Objective:To explore the risk factors of deep vein thrombosis (DVT) in hospitalized rehabilitation patients.Method:Clinical data of 1 130 patients, 737 males and 393 females with the mean age of 63.0 (54.0, 73.0) years, admitted in the Department of Rehabilitation Medicine of the Second Hospital of Jiaxing from August 2021 to September 2022 were retrospectively analyzed. Patient underwent vascular color ultrasound examination, DVT was detected in 194 cases (DVT group) and not detected in 936 cases (control group). The general clinical data, venous thromboembolism (VTE) risk stratification and traditional VTE risk factors of patients were documented. The risk factors of DVT formation were analyzed with multivariate logistic regression.Results:Compared with the control group, the DVT group had a higher proportion of patients with older age, longer length of hospital stay, and positive D-dimer (all P<0.001). The proportion of patients with high risk of VTE in the DVT group was 49.5% (96/194), which was higher than that in the control group (27.0% (253/936), P<0.01). The proportion of patients with age≥70 years, previous venous thromboembolism, and history of recent (≤1 month) trauma or surgery in the DVT group was significantly higher than that in the control group (all P<0.001). The proportion of patients with primary diagnoses of quadriplegia, hemiplegia or other motor disorders in the DVT group was significantly higher than that in the control group ( P<0.01). Multivariate logistic regression analysis showed that old age ( OR=1.014, 95% CI: 1.012-1.016), length of hospital stay ( OR=1.001, 95% CI: 1.001-1.002), positive D-dimer ( OR=2.508, 95% CI: 2.368-2.655), high risk of VTE ( OR=1.178, 95% CI: 1.10-1.250), quadriplegia ( OR=2.776, 95% CI: 2.552-3.021), hemiplegia ( OR=3.232, 95% CI: 2.996-3.488), motor disorders ( OR=2.308, 95% CI: 2.110-2.525), paraplegia ( OR=1.878, 95% CI: 1.622-2.175), previous venous thromboembolism ( OR=1.385, 95% CI: 1.314-1.460), history of recent (≤1 month) trauma or surgery ( OR=1.987, 95% CI: 1.886-2.093) (all P<0.001) were independent risk factors for DVT in rehabilitation inpatients. Conclusion:Age, length of hospital stay, primary diagnosis of quadriplegia, hemiplegia, paraplegia or other motor disorders, positive D-dimer, high risk of VTE, previous venous thromboembolism, and history of recent trauma or surgery are independent risk factors for DVT in rehabilitation specialty inpatients.

Hypoxemia is a common complication of pneumonia, asthma, and bronchopulmonary dysplasia in children.Rapid identification of hypoxemia is of great significance for the disposal and management of critical children.Pulse oximetry is recognized by the World Health Organization as the best way to monitor hypoxemia in children, and it can monitor pulse oxygen saturation noninvasively and continuously.Based on the related literature at home and abroad, combined with the clinical needs of pediatrics, the " Expert consensus on clinical application of pulse oximetry in children" is formulated to improve the understanding of pediatricians and nurses on the application in pediatric clinical practice, principle, operation techniques, and limitations of pulse oximetry.

Objective:To investigate the knowledge, attitudes, and practices (KAP) of pulse oximetry among pediatric healthcare providers in China and analyze the factor influencing the KAP.Methods:A self-developed questionnaire was used for an online research on the KAP of 11 849 pediatric healthcare providers from 31 provinces, autonomous regions, and municipalities of China from March 11 to 14, 2022.The factors influencing the KAP of pulse oximetry among pediatric healthcare providers were examined by Logistic regression. Results:The scores of KAP, of pulse oximetry were 5.57±0.96, 11.24±1.25 and 11.19±4.54, respectively.The corresponding scoring rates were 69.61%, 74.95%, and 55.99%, respectively. Logistic regression results showed that the gender and working years of pediatric healthcare providers, the region they were located, and whether their medical institution was equipped with pulse oximeters were the main factors affecting the knowledge score (all P<0.05). Main factors influencing the attitude score of pediatric healthcare providers included their knowledge score, gender, educational background, working years, region, medical institution level, and whether the medical institution was equipped with pulse oximeters (all P<0.05). For the practice score, the main influencing factors were the knowledge score, gender, age, and whether the medi-cal institution was equipped with pulse oximeters (all P<0.05). Conclusions:Chinese pediatric healthcare providers need to further improve their knowledge about and attitudes towards pulse oximetry.Pulse oximeters are evidently under-used.It is urgent to formulate policies or guidelines, strengthen education and training, improve knowledge and attitudes, equip more institutions with pulse oximeters, and popularize their application in medical institutions.

Objective Based on the Kabat-Zinn's mindfulness decompression therapy and Teasdale's mindfulness cognitive therapy,and using the solution-focused approach as the frame structure,we establish comprehensive,standard mindfulness interventions scheme of domiciliary patients with chronic obstructive pulmonary disease,which can provide the basis for the development of the community and residential care.Methods Twenty-six experts were selected as the target of the study and two rounds of correspondence were used to establish the final mindfulness intervention plan of the domiciliary patients with chronic obstructive pulmonary disease.Meanwhile,the reliability and representativeness of the consultation are tested by using the coordination degree,positive coefficient and authoritative coefficient of expert opinions.Results The positive coefficient of the two round correspondence experts were 88.46%(23/26)and 100.00%(23/23),and the expert authority coefficient was 0.90 and 0.91.The variation coefficient of the indicators after two rounds of expert consultation was 0.04-0.14,the coordination coefficient of experts was 0.32(P＜0.01)and 0.59(P＜0.01)respectively.The final construct of domiciliary patients of chronic obstructive pulmonary disease with the intervention programme consists of 5 steps,25 entries,which was suitable for the positive reading intervention scheme.Conclusions The results show that experts enquiry for representative and high credibility,and the mindfulness intervention plan of domiciliary patients with chronic obstructive pulmonary disease is scientific and practical.

Objective To explore the effect of applying syndrome differentiation and medicated diet in patients with liver cirrhosis as cites based on"Gu Ben Kai Qu"theory of TCM. Methods Seventy patients of liver cirrhosis as cites were randomly divided into observation group (35 cases) and control group(35 cases).The control group was cared with care routine of liver cirrhosis as cites,The observation group was based on care routine traditional nursing and implementation of dialectical medicalated meal which based on "Gu Ben Kai Qu" theory of TCM. The two groups of patients were used to assess the efficacy of liver cirrhosis as cites,urine volume,abdominal circumference,weight,TCM syndrome scale of liver disease. Results The urine volume on the 7th day, the 14th day, 2 weeks after discharge,the weight and the abdominal circumference on the 2 weeks after discharge from the patients in the observation group were respectively(1.90±0.52)L,(2.09±0.56)L,(2.02±0.35)L,(59.36±8.19)kg,(89.56±7.24)cm,while they were(1.63±0.36)L,(1.79±0.40)L,(1.82±0.38)L,(63.33±8.21)kg,(93.57±7.56)cm in the control group,the difference between the two groups was statistically significant (F=6.083, 6.484, 5.030, 4.108, 5.144,all P<0.05). The efficacy of liver cirrhosis as cites from the patients in the observation group were cured 40.0%(14/35),improved 42.9%(15/35),not cured 17.1%(6/35),while they were cured 22.9%(8/35),improved 40.0%(14/35),not cured 37.1%(13/35),the difference between the two groups was statistically significant (Z=2.012,P<0.05). The efficacy of TCM Syndromes on liver disease from the patients in the observation group were respectively[significant effect 37.1%(13/35),valid 45.7% (16/35),invalid 17.2%(6/35)],[significant effect 60.0%(21/35),valid 28.6%(10/35),invalid 11.4%(4/35)], while they were respectively [significant effect 20.0%(7/35), valid 42.9%(15/35), invalid 37.1%(13/35)], [significant effect 40.0%(14/35),valid 25.7%(9/35),invalid 34.3%(12/35)],the difference between the two groups was statistically significant(Z=2.065,2.104,all P<0.05). Conclusions Based on"Gu Ben Kai Qu"theory of TCM,the implementation of dialectical diet can effectively improve efficacy of liver cirrhosis as cites, reduction rate of TCM symptoms scale, urine volume,reduce the weight,shrink down the abdominal circumference,worthy of clinical application.

AIM To investigate the anti-neuroinflammation effects of 4-hydroxybenzyl aldehyde (4-HBAL) from Gastrodia elata Blume on acute cerebral ischemic injury in rats and its nechanism of action.METHODS The rat model of acute cerebral ischemic injury was induced by injecting arachidonic acid via intracarotid artery.Brain tissue samples were taken from the animals 3 h after the model of acute cerebral ischemic injury.Tumor necrosis factor-alpha (TNF-α) and interleukin-1 beta (IL-1β) were detected in brain tissue to evaluate the effects of 4-HBAL in vivo.Lipopolysaccharid (LPS)-induced activation of BV-2 microglia cells model was used to explore the anti-neuroinflammation mechanism of 4-HBAL.RESULTS The experimental results showed that 4-HBAL had a significant protective effect on acute cerebral ischemic injury.It could significandy decrease the contents of tumor necrosis factor-alpha (TNF-α) and interleukin-1 beta (IL-1β),and obviously inhibit the production of nitric oxide (NO),prostaglandin E2 (PGE2) and TNF-α in LPS-stimulated BV-2 cell,and increase the production of interleukin-10 (IL-10) and transforming growth factors-β (TGF-β) in BV-2 cell.CONCLUSION The mechanism of 4-HBAL may be related to the suppression of the excessive activation of microglia after cerebral ischemia and the promotion of the transformation of microglia into anti-inflammatory phenotype.

Objective To study the expression and the clinical significance of glyican-3 (GPC3)in hepatocellular carcinoma (HCC)tissues.Methods Immunohistochemical method was performed to evaluate the expression of GPC3 in 54 cases of HCC tissues,46 cases of para-carcinoma tissues,22 cases of cirrhosis tissues,12 cases of normal liver tissues,the correlation between expression levels of GPC3 and clinicopathologic factors was analyzed.Results GPC3 protein was not expressed in normal livers tissues,the levels of GPC3 (7.39±3.64)and the positive rate (81.48%)in HCC tissues were significantly higher than para-carcinoma tissues (1.15±0.99,13.04%),cirrhosis tissues (0.32±0.56,4.54%),the difference was sta-tistically significant (P <0.05);with the increase of clinical stage ofHCC,the levels of GPC3 were increased,stage Ⅲ/Ⅳ(10.05±3.59)compared with stage Ⅰ (4.31±3.41),stage Ⅱ (7.14±3.63),and the difference was statistically signifi-cant (P <0.05).The positive rate of GPC3 was also increased(stage Ⅰ 69.23%,stage Ⅱ 81.81%,stage Ⅲ/Ⅳ 89.47%) and the difference was not statistically significant (P >0.05);the positive rate in HCC tissues was independent of sex,age, serum HBsAg,alpha-fetoprotein (AFP),tumor diameter,metastasis,clinical stage (P >0.05),only related to the cirrhosis (P <0.05).The high expression rate of GPC3 in HCC tissues was correlated with AFP,tumor diameter,cirrhosis,metasta-sis,clinical stage (P <0.05).Conclusion GPC3 has important clinical significance in the diagnosis of HCC,the expression level of GPC3 associated with the progression of HCC.

OBJECTIVE: To evaluate the efficacy and safety of the sublingual immunotherapy with dermatophagoides farinae drops on patients with allergic rhinitis. METHOD: One hundred and twelve cases were collected from adult patients with dust-mite allergic rhinitis of our hospital who could adhere to treatment and regular follow-up. These patients were randomly allocated to receive either sublingual immunotherapy (SLIT group, n = 56) or medical treatment (Control group, n = 56). To evaluate the clinical efficacy by side effects which were registered, symptom and medication scores which were assessed and rhinoconjunctivitis quality of life questionnaire (RQLQ) which was completed in the baseline and two years after treatment. RESULT: Dropouts after the 2 years' treatment were 5 of SLIT group and 4 of Control group respectively. SLIT group induced the significant reductions on both the symptom scores (7.81 ± 3.14 to 3.89 ± 2.01, P < 0.0 1) and the medication scores (2.86 ± 0.75 to 0.44 ± 0.06, P < 0.01). Meanwhile, Control group induced the reductions on both the symptom scores (8.01 ± 3.32 to 5.20 ± 2.43) and the medication scores (2.95 ± 0.80 to 1.75 ± 0.40). There were significant differences (P< 0. 01) in symptom and medication scores between the two groups after 2-year treatment. The patients in SLIT group had fewer symptoms and lower intake of medication. There were statistically significant differences in RQLQ between SLIT group [19 (15,22)] and Control group [36 (26,47)] after two years treatment (Z = -5. 21, P < 0.01). SLIT group also had significant improvement in RQLQ (Z = -6.10, P < 0.01) between before and after the treatment. There were 4 patients who showed adverse reactions in SLIT group (3 occurred in increment period, and 1 occurred in the maintenance period). The incidence of adverse reactions was 7.14%. No severe systemic side effects were registered. CONCLUSION SLIT with standardized dermatophagoides farinae drops in China is safe and effective to patients with allergic rhinitis.
Administration, Sublingual ; Adult ; Animals ; Antigens, Dermatophagoides ; immunology ; China ; Dermatophagoides farinae ; Humans ; Quality of Life ; Rhinitis, Allergic ; drug therapy ; Sublingual Immunotherapy ; Treatment Outcome

OBJECTIVETo assess the anxiolytic effect of Anshenfang granules (ASF), a compound traditional Chinese medicinal preparation, on anxiety in rats and the mechanism of its actions.

METHODSMale Wistar rats with anxiety induced by chronic emotional stress were randomized to receive treatments with diazepam or ASF at high, medium or low doses. The behavioral changes of the rats were evaluated using plus-maze test, after which the rats in normal control group, model group, and medium AFS dose group were sacrificed to measure the hippocampal contents of glutamic acid and γ-aminobutyric acid (GABA) using high-performance liquid chromatography (HPLC); immunohistochemistry was employed to evaluate the expressions of GABAA receptor and N-methyl-D-aspartate receptor 1 (NMDAR1).

RESULTSPlus-maze test showed obvious anxiety behaviors in the model group, which were significantly meliorated by diazepam and ASF, especially at the medium dose. Hippocampal glutamate levels increased and GABA decreased significantly in the model group, and such changes were obviously attenuated, by comparable amplitudes, by treatments with diazepam and medium-dose ASF. The model group showed significantly diminished GABAA receptor-positive cells and increased NMDAR1-positive cells, which were improved by diazepam and ASF at the medium dose.

CONCLUSIONASF produces strong anxiolytic effect in rats by increasing the content of GABA in the brain, enhancing GABAA receptor expression, reducing glutamic acid content, and decreasing NMDAR1 expression.

Animals ; Anti-Anxiety Agents ; pharmacology ; Drugs, Chinese Herbal ; pharmacology ; Glutamic Acid ; metabolism ; Hippocampus ; metabolism ; Male ; Rats ; Rats, Wistar ; Receptors, GABA ; metabolism ; Receptors, N-Methyl-D-Aspartate ; metabolism ; gamma-Aminobutyric Acid ; metabolism

Objective To study the relationship between ATP level changes detected by hepatic 31P MRS with the pathologic changes of liver in rabbits and to investigate the diagnostic value of ATP level changes in acute hepatic radiation injury. Methods A total of 30 rabbits received different radiation doses ( ranging from 5,10,20 Gy) to establish acute hepatic injury models. Blood hepatic function tests, 31P MRS and pathological examinations were carried out 24 h after irradiation The degree of injury was evaluated according to hepatocyte pathology. Ten healthy rabbits served as controls. The MR examination was performed on a 1.5 T imager using a 1H-31P surface coil with 2D chemical shift imaging technique. The relative quantities of phosphomonoesters (PME), phosphodiesters (PDE), inorganic phosphate (Pi) and adenosine triphosphate (ATP) were measured. Analysis of variance was used to compare the results of 31P MRS and histopathology under various acute hepatic radiation injuries, and SNK was used further to conduct comparison between each other if there was significant difference. Results The ATP relative quantification in control( n= 10), mild ( n = 12), moderate ( n = 11 ), and severe ( n = 7 ) injury groups according to pathological grading were 1.83 ± 0. 33, 1.58 ± 0. 25, 1.32 ± 0. 07 and 1.02 ± 0. 18, with significant differences among them (F =22. 878 ,P ＜0. 01 ), and it decreased progressively with the increased degree of injury. The PDE index showed no significant trend for the evaluation of hepatic radiation injury. The area under the peak of β-ATP decreased with the increased severity of radiation injury. Conclusions The relative quantification of hepatic ATP levels can reflect the pathological severity of acute hepatic radiation injury. The decreasing hepatic ATP levels may be used as biomarker of acute liver injury following radiation.