Objective To study the effects of different pellet feed hardness on the growth and reproduction,feed utilization rate,and environmental dust in laboratory mice.Methods One hundred of fifty 50 3-week-old SPF-grade C57BL/6JGpt and 150 ICR laboratory mice were randomly divided into three groups,with an equal number of males and females.They were fed diets with different hardness of 18.62 kg,23.15 kg,and 27.89 kg.Body weight,feed utilization rate,and dust levels in cages were recorded and calculated for mice aged 3-10 weeks.Forty-five 6-week-old male mice and ninety 4-week-old female mice from each strain were randomly divided into three groups and fed pellet feeds with three different hardness levels.After 2 weeks of adaptation to the same hardness feed,the mice were paired at a 1:2 male-to-female ratio and monitored for reproductive data for 3 months.Results At the age of 4 weeks,the body weight of male C57BL/6JGpt mice in 23.15 kg group was significantly higher than that in the 18.62 kg and 27.89 kg groups(P＜0.01),and the body weight of females in the 18.62 kg group was significantly higher than that in the 27.89 kg group(P＜0.05).There was no significant difference in body weight among ICR mice aged 3-10 weeks across different feed hardness groups(P＞0.05).For both strains,feed utilization rate for males was higher than that for females across different feed hardness groups at all weeks of age(P＜0.01).Compared to the 27.89 kg group,both the 18.62 kg and 23.15 kg groups showed a significant increase in the 50-mesh dust levels in cages for both strains aged 4-8 weeks(except for 7-week-old C57BL/6JGpt mice)(P＜0.05).For both C57BL/6JGpt and ICR mice,there was no significant difference in basic reproductive performance such as interval between the first litter and the monthly production index among the three feed hardness groups during the experimental period(P＞0.05).However,the monthly production index of C57BL/6JGpt mice first increased and then decreased with the increase of feed hardness,while that of ICR mice increased with increasing feed hardness,though these differences were not statistically significant(P＞0.05).Conclusion Different strains and genders had different tolerance to feed hardness.C57BL/6JGpt mice are more adapted to lower hardness feeds,while ICR mice are better suited to slightly higher hardness feeds.

Objective:To investigate the effect of volatile organic compounds (VOCs) exposure in the atmosphere on the risk of daily death from stroke in Guangzhou.Methods:Daily average concentrations of twelve atmospheric VOCs, meteorological factors, and daily deaths for stroke and its subtypes (including ischemic and hemorrhagic stroke) in Guangzhou from 2020 to 2021 were collected. The time-series Poisson generalized additive model was established to analyze the relationship between daily average concentrations of atmospheric VOCs and daily mortality from a stroke on different lag days. The season, gender, and age group further performed stratification analysis.Results:Toluene and n-pentane were associated with a higher mortality risk from stroke and its subtypes. For each interquartile range ( IQR) increment in toluene concentration at lag0- 1 days, the RRs for mortality from stroke and hemorrhagic stroke were 1.060 (95% CI: 1.036-1.085) and 1.071 (95% CI: 1.030-1.113), respectively. For each IQR increment in n-pentane concentration, the RR for mortality from ischemic stroke was 1.064 (95% CI: 1.030-1.099). The effect estimates of VOCs may be higher during the cold season and among women and people aged ≥75 years. For each IQR increment in toluene concentration, the RRs for mortality risk of stroke in the cold season and women were 1.099 (95% CI: 1.056-1.143) and 1.085 (95% CI: 1.050-1.120), respectively. For n-pentane, the RR for death risk of stroke in people aged ≥75 years old was 1.072 (95% CI: 1.036-1.109). Results of sensitivity analysis showed that the effect estimates fluctuated less when PM 2.5 and O 3 were separately introduced for the two-pollutant model, as well as changing the degrees of freedom for covariates. Conclusions:This study suggests that VOCs may be an independent risk factor for daily mortality from stroke. Moreover, Toluene presented the most significant health impact.

Objective:To study the application of flipped classroom teaching mode in nursing teaching of Gastroenterology Department and its influence on the mastery of nursing theory and professional skills of nursing students.Methods:Using the convenient sampling method, a total of 136 nursing students who took internship Gastroenterology Department of Shanxi Provincial People's Hospital from July 2018 to January 2020 were selected. From July 2019 to January 2020, 69 nursing students were selected as the experimental group, and they were given flipped classroom teaching mode. From July 2018 to January 2019, 67 nursing students were set as the control group, and they were given the traditional teaching mode. The nursing theory, professional skills and comprehensive ability of nursing students and their evaluation of the teaching quality and satisfaction were observed and compared between the two groups.Results:The scores of after-department nursing theory and professional skills of nursing students in the experimental group were respectively (88.45±7.12) and (92.78±3.03) , which were higher than (80.32±8.56) and (88.15±3.62) of the control group, and the differences were statistically significant ( t=5.921, 7.952; P<0.05) . Scores of nursing consultation, physical examination, diagnosis, measures, health education, humanistic care, organizational efficiency and overall evaluation of the experimental group were respectively (6.21±1.25) , (6.45±1.03) , (6.53±1.21) , (6.59±1.28) , (6.98±1.12) , (6.59±1.21) , (6.30±1.18) and (7.01±1.16) , higher than (5.37±1.59) , (5.58±1.32) , (5.29±1.64) , (5.62±1.71) , (6.03±1.57) , (5.70±1.42) , (5.21±1.72) and (6.08±1.65) of the control group ( t=3.370, 4.216, 4.940, 3.686, 4.001, 3.867 , 4.246, 3.746; P<0.05) . The scores of teaching effect, teaching content and teaching method in experimental group were respectively (21.65±1.19) , (20.27±1.80) and (21.43±1.25) , which were higher than (19.13±1.28) , (18.81±2.79) and (19.47±1.21) in control group, and the differences were statistically significant ( t=11.676, 3.575, 9.112; P<0.05) . The satisfaction of the nursing students in the experimental group on theoretical knowledge, learning interest, practical skills, self-study ability and actual problem-solving ability were respectively 94.03%, 97.01%, 95.52%, 91.04% and 92.54%, which were higher than 81.25%, 85.94%, 84.38%, 78.13%, 79.69% in the control group, and the differences were statistically significant (χ 2=4.986, 5.222, 4.550, 4.224, 4.560; P<0.05) . Conclusions:The application of the flipped classroom teaching mode in the nursing teaching of Gastroenterology Department helps nursing students to master nursing theory and professional skills and improve the quality of teaching.

Objective: To investigate the forecasting value of serum fibroblast growth factor 23(FGF23) for major adverse cardiovascular adverse events (MACE) after percutaneous coronary intervention (PCI) in acute coronary syndrome (ACS). Methods: One hundred and five patients with ACS who underwent PCI in the First People′s Hospital of Tianmen City from June 2017 to June 2019 were enrolled. According to the happening of a MACE event occurs, the patients were divided into the MACE group (32 cases) and the non-MACE group (32 cases). The differences of general data, ultrasound indicators and biochemical indicators of patients between the two groups were compared. Logistic regression analysis was used to analyze independent risk factors for MACE after PCI in patients with ACS. Receiver operating characteristic (ROC) curve analysis was used to predict the predictive value of postoperative MACE in patients with ACS. Results: There were no significant difference in the comparison of general data such as age and gender between the two groups (P>0.05). The Global Registered Risk of Acute Coronary Events (GRACE) score in the MACE group was significantly higher than that in the non-MACE group [(119.18 ± 11.49) scores vs. (111.57 ± 9.31) scores, P<0.05]. Compared with the non-MACE group, the left ventricular end diastolic diameter (LVEDD), brain natriuretic peptide (BNP), C-reactive (CRP), and FGF23 in the MACE group were significantly increased, and the left ventricular ejection fraction (LVEF) was significantly decreased [(52.04 ± 3.43) mm vs. (48.57 ± 3.69) mm, (509.48 ± 52.08) ng/L vs. (474.68 ± 89.27) ng/L, (9.61 ± 2.06) mg/L vs. (7.85 ± 0.83) mg/L, (504.73 ± 82.27) ng/L vs. (331.99 ± 81.68) ng/L, (34.77 ± 2.93)% vs. (37.80 ± 3.62)%] (P<0.05). Logistic multivariate regression analysis showed that LVEF, CRP, and FGF23 were independent risk factors for MACE after PCI in patients with ACS (P<0.05). ROC curve analysis showed that AUC of LVEF that predicted for MACE after PCI in patients with ACS was 0.747,and AUC of CRP and FGF23 were 0.772 and 0.944. The AUC of FGF23 was significantly higher than that of LVEF and CRP (Z = 3.867, 2.698, P<0.05). Conclusions Abnormal elevation of serum FGF23 is associated with cardiovascular adverse events after PCI in patients with ACS, which can be used as a serum indicator for early assessment of poor cardiovascular outcomes in patients.

Objective:To investigate the correlation between the plasma trimethylamine oxide (TMAO) level and the disease severity in patients with acute coronary syndrome (ACS).Methods:The clinical data of 200 patients with ACS (ACS group) and 90 chest discomfort patients without obvious coronary artery disease (control group) in Department of Cardiology Medicine, the First People′s Hospital of Tianmen City, Hubei Province, from June 2018 to June 2019 were retrospectively analyzed. The plasma TMAO level were detected by high performance liquid chromatography tandem spectroscopy with stable isotope dilution. Left ventricular ejection fraction (LVEF), left ventricle diameter (LAD), left ventricular posterior wall end-systolic thickness (PWS) and left ventricular posterior wall end-diastolic thickness (LVPWT) were examined by color ultrasound. The diagnostic value of plasma TMAO for ACS was analyzed by receiver operating characteristic (ROC) curve. Correlation was analyzed by Pearson correlation analysis.Results:The TMAO, LAD, PWS and LVPWT in ACS group were significantly higher than those in control group: (6.33 ± 1.31) μmol/L vs. (3.75 ± 1.11) μmol/L, (39.63 ± 8.89) mm vs. (31.90 ± 8.79) mm, (12.88 ± 1.76) mm vs. (7.00 ± 1.27) mm and (13.45 ± 2.51) mm vs. (8.97 ± 2.00) mm, the LVEF was significantly lower than that in control group: (44.63 ± 10.00)% vs. (59.71 ± 11.58)%, and there were statistical differences ( P<0.01). ROC curve analysis result showed that when the optimal cutoff value of plasma TMAO was 4.83 μmol/L, the area under curve (AUC) was 0.942, and its sensitivity and specificity for diagnosing ACS were 87.50% and 88.89%; when the optimal cutoff value of plasma TMAO was 4.66 μmol/L, the AUC was 0.908, and its sensitivity and specificity of early diagnosis of ACS were 88.00% and 83.33%. The correlation analysis result showed that the plasma TMAO had negative correlation with LVEF in patients with ACS ( r=-0.715, P<0.01), and positive correlation with LAD, PWS and LVPWT ( r=0.715, 0.746 and 0.729; P<0.01). Conclusions:The plasma TMAO level in patients with ACS is significantly increased, which is related to the level of heart function. Plasma TMAO can be used as an indicator of early diagnosis and severity assessment of ACS.

Objective:To analyze the dimensional structure and the item characteristics of the Chinese version of the cerebral palsy quality of life questionnaire for children (CPQOL-child).Methods:Multi-dimensional and single-dimensional item response models were used. Ninety children aged 4 to 12 with cerebral palsy were evaluated using the CPQOL-child. The internal consistency was determined by analyzing the correlations among the different dimensions using a multi-dimensional response model. Dimensions were merged or split based on a one-dimensional Rasch analysis of the primary and secondary dimensions to revise the main and additional questionnaires.Results:The multi-dimensional item response model analysis found greater than 0.90 correlation among the four dimensions of social well-being and tolerance, function, participation ability and physical health, and emotional health and self-esteem, showing that they have good internal consistency and could be analyzed as the primary dimension. The correlation coefficients relating the other three dimensions were relatively low and could be analyzed as secondary dimensions. A single-dimension Rasch analysis was used to form a revised CPQOL main questionnaire consisting of 40 items, with three additional questionnaires for pain and disability impact consisting of 8 items, for access to services consisting of 6 items, and for family health consisting of 3 items. Compared with the original 65 items, the 8 items deleted were mainly about relationships between children and with siblings, providing respite services, as well as community and school services.Conclusions:Applying the Chinese version of the CPQOL-Child in Shanghai requires appropriate adjustments based on the children′s cultural background.

Objective To investigate the selective targeting ability of a novel folate-modified nanobubbles with two-fold amount of folate [(FOL)2-NBs] . Methods DSPE-PEG2000-AD-(FOL)2with two-fold of folate per DSPE-PEG2000 chain was synthesized and then tested by 1 H nuclear magnetic resonance (1H NMR) . The novel (FOL)2-NBs was prepared using the mechanical shaking method based on lipid-stabilized perfluoropropane . The bubble size was measured by Malvern laser particle size analyzer and the contrast enhancement ability was also detected with imaging machine using a self-made agarose mold . The experiment of selective targeting ability was also carried out in human breast cancer MCF-7 cell with over-expression of folate receptor ( FR) using fluorescence activated cell sorting ( FACS) . Results The result of 1H NMR proved that DSPE-PEG2000-AD-( FOL )2was successfully synthesized ,and the purity reached up to 90% . The novel prepared ( FOL) 2-NBs showed superior contrast enhancement ability with a particle size of ( 286 .87 ± 22 .96) nm . Compared with the conventional NBs ,the novel ( FOL) 2-NBs exhibited improved selective cellular targeting ability proven by FACS . Conclusions A novel nanobubble with improved selective targeting ability is successfully prepared and shows great potential in extravascular imaging and curation in FR overexpressed tumors .

Objective To explore the clinical characteristics,prevention,and treatment of acute liver injury (AHI) induced by intravenous amiodarone.Methods The medical records data of 5 patients with AHI caused by intravenous amiodarone in our hospital were collected and retrospectively analyzed,and in the meantime,case reports on intravenous amiodarone-induced AHI in PubMed,CNKI and Wanfang Data were searched.The clinical data of 5 patients in our hospital and case reports from the literature were summarized and the clinical characteristics of AHI induced by intravenous amiodarone were analyzed.Results The 5 patients with AHI induced by intravenous amiodarone in our hospital included 3 males and 2 females with ages of 22-70 years.The total doses of amiodarone were 450-750 mg,incubation periods (the period from drug use to AHI occurrence) were 24-48 h,and the types of liver injury were all hepatocyte type,of which 2 patients' were liver failure.A total of 59 patients with amiodarone-induced AHI were collected (5 in our hospital and 54 from the literature),including 40 males (67.8％) and 19 females (32.2％) with ages from 1 year and 10 months to 93 years and a median age of 69 (58,75) years.In these 59 patients,the incubation periods ranged from 6 hours to 8 days and the median period was 2 (1,3) days,and that of 55 patients (93.2％) were less than or equal to 3 days.The incubation periods of 17 patients with liver failure and 42 patients with non-liver failure were 1 (1,2) days and 2 (1,3) days respectively,and the difference was statistically significant (P =0.033).The peak values of ALT,which were recorded in 55 patients,ranged from 178 to 8 400 U/L,and the median value was 2 418 (922,4 250) U/L.The peak values of AST,which were recorded in 56 patients,ranged from 165 to 17 471 U/L,and the median value was 2 658 (1 205,7 250)U/L.The AST peak values of 16 patients with liver failure and 42 patients with non-liver failure were 6 195 (3 370,6 850) U/L and 2 383 (1 115,5 040) U/L,respectively,and the difference was statistically significant (P =0.032).Among the 59 AHI patients,44 patients' liver function returned to normal,4 patients' liver function improved,and 11 patients died,of whom 9 (81.8％) developed liver failure.Conclusion AHI induced by intravenous amiodarone is an acute onset and severe disease with a short incubation period,and should be monitored timely.

Objective To explore the clinical characteristics,prevention,and treatment of acute liver injury (AHI) induced by intravenous amiodarone.Methods The medical records data of 5 patients with AHI caused by intravenous amiodarone in our hospital were collected and retrospectively analyzed,and in the meantime,case reports on intravenous amiodarone-induced AHI in PubMed,CNKI and Wanfang Data were searched.The clinical data of 5 patients in our hospital and case reports from the literature were summarized and the clinical characteristics of AHI induced by intravenous amiodarone were analyzed.Results The 5 patients with AHI induced by intravenous amiodarone in our hospital included 3 males and 2 females with ages of 22-70 years.The total doses of amiodarone were 450-750 mg,incubation periods (the period from drug use to AHI occurrence) were 24-48 h,and the types of liver injury were all hepatocyte type,of which 2 patients' were liver failure.A total of 59 patients with amiodarone-induced AHI were collected (5 in our hospital and 54 from the literature),including 40 males (67.8％) and 19 females (32.2％) with ages from 1 year and 10 months to 93 years and a median age of 69 (58,75) years.In these 59 patients,the incubation periods ranged from 6 hours to 8 days and the median period was 2 (1,3) days,and that of 55 patients (93.2％) were less than or equal to 3 days.The incubation periods of 17 patients with liver failure and 42 patients with non-liver failure were 1 (1,2) days and 2 (1,3) days respectively,and the difference was statistically significant (P =0.033).The peak values of ALT,which were recorded in 55 patients,ranged from 178 to 8 400 U/L,and the median value was 2 418 (922,4 250) U/L.The peak values of AST,which were recorded in 56 patients,ranged from 165 to 17 471 U/L,and the median value was 2 658 (1 205,7 250)U/L.The AST peak values of 16 patients with liver failure and 42 patients with non-liver failure were 6 195 (3 370,6 850) U/L and 2 383 (1 115,5 040) U/L,respectively,and the difference was statistically significant (P =0.032).Among the 59 AHI patients,44 patients' liver function returned to normal,4 patients' liver function improved,and 11 patients died,of whom 9 (81.8％) developed liver failure.Conclusion AHI induced by intravenous amiodarone is an acute onset and severe disease with a short incubation period,and should be monitored timely.

OBJECTIVE: To explore the current situation of work stress,mental resilience and mental health in the local policemen,and to explore the association among these three variables. METHODS: A total of 260 local policemen in 3 districts of a city in Hebei Province were selected as the study subjects using cluster sampling method. The Chinese version of Perceived Stress Scale,Connor-Davidson Resilience Scale and General Health Questionnaire were used to evaluate their work stress,mental resilience and mental health. RESULTS: There was a negative correlation between work stress and mental resilience( P < 0. 01). Positive correlation was found between work stress and mental health( P < 0. 01). The mental resilience was negatively correlated with mental health( P < 0. 01). The mental resilience could negatively predict mental health( β =-0. 31,P < 0. 01). Work stress could positively predict mental health( β = 0. 56,P < 0. 01). Work stress had a negative prediction on mental resilience( β =-0. 47,P < 0. 01). Mental resilience played a partial mediating role between work stress and mental health( β = 0. 41,P < 0. 01). The mediating effect accounted for 26. 0% of the total effect. CONCLUSION: Mental resilience plays a partial mediating role in influencing work stress on mental health. Reducing work stress and increasing resilience play an important protective role in mental health of local policemen.