ObjectiveTo explore the relationship of blood volume changes and postoperative delirium in elderly patients undergoing surgery for hip fracture.Methods One hundred and fifty elderly patients who underwent surgery for hip fracture were enrolled in the study.Delirium was diagnosed by Confusion Assessment Method(CAM).Preoperative,intraoperative and postoperative data were collected,and the correlation of postoperative delirium and blood volume changes were analyzed by logistic regression analysis.ResultsA total of 59 patients(28 males and 31 females)had delirium after surgery and the occurrence rate of postoperative delirium was 39.3％ (59/150).The average age in delirium group was significantly older than that in the control group[ (77.71 ±6.63)years old vs(73.79 ±5.42) years old,t =-3.958,P ＜0.001 ].The average hemoglobin concentration and hematocrit in delirium group were both less than that in control group whether before surgery or at 7 days after surgery( before surgery:average hemoglobin concentration:[ ( 117.80 ± 16.59)g/L vs( 123.92 ±14.61 ) g/L,t =2.378,P =0.019; hematocrit:(0.355 ± 0.154) vs(0.372 ± 0.210),t =2.291,P =0.023 ;7days after surgery:average hemoglobin concentration:(98.15 ± 11.51 ) g/L vs ( 102.33 ± 9.88 ) g/L,t =2.369,P =0.019; hematocrit:(0.296 ± 0.040 ) vs (0.306 ± 0.030),t =-3.958,P ＜ 0.001 ].There was no significant difference on gender,fracture type,surgical approach,operative time,blood loss and hemoglobin concentration at 1,3 days after surgery between the two groups( P ＞0.05 ).Logistic regression analysis showed that age ( OR 3.280 ),education ( OR 0.389 ),and hemoglobin concentration at 7 days after operration ( OR 1.097) were significantly related to the occurrence of postoperative delirium ( P ＜ 0.05 ).Conclusion Our findings suggest that the risk for postoperative delirium is the result of more than one factor.Older age,continued postoperative low hemoglobin concentration and low degree of education present high risk of delirium in patients underwent surgery for hip fractures.

Objective To observe the efficacy and prognosis of recombinant human brain natriuretic peptide ( rhBNP) and conventional treatment in acute myocardial infarction patients undergoing percutaneous coronary intervention therapy complicated by acute of left heart failure. Methods Retrospective analysis of 229 cases of hospitalized patients with acute myocardial infarction undergoing percutaneous coronary intervention therapy in 24 hours after admission, complicating with acute left ventricular failure in Shenyang Military General Hospital from June 2012 to January 2014 were enrolled and devided into: the conventional heart failure therapy group (the control group, n=122) and the rhBNP plus conventional treatment group ( the treatment group, n =107 ) , according to the patient's economic conditions and wishes. Observed improvement in heart failure symptoms before and after treatment during hospitalization and follow-up and also the 30 days and 12 months mortality. Results After 72 hrs of treatment of heart failure, both groups had decrease in heart rates, systolic blood pressure and NT-proBNP levels as compared to pre-treatment levels ( all P ﹤ 0. 05 ) . The NT-proBNP levels and heart rate of the treatment group decreased more significantly compared to the control group (both P﹤0. 05). Compared with the control group, rhBNP which to be used 72 hrs, can improve the cardiac function of AMI patients with the ratio of KillipⅡ-Ⅲ(72. 9%vs. 54. 9%, P=0. 005). There was no significant differences between two groups in in-hospital mortality and early follow-up period ( 30 days ) ( P ﹥0. 05 ) . After 12 months of follow-up, the mortality of the treatment group was lower than the control group ( 6. 5% vs. 13. 9%, P = 0. 068 ) . Through logistic regression analysis, the value of NT-proBNP and whether patients were treated with rhBNP on the basis of the routine drug were independent influencing factors for mortality of 12 months. Conclusions Additional to standard conventional therapy for acute left heart failure in patients with acute myocardial infarction undergoing PCI, rhBNP can lower the 12 months mortality and improve prognosis.

Objective: To investigate the health-related quality of life and its influencing factors among urban adults in Hangzhou City, so as to provide the evidence for formulation and assessment of health policy. Methods: A total of 1 800 permanent residents at ages of 18 to 64 years were sampled from Gongshu and Xihu districts, Hangzhou City using a stratified cluster random sampling method from May to August 2022. The health-related quality of life was measured with the EuroQol five-dimensional questionnaire (EQ-5D-5L), and factors affecting health-related quality of life were identified with a Tobit regression model. Results: A total of 1 624 valid questionnaires were recovered, with a response rate of 90.22%, and the respondents included 693 men (42.67%) and 931 women (57.33%). The proportions of difficulty in mobility, self-care, usual activities, pain/discomfort, and anxiety/depression were 1.23%, 0.43%, 0.74%, 11.15% and 8.56%, and the median (interquartile range) of health state utility value and EuroQol Visual Analogue Scale (EQ-VAS) score were 1 (0) and 90 (15) points, respectively. Female (β=-0.050), age of 45 to 64 years (β=-0.067) and development of chronic disease (one chronic disease: β=-0.036; two and more chronic diseases: β=-0.090) were factor affecting of health state utility values, and age of 35 to 44 years (β=-1.945) and 45 to 64 years (β=-3.459), unemployment (β=-1.913), development of chronic disease (one chronic disease: β=-3.444; two and more chronic diseases: β=-8.529), high-level physical activity (β=2.355) and overweight/obesity (β=-1.456) were factors affecting the EQ-VAS score. Conclusions The overall health related quality of life is relatively good among urban adults in Hangzhou City. Gender, age, employment, physical activity, presence of chronic diseases and overweight/obesity may be associated with health-related quality of life among urban adults in Hangzhou City.

Aim To investigate the mechanism for the inhibitory effect of hydrogen sulfide on the expression of tissue factor(TF)induced by oxidative low-density lipoprotein(ox-LDL)in endothelial cells.Methods Human umbilical vein endothelial cells (HUVECs ) were treated with 50 mg·L-1 ox-LDL in the absence or presence of different concentrations of NaHS (25 , 50,100 and 200 μmol·L-1 )for 24 h.The mRNA expression and protein content of TF in HUVECs were determined by reverse transcription PCR and ELISA, respectively.The content of intracellular reactive oxy-gen species (ROS)was determined by DCFH,an oxi-dative sensitive fluorescent indicator.The activation of nuclear factor-kappaB (NF-κB)was estimated by its expression in nuclear extracts analyzed by Western blot.Results Ox-LDL induced TF mRNA expression and increased TF protein content in HUVECs.The in-crease in intracellular ROS production and the activa-tion of NF-κB were observed in HUVECs treated with ox-LDL.However,NaHS could markedly inhibit the increases in TF mRNA and protein levels induced by ox-LDL.Also the elevation of intracellular ROS pro-duction and the activation of NF-κB elicited by ox-LDL were significantly suppressed by pretreatment with NaHS.In addition,pretreatment with BAY 1 1-7082 (10 μmol·L-1 ),the inhibitor of NF-κB or N-acetyl-L-cysteine(1 mmol·L-1 ),an antioxidant,could also decrease the TF mRNA and protein level as well as ROS production and NF-κB activation induced by ox-LDL in HUVECs,similar to the effects of 200 μmol· L-1 NaHS.Conclusion The mechanism for the in-hibitory effect of H2 S on the ox-LDL- induced TF ex-pression in endothelial cells may be related to inhibi-ting intracellular ROS production and subsequently NF-κB activation.

Objective:To study the influence of different culture conditions on charcic and inhibition activity of nature killer cells ( NK) ,whether to join the modified K562 cells with IL-6 cytokine.Methods:According to the 5′end of the human IL-6 cDNA sequence,PCR primers designed to amplificate,express and transfect K562 cells cDNA library as a template for DNA.Genetic modified K562 cells as stimulating cells were prepared by expressing IL-6.To extract peripheral blood mononuclear cells( PBMC) from human peripheral blood.PBMC were explanted by genetic modified K562 stimulated.The expansion was initiated by CO-culture of PBMC and irradiate genetic modified K562 cell.The number of NK cell increased by directed induced generation of genetic modified K562 cell.Immunophenotypic analysis of NK cell surface markers was performed by flow cytometry (FCM).51Cr release assay was employed to measure the specific lysis skilling of NK cell target K562 cells.Results:We have constracted genetic modified K562 cells by genetic engineering.As stimulated cell added into the PBMC,an average of 760 ±18 fold expansion of CD56+CD16+CD3-cells was observed after 3 weeks of co-culture system.The NK cells population could proliferated more 91%±2% after expansion comparing with 6%± 0.4%in PBMC before expansion by FCM.The cytotoxical activity of NK cells which was induced by genetic modified K562 cell was the strongest than induced by IL-6 cytokine alone.The expanded NK cells lysed 92%±2% of K562 targets in a 5∶1 effector to target ratio.In this case,the NK cells induced by genetic modified K562 cells against tumor cells was more lethal.Conclusion:PBMC based in vitro expansion of natural killer cells was set up by genetic modified K562 cells.The cytotoxicity of NK cells was the strongest induced by genetic modified K562 cell treated.These results had important guiding significance for the the NK large number of amplification and used in clinical.

Objective:To explore the status quo of nurses' perceived hospital ethical climate (HEC) and body constraint knowledge, attitude and practice, and discuss the correlation between HEC and body constraint knowledge, attitude and practice.Methods:Between April and May 2019, totally 400 clinical registered nurses from a Class Ⅲ Garde A hospital in Shanxi province were selected using convenient sampling, and investigated with the general information questionnaire, Hospital Ethical Climate Survey (HECS) and knowledge, attitude and practice questionnaire. The effects of HEC on nurses' body constraint perception were analyzed. Totally 400 questionnaires were distributed, and 387 valid ones were collected, accounting for an effective recovery rate of 96.75%.Results:The total HECS score of the 387 nurses was (89.72±32.78) . Their scores of body constraint knowledge, attitude and practice were (10.86±2.37) , (30.48±2.94) , and (41.82±7.24) , respectively. There were statistically significant differences in the knowledge, attitude and practice scores between nurses with different educational background, professional title and training experience ( P<0.05) . Correlation analysis revealed that the total score and scores of different HECS dimensions were positively correlated with body constraint knowledge, attitude and practice scores ( P<0.05) . Hierarchical regression analysis showed that the relationships with the doctor, the patient, and the manager in HEC were the influencing factors to nurses' body constraint knowledge and attitude, and the relationships with the doctor and the manager in HECS were the influencing factors to nurses' body constraint practice ( P<0.05) . Conclusions:HEC is closely related to nurses' body constraint knowledge, attitude and practice. Creating a sound HEC will help improve nurses' perception of body constraints, thus standardizing nurses' body constraint practice.

Objective:To explore the influence of nursing organization atmosphere on clinical nurses' workplace loneliness, verify and analyze the mediating role of psychological capital between nursing organization atmosphere and workplace loneliness.Methods:This study was a cross-sectional survey, using the convenience sampling to select clinical nurses from two Class Ⅲ Grade A hospitals in Shanxi Province from October to December 2019 as the research object. The survey was conducted using the General Information Questionnaire, Organizational Climate Scale for Nursing, Questionnaire about Workplace Loneliness, and Psychological Capital Scale. The structural equation model was used to analyze the mediating effect of psychological capital between nursing organization atmosphere and workplace loneliness. A total of 1 035 questionnaires were collected in this study, with 963 valid questionnaires, and the effective response rate was 93.04%.Results:Among 963 clinical nurses, the total scores of Organizational Climate Scale for Nursing, Questionnaire about Workplace Loneliness, and Psychological Capital Scale were (88.08±10.08) , (30.42±5.23) and (83.21±12.62) respectively. The structural equation model showed that the nursing organization atmosphere had a direct and indirect predictive effect on nurses' workplace loneliness, and the path coefficients were -0.27 and -0.22 respectively. Psychological capital had a mediating effect between the nursing organization atmosphere and workplace loneliness.Conclusions:Psychological capital plays a mediating role between nursing organization atmosphere and workplace loneliness. Nursing managers should take effective measures to create a good organizational atmosphere, improve the level of psychological capital of clinical nurses, and reduce nurses' workplace loneliness.

Objective:To explore the effect of team positive psychological intervention on psychological state and coping style of nurses after being impacted by life events.Methods:From September 2020 to January 2021, 84 nurses who had suffered life events in Shanxi Provincial People's Hospital were selected by the convenient sampling method. According to the enrollment time, they were divided into the experimental group ( n=42) and the control group ( n=42) . The nurses in the control group were not give external intervention measures, while nurses in the experimental group adopted team positive psychological intervention. After 6 weeks of intervention, the Chinese version of Psychological Resilience Scale, Symptom Checklist 90 (SCL-90) and Simple Coping Style Questionnaire were used to compare changes in the psychological resilience level, mental health level and coping style of nurses in the two groups. Results:After intervention, the scores of toughness, strength and optimism dimensions and the total scores of Psychological Resilience Scale in the experimental group were significantly higher than those in the control group, and the differences were statistically significant ( P<0.05) . The total score of SCL-90 in the experimental group was significantly lower than that in the control group, and the difference was statistically significant ( P<0.05) . The score of positive coping dimension of nurses in experimental group was significantly higher than that in control group, and the score of negative coping dimension was significantly lower than that in control group, and the differences were statistically significant ( P<0.05) . Conclusions:Team positive psychological intervention can improve psychological resilience and mental health level of nurses who are impacted by life events. At the same time, it can also encourage them to adopt active coping methods to face problems, which is conducive to improving quality of nursing.

Objective:To observe multiple locus variable-number tandem repeat analysis (MLVA) typing of Brucella isolated from Himalayan marmot in Qinghai-Tibet Plateau of Qinghai Province, and to explore the relationship between the strains and strains previous isolated from Qinghai Province. Methods:Blood samples of Himalayan marmot were collected in Qinghai-Tibet Plateau of Qinghai Province from March 2019 to October 2020. Pathogens were isolated and cultured from Brucella antibody positive samples identified by using the rose bengal test (RBT). Conventional biological methods and molecular biological methods (BCSP31-PCR and AMOS-PCR) were used for strain identification. At the same time, MLVA method was used to genotype the isolated strains, and cluster analysis was used to analyze the genetic relationships between the strains based on the genotype of 70 Brucella isolated from different hosts in Qinghai Province. Results:A total of 1 466 blood samples of Himalayan marmot were collected from Qinghai-Tibet Plateau. Two strains of Brucella were isolated and cultured from 64 RBT-positive samples, named QH2013054 and QH2013062, respectively. They were identified as Brucella ovis biotype Ⅲ by conventional and molecular biological methods. The MLVA genotyping results showed that QH2013054 and QH2013062 were different at the Bru16 locus, indicating different MLVA genotypes. Cluster analysis showed that strain QH2013054 had the same MLVA genotype as 7 strains, among which 6 strains were from 3 farmers and 3 sheep from the same family in Gonghe County, and 1 strain was from a farmer in Menyuan Hui Autonomous County. The strain QH2013062 had the same MLVA genotype as 4 strains, including 3 strains from 3 farmers in Menyuan Hui Autonomous County and 1 strain from a farmer in Tu Autonomous County of Huzhu. Conclusions:The strains of Brucella isolated from Himalayan marmot in Qinghai-Tibet Plateau of Qinghai Province have the same MLVA genotype as some strains of Brucella isolated from humans and sheep in Qinghai Province. It is speculated that the host humans, sheep and Himalayan marmot in Qinghai-Tibet Plateau may have a common source of infection.

Objective:To learn about the epidemic situation and trend of human brucellosis in Menyuan Hui Autonomous County (referred to as Menyuan County) of Qinghai Province, and to provide reference for formulating brucellosis prevention and control measures in Menyuan County.Methods:Data on human brucellosis in Menyuan County reported by the Infectious Disease Reporting Information Management System of China Disease Control and Prevention Information System from 2013 to 2020 were collected and analyzed by descriptive epidemiological analysis (three distribution).Results:A total of 186 cases of brucellosis were confirmed from 2013 to 2020, with an average annual incidence of 14.553/100 000. The annual incidence rate was increasing year by year(χ 2trend = 22.08, P = 0.002). The cases were distributed in 67 villages of 12 towns; cases were more common in the age group of 15-< 65 years old (96.24%, 179/186), and there were more men than women cases (sex ratio was 3.89∶1.00, 148/38). Conclusions:The incidence rate of brucellosis cases in Menyuan County is increasing year by year, and the scope of its impact is constantly expanding. A multi-sectoral joint prevention and control mechanism should be established to strengthen management, increase the prevention and control of brucellosis, and stop the spread of the epidemic to surrounding counties and cities.