Objective To investigate the rehabilitation outcome in hemiplegic stroke patients with upper limb dysfunction treated with electromyographic(EMG)biofeedback therapy in combination with an intelligent Tongluo therapeutic apparatus.Methods A total of 132 stroke patients with hemiplegia were chosen and divided into observation group and control group according to the rehabilitation strategies,with 66 cases in each group.Control group was treated with EMG biofeedback therapy,while observation group was given the integrated therapy of EMG biofeedback therapy and intelligent Tongluo therapeutic apparatus.The two groups were compared for motor function of the hemiplegic upper limb(shoulder,hand and wrist muscle),integrated electromyography(iEMG)in the affected limb flexion and extension(biceps brachii and triceps brachii),range of motion of the shoulder joint(abduction,external rotation,internal rotation)and Barthel index of activities of daily living(ADL).Results The differences in the iEMG of biceps brachii and triceps brachii of the elbow joint,motor function of the hemiplegic upper limb,range of motion of the shoulder joint and ADL between two groups before treatment were trivial(P>0.05).The treatment in observation group increased the iEMG of biceps brachii and triceps brachii in elbow flexion(P<0.05),decreased the iEMG of biceps brachii in elbow extension but increased the iEMG of triceps brachii in elbow extension(P<0.05),and these improvements were more significant than those in control group(P<0.05).After treatment,the scores for shoulder function,hand function,and wrist muscle function in observation group increased from(12.23±2.76)to(26.77±4.28),(6.54±1.34)to(15.35±2.46),and(2.36±0.46)to(8.13±2.52),and the scores of the above indexes were higher than those in control group(P<0.05).The shoulder abduction,external rotation and internal rotation ranges of motion in observation group after treatment were greater than those before treatment[(90.77±8.35)° vs(61.23±6.35)°,(45.36±5.33)° vs(26.33±4.65)°,(52.55±5.86)° vs(32.44±3.87)°],and the observation group had greater shoulder ranges of motion than control group(P<0.05).The ADL score in observation group after treatment was higher than that before treatment[(62.45±5.25)vs(33.35±4.85),P<0.05],and it was also higher than that in control group(P<0.05).Conclusion EMG biofeedback therapy combined with intelligent Tongluo therapeutic apparatus can effectively improve the iEMG in the affected limb flexion and extension,enhance the ranges of motion of the shoulder joint,and ultimately improve the upper limb motor function and life quality of hemiplegic stroke patients.

Objective:To analyze the operational effectiveness of a multi-medication management and consultation service platform for elderly patients based on quality function deployment (QFD) and “Internet+”.Methods:It was a non-randomized controlled trial. A total of 100 elderly patients were selected from the Department of Neurology of the First Affiliated Hospital of Wenzhou Medical University from September to November 2023 with convenience sampling method. The medication management was carried out through the multiple medication management and counseling service platform for the patients based on QFD and “Internet+”. The core modules included reminder module, evaluation module, consultation module and popularization module. A self-designed satisfaction questionnaire was used to collect the satisfaction scores of hospital service quality, medication adherence, medication knowledge, and medication safety before and one month after the platform was implemented. A total of 100 questionnaires were distributed, and 100 valid questionnaires (100%) returned. The t-test was used to analyze the differences between the satisfaction scores before and after the operation of the platform to evaluate the operation effects. Results:Among the 100 elderly patients with multiple medications included in the analysis, 65 were male and 35 were female, 84 patients had a combination of ≥2 chronic diseases. The patients aged (68.73±5.99) years, and the number of medications they were taking was (7.65±1.04). The scores of hospital service quality, medication adherence, medication knowledge, and medication safety after the application of the platform were all significantly higher than those before the launch of the platform [(3.66±0.48) vs (2.91±0.70) points, (3.90±0.30) vs (1.30±0.46) points, (3.39±0.49) vs (3.02±0.63) points, (3.75±0.44) vs (1.48±0.59) points](all P<0.05). Conclusion:The multiple medication management and consultation service platform for elderly patients based on QFD and “Internet+” can enhance the scientific management of multiple medication in elderly patients, reduce the burden of medication, improve the quality of medical services, and promote the development of intelligent elderly care services.

Objective To investigate the rehabilitation outcome in hemiplegic stroke patients with upper limb dysfunction treated with electromyographic(EMG)biofeedback therapy in combination with an intelligent Tongluo therapeutic apparatus.Methods A total of 132 stroke patients with hemiplegia were chosen and divided into observation group and control group according to the rehabilitation strategies,with 66 cases in each group.Control group was treated with EMG biofeedback therapy,while observation group was given the integrated therapy of EMG biofeedback therapy and intelligent Tongluo therapeutic apparatus.The two groups were compared for motor function of the hemiplegic upper limb(shoulder,hand and wrist muscle),integrated electromyography(iEMG)in the affected limb flexion and extension(biceps brachii and triceps brachii),range of motion of the shoulder joint(abduction,external rotation,internal rotation)and Barthel index of activities of daily living(ADL).Results The differences in the iEMG of biceps brachii and triceps brachii of the elbow joint,motor function of the hemiplegic upper limb,range of motion of the shoulder joint and ADL between two groups before treatment were trivial(P>0.05).The treatment in observation group increased the iEMG of biceps brachii and triceps brachii in elbow flexion(P<0.05),decreased the iEMG of biceps brachii in elbow extension but increased the iEMG of triceps brachii in elbow extension(P<0.05),and these improvements were more significant than those in control group(P<0.05).After treatment,the scores for shoulder function,hand function,and wrist muscle function in observation group increased from(12.23±2.76)to(26.77±4.28),(6.54±1.34)to(15.35±2.46),and(2.36±0.46)to(8.13±2.52),and the scores of the above indexes were higher than those in control group(P<0.05).The shoulder abduction,external rotation and internal rotation ranges of motion in observation group after treatment were greater than those before treatment[(90.77±8.35)° vs(61.23±6.35)°,(45.36±5.33)° vs(26.33±4.65)°,(52.55±5.86)° vs(32.44±3.87)°],and the observation group had greater shoulder ranges of motion than control group(P<0.05).The ADL score in observation group after treatment was higher than that before treatment[(62.45±5.25)vs(33.35±4.85),P<0.05],and it was also higher than that in control group(P<0.05).Conclusion EMG biofeedback therapy combined with intelligent Tongluo therapeutic apparatus can effectively improve the iEMG in the affected limb flexion and extension,enhance the ranges of motion of the shoulder joint,and ultimately improve the upper limb motor function and life quality of hemiplegic stroke patients.

Objective:To analyze the operational effectiveness of a multi-medication management and consultation service platform for elderly patients based on quality function deployment (QFD) and “Internet+”.Methods:It was a non-randomized controlled trial. A total of 100 elderly patients were selected from the Department of Neurology of the First Affiliated Hospital of Wenzhou Medical University from September to November 2023 with convenience sampling method. The medication management was carried out through the multiple medication management and counseling service platform for the patients based on QFD and “Internet+”. The core modules included reminder module, evaluation module, consultation module and popularization module. A self-designed satisfaction questionnaire was used to collect the satisfaction scores of hospital service quality, medication adherence, medication knowledge, and medication safety before and one month after the platform was implemented. A total of 100 questionnaires were distributed, and 100 valid questionnaires (100%) returned. The t-test was used to analyze the differences between the satisfaction scores before and after the operation of the platform to evaluate the operation effects. Results:Among the 100 elderly patients with multiple medications included in the analysis, 65 were male and 35 were female, 84 patients had a combination of ≥2 chronic diseases. The patients aged (68.73±5.99) years, and the number of medications they were taking was (7.65±1.04). The scores of hospital service quality, medication adherence, medication knowledge, and medication safety after the application of the platform were all significantly higher than those before the launch of the platform [(3.66±0.48) vs (2.91±0.70) points, (3.90±0.30) vs (1.30±0.46) points, (3.39±0.49) vs (3.02±0.63) points, (3.75±0.44) vs (1.48±0.59) points](all P<0.05). Conclusion:The multiple medication management and consultation service platform for elderly patients based on QFD and “Internet+” can enhance the scientific management of multiple medication in elderly patients, reduce the burden of medication, improve the quality of medical services, and promote the development of intelligent elderly care services.

Objective:To explore the teaching effectiveness of curriculum ideological and political teaching model for Fundamentals of Nursing based on outcome based education concept.Methods:Using the convenient sampling method, a total of 194 undergraduates of grade 2019 from School of Nursing at University of South China were selected as the control group from February to December 2021, and 146 undergraduates from 2020 were selected as the experimental group from February to December 2022. The control group was taught in accordance with the conventional teaching methods, and the experimental group was taught in the ideological and political teaching model of Fundamentals of Nursing based on outcome based education concept. After the intervention, the total course scores of nursing undergraduates in the two groups were compared, and the cognitive attitude, implementation effect and teaching satisfaction of the experimental group students on "ideological and political curriculum" were compared.Results:After the intervention, the total course score of nursing undergraduates in the experimental group was (85.65±7.31), and that in the control group was (77.71±7.28), and the difference between the two groups was statistically significant ( P<0.01). The cognitive attitude score of undergraduate nursing students in the experimental group towards "ideological and political curriculum" was (32.62±2.15), and the implementation effect score of "ideological and political curriculum" was (22.78±1.78). The satisfactory form of ideological and political cases for undergraduate nursing students in the experimental group was news reports and hot events, and the satisfactory ideological and political teaching method was experiential teaching method and case-based teaching method. Conclusions:The curriculum ideological and political teaching model of Fundamentals of Nursing based on outcome based education concept can improve the academic performance of nursing undergraduate students and provide reference for the construction of ideological and political teaching courses in nursing basic courses. In the future, this teaching model can be applied to the teaching reform of other nursing courses in order to accelerate the progress of ideological and political construction of professional courses.

【Objective】 To investigate the compatibility of human albumin and its internal packaging materials of Sinopharm Lanzhou Biopharmaceutical Co., Ltd. 【Methods】 One batch of inner packaging materials (medium borosilicate glass-molded injection bottle and halogenated butyl rubber plug for injection) was extracted with 4 extraction solvents to conduct the toxicological evaluation of potential inner packaging extracts. Through the simulated acceleration test, the trend analysis of the elements in the sample and the inner surface of the glass bottle were observed, and the routine drug inspection items during the long-term stability test process were determined. 【Results】 The detection results of the leaching elements of the internal packaging materials did not exceed the limit of 50%, and the organic matter safety threshold (margin of safety, MOS) was greater than 1.0, indicating that both the leaching elements and the organic matter had no safety risk to the user under the current exposure. The results of the simulated acceleration test show that the drug will not have the risk of peeling tablets after the long-term stability condition was placed for a period of time, and the routine inspection items of the long-term stability test drugs all meet the requirements of the pharmacopoeia. 【Conclusion】 The inner packaging material has no significant impact on the quality of drugs and has good overall compatibility, making it suitable for packaging human albumin.

Objective: To apply and evaluate the effect of empowerment educational program on AIDS prevention and treatment among freshmen in one university. Methods: The method of two stage stratified sampling was used to select the experimental and control group. The traditional health education was implemented among the control group, and the empowerment education was implemented for the experimental group. The effect of the two groups was compared before and after intervention. Results: For experimental group, the awareness rate of AIDS(65.02%) ( χ 2=61.02， P <0.01) and the overall score of attitude and behavior(16.71± 2.53 )( t =-2.66， P <0.05) were significantly improved after intervention(82.96%，18.58±1.95). For the control group, there was significant difference in awareness rate of AIDS after intervention(67.70% vs 96.02%， χ 2=18.64, P <0.05), while there was no statistical difference in overall score of attitude and behavior after intervention(16.52±1.50 vs 17.16±1.57， t =-1.51, P =0.14). There was no significant difference in awareness rate between the two groups before intervention ( χ 2=0.36, P =0.55), but there was a statistical difference after intervention ( χ 2=20.42, P <0.01). There was statistical difference in attitude and behavior scores between the two groups after intervention ( P <0.05). Conclusion Empowerment educational program can improve the awareness rate of AIDS among college students, help to establish an objective attitude towards AIDS and infected patients, and to reduce high risk sexual behavior, also it is more effective compared to traditional education method.

Objective:To investigate the status and influencing factors of skin cleaning outside wound (hereinafter referred to as skin) in adult trauma patients.Methods:A multicenter cross-sectional investigation was conducted. From September 1 to 30, 2020, a total of 952 adult trauma patients who met the inclusion criteria were admitted to wound care clinics or trauma surgery wards of 13 military or local Grade Ⅲ Level A hospitals, including the General Hospital of the Eastern Theater Command of People's Liberation Army and the Army Medical Center, etc. A self-designed questionnaire on cleaning status of skin in trauma patients was released through the "questionnaire star" website to investigate basic information such as gender, age, education level, living status, and self-care ability, trauma information such as cause of injury, wound duration, trauma site, trauma depth, wound pain, wound peculiar smell, and wound cleaning solution, and skin cleaning status after injury such as whether to clean or not, cleaning method, cleaning frequency, cleaning duration in each time, or reasons for not cleaning. The patients who cleaned skin regularly after injury were included in cleaning group, and the other patients were included in no cleaning group. The basic information, trauma information, and skin cleaning status after injury of patients in 2 groups were investigated. Data were statistically analyzed with chi-square test, and binary multivariate logistic regression analysis was performed on indicators with statistically significant differences between the two groups to screen the independent influencing factors of skin cleaning in trauma patients.Results:A total of 952 questionnaires were received, and the recovery rate was 100%. Three invalid questionnaires were eliminated, and 949 valid questionnaires were obtained, with an effective rate of 99.68%. In 949 patients, there were 461 (48.6%) males and 488 (51.4%) females, aged 18-100 (50±18) years. Most patients were less than 60 years old, lived with their families, and could take care of themselves completely. Nearly half of the patients were with junior high school or below education level. The main causes of injury were sharp cutting injury and falling injury, the wound duration was 2-365 days, most of the injured parts were limbs and trunk, the wound depth was mostly full-thickness injury, and most patients had wound-related pain and no peculiar smell and used 5 g/L iodophor to clean the wound. Totally 684 (72.1%) patients cleaned their skin after injury, mainly by scrubbing with warm water, the cleaning frequency was mainly once or twice a week, and the cleaning time was mainly 10 or 15 min for each time. Totally 265 (27.9%) patients didn't clean their skin after injury, and the main causes for not cleaning were following the doctor's advice, followed by worrying about wound infection and loss of self-care ability. There were significantly statistical differences in constituent ratios of education level, self-care ability, cause of injury, wound pain, and wound peculiar smell of patients in 2 groups ( χ2=12.365, 24.519, 22.820, 9.572, 92.342, P<0.01). Education level, self-care ability, cause of injury, wound pain, and wound peculiar smell were potential influencing factors of skin cleaning in patients. Binary multivariate logistic regression analysis showed that self-care ability, wound pain, and wound peculiar smell were independent influencing factors of skin cleaning in patients (odds ratio=1.51, 0.52, 3.72, 95% confidence interval=1.08-2.12, 0.42-0.89, 2.66-5.22, P<0.05 or P<0.01). Conclusions:Self-care ability, wound pain, and wound peculiar smell are independent influencing factors of skin cleaning in adult trauma patients.

PURPOSE: Vascular endothelial growth factor (VEGF) signal transduction mainly depends on its binding to VEGF receptor 2 (VEGFR-2). VEGF downstream signaling proteins mediate several of its effects in cancer progression, including those on tumor growth, metastasis, and blood vessel formation. The activation of VEGFR-2 signaling is a hallmark of and is considered a therapeutic target for breast cancer. Here, we report a study of the regulation of the VEGFR-2 signaling pathway by a small molecule, isomangiferin. METHODS: A human breast cancer xenograft mouse model was used to investigate the efficacy of isomangiferin in vivo. The inhibitory effect of isomangiferin on breast cancer cells and the underlying mechanism were examined in vitro. RESULTS: Isomangiferin suppressed tumor growth in xenografts. In vitro, isomangiferin treatment inhibited cancer cell proliferation, migration, invasion, and adhesion. The effect of isomangiferin on breast cancer growth was well coordinated with its suppression of angiogenesis. A rat aortic ring assay revealed that isomangiferin significantly inhibited blood vessel formation during VEGF-induced microvessel sprouting. Furthermore, isomangiferin treatment inhibited VEGF-induced proliferation of human umbilical vein endothelial cells and the formation of capillary-like structures. Mechanistically, isomangiferin induced caspase-dependent apoptosis of breast cancer cells. Furthermore, VEGF-induced activation of the VEGFR-2 kinase pathway was down-regulated by isomangiferin. CONCLUSION: Our findings demonstrate that isomangiferin exerts anti-breast cancer effects via the functional inhibition of VEGFR-2. Pharmaceutically targeting VEGFR-2 by isomangiferin could be an effective therapeutic strategy for breast cancer.
Angiogenesis Inhibitors ; Animals ; Apoptosis ; Blood Vessels ; Breast Neoplasms ; Cell Proliferation ; Heterografts ; Human Umbilical Vein Endothelial Cells ; Humans ; In Vitro Techniques ; Mice ; Microvessels ; Neoplasm Metastasis ; Phosphotransferases ; Rats ; Receptors, Vascular Endothelial Growth Factor* ; Signal Transduction ; Vascular Endothelial Growth Factor A* ; Vascular Endothelial Growth Factor Receptor-2*

Objective To analyze the drug resistance and detect the drug resistance genes of pathogenic bacteria isolated from hospital sewage , and to investigate the sources of antibiotic resistant microorganisms in the environment .Methods The enteric pathogenic bacteria , such as thermotolerant Escherichia coli , Salmonella and Shigella , were isolated from the sewage of Shaoxing hospitals from January 2016 to December 2016 , and the detection of drug resistance of thermotolerant Escherichia coli , the drug resistance of Escherichia coli isolated from clinical specimens of three hospitals was compared and analyzed . Meanwhile , extended spectrum beta lactamases ( ESBLs ) resistance genes were detected in thermotolerant Escherichiacoliinsewage.Results 48strainsofpathogenswereisolatedinsewage,including32strainsof Escherichia coli , 2 strains of Shigella sonnei and 1 strain of Salmonella arizonae .Escherichia coli has a low rate of resistance to most antibiotics .Compared to Escherichia coli isolated from clinical specimens , there were significant differences among the drug resistance rates of Ampicillin , Aztreonam, Amoxicillin/Clavulanic acid and the first to four generation Cephalosporins (P<0.05).11 strains of ESBLs positive bacteria were detected in sewage .Among them , 7 carried CTX-M9 resistance genes , and 4 carried TEM resistance genes , while 1 strain of CTX-M1 and SHV was carried .There were 2 strains carrying CTX-M9 and TEM resistance genes simultaneously , 1 strain simultaneously carrying TEM and SHV resistance genes . Conclusions There are different kinds of intestinal pathogens in hospital sewage , which may lead to contamination of drug-resistant microorganisms in the environment .Therefore the hospitals should strengthen the quality of sewage treatment and improve the qualified rate of sewage disinfection .