Objective To explore the clinical efficacy of prone position ventilation(PPV)in improving hypoxemia in patients with severe brain damage.Methods A retrospective research method was conducted,140 patients with severe brain damage who were admitted to the department of critical care medicine of the First Affiliated Hospital,Zhejiang University School of Medicine from August 2020 to August 2021 were selected as subject objected.According to the inclusion and exclusion criteria,20 patients with oxygenation index≤200 mmHg(1 mmHg≈0.133 kPa)who were treated with PPV were statistically analyzed.The patients'blood gas analysis related indicators[including arterial partial pressure of oxygen(PaO2),fractional of inspired oxygen(FiO2),oxygenation index,arterial oxygen saturation(SaO2),arterial partial pressure of carbon dioxide(PaCO2),pH value],ventilator-related parameters[including peak inspiratory pressure(PIP),positive end-expiratory pressure(PEEP),tidal volume(VT),lung dynamic compliance(Cdyn),etc.],and mean arterial pressure(MAP),heart rate(HR)were compared before PPV,12 hours after PPV,and 12 hours after reverting to supine position.At the same time,the related complications of patients during PPV were recorded.Results There were 15 males and 5 females,the mean age of the patients was(46.10±17.22)years old,the average PPV time was(22.20±5.94)hours.Compared with before PPV,patients showed significant increases in PaO2,oxygenation index,SaO2,VT,and Cdyn at 12 hours after PPV and 12 hours after recovery from supine position[PaO2(mmHg):98.35±21.85,98.45±17.90 vs.72.15±10.14,oxygenation index(mmHg):198.82±40.51,202.27±46.39 vs.133.20±33.95,SaO2:0.97±0.02,0.97±0.01 vs.0.94±0.03,VT(mL):558.42±111.23,580.29±119.44 vs.484.82±123.77,Cdyn(mL/cmH2O):26.11±5.42,27.90±5.80 vs.24.15±6.13,all P<0.05];Compared with 12 hours after PPV,the Cdyn of the patient still showed a significant increase after 12 hours of recovery from supine position(P<0.05).There were no statistical differences in the FiO2,PaCO2,pH value,PIP,PEEP,HR,and MAP of patients at various time points before and after PPV(all P>0.05).Five patients developed redness and swelling at the skin compression site mainly on the face after PPV,which gradually improved after returning to a supine position.During this period,there was no occurrence of catheter detachment,malignant arrhythmia,or significant hemodynamic instability.Conclusion PPV has a certain clinical effect on improving hypoxemia in patients with severe brain damage.

Objective To construct a group psychological training for junior officers based on competency model and explore its intervention effect on competency and mental health of junior officers.Methods Delphi method was used to construct a group psychological training program for junior officers based on competency model.A total of 63 junior officers were subjected with convenience sampling during October and November 2023.According to the principle of randomized controlled experimental design,the participants were divided into experimental group(n=30)and control group(n=33).The experimental group was given our group psychological training program for totally 8 sessions,90～120 min per session,2 sessions per week,while the control group received no such training.Competency scale,12-item general health questionnaire(GHQ-12),Chinese perceived stress scale(CPSS),and Neuroticism Extraversion Openness Five-Factor Inventory(NEO-FFI)were used to assess the 2 groups before and at the end of intervention.Results ① The results of the 2 rounds of expert consultation showed that the total recovery rate was 100％,the expert authority coefficient was 0.87,the Kendall's coordination coefficients(ω)of the 2 rounds of expert consultation were 0.102(P＜0.001)and 0.410(P＜0.001),respectively,with a coefficients of variation of＜0.3,indicating reliable expert consultation.(2)The results of post-intervention time main effect indicated that the total score of competence(P＜0.001),extroversion score(P＜0.05)and responsibility score(P＜0.01)were significantly higher,but the total score of GHQ-12 was obviously lower in the experimental group than the control group(P＜0.001).(3)The results of post-intervention group main effects revealed that the extraversion score of the experimental group was significantly higher than that of the control group(P＜0.01).(4)The results of the post-intervention time × group interaction displayed that the experimental group had notably higher total competency score(P＜0.01),job performance score(P＜0.05),extraversion score(P＜0.05),agreeableness score(P＜0.001)and responsibility score(P＜0.01),but lower total GHQ-12 score(P＜0.01)than the control group.Conclusion Competency-based modeling group psychological training for junior officers can significantly enhance the competency,strengthen the extroversion,agreeableness and responsibility in personality traits,and thus improve job performance for them.

Objective To explore the mediating role of personality traits and mental resilience in the relationship between competence and job performance among junior officers.Methods Competency Inventory,25-Item Connor-Davidson Resilience Scale(CD-RISC-25),short version of the Big Five Personality Scale[Neuroticism Extraversion Openness Five-Factor Inventory(NEO-FFI)],and Chinese Perceived Stress Scale(CPSS)were used as assessment tools to survey 586 junior officers selected by convenience sampling.Results ① For junior officers,their competence was positively and moderately correlated with job performance,openness personality,extroversion personality,agreeableness personality,responsibility personality,and total score and score for each dimension of psychological resilience(P＜0.01),and negatively and moderately correlated with neuroticism personality(P＜0.01).② Significantly mediating role was observed in personality and mental resilience for competence and job performance in junior officers,with an indirect effect of 20.68％for personality and 33.18％for mental resilience.Conclusion Personality and mental resilience mediate significantly between competence and job performance in junior officers.Our findings provide a theoretical basis for the action mechanism of competence in job performance for junior officers.

The diagnosis of chronic pain requires a true and reliable pain assessment, which relies on timely self-reporting. Ecological momentary assessment (EMA) is a method of repeated dynamic sampling through patient self-report to minimize recall bias. This review introduces and analyzes the concept and application of EMA, and expounds the feasibility and limitations of EMA in chronic pain management, aiming to provide reference for medical and nursing staff to evaluate chronic pain management efficiently.

Objective:To translate the Hip Preservation Surgery Expectations Survey (HPSES) into Chinese and test its reliability and validity.Methods:This study strictly followed the principles of Brislin translation, back translation, and cross-cultural adaptation to form a simplified Chinese version of HPSES. From September 2019 to July 2021, a survey was conducted using convenience sampling method to select 215 patients from the Department of Orthopedics of the Affiliated Hospital of Qingdao University who underwent hip preservation surgery to test the reliability and validity of the Chinese version of HPSES. This study used critical ratio determination and correlation analysis for item analysis, and used content validity index and structural validity to evaluate the validity of the scale, and the reliability of the scale was evaluated using Cronbach's α coefficients and half reliability.Results:The Chinese version of HPSES extracted 4 common factors, totaling 22 items, with a cumulative total variance contribution rate of 63.696%. The content validity index at the scale level was 0.97, and the content validity index at the item level was 0.83 to 1.00. The results of confirmatory factor analysis showed that the fit of the scale was good. The total Cronbach's α coefficient of the scale was 0.873, and Cronbach's α coefficients for each dimension ranged from 0.834 to 0.868. The overall Guttman half reliability coefficient of the scale was 0.840, and the Guttman half reliability coefficients for each dimension were 0.755 to 0.865.Conclusions:The Chinese version of HPSES has good reliability and validity, which can be used to evaluate the expected outcomes of patients undergoing hip preservation surgery, facilitating medical and nursing staffs to provide targeted preoperative health education and rehabilitation guidance to patients, and improving patients satisfaction.

Objective: To explore the association between incidence of injuries and health related behavior among middle school students in China, to provide evidence for injury prevention. Methods: A questionnaire survey was conducted among 1 067 students who were selected from Zhejiang, Guangdong, Jiangxi, Sichuan and Guizhou provinces by using stratified random cluster sampling method. Chi square test and multiple Logistic regression analyses were used to analyze incidence of injuries and health related behavior. Results: The prevalence of self injury among middle school students in five provinces was 11.0%, the prevalence of intentional injury was 13.2%. Multiple Logistic regression analyses showed that attempting smoking, not eating breakfast every day, having a low mood more than 2 weeks in the past 6 months were positively correlated with self injury ( OR=3.02, 2.04, 4.30, P ＜0.01) after adjusting for region, and the smoking attempt behavior was positively correlated with intentional injury ( OR=2.03, P ＜0.05) after adjusting for region, urban and rural, residence condition, weekly allowance condition. Conclusion Smoking attempt behavior could be viewed as a shared predictor for both self injury and intentional injury behavior among middle school students, smoking control intervention should be carried out actively among students.

Exosomes are nanoscal-scale vesicles containing a variety of proteins(HSP70, actin, Alix, etc.), lipids, mRNAs and miRNAs.They are commonly found in various tissues and cells of the organism.They are involved in processes such as intercellular communication, immune regulation and cell signaling pathway regulation, and then play an important role.Recent studies have shown that exosome-mediated intercellular signaling plays an important role in the progression of Alzheimer's disease(AD). This paper reviewed the general characteristics of exosomes, clarifies the possible role of exosomes in the pathogenesis of AD, and also discussed the application prospect and the related challenges of exosomes as a new potential option in the future treatment of AD.

Objective:To evaluate the feasibility and accuracy of a multi-dimensional peripheral quick contrast sensitivity function (pqCSF) measurement established based on Bayesian probability estimation algorithm.Methods:A cross-sectional study was conducted.Nineteen eyes of 12 healthy emmetropic subjects in Zhongshan Ophthalmic Center of Sun Yat-sen University from September 2017 to March 2018 were included, with an average age of (22.92±2.91) years.The average spherical power and cylindrical power were (-0.34±0.52)D and (-0.30±0.42)D, respectively, and the average uncorrected vision acuity was≥1.0.Based on the Bayesian probability algorithm, the peak contrast sensitivity γ max, the peak spatial frequency ? max, the bandwidth β and the low contrast intercept δ were used to quickly describe the contrast sensitivity function (CSF) curve of the full spatial frequency through multi-dimensional pqCSF method.The 16 peripheral visual field positions of all subjects were tested at 6°, 12°, 18° and 24° eccentricity of the superior, inferior, the temporal and nasal visual field by the pqCSF method, but the 18° eccentricity of temporal field, which was near the physiological blind spot, was excluded.The area under Log CSF (AULCSF) of different peripheral visual fields and the Log CSF of 19 spatial frequencies (distributed at equal intervals in logarithmic units) were compared.This study followed the Declaration of Helsinki, and the study protocol was approved by an Ethics Committee of Zhongshan Ophthalmic Center of Sun Yat-sen University (No.2018KYPJ017). Written informed consent was obtained from each subject prior to any examination. Results:With the increase of eccentricity in different visual fields, the AULCSF decreased gradually, and there were significant differences in AULCSF between different eccentricities (all at P<0.05). The AULCSF of the nasal and temporal visual field at 6°, 12° and 24° eccentricity was significantly larger than that of the superior and inferior visual field (all at P<0.05). As the distance from the fovea was increased, the pqCSF, the AULCSF, and the high-frequency cutoff were all decreased, and the standard deviation of AULCSF was increased gradually. Conclusions:The pqCSF method can depict a relatively complete peripheral CSF curve of a wide peripheral visual field, and reflect the function quality of the peripheral vision comprehensively and accurately.

Objective:To analyze the mechanism of acidified silk protein sponge matrices and methanolized silk protein sponge matrices in promoting wound healing.Methods:The experimental method was conducted. Acidified silk protein sponge matrices with vascularization ability and methanolized silk protein sponge matrices without vascularization ability were prepared by improved freeze-drying method. General observation was performed. Internal morphology was observed with scanning electron microscope. The secondary structure was observed with X-ray diffractometer (XRD) and infrared spectrometer. Compressive modulus was tested by tensile machine. Two 3-week-old male Sprague-Dawley (SD) rats were used to isolate bone marrow mesenchymal stem cells (BMSCs) cultured in above-mentioned two silk protein sponge matrices, the number of cells was counted under laser scanning confocal microscope after 1, 6 days of culture. Four full-thickness skin defect wounds were made on each one of twelve 8-week-old male SD rats, which were divided into methanolized silk group (24 wounds) and acidified silk group (24 wounds) covered with the corresponding silk protein sponge matrices. On post operation day (POD) 3, 7, 10, and 14, general observation was performed and the remaining wound area was recorded. On POD 3, 7, and 14, the wounds and marginal tissue were collected for hematoxylin-eosin staining (HE) staining and Masson staining to observe growth of new tissue and collagen deposition and CD34 immunohistochemical staining to observe vascularization. Sample number of each index of each group at every time point in animal experiment was 6. Data were statistically analyzed with analysis of variance of factorial design, analysis of variance for repeated measurement, independent-samples t test, and Bonferroni correction. Results:Methanolized silk protein sponge matrices and acidified silk protein sponge matrices had the same composition and similar porous structure, with pore size of 300-500 μm. XRD showed that methanolized silk protein sponge matrices showed a significant crystallization peak, while acidified silk protein sponge matrices was mainly composed of amorphous structure. Infrared spectrometer showed that acidified silk protein sponge matrices appeared a strong absorption peak at 1 650 cm -1, and the methanolized silk protein sponge matrices appeared a strong absorption peak at 1 630 cm -1. Compressive modulus of methanolized silk protein sponge matrices was (23.8±1.3) kPa, which was significantly higher than (6.1±0.9) kPa of acidified silk protein sponge matrices ( t=19.550, P<0.01). After one day of culture, BMSCs successfully adhered to the two kinds of silk protein sponge matrices, and the cells were not spread. After six days of culture, BMSCs were spread on the two kinds of silk protein sponge matrices, and the number of cells on the acidified silk protein sponge matrices increased significantly. On POD 3, the wounds of the 2 groups did not shrink significantly. On POD 7, the wound area in acidified silk group was significantly smaller than that in methanolized silk group, and new epithelium growth occurred at the wound edge. On POD 14, the wounds of acidified silk group basically healed, and the wounds of methanolized silk group were dry and shrinked significantly. Remaining wound area of acidified silk group on POD 3, 7, 10, and 14 were significantly smaller compared with that in methanolized silk group ( t=7.782, 10.620, 3.707, 6.830, P<0.05 or P<0.01). HE staining, Masson staining, and CD34 immunohistochemical staining showed on POD 3, new tissue growing into silk protein sponge matrices of wounds of acidified silk group was more than that in methanolized silk group, the former group secreted a small amount of collagen, collagen formation was not observed in the latter group, the number of vascular endothelial cells migrated into the matrices were more in the former group than the latter group; on POD 7, the area of new tissue covering matrices hole of wounds of acidified silk group was larger than that in methanolized silk group, collagen in the former group was more than that in the latter group and was evenly distributed, the number of blood vessels in the former group was more than that on POD 3, and the new blood vessels in the latter group were scattered; on POD 14, the new tissue in acidified silk group was similar in structure to normal skin tissue and formed a certain thickness, the new tissue in methanolized silk group basically grew into the matrices, the former group had rich collagen deposition, the latter group had scattered collagen, and blood vessels in the former group distributed uniformly and density of blood vessels was significantly higher than that in the latter group ((55.7±6.0) and (34.1±1.0) pieces/mm 2, respectively, t=9.042, P<0.01). Conclusions:Angiogenesis-promoting acidified silk protein sponge matrices have good cytocompatibility, which can facilitate the rapid formation of vascular network in wound area, providing sufficient blood supply to accelerate the tissue regeneration and collagen deposition, thereby promoting wound healing and improving healing quality, these effects are better than methanolized silk protein sponge matrices.

OBJECTIVE: To investigate the effect of Chinese medicine Wubi Shanyao pills on sexual function of kidney-yang-deficiency mice induced by hydrocortisone. METHODS: Male Kunming mice were injected with hydrocortisone for 10 days to prepare the kidney-yang-deficiency model, and administrated with Wubi Shanyao pills (0.91, 1.82, 2.73 g/kg) for 9 weeks. The general behaviors of mice (autonomous activity, grasping power) were observed; sexual behaviors (capture, straddle, ejaculation frequency and incubation period) of mice were detected by mating experiment. The serum levels of cortisol, adrenocorticotropic hormone (ACTH), luteinizing hormone (LH), follicle stimulating hormone (FSH), estradiol (E RESULTS: Wubi Shanyao pills increased the number of independent activities, grasping power, capture frequency of model mice and shortened the capture latency (all CONCLUSIONS Wubi Shanyao pills can improve the sexual function of mice with kidney-yang-deficiency induced by hydrocortisone, which may be related to regulating the hypothalamus-pituitary-adrenal axis (HPA axis), promoting the proliferation of testicular cells, and inhibiting cell apoptosis.
Animals ; Follicle Stimulating Hormone/blood* ; Hydrocortisone ; Hypothalamo-Hypophyseal System ; Kidney/drug effects* ; Kidney Diseases/drug therapy* ; Male ; Mice ; Pituitary-Adrenal System/drug effects* ; Random Allocation ; Sexual Behavior, Animal/drug effects* ; Yang Deficiency/drug therapy*