Objective:To investigate the status of mental health and work engagement of clinical nurses, to explore the correlation between them, and to provide scientific basis for improving the mental health and increase work engagement levels of nurses.Methods:From August to September 2018, 1 140 nurses in Taihe Hospital of Shiyan City of Hubei Province · Affiliated Hospital of Hubei University of Medicine were selected as survey objects by convenient sampling method, and the mental health and work engagement of nurses were investigated by Symptom Checklist-90 (SCL-90) and Utrecht Work Engagement Scale (UWES-9), correlation analysis was used to explore the relationship between mental health and work engagement, and multiple linear regression was used to analyze the influencing factors of work engagement in clinical nurses.Results:The score of SCL-90 of clinical nurses was 123.01±38.14 and the score of UWES-9 was 3.53±1.40. Correlation analysis showed that the nurse with total scores of mental health and work engagement, vitality, dedication, and concentration were negative correlation( r values were -0.250--0.218, P<0.01). Multiple linear regression analysis showed that age, depression, and paranoia were the influencing factors of clinical nurses work engagement ( t values were 4.682, -3.211, -2.715, P<0.01). Conclusions:The mental health level of nurses is good, and their work engagement level is average. Mental health is closely related to work engagement. Nursing managers should take effective measures to improve the mental health and increase work engagement levels of nurses.

Objective:To provide clinical data for early identification and diagnosis of vascular embolism in children.Methods:We collected and analyzed the clinical data of children with vascular embolism diagnosed at the Children Medical Center of the First Affiliated Hospital of Hunan Normal University from January 2017 to January 2020.Results:A total of 29 children with vascular embolism were included.The male to female ratio was 2.2∶1(20/9); the age range was 1 month to 13 years, and the median age(IQR) was 16 (6-41)months.Among them, 22 cases were diagnosed with venous thrombosis, including 13 children with lower limb venous thrombosis(13/29, 44.8%), and six children with intracranial venous thrombosis(6/29, 20.7%). Arterial embolism was found in six cases, and left atrial appendage thrombosis was found in one case.Severe pneumonia was the most common primary disease(19/29, 65.5%), followed by cardiopulmonary resuscitation(3/29, 10.3%), and Kawasaki disease(3/29, 10.3%). Analysis on the risk factors of vascular embolization diseases, including catheter-related, long-term bed rest, elevated D-dimer, mechanical ventilation, and intravenous hormone administration, showed that 89.2%(25/29)had ≥3 risk factors at the same time, and 82.8%(24/29)had ≥5 risk factors at the same time.Conclusion:In children with vascular thrombotic diseases, deep venous thrombosis, especially lower extremity venous thrombosis, are common.The severe pneumonia is more common in primary disease.Children with multiple risk factors have a higher risk of developing vascular embolism.In clinic, coagulation function should be monitored and local symptoms should be observed for early identification.

Brain iron deposition has been proposed to play an important role in the pathophysiology of Alzheimer disease (AD). The aim of this study was to investigate the correlation of brain iron accumulation with the severity of cognitive impairment in patients with AD by using quantitative MR relaxation rate R2' measurements. Fifteen patients with AD, 15 age- and sex-matched healthy controls, and 30 healthy volunteers underwent 1.5T MR multi-echo T2 mapping and T2* mapping for the measurement of transverse relaxation rate R2' (R2'=R2*-R2). We statistically analyzed the R2' and iron concentrations of bilateral hippocampus (HP), parietal cortex (PC), frontal white matter (FWM), putamen (PU), caudate nucleus (CN), thalamus (TH), red nucleus (RN), substantia nigra (SN), and dentate nucleus (DN) of the cerebellum for the correlation with the severity of dementia. Two-tailed t-test, Student-Newman-Keuls test (ANOVA) and linear correlation test were used for statistical analysis. In 30 healthy volunteers, the R2' values of bilateral SN, RN, PU, CN, globus pallidus (GP), TH, and FWM were measured. The correlation with the postmortem iron concentration in normal adults was analyzed in order to establish a formula on the relationship between regional R2' and brain iron concentration. The iron concentration of regions of interest (ROI) in AD patients and controls was calculated by this formula and its correlation with the severity of AD was analyzed. Regional R2' was positively correlated with regional brain iron concentration in normal adults (r=0.977, P<0.01). Iron concentrations in bilateral HP, PC, PU, CN, and DN of patients with AD were significantly higher than those of the controls (P<0.05); Moreover, the brain iron concentrations, especially in parietal cortex and hippocampus at the early stage of AD, were positively correlated with the severity of patients' cognitive impairment (P<0.05). The higher the R2' and iron concentrations were, the more severe the cognitive impairment was. Regional R2' and iron concentration in parietal cortex and hippocampus were positively correlated with the severity of AD patients' cognitive impairment, indicating that it may be used as a biomarker to evaluate the progression of AD.

Objective To observe the activities of serum peroxidase capacity,and lipid peroxidation of children from Kaschin-Beck disease (KBD) areas of Xinghai county in Qinhai province,and to explore the relationship between antioxidant capacity and KBD.Methods Sixty four KBD and forty six health subjects without KBD were chosen from KBD endemic areas,which included primary schools of Tangnaihai,Xialujuan and Qushian of Xinghai county in Qinghai province,and fifty nine age-matched healthy control subjects without KBD were from a non-KBD endemic area,Nanfan primary school of Chang'an county in Shaanxi province.Twenty patients with KBD and twenty control subjects from KBD areas and non-KBD area were extracted by simple random sampling method.2,3-DAN fluorescence technique was used to test the hair and blood selenium.The biochemical techniques were used to test the indicators of oxidative stress including malondialdehyde(MDA),antioxidant enzyme activities,total antioxidant capacity(T-AOC),serum superoxide dismutase(SOD),catalase(CAT) and glutathione peroxidase(GSHPx).ResultsAll patients with KBD had significantly lower serum GSH-Px activities[ (59.53 ± 25.23)kU/L] and selenium levels in hair[ (67.64 ± 17.28)μg/L] and blood[(36.27 ± 13.29)μg/L],respectively,than that of control subjects from KBD areas [ ( 91.88 ± 22.99 ) kU/L,( 153.32 ± 24.31 ) μg/L,( 63.06 ± 13.66) μg/L ] and nonKBD areas[ ( 122.68 ± 41.74)kU/L,(242.35 ± 38.56)μg/L,(98.93 ± 17.18)μg/L,all P ＜ 0.05].Serum MDA levels in KBD patients[ (4.64 ± 1.11 )μmol/L] were significantly higher than that in control subjects from KBD [(3.31 ± 1.22)μmol/L] and non-KBD areas[ (3.43 ± 1.29)μmol/L,all P ＜ 0.05].On the other hand,T-AOC,SOD and CAT activities were significantly higher in both KBD[(19.80 ± 6.64),(55.80 ± 8.14),(16.45 ± 5.61 ) kU/L] and control subjects[ (21.71 ± 8.82),(57.45 ± 6.96),(15.63 ± 9.18)kU/L] from KBD areas than that of control subjects from non-KBD area[ (13.56 ± 5.38),(42.79 ± 8.10),(6.05 ± 2.71 )kU/L,all P ＜ 0.05 ].Hair selenium levels,blood selenium levels and GSH-Px activity of control subjects from KBD areas were,respectively,significantly lower than that in control subjects from non-KBD area(all P ＜ 0.05).Conclusions These findings strongly confirm the evidence that KBD patients are susceptible to oxidative stress.The results also show the increase in antioxidant enzymes,which could probably be due to adaptive response to pro-oxidant in KBD state.Hence,there seems to be an imbalance between oxidant and antioxidant systems in KBD patients.

OBJECTIVETo observe the effect of nourishing yin removing fire Chinese herbs (NYRF-CH) on the gene expression of hypothalamic growth hormone secretion peptide (Ghrelin) and its receptor growth hormone secretion peptide receptor 1alpha (GHSR1-alpha) at the puberty onset of danazol induced female precocious rats.

METHODSForty female SD rats were randomly divided into 4 groups, i.e., the normal group (N), the model group (M), the normal saline intervention group (NS), and the NYRFCH intervention group (NI), 10 in each group. 300 microg danazol was subcutaneously injected to all rats except those in the N group to prepare precocious rat model. NYRFCH and normal saline was respectively administered to rats in the NI and the NS group from the 15th day old for 7-10 days. No treatment was given to rats in the N group. Time of rats' vulva opening was recorded. Ovary index and uterus index were calculated. Peripheral blood levels of estradiol (E2), follicle stimulating hormone (FSH), and luteinizing hormone (LH), and hypothalamic contents of gonadotropin releasing hormone (GnRH) as well as the gene expression of hypothalamic Ghrelin and GHSR1-alpha were determined. Results Compared with the N group, the vulva opening time was advanced in the model group; peripheral blood levels of E2 and LH, uterus index, hypothalamic contents of GnRH increased; peripheral blood FSH levels and mRNA levels of hypothalamic Ghrelin and GHSR1-alpha decreased (P < 0.05, P < 0.01). Compared with the M group and the NS group, the vulva opening time was not advanced in the NI group; peripheral blood levels of E2 and LH, uterus index and hypothalamic contents of GnRH obviously decreased (P < 0.05, P < 0.01); mRNA levels of hypothalamic Ghrelin and GHSR1-alpha increased (all P < 0.01). But there was no statistical difference in the hypothalamic contents of Ghrelin, or the number and activity of GHSR1-alpha (P > 0.05).

CONCLUSIONNYRFCH had regulatory effect on regulating hypothalamic Ghrelin and GHSR1-alpha at gene transcription levels.

Animals ; Drugs, Chinese Herbal ; pharmacology ; Estradiol ; Female ; Follicle Stimulating Hormone ; metabolism ; Gene Expression ; drug effects ; Ghrelin ; genetics ; Gonadotropin-Releasing Hormone ; metabolism ; Hypothalamus ; metabolism ; Luteinizing Hormone ; metabolism ; Ovary ; Puberty, Precocious ; metabolism ; Rats ; Rats, Sprague-Dawley ; Uterus

ObjectiveTo explore the diagnosis and prognosis value of clinical pneumonic infection score (CPIS) in patients with stroke-associated pneumonia (SAP).MethodsOne hundred and fifty stroke patients were evaluated and analyzed by CPIS.SAP was regarded as gold standard,and sensitivity,specificity,diagnose accordance rate,positive predictive value and negative predictive value were calculated.Results Thirty-nine patients had SAP and 111 patients did not have SAP by CPIS,and the incidence of SAP was 22.0％ (33/150).CPIS diagnostic sensitivity was 84.8％ (28/33),specificity was 90.6％ ( 106/117 ),positive predictive value was 71.8％ (28/39),negative predictive value was 95.5％ (106/111),and diagnose accordance rate was 89.3％(134/150).The patients of SAP were divided into good prognosis (28 cases) and bad prognosis (5 cases),and the CPIS was significantly lower in patients of good prognosis 7 days after SAP than that in patients of bad prognosis[(4.21 ± 2.23) scores vs. (6.05 ±2.32) scores,P ＜0.05].ConclusionsNot only CPIS has higher diagnosis rate in SAP incidence,but also has good judgment to prognosis.It is worthy of clinical application.

Objective: To explore the correlation between serum level of high molecular weight adiponectin (HMW-ADPN) and arteriosclerosis. Methods: Clinical data of 87 middle-aged and aged people living in home, who underwent health examinations in Xiangya second hospital from Jan 2011 to Dec 2011, were collected. According to carotid-femoral pulse wave velocity (cf-PWV) = 9 m/s, they were divided into group A (cf-PWV<9 m/s, n=21) and group B (cf-PWV≥9 m/s, n=66). Blood pressure, blood lipid, blood glucose etc. were measured and compared between two groups. Results: Compared with group A, there were significant rise in blood pressure, levels of low density lipoprotein cholesterol, triglyceride and total cholesterol, and significant reduction in levels of high density lipoprotein cholesterol (HDL-C), serum total ADPN and HMW-ADPN in group B, P<0.05 or <0.01. Multiple regression analysis indicated that serum HMW-ADPN (B= - 4.469，P=0.011), total ADPN ((B= - 3.965，P=0.012), HDL-C（B= - 2.077，P=0.015) and systolic blood pressure levels (B= 0.045，P=0.045) were independent predictors of cf-PWV. Conclusion: Serum high molecular weight adiponectin and total adiponectin levels may be protective factors against arteriosclerosis. Its role in predicting occurrence and development of arteriosclerosis is worthy of further study.

Objective To explore the correlation of the distance between anastomosis and dentate line in patients with severe circumferential prolapsed haemorrhoids treated by stapled haemorrhoidectomy with the patients' postoperative clinical manufestival score, and assess its value in the choice of anastomosis site in stapled haemorrhoidectomy. Methods One hundred and six patients with severe circumferential prolapsed haemorrhoids was treated by stapled haemorrhoidectomy. The distance between anastomosis and dentate line was documented during the operation, effect of the treatment and complications were also documented postoperatively. All above-mentioned data were analysed statisticaly by one-way ANOVA and ridit test.Results Four groups were established in 106 patients according to the distance between anastomosis and dentate line. Patients with distance less than 1.0cm were defined as group A, between 1.0 cm and 1.5 cm as group B, between 1.5 cm and 2.0 cm as group C, more than 2.0 cm as group D. Concerning the postoperative incontinence score, satisfaction index and complications such as haemorrhage,ederma of anal everage,residal skin-tags, there was no significant difference between all groups. But there was significant difference between four groups in score of pain. Conclusions Patients with severe circumferential prolapsed haemorrhoids treated by Stapled haemorrhoidectomy tend to have good clinical outcome. The appropriate distance between anastomosis and dentate line should be chosed by the status of prolapsed haemorrhoids.

ObjectiveTo observe the clinical efficacy of electroacupuncture plus constraint-induced movement therapy (CIMT) in recovering neurologic function of patients with spastic hemiplegia.MethodSixty patients with post-stroke spastic hemiplegia were randomized into an electroacupuncture group, a CIMT group, and an electroacupuncture+CIMT (integrated) group to receive corresponding intervention in addition tothe ordinary rehabilitation treatment, 20 cases in each group. Before treatment and after 4-week treatment, the modified Ashworth Scale, Clinical Neurologic Deficit Scale, Short-form Fugl-Meyer Assessment Scale (FMA), and Berg Balance Scale (BBS) were adopted for evaluation and comparison.ResultAfter 4-week treatment, the Ashworth score and neurologic deficit score were significantly reduced in the three groups (P<0.01), and the scores in CIMT group were significantly lower than that in the electroacupuncture group (P<0.05), and the scores in the integrated group were markedly lower than that in the other two groups (P<0.05); the FMA and BBS scores were significantly increased after intervention in the three groups (P<0.01), and the scores in CIMT group were higher than that in the elctroacupuncture group (P<0.05), and the scores in the integrated group were higher than that in the other two groups(P<0.05).ConclusionElectroacupuncture plus CIMT can reduce the muscular tension of the affected limb in patients with spastic hemiplegia, and improve the neurologic function, motor function, and the quality of life of the patients.

Network pharmacology is an emerging discipline based on the Disease-Gene-Drug multilevel network. And it has been used to forecast the drug targets and improve the efficiency of drug discovery. Its research ideas are similar to the overall efficacy of traditional Chinese medicine (TCM), which attracts more and more medical re-searchers to look for the joint point of TCM and network pharmacology. A series of approaches on disease-related genes, predicting the information of target and active ingredients of TCM emerge. In this paper, the network pharma-cology research tools, databases and their applications were summarized and introduced. This paper also proposed scientific strategies to separate active ingredients of TCM using network pharmacology, so as to improve the efficiency and speed of finding active ingredients of TCM.