Objective To systematically analyze the influencing factors of chronic liver disease patients' perception of symptoms based on the Andersen model,and to provide methodological reference for the study in the prevention and treatment of chronic diseases.Methods Based on the predisposing factors,enabling factors,demand factors,health behaviors,and health outcomes of the Andersen model,an influencing factor model was constructed.A community cluster convenience sample survey method was used to conduct a questionnaire star survey on chronic liver disease patients in multiple communities in Liwan,Guangzhou from November 2018 to March 2020.Univariate Mann-Whitney U test,Kruskal-Wallis H test,Spearman correlation analysis,and multivariate generalized linear hierarchical model analysis were performed.Results A total of 494 valid questionnaires were collected,and the median score for the patients' perception of the symptoms was 32(26,42)points.For the predisposing factors:age,education level,overtime status,and formal medical treatment;for the enabling factors:income and expenditure situation,personal history of hyperlipidemia;for the demand factors:cognition of medical and nursing integration,regular reexamination;and for the health behaviors:daily water intake,use of digital devices,and exercise and health care were all influencing factors(P＜0.05).Comparing the hierarchical models,health behaviors had the highest impact on the perception of the symptoms in chronic liver disease patients,followed by enabling factors,and demand factors had the lowest impact.Conclusion Medical staff should focus on the health behaviors of chronic liver disease patients with different predisposing factors,optimize the enabling factors,strengthen the guidance and intervention of demand factors,and provide comprehensive and personalized medical care plans.

OBJECTIVE To establish a preparation method for Phellodendrine-11-O-β-D-glucuronide(M1),a metabolite of Phellodendrine(PHE),and to evaluate its regulatory effects on glycolipid metabolism disorder in insulin-resistant HepG2(IR-HepG2)cells.METHODS The preparation,extraction,separation,purification and identification of M1 were completed by in vitro incuba-tion of intestinal microsomes combined with liquid phase,mass spectrometry and NMR.With Metformin as positive control,IR-HepG2 cells were treated with low(25 μmol·L-1),medium(50 μmol·L-1)and high(100 μmol·L-1)doses of M1 for 24 h.Glucose con-sumption,glucose uptake,triglyceride(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C)and low density lipoprotein cholesterol(LDL-C)were quantified.The binding ability of M1 to the key targets INSR,IRS1,PI3K and AKT2 in the IRS1/PI3K/AKT pathway was explored through molecular docking technology.The effects of M1 on the mRNA and protein expression of these key targets in the IRS1/PI3K/AKT pathway were detected by qPCR and Western blot,respectively.RESULTS The purified product was confirmed by NMR as Phellodendrine-11-O-β-D-glucuronide(95%purity).Compared to the model group,all M1 do-ses significantly enhanced glucose consumption(P<0.01,P<0.001)and uptake(P<0.001)in IR-HepG2 cells,outperforming PHE(P<0.001).At medium and high doses,it could significantly reduce the content of TG and TC in cells(P<0.001),and its improve-ment effect at the TG level was better than that of PHE(P<0.01);while all concentrations decreased LDL-C(P<0.001)and in-creased HDL-C(P<0.01,P<0.001).Molecular docking revealed strong binding interactions between M1 and INSR,IRS1,PI3K,and AKT2.Compared with the model group,M1 administration group increased the expression of INSR,IRS1,PI3K,AKT2,and GLUT2 mRNA to varying degrees,downregulated the protein expression of p-IRS1/IRS1(P<0.001),and upregulated the protein ex-pression of PI3K,p-AKT/AKT,and p-GSK3β/GSK3β.CONCLUSION The established protocol enables high purity M1 prepara-tion.M1 alleviates IR by regulating IRS1/PI3K/AKT signaling pathway to improve the disorder of glycolipid metabolism.

OBJECTIVE To establish a preparation method for Phellodendrine-11-O-β-D-glucuronide(M1),a metabolite of Phellodendrine(PHE),and to evaluate its regulatory effects on glycolipid metabolism disorder in insulin-resistant HepG2(IR-HepG2)cells.METHODS The preparation,extraction,separation,purification and identification of M1 were completed by in vitro incuba-tion of intestinal microsomes combined with liquid phase,mass spectrometry and NMR.With Metformin as positive control,IR-HepG2 cells were treated with low(25 μmol·L-1),medium(50 μmol·L-1)and high(100 μmol·L-1)doses of M1 for 24 h.Glucose con-sumption,glucose uptake,triglyceride(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C)and low density lipoprotein cholesterol(LDL-C)were quantified.The binding ability of M1 to the key targets INSR,IRS1,PI3K and AKT2 in the IRS1/PI3K/AKT pathway was explored through molecular docking technology.The effects of M1 on the mRNA and protein expression of these key targets in the IRS1/PI3K/AKT pathway were detected by qPCR and Western blot,respectively.RESULTS The purified product was confirmed by NMR as Phellodendrine-11-O-β-D-glucuronide(95%purity).Compared to the model group,all M1 do-ses significantly enhanced glucose consumption(P<0.01,P<0.001)and uptake(P<0.001)in IR-HepG2 cells,outperforming PHE(P<0.001).At medium and high doses,it could significantly reduce the content of TG and TC in cells(P<0.001),and its improve-ment effect at the TG level was better than that of PHE(P<0.01);while all concentrations decreased LDL-C(P<0.001)and in-creased HDL-C(P<0.01,P<0.001).Molecular docking revealed strong binding interactions between M1 and INSR,IRS1,PI3K,and AKT2.Compared with the model group,M1 administration group increased the expression of INSR,IRS1,PI3K,AKT2,and GLUT2 mRNA to varying degrees,downregulated the protein expression of p-IRS1/IRS1(P<0.001),and upregulated the protein ex-pression of PI3K,p-AKT/AKT,and p-GSK3β/GSK3β.CONCLUSION The established protocol enables high purity M1 prepara-tion.M1 alleviates IR by regulating IRS1/PI3K/AKT signaling pathway to improve the disorder of glycolipid metabolism.

Objective To systematically analyze the influencing factors of chronic liver disease patients' perception of symptoms based on the Andersen model,and to provide methodological reference for the study in the prevention and treatment of chronic diseases.Methods Based on the predisposing factors,enabling factors,demand factors,health behaviors,and health outcomes of the Andersen model,an influencing factor model was constructed.A community cluster convenience sample survey method was used to conduct a questionnaire star survey on chronic liver disease patients in multiple communities in Liwan,Guangzhou from November 2018 to March 2020.Univariate Mann-Whitney U test,Kruskal-Wallis H test,Spearman correlation analysis,and multivariate generalized linear hierarchical model analysis were performed.Results A total of 494 valid questionnaires were collected,and the median score for the patients' perception of the symptoms was 32(26,42)points.For the predisposing factors:age,education level,overtime status,and formal medical treatment;for the enabling factors:income and expenditure situation,personal history of hyperlipidemia;for the demand factors:cognition of medical and nursing integration,regular reexamination;and for the health behaviors:daily water intake,use of digital devices,and exercise and health care were all influencing factors(P＜0.05).Comparing the hierarchical models,health behaviors had the highest impact on the perception of the symptoms in chronic liver disease patients,followed by enabling factors,and demand factors had the lowest impact.Conclusion Medical staff should focus on the health behaviors of chronic liver disease patients with different predisposing factors,optimize the enabling factors,strengthen the guidance and intervention of demand factors,and provide comprehensive and personalized medical care plans.

Objective To investigate the current status,diagnostic difficulties,and the necessity of formulating a consensus on several issues of cerebrovascular ultrasound examination in China.Methods A network questionnaire survey was conducted to investigate several problems of cerebrovascular ultrasound and the needs of expert consensus among practitioners of transcranial Doppler(TCD)ultrasound and transcranial color coded Doppler(TCCD)ultrasound in medical institutions.The questionnaire covered the basic information of the respondent group,including the region where the medical institution was located(Q1),the level of the medical institution(Q2),the scope of practice of TCD or TCCD practitioners(Q3),title(Q4);the assessment mode of cerebrovascular and cervical vascular(Q5);the general demand for expert consensus(Q6)and TCD diagnosis-related issues(Q7-Q17).There were three dimensions of TCD diagnosis-related issues(diagnostic criteria,multi-dimensional comprehensive assessment,and dynamic monitoring during the perioperative period of angioplasty),with a total of 11 items(Q7-Q17:intracranial artery stenosis or occlusion,vascular development anomalies,side branch circulation judgment,ultrasound dynamic monitoring after angioplasty,cerebral vasospasm,contrast-enhanced TCD examination,etc.).At the same time,open-ended questions were also set up:the most important content to be improved in cerebrovascular ultrasound(Q18).The reliability analysis of the questionnaire was used to assess the reliability,with Cronbach's α coefficient ≥0.7 considered as good reliability.The validity evaluation was conducted by factor analysis.The comparison of the demand for each item under different conditions was conducted by x2 test,and the Kruskal-Wallis H test was used to compare ranked data among different groups.Results A total of 1 395 complete and valid questionnaires were collected,involving TCD or TCCD practitioners from 31 provinces,autonomous regions,and municipalities(there was no response from the Xizang Autonomous Region),which had a certain representativeness.Survey reliability evaluation:Cronbach's α coefficient=0.917(F=132.702,P＜0.01).Factor analysis,KOM=0.930(x2=8 478.844,P＜0.01),the cumulative contribution rate was 70.600％when taking into account three factors.Among the respondents,the proportion of those from tertiary-level grade A hospitals was the highest(64.2％[896/1 395]);the distribution of titles was dominated by those of attending physicians(48.5％[676/1 395]),followed by senior titles(37.2％[519/1 395]);among the respondents,66.6％(929/1 395)said they urgently needed expert consensus,while 32.7％(456/1 395)said they needed to improve existing standards.There were significant differences in the needs for expert consensus and each item across different regions,professional titles and evaluation models(all P＜0.05).Conclusions The questionnaire have high reliability and validity.There is an urgent need for expert consensus on several issues related to cerebrovascular ultrasound among the respondents.The establishment of expert consensus would contribute to standardized and precise evaluation system,thereby promoting quality control management and standardization of cerebrovascular ultrasound practices.

Objective:To summarize the clinical characteristics of patients with coronavirus disease 2019 (COVID-19) infected with Delta variant, so as to provide further references for clinical diagnosis and treatment.Methods:A real-world study was conducted to analyze the characteristics of 166 COVID-19 patients infected with Delta variant at Guangzhou Eighth People’s Hospital, Guangzhou Medical University.Results:The study enrolled 5 asymptomatic cases, 123 non-severe cases (mild and moderate type), and 38 severe cases (severe and critical type). Among these patients, 69 (41.6%) were male and 97 (58.4%) were female, with a mean age of 47.0±23.5 years. Thirty-nine cases (23.5%) had received 1 or 2 doses of inactivated vaccine. The incidence of severe COVID-19 cases was 7.7% in 2-doses vaccinated patients, which was lower than that of 11.5% in 1-dose and 26.8% in unvaccinated patients. The proportion of severe cases in 2 dose-vaccinated patients was 7.7%, which was lower than that of 11.5% in 1-dose vaccinated patients and 26.8% in unvaccinated patients, but the difference was not significant ( P>0.05). The most common clinical symptom was fever (134 cases, 83.2%), and 39.1% of cases presented with high-grade fever (≥39 °C); other symptoms were cough, sputum, fatigue, and xerostomia. The proportion of fever in severe cases was significantly higher than that of non-severe cases (97.4% vs. 76.4%, P<0.01). Similarly, the proportion of severe cases with high peak temperature (≥39 ℃) () was also higher than that of non-severe cases (65.8% vs. 30.9%, P<0.01). The median minimal Cycle threshold (Ct) values of viral nucleic acid N gene and ORFlab gene were 20.3 and 21.5, respectively, and the minimum Ct values were 11.9 and 13.5, respectively. Within 48 h of admission, 9.0% of cases presented with decreased white blood cell counts, and 52.4% with decreased lymphocyte counts. The proportions of increased C-reactive protein, serum amyloid A, interleukin 6, and interleukin 10 were 32.5%, 57.4%, 65.3%, and 35.7%, respectively. The proportions of elevated C-reactive protein, serum amyloid A and interleukin-6 in severe cases were significantly higher than those in non-severe cases ( P<0.01). Logistic regression analysis showed that older age and higher peak temperature were associated with a higher likelihood of severe cases ( OR>3, 95% CI: 2-7, P<0.01). In terms of treatment, traditional Chinese medicine (TCM) was used in 97.6% of non-severe cases and 100% in severe cases. Other treatments included respiratory and nutritional support, immunotherapy (such as neutralizing antibodies and plasma of recovered patients). The median times from admission to progression to severe cases, of fever clearance, and of nucleic acid conversion were 5 days, 6 days and 19 days, respectively. No deaths were reported within 28 days. Conclusions:The symptoms of Delta variant infection in Guangzhou are characterized by a high proportion of fever, high peak temperature, long duration of fever, high viral load, a long time to nucleic acid conversion, and a high incidence of severe cases. The severe cases exhibit a higher percentage of elderly patients, a longer duration of fever and have a higher fever rate and a higher hyperthermia rate than non-severe cases. Age and hyperthermia are independent risk factors for progression to severe disease. The combination of TCM and Western medicine can control the progression of the disease effectively.

In order to improve the storage and transmission efficiency of dynamic photoplethysmography (PPG) signals in the detection process and reduce the redundancy of signals, the modified adaptive matching pursuit (MAMP) algorithm was proposed according to the sparsity of the PPG signal. The proposed algorithm which is based on reconstruction method of sparse adaptive matching pursuit (SAMP), could improve the accuracy of the sparsity estimation of signals by using both variable step size and the double threshold conditions. After experiments on the simulated and the actual PPG signals, the results show that the modified algorithm could estimate the sparsity of signals accurately and quickly, and had good anti-noise performance. Contrasting with SAMP and orthogonal matching pursuit (OMP), the reconstruction speed of the algorithm was faster and the accuracy was high.
Algorithms ; Humans ; Image Processing, Computer-Assisted ; Photoplethysmography

In order to derive dynamic pulse rate variability (DPRV) signal from dynamic pulse signal in real time, a method for extracting DPRV signal was proposed and a portable mobile monitoring system was designed. The system consists of a front end for collecting and wireless sending pulse signal and a mobile terminal. The proposed method is employed to extract DPRV from dynamic pulse signal in mobile terminal, and the DPRV signal is analyzed both in the time domain and the frequency domain and also with non-linear method in real time. The results show that the proposed method can accurately derive DPRV signal in real time, the system can be used for processing and analyzing DPRV signal in real time.
Electrocardiography ; Heart Rate ; Monitoring, Physiologic ; Signal Processing, Computer-Assisted

In order to derive dynamic pulse rate variability (DPRV) signal from dynamic pulse signal in real time, a method for extracting DPRV signal was proposed and a portable mobile monitoring system was designed. The system consists of a front end for colecting and wireless sending pulse signal and a mobile terminal. The proposed method is employed to extract DPRV from dynamic pulse signal in mobile terminal, and the DPRV signal is analyzed both in the time domain and the frequency domain and also with non-linear method in real time. The results show that the proposed method can accurately derive DPRV signal in real time, the system can be used for processing and analyzing DPRV signal in real time.

Objective To investigate publication of papers by nursing staff in a TCM hospital and to find out the problems as well as countermeasures.Method A retrospective analysis about authors,education,academictitle,length of service and age was done to investigate the classes of published papers from 2008 to 2012.Results The academic publication by the nurses from 2008 to 2012 was increased.Among these articles,the TCM nursing techniques took up the largest ratio,which accounted for 29.12%. There were significant differences in ages,length of service and educational background in authors(P<0.05).Conclusions Nurses’ awareness and capabilities of publishing academic papers needs enhancement as well as training.It may be significant to strengthen their incentives in scientific research by enforcing encouraging policies.