Objective To explore the relationship between bone mineral density(BMD) and body tat disrribution in the aged in Ningbo area of China. Methods The BMD of lumbar vertebra and total body bones as well as body composition were measured by dual-energy X-ray absorptiometry (DXA) in 61 aged males, and also in 63 aged females as control group. Results In the aged males, a negative correlation was found between BMD and age, while BMI, muscle, trunk fat were positively correlated with BMD. As for the aged female, age, BMI, muscle and fat were all positively correlated with BMD. Conclusions The correlation between body fat and BMD is closer in females than in males in the aged. There is a positive correlation between trunk fat and lumbar spine BMD, and it indicates that central obesity may have a protective effect on lumbar spine BMD.

ObjectiveTo evaluate effect intervened by the linden relaxation technique (LRT) in the group of long-term naval shipmen's anxiety on surface ship.MethodsSelected naval surface ship unit 1402 shipmen serve as study subjects.140 anxiety shipmen (70 ≥ SAS score ≥ 50) screen out with Zung'self-rating anxiety scale (SAS).The person's group with anxiety mood,but did not meet the diagnostic criteria for anxiety disorders of DSM-Ⅳ.Anxiety shipmen were random divided into the linden relaxation technique group ( n =70) and No-intervention control group ( n =70).In the LRT intervention group:LRT exercises time course was 1 time/ day,and 30 min/time to persist 10 days.The control group without relaxation training.Before and after interventions,anxiety level separately were evaluated with SAS.ResultsBefore intervention,there were not statistically significant between intervention group and control group in SAS anxiety scores,respectively ( ( 54.00 ± 4.43 ) vs (53.91 ± 4.88 )).After intervention,there were statistically significant between intervention group and control group anxiety scores,respectively was ( (40.57 ± 8.98 ) vs ( 53.13 ± 5.51 ) ).The difference before and after intervention,anxiety scoring in intervention group (13.43 ± 7.82 ) was lower than that of the control group (0.79 ± 3.41 ).After following 2 months,SAS scores in the intervention group was more lower (36.76 ± 8.57 ) than the right finish intervention,there was significant different; but there was not significant different belong to the control group (52.34 ± 5.50).ConclusionLinden relaxation technique improves anxiety mood in the naval servicemen.

Objective To discuss some characteristics of aggressive behavior of junior middle school students addicted to violence online game.Methods From Aug.to Dec.at 2009,6000 volunteers have been investigated with the self-made violence online game survey scale and the Chen's were screen out by CIAS,and in which 71 violence game addicts,and 66 entertainment game addicts.They were divided into two groups matched as age and sex(male 55 and female 11 in every group),average age was 14.36±0.81 years old.66 no-play game students served as control group.The mean value and standard deviation of aggressive behaviors in each group were compared with one way ANOVA with SPSS12.0 version.Results There were significant different inter groups in the behavioral scores expressed in physiological attack((21.59±4.36),(18.10±6.10,(14.92±5.61)),spoken language attack((21.04±3.98),(18.36±6.26),(15.66±5.23)),angry mood((21.37±4.43),(18.72±5.90),(16.56±5.70)),hostility cognition((21.69±5.77),(20.06±7.74),(16.39±6.85))and the total score((85.56±13.71),(75.28±22.36),(63.54±20.32))(F1-4=25.07,17.35,3.25,10.40,21.81);Moat severity attack behaviors were observed in the violence online game addictive group,but less done in other two groups(t1-4=3.48,2.68,2.65,10.27,P<0.01;t 1-5=6.66,5.37,4.48,5.30,22.01,P<0.01);and secondary was found in Entertainment online game addicts(t1-5:3.18,2.69,2.16,3.66,11.74,P<0.01).Conclusion Higher attack behavior scores are found in the violence online game in junior middle students,and entertainment online game also induce attack behavior,but is not so notable.

Objective To find some risk factors correlated with test anxiety of middle school students,and to find out influencing pathway for test anxiety. Methods 647 middle school students were investigated with Sarason' Test Anxiety Scale (TAS), Achievement Motivation Scale (AMS), Coping Style Scale for School Students ( CSS), Eysenck Personality Questionnaire( EPQ), Egma Minnen av Bardndosnauppforrestran(EMBU) and Family Environment Scale-Chinese Version(FES-CV). Statistics were done with version of SPSS14.0,and data were analyzed by Pearson correlation, multiple linenear stepwise regression and path analysis. Results The rates of test anxiety respectively was mild 25.97% ,moderate 45.65% ,severe 28.38%; there were no significant different between the male and female students anxiety ( 16.71 ± 6.44,17.01 ± 7.02, t = 1. 469, P = 0.334). Test anxiety positively correlated with Achievement motivation, reach motivation of competition, endurance, escape, expos, deny the fantasy,family conflicts,parental punished severely,excessive interference,objective deny,overprotective of father.( r 1-16 :0. 214,0. 135,0. 254,0. 216,0. 308,0.472,0. 492,0. 168,0. 249,0. 537,0. 282,0. 102,0. 238,0. 185,0. 233,0.301,0.273; P 1-16 = 0. 000 ～ 0. 030) , and negatively correlated with Problem-solving, rationalizing interpretation, family cohesion, informative, entertaining, emotional expression, organization, parental warmth and understanding ( r1-9: -0. 121, -0. 134, -0. 178, -0. 215, -0. 221, -0. 101, -0. 298, -0. 136, -0. 168; P 1-9 =0.000 ～0.007). Enter test anxiety regression equation is the reached motivation of competition,emotional expose,organization, psychosis, Neuroticism, parent's warm and understanding , mother's refuse and deny ( t 1-7: 2.496,2.521, -2.687, -2. 150,3.503,2.237,2.259; P1-7 =0.001 ～0.038). Conclusion Test anxiety is commonly find in middle school students. Test anxiety is affected by some paths that are personality,achievement motivation,emotional coping style,family environment and parental education methods.

Objective? To develop a perioperative care model for patients with thyroid disease under the guidance of enhanced recovery after surgery and to provide a reference for the performance of enhanced recovery after surgery in clinical thyroid nursing mode. Methods? The enhanced recovery after surgery care strategies during the perioperative period for thyroid neoplasms patients were formulated by literature review in combination with focal group interviews and the Delphi method from October 2016 to February 2017. Results? The response rates for the questionnaires during the two rounds of communication with experts were both 100%(16/16). The authority coefficients (Cr) of experts for the 2 rounds were 0.870 3 and 0.882 8, respectively. It was found that the nursing mode based on enhanced recovery after surgery included 13 primary indicators and 32 secondary indicators. The significance score of these primary indicators averaged 0.90-0.95, with a full mark ratio of 0.50-0.87, while the significance score of these secondary indicators was 0.89-0.96, with a full mark ratio of 0.56-0.93. The coefficient of significance variance was 0-0.15, and Kendall's W was 0.227 (P＜ 0.01). Conclusions? The perioperative care strategies for thyroid surgery under the guidance of enhanced recovery after surgery are developed in this study using the Delphi method, which may provide a scientific reference for clinical nursing work.

Objective:To detect the expressions of S100P, mucin 5A, mucin 6, estrogen-inducing protein pS2, C-reactive protein (CRP), N-cadherin and CD56 in intrahepatic cholangiocarcinoma (ICC) and to analyze the sensitivity and specificity in the diagnosis of large and small bile duct cholangiocarcinoma.Methods:Clinical data of 47 patients (22 patients small bile duct and 25 patients large bile duct ICC) diagnosed with ICC at Ningbo Clinical Pathology Diagnosis Center from January 2018 to September 2019 were retrospectively analyzed, including 29 males and 18 females, aged (64.0±11.1) years. Cancer tissue specimens were collected. The expressions of S100P, mucin 5A, mucin 6, estrogen-induced protein pS2, CRP, N-cadherin and CD56 in cancer tissues were detected by immunohistochemical method, and the sensitivity and specificity of these proteins in the diagnosis of small bile duct and large bile duct ICC were analyzed.Results:In 22 patients with small bile duct type ICC, CD56 expression was positive in 12 (54.5%), CRP expression in 22 (100.0%) and N-cadherin expression in 21 (95.5%), large bile duct type ICC were 8.0%(2/25), 28.0%(7/25), 40.0%(10/25). In 25 cases of large bile duct type ICC, S100 calcium-binding protein P expression was positive in 23 cases (92.0%), estrogen-induced protein pS2 expression in 21 (84.0%) and mucin 5A expression in 23 (92.0%), small bile duct type ICC were 9.1%(2/22), 36.4%(8/22), 0. The positive expression rates of CD56, CRP and N-cadherin in small bile duct type ICC were significantly higher than those in large bile duct type ICC, while S100 calcium-binding protein P, estrogen-induced protein pS2 and mucin 5A were lower than those in large bile duct type ICC (all P<0.05). The sensitivity of CD56, CRP and N-cadherin in the diagnosis of small bile duct type ICC were 54.5%, 100.0% and 95.5%, and the specificity were 92.0%, 72.0% and 60.0%, respectively. The sensitivity of S100 calcium-binding protein P, estrogen-induced protein pS2 and mucin 5A in the diagnosis of large bile duct type ICC were 92.0%, 84.0% and 92.0%, and the specificity were 90.9%, 63.6% and 100.0%, respectively. Conclusion:The positive expressions of CD56, CRP, N-cadherin, S100 calcium-binding protein P, estrogen-induced protein pS2 and mucin 5A are of great value in the differential diagnosis of large bile duct type and small bile duct type ICC, and the diagnostic accuracy is reasonable, which could facilitate the accurate histological classification of ICC.

Objective:To evaluate the independent prognostic value of minute ventilation/carbon dioxide production slope (VE/Vco 2 slope)on heart failure after acute myocardial infarction. Methods:131 patients with acute myocardial infarction (AMI) treated in the cardiology department of China-Japan Friendship Hospital from September 2018 to September 2019 were collected and followed up 3 months after discharge. They were divided into heart failure (HF) group and non-heart failure (NHF) group. All the patients underwent cardiopulmonary exercise test (CPET) before discharge.Results:Three months after discharge, the VE/Vco 2 slope was higher in HF group than in NHF group (36.7±3.8 vs 29.7±4.0, P=0.014). The best VE/Vco 2 slope cutoff for the prediction of heart failure after 3 month was 33.05 with a sensitivity of 81.4% and a specificity of 80.6% [area under curve (AUC) was 0.844, P<0.001]. VE /Vco 2 slope level was an independent predictor of heart failure in patients with acute myocardial infarction after discharge ( OR=1.245, 95% CI: 1.021-1.366, P=0.019). Other independent indicators related to heart failure included N-terminal pro-B type natriuretic peptid (NT-proBNP) level ( OR=1.283, 95% CI: 1.019-1.399, P=0.033). Conclusions:VE/Vco 2 slope yielded strong, independent predictive value for heart failure at 3 month after discharge to AMI patients.

OBJECTIVE To investigate the transfer and diffusion of berberine hydrochloride(BBH), the main active component of Coptis and Phellodenticum in the system of carboxymethyl chitosan(CMCS)-sodium alginate(SA). METHODS CMCS and SA were stirred in a certain proportion, and D-gluconolactone(GDL) was added to form polyelectrolyte hydrogel. Rheometer was used to study the rheological properties of CMCS-SA hydrogel, including the elastic modulus G′ and the viscous modulus G′′. A BBH diffusion model for CMCS-SA hydrogel was designed, and the relevant rules of BBH permeation through CMCS-SA polyelectrolyte hydrogel were observed by UV-VIS. RESULTS The elastic modulus G′ of the hydrogel was measured when the ratio of CMCS to SA was 3∶1, 2∶1, 1∶1, 1∶2, and 1∶3. When the ratio of CMCS to SA was 1∶1, G′ was the highest, and the crosslinking strength of the hydrogel was the highest. The cumulative amount of BBH transfer was measured by the BBH transfer model, and the diffusion of BBH in CMCS-SA hydrogel was fitted as the skeleton dissolution by Peppas equation, indicating that BBH dissociation and the transfer efficiency increased as the amino group of CMCS decreased or the carboxyl group of SA increased. The elastic modulus G′ of CMCS-SA hydrogel increased with the increase of GDL content. The reason was that the binding force between CMCS and SA molecules gradually increased with the decrease of pH, and the crosslinking degree of the hydrogel was enhanced. When ratio of fixed CMCS to SA was 1∶1 and the GDL content was 0.15 g·mL−1, the formability of CMCS-SA hydrogel was good. In addition, when BBH was transferred in hydrogel with different concentrations of GDL, the transfer efficiency increased with the increase of GDL content. When BBH was delivered in different thickness hydrogel, the delivery efficiency of CMCS-SA hydrogel increased with the decrease of thickness. CONCLUSION The CMCS-SA hydrogel system, as a potential drug carrier for traditional Chinese medicine extracts such as BBH, is expected to serve as a gel carrier for transdermal drug delivery.

Objective:To explore the efficacy and safety of Rivaroxaban in preventing catheter related thrombosis (CRT) in patients with breast cancer who are undergoing central venous catheter chemotherapy, and provide basis for making standardized prevention and treatment strategies.Methods:In this research, a prospective cohort study was adopted, and breast cancer patients who received central venous catheter chemotherapy in Sanhuan Cancer Hospital during September 2020 to March 2022 were selected as a treatment group to take the rivaroxaban anticoagulation therapy with 10 mg.po.qd for one month. The control group got no preventive anticoagulation therapy. Vascular ultrasound examination was taken to confirm the occurrence of CRT, and a chi-square test was done for comparison the disparity between the groups. Logistic regression was applied to analyze the univariate and multivariate factors for the formation of CRT.Results:In the research, a total of 235 patients were selected, and there were a total of 19 035 days of catheterization with 81 days of catheterization on average. While in the control group, the incidence of CRT was 28.0% (33/118), the incidence of CRT in the treatment group was 20.5% (24/117), the difference was no significant ( P=0.183). Subgroup analysis results showed that the peripherally inserted central catheter (PICC) was performed in 165 cases with the CRT incidence of 18.2% (30/165) and thrombosis was mostly seen around axillary vein, accounting for 63.3%. Subclavian vein catheterization was performed in 63 cases with the CRT incidence of 39.7% (25/63), and thrombosis was mostly seen around subclavian vein, accounting for 88.0% (22/25). Implantable venous access port was implanted in 7 cases around subclavian vein and internal jugular vein with the CRT incidence of 28.6% (2/7). The patients who developed CRT within 30 days after catheterization accounted for 54.4% (31/57), 22.8% (13/57) in a period during 30 days and 60 days) and 22.8% (13/57) in a period during 60 days and 180 days). The diagnosed CRT patients had been treated with rivaroxaban 15 mg.bid.po for 3 months. During the 3 months, 100.0% of the thrombosis waned, 71.9% (41/57) of the thrombosis waned within 30 days, 19.3% (11/57) in a period during 30 and 60days and 8.8% (5/57) in a period during 60 days and 90 days. Univariate and multivariate analysis indicated that the risk of CRT in subclavian vein catheterization was higher than that in PICC, respectively ( OR=2.898, 95% CI:1.386-6.056 P=0.005), and the type of catheterization was an independent factor for the formation of thrombosis. Safety analysis result showed that in the prevention of CRT, rivaroxaban treatment did not induce drug-related bleeding, liver function damage, bone marrow suppression or any other side effects. While CRT diagnosed patients were treated with anticoagulation, they kept the central venous catheter, and the infusion was smooth. These patients all finished the anti-tumor treatment as planned, and no abnormalities like new thrombosis or pulmonary embolism were observed. Conclusions:In the mid-term analysis, the proportion of Rivaroxaban in preventing anticoagulant CRT decreases, but it don't reach statistical significance. The sample size should be further increased for observation. Rivaroxaban is proved effective and very safe in the treatment of CRT, and does not affect the concurrent chemotherapy. Medical personnel should carry out the policy of "early prevention, early detection and early treatment" for CRT so as to improve the patients' quality of life.

Background::Pancreatic ductal adenocarcinoma (PDAC) is one of the main types of malignant tumor of the digestive system, and patient prognosis is affected by difficulties in early diagnosis, poor treatment response, and a high postoperative recurrence rate. Carbohydrate antigen 19-9 (CA19-9) has been widely used as a biomarker for the diagnosis and postoperative follow-up of PDAC patients. Nevertheless, the production mechanism and potential role of CA19-9 in PDAC progression have not yet been elucidated.Methods::We performed single-cell RNA sequencing on six samples pathologically diagnosed as PDAC (three CA19-9-positive and three CA19-9-negative PDAC samples) and two paracarcinoma samples. We also downloaded and integrated PDAC samples (each from three CA19-9-positive and CA19-9-negative patients) from an online database. The dynamics of the proportion and potential function of each cell type were verified through immunofluorescence. Moreover, we built an in vitro coculture cellular model to confirm the potential function of CA19-9. Results::Three subtypes of cancer cells with a high ability to produce CA19-9 were identified by the markers TOP2A, AQP5, and MUC5AC. CA19-9 production bypass was discovered on antigen-presenting cancer-associated fibroblasts (apCAFs). Importantly, the proportion of immature ficolin-1 positive (FCN1+) macrophages was high in the CA19-9-negative group, and the proportion of mature M2-like macrophages was high in the CA19-9-positive group. High proportions of these two macrophage subtypes were associated with an unfavourable clinical prognosis. Further experiments indicated that CA19-9 could facilitate the transformation of M0 macrophages into M2 macrophages in the tumor microenvironment. Conclusions::Our study described CA19-9 production at single-cell resolution and the dynamics of the immune atlas in CA19-9-positive and CA19-9-negative PDAC. CA19-9 could promote M2 polarization of macrophage in the pancreatic tumor microenvironment.