 ± 1.34) points vs. (9.48 ± 1.82) points, t = 7.76, P < 0.001]. After treatment, the levels of serotonin in each group were significantly decreased compared with those before treatment (both P < 0.001). The levels of serotonin in the observation group were significantly higher than those in the control group [(40.65 ± 5.37) μg/L vs. (32.52 ± 4.20) μg/L, t = 8.43, P < 0.001]. The total effective rate in the observation group was significantly higher than that in the control group [94% (47/50) vs. 80% (40/50), χ2= 4.33, P = 0.037]. The incidence of adverse reactions in the observation group was significantly lower than that in the control group [8% (4/50) vs. 10% (5/50), χ2= 0.12, P = 0.727]. Conclusion:The combination of ear acupoint pressing beans and escitalopram tablets shows good clinical efficacy in the treatment of depression. This combined therapy can reduce symptoms, improve sleep quality, increase serotonin levels and also has fewer adverse reactions, making it a worthy candidate for clinical promotion.

Objective To evaluate the efficacy of chemical thoracic sympathetic nerve modulation combined with pulsed radiofrequency in treating upper limb postherpetic neuralgia ( PHN). Methods Forty-two patients of both sexes with upper limb PHN, aged 48-75 yr, were divided into 2 groups ( n=21 each) using a random number table method: chemical thoracic sympathetic nerve modulation combined with pulsed radiofrequency group ( TSNM+PR group) and pulsed radiofrequency group ( PR group) . TSNM+PR group was treated using chemical thoracic sympathetic nerve modulation combined with pulsed radiofrequen-cy, and PR group received pulsed radiofrequency alone. The occurrence of treatment-related adverse reac-tions was recorded. Numeric rating scale scores were recorded preoperatively and at 1 day and 1 and 3 months after operation, and the efficacy was graded. The effective treatment and pain recurrence were re-corded 3 months after operation. Quantitative sensory nerve tests were performed to record the current per-ception threshold before operation and on 1 day, 1 month and 3 months after operation. Results Compared with PR group, numeric rating scale score was significantly decreased, the therapeutic effect was en-hanced, the rate of effective treatment was increased, the recurrence rate of pain was decreased at 1 and 3 months after surgery, the current perception threshold at 250 and 5 Hz on the ipsilateral side was increased at 1 and 3 months after surgery in TSNM+PR group ( P<0. 05) . No treatment-related adverse reactions were found in two groups. Conclusion Chemical thoracic sympathetic nerve modulation combined with pulsed radiofrequency provides reliable therapeutic effect and higher safety for upper limb PHN.

Objective:To determine the influences of structural changes after valgus impacted femoral neck fracture on hip range of motion (ROM) so as to provide evidence for clinical judgment of whether reduction is necessary or not in the internal fixation of such fractures.Methods:1. 3D reconstructions of the CT hip scans were performed for the 73 patients who had been treated at Department of Orthopaedic Surgery, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University for valgus impacted femoral neck fractures from January 2019 to April 2019.The femoral neck-shaft angle, anteversion angle, femoral offset, axial alpha angle, lateral center edge angle (LCEA), anterior center edge angle (ACEA) and center displacement were measured and compared between the affected and healthy sides to determine the influences of the fracture on the above indexes. 2. Hip motions (flexion and MIR-90°) were simulated on bilateral sides to determine the influences of structural changes after fracture on hip ROM using stepwise regression and Logistic regression. 3. The distribution of femoral-acetabular contact points on the femoral side was observed in simulation of hip flexion to detect the potential area for femoracetabular impingement (FAI) induced by the fracture displacement.Results:1. The valgus impacted femoral neck fractures had significant influences on femoral neck-shaft angle, anteversion angle, femoral offset and axial alpha angle. Compared with the healthy side, on average, the femoral neck-shaft angle increased by 5.1°, anteversion angle decreased by 6.5°, femoral offset decreased by 8.2 mm and axial alpha angle increased by 9.7° on the affected side, showing significant differences ( P<0.05).The displacements of the femoral head center averaged 9.2 mm. There was no significant difference in LCEA or ACEA between the affected and healthy sides ( P>0.05). 2. Compared with the healthy side, on average, the simulated hip flexion decreased significantly by 27.0° and the hip MIR-90° decreased significantly by 20.3° on the affected side after fracture ( P<0.05). Regression analysis showed that femoral anteversion angle, ACEA and displacement of the femoral head center had a significant influence on hip ROM, especially the anteversion angle. When the anteversion angle decreased by more than 7.1°, the hip flexion would decrease by at least 20%. 3. The points of FAI distributed more widely on the fracture side. Compared with the healthy side, the impact points extended outward and upward in hip flexion and extended inwardly in hip MIR-90° on the affected side. Conclusions:After a valgus impacted femoral neck fracture, if the femoral anteversion angle has been decreased by more than 7.1°, the hip ROM can be greatly influenced and the points of FAI can be distributed more widely. Therefore, reduction should be recommended before internal fixation of the fracture.

Objective To provide reference for clinical pharmacists to participate in rational drug use through case study. Methods Clinical pharmacists participated in the optimization of treatment plan and performed pharmaceutical care for the patients according to their own characteristics, drug interactions, compatibility contraindications and adverse drug reactions. Results Clinical pharmacists provided pharmaceutical care for the patients with cerebrovascular diseases, Parkinson's disease, encephalitis and other diseases in the Department of Neurology by using pharmaceutical expertise, retrieved evidence-based support from literature and participating in the formulation of treatment plans. Those achieved individualized drug treatment, improve patient compliance, reduced the occurrence of unreasonable usage and dosage, inappropriate drug combination and improper drug selection, the treatment of adverse drug reactions, drug safety, and rational drug use. Conclusion Clinical pharmacists need to use their sound professional ability and good communication skills to help doctors make individualized drug delivery plans to ensure the safety, effectiveness and economy of drug treatment.