Objective To summarize clinical and histopathological features of trauma-triggered autoimmune bullous skin diseases,and to explore its possible pathogenesis.Methods Clinical manifestations,histopathological features and treatment of 3 cases of trauma-triggered pemphigus or pemphigoid were analyzed,and summarized according to related domestic and overseas literature.Results Of the 3 cases,1 was a female aged 62 years,and 2 were males aged 60 and 71 years respectively.They all had a history of skin trauma or surgery before the onset of the diseases,and time intervals from trauma to diseases were 5,5 weeks and 3 days respectively.The 3 cases were diagnosed as bullous pemphigoid (anti -BP180 antibody 109 U/ml,anti-BP230 antibody negative),pemphigus vulgaris (anti-Dsg1 antibody 68.8 U/ml,anti-Dsg3 antibody 219 U/ml) and pemphigus foliaceus (anti-Dsg1 antibody 143 U/ml,anti-Dsg3 antibody negative) respectively.Their lesions were relieved dramatically after oral and (or) topical glucocorticoid treatment.Conclusions Trauma may be a triggering factor for autoimmune bullous skin diseases.For patients with post-traumatic poor wound healing or skin erythema,blisters and erosion,which can hardly be attributed to trauma or surgery itself,autoimmune bullous skin diseases should be considered,and histopathological or immunopathological examinations should be performed timely.

Objective To investigate the incidence and risk factors of adverse drug reactions in hematological system induced by linezolid.Methods In this retrospective study, 124 inpatients treated with linezolid (n=62) or vancomycin (n=62) for anti-infective therapy between January 2012 and December 2015 in clinical departments of the Second Affiliated Hospital of Anhui Medical University were included.The incidence hematological adverse drug reactions were observed, and the single factor and the multiple factor Logistic regression methods were used to analyze the risk factors of developing thrombocytopenia and decline of hemoglobin.Results Among the 62 inpatients treated with linezolid, thrombocytopenia occurred in 21 patients(33.87%), and decline of hemoglobin occurred in 17 patients (27.42%).No patient discontinued the use of linezolid for the reason of thrombocytopenia or decline of hemoglobin.In multiple stepwise regression analysis, linezolid use[OR=7.699,95%CI (1.408,42.090),P=0.019], treatment duration>14 d[OR=7.639,95%CI(1.162,50.226),P=0.034], baseline eGFR<80 mL·min-1[OR=6.150,95%CI(1.604,23.577),P=0.008], baseline ALB<25 g·L-1[OR=4.078,95%CI(1.017,16.351),P=0.047] and baseline platelet count<200×109·L-1[OR=6.148,95%CI(1.705,22.172),P=0.006] were independent risk factors for thrombocytopenia;linezolid use [OR=4.335,95%CI(1.308,14.365),P=0.016] and baseline ALB<25 g·L-1[OR=5.424,95%CI(1.824,16.129),P=0.002] were independent risk factors for the decline of hemoglobin.Conclusion The incidences of thrombocytopenia and anemia induced by linezolid are not rare, and most of them can be returned to normal.The risk factors of thrombocytopenia and anemia should be concerned and the routine blood test should be monitored during use.

BACKGROUND:Digital three-dimensional model which can reflect the fine structure of the chambers inside heart not only enhances the understanding of cardiac physiology, but also provides basic medical data for the study of cardiac electrophysiology simulation and endocardial electrophysiological mapping navigation. OBJECTIVE:To construct the digital three-dimensional model of cardiac cavity from sectional data and in conformity with the actual anatomical structure. METHODS:Image segmentation was accomplished in MATLAB environment. Firstly, registration of human cardiac cavity slice dataset was realized. Secondly, classifying each composition was achieved by clustering method according to color characteristics of the image. Then, both cardiac cavity and related connected region was distinguished by region growing method. At last, the processed image was reconstructed through dedicated medical processing software into three-dimensional model of the cardiac cavity. RESULTS AND CONCLUSION:The proposed method could reconstruct quite exquisite three-dimensional model of the cardiac cavity. In models, left and right atrial and ventricular structure was clear. Aorta and superior vena cava were visible. Three tricuspid and mitral valve were also observed. Results indicated that reconstructed model can reflect the anatomical characteristics of cardiac cavity accurately, and provide basic medical data for the study on electrophysiological simulation and endocardial electric mapping.

Objective:To explore the application value of multiple indexes of high-frequency ultrasound in the diagnosis of shoulder stiffness, and to provide data support and theoretical basis for the diagnosis and treatment of shoulder stiffness.Methods:Clinical data of 261 patients with unilateral shoulder pain with limited mobility admitted to the Orthopedic Trauma, Hebei Medical University Third Hospital from January to December 2023 were retrospectively analyzed. With the results of shoulder arthroscopy as the gold standard, the patients were divided into 127 patients with shoulder stiffness (observation group) and 134 patients with non-shoulder stiffness and shoulder pain (control group). The fluid accumulation of long head of the biceps tendon (LHBT), echo of rotator interval (RI) and blood flow signal, thickness of coracohumeral ligament (CHL), thickness of subacromial-subdeltoid bursa (SASD), fluid accumulation and blood flow signal, fluid accumulation of posterior glenohumeral joint capsule (PJ), the inferior capsule thickness (ICT) and the thickness of inferior glenohumeral ligament (IGHL) were observed and measured in the two groups in addition, the CHL difference, ICT difference and IGHL difference between the affected side and the contralateral side were calculated, and the difference between the two groups of ultrasound indicators was compared and the multivariate logistic stepwise regression analysis was performed, and the receiver operating characteristic (ROC) curve was drawn to evaluate the diagnostic value of each indicator for shoulder stiffness.Results:RI hypoecho with increased blood flow signal, SASD thickening, SASD effusion, SASD blood flow signal detection rate, IGHL thickness, IGHL difference and ICT difference in observation group were significantly higher than those in the control group (all P<0.05). Multivariate logistic stepwise regression analysis showed that SASD thickening, SASD effusion and IGHL difference were independent predictors of shoulder stiffness (all P<0.05). The area under the curve of SASD thickening, SASD effusion and IGHL difference in the diagnosis of shoulder stiffness were 0.550, 0.540 and 0.636, respectively. The diagnostic sensitivity was 89.8%, 10.2% and 60.6%, and the specificity was 20.1%, 97.8% and 67.2%, respectively. The area under the curve was 0.676, the diagnostic sensitivity was 59.8%, and the specificity was 75.4%. Conclusions:High-frequency ultrasound is an effective imaging method to assist clinical diagnosis of shoulder stiffness. SASD thickening, SASD effusion and IGHL difference may be independent predictors of shoulder stiffness. The combined application of these three indicators has higher clinical application value and provides favorable ultrasound indicators for clinical differential diagnosis of shoulder stiffness.

Objective To investigate the levels and significance of Th17 cells and regulatory T cells (Treg) in peripheral blood of children with allergic rhinitis during pollen and non-pollen seasons.Methods Thirteen children with hay fever, 10 children with house dust mite(HDM)-allergic asthma and 10 healthy children were recruited into this study.Percentages of Th17 and Treg cells were detected by flow cytometry.Levels of IL-17, IL-10 and TGF-β in cell culture supernatants were measured by ELISA.Results (1) The percentages of Th17 cells in children with allergic rhinitis [(3.4±2.4)%] were significantly higher than those in HDM-allergic asthmatics [(2.1±1.6)%] and those in healthy children [(0.5±0.3)%] during pollen season (both P<0.05).The levels of Treg cells in allergic rhinitis group [(2.1±1.3)%] and in HDM-allergic asthma group [(3.6±1.9)%] were significantly lower than those in healthy control group [(5.5±2.8)%] (both P<0.05).The levels of Th17 cells [(3.0±1.9)% vs (3.4±2.4)%, P<0.05] and ratios of Th17/Treg cells [(1.4±1.0)% vs (1.7±1.5)%, P<0.05] in children with allergic rhinitis were significantly decreased during non-pollen season as compared with those during pollen season, but the levels of Treg cells were up-regulated [(2.4±1.6)% vs (2.1±1.3)%, P<0.05].(2) Correlation analysis revealed that the ratios of Th17/Treg cells were positively correlated with the concentrations of FeNO (fractional concentration of exhaled NO) (r=0.321, P<0.05) and the counts of circulating eosinophils (r=0.198, P<0.05) in children with allergic rhinitis during pollen season.Conclusion The imbalanced Th17 and Treg cells in children with allergic rhinitis during pollen season might play a vital role in the regulation of allergic airway inflammation.

Objective To construct a rating scale on the knowledge,attitude,and practice of geriatrics for 8-year clinical medical students and undergraduate nursing students,and to test the reliability and validity of the scale.Methods The Knowledge,Attitude,Practice(KAP)theory was used as a guided framework,relative literatures were reviewed,and topics for question answering were discussed by experts group.Then,a questionnaire was initially constructed.Five methods,including discrete trend method,Cronbach coefficient,t-test,correlation analysis,and factor analysis,were used to screen the attitude and practice items.The knowledge items were evaluated by experts.Items with over three exclusion criteria were deleted when combining the literal questions.The construct validity of the integrated scale was assessed by factor analysis.A pilot research was conducted by 100 eight-year medical students and nursing undergraduates selecting question entries,and the reliability and validity of the scale were examined.Results The scale consisted of three dimensions.A 43-item initiate questionnaire on the scale included 13 items for knowledge,11 for attitude,and 19 for practice.Two knowledge items were deleted according to expert evaluation.Seven items with more than three exclusion criteria were deleted after statistical analyses.Eventually,34 items were included in the questionnaire.The Cronbach α coefficient of the questionnaire was 0.702.And three common factors were extracted according to exploratory factor analysis.Conclusions The reliability and validity of Geriatrics Knowledge,Attitude and Practice scale for eight year medical students and nursing undergraduates are acceptable,but the knowledge items should be recomposed.

Objective To observe the effect of Baduanjin on the sleep quality of college students with Yang deficiency.Methods Forty college students with Yang deficiency and sleep quality problems were randomly divided into a control group and a Baduanjin group,each of 20.Both groups received health education,while the Baduanjin group additionally practiced daily 60-minute Baduanjin at least 4 times a week for 10 weeks.Before and after the intervention,the Yang deficiency physical transfor-mation score and Pittsburgh sleep quality index(PSQI)of both groups were observed,and their correla-tion was analyzed.Results After the intervention,the average Yang deficiency physical transformation score of the Baduanjin group decreased significantly compared with before the intervention and the con-trol group at the same time point(P＜0.01 for both).Moreover,after the intervention,the average total PSQI scores and scores of all dimensions except the sleep time and sleep efficiency of the Baduanjin group were significantly lower than those before that,and the control group at the same time point(P＜0.05 for both).The total PSQI scores and scores except sleep time and sleep efficiency in the Baduan-jin group after the intervention were lower than those in the control group at the same time(P＜0.05).However,no significant differences were found in all the measurements of the control group before and after the intervention(P＞0.05).In addition,there was a significant positive correlation between the change in the Yang deficiency physical transformation score and the total PSQI in the Baduanjin group before and after intervention(P＜0.05),but not in the control group.Meanwhile,the total effective rate of the Baduanjin group was significantly higher than the control group(P＜0.05).Conclusion Practicing Baduanjin can effectively improve the sleep quality of college students with Yang deficiency and their biased Yang deficiency constitution,and their improvement is of positive correlation.

Objective:To explore the mediating effects of resilience and depression on the relationship between social support and self-neglect.Methods:From July to October 2020, a cross-sectional survey was conducted among 549 empty-nest community-dwelling elderly in the community using the social support rating scale, Connor and Davidson resilience scale, geriatric depression scale and elderly self-neglect scale. SPSS 22.0 and AMOS 24.0 were used for data analysis, including descriptive analysis, correlation analysis and structural equation modeling.Results:The scores of social support, resilience and self-neglect of the empty-nest elderly were (38.63±7.47), (64.30±14.57) and (3.72±2.67) respectively, and 31.70% (174/549) of the subjects had depressive symptoms. The score of self-neglect was negatively correlated with the score of social support ( r=-0.597, P<0.01) and resilience ( r=-0.557, P<0.01), and positively correlated with depression score ( r=0.675, P<0.01). The score of social support was positively correlated with resilience score ( r=0.531, P<0.01) and negatively correlated with depression ( r=-0.597, P<0.01). Social support could affect self-neglect directly ( β=-0.485, P<0.05), and it could also influence self-neglect indirectly through the partial mediating effect of resilience ( β=-0.451, P<0.05). The mediating effect of resilience and depression accounted for 12.18% and 36.00% of the total effects respectively. Conclusion:Social support could influence self-neglect directly or indirectly through resilience and depression. The empty-nesters should be encouraged to participate more in social activities so as to improve their resilience, reduce the occurrence of self-neglect.

Objective:To explore the situation and influencing factors of online health information seeking behavior of older patients with coronary heart disease.Methods:From July to November 2021, a cross-sectional survey was conducted on 451 older patients with coronary heart disease in four districts of Qingdao City using the general information questionnaire, Patient Activation Scale, Social Support Scale and Online Health Information Seeking Behavior Scale.Results:Olderpatients with coronary heart disease had a score of (70.69 ± 9.19) for online health information seeking behavior. The results of multiple linear regression analysis showed that gender, education, internet use frequency, social support and patient activation were the main influencing factors of online health information seeking behavior ( R2=0.639, F=31.58, all P<0.05). Conclusions:Older patients with coronary heart disease have a moderate level of online health information seeking behavior, and is influenced by multiple factors. Targeted measures should be taken to make patients actively search for disease information online to prevent disease deterioration and promote healthy aging.

Objective:To systematically integrate the attitudes and experiences of medical staffs towards the family presence during resuscitation and provide a reference for the development of family presence during resuscitation clinical practice in China.Methods:To search PubMed, Embase, Web of Science, The Cochrane Library, CINAHL, CNKI, CBM and Wanfang database for qualitative studies on medical staff's attitudes and experiences of family presence during resuscitation since its inception to August 2022. The quality of the literature was evaluated using the Australian JBI Centre for Evidence-Based Health Care (2017) quality assessment criteria for qualitative studies, which were integrated using a pooled integration approach.Results:A total of 12 papers were included to distil the findings of 74 studies, which were summarized to form 10 new categories and 4 consolidated findings including medical staffs′ attitudes towards and reasons for family presence during resuscitation, the impact of family presence during resuscitation on the resuscitation team, the impact of family presence during resuscitation on patients and families, and the real-life dilemmas and recommendations for medical staffs to allow family presence during resuscitation.Conclusions:We should pay attention to the difficulties and needs of family presence during resuscitation by medical staff, take into account the medical context in China, and improve the humanistic care system in our hospitals by considering hospital management, clinical practice, and the demands of patients and their families, in order to improve the accessibility of family presence during resuscitation by the medical staff.