Objective:To investigate the relationship between previous bleeding history and poor prognosis of patients with acute upper gastrointestinal bleeding.Methods:This study was a prospective multicentre real-world study (Acute Upper Gastrointestinal Real-word study, AUGUR study). The data of patients with UGIB who were admitted to the emergency department of 20 tertiary hospitals in China from June 30, 2020 to February 10, 2021 were collected. According to the number of previous bleeding history, the patients were divided into three groups (0 time, 1-3 times, and≥4 times). Based on the patient’s demographic data, clinical characteristics, laboratory data, treatment, and outcomes, univariate and logistic regression analysis were performed to investigate the correlation between the number of previous bleeding and the 90-day mortality and rebleeding of patients with gastrointestinal bleeding.Results:A total of 1 072 patients with acute UGIB were included in this study. The all-cause mortality and rebleeding rate of all patients were 10.9% (117/1 072) and 11.8% (129/1 072), respectively. Among them, 712 patients (66.42%) had no previous bleeding, 297 patients (27.71%) had previous bleeding 1-3 times, and 63 patients (5.88%) had previous bleeding≥4 times. In univariate analysis, age, vital signs and consciousness on admission, history of liver cirrhosis, onset with hematemesis, admission hemoglobin, varicose veins bleeding, peptic ulcer bleeding, red blood cell infusion, tracheal intubation and the use of vasopressors after admission were risk factors for the 90-day mortality and rebleeding rate. Multivariate logistic regression analysis showed that patients with previous bleeding≥4 times had a higher risk of the 90-day mortality ( OR=2.17, 95% CI: 1.04-4.57, P=0.040) and rebleeding ( OR=2.32, 95% CI: 1.19-4.53, P=0.013). Conclusions:The history of previous bleeding≥ 4 times can be used as an independent risk factor for the 90-day mortality and rebleeding in patients with acute UGIB.

OBJECTIVETo study clinicopathological features, diagnosis, differential diagnosis of oral Langerhans cell histiocytosis (LCH), retrospective clinicopathologic study was carried on and a variety of immune phenotype were detected.

METHODSThe clinicopathological features of 29 cases of oral LCH were analyzed. The immunohistochemical staining of S-100 protein, CD1a, CD83 and Ki-67 were used in above cases by immunohistochemical streptavidin-biotin peroxidase (SP) and Elivison two-step method. Statistical analysis was adopted for the results.

RESULTSOf the 29 cases of LCH, the expression of S-100 protein and CD1a were positive in 24 cases and negative in 5 cases, so 5 cases were excluded from the diagnosis of LCH. Among 24 cases of LCH, 15 patients were male and 9 were female. The median age was 7.50 years. 14 lesions were in the mandible, 5 were in the maxilla and 5 involved the mandible and maxilla. 9 cases were in stage I, 13 in stage II and 2 in stage III, according to Bartnick classification. Immunohistochemistry showed all 24 cases staining for S-100 protein and CD1a were positive. Comparing with maxillofacial lesions involved soft tissue, Ki-67 positive rate was lower and CD83 positive rate was higher in maxillofacial single bone lesion.

CONCLUSIONThe immunohistochemical staining of S-100 protein and CD1a are important for the diagnosis of LCH. Maxillofacial bone single LCH might have lower proliferative activity and a higher state of maturity. Maxillofacial LCH involved soft tissue might have a higher proliferative activity and a lower state of maturity.

Antigens, CD1 ; Diagnosis, Differential ; Female ; Histiocytosis, Langerhans-Cell ; Humans ; Immunohistochemistry ; Male ; Mandible ; Maxilla ; Retrospective Studies ; S100 Proteins

With the accelerated aging of the global population, the problem of elder abuse has become increasingly prominent, among which mental abuse is the type with the highest incidence. Mental abuse seriously damages the mental health of the elderly, increases their risk of illness and suicide, and reduces the quality of life of the elderly. This article combs the relevant research on mental abuse of the elderly at home and abroad in detail, introduces the definition, assessment tools and the current situation of mental abuse, and summarizes the corresponding influencing factors from the three levels of the elderly, caregivers and society, and aims at providing a basis for further research on the intervention of mental abuse of the elderly and the prevention of the occurrence of mental abuse.

Objective:To explore the mediating effects of self-efficacy between leadership empowerment behavior and neglect of care among senior care workers.Methods:In this cross-sectional study, from July to September 2020, totally 423 senior care workers from 50 nursing institutions for the aged in Jining, Jiaozuo, and Shijiazhuang were selected by convenient sampling and investigated with the General Information Questionnaire, Leadership Empowerment Behavior Scale, Self-Efficacy Scale, and Nursing Caregiver Negligence Assessment Scale. Pearson's correlation analysis was used to analyze the correlation of each variable, and bootstrapping was employed to test the mediating effect.Results:In this study, 423 questionnaires were distributed and 386 valid questionnaires were recovered. The total score of leadership empowerment behavior of 386 care workers was (47.93±7.51) ; the total score of self-efficacy was (28.65±5.92) ; the total score of neglecting care was (73.04±8.80) . The leadership empowerment behavior, self-efficacy, and neglect of care in the senior care workers were positively correlated ( P<0.01) . Self-efficacy played a partial mediating role between leadership empowerment and neglect of care, and the mediating effect accounted for 19.73%. Conclusions:The neglect of care in the senior care workers is at a low level, and self-efficacy plays a partial mediating role between leadership empowerment and neglect of care. Leaders of nursing institutions for the aged should improve their level of empowerment behaviors and strengthen the self-efficacy of senior care workers, so as to reduce the neglect of care among senior care workers.

Mucinous adenocarcinoma is a rare epithelial malignant tumor which usually arises in appendix, pancreas, breast and other sites, rarely occurs in salivary gland. In this article, a mucinous adenocarcinoma of salivary gland was reported and relevant literatures were reviewed.
Adenocarcinoma, Mucinous ; Carcinoma ; Humans ; Salivary Glands

Objective:To evaluate the image quality of dual-source computed tomography pulmonary angiography (DE-CTPA) with low-dose contrast agent using the advanced modeled iterative reconstruction (ADMIRE) method with 70 kVp and non-linear blending in overweight patients.Methods:Seventy patients (normal BMI, 35; overweight, 35) with suspected pulmonary embolization who underwent DE-CTPA between October 2018 and March 2019 were included in this study. The imaging protocol included assessments at 70 kV/sn150 kV with 30 ml of contrast agent, and images were obtained at 70 kVp and 150 kVp with and without linear blending. The CT value, SD value, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) of pulmonary arteries were compared and analyzed among groups 1 (70 kVp, normal BMI), 2 (non-linear blending, normal BMI), 3 (70 kVp, overweight), and group 4 (non-linear blending, overweight). The radiation dose parameters included CT volume dose index (CTDI vol), dose length product (DLP), and effective dose ( E). Results:The CT values for the pulmonary artery did not show significant differences among the four groups ( P>0.05). The SD value of the segmental artery in group 1 was higher than that in group 4 ( t=2.69, P<0.05). The SNR values of the pulmonary artery trunk and sub-segmental artery in group 2 were higher than those in group 3 ( t=1.44, 5.40, P<0.05), while the corresponding value of the left pulmonary artery trunk in group 2 was higher than those in groups 3 and 4 ( t=1.52, 1.52, P<0.05). The CNR values of the pulmonary artery trunk and sub-segmental artery in group 2 were higher than those in group 3 ( t=1.45, 5.01, P<0.05) and that of the left pulmonary artery trunk in group 2 was higher than those in groups 3 and 4 ( t=1.50, 1.50, P<0.05). The E values for normal BMI and overweight patients were(1.60±0.54)mSv and(1.88±0.45)mSv, respectively. Conclusions:For overweight patients, the CTPA protocol using ADMIRE with a 70 kV/sn150 kV scanning mode could yield diagnostic image quality with significantly lower radiation and contrast material doses.

Elder financial exploitation is an important subtype of elder abuse, which has become a global social problem. Financial exploitation of the elderly will not only damage their physical and mental health, reduce the quality of life, but also bring huge financial losses to society. The research on the elder financial exploitation in foreign countries started earlier, while the research on the elder financial exploitation in China is still in its infancy. Therefore, this paper summarizes the concept, theoretical framework, current situation and countermeasures of elder financial exploitation, with a view to providing reference for the study of elder financial exploitation in China.

Objective:To understand the infection status and molecular types of rhinovirus (RV) among cases of Acute Respiratory Infections (ARIs) in Luohe City, Henan Province, from 2017 to 2022.Methods:From October 2017 to June 2022, clinical and epidemiological data were collected from 2 270 cases of ARIs at Luohe Central Hospital in Henan Province. Throat swab specimens were obtained from these cases. Real-time quantitative polymerase chain reaction (qPCR) was used to screen for RV-positive specimens. Subsequently, the positive samples were subjected to nested reverse transcription polymerase chain reaction (nested RT-PCR) to amplify the full-length VP1 region. Using the MEGA software, along with 169 RV reference strains recommended by the International Committee on Taxonomy of Viruses, a phylogenetic tree was constructed to determine RV types.Results:Among the 2 270 cases of ARIs, there were 1 283 male cases (56.52%). The median age ( Q 1, Q 3) was 3 (1, 6) years, with the population under 5 years old accounting for 68.59% (1 557/2 270). RV was detected in 137 cases (6.04%), of which 68 cases (49.64%) showed co-detection with other viruses, with the most common being co-detection with enterovirus, accounting for 14.60% (20/137). The RV detection rates in the age groups of 0-4 years, 5-14 years, 15-59 years, and≥60 years were 6.42% (100/1 557), 4.69% (21/448), 3.80% (6/158), and 9.35% (10/107), respectively, with no statistically significant differences ( χ2=5.310, P=0.150). The overall detection rates of RV before (2017-2019) and during (2020-2022) the COVID-19 pandemic showed no statistically significant difference ( χ2=1.823, P=0.177). A total of 109 VP1 sequences were obtained, including 62 types. Among them, RV-A, RV-B, and RV-C had 42, 3, and 17 types respectively. Conclusion:RV is one of the predominant pathogens in ARIs cases in Luohe City, Henan Province, from 2017 to 2022. Multiple types of RV co-circulate without any apparent dominant type.

Objective:To understand the infection status and molecular types of rhinovirus (RV) among cases of Acute Respiratory Infections (ARIs) in Luohe City, Henan Province, from 2017 to 2022.Methods:From October 2017 to June 2022, clinical and epidemiological data were collected from 2 270 cases of ARIs at Luohe Central Hospital in Henan Province. Throat swab specimens were obtained from these cases. Real-time quantitative polymerase chain reaction (qPCR) was used to screen for RV-positive specimens. Subsequently, the positive samples were subjected to nested reverse transcription polymerase chain reaction (nested RT-PCR) to amplify the full-length VP1 region. Using the MEGA software, along with 169 RV reference strains recommended by the International Committee on Taxonomy of Viruses, a phylogenetic tree was constructed to determine RV types.Results:Among the 2 270 cases of ARIs, there were 1 283 male cases (56.52%). The median age ( Q 1, Q 3) was 3 (1, 6) years, with the population under 5 years old accounting for 68.59% (1 557/2 270). RV was detected in 137 cases (6.04%), of which 68 cases (49.64%) showed co-detection with other viruses, with the most common being co-detection with enterovirus, accounting for 14.60% (20/137). The RV detection rates in the age groups of 0-4 years, 5-14 years, 15-59 years, and≥60 years were 6.42% (100/1 557), 4.69% (21/448), 3.80% (6/158), and 9.35% (10/107), respectively, with no statistically significant differences ( χ2=5.310, P=0.150). The overall detection rates of RV before (2017-2019) and during (2020-2022) the COVID-19 pandemic showed no statistically significant difference ( χ2=1.823, P=0.177). A total of 109 VP1 sequences were obtained, including 62 types. Among them, RV-A, RV-B, and RV-C had 42, 3, and 17 types respectively. Conclusion:RV is one of the predominant pathogens in ARIs cases in Luohe City, Henan Province, from 2017 to 2022. Multiple types of RV co-circulate without any apparent dominant type.

Objective To investigate the influence of Wechat follow-up on the treatment compliance and quality of life for young adult patients with type 2 diabetes mellitus.Methods A total of 120 cases, who were able to use Wechat independently,were selected as the research objects from patients with type 2 diabetes mellitus during February 2015 to December 2015. They were randomly divided into control group (60 cases) and intervention group (60 cases). Patients in control group received routine nursing and health education,while patients in intervention group received knowledge about type 2 diabetes mellitus and nursing care through Wechat. Data of the patients in these two groups were obtained after 6 months. And the parameters including treatment compliance,blood glucose control,the incidence of complications,sleeping quality (PSQI), depression (SDS),and anxiety (SAS) of these patients were analyzed.Results After intervention,the score of treatment compliance in intervention group (12.7±1.5) was higher than (8.7±1.7) of control group (t=-3.056, P<0.05). The compliance of reasonable diet,standardized medication,moderate exercise,benign psychology and regular blood glucose monitoring for intervention group were significantly improved than that of control group (P<0.05). The infection,glycopenia,diabetic eye diseases,acute complications in the intervention group were lower than that of control group (P<0.05),but neuropathy and rate of nephropathy in intervention group were better than that of control group,but there were no statistical significance (P>0.05). Before intervention, there were no statistical significance between two groups in the levels of fasting blood glucose,postprandial 2 h plasma glucose and glycosylated hemoglobin,as well as PSQI,SDS and SAS (P>0.05). However,the levels of fasting blood glucose,postprandial 2h plasma glucose and glycosylated hemoglobin,as well as PSQI,SDS and SAS were significantly decreased compared with the control group with statistical significance (P<0.05). Conclusions Follow-up by Wechat can effectively improve the treatment compliance of young adult patients with type 2 diabetes mellitus,and improve the quality of life and patients' satisfaction.