PURPOSE: To investigate the incidence and influencing factors of bone loss in patients with spinal cord injury (SCI). METHODS: A retrospective case-control study was conducted. Patients with SCI in our hospital from January 2019 to March 2023 were collected. According to the correlation between bone mineral density (BMD) at different sites, the patients were divided into the lumbar spine group and the hip joint group. According to the BMD value, the patients were divided into the normal bone mass group (t > -1.0 standard deviation) and the osteopenia group (t ≤ -1.0 standard deviation). The influencing factors accumulated as follows: gender, age, height, weight, cause of injury, injury segment, injury degree, time after injury, start time of rehabilitation, motor score, sensory score, spasticity, serum value of alkaline phosphatase, calcium, and phosphorus. The trend chart was drawn and the influencing factors were analyzed. SPSS 26.0 was used for statistical analysis. Correlation analysis was used to test the correlation between the BMD values of the lumbar spine and bilateral hips. Binary logistic regression analysis was used to explore the influencing factors of osteoporosis after SCI. p < 0.05 was considered statistically significant. RESULTS: The incidence of bone loss in patients with SCI was 66.3%. There was a low concordance between bone loss in the lumbar spine and the hip, and the hip was particularly susceptible to bone loss after SCI, with an upward trend in incidence (36% - 82%). In this study, patients with SCI were divided into the lumbar spine group (n = 100) and the hip group (n = 185) according to the BMD values of different sites. Then, the lumbar spine group was divided into the normal bone mass group (n = 53) and the osteopenia group (n = 47); the hip joint group was divided into the normal bone mass group (n = 83) and the osteopenia group (n = 102). Of these, lumbar bone loss after SCI is correlated with gender and weight (p = 0.032 and < 0.001, respectively), and hip bone loss is correlated with gender, height, weight, and time since injury (p < 0.001, p = 0.015, 0.009, and 0.012, respectively). CONCLUSIONS The incidence of bone loss after SCI was high, especially in the hip. The incidence and influencing factors of bone loss in the lumbar spine and hip were different. Patients with SCI who are male, low height, lightweight, and long time after injury were more likely to have bone loss.
Humans ; Spinal Cord Injuries/complications* ; Male ; Female ; Retrospective Studies ; Incidence ; Adult ; Bone Density ; Middle Aged ; Case-Control Studies ; Osteoporosis/etiology* ; Lumbar Vertebrae ; Bone Diseases, Metabolic/etiology* ; Aged ; Risk Factors

Objective:To isolate and purify the chemical constituents from Goodyera schlechtendaliana, and lay a foundation for further research on the effective materials of the plant. Method:The dried grass of G. schlechtendaliana(10 kg)was heated by 95% EtOH for reflux extraction for 4 times at 85℃. The extract liquids were combined, decompressed and concentrated to obtain the crude extract. The crude extract was then suspended in distilled water and extracted with petroleum ether,EtOAc and n-BuOH in turn to obtain corresponding fractions. Silica gel,Sephadex LH-20,ODS and semi-preparation high performance liquid chromatography (HPLC) were used for the separation and purification of EtOAc and n-BuOH fractions. The structures of compounds obtained were identified by ¹H-NMR,¹³C-NMR,MS,physicochemical properties and reference literature. Result:Ten compounds were isolated and identified as 2,5-dihydroxy-4-methoxy-9,10-dihydroxyphenanthrene (1),1,3,5-trimethoxybenzene (2),protocatechuic acid (3),p-hydroxybenzaldehyde (4),p-hydroxybenzoic acid (5),quercetin (6),vanillin(7),daucosterol (8),adenine (9) and adenosine (10). Conclusion:Compounds 1-10 were obtained from the genus of Goodyera for the first time.

Objective:This paper summarizes the practical problems encountered in the implementation of the tuition-free medical students' policyin rural areas of Sichuan Province, and provides a reference for the implementation of this policy across the province. Methods :Semi-structured interviews were conducted with the principals of the orientation management policies of the health administrative departments and county level and primary health care in-stitutionsin Sichuan, and the focus group interviews were used to understand the dynamics of directed students. Results :The survey results showed that there were limited channels for students to understand the policy ; students' barren understanding of the work of grass-roots doctors ; credit and integrity files played a relatively low role in retaining medical talent students;the willingness of orientation students is higher, but there is a contradiction between applying for graduate students and retaining grassroots in rural areas ; and the relevant departments lacked a rational and efficient management mode for students. Conclusions :In order to ameliorate the construction of rural health human resources,policy administrators should place their emphasis on cultivating the sense of honor and responsibility in the rural-oriented tuition-free medical students'policy, improve the reward and punishment mechanism in policies, optimize the management and assessment process, and promote the orientation of the work among the various policy-participating departments in a more harmonious and orderly manner.

BACKGROUNDPlatelet function tests are widely used in clinical practice to guide personalized antiplatelet therapy. In China, the thromboelastography (TEG) test has been well accepted in clinics, whereas VerifyNow, mainly used for scientific research, has not been used in routine clinical practice. The aim of the current study was to compare these two point-of-care platelet function tests and to analyze the consistency between the two tests for evaluating on-clopidogrel platelet reactivity in Chinese acute myocardial infarction patients undergoing percutaneous coronary intervention (PCI).

METHODSA total of 184 patients admitted to Fuwai Hospital between August 2014 and May 2015 were enrolled in the study. On-clopidogrel platelet reactivity was assessed 3 days after PCI by TEG and VerifyNow using adenosine diphosphate as an agonist. Based on the previous reports, an inhibition of platelet aggregation (IPA) <30% for TEG or a P2Y12 reaction unit (PRU) >230 for VerifyNow was defined as high on-clopidogrel platelet reactivity (HPR). An IPA >70% or a PRU <178 was defined as low on-clopidogrel platelet reactivity (LPR). Correlation and agreement between the two methods were analyzed using the Spearman correlation coefficient (r) and kappa value (κ), respectively.

RESULTSOur results showed that VerifyNow and TEG had a moderate but significant correlation in evaluating platelet reactivity (r = -0.511). A significant although poor agreement (κ = 0.225) in identifying HPR and a significantly moderate agreement in identifying LPR (κ = 0.412) were observed between TEG and VerifyNow. By using TEG as the reference for comparison, the cutoff values of VerifyNow for the Chinese patients in this study were identified as PRU >205 for HPR and PRU <169 for LPR.

CONCLUSIONSBy comparing VerifyNow to TEG which has been widely used in clinics, VerifyNow could be an attractive alternative to TEG for monitoring on-clopidogrel platelet reactivity in Chinese patients.

Adenosine Diphosphate ; therapeutic use ; Aged ; Aspirin ; therapeutic use ; Blood Platelets ; drug effects ; China ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; drug therapy ; surgery ; Percutaneous Coronary Intervention ; methods ; Platelet Aggregation ; drug effects ; Platelet Aggregation Inhibitors ; therapeutic use ; Point-of-Care Systems ; Receptors, Purinergic P2Y12 ; metabolism ; Thrombelastography ; Ticlopidine ; analogs & derivatives ; therapeutic use

To evaluate the anti-HIV-1 activities of 5 benzophenones non-nucleoside reverse transcriptase inhibitors (NNRTIs) such as DY1203, DY1204, DY1119, DY1208 and DY1209 in vitro, the cytotoxicity of 5 compounds were tested on C8166, MT-4, H9 and PBMC with the MTT assay. The anti-HIV-1 activities of compounds were evaluated on laboratory-adapted strain, drug-resistant strains and primary isolated strains by p24 antigen expression ELISA. The inhibition of HIV-1 recombinant reverse transcriptase activity was assessed by ELISA assay. Among 5 compounds, DY1203 and DY1204 showed low cytotoxicities with CC₅₀ greater than 200 μg·mL^-1. DY1119, DY1208 and DY1209 showed strong anti-HIV-1 activities against HIV-1_IIIB, HIV-1_74V, HIV-1_RF/V82F/184V, HIV-1_{NL4-3 gp41(36G) N42S}, HIV-1_KM018, HIV-1_TC-1 and HIV-1_Wan. However, NNRTIs drug-resistant strain HIV-1_A17 showed different resistance to these compounds. The 5 compounds proved active against HIV-1 recombinant reverse transcriptase. DY1208 is expected to become a new lead compound for its high therapeutic index. The results can provide new information for HIV-1 drug research and promote the development of new HIV-1 drugs.

Objective To learn the willingness to engage in elderly care among nursing students in junior college in order to provide the basis for the training of geriatric nursing staff.Methods Totally 1 1 76 junior college nursing students in Ningbo were selected by stratified sampling method and were investigated with a questionnaire based on the theory of planned behavior.The willingness and plan to engage in elderly care among the students were analyzed.Results Fifty six percent of the nursing students would like to work in geriatric nursing.The average score of behavioral attitude,subjective norm,and perceived behavior control were (52.1 2 ±9.52),(1 6.42 ±6.21 ),and (31 .54 ±7.94).The regression analysis showed that the score of behavior attitude (β=0.1 8),subjective norm (β=0.35 ),and perceived behavior control (β=0.25 )were the factors influencing the willingness to work in geriatric nursing.Different major,grade, experience in elderly care and knowledge had different attitude and behavior in the willingness to engage in elderly care work(P <0.05).There were positive correlations among behavioral attitude,subjective norm,perceived behavior control and behavior intention (P <0.01 )Conclusion The investigation suggested that training nursing staff achievements previews in this area.Nursing students in higher vocational colleges have good professional intention in the work of geriatric nursing work.

Objective To investigate the impact of cytochrome P450 (CYP) 2C19 681G>A polymorphism on long-term prognosis of clopidogrel-treated Chinese patients after percutaneous coronary intervention (PCI).Methods Between January 1, 2009 and August 31,2009, 267 patients with coronary heart disease who received PCI and treated with clopidogrel for 12 months were enrolled. CYP2C19*2 was detected by MALDI-TOF MS and patients were grouped into CYP2C19*1/*1(n=130) and CYP2C19*2 carriers group (n=137). Follow-up was 12 months. The primary endpoint was angina recurrence, urgent coronary revascularization, acute myocardial infarction, stent thrombosis, death and the combined end points. Results Baseline data were similar between two groups (P>0.05).Urgent coronary revascularization and the combined end points occurred more frequently in CYP2C19*2 carriers than in CYP2C19*1/*1 patients (7.3% vs. 1.5% and 8.0% vs. 2.3% respectively,all P<0.05). But incidence of angina recurrence, acute myocardial infarction, stent thrombosis and death was similar between two groups (all P>0.05).Hazard risk of 1 year cumulative survival of CYP2C19*2 carriers group was significantly higher than CYP2C19*1/*1 group after PCI (HR=3.59, 95%CI: 1.02-12.87, P<0.05). Conclusion CYP2C19 681G>A polymorphism is a determinant of prognosis in coronary heart disease patients receiving chronic clopidogrel treatment after PCI.

OBJECTIVETo assess the efficacy of Mytrolimus (CCI-779), a derivative of rapamycin, eluting stents in preventing restenosis in the porcine model.

METHODSThe bare stents (n = 10), stents coated with polyolefin (n = 10) or stents coated with Mytrolimus (160 microg/18 mm) in polyolefin (n = 8) were implanted in left anterior descending coronary arteries or right coronary artery of mini-swine. Coronary angiography was performed after 4 weeks then the animals were sacrificed. The cross sections of the stented coronary arteries were analyzed, the injury score, luminal area, neointimal thickness above the struts and between the struts of stents, neointimal area and percentage of restenosis were measured.

RESULTSThe mean injury scores and luminal area were similar in three groups. There was no difference in above-stated items between the polyolefin coating stent and bare mental stent. To compare Mytrolimus-eluting stent with bare-stent, neointimal thickness above the struts [(0.18 +/- 0.08) mm vs (0.33 +/- 0.25) mm, P < 0.05] and between the struts [(0.14 +/- 0.05) mm vs (0.28 +/- 0.23) mm, P < 0.05] and neointimal area [(1.09 +/- 0.24) mm(2) vs (2.44 +/- 1.59) mm(2), P < 0.05] were significantly decreased in the Mytrolimus-eluting stent group than in bare mental stent group. Compared with bare-stent, the Mytrolimus eluting stent was associated with a 55.33% reduction in neointimal area. No restenosis developed in the Mytrolimus group.

CONCLUSIONThe Mytrolimus-eluting stents can effectively inhibit the neointimal hyperplasia in stented areas of coronary arteries 4 weeks after stent implantation in porcine model.

Animals ; Blood Vessel Prosthesis Implantation ; Coronary Artery Disease ; therapy ; Coronary Restenosis ; prevention & control ; Drug-Eluting Stents ; Sirolimus ; analogs & derivatives ; pharmacology ; therapeutic use ; Swine