Objective To investigate the effect of ankle pump exercises,based on hemodynamic mechanisms,on the prevention of venous thrombosis in stroke patients.Methods A total of 110 stroke patients,admitted to a tertiary A hospital in Jiangsu Province between June 2023 and June 2024,were selected using a convenience sampling method.The patients were divided into an experimental group and a control group,with 55 patients in each group.The experimental group received ankle pump exercise nursing interventions based on hemodynamic mechanisms,while the control group received routine nursing interventions.The incidence of lower extremity deep vein thrombosis,Pittsburgh Rehabilitation Participation Scale scores,subjective perceived fatigue,and exercise self-efficacy scores were compared between 2 groups on the 7th day of hospitalization.Results No dropouts occurred in either group.The incidence of deep vein thrombosis was significantly lower in the experimental group than it in the control group(P=0.004).The Pittsburgh Rehabilitation Participation scores on day 1,3,5,and 7 were higher in the experimental group compared to them in the control group(P＜0.001).A significant time-dependent trend was observed in Pittsburgh Rehabilitation Participation scores(P=0.034).Subjective fatigue was significantly lower in the experimental group at various time points(P＜0.001).Both groups showed an increase in exercise self-efficacy over time(P=0.016),with the experimental group demonstrating higher exercise self-efficacy than the control group on the day before discharge(P=0.003).Conclusion Ankle pump exercises,based on hemodynamic mechanisms,can effectively reduce the incidence of deep vein thrombosis in stroke patients,enhance rehabilitation participation and exercise self-efficacy,without increasing subjective fatigue.

Objective To investigate the effect of ankle pump exercises,based on hemodynamic mechanisms,on the prevention of venous thrombosis in stroke patients.Methods A total of 110 stroke patients,admitted to a tertiary A hospital in Jiangsu Province between June 2023 and June 2024,were selected using a convenience sampling method.The patients were divided into an experimental group and a control group,with 55 patients in each group.The experimental group received ankle pump exercise nursing interventions based on hemodynamic mechanisms,while the control group received routine nursing interventions.The incidence of lower extremity deep vein thrombosis,Pittsburgh Rehabilitation Participation Scale scores,subjective perceived fatigue,and exercise self-efficacy scores were compared between 2 groups on the 7th day of hospitalization.Results No dropouts occurred in either group.The incidence of deep vein thrombosis was significantly lower in the experimental group than it in the control group(P=0.004).The Pittsburgh Rehabilitation Participation scores on day 1,3,5,and 7 were higher in the experimental group compared to them in the control group(P＜0.001).A significant time-dependent trend was observed in Pittsburgh Rehabilitation Participation scores(P=0.034).Subjective fatigue was significantly lower in the experimental group at various time points(P＜0.001).Both groups showed an increase in exercise self-efficacy over time(P=0.016),with the experimental group demonstrating higher exercise self-efficacy than the control group on the day before discharge(P=0.003).Conclusion Ankle pump exercises,based on hemodynamic mechanisms,can effectively reduce the incidence of deep vein thrombosis in stroke patients,enhance rehabilitation participation and exercise self-efficacy,without increasing subjective fatigue.

In recent years， there have been both achievements and criticisms in using the methods of evidence-based medicine to evaluate the efficacy of traditional Chinese medicine （TCM）， which is mainly due to the differences between TCM and Western medicine. To facilitate the clinical evidence-based evaluation in TCM， this paper analyzes the challenges faced in TCM clinical evaluation， particularly in the diagnosis， clinical intervention， and efficacy assessment methods. Considering the current state of TCM clinical evaluation and our clinical research experience， we believe that establishing and refining the TCM disease-syndrome diagnostic system is a prerequisite for the practice of clinical evidence-based evaluation in TCM. Furthermore， this paper discusses the specific connotation， development， and challenges of the disease-syndrome diagnostic system， especially the choice of TCM disease name or modern medical disease name in this system. Then， the clinical application scenarios are expounded from ''TCM disease name + syndrome differentiation'' and ''Western medicine disease name + syndrome differentiation''. Moreover， this paper proposed solutions for practical issues such as the standardization of disease and syndrome diagnosis， selection of clinical evaluation methods， and application of evidence-based approaches in clinical evaluation. Establishing the criteria for the disease-syndrome diagnostic system is crucial for the determination of clinical intervention regimen， the selection of clinical research methods， and the establishment of evaluation indicators， which are essential for generating high-quality clinical evidence. To sum up， this paper reviews the development and current situation of the disease-syndrome diagnostic system and proposes an exploratory approach for the standardization and application of this system in clinical evidence-based evaluation. This approach aims to facilitate the integration of TCM with modern clinical practice， thereby achieving standardized evaluation of TCM efficacy and deepening the integration of TCM with evidence-based medicine.

Objective To construct a rehabilitation nursing program for stroke patients based on the international classification of functioning, disability and health (ICF). Methods The relevant domestic and foreign literatures were systematically searched, and a draft of the rehabilitation nursing program for stroke patients based on the 17 functional items in the four dimensions of ICF functional evaluation was constructed. The Delphi method was used to consult experts to further improve the program. Results A total of 16 experts completed two rounds of expert consultation. The expert authority coefficients of the first and second rounds of consultation were 0.897 and 0.897, respectively, with coefficient of variations ranging from 0.05 to 0.27 and 0.05 to 0.19, respectively. The Kendall's W coefficients were 0.384 and 0.452 (χ²=104.375, 122.831, P < 0.001), respectively. In the final rehabilitation nursing program for stroke patients, there were four first-level indicators (functional domains), 17 second-level indicators (intervention contents), and 73 third-level indicators (specific measures). Conclusion The rehabilitation nursing program for stroke patients based on ICF is scientific and reliable, and may provide theoretical support and practical guidance for the rehabilitation nursing of clinical stroke patients.

Objective To explore the action mechanism and clinical significance of CD4+CD25+ regulatory T (Treg) cells in the development of atopic dermatitis (AD). Methods Peripheral blood mononuclear cells (PBMC) were obtained from 46 patients with AD and 20 normal human controls. Flow cytometry was performed to detect the number of CD4+CD25+ Treg cells, real-time fluorescence PCR assay to measure the Foxp3 mRNA level in PBMC, ELISA to determine the serum levels of IL-2, IL-4, IL-10 and IFN-γ. Results A statistical decrease was observed in the percentages of peripheral CD4+CD25+ Treg cells among CD3+ T cells and CD4+ T cells in AD patients compared with normal controls (t' = 3.775, 4.533, both P＜ 0.01 ), and in the percentage of peripheral CD4+CD25+ Treg cells among CD3+ T cells in patients with acute AD compared with those with chronic AD (t = 2.217, P ＜ 0.05), but no significant difference was noted between patients with acute AD and those with subacute AD or between those with subacute AD and those with chronic AD in the percentage of peripheral CD4+CD25+ Treg cells among CD3+ T cells (t = 1.558, 0.49, both P ＞ 0.05). The mRNA level of Foxp3 in PBMC from AD patients was statistically decreased compred with that from normal controls (z =-2.368, P ＜ 0.05 ). The count of CD4+CD25+ Treg cells was positively correlated with serum levels of IL-2 and IL-10 (r = 0.512, 0.494, both P ＜ 0.05), but had no significant correlation with serum levels of IL-4 and IFN-γ (r = -0.110, -0.237, both P ＞ 0.05). Conclusions In AD patients, there is a decrease in the count of CD4+CD25+ Treg cells and in the level of Foxp3 mRNA, which may suppress the proliferation of and secretion of Foxp3 mRNA by Th2 cells, lead to Th2 predominance, participate in the development of AD.

BACKGROUND:Hereditary factor occupies a certain position in suicidal behavior of depression. The researches in the past are focused on the hereditary effect on bipolar depression suicide.How do hereditary patterns and effects work in suicidal behavior in unipolar depression?OBJECTIVE: To probe into hereditary patterns and effects on suicidal behavior in unipolar depression.DESIGN:Retrospective investigation.SETTING:A municipal psychiatric hygienic centerPARTICIPANTS:Unipolar depression group included 115 outpatients and inpatients diagnosed in Wuxi Psychiatric Hygienic Center from June 1st 1983 to May 31st 2002.The diagnosis tallied with Standards on Depression Onset in Categories and Diagnostic Standards on Psychiatric Disturbance in China of 3rd Edition and with Standards on Severe Depression Onset in Manual of Diagnosis and Statistics of Psychiatric Disturbance in America of 4th Edition.The attack frequency of all the cases ≥ 3 times or the cases had been relieved ≥8 years after a couple of attacks.METHODS:The patients who tallied with the standards on unipolar depression received the investigation in every family tree under the instruction of 2 physicians-in-charge and more than 2 physicians and filled up the self-made investigation form of psychiatric family tree,including mainly the data of social demography of patients and their first grade relatives,characters of disease onset,frequency of attack,history of treatment and suicide. After re-diagnosed by 2 physicians-incharge and more than 2 physicians and checked by one physician-incharge,the cases were collected in patient group. The interview was carried on for the patients with suicidal behavior among all of the survived patients (107 cases) and first grade relatives (14 cases).The interview (337 cases) and investigation with letter (380 cases) were carried on for the first grade relatives without suicidal behavior. The investigation forms of 13 dead cases (8 cases of patients, 5 cases of first-grade relatives) were provided and filled-up by one or two first grade relatives. Two researchers interviewed the cases in the control,inquired the first grade relatives and filled up the investigation form of family tree.Single factor analysis was used for all the data and Falconer pattern of polygenetic threshold-value theory was used to estimate hereditary rate and standard error in suicidal behavior.Separation analysis in medical hereditary mathematic method and polygenetic threshold-value theory were applied to discuss the hereditary patterns.MAIN OUTCOME MEASURES:Hereditary effects and patterns of suicidal behavior in unipolar depressed patients.RESULTS:Suicidal risk of unipolar depressed patients(51.30%,59/115)was higher than their first grade relatives (2.58%,19/736) (x2=283.16,P ＜ 0.01).Suicidal risk of the first grade relatives (2.58%,19/736) of unipolar depressed patients was higher than the control (0.12%,3/2469)(x2=50.36,P ＜ 0.01).Suicidal risk of the first grade relatives of the patients with suicidal behavior (3.8%,14/372) was higher than that of the first grade relatives of the patients without suicidal behavior (1.4%,5/363)(x2=4.14,P＜ 0.05).The weighted average hereditary rate and standard error was (70.16±0.79)% for suicidal behavior in unipolar depression.The predictive morbidity of suicidal behavior in the first grade relatives was 3.1% and the real morbidity was 2.6%,which did not indicate significant difference (u =0.766, P ＞ 0.05).CONCLUSION:Suicidal behavior of unipolar depression presents obvious hereditary effects and its hereditary patterns tally with polygenetic inheritance.

This assay was aimed to evaluate the influence of different contact ways and extracting conditions on the hemolytic effect of biomaterials. Using direct contact method and extract contact method, we assessed the hemolytic effect of PDLLA and PVC. The extracting conditions included: 37 degrees C 24 h, 37 degrees C 72 h, 37 degrees C 120 h, 50 degrees C 72 h, and 70 degrees C 24 h. After the material or extract had been in contact with the diluted blood of rabbit for certain times, the hemolysis rate was calculated. The results for PDLLA showed there were some differences between direct contact and extract contact at 37 degrees C for different extraction time (P < 0.05), but the hemolysis rates, lower than 5%, were in accord with the requirements of medical devices. However, under the condition of 50 degrees C and 70 degrees C, there were significant differences when extract contact method was compared with direct method (P < 0.01). For PVC, there was no statistically significant difference under all conditions (P > 0.05). Our conclusions: (1) Under the extracting condition of 37 degrees C from 24 h to 120 h, the soluble part of PDLLA and PVC that might influence erythrocyte did not dissolve considerably. (2) Under the extracting condition of 50 degrees C and 70 degrees C, the hemolysis rate may remarkably vary with the chemical characteristics of tested materials; (3) As to an unknown material, it is advisable to adopt two methods at the same time, one for direct contact and the other for extracontact. Thus the hemolytic effect of biomaterials can be evaluated from physical and chemical angles. (4) In case that the chemical property of the sample can endure the test, the extracting condition at 50 degrees C and 70 degrees C may be of benefit to assessing the hemolytic effect of biomaterials. (5) The extract contact method as a supplemental test of direct contact method is of realistic significance.
Animals ; Biocompatible Materials ; toxicity ; Hydrolysis ; drug effects ; In Vitro Techniques ; Materials Testing ; methods ; Rabbits ; Temperature ; Time Factors

Aim To evaluate the short-term biocompatibility of a newkind of prosthetic nucleus-Evergel, which is made from the modifiedpolyvinyl alcohol hydrogel. Methods According to China national standardGB/T16886 documents, the toxicity of Evergel prosthetic nucleus materialwas investigated by the cytotoxicity test, sensitization test, haemolysis test,Ames test, mice marrow micronucleus test and chromosome aberration test ofmammalian cell in vitro. Results This material had no cytoxicity, no sen-sitivity, no obvious haemolysis, and no mutagencity in Ames test, micemarrow micronucleus test and chromosome aberration test of mammalian cellin vitro. Conclusion The Evergel prosthetic nucleus has a good biocom-patibility and can be used clinically.

Objective: To observe the level of pro-opiomelanocortin (POMC) mRNA expression in the hypothalamic arcuate nucleus in young and senile rats. Methods: POMC mRNA was determined with in situ hybridization, the hybridization signals and areas of POMC mRNA-positive cells were measured with computer image analysis system. Results: Compared with young rats, average gray values of POMC mRNA-positive neurons in the hypothalalmic arcuate nucleus and near region in the senile rats decreased, but the numbers of POMC mRNA-positive neurons did not change significantly. Conclusion: The decrease of POMC mRNA expression level in individual neurons in hypothalamic arcuate nucleus of senile rats is one of the causes that decrease the expression of peptides-derived from POMC gene.

A new menthod for treating old laceration of Lacrimal canaliculus with dacryocystoplasty using conjunctiva or labial mucosa was recommended by the authors. Out of 14 cases,9 cases were operated on with conjunctiva.7 cases were markedly effec- tive,1 cases improved and 1 cases failed.5 cases were operated on with labial mucosa.4 cases were markdly effective and 1 cases improved. The advantages of these two kinds of transplants have been compared.Labial mucosa is better than conjunctiva,and dacryocystoplasty with labial mucosa is more handy and appli- cable.