Objective:To investigate the correlation relationship between self-esteem and imposter phenomenon among nurses,and to provide reference for optimizing nurse team.Methods:A total of 836 nurses were selected from February to March 2023 in the Yongzhou Central Hospital of Hunan Province and the People′s Hospital of Longhua, Shenzhen. A cross-sectional survey was conducted on nurses using the General Data Questionnaire, Impostor Phenomenon Scale and Self-Esteem Scale.Results:The imposter phenomenon score of nurses was (48.97 ± 12.58) points and the self-esteem score was (28.93 ± 3.86) points. The total score of self-esteem was negatively correlated with the total score of imposter phenomenon ( r= -0.433, P<0.01). Multivariate linear regression analysis showed that with the increase of self-esteem score, the score of imposter phenomenon decreased ( B=-1.402, P<0.01). Self-esteem was an important factor affecting the imposter phenomenon among clinical nurses, accounting for 18.9% of the total variation. Conclusions:The self-esteem and imposter phenomenon of clinical nurses are both at a moderate level, the improvement of self-esteem is beneficial to decreased their imposter phenomenon.

Objective:To analyze the curative effect of the modified sinus tarsi small incision and minimally invasive internal fixation in the treatment of Sander Ⅱand Ⅲ calcaneal fractures and its influence on inflammatory factors and immune function.Methods:From February 2018 to February 2020, 116 patients with Sander Ⅱand Ⅲ calcaneal fractures admitted to the First People′s Hospital of Linping District, Hangzhou City were prospectively selected and randomly divided into the control group and the observation group according to the digital table method. There were 58 cases in each group, the control group was treated with traditional lateral L-shaped incision internal fixation, and the observation group was treated with modified tarsal sinus small incision internal fixation and minimally invasive treatment. The clinical indicators, incision healing, postoperative complications, Bohler angle, Gissane angle, interleukin(IL)-1β, IL-6 , IL-22 and immunoglobulin (IgA, IgG, IgM) before and after surgery were compared between the two groups. The function of the hind foot and ankle were evaluated by American Foot and Ankle Society Ankle and Hindfoot Function Score (AOFAS) before and 6 months after surgery.Results:The operation time, intraoperative blood loss, hospital stay and fracture healing time in the observation group were lower than those in the control group: (61.08 ± 15.17) min vs. (85.82 ± 13.50) min, (27.51 ± 2.64) ml vs. (82.53 ± 3.81) ml, (7.14 ± 1.18) d vs. (10.76 ± 1.50) d, (46.44 ± 8.16) d vs.(52.28 ± 10.40) d, there were statistical differences ( P<0.05). The Bohler angle in the observation group at 3 months after the operation was greater than that in the control group: (26.46 ± 3.64)° vs. (24.55 ± 3.86)°; and Gissane angle was smaller than that in the control group: (113.73 ± 6.56)° vs. (117.09 ± 7.16)°, there were statistical differences ( P<0.05). The grade A healing rate in the observation group was higher than that in the control group: 89.66%(52/58) vs. 32.76%(19/58), χ2 = 39.54, P<0.05. The incidence of complications in the observation group was lower than that in the control group: 3.45%(2/58) vs. 20.69%(12/58), χ2 = 8.12, P<0.05. The levels of IL-1β, IL-6 and IL-22 in the observation group at 3 months after operation were lower than those in the control group, the levels of IgA, IgG and IgM in the observation group at 3 months after operation were higher than those in the control group, there were statistical differences ( P<0.05). Conclusions:The modified tarsal sinus small incision internal fixation and minimally invasive surgery have better curative effect in the treatment of Sander Ⅱ and Ⅲ calcaneal fractures. The function of the hind foot and ankle is restored.

background The lead isotope ratios (LIR) differ among different sourced samples. Previous domestic and oversea studies on source tracing by LIR in human blood or urine mainly focused on the comparison of blood or urine samples from the same or different individuals, while few comparisons between biological and environmental samples, and the reported relative standard deviations (RSDs) of the main LIR (^207/206Pb and ^208/206Pb) fluctuate widely from 0.3% to 1%. Objective To optimize inductively coupled plasma mass spectrometry (ICP-MS), obtain a better RSD, and determine LIRs of human blood, urine, and related environmental samples. Methods The ICP-MS was optimized for operating conditions and parameters according to the sensitivity and RSD of LIR. The study subjects were 40 lead-exposed workers in a lead-acid battery factory and 2 lead poisoned children in a hospital. The samples included 40 blood and 40 urine samples from the workers before shift, 4 dust samples and 2 water samples in the workplace on the same day before shift, 2 blood and 3 urine samples from the children before hospital admission due to lead-poisoning, and 4 urine samples after medical treatment. After heating and acid digestion, the LIR (^207/206Pb and ^208/206Pb) of biological and environmental samples were determined by the optimized ICP-MS method. t-test and two-dimensional traceability graphics were adopted to analyze the detection results. Results The calibrated RSDs of the LIR (^207/206Pb and ^208/206Pb) of lead isotope standard solution were 0.11% and 0.08% respectively, and the NIST-SRM-981 actual values were 0.91531±0.00097 and 2.1670±0.0017, respectively. When the total concentration of lead was greater than 5 μg·L⁻¹, the RSD of each isotope ratio was stable gradually; when the total concentration of lead was between 10-80 μg·L⁻¹, the RSD was below 0.20%. There were statistically significant differences in the blood and urine LIR (^207/206Pb and ^208/206Pb) of the lead-exposed workers (t=5.831, P<0.001; t=21.021, P<0.001), the LIR (^207/206Pb and ^208/206Pb) between workplace dust samples and workers’ urine samples (t=−6.879, P=0.038; t=12.521, P<0.001), and the ^208/206Pb between workplace dust samples and workers’ blood samples (t=−10.46, P<0.001), except the ^207/206Pb between workplace dust samples and workers’ blood samples (t=−0.12, P=0.912). In the patients afflicted with lead poisoning, the projection points of LIR of blood and urine samples from the same individual were not at the same level in the two-dimensional model, nor was the LIR of urine samples before and after medical treatment of the same individual. Conclusion The optimized ICP-MS can control the RSD of main LIR (^207/206Pb and ^208/206Pb) below 0.20%. There are differences in the LIR distributions of different samples.

To explore the effects and molecular mechanism of icariin on the vascular function of mice with type 1 diabetes induced by alloxan, type 1 diabetic mice model was established by intraperitoneal injection with 200 mg/kg alloxan.After oral administration with icariin (60, 120 mg/kg) daily for 2 weeks, blood glucose, body weight, food intake and water intake were detected.To evaluate the impact of icariin on the function of isolated vascular ring contraction and relaxation, thoracic aortas of mice were removed and the Ach-induced vascular ring relaxation, Phe-induced vascular ring contraction, SNP-induced vascular ring relaxation and KCl-induced vascular ring contraction response were detected.To further confirm the mechanism of icariin to improve vascular function, human umbilical vein endothelial cells (HUVECs) were induced by high glucose (HG) in vitro.Western blot was used to detect the effect of icariin on eNOS, p-eNOS, p38 MAPK and p-p38 MAPK expressions in HG-induced human umbilical vein endothelial cells (HUVECs).The results indicated that icariin significantly ameliorated the weight loss and dampened the increase in water intake of the diabetic mice.Meanwhile, icariin had a certain ameliorative effect on blood glucose and food intake without significant difference.The results of isolated thoracic aortas vascular rings contraction and vasodilation function indicated that icariin significantly improved Phe-induced vascular contraction and Ach‐induced vascular relaxation.Meanwhile, icariin had a certain ameliorative effect on KCl-induced vascular contraction response without significant difference.However, no significant change was observed on endothelium‐independent vascular rings relaxation response induced by SNP after treatment with icariin.Results of Western blot showed that icariin inhibited the expression of p-p38 MAPK and induced expression of p-eNOS in the high glucose-induced HUVECs cell model.Therefore, icariin may attenuate alloxan-induced type 1 diabetic mice vascular diastolic function by inhibiting expression of p-p38 MAPK and inducing expression of p-eNOS.

Objective To predict the molecular mechanism of Dihuang (Rehmanniae Radix) in the treatment of diabetic nephropathy (DN) complicated with depression based on network pharmacology. Methods The components of Dihuang (Rehmanniae Radix) were identified from the Integrated Pharmacology-based Research Platform of Traditional Chinese Medicine (TCMIP), Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP), and relevant literature. The component targets were detected by combining the SwissTargetPrediction and PubChem databases. Disease targets were collected from the Therapeutic Target Database (TTD), DisGeNET, and Ensembl databases with “diabetic nephropathy” and “depression” as keywords. The disease-component targets were mapped using Venny 2.1.0 to obtain potential targets. A protein-protein interaction (PPI) network was constructed using the Search Tool for the Retrieval of Interacting Genes/Proteins (STRING) database and Cytoscape 3.7.2. The co-expression genes of the key targets were collected based on the COXPRESdb 7.3. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis were performed for potential targets using R language. Target-component docking was verified and evaluated using Discovery Studio 4.5. Results According to the databases and literature reports, Dihuang (Rehmanniae Radix) contained 65 active components, and had 155 related targets for the treatment of DN complicated with depression. PPI screening showed that the key targets included serine/threonine protein kinase 1 (AKT1), signal transducer and activator transcription 3 (STAT3), interleukin 6 (IL-6), mitogen-activated protein kinase 1 (MAPK1), and vascular endothelial growth factor A (VEGFA), etc. GO enrichment analysis mainly involved biological processes, such as lipid metabolism, protein secretion regulation, cell homeostasis, and phosphatidylinositol 3 kinase activity. KEGG pathway enrichment analysis included the role of the AGE-RAGE signaling pathway in diabetic complements, insulin resistance (IR), neurotrophin signal path, Toll-like receptor signaling pathway, relaxin signaling pathway, epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs), etc. Molecular docking showed that the target had high affinity for stachyose, manninotriose, verbascose, nigerose, etc. Conclusion Based on network parmacology, this study preliminarily predict the effects of Dihuang (Rehmanniae Radix) in treating DN complicated with depression by regulating inflammation, glucose metabolism, nution nerve, etc.

OBJECTIVETo explore the genetic basis for fetuses with cleft lip and palate.

METHODSFor 100 fetuses diagnosed with cleft lip with or without palate, G-banding chromosomal karyotyping and copy number variation sequencing (CNV-seq) were carried out on chorionic villi, amniotic fluid or cordocentesis samples.

RESULTSNo genomic abnormality was found among 49 fetuses with isolated cleft lip and palate, while 12 genomic aberrations were found among 51 fetuses with syndromic cleft lip and palate, which included 4 cases with trisomy 13, 2 cases with trisomy 18, 1 with X chromosome aneuploidy, 2 with other chromosomal aneuploidies and 3 with pathogenic CNVs.

CONCLUSIONThe incidence of genomic abnormalities in fetuses with cleft lip and palate was high. In addition to chromosomal abnormalities, attention should also be paid to pathogenic CNVs.

Objective: To investigate the value of four-dimensional echocardiography combined with speckle tracking technique on the assessment of right heart function and prognosis in patients with pulmonary arterial hypertension (PAH). Methods: In this prospective study, 51 patients with PAH diagnosed by right heart catheterization in east hospital and south hospital of Renji hospital affiliated to school of medicine of Shanghai Jiaotong University from September 2015 to July 2017 were enrolled as PAH group from July to November 2017. Meanwhile, 26 healthy volunteers with age and sex matched with pulmonary hypertension patients were recruited as control group. The patients were aged (45.8±15.5) years old in PAH group, and there were 6 males and 45 females. The healthy volunteers were aged (45.4±14.6) years old in control group, and there were 4 males and 22 females. Two-dimensional and four-dimensional echocardiographic images were obtained to measure the structure and function of the right heart. The myocardial strain of each ventricle and atrium was measured by sparkle tracking. The patients in PAH group were followed up from July 2017 to August 2018 to observe the endpoint events including all-cause death, re-hospitalization, and clinical deterioration. Results: There were significant differences in two-dimensional echocardiographic parameters(including tricuspid annular plane systolic excursion (TAPSE), right ventricular area change fraction (FAC), and right ventricular systolic pressure (RVSP)), speckle tracking parameters (including global longitudinal systolic peak strain of left ventricle (LVGLS), global longitudinal systolic peak strain of right ventricle (RVGLS),left atrial reservoir function(LASr), left atrial conduit function (LASc), left atrial pump function (LASp), right atrial reservoir function (RASr), right atrial conduit function (RASc), and right atrial pump function (RASp)), and four-dimensional echocardiographic parameters(including right ventricular end diastolic volume (RVEDV) , right ventricular end systolic volume(RVESV), right ventricular stroke volume(RVSV), right ventricular freewall longitudinal strain(RVLSf), interventricular septum longitudinal strain(IVSLS), right ventricular ejection fraction(RVEF)) between control group and PAH group (all P<0.01 or 0.05).Spearman correlation analysis showed that RVEF was correlated with 6-minute walking distance (r=0.540, P<0.001), B-type natriuretic peptide (r=-0.545,P<0.001), New York Heart Association (NYHA) cardiac function classification(r=-0.583, P<0.001), TAPSE(r=0.595, P<0.001), LVGLS (r=-0.461, P=0.001) ,LASc (r=0.453, P=0.002) ,RASc (r=0.532, P<0.001) ,RVESV (r=-0.418, P=0.004) , RVSV (r=0.351, P=0.017) , and IVSLS (r=-0.450, P=0.002) . Pearson correlation analysis also showed that RVEF was correlated with FAC(r=0.579, P<0.001),RVSP (r=-0.442, P=0.002) ,RVGLS (r=-0.521, P<0.001) , LASr (r=0.483, P=0.001) , RASr (r=0.617, P<0.001) , RASp (r=0.513, P<0.001) , and RVLSf (r=-0.592, P<0.001) .After a follow-up of (10.4±2.7) months, there were 4 all-cause deaths, 5 re-hospitalizations and 5 clinical deterioration. Multivariate Cox regression analysis showed that increased RVEF was independent protective factor for end-point events in PAH patients (HR=0.702, P=0.043), and increased RVSP was independent risk factor for end-point events in PAH patients (HR=1.083, P=0.017). The receiver operating characteristic (ROC) curve showed that RVEF and RVSP could be used to predict the end-point events in PAH patients. The area under the curve (AUC) was 0.835(P=0.001) and 0.820(P=0.001), respectively. Conclusions RVEF measured by four-dimensional echocardiography is correlated with right ventricular function parameters measured by two-dimensional echocardiography and can be used to estimate the prognosis of PAH patients. The right atrial and left atrial function assessed by speckle tracking can also reflect the right ventricular function to a certain extent.

Chronic high-salt diet-associated renal injury is a key risk factor for the development of hypertension. However, the mechanism by which salt triggers kidney damage is poorly understood. Our study investigated how high salt (HS) intake triggers early renal injury by considering the ‘gut-kidney axis’. We fed mice 2% NaCl in drinking water continuously for 8 weeks to induce early renal injury. We found that the ‘quantitative’ and ‘qualitative’ levels of the intestinal microflora were significantly altered after chronic HS feeding, which indicated the occurrence of enteric dysbiosis. In addition, intestinal immunological gene expression was impaired in mice with HS intake. Gut permeability elevation and enteric bacterial translocation into the kidney were detected after chronic HS feeding. Gut bacteria depletion by non-absorbable antibiotic administration restored HS loading-induced gut leakiness, renal injury and systolic blood pressure elevation. The fecal microbiota from mice fed chronic HS could independently cause gut leakiness and renal injury. Our current work provides a novel insight into the mechanism of HS-induced renal injury by investigating the role of the intestine with enteric bacteria and gut permeability and clearly illustrates that chronic HS loading elicited renal injury and dysfunction that was dependent on the intestine.
Animals ; Bacteria ; Bacterial Translocation ; Blood Pressure ; Drinking Water ; Dysbiosis ; Enterobacteriaceae ; Gastrointestinal Microbiome ; Gene Expression ; Hypertension ; Intestines ; Kidney ; Mice* ; Microbiota ; Permeability ; Risk Factors

Objective To study the correlation between marital adjustment and personality characteristics in infertile patients. Method The Locke-Wollance marital adjustment measurement scale and Eysenck personality questionnaire(EPQ)were used among 156 patients with infertility to investigate the correlation between marital adjustment and personality characteristics in infertile patients. Results The total score on the marital adjustment was(100.7±15.5). The rate of good marital adjustment was 51.3%and the rate of marital maladjustment was 48.7%. Those with a marital time of shorter than 5 years were better at marital adjustment compared to those with more than 5 years adjustment(P<0.01). In the characteristics of personality,the items of psychoticism(P)and neuroticism(N)fell at the mode of propensity. The scores on introversion and covering were at the middle level. The groups between the marriage age of shorter than 5 years and more than 5 years were significantly different in psychoticism,introversion and extroversion and nervousness(P<0.01). The marital adjustment were negatively correlated with psychoticism and nervousness,but positively correlated with extraversion. The marriage adjnstmc-nt were positively correlated to cpsychoticism and nervousness,but postively correlated with extroversion. The marriage age was positively correlated with psychoticism and nervousness,but negatively related to extraversion and covering with statistically significant difference (P<0.01).Conclusions In the infertile patients,there are many cases of family marriage disorder. The marriage adjustment and age can affect the personality traits of infertile patients. It indicates that infertility affects the physical and mental health.

Objective To investigate the effect of pedicle screw fixation and posterior inter-body fusion in the treatment of lumbar spondylolisthesis.Methods 80 vertebral spondylolisthesis patients were randomly divided into study group and the control group,the study group was taken pedicle screw fixation and posterior interbody fusion and control group was taken pedicle screw fixa-tion and the rear side of the bone graft fusion group.Operation time,bleeding,and clinical efficacy, fusion rate and clinical efficacy were compared.Results Surgical operation time,bleeding in two groups were longer than that in the control group ,the difference was statistically significant (P <0.05).Interbody fusion rate in the study group were higher,the difference was statistically signifi-cant (P <0.05).Conclusion Pedicle screw fixation and posterior interbody fusion is safe and reli-able surgical approach.Although the time of surgery and trauma appeared,its clinical efficacy was higher than the bone graft and fusion fusion,so it is a better surgical treatment of lumbar spondy-lolisthesis.