Objective To discuss different effect of periocular injection and subconjunctival injection in treatment of iridocyclitis. Methods Eighty people with iridocyclitis were divided into group A and group B according to their admission order. Group A adopted periocular injection and group B was given subconjunctival injection. The incidence of complication was compared between the two groups. Results Significant difference existed in complications and related factors between two groups after treatment, periocular injection proved to be superior to subconjunctival injection. Conclusions Periocular injection is a desirable treatment method for iridocyclitis. It is easy to operate, safe, rapid and with less pain, so it is worthy of clinical application.

Objective To investigate the influence of social support on the depression and anxiety of standardized training residents.Methods Three hundred and eighteen standardized training residents selected by random sampling method from 4 training bases in Shanghai participated in this survey.ResultsThe average score of PHQ-9 was(7.24±5.20), and 67.30%(n=214)of participants had different degrees of depression;the average score of GAD-7 was(5.57±4.55), and 55.03%(n=175)of participants had different degrees of anxiety.One-way analysis of variances showed that standardized training residents who had work experience, longer training years and less salary satisfaction got higher scores in PHQ-9 and GAD-7.Male physicians had higher scores in GAD-7 than female ones.The scores of PHQ-9 (r=-0.390, P<0.01) and GAD-7 (r=-0.376, P<0.01) were both negatively correlated with social support.Regression analysis showed that training years,salary satisfaction,objective social support and the availability of support were significant for predicting the scores of PHQ-9(adjusted R2=0.242,F=17.893), work experience, salary satisfaction,objective social support and the availability of support were significant for predicting the scores of GAD-7(adjusted R2=0.228,F=14.390).After controlled the demographic variables, social support explained the variation rate of 0.119 to the score of PHQ-9 and 0.126 to the score of GAD-7.Conclusion The depression and anxiety of standardized training residents in this study is in a serious situation.Providing the objective social support and the availability of support as well as improving the salary satisfaction of standardized training residents may relieve the depression and anxiety and enhance their mental health.

Objective To investigate the clinical effects of pars repair by the pedicle screws,laminal hooks and auto iliac bone graft through the Wiltse approach via Quadrant channel for the treatment of the adolescent spodylolysis.Methods From November 2007 to April 2011,pars defects of 11 patients (10 males and 1 female) were repaired with pedicle screws,laminal hooks and auto iliac bone graft via Quadrant channel through the Wiltse approach.The mean age of 11 patients was 17.3 years (range 15-19).Mean course was 9.9 months (range 6-14 months).All patients have bilateral pars defect of L5.There was no poroma across the pars that have been proved by X-ray film and 3-D CT before the operation.There were 4 patients with Ⅰ grade spondylolisthesis.The degeneration of the intervertebral disc assessed by Pfirrmann grade of all patients was no more than Ⅰ grade.Visual analogue scale (VAS) and Oswestry disability index (ODI) were compared before and after operation.The fusion of pars defect was observed by X-ray film and 3-D CT.Results The mean operation time was 85.5±12.3 min (range 70-110 min); intraoperatve blood loss was 80-150 ml (mean 105 ± 19.4 ml).Two patients were lost in follow-up after operation and the others had been followed up for 12 to 24 months (mean 16 months).All patients had significant pain relief and function recovery after operation.Mean postoperative VAS score was 1.5± 1.0 compared with 4.5± 1.0 of preoperation (t=4.603,P=0.002).ODI was decreased from 49.3％± 14.2％ of preoperation to 12.0％±4.9％ of the last follow-up (t=7.344,P=0.000).With the Macnab grades,7 patients are excellent,2 patients are good.3-D CT showed that all pars defect were fused in the last follow-up.Conclusion Pars repair by the pedicle screws,laminal hooks and auto iliac bone graft through the Wiltse approach via Quadrant channel can protect the paravertebral muscle,relief patients from pain,and improve function.

The elastic parameters of soft tissues are important for medical diagnosis and virtual sur-gery simulation.In this study;we propose a novel nonlinear parameter estimation method for soft tissues.Firstly;an in-house data acquisition platform was used to obtain external forces and their corresponding deformation values.To provide highly precise data for estimating nonlinear param-eters;the measured forces were corrected using the constructed weighted combination forecasting model based on a support vector machine (WCFM_SVM). Secondly;a tetrahedral finite element parameter estimation model was established to describe the physical characteristics of soft tissues;using the substitution parameters of Young's modulus and Poisson's ratio to avoid solving compli-cated nonlinear problems.To improve the robustness of our model and avoid poor local minima;the initial parameters solved by a linear finite element model were introduced into the parameter estimation model. Finally;a self-adapting Levenberg–Marquardt (LM) algorithm was presented;which is capable of adaptively adjusting iterative parameters to solve the established parameter estimation model. The maximum absolute error of our WCFM_SVM model was less than 0.03 Newton;resulting in more accurate forces in comparison with other correction models tested. The maximum absolute error between the calculated and measured nodal displacements was less than 1.5 mm;demonstrating that our nonlinear parameters are precise.

Objective:To explore the influence of nursing organization atmosphere on clinical nurses' workplace loneliness, verify and analyze the mediating role of psychological capital between nursing organization atmosphere and workplace loneliness.Methods:This study was a cross-sectional survey, using the convenience sampling to select clinical nurses from two Class Ⅲ Grade A hospitals in Shanxi Province from October to December 2019 as the research object. The survey was conducted using the General Information Questionnaire, Organizational Climate Scale for Nursing, Questionnaire about Workplace Loneliness, and Psychological Capital Scale. The structural equation model was used to analyze the mediating effect of psychological capital between nursing organization atmosphere and workplace loneliness. A total of 1 035 questionnaires were collected in this study, with 963 valid questionnaires, and the effective response rate was 93.04%.Results:Among 963 clinical nurses, the total scores of Organizational Climate Scale for Nursing, Questionnaire about Workplace Loneliness, and Psychological Capital Scale were (88.08±10.08) , (30.42±5.23) and (83.21±12.62) respectively. The structural equation model showed that the nursing organization atmosphere had a direct and indirect predictive effect on nurses' workplace loneliness, and the path coefficients were -0.27 and -0.22 respectively. Psychological capital had a mediating effect between the nursing organization atmosphere and workplace loneliness.Conclusions:Psychological capital plays a mediating role between nursing organization atmosphere and workplace loneliness. Nursing managers should take effective measures to create a good organizational atmosphere, improve the level of psychological capital of clinical nurses, and reduce nurses' workplace loneliness.

Gastric cancer is one of the major causes of cancer-related deaths worldwide, and infection with Helicobacter pylori and EBV, smoking and a salt-heavy diet have been shown to be risk factors for the development of gastric cancer. Currently, numerous research has demonstrated that differences in the structure of the gastric flora can be exploited to distinguish the different stages of gastric mucosal lesions and to predict the progression of gastric cancer. Therefore, a new biomarker is presented for the diagnosis of gastric cancer based on the structural differences of the gastric flora. Gastric flora has also potential in the treatment of gastric cancer. The application of non-H. pylori flora to modulate immune cells may increase the sensitivity of tumour cells for chemotherapy, improve the efficacy of immune checkpoint inhibitors and significantly prolong the survival of patients. This review of advances in the application of gastric flora in the diagnosis and treatment of gastric cancer is aimed at providing a reference and basis for future research in this field.

Gastric cancer is one of the major causes of cancer-related deaths worldwide, and infection with Helicobacter pylori and EBV, smoking and a salt-heavy diet have been shown to be risk factors for the development of gastric cancer. Currently, numerous research has demonstrated that differences in the structure of the gastric flora can be exploited to distinguish the different stages of gastric mucosal lesions and to predict the progression of gastric cancer. Therefore, a new biomarker is presented for the diagnosis of gastric cancer based on the structural differences of the gastric flora. Gastric flora has also potential in the treatment of gastric cancer. The application of non-H. pylori flora to modulate immune cells may increase the sensitivity of tumour cells for chemotherapy, improve the efficacy of immune checkpoint inhibitors and significantly prolong the survival of patients. This review of advances in the application of gastric flora in the diagnosis and treatment of gastric cancer is aimed at providing a reference and basis for future research in this field.

PEGylated uricase was prepared with the N-terminal amino site-specific modification by periodate oxidation followed by reductive-amination. A monomethoxy poly(ethylene glycol)intermediate was synthesized by amidation from monomethoxy poly(ethylene glycol)amine hydrochloride 20000(mPEG20000-NH2 ·HCl)with the relative molecular mass of 20 kD and N-(tert-butoxycarbonyl)-L-serine(Boc-Ser-OH), and then the Boc group of the intermediate was removed by trifluoroacetic acid(TFA)to produce the desired product Ser-mPEG20000. This compound could be oxidated by periodate to obtain a new poly(ethylene glycol)aldehyde derivative with high activity, which could be used to modify proteins with the N-terminal amino site-specific PEGylation after ultrafiltration, and the modification conditions to uricase by Ser-mPEG20000 were optimized. The structures of poly(ethylene glycol)intermediate and the target product were characterized by IR and 1H NMR, and the overall yield of the target product was 72. 8%. The preliminary modification to uricase indicated that the desired product Ser-mPEG20000 could modify proteins easily and efficiently. The optimal modification conditions of uricase PEGylated by Ser-mPEG20000 were obtained as follows: the molar ratio of Ser-mPEG20000 to uricase was 2 ∶1; the pH value of solution was 5. 0; the reaction temperature was 25 °C and the reaction time was 6 h.

Objective To investigate the effect of ultrasound debridement combined with vacuum sealing drainage on the treatment of diabetic foot ulcer and the potential mechanism. Methods Eighty-one patients with diabetic ulcer were randomly divided into two groups:ultrasound debridement combined with vacuum sealing drain-age as the experimental group,routine debridement combined with vacuum sealing drainage as the control group. The clinical curative effect,the reduction rate of the wound,the rate of blastocyst and the rate of bacterial clear-ance and blood flow were detected.Results The clinical curative effect in the experimental group was significantly better than that in the control group(P < 0.05). The rates of wound reduction and granulation were significantly higher than those in the control group(P<0.05).After 14-day treatment,the blood perfusion in the experimental group was significantly higher than that in the control group(P<0.05),and the expression of HIF-1α and VEGF in the ulcer tissue was significantly higher than that in the control group(P<0.05).Conclusions Ultrasound de-bridement combined with vacuum sealing drainage can improve the clinical efficacy,wound reduction rate,granu-lation coverage rate and bacterial clearance rate,and increase ulcer tissue blood flow. The potential mechanism is related with the increases of HIF-1α and VEGF in ulcer tissue.