Objective To evaluate the status of self-efficacy and its influencing factors in adult patients with low vision,then explore an effective approach to improve their self-efficacy levels.Methods Seventy adult patients with low vision were sampled by random number table method.General social-demographic questionnaire and self-efficacy questionnaire were used to investigate these patients' general information and self-efficacy.Seventy pieces of questionnaires were issued and returned with the valid rate of 100％.Results The total score of self-efficacy in seventy adult patients with low vision was(16.25:±:1.93) points,92％ of patients had a low level of self-efficacy.The influencing factors of self-efficacy in adult patients with low vision were the attitude toward disease,mental status and gender.Conclusions The selfefficacy in patients with low vision was affected by many factors at different levels,so we should focus on main influencing factors to adopt corresponding nursing measures in order to improve self-efficacy of adult patients with low vision.

Objective To provide vessel anatomical materials guidance for endovascular aortic repair,the branches artery of thoracic aortic was studied by CT angiography (CTA).Methods From January 2008 to February 2012,739 adult cases' CTA data were collected,all cases performing thoracic CTA in Wuhan General Hospital of Guangzhou Command.We measured the diameter and/or leugth of the ascending aorta,aortic arch and branches artery of aortic arch,and made an analysis.Results The aortic arch includes standard and variant types.Standard type is common,which accounted for 91.1％ of the total number,while variant type accounted for 8.9％.In the standard aortic arch of patients,the diameter of aortic arch above the opening of coronary artery (CA) was (35.7 ±4.3) mm,the diameter of ascending aortic arch at the opening of brachiocephalic trunk (BCT) was (33.6 ±4.2) mm,the diameter of aortic arch between the BCT and the left common carotid artery (LCCA) was (29.4 ± 5.7) mm,the diameter of aortic arch between the LCCA and the left subclavian artery (LSA) was (27.6 ± 4.2) mm,the diameter of descending aortic at the opening of the LSA was (25.4 ± 4.5) mm,the diameter of the head BCT from aortic arch was (12.9 ±0.9) mm,the diameter of the head LCCA from aortic arch was (8.5 ± 0.7) mm,the diameter of the head LSA from aortic arch was (10.4 ± 1.1) mm,the length of aorta between the CA and the BCT was (53.3 ±12.5) mm,the length of aortic between the BCT and the LCCA was (4.7 ± 1.5) mm,the length of aortic between the LCCA and the LSA was (7.9 ± 2.6) mm,the length between the opening of BCT and the right subclavian artery (RSA) was (41.1 ± 8.2) mm,the length between the opening of LSA and the opening of left vertebral artery was (38.5 ±5.7) mm,the angle between the horizontal of BCT and the LCCA and the sagittal plane was (71.2 ± 7.2) °,the angle between the plane of LCCA and the LSA and the plane of sagittal was (31.1 ± 2.9)°.Conclusions The CT data of the thoracic aorta can be used as reference for production of stents and guide releasing the stents in endovascular repair.

Objective To investigate the expression of transforming growth factor β1,transforming growth factor beta receptor(TBR)Ⅰ,TβR Ⅱ,Smad4 and C-Jun in rats with nonalcoholic fatty liver disease(NAFLD)and to find out the mechanisms of liver fibrosis in patients with NAFLD.Methods A total of 18 male SD rats were randomly divided into normal control group(n=9)and model group(n=9).The rats in control group were fed with normal diet,and those in model group were fed with fat-rich diet(consisted of 10%lard oil+2%cholesterol).An rats were sacrificed at the 20th week.The levels of TGFβ1,TβR Ⅰ and TβR Ⅱ mRNA were examined by RT-PCR.The expressions of TGFβ1 and Smad4 in liver tissue were detected by immunohistochemistry.The expression of C-Jun protein was detected by Western blotting.Results The NAFLD model was successfully established.The immunohistochemistry examination revealed that TGFβ1 and Smad4 were expressed weekly in control group,but strongly expressed in model group.RT-PCR showed that A values of TGFβ1,TβR Ⅰ and TβR Ⅱ mRNA were 0.46±0.12,5.z4±2.70 and 3.35±1.95,respectively,in model group,which were higher than those in control group(0.21±0.09,1.36±0.77 and 0.52±0.19,all P values＜0.01).The Western blotting results demonstrated that the expression of C-Jun protein in model group(0.93±0.41)was higher than that in control group (0.32±0.25,P=0.001).Conclusion TGFβ1/Smad4 signal pathway might be involved in the development of hepatic fibrosis in NAFLD.Blocking TGFβ1/Smad4 signal pathway will be helpful in treatment of NAFLD.

Objective:To observe any clinical effect of supplementing ultrasound stimulation with balloon-guided injection of botulinum toxin into the upper esophageal sphincter in the treatment of cricopharyngeal achalasia.Methods:Forty patients with cricopharyngeal achalasia were randomly divided into an observation group and a control group, each of 20. Both groups were given routine swallowing rehabilitation training, while the observation group additionally had botulinum toxin injected into the upper esophageal sphincter guided by ultrasound and with the aid of balloon dilation. Before the experiment and after 2 weeks, both groups were evaluated videofluoroscopically and flexible endoscopic evaluation of swallowing was performed. Moreover, 2 weeks before the treatment and 2, 4 and 24 weeks afterward, everyone′s eating, leakage and aspiration, and oral and pharyngeal secretions were assessed using the functional oral intake scale (FOIS), the penetration-aspiration scale (PAS), the fiberoptic endoscopic dysphagia severity scale (FEDSS) and the Murray secretion scale (MSS).Results:After 2 weeks the average PAS, FEDSS and MSS scores of both groups had improved significantly, but the observation group′s averages[3(2, 5), 3(2, 5) and 2(1, 2)] were significantly better than those of the control group. 2, 4 and 24 weeks after the experiment the average FOIS scores of both groups also showed significant improvement, with the observation group′s average[3(2, 4), 4(2, 6) and 6(3, 7)] again significantly better than that of the control group.Conclusions:A botulinum toxin injection into the upper esophageal sphincter can effectively improve the swallowing of persons with cricopharyngeal achalasia with adequate safety and significant long-term benefits. Therefore, such treatment is worthy of clinical promotion and application.

【Objective】 To analyze the association of sexual development characteristics and phases with the cognitive and behavioral development of adolescents aged 10 to 14 in rural areas of Shaanxi Province, in order to provide scientific reference for enhancing adolescent health. 【Methods】 The study population was selected from a birth cohort study′s follow-up data for the adolescent phase. The Tanner quintile method was used to assess sexual development, the Wechsler Intelligence Scale for Children, Fourth Edition (WISC-Ⅳ) was used to assess cognitive development, and the Youth Self-Rating Scale(YSR-2001) was used to assess behavioral development. Generalized linear models was used to examine the association of the stages of adolescent sexual development with their cognitive and behavioral development. 【Results】 A total of 1 887 adolescents were enrolled in this study, with 1 111 (58.9%) boys. The proportion of boys and girls who have started sexual development was 78.22% and 89.30%, respectively. The detection rate of behavioral problems in adolescents was 9.70%, with 11.80% in boys and 6.70% in girls, and the gender difference was significant (χ²=13.517, P<0.001). Compared to adolescents in Tanner stage Ⅰ, adolescents in stage Ⅲ had a higher total cognitive score of 2.19 (95%CI: 0.15 - 4.23), and a higher total score of 3.84 (95%CI: 0.85 - 6.83,P<0.05) in stages Ⅳ-Ⅴ. The detection rate of total behavioral problems of children in Tanner stages Ⅳ-Ⅴ was 2.63 times (95%CI:1.27 - 5.46,P<0.05) higher than that in stage Ⅰ. In boys, the rate of detection of internalizing problems was 3.96 times(95%CI:1.60 - 9.81,P<0.01) higher than that in stage Ⅰ, and the detection rate of internalizing problems was 2.88 times(95%CI:1.19 - 7.01,P<0.05) higher than that in stage Ⅰ. 【Conclusions】 There is a significant correlation of sexual developmental phrase with cognitive and behavioral development among adolescents aged 10 - 14 years in rural Shaanxi Province. The detection rate of adolescent behavioral problems increases with the increase of sexual development level and cognitive level, and there are significant gender differences.

【Objective】 To explore the impact of intrapartum antibiotic prophylaxis (IAP) on antibiotic resistance genes (ARGs) in the gut microbiota of infants up to 6 months of age and their longitudinal changes, in order to provide theoretical basis for the rational use of antibiotics and antibiotic resistance control. 【Methods】 Fecal samples were collected within 3 days, 2 months, and 6 months from a maternal and birth cohort conducted between January 2018 and June 2019. A panel of 6 common ARGs (aac(6′)-Ib, qnrS, blaTEM, ermB, mecA, tetM) were tested, the absolute abundance and positive detection rate by qPCR were calculated. Nonparametric and linear mixed model (LMM) analysis were used to assess the influence of IAP on the absolute abundance of antibiotic resistance genes and the longitudinal changes in their abundance at the three time points. 【Results】 A total of 157 samples from 65 singleton infants were analyzed, including 15 mothers (23.1%) who received IAP. The detection rate of ARGs was high in infants up to six months of age, and the abundance of ARGs tended to increase over time. IAP significantly increased the abundance of the mecA gene in the gut microbiota of vaginally delivered infants at 6 months of age (6.1±1.1 in the VDIAP group vs. 3.8±4.6 in the VDno-IAP group, P=0.046). Additionally, in cesarean section infants, there was a significant increase in the abundance of aac(6′)-Ib genes at 2 months (β=3.81, ,P<0.05), P<0.05] and 6 months of age (β=4.89, ,P<0.001), P<0.001) compared to 3 days of age. 【Conclusions】 The findings suggest that IAP can increase the abundance of ARGs in 6-month-old infants, and this effect is still significant after stratifying by delivery mode. Therefore, the rational and standardized use of intrapartum antibiotics may help reduce the development of antibiotic resistance.

OBJECTIVETo evaluate the roles of cell adhesion, multidrug resistance and cell proliferation in short-term recurrent cases with superficial bladder cancer, and the prognostic value of the three indexes.

METHODSImmunohistochemical staining for E-cad, P-gp and Ki-67 was performed on the tumors of 100 patients with stage T0-T1 transitional cell carcinoma of the bladder who had been included in a retrospective research by follow-up.

RESULTSE-cad and P-gp expression was positive in 51 (43.2%)and 17 (14.4%) of the tumors, respectively and mean proliferation index (PI) was 22.1%. The decrease in E-cad expression was accompanied with the increasing recurrent episodes (P < 0.05), while increase of P-gp expression and PI were accompanied with the increasing recurrence episodes (P < 0.05). There was significant difference according to E-cad, P-gp positivity and between T(1)G(3) patients and no-T(1)G(3) patients (P < 0.05). There was negative correlation of E-cad expression with P-gp expression and PI.

CONCLUSIONSMinimum adhesion, strong drug resistance and maximum proliferation are the main factors that promote short-term recurrence of superficial bladder cancer and also the inherent reasons for easy recurrence and high malignancy of T(1)G(3) tumors. During this course, the three aspects may interact.

ATP-Binding Cassette, Sub-Family B, Member 1 ; analysis ; Adult ; Cadherins ; analysis ; Cell Adhesion ; Cell Division ; Drug Resistance, Multiple ; Drug Resistance, Neoplasm ; Female ; Humans ; Ki-67 Antigen ; analysis ; Male ; Neoplasm Recurrence, Local ; etiology ; Urinary Bladder Neoplasms ; drug therapy ; etiology ; pathology

OBJECTIVETo observe the effect of Chinese herbal compound on variance of neurotransmitters in rat telencephalon and to further discuss the mechanism underlying Chinese herbal compound in improving exercise capacity and promoting recovery from exercise-induced fatigue.

METHODS64 rats (8 week old) were randomly divided into medicine group (MG) and control group (CG). Chinese herbal compound was administered to rats of MG for 8 weeks. 8 weeks later, every group was divided into 4 subgroups and all were killed at different time point separately, and then neurotransmitter in rat brain was tested.

RESULTSThe exhaustion time of MG was significantly longer than that in CG (P < 0.01). In rest conditions, glutamic acid (GLU) of MG was significantly higher than that in CG (P < 0.01), while, there were no significant differences between MG and CG in other indexes. After fixed quantitative load exercise, the content of 5-hydroxytryptamineZZ(5-HT), 5-hydroindole acetic (5-HIAA), gamma-aminobutyric acid (GABA), Dopamine (DA) and 5-HT/5-HIAA were significantly lower than those in CG, while, GLU, GLU/GABA and DA/5-HT were significantly higher than those in CG. Compared with CG, exhaustion significantly (P < 0.05) decreased 5-HT, GABA and 5-HT/5-HIAA, and significantly (P<0.05) increased GLU, DA/5-HT and GLU/GABA level in MG. 12 h after exhaustion, in contrast to CG, level of 5-HT and 5-HT/5-HIAA in MG were significantly (P < 0.01) lower while GLU, DA, GABA and DA/5-HT were significantly (P < 0.01) higher.

CONCLUSIONDuring exhaustion exercise, Chinese herbal compound demonstrated strong inhibiting effect on synthesis of 5-HT, 5-HIAA, DA, GABA and promoting effect on GLU synthesis, this had been confirmed by the combined effect, including increase of excitatory transmitter and excitability of central nervous system and the prolongation of exhaustion time and promoting recovery from fatigue.

Amino Acids ; metabolism ; Animals ; Biogenic Monoamines ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; Fatigue ; metabolism ; physiopathology ; Hydroxyindoleacetic Acid ; metabolism ; Male ; Neurons ; metabolism ; Physical Conditioning, Animal ; physiology ; Physical Exertion ; physiology ; Rats ; Rats, Wistar ; Serotonin ; metabolism ; Telencephalon ; drug effects ; metabolism

OBJECTIVETo study the evidence-based therapy of edema in nephrotic syndrome by analyzing the literatures systematically.

METHODSThe literatures related to the treatment of nephrotic edema were retrieved from the following: Chinese Biological Medicine Database (CBM-disk), Chinese Journals Full-text Database (CNKI, 1994-2006), Chinese Technological Periodicals Database (VIP, 1989-2006), Chinese Evidence Biological Medicine/Cochrane Central Database (CEBM/CCD), Cochrane Library Database, MEDLINE (1966-2006), EMBASE (1975-2006), MEDLARS, SCI (1985-2006) and OVID by electron and craft search with the following key words: nephrotic syndrome, edema, recalcitrant edema, refractory edema or resistant nephrotic edema, and treatment, diuretic therapy or human albumin treatment. The relevant literatures on randomized controlled trials (RCT) that met the criteria were statistically analyzed by the Coorporative network software RevMan 4.2.

RESULTSA total of 113 articles were searched (60 in Chinese and 53 in English), of which 12 were RCT. Three of the 12 articles were included for Meta analysis. Meta analysis showed that dextran-40 together with furosemide was effective for nephrotic edema. Human albumin solution could be used in nephrotic edema patients with coexistent severe hypoalbuminemia. A combination of diuretics by intravenous drip infusion was effective for diuretic-resistant nephrotic edema.

CONCLUSIONSThe treatment for nephrotic edema should be individualized. The evidence of treatment of nephrotic edema has not been fully elucidated. Further multicentre, large sample, and randomized controlled trials are needed.

Edema ; therapy ; Evidence-Based Medicine ; Humans ; Meta-Analysis as Topic ; Nephrotic Syndrome ; therapy ; Randomized Controlled Trials as Topic

Humans ; Liver Cirrhosis ; Renin-Angiotensin System ; Self-Control