Objective To observe the protective effect of bioimpedance spectroscopy guided ultrahltration on residual renal function in new hemodialysis patients.Methods Patients with end-stage renal disease recruited from January 2015 to June 2016,were randomly divided into experimental group and control group.And all the patients were followed up for 3 months.The ultrafiltration was guided by the bioimpedance spectroscopy analysis in the experimental group,while the ultrafiltration was based on the edema,blood pressure,symptoms of low blood pressure and the increase of weight during the hemodialysis interphase in the control group.The difference of residual renal function,24 hours urine volume and the incidence rate of adverse events between the two groups were collected.Results Compared with the control group,the urine volume(932.58 ± 230.16 ml vs 584.45 ± 137.76 ml,t =7.226,P ＜ 0.001) and residual renal function (RRF) (4.55 ± 0.90 ml/min vs 3.08 ±0.68 ml/min,t =7.300,P ＜0.001)in the experimental group were higher.The drop of RRF(3.14 ±2.05 ml/min vs 4.40 ±2.09 ml/min,t =-2.384,P =0.020) and urinary volume (452.58 ±456.96 ml vs 877.45 ± 452.45 ml,t =-3.679,P =0.001) were lower in the experimental group.While there was no significant difference in the incidence of adverse events between the two groups (t =2.081,P =0.084).Conclusions It is helpful for slowing down the decline of residual renal function by using the bioimpedance spectroscopy guided ultrafiltration.

Objective:To investigate the correlation between low-density lipoprotein cholesterol (LDL-C) and hemorrhagic transformation (HT) after intravenous thrombolysis in patients with acute ischemic stroke (AIS).Methods:Patients with AIS received intravenous thrombolysis using standard dose alteplase in the First Hospital of Shanxi Medical University from January 2014 to December 2019 were enrolled retrospectively. Head CT scan was performed within 24 h after thrombolytic therapy to identify the occurrence of HT. The demographic and baseline clinical data were compared between the HT group and the non-HT group. Multivariate logistic regression analysis was used to determine the correlation between LDL-C and HT after thrombolysis. Results:A total of 323 patients with AIS who received intravenous thrombolytic therapy were enrolled, their age was 65±12 years (range, 54-78 years), and 219 were males (67.8%). The median baseline National Institutes of Health Stroke Scale (NIHSS) score was 4 (interquartile range, 3-9). Ninety one patients (28.17%) developed HT, of which 8 (2.48%) had symptomatic intracerebral hemorrhage. Univariate analysis showed that there were significant differences in LDL-C, age, baseline NIHSS score, baseline systolic and diastolic blood pressure, baseline fibrin degradation products, and the proportion of patients with atrial fibrillation and stroke etiology between the HT group and the non-HT group (all P<0.05). Multivariate logistic regression analysis showed that lower LDL-C (odds ratio [ OR] 0.531, 95% confidence interval [ CI] 0.358-0.788; P=0.002), higher baseline NIHSS score ( OR 1.063, 95% CI 1.010-1.120; P=0.020) and higher baseline systolic blood pressure ( OR 1.015, 95 CI 1.004-1.026; P=0.008) were the independent risk factors for HT after intravenous thrombolysis in patients with AIS. Conclusions:Low LDL-C is an independent risk factor for HT in patients with AIS after intravenous thrombolysis. The patients with lower LDL-C should be cautious in lipid-lowering therapy and be alert to the occurrence of HT.

Objective To observe the effect of intensive training on lower extremity motor function and depression after stroke.Methods Thirty patients with post-stroke depression were randomly divided into an intensive training group and a control group,each of 15.Both groups received conventional anti-stroke and antidepressant drug therapy,and rehabilitation training.The intensive training group,however,was additionally provided with lower extremity motor function training each day.Hamilton Depression Rating Scale,the Fugl-Meyer assessment (FMA),10-meter maximum walking speed test (10MWT) and the Holden functional ambulation categories (FAC) were conducted before treatment,and 2 and 4 weeks after the treatment.The level of human β-endophin (β-EP) and brain derived neurotrophic factor (BDNF) in the serum were also detected.Results After 4 weeks of treatment,the FAM,10MWT,BDNF and β-EP were significantly improved in both groups compared to those before the treatment (P＜ 0.05).No significant differences,however,were found between the 2 groups in the above measurements after 2 weeks of treatment (P＞0.05).After 4 weeks of treatment,the FAM (20.67±6.79),10MWT [(0.48±0.22)m/s],BDNF [(10.81±2.33)μg/L] and β-EP [(164.02±42.15)ng/L] of the intensive training group were significantly improved compared to those of the control group (P＜0.05).Both after 2 weeks and 4 weeks treatment,the HAMD scores of the intensive training group (16.33±6.74 and 12.13±5.44) were significantly better than those of the control group (P＜ 0.05).However,there was no significant difference in terms of FAC between the two groups either after 2 weeks or 4 weeks of treatment (P＞0.05).Conclusion The intensive training can improve motor function and relieve poststroke depression of stroke survivors.It is worth promoting and applying in clinical practice.

Objective To survey the current situation and explore the association between empathic ability and job adjustment disorder of pediatric nurses. Methods The Jefferson scale of empathy health professionals and job adjustment disorder scale were used for the survey among 189 pediatric nurses. Pearson correlation analysis was used to explore the association between empathic ability and job adjustment disorder of pediatric nurses. Results The total score of empathic ability of pediatric nurses was (76.32 ±5.03), the score of their job adjustment disorder was (23.69 ±6.03). Their empathic ability and its dimensions were significantly negatively related with job adjustment disorder (P ＜0.01). Conclusions The empathic ability of pediatric nurses was at a medium to low level, job adjustment disorder was at a medium to high level. The higher level of pediatric nurses' empathic ability, the lower level of job adjustment disorder is. Hospital staff should take measures to improve pediatric nurses' empathic ability, and the pediatric nurses themselves should also actively cultivate their own perception, and improve the empathic ability so as to better acclimatize themselves to pediatric nursing job and reduce the degree of job adjustment disorder.

This paper introduces the development and status quo of disaster prevention training at home and abroad,analyzes the necessity and importance disaster prevention simulation,and summarizes the ways to foster critical thinking and disaster prevention capabilities in disaster prevention training as well as the simulation model of disaster prevention training in lab. It provides scientific guidance for future disaster education and rescue activities so as to ensure the affected people can evacuate safely when disasters occur,thus reducing causalities and the wound and deformity rate.

Objective:To investigate the mechanism by which glycoprotein non-transferable melanin B(GPNMB)regulates microglia M2 polarization to reduce nerve damage after cerebral ischemic stroke(CIS).Methods:SD rats were used for establishment of middle cerebral artery occlusion(MCAO)model.Neurons,astrocytes and microglia were cultured under oxygen and glucose depri-vation(OGD)conditions,and the expression of GPNMB in tissues and cells were measured by Western blot.Gpnmb wrapped with adeno-associated virus(AAV)or shRNA-Gpnmb were injected into rat brain tissues for overexpression or inhibition of GPNMB,modified neurological deficit score(mNSS),Rotarod fatigue test and tape removal test were used to evaluate rat nerve function,the proportion of cerebral infarction was determined by TTC staining,microglia M1/M2 polarization markers were detected by immunofluorescence and RT-PCR,and the expression of Phosphatidylinositol 3-kinase(PI3K)/Serine/threonine kinase(Akt)pathway was determined by Western blot.Microglia was cultured under OGD conditions in vitro,Gpnmb was overexpressed and PI3K expression were inhibited by LY294002,and M1/M2 polarization markers were measured.Results:Compared with normal rats or normal cultured cells,the expres-sion of GPNMB in MCAO model or OGD-intervened microglia was up-regulated(P<0.05);when Gpnmb was overexpressed in the brain tissue of MCAO rats,the mNSS score decreased,the Rotarod time of latency to fall lengthened,the contact time and removal time shortened in the tape removal test,the proportion of cerebral infarction decreased,the M1 polarization level of microglia decreased while the M2 polarization level increased,PI3K/Akt pathway activated,and these difference were statistically significant(P<0.05);inhibition of PI3K reversed the effect of overexpression of Gpnmb on promoting M2 polarization of microglia in vitro(P<0.05).Conclusion:GPNMB promotes M2 polarization of microglia by activating the PI3K/Akt pathway,thereby reducing nerve damage after CIS.

Objective The biomechanical model for the musculoskeletal system of a human knee joint was established using a numerical simulation method.The kinematic and dynamic information captured during jumping motion simulated by the human dynamic model was used as driven data of the knee biomechanical model,followed by further analysis of the stress field distribution characteristics of the meniscus under different thermal-force coupling knee brace conditions.Methods Based on computed tomography and magnetic resonance imaging of the subject,a realistic human knee model,including bone,articular cartilage,meniscus,ligaments and peripheral soft tissues of the knee joint,was constructed.Furthermore,two gaits,namely taking-off and landing-on,of jumping motion with an increased risk of meniscus injuries were selected according to mechanical features in full-cycle jumping motion.Subsequently,the stress field characteristics of the knee meniscus under four different thermal-force coupling knee braces were analyzed,the changes of the peak stress of the meniscus and its stress concentration area were discussed,and the protective efficacy and mechanical basis of meniscal injuries and wearing knee braces were explored.Results The anterior part of the medial knee meniscus was a vulnerable area under concentrated stress.Under the knee brace thermal-force coupling condition,the stress concentration area of the medial meniscus was transferred from its narrow and weak anterior part to its wide and thick middle part,and the peak stress was also significantly reduced.The peak stress on the medial meniscus and that on the lateral meniscus were similar,indicating that the two parts of the meniscus bore the external load evenly,and the meniscus stress concentration area decreased.Conclusions Thermal-force coupling knee braces have good protective effects against knee meniscus injury.The numerical simulation provides theoretical support and technical guidance for the design of multifunctional thermal knee braces.

AIM:This study employs Brainbow 2.1 mice to trace myocardial cell lineage and investigates the optimal dose of tamoxifen for labeling proliferating myocardial cells.METHODS:Four-week-old Brainbowfl/+;Myh6-Mer-CreMer+mice were administered tamoxifen at three different doses(3,9 and 27 mg/kg)via intraperitoneal injection to in-duce Cre recombinase expression and label myocardial cells with specific colors.Four weeks later,the samples were stained,and the number of myocardial cells labeled with varying doses of tamoxifen was quantified under confocal micro-scope.This quantification included the proportion of individually labeled cells,adjacent clusters of two cells,and clusters of three or more cells.An appropriate dose(9 mg/kg)of tamoxifen for labeling Brainbow mice was selected to compare myocardial cell proliferation between sham and myocardial infarction(MI)model groups.RESULTS:(1)After 9 mg/kg tamoxifen injection,the proportion of individually labeled cells was 99.13%±0.03%,that of adjacent 2-cell clusters was 0.82%±0.09%,and that of≥3-cell clusters was 0.05%±0.01%.The 3 mg/kg group had fewer total labeled cells,while the 27 mg/kg group showed significant clonal expansion and enrichment.(2)After labeling myocardial cells with 9 mg/kg tamoxifen,the MI mice showed increased proportions of 2-cell and≥3-cell clusters compared with sham group(P<0.01),indicating an increase in myocardial cell proliferation after MI.CONCLUSION:The proportion of adjacent myocardial cell clusters labeled with 9 mg/kg tamoxifen more closely approximates the physiological myocardial cell proliferation rate,indicating 9 mg/kg as the most suitable tamoxifen dose for tracing myocardial cell proliferation.

Objective:To retrospectively analyze the prognosis and related risk factors of lymph node metastasis in early-stage (Ⅰ B-Ⅱ A) cervical cancer patients with postoperative positive lymph nodes who were treated with intensity modulated radiotherapy (IMRT). Methods:A retrospective analysis was conducted for 292 early-stage cervical cancer patients with postoperative high and/or moderate risk factors who were treated with pelvic-abdominal IMRT with/without concurrent chemotherapy in Ningxia Medical University General Hospital from January 2016 to December 2018. These patients included 239 with negative pelvic lymph nodes and 53 with positive lymph nodes, who were incorporated into the negative group and the positive group, respectively. Multivariate and univariate analyses of the risk factors of lymph node metastasis and prognosis were performed for both groups.Results:The univariate and multivariate analyses showed that the lesion ≥4 cm, deep interstitial invasion, and the number of risk factors were independent factors influencing pelvic lymph node metastasis ( χ2 = 7.11, 9.05, 90.08, P < 0.05). There was no statistically significant difference in the 3- and 5-year OS ( P>0.05) between both groups. The 3-year disease-free survival (DFS) and 5-year DFS of the negative group were 87.6% and 84.5%, respectively, and those of the positive group were 72.5% and 69.3%, respectively ( χ2=8.59, P=0.003). Regarding failure modes, distant metastasis mainly occurred in the positive group, while local recurrence was dominant in the negative group ( χ2=9.40, P<0.05). The univariate analysis of the DFS in 53 patients with postoperative positive lymph nodes showed that deep interstitial invasion affected DFS, with statistically significant differences ( χ2 = 7.25, P < 0.05). The result of the multivariate analysis showed that the lesion size >4 cm, positive residual, and deep interstitial invasion significantly influenced the DFS ( χ2 = 4.37, 4.69, 4.39, P < 0.05). Conclusions:The lesion size, deep interstitial invasion, and risk factor number were independent factors influencing lymph node metastasis, and the DFS after radiotherapy of patients with pelvic lymph node metastasis was significantly lower than the patients with negative lymph nodes. The main recurrence type of patients with lymph node metastasis was distant metastasis. Moreover, the deep interstitial invasion was independent factor affecting the DFS of early-stage cervical cancer patients with postoperative positive lymph nodes.