Objective To investigate the effect of atorvastatin on the expressions of solubility P-selectin(sP-selectin) and high sensitive C reactive protein(hs-CRP) in patients with percutaneous coronary intervention (PCI),and to explore the protective effect of atorvastatin on myocardium.Methods A total of 100 acute coronary syndrome patients having underwent successful PCI were enrolled in this study.All patients were divided into 3 groups by random digits table method:standard treatment group (group A,30 patients,atorvastatin 20 mg),low-dose atorvastatin pretreatment group (group B,35 patients,preoperative 12 h and 2 h atorvastatin 40 mg and 20 mg,respectively) and high-dose atorvastatin pretreatment group (group C,35 patients,preoperative 12 h and 2 h atorvastatin 80 mg and 40 mg,respectively).The level of sP-selectin was measured with ELISA.The level of hs-CRP was measured with latex enhanced immunoturbidimetry.Results Before operation,the levels of sP-selectin in group A,B,C were (2.32 ±0.40),(2.51 ± 0.33),(2.47 ± 0.28) μ g/L.After 6 and 12 h of operation,the levels of sP-selectin in group A,B,C were (4.12 ± 0.75),(3.34 ± 0.42),(3.31 ± 0.46) μ g/L and (5.64 ± 1.07),(4.08 ± 0.74),(3.84 ±0.48) μg/L.The levels of sP-selectin in group A,B,C after operation were significantly higher than that before operation (P ＜ 0.05).At the same time point,the levels of sP-selectin in group B,C after operation were significantly lower than that in group A (P＜ 0.05).Before operation,the levels of hs-CRP in group A,B,C were (4.32 ±0.51),(4.46 ±0.57),(4.29 ±0.43) mg/L,after 6 and 12 h of operation,the levels of hs-CRP in group A,B,C were (8.91 ± 1.34),(7.44 ± 1.06),(7.28 ±0.95) mg/L and (13.66 ± 1.49),(8.08 ± 1.14),(7.92 ± 1.04) mg/L.The levels of hs-CRP in group A,B,C after operation were significantly higher than that before operation (P＜ 0.05).At the same time point,the levels of hs-CRP in group B,C after operation were significantly lower than that in group A (P ＜ 0.05).The analysis of Pearson correlation showed,the level of sP-selectin was positively related with hs-CRP (r =0.753,P ＜0.01).The incidence of perioperative myocardial infarction was 23.3％ (7/30),5.7％ (2/35) and 2.9％ (1/35) in group A,B and C,respectively.The incidence in group A was significantly higher than that in group B and C (P ＜ 0.05).But there was no significant difference between group B and group C (P＞ 0.05).Conclusion The atorvastatin pretreatment can decrease the levels of sP-selectin and hs-CRP in patients after PCI,which play an important role in myocardium protection.

ObjectiveTo explore the distribution of nanobacteria in prostatic calculus and investigate its role in the formation of prostatic calculus. MethodsThe stones of 40 patients with prostatic calculus was used to isolate and culture the possible bacteria. The genomes of obtained bacteria were extracted, and the 16S rRNA was amplified by PCR followed by sequencing. ResultsThe obtained specific fragment had a 98% resemblance with 16S rRNA of nanobacteria: Score=2 480 bits (1 290), Expect=0.0; Identities=1 387/1 409 (98%), Gaps=4/1 409 (0%); Strand=Plus/Plus. ConclusionNanobacteria is proved existing in the stones of prostatic calculus patients by PCR and sequencing.

Objective To explore relationship of the anesthetic risks and intraoperative complications.Methods Preoperative anesthetic risks were assessed with Hussman's method from May 2015 to May 2016 in 2 494 surgical patients, including 1 462 males and 1 032 females.Intraoperative data and complications were tracked and recorded.Results Three hundred and thirty-six intraoperative complications occurred, accounting for 13.47% of total patients.The cardiovascular complications were a major intraoperative complications, accounting for 80.7%.2 494 patients were graded respectively into risk grade 1 with 1 540 (61.75%), grade 2 with 660 (26.46%), grade 3 with 202 (8.10%), grade 4 with 80 (3.21%) and grade 5 with 12 (0.48%).The incidence of complications were 112 (7.28%), 82 (12.42%), 82 (40.59%), 50 (62.50%) and 10 (83.33%) respectively.The sensitivity of prediction was 33.33%, 24.40%, 24.40%, 14.88% and 2.78%;the specificity 33.76%, 73.26%, 94.44%, 98.61% and 99.91%;and the accuracy 33.76%, 66.64%, 85.01%, 87.33% and 86.85%, respectively, in patients with risk grade 1, 2, 3, 4 and 5.Conclusion Hussman's method of anesthetic risks well predicts the intraoperative complications.

Objective To investigate the occurrence circumstance of acute stress disorder(ASD),clinical features and related risk factors,in the officers and soldiers who had gone to Beichuan county to provide disaster relief.Methods We used the self-general questionnaire,post-traumatic stress symptoms self-rating scale(PCL-C),perceived social support scale(PSSS),and coping style questionnaires(SCSQ)to assess the 126 subjects,combining with semi-structured interviews to determine and compare the ASD group and control group,and then analyzed the related factors.Results The prevalence rate of ASD officers and soldiers was 13.49%,with main symptoms of repeatedly breaking into painful memories,nightmares,reproducing the scenes of traumatic events,strong trouble of psychological pain,decreased interest,sleep disorders and emotional instability.These main symptoms of ASD interacts each other,and were reduced with positive response and good social support.Conclusion In the phase of acute stress(one month),the officers and soldiers taking part in earthquake relief have symptoms of ASD,so we should strengthen the necessary psychological assessment and comprehensive psychological intervention means,in order to slow down psychological trauma after disaster,prevent and reduce the possibility that ASD turns into post-traumatic stress disorder(PTSD).

Objective: To investigate the factors influencing the development of gastric cancer in Chinese populations, so as provide insights into creating a model for predicting gastric cancer incidence among Chinese populations. Methods: The case-control and cohort studies pertaining to factors affecting the development of gastric cancer were retrieved in electronic Chinese and English databases, including CNKI, Wanfang Data, VIP, PubMed, Web of Science and Embase from their inception until September 30, 2021. A meta-analysis was performed using R package version 4.1.0. Sensitivity analysis was performed using the “leave-one-out” evaluation procedure, and the publication bias was evaluated using the Egger regression test and the trim-and-fill procedure. Results: A total of 5 301 publications were screened and 116 eligible studies were included in the final analysis, including 103 case-control studies and 13 cohort studies, which covered approximately 3.23 million study subjects. A total of 45 factors affecting the development of gastric cancer were collected, and there were less than 4 publications reporting 7 factors, which were only qualitatively described. There were 38 factors included in the final meta-analysis. A total of 21 factors were identified as risk factors of gastric cancer, including a history of gastrointestinal diseases (pooled OR=4.85, 95%CI: 3.74-6.29), H. pylori infection (pooled OR=3.18, 95%CI: 2.35-4.32), binge eating and drinking (pooled OR=2.88, 95%CI: 2.09-3.97) and a family history of tumors (pooled OR=2.78, 95%CI: 2.17-3.56), and 10 factors as protective factors, including vegetable intake (pooled OR=0.48, 95%CI: 0.38-0.61), tea consumption (pooled OR=0.55, 95%CI: 0.47-0.64), administration of aspirin (pooled OR=0.53, 95%CI: 0.31-0.92) and administration of statins (pooled OR=0.59, 95%CI: 0.44-0.80). Sensitivity analyses of eating moldy food frequently, white meat intake, favoring spicy food and administration of sulfonylureas were not robust. Following correction with the trim-and-fill procedure, there was still a publication bias pertaining to high income, diabetes, administration of stains, alcohol consumption, tea consumption and white meat intake. Conclusions The development of gastric cancer is associated with a medical history of gastrointestinal disease, H. pylori infection, family history of tumors and poor dietary habits. Risk and protective factors of gastric cancer are recommended to be included in models used to predict gastric cancer incidence among Chinese populations.

Objective To analyze the clinical efficacy of gamma-ray fractionated stereotactic radiotherapy (FSRT) in the treatment of intracranial metastatic polycystic tumors.Methods Forty cases with 61 metastatic polycystic tumors were selected from 189 patients with 373 intracranial metastatic tumors admitted to our hospital from 2013 to 2015.All cases received gamma-ray FSRT.The isodose line at 50％ was defined as the prescription dose.The prescription dose was ranged from 40 to 48 Gy/10-12f.The survival rate was calculated by Kaplan-Meier method.The single factor analysis was performed by Log-rank method.Results The median follow-up time was 21months (range:6-39 months).The median survival time was 15.3 months.The 6-month,1-and 2-year local control rate was 93％,82％ and 79％,respectively.The 1-and 2-year survival rate was 63％ and 30％.Single factor analysis demonstrated that the volume of cysts and the volume of lesions were not significantly correlated with local control rate (P=0.17 and 0.48).Conclusion Gamma-ray FSRT can be adopted to treat intracranial metastatic polycystic tumors,which yields similar clinical efficacy to metastatic solid tumors.It deserves wide application in clinical practice due to high local control rate and safety.

Objective To get an understanding of the patient experience in public hospitals nationwide, and to evaluate the implementation of the Action Plan to Improve Health Care. Methods Supported by the mobile technology, from September 6, 2017 to December 15, 2018, the authors conducted an online survey that measured the satisfaction of both inpatients and outpatients at secondary and tertiary hospitals across the country. 15 questions from six dimensions including registration experience, patient-doctor communication, nurse-patient communication, the healthcare signage system, responsiveness of care providers and privacy protection were prepared for outpatients, while 20 questions from nine aspects such as nurse-patient communication, patient-doctor communication, pain management, medication communication, admission and discharge information, responsiveness of care-givers, food service, friendliness to patient family, and the healthcare signage system were directed at inpatients. Descriptive statistical analysis was used to describe the basic features of the data. Results 9.18 million valid responses from outpatients and another 5.38 million from inpatients were obtained. The overall satisfaction rate with outpatient services had reached a score of 90.45 points where nurse-patient communication stands out as the top-rated dimension and privacy protection gets the lowest rating. On the other hand, the inpatient satisfaction stands at a score of 93.01 with friendliness to patient family receiving the top score and patient-doctor communication the lowest. Conclusions Despite the positive feedback Chinese patients give on the outpatient care they receive, we should make efforts to improve the outpatient care environment, the wayfinding system, privacy protection, and responsiveness of care-givers.

Objective:This study aimed to compare the detection efficacy of transrectal ultrasound-guided transrectal cognitive fusion targeted+ systematic prostate biopsy and transperineal cognitive fusion targeted + systematic biopsy in patients with suspected prostate cancer (PCa). In addition, the relative clinical characteristics of PCa were evaluated.Methods:A total of 385 patients with suspected prostate cancer in the affiliated hospital of Qingdao University from May 2019 to November 2019 were retrospectively analyzed. All patients met the prostate biopsy criterion, who underwent transrectal(n=275)and transperineal(n=110)prostate biopsy respectively. There were no significant differences of mean age [(70.7±7.3)years vs.(69.2±8.4) years], PSA [(55.12±116.96)ng/ml vs. (63.41±315.34)ng/ml], prostate volume [(55.96±35.26)ml vs. (64.35±55.99)ml] between two groups. According to preoperative prostate magnetic resonance imaging combined with intraoperative ultrasound, 2-4 needles targeted puncture of suspected lesion were performed, followed by 12 needle systematic prostate biopsy. The detection rate of prostate cancer between two biopsy ways were compared. The related factors of PCa including age, prostate volume and PSA level were collected for univariable and multivariable logistic analysis. The cancer detection rate was compared and logistic regression was used to assess the impact of patient characteristics on PCa detection.Results:For all patients, the detection rate with cancer between transrectal group and transperineal group were 121/275(40.0%) and 67/110(60.9%), respectively. The transperineal group detected a higher rate of PCa ( P=0.003)and more clinically significant prostate cancers (csPCa) (54.6% vs.36.7%, P=0.001) than that of the transrectal group, there were significant differences between two groups ( P<0.05). Univariate and multivariate logistic regression analysis revealed that PSA( OR=1.025, P=0.001) and prostate volume( OR=0.984, P=0.001)were two independent factors for the detection rate of prostate cancer between two biopsy ways( P<0.05). The effect of age on the detection rate of PCa in the transperieal group was significantly lower than that of the transrectal group( OR=0.037, P=0.238 vs. OR=0.053, P=0.002). Conclusion:The transperieal biopsy could find more PCa than the transrectal biopsy. PSA level and prostate volume could affect the detection rate of cancer between two prostate biopsy ways.

Objective:To systematically integrate qualitative studies on psychological experience of breast cancer patients in rehabilitation period, so as to provide basis for improving psychological care and rehabilitation efficacy.Methods:Qualitative research on psychological experience of breast cancer patients during rehabilitation was electronically retrieved in databases, including PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Wanfang data, and China Biology Medical disc. The search period was from database establishment to September 2023. The quality evaluation of the literature was conducted using the 2020 version of the quality evaluation criteria for qualitative research of the Joanna Briggs Institute Evidence-Based Health Care Center. The results were integrated using the aggregative Meta integration method.Results:A total of 18 articles were included. Sixty-six research topics were extracted and categorized into 10 new categories, forming three integrated results, namely, psychological adjustment of patients with negative emotions and rehabilitation needs in the process of coping, family and social factors affecting patient rehabilitation experience, and patients perceiving that the healthcare system was not yet perfect.Conclusions:Medical and nursing staff should pay attention to the psychological problems of breast cancer patients in the rehabilitation period, understand their rehabilitation needs, provide targeted counseling and services, pay attention to the family and social support factors of breast cancer patients, help them improve their quality of life, and actively promote rehabilitation.

Objective:To explore the feasibility and safety of long-distance urological nephrotomy with the support of 5G communication technology by using the domestic robot.Methods:Clinical data of the patients with remote robot-assisted laparoscopic nephrectomy, which were completed from March to April 2021 by the Affiliated Hospital of Qingdao University (as the host hospital where the main operating system located) were retrospectively analyzed. There were 3 patients, including 2 males and 1 female.The average age was 61 (49-73) years, and the average body mass index was 23.73 (20.00-27.76) kg/m 2. One patient had a ASA classification of grade 2, and the other 2 patients had grade 3. All patients met the surgical criteria for non-functional nephrectomy. The chief surgeon who performing the telesurgery was located at the Affiliated Hospital of Qingdao University. The surgeon remotely controlled the bedside operating system (slave system) in 3 local hospitals located in other cities in Shandong Province (network communication distances of 82.5, 141 and 229 km, respectively) by manipulating the master system located in Qingdao. Images and operating instructions during surgery were transmitted using 5G wireless communication technology. Intraoperative network conditions, robot operation, and patient perioperative data were summarized. Results:All 3 tele-nephrectomies were successfully completed. The average network signal latency time was 27.3 (23-30) ms, with no packet loss, and the average total latency time was 177.3(173-180) ms. The mean resection time was 79.3 (52-111) min, and the average intraoperative blood loss was 31.1 (15.6-41.9) ml. There were no network related adverse events occurred during the operation, and the robot-related adverse events occured 3 times, all three of which were characterized by inconsistent master and slave movements of the manipulator arm and the bedside robotic arm. None of these adverse events affected the successful performance of the telesurgery. The mean postoperative exhaust time was 60.5 (38.5-78.0) h. The mean postoperative VAS score at 24 hours was 3.7 (3-4). The Clavien-Dindo classification were all grade I. No significant abnormality was found on the 30th day after surgery, and the patients recovered well at the follow-up until 6 months postoperatively.Conclusions:It is safe and feasible to perform remote robot-assisted laparoscopic nephrectomy based on 5G communication technology with no serious adverse events or surgical complications.However, the conclusion needs to be further verified by large sample and multi-center prospective study.