Objective To explore the rate of return to work among a cohort of spinal cord injury (SCI) who were at least 18 months post injury and some psychosocial factors contributing to return to work. MethodsA convenient sampling method was adopted and total 161 subjects were involved. The demographic characteristic and psychosocial variable were collected by 6 self-reported questionnaires: World Health Organization Disability Assessment Schedule Ⅱ, Acceptance of Disability Scale, Rosenberg Self-Esteem Scale, Center for Epidemiologic Studies Short Depression Scale, Generalized Self-Efficacy Scale and Multidimensional Scale of Perceived Social Support. Self-administered, telephone and face-to-face interview were the manners to capture data. ResultsThe return to work rate is 31%. The result generated from Logistic regression showed that the type of SCI (paraplegia or quadriplegia) （OR=4.397）, acceptance of disability (OR=0.979), disability assessment level (OR=0.948), and the impact of belief to activities of daily living (OR=0.681) were the contributors for successful return to work. ConclusionFor those who suffering from SCI after 18 months, both psychosocial adjustment factors and physical functioning may have the great impacts for the outcomes of return to work rather than that of external factors, such as social supports.

Objective To measure the reliability and validity of the Lam Assessment of Stages of Employment Readiness (LASER) Putonghua version for injured workers, and observe the confidence of return to work on different preparation stages. Methods 85 injured workers with limb fractures were included. The data was obtained through face-to-face structured interview. The test-retest reliability and internal consistency were measured. Factor analysis was used to examine construct validity of the Putonghua version LASER. Results Principle component analysis extracted four factors, which was consistent with the original version of LASER. Intra- class correlation coefficient (ICC) of test-retest ranged 0.27~0.89, whereas the internal consistence among these 4 stages ranged 0.691~0.796. There were significantly differences in confident scores in different stages among 3 different confidence groups. Conclusion The structure validity of Putonghua version of LASER is useful for reflecting the readiness of injured workers' return to work. However, the reliability coefficient is rather low in some of the items, which could be resulted in incorrect judgment of readiness of return to work of injured workers. The further study on items correction and development is apparent.

Humans ; Diverticulum, Colon ; Fecal Impaction ; Hydrodynamics

Objective To investigate the effect of mircoRNA-128-3p (miR-128-3p) on epithelial-mesencfrymal transition (EMT) of ovarian cancer cells and its regulatory mechanism on zinc finger E-box binding homobox 1(ZEB1). Methods Real-time PCR technology was used to detect the expression of miR-128-3p in epithelial ovarian cancer tissue (EOC) and adjacent normal tissue (30 cases each), and to observe whether there was a difference. Two human ovarian cancer cell lines, SK0V3 and A2780, were selected and transfected respectively. MiR-128-3p mimic (miR-128-3p mimic group) and negative control mimic (NC mimic group) were used to detect the expression of miR-128-3p in 4 groups by Real-time PCR to verify the interference effect. Transwell assay was used. The migration and invasion abilities of the four groups of cells were observed. The regulatory relationship between miR-128-3p and ZEBl was verified by dual luciferase assay, and the expression level of ZEBl protein after overexpression of miR-128-3p was detected by Western blotting; pcDNA-ZEBl was transfected into SK0V3 and A2780 cell lines to make it overexpression of ZEBl was divided into NC mimic group, miR-128-3p mimic group, and miR-128-3p mimic+pcDNA-ZEBl group. Western blotting was used to detect the EMT-related protein E-cadherin in 6 groups of cells and the expression level of vimentin. Results Real-time PCR result showed that the expression of miR-128-3p in EOC tissues decreased compared with that in adjacent tissues (P < 0. 01); The relative expression of miR-128-3p in the miR-128-3p mimic group was higher than that in the NC mimic group, while the numbers of migrating cells and invasive cells were lower than those in the NC mimic group (P < 0 . 0 1) . The result of dual luciferase experiments showed that miR-128-3p had a negative regulatory effect on ZEBl. In SK0V3 and A2780 cells, the relative expression of ZEBl protein in the miR-128-3p mimic group was lower than that in the NC mimic group, while the relative protein expression of E-cadhein was higher than that in the NC mimic group (P < 0 . 0 1) . The relative protein expression of E-cadhein in the miR-128-3p mimic+pcDNA-ZEBl group was lower than that in the miR-128-3p mimic group (P < 0 . 0 1) . In SKOV3 and A2780 cells, the relative protein expression of vimentin in the miR-128-3p mimic group was lower than that in the NC mimic group, and the relative protein expression of vimentin in the miR-128-3p mimic+pcDNA-ZEBl group was higher than that in the miR-128-3p mimic group (P < 0 . 0 1) . Conclusion The expression of miR-128-3p decreases in epithelial ovarian cancer tissues, which ma)' be due to the regulation of ZEBl to affect the expression of EMT-related proteins and participate in the EMT process of ovarian cancer cells.

Objective: To compare and quantify the differences in size-specific dose estimates (SSDE) obtained by effective diameter and water-equivalent diameter from the central slice of the scan range in head CT examination. Methods: A total of 111 consecutive adult patients who underwent head CT examination were enrolled in this study. All of CTDI_vol values in the dose report were documented. The dataset was assigned into group A and group B, based on the individual size-dependent conversion factors (f) of effective diameter (d_eff) and water-equivalent diameter (d_w) at the central slice multiplied by normalized volume computed tomography dose index (CTDI_vol ) respectively. Body size, f and SSDE were calculated. With SSDE_gross served as the reference level, the performance of SSDE_deff and SSDE_dw was evaluated. Results: Statistically significant differences were found in body size (t=47.587, P<0.05) and f(z=-9.242, P<0.05) between group A and group B. Statistically significant difference also existed in SSDE (t=-46.687, P<0.05), (56.20±2.66) and (53.49±2.48) mGy for group A and group B respectively. Strongly positive correlation was shown in body size (r=0.873, R² =0.761) and SSDE (r=0.974, R² =0.949) between group A and group B(all P<0.05). Positive correlation was also found between SSDE_deff and SSDE_gross(r=0.900, R² =0.809), SSDE_dw and SSDE_gross (r=0.904, R² =0.817, all P<0.05). Mean absolute difference was 2.34 and 0.78 mGy, for SSDE_deff vs. SSDE_gross and SSDE_dw vs. SSDE_gross respectively; mean absolute relative difference was 4.38%, 1.40%; root mean square difference was 1.17 mGy (2.17%), 1.06 mGy (1.91%). Interquartile range and full range of SSDE_deff and SSDE_dw were 3.22 vs. 2.39 mGy, 13.65 vs. 12.48mGy, respectively. A less degree of variation was observed in SSDE_dw than that in SSDE_deff. Conclusions SSDE_dw values based on the water-equivalent diameter at the central slice of the scan range got better agreement with those derived from all slices, which could serve as a simpler and more valid indicator to represent the average value of size-specific dose estimates of the whole scan range in head CT examination.

【Objective】 To explore the clinical value of thromboelas-tography, coagulation four items and platelet count in guiding platelet transfusion in critically ill patients. 【Methods】 A total of 188 critically ill patients in Intensive Care Unit of our hospital from January 2020 to January 2022 were selected as subjects, and were divided into study group(n=89) and the control(n=99) according to the presence of bleeding symptoms. T-test was used for comparative analysis between the two groups. Spearman was used to analyze the correlation between TEG, coagulation four items and platelet count, and binary Logistic regression analysis was used to predict the influential factors of bleeding in critically ill patients, ROC curve was used to analyze the guiding value of the above-mentioned indexes for platelet transfusion. 【Results】 1) K and PT values in the study group, above the normal range, were significantly higher than those in the control, while the Angle value, MA value, CI value, FIB value and platelet count were significantly lower than those of the control, among which MA value, CI value and platelet count were below the normal range. 2) TEG, coagulation four items and platelet count were correlated. MA and CI values were positively correlated with platelet count, instead, R and K values were negatively correlated. R value was positively correlated with PT and APTT, CI value, on the contrary, was negatively correlated, K value was positively correlated with PT, while Angle value and MA value were negatively correlated. 3) Binary Logistic regression analysis showed that decreased MA value and decreased platelet count were independent risk factors for predicting bleeding in critically ill patients(P<0.05). 4) ROC curve analysis showed that the areas under ROC curve corresponding to Angle value, MA value, CI value, FIB value and platelet count were 0.866, 0.932, 0.9, 0.838 and 0.987(P<0.05). The sensitivity was highest in platelet count and lowest in FIB. The specificity was highest in MA and lowest in Angle. Compared with the single index, the area under the curve of the combined index(K value, MA value, CI value, PT value and platelet count) was 0.995(P<0.05), Yoden index 0.944, sensitivity 100%, specificity 93.3%, all higher than the individual index. 【Conclusion】 Thromboelas-tography combined with coagulation four items and platelet count can be used to accurately predict the critically ill patients with bleeding risk. To guide clinical platelets transfusion, the combined use of indexes, including K value, MA, CI value, PT and platelet count, is superior to separate use of them as the former showed better sensitivity and specificity, demonstrating a good clinical value.

Accessory gene regulator(agr)-mediated quorum sensing system plays a crucial role in staphylococcal aureus(S.aureus) pathogenesis.It upregulates secreted virulence factors and downregulates cell surface proteins, thereby influencing invasiveness of S. aureus and cell dispersal from biofilms.S.aureus can be divided into four groups according to the polymorphism in the sequence of agr system and of its corresponding receptor.Auto-inducing peptide(AIP)can activate the agr locus in the same group, but mutually inhibit agr locus from different groups.Recent researches have demonstrated that agr dysfunction is common among S. aureus isolates.Certain agr classes and agr-defective strains have been associated with specific clonal complexes and a variety of diseases, influencing the courses of infections and the antibiotic resistance.In this paper, the effects of different agr types and dysfunctional agr on the virulence, antibiotic resistance and biofilm formation of S. aureus were reviewed.

OBJECTIVETo investigate the relationship between apical root resorption and orthodontic tooth movement in growing subjects.

METHODS58 growing subjects were collected randomly into the study sample and another 40 non-treated cases were used as control. The apical resoption of the upper central incisors was measured on periapical film and the incisor displacement was measured on lateral cephalogram. Using multiple linear regression analysis to examine the relationship between root resoption and the displacement of the upper incisor apex in each of four direction (retraction, advancement, intrusion and extrusion).

RESULTSThe statistically significant negative association were found between resorption and both intrusion (P < 0.001) and extrusion (P < 0.05), but no significant association was found between resorption and both retraction and advancement. The regression analysis implied an average of 2.29 mm resorption in the absence of apical displacement.

CONCLUSIONSThe likelihood that the magnitude of displacement of the incisor root is positively associated with root resoption in the population of treated growing subjects is very small.

Objective : To evaluate the effects of transcutaneous electrical nerve stimulation ( TENS ) and waterbirth with Doula services on the outcome of delivery. Methods: From July 2018 to December 2019, 150 primiparas in Hangzhou Women's Hospital were randomly divided into three groups: TENS, waterbirth and control groups. They were given TENS, waterbirth and conventional midwifery, accompanied by Doula services. The visual analogue scores ( VAS ) , length of labor stages and neonatal asphyxia were compared. Results: It finally included 45 cases in the TENS group, 45 cases in the waterbirth group and 44 cases in the control group. There were no significant differences in gestational weeks, age, height, weight, fetal biparietal diameter and newborn birth weight among the three groups ( P>0.05 ) . The VAS scores of TENS group and waterbirth group were lower than those of the control group ( P<0.05 ) , but there were no significant differences between the two groups ( P>0.05 ) with the cervix open to 2.5-3 cm, 5-7 cm ( 0.5 hours later ) and 10 cm. There was no interaction between the analgesia methods and cervix diameter ( P>0.05 ) . The duration of the first stage of labor in the TENS group and the waterbirth group was less than that in the control group ( P<0.05 ) , and there was no significant difference between the TENS group and the waterbirth group ( P>0.05 ) . The asphyxia rate of neonates in TENS group, waterbirth group and control group were 2.22%, 2.22% and 4.55%, respectively, with no significant difference ( P>0.05 ) . Conclusion Under Doula services, both TENS and waterbirth can effectively relieve the pain of delivery and shorten the first stage of labor, without obvious differences.

Objective: To evaluate the clinical effect and imaging evaluation of cervical spine myelopathy treated with Centerpiece. Methods: A retrospective study of 60 patients underwent posterior cervical spine surgery because of cervical myelopathy in Spinal Department of Peking University People′s Hospital from July 2011 to January 2013.According to the different fixation methods, all patients were divided into cervical posterior open-door Centerpiece fixation group (group A) and cervical posterior open-door silk suspension fixation group (group B). There were 40 patients in group A, including 25 males and 15 females, mean age (59.7±11.9) years old, average course of disease before surgery (53.6±61.5) months, average follow-up time (28.5±3.1) months after operation.There were 20 patients in group B, including 15 males and 5 females, mean age (58.3±9.6) years old, average course of disease before surgery (50.4±14.9) months, average follow-up time (28.3±1.9) months after operation.The operation time, intraoperative blood loss, postoperative drainage, preoperative and postoperative Japanese Orthopaedic Association(JOA) score, the neck disability index(NDI) score, visual analog scale (VAS) score, postoperative axial pain, C₅ nerve root palsy, postoperative "re-closing" and other related complications were observed.Imaging assessment projects include: before and after surgery of cervical curvature, range of motion(ROM), spinal anteroposterior diameter, spinal canal expansion rate, the whole spinal cord backward shift distance and area of the spinal canal and the opening angle. Results: There was no significant difference in general data between the two groups (P>0.05). Group A the average operation time was(117.7±23.4)min, the average amount of operative bleeding was (152.0±122.7) ml, and the postoperative drainage volume was (268.7±222.1) ml.The average operation time of group B was (141.7±23.9) min, the average amount of operative bleeding was (166.7±42.5) ml, and the postoperative drainage volume of group B was (255.3±47.0) ml.There was no significant difference between the two groups in the amount of operative bleeding and postoperative drainage volume (both P>0.05), the operation time between the two groups was statistically significant (P<0.05). At the end of the follow-up, the JOA score, NDI score, and VAS score were significantly improved (P<0.05) in both group A and group B and there was no significant difference between the two groups (P>0.05). C₅ nerve root paralysis was not occurred in both two groups after operation.There were 1 case of axial pain in the group A and 7 cases in the group B and there were significant differences between the two groups (P<0.05). The group A was not found "re-closing" during the follow-up and 12 patients of group B found to be "re-closing" phenomenon, there were statistically different between the two groups (P<0.05). Comparison of preoperative and postoperative, there were no significant differences in cervical curvature and ROM in both groups (P>0.05). Butthe spinal canal diameter and the vertebral canal area were statistically different after surgery (P<0.05). There was no statistical difference between the two groups of cervical curvature and ROM (P>0.05). There was no statistical difference between the two groups of spinal canal diameter, spinal canal area and spinal canal diameter enlargement rate(P>0.05). There was no statistical difference between the two groups of the whole spinal cord backward shift distance(P>0.05). There were significant differences between the two groups at the angle of the open door (P<0.05). Conclusion Centerpiece cervical posterior titanium plate can achieve good clinical efficacy in the treatment of multi segmental spinal cervical spondylosis.