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Objective To explore the reasonable experimental parameters on establishment of rabbit model of infusion phlebitis induced by mannitol.Methods New Zealand rabbits were injected with 20％ mannitol,then pathological lesion of rabbit auricular vein induced by different infusion velocity,different sampling time and sites were observed under microscope with vascular injury,inflammatory cell infiltration,frequency of thrombokinesis as indexes.Results The three indexes were the highest and the most obvious characteristics of infusion phlebitis were noted at the following experimental conditions:5.0 ml/min (infusion velocity),sampling time at 24h after administration and sampling site at 1cm region in front of the catheter tip.Conclusions Rabbit model of infusion phlebitis induced by mannitol can be set up more stable by using these parameters.

Objective Through investigating the consistency of clinical first-line midwives actual working requirements and test outline fits, to make analysis on the rationality of the preliminary design test outline to provides evidence for improving the design of test outline for standardized training of midwives. Methods In September 2016,the investigation was conducted using questionnaire based on "Test Outline for Standardized-Training of Midwives (Draft)" among midwives studying in the training base of standardized-training of midwives. 50 questionnaires were distributed, and 49 were recovered, with a recovery rate of 98%. SPSS 16.0 was used to analyze the data and the Cronbach's alpha coefficient was calculated by factor analysis. Results The content reliability of the following units is good such as the overall of Test Outline for Standardized Training of Midwives (Draft)" and "laws and regulations related to maternal and infant health care ","Basic knowledge of medical psychology and ethics", "Basic theory and knowledge of mid-wives", "Clinical manifestations, identification points, common drugs and principles of treatment of the common diseases " and " Specialized skill". Conclusion The overall design of Test Outline for Standardized-Training of Midwives (Draft) is more scientific, and the rational ranking of the examination content is basi- cally consistent with the post competency requirements of the midwives.

Objective To explore the relationship among depression,anxiety and social support in elderly patients in community outpatient clinic. Methods A total of 551 elderly outpatients from two com-munity health service centers of Hongkou District in Shanghai were evaluated with patient health question-naire-9 (PHQ-9),generalized anxiety disorder-7 (GAD-7),perceived social support scale( PSSS) for de-pression,anxiety,physical health and social support. Results The prevalence rates of depression and anxiety were 26. 1% and 17. 2%,respectively. The scores of PHQ-9 and GAD-7 were 2. 0(4. 0) and 1. 0(2. 0). There were statistically significant differences in the scores of family support,friend support,other support and social support among the elderly patients with different degrees of depression or anxiety (P<0. 01). Fam-ily support(B=-0. 196) and friend support(B=-0. 171) were protective factors of depression in elderly pa-tients in community outpatient clinic. Age,family support and friend support were protective factors of anxiety in elderly patients,while gender and fluctuation of physical diseases were protective factors of anxiety(P<0. 05). Con-clusions The depression and anxiety is intimately related to social support in elderly outpatients. Appropriate measures should be taken to optimize social support,mitigate bad mood negative improve their quality of life.

OBJECTIVEChronic hypoxia at high altitude might result in cardiopulmonary adaptations including pulmonary arterial hypertension and cardiac remodeling. But little is known about the adaptive changes in healthy children born and living at high altitude. We compared the echocardiographic measurements between the healthy children living at 16 m (Shanghai, n = 220) and 3 700 m (Qinghai, total 257, Han children 117, Tibetan children 140).

METHODSChildren's age ranged from 15 d to 14 years. Echocardiography measurements were performed, values of the left and right ventricular dimensions and wall thickness, systolic and diastolic function including cardiac output index (CI), as well as mean pulmonary arterial pressure (mPAP) were obtained.

RESULTSmPAP and right heart dimension, CI, right ventricular anterior wall thickness were significantly higher while ventricular systolic and diastolic function were significantly lower in 3 700 m group than in 16 m group (all P < 0.05). Left ventricular dimension was similar between the two groups. There were no differences on above measured parameters between the Han and Tibetan children from 3 700 m group (all P > 0.05).

CONCLUSIONSChildren born and living at high altitude in China have significantly higher mPAP, dilated right heart and lower systolic and diastolic function of both ventricles and higher CI compared to children born and living at see-level. Above parameters were similar between the Han and the Tibetan childen born and living at high altitude. Present study provides reference values for the healthy children living at high altitude.

Adolescent ; Altitude ; Asian Continental Ancestry Group ; Child ; Child, Preschool ; China ; Diastole ; Echocardiography ; Heart ; Heart Ventricles ; Humans ; Hypertension, Pulmonary ; Hypoxia ; Infant ; Infant, Newborn ; Lung ; Systole

Objective : To evaluate the caries excavation efficacy and minimally invasive potential of three dentine caries excavation methods including traditional excavation, chemomechanical excavation, and fluorescence-aided caries excavation using micro-computerized tomography (micro-CT). Methods: This study was approved by the Biomedical Research Ethics Committee, and all patients provided informed consent. Thirty molars and premolars with dentin caries were collected and randomly divided into three groups. The samples were obtained by traditional excavation (traditional excavation group), chemomechanical excavation (chemomechanical excavation group), and fluorescence-aided caries excavation (fluorescence-aided caries excavation group), and the operation time for each sample was recorded. Micro-CT was used to scan and record the caries volume and healthy tooth volume of each tooth before and after caries excavation. The caries excavation efficacy and minimally invasive potential of the three caries excavation methods were evaluated based on the caries volume and the healthy tooth volume before and after caries excavation. Results: In terms of caries excavation operation time, the chemomechanical excavation group (501.7 s ± 143.6 s) had a longer operation time than the traditional excavation group (263.9 s ± 121.2 s) and the fluorescence-aided caries excavation group (284.2 s ± 135.6 s), with a statistically significant difference (P<0.01); there was no significant difference between the traditional excavation group and the fluorescence-aided caries excavation group. In terms of caries excavation efficacy, the ratio of residual caries volume to initial caries volume was determined in the traditional excavation group (0.087 ± 0.04), followed by the fluorescence-aided caries excavation group (0.36 ± 0.10), and the chemomechanical excavation group was the highest (0.51 ± 0.10); the observed disparity between the groups exhibited statistical significance (P<0.01). In terms of minimally invasive potential, the ratio of the traditional excavation group (0.87 ± 0.05) was lower than the chemomechanical excavation group (0.99 ± 0.01) and fluorescence-aided caries excavation group (0.98 ± 0.01), with statistically significant differences (P<0.01); the difference between the ratio of the chemomechanical excavation group and the fluorescence-aided caries excavation group was not statistically significant. Conclusion The traditional excavation group had the shortest operation time, but the traditional excavation removed too much healthy dentin and demineralized dentin. The chemomechanical excavation group retained demineralized dentin and healthy dentin and had the best minimally invasive potential, but the caries excavation efficacy was poor and the operation time was long. The fluorescence-aided caries excavation preserved part of the demineralized dentin and healthy dentin, had certain minimally invasive potential, and the clinical operation time was moderate.

Objective : To explore the effect of miRNA-222-3p in endothelial progenitor cell-derived exosomes (EPCs-Exo) on skin wound healing in diabetic mice． Methods : Endothelial progenitor cell ( EPCs) derived from C57BL /6 mouse bone marrow were identified by fluorescence staining．Subsequently，EPCs-Exo isolated from the media of EPCs were identified，and high-throughput sequencing of EPCs-Exo miRNA was completed．The skin injury model of diabetic mice was established．According to different groups，the wounds were treated with externally ap- plied phosphate buffer solution ( PBS ) and EPCs-Exo ; Subcutaneous injection of PBS，agomiR-222-3p，and an- tagomiR-222-3p at the edge of the wound was performed continuously for 14 days，and the wound healing rate was observed．Meanwhile，immunofluorescence methods were used to investigate the changes in the expression levels of ROS，CD31，and VEGF in the wound margin tissue before and after treatment. Results : EPCs-Exo significantly ac- celerated skin wound healing in diabetic mice，reduced the level of ROS，and increased the expression level of VEGF and CD31 in the wound margin tissue (P＜0. 05) ．High-throughput sequencing showed that miRNA-222-3p was highly expressed in EPCs-Exo．Local subcutaneous injection of miRNA-222-3p into wound margin tissue signifi- cantly promoted the skin wound healing of diabetic mice，reduced the level of ROS，and increased the expression level of VEGF and CD31 in the wound margin tissue (P ＜0. 05) ． Conclusion MiRNA-222-3p promotes wound healing in diabetic mice and plays an important role in EPCs-Exo promoting wound healing.