【Objective】 To discuss the effect of temperature on the quality of platelet-rich plasma (PRP) prepared manually. 【Methods】 A total of 120 peripheral blood samples (60 mL/ person) were collected from healthy voluntary blood donors in the Blood Center of General Hospital of Southern Theater Command from May 10, 2010 to September 10, 2010. Each whole blood sample (60mL/ person) was randomly divided into 3 aliquots(20 mL each), totaling 360 aliquots, then divided into 9 groups (A1, A2, A3, B1, B2, B3, C1, C2, and C3), with 40 aliquots in each group. In group A: the ambient temperature for PRP preparation was set to (4±2)℃, and the temperature for PRP preparation and centrifugal bin was (4±2)℃, (24±2)℃ and (30±2)℃ for group A1, A2, and A3, respectively. In group B: the ambient temperature for PRP preparation was set to (24±2)℃, and the temperature for PRP preparation and centrifugal bin was (4±2)℃, (24±2)℃ and (30±2)℃ for group B1, B2 and B3 respectively. In group C: the ambient temperature for PRP preparation was set to (30±2)℃, and the temperature for PRP preparation and centrifugal bin was (4±2)℃, (24±2)℃ and (30±2)℃ for group C1, C2 and C3 respectively. Platelet concentrates were separated and prepared by rich slurry method, and the platelet recovery rate was calculated for each group, the platelet morphology was observed under the microscope, and the concentrations of platelet-derived growth factor (PDGF-BB), transforming growth factor β (TGF-β) and vascular endothelial growth factor (VEGF) were quantitatively determined using enzyme-linked immunosorbent assay (ELISA). 【Results】 The platelet count and platelet recovery rate were compared as follows: among group A1, A2, A3, B1, B2, B3, C1, C2 and C3, the results of A3, B3 and C3were (489.2±21.47) × 10⁹/L vs (495.7±23.2) ×10⁹/L vs (489.4±17.1) ×10⁹/L and (57.4±2.3)% vs (54.9±1.3)% vs (50.7±2.3)%, respectively, all showed platelet aggregation, and the differences, relative to A1 and A2, B1 and B2, and C1 and C2, were statistically significant (P<0.05). Microscopic observation was as follows: in the PRPs collected from group A1, A2, B1, B2, C1 and C2, the platelet cells were uniform in size and without aggregation; in the PRPs collected from group A3, B3 and C3, some platelets showed aggregation. Determination of growth factor content was as follows: the content of TGF-β(ng/L) and PDGF-BB(ng/L) was 375.0±119.1 vs 183.67±106.2 and 933.0±273.0 vs 656±113.0 in the non-aggregation group and the aggregation group, respectively (P<0.05), while the content of VEGF(ng/L) was 217.5±93.5 vs 155.3±103.4 (P>0.05), with no statistically difference. 【Conclusion】 The ambient temperature had little effect on the preparation of PRP, and the temperature of the centrifuge bin was better to be maintained at (24±2)℃.

【Objective】 To discuss the repair effect of lyophilized platelet lysate (PL) products on articular cartilage injury model of rats. 【Methods】 A total of 25 SD rats were injected with typeⅡcollagenase at the right knuckle articular cavity respectively on day 1, 3 and 5 of experiment, and the modeling conditions were observed 14 days after the last injection of collagenase. The SD rats with successful modeling were randomly divided into three groups, and were injected with lyophilized PL [Group A, 1 mL/(mouse·time)], PL [Group B, 1 mL/(mouse·time)], and normal saline[Group C, 1 mL/(mouse·time)]. The above three substances were injected with corresponding drugs on day 0, 7, 14 and 21 of experiment based on the grouping conditions, and the changes of knee joint diameters of the rats from the three groups were observed and compared. On day 14 and 28, one rat in each group was randomly killed and two knuckle articular cavities of each were taken for tissue sampling, using hematoxylin-eosin staining (HE) and immunohistochemistry. 【Results】 After 14 days of modeling by injection of type Ⅱ collagenase, the proportion of successful modeling in rats was 84% (21/25), with the knee joint diameter (mm) before and after modeling at 12.84±1.14 vs 14.11±1.17(P<0.01). On day 14, 21 and 28, groups A and B were superior to group C in the knee joint diameter and activity improvement (P<0.05), with 13.33±1.16 vs 13.37±1.08 vs 14.21±1.08, 13.10±1.09 vs 13.01±1.04 vs 14.09±1.09 and 12.38±1.08 vs 12.51±1.03 vs 14.01±1.07, respectively. Histological observation showed that group A and B were superior to group C in the production and arrangement of chondrocytes and the positive expression of type Ⅱ collagen, and there was no significant difference between group A and group B. 【Conclusion】 The lyophilized PL has similar therapeutic effect to PL in the treatment and repair of articular cartilage injury, and is worthy of clinical application.

【Objective】 To explore the clinical effects of autologous platelet-rich plasma (PRP) in the treatment of postoperative bone nonunion for long bone shaft fractures during operation and after operation. 【Methods】 A total of 34 patients with postoperative bone nonunion for long bone shaft fracture, who were admitted and cured in the Orthopedics Department of our hospital from January 2019 to June 2020, were selected. They were randomly divided into the experimental group(n=17) and control group(n=17). Individuals in the control were treated with autologous iliac bone alone., while the experimental group were treated with autologous iliac bone graft plus autologous PRP during and after operation. After surgery, the autogenous PRP was accurately injected with ultrasound guidance every 7 days (5 mL/person, 4 occasions in total). The clinical healing time of the fracture, the grading of callus formation and the functional rehabilitation level of limbs on the affected side at different time were observed in both groups. 【Results】 All 34 patients were followed up. In the experimental group and the control group, the clinical healing time (month) of the fracture was (5.03±1.24) vs (6.91±1.41), P<0.05. The healing rate of the fracture for 6 months and 9 months was 94%(16/17)vs 59%(10/17)and 94%(16/17)vs 82%(14/17), respectively (P<0.05). The grading of callus formation within 3, 6 and 9 months was (2.11±0.69) vs (1.53±0.80), (3.06±0.90) vs (2.59±0.87) and (3.82±0.73) vs (3.35±0.86), respectively (P<0.05). The acceptance rate of functional rehabilitation of limbs on the affected side was 82.35%(14/17)vs 76.47%(13/17), P<0.05. 【Conclusion】 The application of autologous PRP in the treatment of postoperative bone nonunion for long bone shaft fractures during operation and after operation can achieve good clinical treatment.

Ophthalmology is interrelated with a variety of disciplines, and its features determine the need for interdisciplinary joint training of postgraduate students majoring in ophthalmology. The joint training can optimize the students' knowledge structures, enhance their innovation abilities and improve their overall qualities. However, there are still some factors restricting the interdisciplinary joint training in the existing education system. We propose to establish a full-time administrative management system, build a multidisciplinary communication platform, attach great importance to tutors' interdisciplinary researches, and establish dual mentor or multi-tutor training system. Moreover, a reasonable interdisciplinary evaluation system and various incentive mechanisms are advocated to improve the quality of postgraduate education in ophthalmology.

Objective: To analyze the relationship between family behaviors and overweight/obesity in primary and junior school students aged 6-14 years in Xuzhou, and to provide a reference for a targeted measure to prevent and control overweight and obesity. Methods: Using multistage stratified cluster random sampling, a total of 6 220 students aged 6-14 years old from 10 primary schools and 10 junior schools were investigated by a self-designed questionnaire. Chi-square and multivariate Logistic regression models were used to explore the relationship between family behaviors and overweight/obesity in primary and junior school students. Results: The rate of overweight/obesity in primary and junior boys was higher than that in primary and junior girls. The rate of overweight/obesity in urban students was higher than that of rural students(P<0.05). The Chi-square analysis showed that overweight of parents, irregular breakfast, eating fast food, eating sweets, drinking sweetened beverage, long screen time and short sleep duration were risk family behavior factors of overweight/obesity in primary and junior boy students(P<0.05). The risk family behavior factors of overweight/obesity in primary and junior girl students were overweight of parents, irregular breakfast, eating fast food and eating sweets(P<0.05). The risk family behavior factors of overweight/obesity, such as drinking sweetened beverage and short sleep duration, were also related to primary girls(P<0.05), and long screen time was related to junior girls(P<0.05). The multivariate Logistic regression showed that such family behavior factors as irregular breakfast(OR-boy=1.58, OR-girl=1.74), eating fast food(OR-boy=1.37, OR-girl=1.11), eating sweets(OR-boy=1.85, OR-girl=1.52), drinking sweetened beverage(OR-boy=1.64, OR-girl=1.33) and short sleep duration(OR-boy=1.56, OR-girl=1.69) were positively correlated with the prevalence of overweight/obesity in primary students. Long screen time was also correlated to overweight/obesity primary boy students(OR=1.18). Family behavior factors for child overweight and obesity induded overweight of parents(OR-boy=1.29, OR-girl=1.23) and eating sweets(OR-boy=1.44, OR-girl=1.51). Irregular breakfast(OR=1.51), eating fast food(OR=1.22), drinking sweetened beverage (OR=1.75) and long visual screen time (OR=1.15) were also positively correlated with the prevalence of overweight/obesity in junior boy students. Conclusion Family behavior factors were positively correlated with the prevalence of overweight/obesity in primary and junior students. The influence of family behavior factors were different between primary and junior students. Behavioral interventions based on family should be adopted to prevent and control the overweight/obesity of children.

Objective To analyze the relationship between sleep duration, screen viewing time, and the prevalence of overweight/obesity among primary school students in Xuzhou. Methods Using a cluster sampling method, a total of 3 228 students (including 1 679 boys and 1 549 girls with an average age of 10.78±0.69 years) from grade one to six from 10 primary schools in Xuzhou underwent interview using a self?designed questionnaire containing basic characteristics, sleep duration, and screen viewing time. Data on height and weight were also collected. The relationship between sleep duration, screen viewing time, and overweight/obesity was analyzed using a logistic regression analysis. Results The prevalence rates of overweight among boys and girls were 16.56% and 11.94%, respectively (χ2=13.59, P<0.05). The prevalence rates of obesity among boys and girls were 14.47% and 10.07%, respectively (χ2=14.01, P<0.05). In total, 74.41% students reported a lack of sleep; the average sleeping time was (9.24±1.07) h. The average sleeping time among boys was (9.35 ± 1.12) h and among girls was (9.13 ± 1.03) h. The difference in sleep duration between boys and girls was significant (t=5.79, P<0.05). The differences in sleep duration and overweight/obesity were significant between both boys (χ2=18.62, P<0.05) and girls (χ2=21.14, P<0.05). Regarding screen viewing time, 17.29% of students spent more than 2 hours per day viewing a screen. The difference in screen viewing time between boys and girls was significant (Z=3.02, P=0.014). The proportion of children with screen viewing time of more than 2 h/d among overweight/obese and healthy weight male students was 29.50% (82/278) and 22.56% (316/1401), respectively, which was significantly different (χ2=6.18, P=0.01). However, there was no significant difference when examining the same groups among girls (12.98% (24/185;obese/overweight) vs . 9.97% (136/1364; healthy weight); χ2=1.59, P=0.21). After adjusting for parental obesity, eating sweets, and physical activity, logistic regression analysis showed that students who had a sleep duration less than 10 h/d had an odds ratio of 1.4 (95% CI: 1.15-1.71), the odds ratio for boys and girls was 1.56 (95% CI: 1.13-2.14) and 1.69 (95% CI: 1.15-2.46). The students who had a screen viewing time of more than 2 h/d had an odds ratio of 1.14 (95% CI: 1.05-1.80); the odds ratio for boys in this group was 1.18 (95% CI: 1.03-1.67). Conclusion Short sleep duration is a risk factor for being overweight/obese in both boys and girls. However, long screen viewing times were associated with being overweight/obese only in boys.

Objective To evaluate the accuracy of different noninvasive methods for the diagnosis of nonalcoholic steatohepatitis(NASH) and hepatic fibrosis in patients with non-alcoholic fatty liver disease (NAFLD) combined with type 2 diabetes mellitus(T2DM). Method A prospective comparative study was performed for 91 patients with T2DM and NAFLD, which were diagnosed by glucose tolerance test and liver biopsy. The height and body mass of the patient were measured, and the body mass index(BMI) was calculated. The fasting venous blood of the patient was collected, and then the blood routine, liver function and ferritin were measured. NPS, neutrophil lymphocyte ratio(NLR), BARD score, FIB-4 index, APRI, and NAFLD fibrosis score(NFS) were calculated. All patients underwent transient elastography (Fibrotouch) to evaluate the degree of liver stiffness measurement (LSM) and controlled attenuation parameter. All the liver biopsy specimens were categorized by SAF as the gold standard for evaluating NASH and liver fibrosis NASH. Correlation analysis was applied to compare the correlation between the noninvasive methods and SAF. The receiver operating characteristic (ROC) curve and the area under the curve (AUC) were used to assess the diagnostic value of the noninvasive methods for NASH and liver fibrosis NASH. Results In T2DM combine with NAFLD patients, NPS, LSM, NFS, APRI, FIB4 and BMI scores were positively correlated with SAF (r value was 0.509, 0.508, 0.252, 0.396, 0.313 and 0.213, respectively; P value was <0.001, <0.001, 0.016,<0.001, 0.003 and 0.043, respectively). LSM, NPS, NFS and FIB4 scores were positively correlated with liver fibrosis (r value was 0.535, 0.337, 0.315 and 0.315, respectively; P value was <0.001, 0.001, 0.002, 0.002, respectively). The ROC curve shows that the area under the curve of NPS, LSM, APRI, FIB4 and BMI for diagnosing NASH was 0.838, 0.760, 0.734, 0.623 and 0.682, respectively, and P value was 0.000, 0.000, 0.000, 0.044 and 0.003, respectively. For the diagnosis of fibrotic NASH, that value of LSM, NFS, FIB4 and NPS was 0.795, 0.765, 0.686 and 0.623, respectively, and P value was 0.000, 0.001, 0.020 and 0.123, respectively. Conclusions NPS, LSM and APRI have good clinical diagnostic value for NASH. LSM and NFS have good diagnostic value for fibrotic NASH.

Objective To study the effect of target rehabilitation diary in elderly patients with total knee arthroplasty (TKA). Methods One hundred patients who received unilateral first TKA (no patella) were numbered according to the order of admission time, according to random digit table, 50 cases in the control group and the intervention group. Conventional treatment methods were given to both two groups, the control group received routine care measures and health education, the intervention group was given target rehabilitation diary for self- management based on the conventional health education. The differences in American Knee Society Knee Score (KSS), self- management and self- efficacy were compared between the two groups. Results The KSS was (75.50 ± 6.90) points in the intervention group and (71.90 ± 7.20) points in the control group on the first week after operation, the difference was statistically significant (t=2.553, P<0.05). On the twelfth week of intervention, KSS was (85.86 ± 2.80) points in the intervention group and (80.88 ± 2.20) points in the control group, the difference was statistically significant (t=9.880, P<0.01). Self-efficacy and self-management on the twelfth week were (47.22 ± 3.34) and (54.55 ± 2.66) points in the intervention group, which were significantly higher than those in the control group (34.24 ± 4.11) and (42.54 ± 3.76) points, the difference was statistically significant (t=17.33, 18.43, P<0.01). Conclusions The target rehabilitation diary plays a good role in the self-management of elderly patients with TKA.

Objective To investigate the actuality of self-compassion and perceived social support among probationer nursing students, and to analyze the relationship between them. Methods 552 probationer nursing students from three tertiary hospitals in Suzhou were investigated by means of the Self-Compassion Scale (SCS) and Perceived Social Support Scale (PSSS). Results The probationer nursing students′ self-compassion and perceived social support was (3.20 ± 0.61) points and (5.81 ± 1.13) points, respectively. Scores of the total scale and the factors of self-compassion and perceived social support were positively correlated (r=0.485, P<0.01). Hierarchical regression analysis showed that perceived social support (family support and friend support) could be used to forecast the self-compassion of probationer nursing students and independently explain the variation of their self-compassion of 21.5%(△R2=0.215, P<0.01). Conclusions Self-compassion among probationer nursing students is in medium level, and perceived social support an important factor affecting their self-compassion.

Objective To study the application effects of from-bottom-to-up objective management model in nursing quality control.Methods Eight surgical departments in our hospitals were selected as research objects.Traditional objective management model was applied in the control group (8 004 cases,9 453 visiting times) from June 2012 to June 2013.From-bottom-to-up objective management model was applied in the experimental group (8169 cases,9 603 visiting times) from July 2013 to July 2014.Nursing work quality and continuous improvement projects were compared between two groups by questionnaire survey,a return visit by telephone and statistical evaluation.Results The satisfaction of patients with nurses' service attitudes and professional technology level and the awareness of patients about major nurses in the experimental group were significantly higher than those in the control group [95.56％ (7 806/8 169),95.19％ (7 776/8 169),97.17％ (7 938/8 169) vs.93.22％ (7 461/8 004),92.62％ (7 413/8 004),84.60％ (6 771/8 004),allP＜0.01].Patient complaints and the incidence of nursing adverse events in the experimental group were significantly lower than those in the control group (46,16 cases vs.85,39 cases,x2=9.783,P＜0.01).Conclusions Applying from-bottom-to-up objective management model could cultivate self-control abilities and innovation awareness of nurses,which can improve nursing work quality.