Objective:To investigate the consumption situation and cognition of health care products in hospitalized patients, ana-lyze the problems in purchasing and use of health care products to provide evidence for the correct selection and rational use of health care products. Methods:The investigation and analysis was conducted with an anonymous questionnaire on awareness and consumption situation of health care products in hospitalized patients. Results:The survey received 129 valid questionnaires, and more than 1/3 re-spondents did not know the differences between health care products and medicines, and 27. 91％ of them treated diseases with health care products, 57. 36％ of them purchased health care products per month, and 96. 12％ of them thought the efficacy of health care products were inconsistent with the advertising efficacy. Conclusion:Patients cannot distinguish health care products from medicines, and lack of trust in the health care products market. Corresponding measures should be performed to help patients purchase and use of health care products and safeguard their legitimate rights and interests.

Objective To investigate the maturation status of monocytes and their responses to the stimulation of toll like receptor (TLR) ligands during primary HIV-1 infection, and to further understand the correlation between functional status of monocytes and disease progression during primary HIV -1 infection. Methods Peripheral blood mononuclear cells ( PBMCs) were collected from 35 subjects with primary HIV-1 infection and 13 HIV-negative healthy subjects to isolate monocytes .Monocytes were stimulated with LPS and Pam3CSK4, respectively, and cultured for 20 hours.The expression of activaion/inhibitory markers on monocytes were analyzed by flow cytometry before and after stimulation .The secretion of proinflammatory cy-tokines ( IL-1β, TNF-αand IL-6) by stimulated monocytes were detected by ELISA .Results The expres-sion of activation markers CD80, CD86, CD40 and inhibitory marker PD-L1 on monocytes were increased in subjects with primary HIV-1 infection (P<0.001 except for CD86 P=0.01).The level of CD40 was posi-tively correlated with viral load in plasma (P<0.001, R=0.553).Compared with control group, primary HIV-1 infection group showed a less increase in the expression of HLA-DR, CD80, CD86 and PD-L1 on monocytes after stimulation with LPS and Pam3CSK4 (P<0.001), but the secretion of proinflammatory cyto-kines TNF-α(LPS:P=0.004, Pam3CSK4:P=0.012) and IL-6 (LPS:P=0.006) were enhanced in mono-cytes from patients with primary HIV-1 infection.Conclusion Monocytes were activated during primary HIV-1 infection.They secreted higher level of proinflammatory cytokines after stimulation with TLR ligands , indicating monocytes might play a role in microbial translocation and immune activation during HIV -1 infection .

Studies showed that low fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs) diet can improve the symptoms of gastrointestinal dysfunction of inflammatory bowel disease (IBD) patients, the mechanism may be related to decrease of secretion of intestinal liquid and production of gas.Specific carbohydrate diet and paleolithic diet may be suitable for IBD patients.This article reviewed the advances in study on effects of different diets on gastrointestinal dysfunction in patients with IBD.

Objective To study family typology of stroke survivors′spouse and its relationship with perceived social support and offer a basic reference for family intervention. Methods A total of 327 qualified spouses of stroke survivors were investigated in the Family Cohesion and Adaptability Questionnaire (FACESII-CV) and Perceived Social Support Scale (PSSS) for their family typology proportion and relationship with PSSS. Results Compared with normal group, the ratios of extremity type family and middle family type were increased in this study: 23.9%(78/327)vs. 16.4%(20/122), 45.0%(147/327) vs. 29.5%(36/122), while the equilibrium family type were decreased:31.1% (102/327) vs. 54.1%(66/122), and there were significant differences (χ2=23.089, P<0.01). PSSS scores of spouses were (61.99±11.90) points, which included family support (21.71±4.27) points and social support (40.28±8.31) points. The scores were all in high level. Inter-comparison of three types of family showed the scores of PSSS were higher in extremity type families than those in middle and equilibrium type families: (68.27±11.27) points vs. (61.04±12.18), (59.56±10.34) points, and there were significant differences (F=5.636, P=0.005), but no significant difference between the last two (P > 0.05). Family typology was the most important factor to PSSS (β=0.212, P<0.05) in spouses of stroke survivors, followed by education degree of spouses (β=-0.190, P<0.05). There were no significant differences in the patients' spouses the baseline indicators in three types of families (P> 0.05). Conclusions Among the spouses of stroke survivors, the ratios of extremity and middle family type are increased but equilibrium family type are decreased. Family typology is the most important factor to PSSS of survivors′spouse. The PSSS of survivors′spouse in extremity type families is higher than that in middle and equilibrium type families. Intervention should be offered to the families, guiding the conversion of family typology from other types to extremity.

Objective To observe the effect of different airway pressure on ventilation, organ perfusion and return of spontaneous circulation (ROSC) of cardiac arrest (CA) pigs during cardiopulmonary resuscitation (CPR), and to explore the possible beneficial mechanism of positive airway pressure during CPR. Methods Twenty healthy landrace pigs of clean grade were divided into low airway pressure group (LP group, n = 10) and high airway pressure group (HP group, n = 10) with random number table. The model of ventricular fibrillation (VF) was reproduced by electrical stimulation, and mechanical chest compressions and mechanical ventilation (volume-controlled mode, tidal volume 7 mL/kg, frequency 10 times/min) were performed after 8 minutes of untreated VF. Positive end expiratory pressure (PEEP) in LP group and HP group was set to 0 cmH2O and 6 cmH2O (1 cmH2O = 0.098 kPa) respectively. Up to three times of 100 J biphasic defibrillation was delivered after 10 minutes of CPR. The ROSC of animals were observed, and the respiratory parameters, arterial and venous blood gas and hemodynamic parameters were recorded at baseline, 5 minutes and 10 minutes of CPR. Results The number of animals with ROSC in the HP group was significantly more than that in the LP group (8 vs. 3, P < 0.05). Intrathoracic pressure during chest compression relaxation was negative in the HP group, and its absolute value was significantly lower than that in LP group at the same time [intrathoracic negative pressure peak (cmH2O): -4.7±2.2 vs. -10.8±3.5 at 5 minutes, -3.9±2.8 vs. -6.5±3.4 at 10 minutes], however, there was significantly difference only at 5 minutes of CPR (P < 0.01). Intrathoracic pressure variation during CPR period in the HP group were significantly higher than those in the LP group (cmH2O: 22.5±7.9 vs. 14.2±4.4 at 5 minutes, 23.1±6.4 vs. 12.9±5.1 at 10 minutes, both P < 0.01). Compared to the LP group, arterial partial pressure of oxygen [PaO2 (mmHg, 1 mmHg = 0.133 kPa): 81.5±10.7 vs. 68.0±12.1], venous oxygen saturation (SvO2: 0.493±0.109 vs. 0.394±0.061) at 5 minutes of CPR, and PaO2 (mmHg: 77.5±13.4 vs. 63.3±10.5), arterial pH (7.28±0.09 vs 7.23±0.11), SvO2 (0.458±0.096 vs. 0.352±0.078), aortic blood pressure [AoP (mmHg): 39.7±9.5 vs. 34.0±6.9], coronary perfusion pressure [CPP (mmHg): 25.2±9.6 vs. 19.0±7.6], and carotid artery flow (mL/min:44±16 vs. 37±14) at 10 minutes of CPR in the HP group were significantly higher (all P < 0.05). Arterial partial pressure of carbon dioxide (PaCO2) in the HP group was significantly lower than that in the LP group at 10 minutes of CPR (mmHg: 60.1±9.7 vs. 67.8±8.6, P < 0.05). Conclusions Compared to low airway pressure, a certain degree of positive airway pressure can still maintain the negative intrathoracic pressure during relaxation of chest compressions of CPR, while increase the degree of intrathoracic pressure variation. Positive airway pressure can improve oxygenation and hemodynamics during CPR, and is helpful to ROSC.

BACKGROUND:The assessment of asymmetric gait quality plays a pivotal role in guiding rehabilitation training;however,the link between gait quality and kinematic-kinetic gait parameters remains ambiguous. OBJECTIVE:To formulate a machine-learning model for evaluating gait quality based on gait parameters,identify factors sensitive to gait quality from asymmetric gait parameters,investigate the relationship between gait indicators and gait quality,and provide guidance for asymmetric gait training and rehabilitation. METHODS:An asymmetric gait database was established through the creation of asymmetric conditions.Kinematic and kinetic data were collected from 8 young and 8 elderly subjects(all male,right dominant population)during gait tests.Gait quality for each test data set was assessed using symmetry indices,resulting in the creation of a gait parameter-gait quality dataset.Utilizing the Random Forest algorithm,a gait quality evaluation model was developed and key quality parameter factors were identified through differential analysis.This model was iteratively refined.The model's performance was evaluated through 10-fold cross-validation,and its effectiveness was verified using the cross-validation dataset. RESULTS AND CONCLUSION:(1)A gradient test was designed to categorize gait quality into optimal,suboptimal,intermediate,and poor groups,with 759,329,133,and 125 instances,respectively.(2)The application of the Random Forest algorithm in gait quality assessment was explored.A relationship model was established between gait indicators and gait quality,yielding a predictive model accuracy of 95.99%.(3)The 13 main parameters significantly influencing asymmetric gait quality were identified through the Random Forest model's feature importance ranking.(4)An analysis of gait quality sensitivity factors using the 13 important parameters led to the identification of five key sensitivity indexes.The Random Forest model utilizing these sensitivity factors achieved a predictive accuracy of 94.20%.

The pathophysiological nature of type 1 diabetes mellitus (T1DM) as an autoimmune disease provides the basis for immunotherapy.As an important therapeutic approach,immunomodulatory drugs are promising in the protection of pancreatic β-cells by effecting at various stages of autoimmune progression.In this review,we summarize the recent advances of immunomodulatory drugs in the prevention and treatment of T1DM and propose future directions.

Objective:To establish a quality control system of enteral nutrition nursing for critically ill patients, and to apply this system in clinical practice and evaluate its effect.Methods:Delphi method was used to construct the quality control system. By training nurses in this system, through the training of the system for nurses and clinical quality control, enteral nutrition complications of patients before and after the training and nurses' knowledge of enteral nutrition were compared.Results:after the system applied in the nursing clinic, the incidence of enteral nutrition gastrointestinal complications, infectious complications, metabolic complications and mechanical complications in patients with critical illness decreased from 11.3% (18/160), 1.9% (3/160), 5.6% (9/160), 6.9% (11/160) to 3.9% (6/152), 0.7% (1/152), 1.3% (2/152), 1.9% (3/152) respectively, with statistically significant differences ( χ 2 values were 6.35-91.33, P <0.01). ICU nurses' awareness of enteral nutrition theory was significantly improved, and the questionnaire score increased from (70.22±8.78) points to (95.25±4.18) points, with statistically significant difference ( t value was 18.792, P<0.01). Conclusion:The enteral nutrition nursing quality control system developed in this study can effectively guide nursing staff to implement enteral nutrition during nursing behavior, reduce the occurrence of enteral nutrition complications in patients with critical illness, to ensure the safety of patients, and is worthy of clinical promotion and application.

Objective:To investigate the application of retroauricular groove incision in the resection of benign tumors in the deep lobe of parotid.Methods:From January 2017 to January 2022, 19 patients (11 males and 8 females, age ranged from 17 to 69 years, with a median age of 48) with benign tumor in the deep lobe of parotid gland underwent parotidectomy through retroauricular sulcus incision in Linyi People′s Hospital. Among them, 17 cases with tumor diameter≤4.0 cm underwent simple retroauricular groove incision, and 2 cases were dumbbell type with tumor diameter>4.0 cm on the medial side of mandible protruding into the parapharyngeal space, in which the deep lobe and tumor of parotid gland were resected through retroauricular sulcus incision combined with intraoral incision.Results:Tumors were completely removed through retroauricular sulcus incision in 17 cases, and dumbbell type tumors were removed through retroauricular sulcus incision combined with intraoral incision in 2 cases. Postoperative pathological examinations showed pleomorphic adenoma in 13 cases, basal cell adenoma in 4 cases and Warthin′s tumor in 2 cases. Temporary mandibular marginal branch paralysis occurred in 2 patients and returned to normal 3 weeks after operation. All incisions healed in Phase I. By following-up of 1-5 years with a median follow-up time of 3.1 years, none of the patients had Frey syndrome, salivary fistula, other complications and tumor recurrence. The patients and their families were satisfied with the postoperative facial appearances.Conclusion:The retroauricular groove approach can not only preserve the function of parotid superficial lobe and facial nerve, but also has less trauma, less tissue defect and hidden scar. As the advantages of less complication, low recurrence rate and good cosmetic effect, the incision is worthy of clinical application.

Objective To compare the ultrasound signs of symptomatic joint lesions in rheumatoid arthritis (RA) and gouty arthritis (GA), musculoskeletal ultrasound (MSUS) was utilized.Methods A retrospective analysis was performed for 85 hospitalized patients with RA and 55 hospitalized patients with GA in the same period, and the differences in general data, diseased joints and ultrasound signs between the two groups were compared.Re-sults The gender, age and diseased joints of the two groups were statistically significant (all P<0.05).The de-tection rate of knee joint lesions was the highest;the RA group had high sensitivity, high specificity of meniscal in-jury, and high diagnostic efficiency of bone erosion, while the diagnostic performance of the three combined ultra-sound signs of punctate strong echo, double track sign and tophi in the GA group was higher than that of any indi-vidual diagnosis, and the sensitivity and specificity were also higher.The course of disease in the RA group was positively correlated with bone erosion (P<0.05) , and the course in the GA group was positively correlated with tophi (P<0.05).Conclusion The ultrasound signs of RA and GA are different, and MSUS has good value in the diagnosis and differential diagnosis of the two.