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.

Objective To explore the predictive value of lung ultrasound score on the severity of neonatal respiratory distress syndrome(NRDS).Methods The clinical data of 65 children with NRDS in our NICU from July 2021 to July 2022 were retrospectively analyzed,and 65 children were included in the NRDS group,while 40 children with other common pulmonary diseases(neonatal wet lung and infectious pneumonia)were selected as the other pulmonary disease group during the same period,and all children were examined by pulmonary ultrasound and X-ray to observe the children in both groups.The lung conditions of the two groups of children were observed:abnormal pleural line,disappearance of A line,isolated B line,fused B line,diffuse B line,lung consolidation,with or without bronchial inflation sign,and other lung ultrasound manifestations.The lung ultrasound scores of the two groups of children were compared,and the X-ray grading distribution of children in the NRDS group was analyzed,correlation between lung ultrasound scoring and X-ray grading was used by Pearson correlation analysis.The clinical value of lung ultrasound score in the differential diagnosis of NRDS and the severity of the disease was analyzed by receiver operator characteristic(ROC)curve.Results The proportion of solid lung,abnormal pleural line,disappearance of A-line,white lung detection,fused B-line,and bronchial inflation sign was significantly higher in the NRDS group than in the other lung disease groups,and the proportion of isolated B-line and double lung point detection was significantly lower than in the other lung disease groups,with statistically significant differences(P<0.05).The lung ultrasound scores of both lungs,left lung,right lung,bilateral lung,and base of both lungs were significantly higher in the NRDS group than in the other lung disease groups(P<0.05).With the increase of X-ray grading,the lung ultrasound score gradually increased,and there was a statistically significant difference between groups at each grade(P<0.05).Pearson correlation analysis showed that there was a significant positive correlation between lung ultrasound score and X-ray grade(r=0.704,P<0.05).The area under curve(AUC)of lung ultrasound score in differentiating NRDS from common lung diseases was 0.907,with sensitivity and specificity of 89.0%and 92.5%,respectively;the AUC of mild and moderate,moderate and severe NRDS in the differential diagnosis by lung ultrasound score was 0.914 and 0.933,respectively,which had high clinical value.Conclusion The lung ultrasound score has certain value in identifying NRDS.The lung ultrasound score can quantitatively assess the changes in the condition of NRDS,and the lung ultrasound and X-ray grading have good consistency,it has the advantages of radiation free,fast,and intuitive,and can be used as an effective method for early diagnosis of NRDS and evaluation of the severity of the disease.

Minimal access spinal surgery(MASS),a new minimally invasive technique,has been developed on the basis of classic minimally invasive spinal surgery(MISS).With some special equipments,this procedure can reduce approach-related morbidity and collateral damage to surrounding tissues,and can be performed under direct visualization of the spine.The MASS combines the merits of MISS and traditional open procedures,and comparable results can be obtained while decreasing approach-related complications and learning curve.Now,the application of MASS has become more frequent in clinical practice due to its favourable characteristics in curative effect,postoperative recovery and economic efficacy.

AIM: To analyze the risk factors of corneal epithelial dysfunction(CED)after pars plana vitrectomy(PPV).

METHODS: Clinical data of 235 patients with 235 eyes of PPV from July 2016 to June 2018 in our hospital were retrospectively analyzed. The age, sex and related medical history of the patients(such as ocular lesions and systemic diseases)were collected, and the intraocular fillers, operation time, postoperative intraocular pressure were recorded. Logistic regression was used to analyze the risk factors of CED after PPV.

RESULTS: The incidence of CED after PPV was 16.6%(39/235), and the incidence of persistent corneal epithelial lesion was 1.3%(3/235). Logistic regression showed that age, preoperative xerophthalmia, diabetes mellitus, Silicone oil filling, postoperative high intraocular pressure and operation time were risk factors for CED after PPV. The OR values were 1.270, 5.218, 18.598, 4.659, 10.799 and 1.104, respectively.

CONCLUSION: Age, preoperative xerophthalmia, diabetes mellitus, silicone oil filling, postoperative high intraocular pressure and operation time are risk factors for CED after PPV.