Objective: To learn the health literacy level and its influencing factors among permanent residents in Shaanxi Province in order to improve it. Methods: From July to November of 2017,multi-stage stratified cluster sampling method was used to select 15-69 year-old permanent residents in Shaanxi Province. A survey was conducted using“Chinese citizen health literacy monitoring questionnaire”issued by National Health Commission. The influencing factors for health literacy were analyzed by the multivariate logistic regression model. Results: Totally 2 352 valid questionnaires were collected with a response rate of 98.00%. The health literacy level of permanent residents in Shaanxi Province was 10.54%. The levels of basic knowledge,healthy lifestyle and behaviors,and health related skills were 24.81%,9.33% and 14.52%,respectively. The levels of scientific health views,safety and first aid,health information,infectious diseases prevention,basic medical care and chronic diseases prevention were 42.81%,42.73%,19.11%,18.32%,16.27% and 8.24%,respectively. The results of multivariate logistic regression analysis showed that educational background of junior high school or above（OR：6.660-29.077,95%CI：2.050-97.355）was a promoting factor of health literacy,yet rural residency（OR=0.621,95%CI：0.442-0.872）was a constraining factor. Conclusion The heath literacy level of Shaanxi residents in 2017 was 10.54%. Educational background of junior high school or above and rural residency were influencing factors for health literacy.

OBJECTIVETo determine the biomechanical characteristics of mandibular fractures in different site.

METHODSNine adult mandibular specimens were measured precisely. The data was used to establish a three-dimensional model. When mandibular was under functional loading, the bending and torsion moment as well as shear force of angle, body and symphyseal fracture was calculated. The data were analyzed by Origin 6.0 software.

RESULTSAngle fracture had relatively high positive bending moment and high shear force. Body fracture had positive as well as negative bending moment and the highest torsion moments. Symphyseal fracture had only negative bending moment and relatively low shear force.

CONCLUSIONAngle, body and symphyseal fractures each have a biomechanics characteristic. These biomechanics characteristic should have an important meaning in the treatment of mandibular fractures and instructing patient how to bite correctly.

Adult ; Biomechanical Phenomena ; Humans ; Mandible ; Mandibular Fractures

AIMTo determine whether low dose of estrogen in combination with ginsenosides can completely prevent bone loss in ovariectomized rats.

METHODSFour-month-old ovariectomized rats were treated either with 100 and 300 mg.kg-1 of ginsenosides or 30 and 100 micrograms.kg-1 of 17 alpha-ethynylestradiol alone, or ginsenosides 100 mg.kg-1 in combination with 17 alpha-ethynylestradiol 30 micrograms.kg-1 for 10 weeks. Double in vivo fluorochrome labeling was made. The undecalcified longitudinal proximal tibial metaphyseal sections were processed and stained with Goldner's trichrome for histomorphometric analysis of the bone.

RESULTSBody weights and serum cholesterol were increased in ovariectomized (OVX) rats. The rats lost 74% of bone volume and high bone turnover was induced after OVX compared with the sham group. Bone volume increased by 205% in the high dose estrogen treated group while it was increased by 105% in the low dose group. The two doses of estrogen were shown to inhibit osteoclasts surface (by -65% and -55%, P < 0.01) and decrease bone turnover rate (by -85% and -83%, P < 0.01). High dose of estrogen was found to inhibit growth and stimulate uterine weight gain in rats while low dose did not. High dose of ginsenosides increased bone volume by 84% (P < 0.01) and decreased bone turnover rate by -64% (P < 0.05) while lower dose of ginsenosides did not. However, low dose ginsenosides combined with low dose estrogen achieved well preventive effects: increase of 202% in bone volume, decrease of 66% in bone turnover rate and 72% in osteoclasts surface. The combined effect in preventing bone loss equals to that the high dose of estrogen alone did.

CONCLUSIONUse of low dose of estrogen plus ginsenosides showed synergistic effect on prevention of osteoporosis induced by ovariectomy.

Animals ; Bone Density ; Bone Resorption ; prevention & control ; Disease Models, Animal ; Drug Synergism ; Drug Therapy, Combination ; Ethinyl Estradiol ; administration & dosage ; therapeutic use ; Female ; Ginsenosides ; isolation & purification ; therapeutic use ; Osteoporosis ; pathology ; prevention & control ; Ovariectomy ; Panax ; chemistry ; Plant Leaves ; chemistry ; Plant Stems ; chemistry ; Plants, Medicinal ; chemistry ; Random Allocation ; Rats ; Tibia ; pathology

OBJECTIVETo investigate the safety and efficiency of the disposable circumcision suture device (DCSD) in the surgical treatment of phimosis and redundant prepuce.

METHODSWe randomly assigned 249 outpatients with phimosis or redundant prepuce to be treated with DCSD (n = 129) and by conventional circumcision (CC, n = 120), respectively. Then we compared the safety and efficiency of the two strategies.

RESULTSComparisons between DCSD and CC showed that the operation time was (4.02 +/- 0.69) vs (30.8 +/- 4.05) min, blood loss was (1.07 +/- 1.29) vs (8.72 +/- 2.15) ml, intraoperative pain score was 0.81 +/- 0.81 vs 2.42 +/- 1.15, 24-hour postoperative pain score was 1.84 +/- 1.02 vs 4.99 +/- 1.36, postoperative complication rate was 13. 95% (18/129) vs 9.17% (11/120), wound healing time was (13.99 +/- 9.06) vs (17.48 +/- 3.49) d, satisfaction with the penile appearance was 98.4% (127/129) vs 95% (109/120), and treatment cost was (2215.62 +/- 17.67) vs (576.47 + 15.58) Y RMB. DCSD exhibited obvious superiority over CC for shorter operation time, less blood loss, milder intraoperative pain, sooner wound healing, and better penile appearance, but it also had a higher rate of postoperative complications (P > 0.05) and involved more treatment cost than the latter (P < 0.05).

CONCLUSIONThe disposable circumcision suture device affords ideal clinical effects and therefore deserves clinical popularization.

Circumcision, Male ; instrumentation ; Disposable Equipment ; Follow-Up Studies ; Humans ; Male ; Phimosis ; surgery ; Surgical Staplers ; Treatment Outcome

OBJECTIVETo study advantages of Pemberton acetabuloplasty for the treatment of developmental dislocation of hip joint.

METHODSAmong 106 children (116 hips) with development dislocation of hip joint treated by Pemberton acetabuloplasty, 19 patients (29 hips) were boy, and 87 patients (87 hips) were girl, 46 hips were left side, 50 hips were right side and 20 hips were double side, ranging in age from 18 months to 13 years, with an average of 7 years and 3 months. All the 116 hips were treated with Pemberton acetabuloplasty, or "complete operation", which included the cutting of adductor and iliopsoas, Pemberton acetabuloplasty combined with subtrochanteric femoral shortening and rotation osteotomy. Among the hips, 95 hips were treated with simple Pemberton acetabuloplasty, and the other 21 hips were treated with complete operation. All the patients with bilateral developmental dislocation of hip joint were performed the operation at one side firstly, and one year later the other side were performed and the plate fixation in the first operation were removed.

RESULTSAll the patients were followed-up ranging from 2 to 10 years, with an average of 6 years. According to Muller and Seddon's evaluation criteria, 67 hips got an excellent result, 34 good, 10 fair and 5 bad, the excellent and good rate was 87%.

CONCLUSIONPemberton acetabuloplasty is suitable for the treatment of developmental dislocation of hip joint in children at different ages, and the therapeutic effects are good.

Adolescent ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Hip Dislocation ; diagnostic imaging ; physiopathology ; surgery ; therapy ; Hip Joint ; diagnostic imaging ; growth & development ; physiopathology ; surgery ; Humans ; Infant ; Male ; Radiography ; Recovery of Function ; Treatment Outcome

Objective To explore clinical characteristics of human cytomegalovirus (HCMV) and polyomavirus (BKV and JCV) infection after allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods Clinical data of 53 patients with hematologic malignancies who underwent allo-HSCT from June 2016 to December 2017 were collected.HCMV, BKV and JCV loads in patients' peripheral blood and urine were monitored once a week from day 1 to day 100 after transplantation.Incidence, occurrence time, clinical manifestations, and risk factors of viral infection were analyzed.Results A total of 51 patients had viral infection, infection rate was 96.23％.HCMV, BKV, and JCV infection rates were 54.72％ (29/53), 77.36％ (41/53), and 28.30％ (15/53) respectively.Incidences of pulmonary infection, acute graft-versus-host disease (aGVHD), and hemorrhagic cystitis (HC) were 54.72％, 58.49％, and 20.75％respectively.Analysis on risk factors showed that aGVHD (OR, 24.61[95％ CI, 2.30-46.24]), pretreatment with total body irradiation (TBI) (OR, 33.39[95％ CI, 1.57-79.13]), and use of antithymocyte globulin (ATG) (OR, 24.77[95％ CI, 1.16-52.58]) were independent risk factors affecting HCMV.Human leukocyte antigen (HLA) coincidence (OR, 0.003[95％ CI, 0.00-0.10]) could reduce the risk of HCMV viruria;pretreatment with TBI (OR, 15.10[95％ CI, 1.14-39.27]) was an independent risk factor for BKV viruria, compatible blood group of donor and recipient (OR, 0.07[95％ CI, 0.01-0.64]) could reduce the risk of BKV viruria.Conclusion HCMV and polyomavirus infection in blood and urine of recipient should be monitored as soon as possible after transplantation, so as to prevent and reduce complications in time.

Objective To investigate mechanical characteristics of the spirochete flagella with tight-fitting ribbon configuration in micro-periplasmic space. Methods The 2D model of two parallel plates was used to simplify the periplasmic space, and the effects of flagellum spacing and eccentricity on force and torque acted on the spirochete flagella, and wall shear stress acted on the spirochete protoplasmic cylinder were studied by using numerical simulation method. Results (1) The relationship between the flagellum horizontal force and eccentricity was presented as a parabolic curve, and the peak value of the flagellum horizontal force was mainly caused by the gradual increase of pressure difference at two sides of the cylinder and the resistance viscous force as well. Flagellum spacing had no significant influence on flagellum horizontal force. (2) The relationship between the flagellum torque and eccentricity was presented as an exponential curve, and smaller flagella spacing would cause bigger flagella torque. (3) Flagellum spacing had no significant effect on wall shear stress of the protoplasmic cylinder, but it would be increased with the number of flagella and the eccentricity increasing. Conclusions Numerical simulation results in this study can qualitatively reflect mechanical characteristics of the spirochete flagella, and also provide references for further understanding the morphology of spirochete as well as its kinematic mechanism and pathogenic characteristics.

Objective To investigate the efficacy and safety of intravesical instillation of BCG vaccine in the prevention of early recurrence of middle and high risk non-muscle invasive bladder cancer.Methods From July 2015,patients with non-muscle invasive bladder cancer aged 18-75 years with informed consent were screened and underwent transurethral resection of bladder tumor (TURBT).Immediately intravesical instillation of epirubicin 50 mg was given postoperatively.After pathology was comfirmed,patients was enrolled in group 1 (BCG15) or group 2 (BCG 19) or the control group (epirubicin 18) randomly with SAS 9.3 software.Data of follow-up and Adverse event was collected and analyzed.Results By May 31,2019,531 patients were enrolled in the study.The drop-off rate was 20.1％.167 patients (143 males and 24 females)in group 1,172 patients (141 males and 31 females)in group2 and 84(75 males and 9 females) in the control group with follow-up data were analyzed.There were no significant differences in age,gender,BMI,ECOG score,risk stratification between the three groups (P =0.8641,P =0.2906,P =0.9384,P =0.6126).The median follow-up time makes no statistical difference between the groups (P =0.9251),12.0 (6.0,22.5) months,13.0 (6.0,22.3) months,and 13.0 (7.0,22.3) months.The median recurrence time of the three groups was 4.0 (3.0,6.0) months,4.5 (3.0,9.8) months,4.5 (3.0,8.8) months.There was no statistical difference between the three groups (P =0.2852).Risk stratification in the patients got no significant difference between the three groups (P ＞ 0.05).The 1-year recurrence-free survival rates were 80.0％ in the group 1 and 88.3％ in the group 2 and 73.7％ in the control group.The group 2 was superior to the group 1 and the control group (P =0.0281,P =0.0031).There was no significant difference between group 1 and control group (P =0.2951).There was no significant difference in the cumulative recurrence-free survival between the experimental group 1 and the experimental group 2,(95％ CI 0.80-2.43,P =0.2433).The cumulative recurrence-free survival in the group 1 and the group 2 was better than the control group (95 ％ CI 0.31-0.92,P =0.0266;95 ％ CI 0.20-0.65,P =0.0008).All the cases underwent instillation were analyzed for adverse events.The incidence of overall AE(adverse events) in group 1 was 68.5％ (152/222),the incidence of grade Ⅰ-Ⅱ AE was 53.2％ (118/222),the incidence of grade Ⅲ-Ⅳ AE was 15.3％ (32/222).The incidence of overall AE in the group 2 was 71.8％ (160/223),the incidence of grade Ⅰ-Ⅱ AE was 60.1％ (134/223),and the incidence of grade Ⅲ-Ⅳ AE was 11.7％ (26/223).The overall AE rate in the control group was 53.2％ (59/111),of which the incidence of grade Ⅰ-Ⅱ AE was 42.4％ (47/111),and the incidence of grade Ⅲ-Ⅳ AE was 10.8％ (12/111).There was no difference in the incidence of overall AE between the group 1 and the group 2 (P =0.4497).The incidence of AE in the two experimental groups was higher than that in the control group (P =0.0062,P =0.0008).There was no difference in the incidence of grade Ⅲ-Ⅳ AE between the three groups (P =0.3902).Conclusions BCG(19 instillation schedule) has a better effect on preventing recurrence after 1 year of bladder surgery,which is superior to epirubicin group.The long-term efficacy of BCG in preventing recurrence and the efficacy of different schedules need to be further followed up.The lower urinary tract symptoms,which are mainly urinary frequency,are one of the causes of case fallout and should be fouced in future.Compared with epirubicin,BCG perfusion does not increase the incidence of grade Ⅲ-Ⅳ adverse reactions,and is safe to use.

With the rice-steamed Rehmanniae Radix unearthed from the tomb of Haihunhou in the Western Han Dynasty as the re-ference, the present study evaluated the quality of Rehmanniae Radix and investigated the processing technology of rice-steamed Rehmanniae Radix to lay the foundation for the research on rice-steamed Rehmanniae Radix products. With catalpol and rehmannioside D as the investigation indexes, the quality and grade of Rehmanniae Radix from different producing areas were evaluated with the methods in 2020 edition of Chinese Pharmacopoeia. UPLC method was established for the determination of catalpol and rehmannioside D in the rice-steamed Rehmanniae Radix. The effects of steaming time, the amount of supplementary rice, and steaming times in the rice-steamed processing on the quality of products were investigated by L_9(3~4) orthogonal test and multi-index comprehensive balance scoring method combined with the content of catalpol and rehmannioside D and appearance characteristics. At last, the stability of the processing technology was tested. The results showed that the optimal processing technology for rice-steamed Rehmanniae Radix was as follows: Rehmanniae Radix and rice(200 g∶4 g) were steamed twice at atmospheric pressure, four hours each time. The mass fractions of catalpol and rehmannioside D were 0.184% and 0.335%, respectively, and the character score was 6.5. The processing conditions are reaso-nable, stable, and feasible. It can provide a basis for the restoration of the ancient rice-steamed processing technology and references for the development of rice-steamed Rehmanniae Radix products in the future.
Drugs, Chinese Herbal/pharmacology* ; Oryza ; Plant Extracts ; Rehmannia ; Technology

Objective:To investigate the 2 years’ efficacy of intravesical instillation of domestic BCG versus epirubicin in the prevention of recurrence of intermediate-risk or high-risk non-muscular invasive bladder cancer and predictive factors of BCG instillation.Methods:From July 2015 to June 2020, 18-75 years old patients with moderate to high-risk non muscle invasive bladder cancer (NMIBC) confirmed by pathological examination were involved. The ECOG score was 0-2. Exclusion criteria included ①immune deficiency or impairment (such as AIDS), using immunosuppressive drugs or radiotherapy, suspected allergic to BCG or epirubicin or excipients of the two drugs, fever or acute infectious diseases including active tuberculosis or receiving anti tuberculosis treatment, with severe chronic cardiovascular and cerebrovascular diseases or chronic kidney disease; ②combined with other urogenital system tumors or other organ tumors; ③combined with muscle invasive bladder urothelial carcinoma (≥T 2); ④undergoing chemotherapy, radiotherapy or immunotherapy within 4 weeks (immediate instillation after surgery not included); ⑤ pregnant or lactating women; ⑥ comfirmed or suspected bladder perforation; ⑦gross hematuria; ⑧cystitis with severe bladder irritation that may affect the evaluation; ⑨participat in other clinical trials within 3 months; ⑩alcohol or drug addiction; ?any risk factors that may increasing the risk of patients. Epirubicin 50 mg was irrigated immediately after the operation(TURBT or laser resection). The patients were randomly divided into BCG15 group, BCG19 group and epirubicin group by the ratio of 2∶2∶1, and the patients were maintained intravescical instillation for 1 year. The recurrence and adverse events of the three groups were compared. Univariate and multivariate analysis was performed to predict the risk factors of BCG irrigated therapy failure. Result:By June 15, 2020, the median follow-up duration was 22.1 months(12.1, 32.3), and there was no statistical difference between the groups ( P=0.9024). There were 274 patients enrolled in BCG19 group, 277 patients enrolled in BCG15 group and 130 patients enrolled in the epirubicin group. The drop-off rate was 16.6%(113 cases)and made no difference between groups( P=0.6222). There were no significant difference in age, gender, BMI, or ECOG score( P>0.05). During the follow-up, 116 cases was detected recurrence or progression. The recurrence rate of the three groups was 14.2% and 14.8% in BCG19 group and BCG15 group, and 27.7% in the epirubicin group. There was no difference in recurrence rate between BCG19 and BCG15 group( P=0.9464). The recurrence rate of BCG19 group was lower than that of the epirubicin group ( P=0.0017). The recurrence rate of BCG15 group was lower than that of the epirubicin group ( P=0.0020). There was no difference in the cumulative recurrence free survival rate between BCG19 and BCG15 group (95% CI0.57-1.46, P=0.7173). The cumulative recurrence free survival rate of BCG 19 group was better than that of the epirubicin group( HR=0.439, 95% CI0.26-0.74, P=0.0006), and the cumulative recurrence free survival rate of BCG15 group was better than that of the epirubicin group ( HR=0.448, 95% CI0.29-0.80, P=0.0021). The total incidence of adverse events in 19 BCG19, BCG15 and epirubicin group were 74.5%, 72.6% and 69.8% respectively. There was no difference in the incidence of adverse events between BCG19 and BCG15 group( P=0.6153). The incidence of adverse events in epirubicin group was lower than that of BCG19( P=0.0051) and BCG15( P=0.0167) groups.There was no significant difference in the incidence of serious adverse events (SAE) among the three groups ( P=0.5064). Log rank test univariate analysis and Cox risk regression model multivariate analysis showed that the history of bladder cancer recurrence( HR=6.397, 95% CI1.95-20.94, P=0.0001)was independent risk factor for BCG irrigation failure. Conclusions:The 2 years’ efficacy of intravesical instillation of domestic BCG is better than than of epirubicin with good tolerance and safety. There is no difference between BCG19 and BCG15 group. BCG doesn’t increase SAE compared with epirubicin. Recurrence status was an independent prognostic factor regarding recurrence-free survival.