Objective To observe the correlation between fat fraction(FF)and T2 value of multifidus muscle and Pfirrmann grade of L4-5 intervertebral disc in patients with lumbar muscle strain.Methods Totally 200 L4_5 intervertebral discs in 200 patients with lumbar muscle strain were retrospectively enrolled,including 6 cases of Pfirrmann grade Ⅰ,61 of grade Ⅱ,52 of grade Ⅲ,56 of grade Ⅳ and 25 cases of grade V.Based on modified DIXON quantification(mDIXON-Quant)and T2 mapping,FF and T2 value of multifidus muscle were calculated and compared among intervertebral discs with different Pfirrmann grades,and the correlations between the above parameters and Pfirrmann grade of intervertebral disc were analyzed.Results Significant differences of left,right and bilateral multifidus muscles FF,as well as of T2 values in left and bilateral multifidus muscles were found among L4-5 intervertebral discs with different Pfirrmann grades.Multifidus muscle FF was moderately positively correlated with Pfirrmann grade of L4-5 intervertebral disc(r=0.538,P＜0.05),while T2 value was weakly positively correlated with Pfirrmann grade of L4-5 intervertebral disc(r=0.202,P＜0.05).Conclusion FF of multifidus muscle was moderately positively correlated with Pfirrmann grade of L4-5 intervertebral disc,while T2 value of multifidus muscle was weakly positively correlated with Pfirrmann grade of L4-5 intervertebral disc in patients with lumbar muscle strain.

Objective To observe the correlation between fat fraction(FF)and T2 value of multifidus muscle and Pfirrmann grade of L4-5 intervertebral disc in patients with lumbar muscle strain.Methods Totally 200 L4_5 intervertebral discs in 200 patients with lumbar muscle strain were retrospectively enrolled,including 6 cases of Pfirrmann grade Ⅰ,61 of grade Ⅱ,52 of grade Ⅲ,56 of grade Ⅳ and 25 cases of grade V.Based on modified DIXON quantification(mDIXON-Quant)and T2 mapping,FF and T2 value of multifidus muscle were calculated and compared among intervertebral discs with different Pfirrmann grades,and the correlations between the above parameters and Pfirrmann grade of intervertebral disc were analyzed.Results Significant differences of left,right and bilateral multifidus muscles FF,as well as of T2 values in left and bilateral multifidus muscles were found among L4-5 intervertebral discs with different Pfirrmann grades.Multifidus muscle FF was moderately positively correlated with Pfirrmann grade of L4-5 intervertebral disc(r=0.538,P＜0.05),while T2 value was weakly positively correlated with Pfirrmann grade of L4-5 intervertebral disc(r=0.202,P＜0.05).Conclusion FF of multifidus muscle was moderately positively correlated with Pfirrmann grade of L4-5 intervertebral disc,while T2 value of multifidus muscle was weakly positively correlated with Pfirrmann grade of L4-5 intervertebral disc in patients with lumbar muscle strain.

Objective:To explore the chain mediating effect of self-efficacy and hope in stigma and loneliness among patients with traumatic paraplegia and provide scientific theoretical guidance for effective nursing intervention for these patients in clinical practice.Methods:Totally 307 patients with traumatic paraplegia who were admitted to the Department of Orthopedics of Jiangsu Taizhou People's Hospital from June 2017 to May 2021 were selected by convenience sampling and investigated with the general information questionnaire, General Self-efficacy Scale (GSES), Herth Hope Index (HHI), Social Impact Scale (SIS), and UCLA Loneliness Scale. Pearson correlation was used to analyze the relationship between self-efficacy, hope, stigma, and loneliness. Amos 21.0 was used to construct a structural equation model (SEM) and test the mediating effect. A total of 307 questionnaires were distributed in this study, and 292 were recovered, accounting for a recovery rate of 95.11%. After excluding the questionnaires with more than 10% regular answers and missing items, 289 valid questionnaires were obtained, and the effective recovery rate was 94.14% (289/307) .Results:There were significant differences in the total score of UCLA Loneliness Scale among patients with different gender, age, marital status, family relationship, and bedridden conditions ( P<0.05). The total score of self-efficacy among the 289 patients with traumatic paraplegia was (25.54±3.37) ; the total score of hope was (27.73±3.66) ; the total score of stigma was (65.97±8.35) ; the total score of loneliness was (53.82±6.78). Pearson correlation analysis showed that loneliness was positively correlated with stigma ( P<0.05), and negatively correlated with self-efficacy and hope ( P<0.05). The mediating effect of stigma on loneliness in patients with traumatic paraplegia was established, and the total indirect effect accounted for 46.39% of the total effect, of which the specific mediating effects of self-efficacy and hope accounted for 19.91% and 19.12%, respectively. The chain mediating effect of self-efficacy and hope between stigma and loneliness accounted for 7.37%. Conclusions:The scores of self-efficacy, hope, stigma, and loneliness in patients with traumatic paraplegia are all at moderate levels. Loneliness is positively correlated with stigma, and negatively correlated with self-efficacy and hope. The chain mediating effect of self0effect between self-efficacy and hope between stigma and loneliness is established, suggesting that stigma can adjust hope through self-efficacy, and ultimately affect loneliness. While paying attention to patient' stigma, clinical medical and nursing staff should pay attention to evaluating self-efficacy and hope levels and take targeted measures to reduce the impact of stigma on loneliness.

Objective To analyze the medical disputes occurred in the emergency department of our hospital,and discuss the fine management strategy.Methods The medical disputes occurred in 2015 were reviewed.We reviewed the related literature and analyzed the causes of medical disputes by brainstorming and fishbone diagrams.For the root causes,in 2016 to carry out the corresponding fine management.To compare the incidence of medical disputes in emergency department of our hospital before and after the implementation of 1 years,and compare the anxiety and depression scores of 62 emergency medical staff before and after the implementation of fine management.At the same time,satisfaction of emergency services for 60 patients were randomly investigated in 2015 and 2016.Results In 2016,after the implementation of fine management of medical disputes,the percentage of emergency medical disputes was significantly lower than in 2015,and the difference was statistically significant (P ＜ 0.05).Before and after the implementation of fine management,the SAS and SDS scores of emergency medical staff were significantly reduced,and the difference was statistically significant (P ＜ 0.05).At the same time,in the results of random survey,we found that in 2016,the satisfaction rate of patients with emergency technology and service were higher than that in the year of 2015,and the difference was statistically significant (P ＜0.01).Conclusion After fully understanding the causes of emergency medical disputes,the formulation and implementation of the appropriate management strategy can effectively prevent emergency medical disputes,improve the professional and the service satisfaction of emergency medical staff.

Objective To explore the application of the quality control circle ( QCC) on the resuscitation cart management , and whether the QCC strategy can improve the management quality .Methods The QCC of emergency safeguard was established by survey .The medicine and equipments of the resuscitation cart from 45 nursing unit in the hospital were managed and checked .Then we evaluated the effects before and after the QCC strategy implemented .Results After implemented the QCC , the time of nurse handover the resuscitation cart was decreased from the ( 5.0 ±1.3 ) minutes to ( 2.0 ±0.3 ) minutes.The difference was statistically significant (t =-14.632, P <0.01).The satisfaction of using resuscitation carts was improved , and the difference was statistically significant (χ2 =22.500, P<0.01).The average checking score of medicines and equipment management of the resuscitation cart was increased from (95.8 ±1.8) to (98.2 ±2.1), and the perfectness rate of resuscitation equipments was increased from 92%to 100%.The differences were statistically significant (t/χ2 =-5.821, 6.380, respectively; P<0.05).There were changes in using the technique of QCC, confidence, team spirit, communication and coordination, engaged, centripetal force, and the differences were statistically significant ( t =-28.7, -9.5, -11.2, -29.8, -55.9, -15.5, respectively; P <0.01).Conclusions After carrying out QCC, not only do we reduce the time of nurse handover , improve the satisfaction of using , and increase the perfectness rate of rescue medicine and equipments , but also we greatly improve the management quality of resuscitation cart , and the quality management ability as well as the team cooperation spirits .

Objective To observe the contents of homocysteine (Hcy),C-reactive protein (hsCRP) and D-dimer(DD) in patients with cerebral infarction and the effects of hyperbaric oxygen (HBO) on them.Methods One hundred and twenty cases of cerebral infarction were voluntarily divided into 2 groups,the control group and the therapy group,each consisting of 60 cases.The patients of the control group received drug treatment,while the therapy group received HBO treatment in addition to routine drug treatment.The levels of Hcy,hsCRP and DD in the patients of the 2 groups were measured both before and after therapy,and changes in neurological functional defect (NFD) were also evaluated both before and after treatment.Results For both groups,the levels of Hcy,hsCRP and DD before therapy were higher than the normal reference value,and they all significantly decreased following therapy (P ＜ 0.01).When compared with those of the control group,the levels of Hcy,hsCRP and DD all decreased significantly (P ＜ 0.05 or P ＜ 0.01).The NFD in the patients of both group were decreased after therapy(P ＜ 0.01),with the NFD decreased more significantly in the patients of the therapy group (P ＜ 0.01).Conclusions HBO therapy could obviously reduced the levels of Hcy,hsCRP and DD in patients with cerebral infarction,which might be beneficial to the recovery of patients with cerebral infarction.

Objective To observe the contents of homocysteine (Hcy),C-reactive protein (hsCRP) and D-dimer(DD) in patients with cerebral infarction and the effects of hyperbaric oxygen (HBO) on them.Methods One hundred and twenty cases of cerebral infarction were voluntarily divided into 2 groups,the control group and the therapy group,each consisting of 60 cases.The patients of the control group received drug treatment,while the therapy group received HBO treatment in addition to routine drug treatment.The levels of Hcy,hsCRP and DD in the patients of the 2 groups were measured both before and after therapy,and changes in neurological functional defect (NFD) were also evaluated both before and after treatment.Results For both groups,the levels of Hcy,hsCRP and DD before therapy were higher than the normal reference value,and they all significantly decreased following therapy (P ＜ 0.01).When compared with those of the control group,the levels of Hcy,hsCRP and DD all decreased significantly (P ＜ 0.05 or P ＜ 0.01).The NFD in the patients of both group were decreased after therapy(P ＜ 0.01),with the NFD decreased more significantly in the patients of the therapy group (P ＜ 0.01).Conclusions HBO therapy could obviously reduced the levels of Hcy,hsCRP and DD in patients with cerebral infarction,which might be beneficial to the recovery of patients with cerebral infarction.

A total of 127 type 2 diabetic patients were divided into low glycemic index meal replacements (intervention) group and standard food-based diet (reference) group in an experiment for 12 weeks.The results showed that fasting plasma glucose,postprandial 2 h plasma glucose,fasting insulin,and homeostasis model assessment insulin resistance(HOMA-IR) in the intervention group decreased significantly after 12 weeks trial ( P＜0.05 or P＜0.01 ).However,there were no significant changes in lipid profile and HbA1C in intervention group.In addition,percentage of body fatty,visceral fatty area,and waist-hip ratio also decreased in intervention group( all P＜0.01 ).Superoxide dismutase and glutathione levels increased significantly in intervention group by the end of trial (both P＜0.01 ),while malondialdehyde was decreased (P＜0.01 ).There were no significant changes in the aforementioned indices in the reference group.Weight,body mass index,and waist circumferences were decreased in both groups,but without significant difference between the two groups.

Isolated freshly rat islets were transferred to 24-well plates and incubated with different concentrations of glucose or resveratrol for 1 or 24 h.The results showed that resveratrol dose-dependently inhibited glucose-stimulated insulin secretion from isolated rat islets after 1 h incubation,with 10%,35%,and 80% (P<0.05 or P<0.01) decrease at the concentrations of 1,I0,and 100 μmol/L.10 μmol/L resveratrol decreased the intracellular calcium concentration by 60% (P<0.05).After incubation for 24 h,resveratrol increased palmitatesuppressed insulin secretion to 75% (P<0.01) of control.These results suggest that resveratrol acutely inhibits insulin secretion from primary pancreatic islet via regulating intracellular calcium ion concentration,and in the long run resveratrol may protect β-cells from lipotoxicity.