Objective To explore the relationships among social adaptation and the resilience,social support and coping style in undergraduate nursing students.Methods 758 students from two medical colleges in Shandong province were recruited by stratified random sampling method.They were assessed with China College Student Adjustment Scale (CCSAS),Resilience Scale for Adults (RSA),Social Support Rating Scale (SSRS),Simplified Coping Style Questionnaire (SCSQ).The data was analyzed with the structural equation mode.Results The social adaptation of undergraduate nursing students showed significantly positive association with the resilience,social support,positive coping style(r=0.113-0.607,P＜0.01),but the campus adaptation had negative association with negative coping style(r=-0.117,P＜0.01).The path analysis showed that the resilience,social support and coping style were the direct predictors of social adaptation (β=0.57,P＜0.05;β=0.0.26,P＜0.05;β=0.1,P＜ 0.05),and the resilience,active coping style played the mediating role between social support and social adaptation (β=0.31,P＜0.05;β=0.05,P＜0.05).Conclusion The social adaptation and the resilience,social support and active coping style of nursing undergraduates are closely related.

Objective Observation of 2 diabetic patients with insulin homocysteine(Hcy) levels before and after treatment ,to explore new diagnosis of diabetes patients with blood glucose control for the effect Hcy .Methods Extracted from 128 cases accord with standard of newly diagnosed type 2 diabetic patients ,randomly divided into control group and strengthen group ,64 cases each . Give control group oral sulfonylureas .To observe group use insulin intensive therapy .In the three months after treatment compared two groups before and after treatment of FBG ,HbA1c indicators related to change .Results All patients after treatment ,Hcy , FBG ,PBG ,HbA1c have decreased ,and Hcy in strengthen group decreased more obviously than in control group ,the difference was statistically significant level changes(P<0 .05) .Conclusion Insulin intensive therapy can be effective in the treatment of newly di‐agnosed type 2 diabetes .

Objective To realize the contamination status of dental unit waterlines (DUWL)in general hospitals, and provide scientific evidence for making preventive measures.Methods Three hospitals were selected for study, water source adopted by hospital A,B and C was running water,reservoir water,and filtered water through reverse osmosis filtration system respectively,specimens of dental handpiece spray water and flushing water of dental chair units were collected quarterly,total bacterial colony in water were detected.Results The qualified rate of source wa-ter,handpiece spray water,and flushing water in hospital A was 75.00%(3/4),0 (0/40)and 0 (0/40)respectively,col-ony count of handpiece spray water and flushing water was (1.20×103 -5.53×104 )CFU/mL(M=3.80×104 CFU/mL) and (2.11×104 -1.66×105 )CFU/mL(M=4.80×104 CFU/mL)respectively.The qualified rate of source water,hand-piece spray water,and flushing water in hospital B was 50.00%(2/4),60.00%(24/40)and 72.50%(29/40)respectively, colony count of handpiece spray water and flushing water was (0.00 -3.71 ×106 )CFU/mL(M=83.00 CFU/mL)and (0.00-2.39×106 )CFU/mL(M=72.00 CFU/mL)respectively.The qualified rate of source water,handpiece spray wa-ter,and flushing water in hospital C was 100.00%(4/4),55.00%(22/40)and 65.00%(26/40)respectively,colony count of handpiece spray water and flushing water was (0.00-6.20×103 )CFU/mL(M=96.00 CFU/mL)and(0.00-1.63×103 )CFU/mL(M=87.50 CFU/mL)respectively.Conclusion Water of DUWL in general hospitals is seriously con-taminated,disinfection and standardized management of source water and DUWL must be strengthened.

Objective To investigate whether ultrasonic coupling agent (UCA)can produce shielding or antago-nistic effect on iodine disinfectant for preoperative skin disinfection.Methods Shielding or antagonistic effect of UCA on iodine disinfectant were detected by laboratory carrier immersion killing test and on-the-spot skin disinfec-tion test.Results Antagonistic effect:after the mixing of iodophor with UCA,the average killing rate of iodophor containing available iodine 2 500mg/L and 625 mg/L to Staphylococcus aureus decreased from 100.00% to 99.67%-99.78% and 96.85 % - 98.25 %,respectively;the average killing rate to Escherichia coli decreased from 100.00% to 99.71 %-99.82% and 95 .93 %-98.56%,respectively.Shielding effect:after smearing with UCA, the average killing rate of iodophor and iodine tincture + alcohol to Escherichia coli decreased from 100.00% to 30.76% and 100.00% to 94.48%,respectively;the average killing rate to Staphylococcus aureus decreased from 99.99% to 55 .55 % and 100.00% to 98.22%,respectively.On-the-spot skin disinfection test:the killing rate of io-dophor and iodine tincture +alcohol to natural bacteria on skin surface were both 99.99%,after skin was smeared with UCA,the killing rate decreased to 92.62% and 93 .57%,respectively.Conclusion UCA remained on the oper-ative field has shielding and antagonistic effect on iodine disinfectant.

OBJECTIVETo investigate the expression and clinical significance of G protein-coupled receptor 31 (GPR31) in colorectal cancer tissue.

METHODSCancer tissues and adjacent normal tissues of 321 cases with colorectal cancer confirmed by pathology and undergoing resection in the First Affiliated Hospital of Sun Yat-sen University from January 1996 to December 2008 were collected. The expression of GPR31 was examined by immunohistochemical staining. According to the expression level of GPR31 (A value=0.051), all the patients were divided into low GPR31 expression group and high GPR31 expression group. Clinicopathology and prognosis between the two groups were compared. Risk factors affecting prognosis were investigated.

RESULTSGPR31 expression was significantly higher in colorectal cancer tissues compared to adjacent normal tissues (mean A, 0.063±0.014 vs. 0.045±0.020, P<0.001). A total of 197 cancer tissue samples were defined as low expression and 124 as high expression. Significant difference was observed in the number of patient in pM classification between the two groups (P=0.007). High expression group had obviously higher distant metastasis rate than low expression group [12.1% (15/124) vs. 4.1% (8/197), P=0.007]. The 5-year survival rate and tumor-free survival rate were 84.3% and 82.2% in the low expression group, and both 59.7% in high expression group (all P<0.05). Multivariate analysis revealed elderly, abnormal CEA, lymphatic metastasis, distant metastasis and up-regulated GPR31 expression were independent risk factors of overall survival and disease-free survival in colorectal cancer patients (all P<0.05).

CONCLUSIONSGPR31 expression is significantly up-regulated in colorectal cancer tissues. High GPR31expression indicates poor prognosis of colorectal cancer, and may be used as a predictive marker.

Aged ; Biomarkers, Tumor ; metabolism ; Colorectal Neoplasms ; diagnosis ; metabolism ; Disease-Free Survival ; Humans ; Lymphatic Metastasis ; Prognosis ; Receptors, G-Protein-Coupled ; metabolism ; Risk Factors ; Survival Rate ; Up-Regulation

Objective:To observe the susceptibility factors of elderly patients with corynebacterium striata in sputum of lower respiratory tract and analyze its clinical therapeutic effect.Methods:The clinical data of 192 elderly inpatients infected with corynebacterium striatum detected in sputum of lower respiratory tract were retrospectively analyzed in Quanzhou First Hospital Affiliated to Fujian Medical University from January 2019 to June 2021.The detection rate of corynebacterium striata was calculated, and the susceptibility factors and clinical efficacy were compared between the infection group(n=102)and the colonization group(n=90).Results:The detection rate of corynebacterium striata(detected cases / numbers of qualified lower respiratory tract sputum specimen)was 0.8%(72/8976)from January to December 2019, 2.3%(134/5877)from January to December 2020, and 3.0%(121/4 039)from January to June 2021, the difference was statistically significant( χ2=93.93, P<0.01). The detection rates of corynebacterium striatum during three corresponding periods in elderly patients were 0.6%(57/8 976), 1.4%(81/5 877)and 1.9%(78/4 039), respectively, with statistically significant differences( χ2=45.57, P<0.01). The incidences or values of following indexes were higher in infection group than in colonization group: age of patients, admission of intensive care unit, malnutrition, use of hormones, combined use of antibiotics, use of invasive mechanical ventilation, use of fiber bronchoscope, reduced cough reflex, other basic diseases, and so on, but the differences were not statistically significant(all P>0.05). The clinical effective rates were 41.2%(42/102)in the infection group and 48.9%(44/90)in the colonization group, respectively, and the differences was not statistically significant( P>0.05). Only 25 patients(24.5%)in the infected group were treated on corynebacterium striatum according to drug sensitivity results.Among them, the clinical effective rate of the treatment group and the untreated group was 68.0%(17/25)and 32.5%(25/77), respectively, the difference was statistically significant( χ2=9.84, P<0.01). The clinical effective rate of untreated group was lower than that of colonization group, the difference was statistically significant( χ2=4.62, P<0.05). Conclusions:The detection rate of corynebacterium striatum in elderly patients is high, and increases year by year.Patients infected with corynebacterium striatum usually has a variety of susceptibility factors, if not taking effective treatment measures, may have adverse outcomes.In clinical work, it is necessary to pay attention to and reduce the susceptibility factors of corynebacterium striatum, and to correctly interpret the etiological reports, so as to adopt a reasonable and effective therapeutic schedule.

Objective:To explore the clinical and chest CT features of anti-interferon(IFN)-γ autoantibodies-positive talaromycosis marneffei (TSM) infection in human immune deficiency virus (HIV)-negative patients.Methods:Clinical data and chest CT findings including pulmonary manifestations, bronchial changes, pleural changes, and extrapulmonary manifestations in 54 HIV-negative patients with Talaromyces marneffei (TM) infection and positive anti-interferon-γ(IFN-γ) autoantibody in the First Affiliated Hospital of Guangxi Medical University from December 2012 to September 2019 were retrospectively analyzed. CT score was rated for the degree of lung involvement, and the difference of involvement at different regions of the lung were compared. Results:Of 54 patients, 46 cases had fever, 43 cases had cough and expectoration, 28 cases had cutaneous or subcutaneous lesion, and 19 cases had arthritis or arthralgia. Laboratory tests showed that the value of CD4/CD8 decreased in 29 cases and platelet count increased in 32 cases. Only one of 54 patients had no abnormal findings on chest CT. In the remaining patients, chest CT manifestations were diverse, mainly presenting as fibrous cord-like lesions (87.0%, 47/54), lymph node enlargement (75.9%, 41/54), sporadic nodules (74.1%, 40/54), patchy consolidation (72.2%, 39/54), pleural effusion (59.2%, 32/54), and consolidation lesions associated with air bronchogram (63.0%, 34/54). Most of the lesions showed bilateral distribution (77.8%, 46/54), and involved both peripheral and central regions in 38 cases (70.4%, 38/54). CT score showed that there was no significant difference in the degree of involvement at different regions of the lung.Conclusions:The clinical and imaging manifestations of anti-IFN-γ antibody-positive patients with TM infection are characteristic. Most TSM patients with positive anti-IFN-γ antibody have fever, cough and expectoration. The main features of chest CT are cord focus, nodules, consolidation and pleural effusion. Lymph node enlargement often coexists with the above signs, and most of the lesions are distributed bilaterally.

A new-type digital electric plum-blossom needle instrument of controllable and adjustable parameters was developed to achieve an automatic tapping instead of manual tapping technique and integrate the function of plum-blossom needle with that of micropulse electrical phase. The alternating current of periodic variation changes the direction of magnetic field around, induces the vibration of the cone head and tapping movement, outputs the micropulse current and acts on the affected area in treatment. The new-type digital electric plum-blossom needle instrument achieves the automatic tapping movement, precisely adjusts the stimulating strength and frequency according to diseases and integrates the tapping stimulation with pulse current to form circulation loop on the skin and intensify the therapeutic effects. This instrument is the big innovation of traditional plum-blossom needle. It is not only applicable for clinical treatment or family healthcare, but also for scientific research with the adoptable digital therapeutic parameters, which benefits the application and development of plum-blossom needle therapy.

ObjectiveTo explore the application value of CT pulmonary angiography (CTPA) in assessing the severity of acute pulmonary embolism (APE) and right heart function in rehabilitation patients. MethodsFrom January, 2013 to January, 2020, 133 inpatients (94 positive and 39 negative) who underwent CTPA examination in Beijing Bo'ai Hospital were involved. Positive patients were further divided into mild, moderate and severe groups based on the pulmonary artery obstruction index (PAOI). The clinical parameters and right heart function indicators were compared. Spearman correlation analysis was used to analyze the correlation between PAOI, and clinical parameters and right heart function indicators, and Logistic regression analysis was used to predict the risk factors of APE. ResultsThere was significant difference in lower extremity venous thrombosis, D-dimer, oxygen partial pressure, PAOI and left process of interventricular septum among four groups (H ≥ 12.350, P < 0.01). PAOI was moderately positively correlated with D-dimer (r = 0.443, P < 0.001) and left process of interventricular septum (r = 0.520, P < 0.001), and was weakly positively correlated with lower extremity venous thrombosis (r = 0.399, P < 0.001), left pulmonary artery diameter (r = 0.213, P = 0.014) and inferior vena cava regurgitation (r = 0.229, P = 0.008). Lower extremity venous thrombosis (OR = 7.708, P < 0.001) and left process of interventricular septum (OR = 3.641, P = 0.008) were independent risk factors for the onset of APE. The combination of the two indicators was effective for diagnosis of APE, and AUC was 0.795 (95% CI 0.715 to 0.874). ConclusionCTPA may be applied to evaluate the severity of APE and right heart function in rehabilitation patients.

Although the epidemic outbreak of Corona Virus Disease 2019 (COVID-19) restricted freecoming and going of people, it was inevitable that fracture patients, elderly ones with low-energy fracture in part ICU lar, sought medical attention. In this special situation, itwas crucial for trauma orthopaedists to do well in prevention and control of COVID-19 infection and in perioperative management of their patients as well while they went on with routine diagnosis and treatment. It was also of great significance for prognosis of the patients and prevention and control of the epidemic that orthopaedic surgeons chose proper surgical and anesthesia methods. In the process of diagnosis, treatment, nursing and rehabilitation, medical staff too was challenged by how to prevent themselves from infection and how to eliminate cluster COVID-19 transmission. This paper, from the perspectives of orthopedic surgeons, nurses and patients, expounds briefly on the management of patients with orthopedic trauma during the epidemic period of COVID-19 in a mode of multidisciplinary comprehensive interventions.