Objective To observe the effects of physical agents therapy on serum hs-CRP, TNF-α andadiponectin in patients with cerebral infarction and the possible underlying mechanisms. Methods Sixty patientswith cerebral infarction were randomly and equally divided into two groups: 30 cases were treated with physical a-gents therapy ( physical therapy group) , and 30 with drugs only ( drug treated group). Thirty normal subjectsserved as the control group. The level of hs-CRP in the serum was determined by latex agglutination reaction, TNF-and adiponectin were determined by using ELISA before and after therapy. Results The levels of serum hs-CRP and TNF-α of patients with cerebral infarction before therapy were much higher than those of the control group,but adiponectin was significantly lower than those of the control group( P < 0.01 ). After therapy, the levels of ser-um hs-CRP and TNF-α were decreased and adiponectin was increased significantly in both treated groups ( P <0.01 ). Comparison with two treated groups showed that the levels of hs-CRP and TNF-α were lower and adiponec-tin was obviously higher in physical agents therapy group than those in the drug treated group ( P < 0.05 ). Con-clusion The patients with cerebral infarction have low level of serum adiponectin. Physical therapy might exertbeneficial effects on patients with cerebral infarction by the decreasing serum hs-CRP and TNF-α, as well as by ele-vating adiponectin.

Objective To construct nursing service quality evaluation index system for abdominal operation patients. Methods Based on the service quality(SERVQUAL)model, a total of 33 nursing experts were selected by Delphi method for two turns of consultation. All the consultation experts have got senior professional title and 90.9%(30/33) have been working for more than 20 years. Finally, we calculated the questionnaire response rates, the authority coefficient, the mean and standard deviation, the coefficient of variation and the harmony coefficient. Results The response rates of questionnaires was 91.89% and 100% respectively, while the authority coefficient of experts was 0.91. The harmony coefficient of first and second and third indictors was 0.43, 0.47 and 0.53 respectively in the second consultation. Combined with selection of indicators and expert opinion, the final evaluation index system includes 6 first grade indexes, 14 second grade indexes and 49 third grade indexes. Conclusions There is a high level of authority and team coordination in experts. The results of the study can provide a reference for evaluating the nursing service quality of abdominal operation patients.

Objective To study the clinical characteristics, diagnosis, treatment and prognosis of primary pulmonary peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS). Methods Two cases of primary pulmonary PTCL-NOS were studied and relevant literature were reviewed. Results Case 1 diagnosed as primary pulmonary PTCL-NOS was a 44 years old woman and disease progressed after GLD (Gem+L-OHP+ DXM) chemotherapy regimen. At last, the patient died of respiratory failure after one month. Case 2 diagnosed as primary pulmonary PTCL-NOS was a 46 years old man and reach partial response after CHOP regimen, and still alive now.Conclusion Primary pulmonary PTCL-NOS is very rare. It is easy to be misdiagnosed due to non-specific clinical and imaging manifestations. Acquiring enough tissue specimens for pathologic examination is the key to a definitive diagnosis. At present, there is no standard chemotherapy regimen for these patients, the prognosis is relatively poor.

OBJECTIVE To investigate the prevalence of multidrug resistance(MDR) mechanisms of Staphylococcus haemolyticus against oxacillin,gentamycin and erythromycin.METHODS Agar dilution method was performed to detect the minimal inhibition concentration(MIC) of 3 antimicrobial agents against 63 strains of S.haemolyticus,and the resistance genes of mecA,aac(6′)+aph(2″),ermA,ermB,ermC and msrA/msrB were investigated by PCR in all clinical isolates.RESULTS mecA Gene was detected in 62 isolates of meticillin-resistant S.haemolyticus(MRSH),and aac(6′)+aph(2″) gene was found in 50 isolates resistant to gentamicin,and the most prevalence erythromycin resistance gene in S.haemolyticus was msrA/msrB(58.7%),followed by ermC(31.7%).Among the 43 MDR strains,the more commonly encountered three genes were mecA,aac(6′)+aph(2″) and msrA/msrB(58.1%)or ermC(20.9%),and 8 isolates(18.6%) were found harboring four genes of mecA,aac(6′)+aph(2″),ermC and msrA/msrB.CONCLUSIONS The mecA,aac(6′)+aph(2″),msrA/msrB and ermC genes are main resistance mechanisms against oxacillin,gentamicin and erythromycin in mutidrug resistant S.haemolyticus.

Objective:To explore the relationship between childhood trauma and aggressive behavior in patients with major depressive disorder(MDD), and the mediating role of self-esteem in childhood trauma and aggression.Methods:A total of 241 MDD patients with childhood trauma were investigated by Chinese version of the Buss & Perry aggression questionnaire(AQ-CV) and self-esteem scale (SES). Data were analyzed by SPSS 23.0 and AMOS 24.0.Pearson correlation analysis was used to assess the correlation of childhood trauma, aggressive behavior and self-esteem.The Bootstrap method was applied to test the mediating effect of self-esteem between childhood trauma and aggressive behavior.Results:The total score of attack questionnaire, self-esteem and childhood trauma were (48.81±18.81), (24.91±5.29)and(53.87±10.43), respectively. Self-esteem of MDD patients was negatively correlated with aggressive behavior and childhood trauma ( r=-0.45, -0.24, P<0.01). Childhood trauma was positively correlated with aggressive behavior ( r=0.42, P<0.01). The direct effect of childhood trauma on aggressive behavior was 0.438(95% CI: 0.305, 0.579). Self-esteem played a partly mediating effect between childhood trauma and aggressive behavior, and the mediating effect value was 0.161 (95% CI: 0.080, 0.256), accounted for 26.9% of the total effect. Conclusion:Self-esteem plays a partly mediating role between childhood trauma and aggressive behavior.Childhood trauma can directly and through the part of mediating role of self-esteem affect aggressive behavior.

Objective:To analyze the prognostic factor of arteriovenous fistula (AVF) maturation and provide the theoretical basis for the hemodialysis patients' AVF surgery.Methods:Retrospective investigation was conducted on patients that underwent AVF surgery in Wuhan Central Hospital from January 2017 to June 2019 as study subjects to investigate the prognostic factor of AVF maturation. The general information, hematological indicators, preoperative and postoperative ultrasound data of patients were recorded. Patients were divided into mature group and immature group according to the physical examination status, functional status and postoperative color doppler ultrasound data after AVF surgery, and the differences between the two groups were compared. Logistic regression analysis was used to analyze the prognostic factors of AVF maturation, and receiver operating characteristic (ROC) curve was drawn to evaluate the predictive value of each factor for AVF maturation.Results:A total of 164 patients were included, including 110 patients in the mature group and 54 patients in the immature group. There were statistically significant differences between the two groups in surgical vein diameter, surgical artery diameter, brachial artery flow, cardiac ejection fractions, systolic blood pressure, diastolic blood pressure and history of diabetes (all P<0.05), while there were no statistically significant differences in other indicators such as gender, age, etc. Logistic regression analysis showed that preoperative surgical artery diameter (every increase by 0.1 mm, OR=1.402, 95% CI 1.159-1.697, P=0.001), surgical vein diameter (every increase by 0.1 mm, OR=1.341, 95% CI 1.176-1.528, P<0.001), cardiac ejection fraction (every increase by 5%, OR=1.184, 95% CI 1.087-1.289, P<0.001), systolic blood pressure (every increase by 10 mmHg, OR=1.407, 95% CI 1.103-1.796, P=0.006), brachial artery flow (every increase by 10 ml/min, OR=1.047, 95% CI 1.004-1.091, P=0.034) and history of diabetes ( OR=0.271, 95% CI 0.103-0.715, P=0.008) were the independent influencing factors for AVF maturation. ROC curve showed that preoperative surgical artery diameter ( AUC=0.728, 95% CI 0.643-0.839, P<0.001), surgical vein diameter ( AUC=0.762, 95% CI 0.686-0.839, P<0.001), cardiac ejection fraction ( AUC=0.711, 95% CI 0.626-0.796, P<0.001) were the important indicators for predicting AVF maturation. Conclusions:Preoperative surgical artery diameter, surgical vein diameter, cardiac ejection fraction and diabetes mellitus are the prognostic factors of AVF maturation. In preoperative vascular assessment, attention should be paid to the diameter of target arteries and veins, as well as to the cardiac function and diabetes mellitus of patients.

Objective? To investigate the effect of Team collaboration management program on the metabolic syndrome in schizophrenic patients. Methods? From March 2017 to March 2018, the schizophrenic patients with metabolic syndrome who were admitted in Shanghai Mental Health Center Affiliated to Shanghai Jiao Tong University School of Medicine were selected as the participants of this study and divided into observation group (n=45) and control group (n=47) according to the time of admission. The two groups were both given routine treatment and nursing care in psychiatric department. Besides of that, the team collaboration management program was implemented in the observation group. Assessments were done before intervention and 16 weeks after intervention using related metabolic parameters, the Brief Scale of World Health Organization Quality of Life (WHOQOL-BREF) and the Positive and Negative Symptoms Scale (PANSS). Results? There was no significant difference in metabolic parameters, WHOQOL-BREF and PANSS scores between the two groups before intervention (P＞0.05). After 16 weeks of intervention, patients' fasting blood sugar level, body weight, waist circumference, triglyceride, high density lipoprotein and systolic pressure in the observation group were lower than those in the control group, and the difference was statistically significant (P＜0.05). The scores of"physical health" and "psychological function" in WHOQOL-BREF in the observation group were higher than those in the control group, meanwhile, the scores of "positive and general pathological symptoms" in PANSS in the observation group were lower than those in the control group, both with statistical significance (P＜0.05). Conclusions? Team collaboration management program can help controlling the related metabolic parameters of the schizophrenic patients with metabolic syndrome effectively, improve their quality of life and promote recovery from their mental symptoms.