Objective To analyze the electrocardiogram (ECG) characteristics of apical ballooning syndrome (ABS) in female patients in China. Methods 50 female cases of ABS patients from medical periodicals in China were analyzed. Results 50 patients were in sinus rhythm, 98% patients were abnormal in ECG. ST segment elevated in 85.7% of them, ranged 0.1-0.8 mV, and came down in 30 min-2 weeks. T wave inversion was found in 42% of them, 24% with pathological Q wave, which disappeared in 6 hours-1 month. 28% showed QT interval prolongated, 38% complicated with arrhythmia. Conclusion The abnormal ECG is common in female patients with ABS, which is transient and reversible.

Objective To evaluate the accuracy and sensitivity of three techniques in the diagnosis of renal diseases following multiple myeloma. Methods 41 serum samples from the kidney-damaged patients with multiple myeloma and 36 from the control group with general renal diseases were detected by quantitative analysis of immunoglobulins, serum protein electrophoresis and serum Immunofixation Electrophoresis. The accuracy and sensitivity of the three techniques were analysed by Two-way ANOVA and Multiple Comparisons of the check-out rate of monoclonal immunoglobulin. Results No monoclonal components were checked out by quantitative analysis of immunoglobulins. The checkout rate of IgG and IgM myelomas were 100% by serum protein electrophoresis, which had application limit on other types of myelomas. Whereas all secretarial myelomas could be diagnosed and typied by Immunofixation Electrophoresis, the sensitivity and accuracy was 100%, there was no false positive in the control group. Comparing with quantitative analysis of immunoglobulins and serum protein electrophoresis, serum Immunofixation electrophoresis had higher sensitivity and accuracy in diagnosis of renal diseases following multiple myeloma ( P

Objective To establish the proper review rules for the microscopic screening of urine analyzed by UF-1000i automatic urinalysis work station (composed of UF-1000i urine flow cytometer and AX-4030 urine dry chemical analyzer).Methods A total of 2 839 random urine samples were collected at Chinese People′s Liberation Army General Hospital from September 2009 to February 2010, and were analyzed using UF-1000i urinalysis work station.The parameters obtained from UF-1000i and AX-4030 included RBC, WBC, CAST and ERY, LEU, PRO.After analysis by urinalysis work station, each urine sample was examined microscopically by two technologists using double-blind method.The average results got from the two technologists were regarded as the judging criterion.Based on the criterion, the review rules for the 2 839 urine samples tested by urinalysis work station were created and adjusted, and the true positive rate, false positive rate, true negative rate, false negative rate and review rate of these review rules were calculated.After that, 299 randomly selected urine samples were tested to validate these review rules.Omission diagnostic rate and review rate were used to assess the clinical practicability of the review rules.Results Thirty seven rules for microscopic review and twenty seven rules without further microscopic examination were set up based on six parameters using UriAccess 3.0 Software.The microscopic examination result was taken as the judging criterion, the consistency rate of these rules was 81.11%(2 311/2 839), the true positive rate was 40.51%(1 150/2 839), the false positive rate was 16.17%(459/2 839), the true negative rate was 41.00%(1 164/2 839), the false negative rate(omission diagnostic rate) was 2.43%(69/2 839) and the review rate was 18.28% (519/2 839).Additional 299 urine samples were assayed using UriAccess3.0 software to further verify these review rules.The consistency rate was 82.27%(246/299), the true positive rate was 36.12%(108/299), the false positive rate was 16.39%(49/299), the true negative rate was 46.15%(138/299), the false negative rate(omission diagnostic rate) was 1.34%(4/299), the review rate was 19.06%(57/299). The 4 false negative samples selected by these review rules did not come from the nephropathy department or the urology department.Microscopic results of RBC and WBC form these 4 samples ranged 3-8 cells/HP. Thus, these review rules could avoid the missed diagnosis of those patients with severe renal dysfunction.Conclusion The review rules established from this study for the UF-1000i urinalysis work station can effectively detect abnormal urine samples and improve the efficiency and the quality of urinalysis in routine clinical practice.

OBJECTIVE:To study the plasma total homocysteine(tHcy)level in the uremia patients and to study the therapeutic effects of folic acid combined with methylcobalamin in the intervention treatment of uremia patients with homo-cysteinemia.METHODS:Levels of plasma tHcy of60uremia patients(treatment group)and40normal subjects(control group)were determined both before treatment and8weeks after intervention treatment with folic acid combined with methylcobal-amin.RESULTS:The plasma level of tHcy in uremia patients were significantly higher than that in the normal subjects(P

Objective To observe the incidence of spontaneous clearance of hepatitis B virus (HBV) DNA in chronic hepatitis B (CHB) patients ,and to investigate the related factors of the spontaneous clearance of HBV DNA and to determine the time to start antiviral therapy .Methods Patients who met the inclusion criteria were recruited from the follow-up cohort of chronic HBV infection from January 2008 to August 2017 for observation .The liver function including alanine aminotransferase (ALT) levels ,HBV DNA load and serum markers of HBV were measured at baseline ,month 1 ,month 3 and month 6 of follow-up . Evaluation index included cumulative HBV DNA negative conversion rate and cumulative HBeAg negative conversion rate .Multivariable analysis was used to analyze the factors associated with the spontaneous clearance of HBV DNA .Results A total of 116 patients were recruited in this study .All the patients showed ALT level elevation at baseline .Without antiviral treatment ,the cumulative HBV DNA negative conversion rate was 12 .9％ after 6-month observation .HBeAg negative conversion rate was 22 .5％ .Multivariable analysis showed that patients without a family history of HBV infection ,baseline ALT level >3 times the upper limit of normal (ULN) and HBV DNA level <6 lg copies/mL had higher cumulative HBV DNA spontaneous clearance rate .HBV DNA negative conversion rate in patients whomet all the above three conditions was up to 75％ .Conclusions In CHB patients and ALT level elevation for the first time , some patients could achieve spontaneous clearance of HBV DNA without antiviral therapy .Patients without a family history of HBV infection ,baseline ALT level >3 ULN and HBV DNA level <6 lg copies/mL have higher rate of cumulative HBV DNA spontaneous clearance .

Objective:To investigate the effects and its mechanism of chronic unpredictable stress on intestine and liver injuries in rats, and explore the possibility of the existence of brain-gut-liver axis.Methods:Twenty male SD rats were randomly divided into control group and stress group (with 10 in each group). The rats in the stress group were stimulated by chronic unpredictable stress for 4 weeks to prepare the chronic stress model. The rats in the control group were fed normally without stress stimulation. After modeling, ten rats in the control group and seven rats in the stress group were included. The depressive behavior of the two groups was evaluated by sugar water preference experiment. Then the rats were sacrificed. The diversity of gut flora in intestinal feces was analyzed by 16S rRNA sequencing analysis. The pathological injuries of ileum and liver were detected by HE staining. The expressions of occludin in ileum and Toll-like receptor 4 (TLR4) in liver were detected by immunohistochemistry. The expression of TLR4 protein in liver tissue was detected by Western blot. The level of lipopolysaccharide (LPS) in rat portal vein serum was detected by AZO chromogenic limulus test and blood biochemical method was used to detect liver function.Statistical analysis was performed using SPSS 25.0 software, and t-test or Mann-Whitney U test was used for comparison between the two groups. Using STAMP software, Wilcoxon rank sum test was used to analyze the difference in bacterial abundance between the two groups. Results:The consumption of sugar water ((7.86±0.90)ml) and the preference rate of sugar water ((43.06±5.65)%) in the stress group were lower than those in the control group ((15.10±1.51)ml, (76.81±6.44)%), and the difference were statistically significant ( t=11.33, 11.16, both P<0.01). Chronic stress caused pathological damage to rat ileum tissue. Compared with the control group, the ileum villi of rats in the chronic stress group were longer ((448.93±12.71)μm, (497.12±16.72)μm, t=-5.88, P<0.01) and thicker ((81.99±16.54)μm, (133.93±6.78)μm, t=-7.12, P<0.01), and the expression of occludin was significantly down-regulated ((0.236±0.011), (0.130±0.026), t=9.12 , P<0.01), the LPS level increased significantly ((18.83±2.62)EU/L, (38.64±2.51)EU/L, t=-5.79, P<0.01). The Beta diversity of rat intestinal flora changed under chronic stress, and the abundance of WPS-2 phylum in intestinal tract of rats in stress group was higher than that in control group ( t=2.76, P<0.05). Chronic stress caused pathological damage to the liver tissue of rats. Compared with the control group, the expression of TLR4 protein in the liver tissue of the chronic stress group increased ((0.169±0.014), (0.475±0.034), Z=-2.37, P<0.05). Compared with the control group, the ALT ((39.7±6.2)U/L, (82.9±43.1)U/L, Z=-2.35, P<0.05) and AST((130.9±28.9)U/L, (472.7±263.3)U/L, Z=-2.64, P<0.05) levels of the chronic stress group increased, especially in AST. Conclusion:Chronic stress cause synchronous damage to the intestine and liver in rats. The mechanism may be related to the results caused by chronic stress such as the changes of the diversity of intestinal flora, the increasing of intestinal permeability, the action of LPS translocated through portal vein blood on TLR4 in liver.

Objective:To analyze the knowledge, skills and self-efficacy of cardiopulmonary resuscitation among the public in mountainous areas of southern Ningxia, and provide scientific support for the popularization of cardiopulmonary resuscitation.Methods:According to inclusion and exclusion criteria, a total of 1 503 inhabitants in Ningxia district (Jan. 2018 to Jan. 2019) were chosen as research samples. The general data was analyzed; the self-made questionnaire was applied to evaluate the inhabitants ′ theory knowledge, skill mastery and self-efficacy by professional nurses. Multiple linear regression was used to analyze the influence factors of theory knowledge and skill mastery degree. Results:A total of 1 503 valid questionnaires were collected, the assessment scores of theory knowledge, skill mastery and overall self-efficacy were (53.11±12.34), (62.64±18.35) and (6.09±2.18) points; According to demographic characteristics, multiple linear regression indicated that the influence factors of theory knowledge and skill mastery assessment scores included age, occupational distribution, education backgrounds, training conditions, time of taking training to survey, "onlooker" experience and self-efficacy indicators ( t/ F values were 5.723, 4.393, 5.817, 6.435, 5.990, 6.438, 6.631, P<0.01). The positive correlations were assumed ( r values were 0.012, 0.016, P<0.05) . Conclusion:In Ningxia, the inhabitants generally have low theory knowledge, skill mastery and self-efficacy levels. Therefore, the relevant medical institutions shall enhance the inhabitants ′ cardio-pulmonary resuscitation training through multiple methods and approaches.

Objective:To explore the application value of primary trauma treatment (PTC) teaching mode in special professional cardiopulmonary resuscitation (CPR) guide training.Methods:Cluster sampling method was adopted, and the residents' committee selected special occupation population from every town/sub-district office in the southern mountainous area of Ningxia Hui Autonomous Region for CPR training. A monthly session was held from January to December 2019, with personnel trained by traditional operation teaching and individual practice method from January to June 2019 as the control group and personnel trained by PTC teaching mode from July to December 2019 as the observation group. The two groups of trainers, training objectives and assessment standards were consistent. Questionnaire survey was conducted at the beginning and end of each training period, including the degree of mastery of first-aid knowledge and skills and the level of self-efficacy, etc., to evaluate the training effect.Results:There were 503 trainees in each group, and there was no significant difference in gender, age, education and occupation distribution between the two groups. There was no significant difference in the first aid principles, CPR skill level and self-efficacy between the two groups before the training. The first aid principle, CPR skills level and self-efficacy of the two groups after training were all improved, and the principle of first aid and CPR skills level in the observation group was obviously higher than that in the control group (first aid related concepts: 4.39±0.76 vs. 3.87±0.89, gold life-saving time: 5.71±0.49 vs. 4.53±0.62, the meaning of the first witnesses: 5.33±0.82 vs. 4.18±0.78, cardiac, respiratory cardiac arrest in the judgment: 5.12±0.73 vs. 4.07±0.73, CPR skills: 5.29±0.64 vs. 4.15±0.71, all P < 0.05). The self-efficacy score of the observation group was significantly higher than that of the control group (emergency attitude: 18.17±1.24 vs. 17.35±1.25, self-efficacy: 13.56±1.54 vs. 11.35±1.26, behavioral intention: 9.56±0.84 vs. 8.92±0.95, all P < 0.05). Conclusion:The application of PTC teaching mode in the training of CPR guidelines for special professions has significant effects, which can effectively help special professions to master CPR knowledge and skills, and has promotion value.

Objective To observe the effect of wrist-hand orthosis combined with modified constraint-induced movement therapy(mCIMT)on upper limb and hand function in patients with stroke. Methods From February,2022 to December,2023,32 patients after stroke in Huashan Hospital,Fudan University were randomly assigned to control group(n=16)and experimental group(n=16).Both groups underwent routine re-habilitation,and wore constraint glove almost four hours a day.The experimenal group wore dynamic wrist-hand orthosis four hours everyday,additionally;five days every week,for three weeks.They were evaluated with Wolf Motor Function Test(WMFT),Action Reach Arm Test(ARAT),the strength of gripping,Amount of Use(AOU)and Quality of Movement(QOM)of Motor Activity Log(MAL),Hamilton Anxiety Scale(HAMA)and Hamil-ton Depression Scale(HAMD)before and after treatment,while root mean square ratio of affected/healthy exten-sor muscle of wrist was measured with surface electromyography Results After treatment,the scores of WMFT,ARAT,MAL-QOM,HAMA and the root mean square ratio of affected/healthy extensor muscle of wrist improved in both groups(|t|＞2.179,P＜0.05),and the improvement of WMFT score and the strength of gripping was greater in the experimental group than in the control group(|t|＞2.343,P＜0.05);the strength of gripping,the scores of MAL-AOU and HAMD improved in the experimental group(|t|＞2.819,P＜0.05). Conclusion mCIMT assisted with dynamic wrist-hand orthosis could improve upper limb and hand function in stroke pa-tients.

Objective:To investigate the application of diagnostic criteria for common occupational radiation-induced diseases to radiation workers, in order to provide a basis for the revision, publicity and standardization of the standards.Methods:Radiation workers were selected from 1 city, 7 provinces and 1 corporation by using cluster random sampling method from January 2021 to May 2021. Awareness of the criteria and the effects of ionizing radiation, and the suggestions for diagnostic works were investigated and analyzed.Results:A total of 2 839 radiation workers were investigated. There were differences in the awareness of different diagnostic criteria, the inclusions in complex diagnostic criteria, the materials required for applying for diagnosis, and the ways of knowing the diagnostic criteria( χ2=416.06, 2 924.14, 83.45, 895.67, 815.94, P<0.001). The correct understanding rates of deterministic effects and stochastic effects were 80.63% and 43.64%, respectively. The acceptance rates in applicable materials were 96.79% for occupational exposure history, 94.72% for occupational health monitoring records and 93.55% for individual monitoring of occupational exposure, respectively. Pre-employment training rate was 80.20%, on-job training rate was 81.19%, and untrained rate was 3.77%. The suggestions to the diagnosis of occupational radiation-induced diseases are to strengthen training, pay attention to individual monitoring, occupational health examination, and strengthen health supervision and law enforcement. Conclusions:Radiation workers have a low awareness rate of certain diagnostic standards and a high awareness rate of diagnostic procedures. Publicity and training of health effects of ionizing radiation and diagnostic criteria of occupational radiation-induced diseases should be strengthened. Diagnostic procedure should be optimized.