Objective:To investigate the trends in insulin resistance, as represented by the triglyceride-glucose index (TyG index), among Chinese adult residents from 2010 to 2018 and to explore influencing factors.Methods:China Chronic Disease and Risk Factor Surveillance was conducted in 2010, 2013, and 2018, using a multi-stage stratified cluster random sampling method across all 31 provinces (autonomous regions and municipalities) in China. This study sampled 98 712 adults in 2010, 176 534 adults in 2013, and 184 876 adults in 2018, all aged ≥18 years, totaling 406 933 participants. Individuals with a TyG index > P75 were classified as having insulin resistance. The mean TyG index and the prevalence of insulin resistance were calculated for different years, sexes, age groups, provinces (autonomous regions and municipalities), and subgroups for 2018. Linear and logistic regression models were used to test trends in means and rates over time, and multivariate logistic regression models were conducted to analyze potential factors associated with insulin resistance. All analyses were adjusted for complex sampling weights based on the study design. Results:From 2010 to 2018, the mean TyG index among Chinese adults increased from 8.44±0.63 to 8.70±0.64, with significant upward trends observed across different age groups, sexes, and urban-rural residencies (all P<0.001). The mean TyG index was higher among males, urban residents, and those aged 45-59. There were significant differences in the mean TyG indices and prevalence of insulin resistance across provinces (autonomous regions and municipalities) (all P<0.05). Higher insulin resistance prevalence was independently associated with being male, aged ≥45 years, living in urban areas, excessive alcohol consumption, and insufficient physical activity (all P<0.05). Conclusions:From 2010 to 2018, the level of insulin resistance, as indicated by the TyG index, showed an increasing trend among Chinese adults. Males, individuals aged ≥45 years, urban residents, and individuals with unhealthy lifestyles such as excessive alcohol consumption or insufficient physical activity should be the focus of efforts to prevent and control metabolic diseases related to insulin resistance.

Objective:To investigate the trends in insulin resistance, as represented by the triglyceride-glucose index (TyG index), among Chinese adult residents from 2010 to 2018 and to explore influencing factors.Methods:China Chronic Disease and Risk Factor Surveillance was conducted in 2010, 2013, and 2018, using a multi-stage stratified cluster random sampling method across all 31 provinces (autonomous regions and municipalities) in China. This study sampled 98 712 adults in 2010, 176 534 adults in 2013, and 184 876 adults in 2018, all aged ≥18 years, totaling 406 933 participants. Individuals with a TyG index > P75 were classified as having insulin resistance. The mean TyG index and the prevalence of insulin resistance were calculated for different years, sexes, age groups, provinces (autonomous regions and municipalities), and subgroups for 2018. Linear and logistic regression models were used to test trends in means and rates over time, and multivariate logistic regression models were conducted to analyze potential factors associated with insulin resistance. All analyses were adjusted for complex sampling weights based on the study design. Results:From 2010 to 2018, the mean TyG index among Chinese adults increased from 8.44±0.63 to 8.70±0.64, with significant upward trends observed across different age groups, sexes, and urban-rural residencies (all P<0.001). The mean TyG index was higher among males, urban residents, and those aged 45-59. There were significant differences in the mean TyG indices and prevalence of insulin resistance across provinces (autonomous regions and municipalities) (all P<0.05). Higher insulin resistance prevalence was independently associated with being male, aged ≥45 years, living in urban areas, excessive alcohol consumption, and insufficient physical activity (all P<0.05). Conclusions:From 2010 to 2018, the level of insulin resistance, as indicated by the TyG index, showed an increasing trend among Chinese adults. Males, individuals aged ≥45 years, urban residents, and individuals with unhealthy lifestyles such as excessive alcohol consumption or insufficient physical activity should be the focus of efforts to prevent and control metabolic diseases related to insulin resistance.

The overall health condition of patients significantly affects the diagnosis,treatment,and prognosis of endodontic diseases.A systemic consideration of the patient's overall health along with oral conditions holds the utmost importance in determining the necessity and feasibility of endodontic therapy,as well as selecting appropriate therapeutic approaches.This expert consensus is a collaborative effort by specialists from endodontics and clinical physicians across the nation based on the current clinical evidence,aiming to provide general guidance on clinical procedures,improve patient safety and enhance clinical outcomes of endodontic therapy in patients with compromised overall health.

Objective:To investigate the occurrence of human papillomavirus (HPV) single and multiple infections in different cervical lesions, and to analyze the distribution of HPV types in patients with single infection and the change of viral load before and after treatment.Methods:A total of 4 783 HPV-DNA-positive cases who were detected by cervical exfoliated cells HPV-DNA testing from May 2017 to March 2019 in Shanxi Provincial People's Hospital were retrospectively analyzed, of which 3 728 cases met the criteria and were included in this study. Fluorescence quantitative polymerase chain reaction (PCR) was used to determine HPV genotype and viral load, and liquid-based thin-layer cytology (TCT) test and colposcopic histopathological diagnosis were performed. According to the histopathological results, the patients were divided into chronic cervicitis+cervical intraepithelial neoplasia (CIN) Ⅰ group, CIN Ⅱ+CIN Ⅲ group and cervical cancer group.Results:A total of 3 364 cases had HPV single infection, of which chronic cervicitis+CIN Ⅰ accounted for 78.27% (2 633/3 364), CIN Ⅱ+CIN Ⅲ accounted for 18.73% (630/3 364), and cervical cancer accounted for 3.00% (101/3 364); 364 cases had HPV multiple infections, of which chronic cervicitis+CIN Ⅰ accounted for 51.65% (188/364), CIN Ⅱ+CIN Ⅲ accounted for 42.58% (155/364), and cervical cancer accounted for 5.77% (21/364). The difference in the proportion of cervical lesions with different pathological grades in HPV single infection and multiple infections was statistically significant ( χ2 = 127.21, P < 0.01). The top four HPV single infection genotypes in chronic cervicitis+CINⅠ group and CINⅡ+CINⅢ group were type 16, 52, 58 and 53, and their proportions were 17.05% (449/2 633), 12.91% (340/2 633), 9.08% (239/2 633) and 8.89% (234/2 633) in chronic cervicitis+CINⅠ group, and 32.22% (203/630), 10.32% (65/630), 8.41% (53/630) and 5.87% (37/630) in CINⅡ+CINⅢ group. In the cervical cancer group, the top two HPV single infection genotypes were type 16 and 18, and their proportions were 81.19% (82/101) and 6.93% (7/101). The viral load of 120 patients with HPV infection was 4.89±1.14 before treatment and 2.86±1.63 after treatment, and the difference was statistically significant ( t = 13.260, P < 0.01). Conclusions:HPV multiple infections are more likely to aggravate the degree of cervical lesions than single infection. Common HPV infection subtypes in different cervical lesions include type 16, 52, 58, 53 and 18.

Objective To study relationships between myocardial injury and the levels of serum complement C3, C4 and C5b-9 in patients with acute coronary syndrome (ACS). Methods A retrospectively analysis was conducted. 170 ACS patients [including 110 cases of ST-segment elevation myocardial infarction (STEMI) and 60 cases of non-ST-segment elevation acute coronary syndrome (NSTE-ACS)] with ischemic chest pain or chest discomfort onset within the prior 12 hours admitted to the cardiology department of Tianjin Union Medicine Center from January 2014 to July 2016 were enrolled. Thirty-six healthy cases were enrolled as control during the same time. The levels of serum complement C3, C4 and C5b-9 on 1, 3 and 7 days after admission and myocardial function indicators were analyzed. Major adverse cardiovascular events (MACE) and readmission rate were analyzed after 1 year follow-up. The correlation between serum complement levels and myocardial function indicators was analyzed by Pearson correlation analysis. Results ① The levels of serum C3, C4 and C5b-9 on the first day in NSTE-ACS group and STEMI group were significantly higher than control group [C3 (g/L): 1.04±0.33, 1.26±0.35 vs. 0.39±0.21, C4 (g/L): 0.31±0.14, 0.33±0.10 vs. 0.19±0.07, C5b-9 (g/L): 575.46±197.26, 659.26±160.77 vs. 501.40±141.51, all P < 0.05]. There were no changes of serum C3, C4 in NSTE-ACS group, but C5b-9 decreased after a peak (g/L: 700.63±218.42) at 3 days. Serum complements in STEMI group reached peak on the third day [C3 (g/L): 1.37±0.33, C4 (g/L): 0.42±0.12, C5b-9 (g/L): 754.72±136.22]. The levels of serum C4 and C5b-9 in STEMI group were higher than NSTE-ACS group on the third and seventh day. ② The levels of troponin T (TnT), creatine kinase-MB (CK-MB), solution intercellular adhesion molecule-1 (sICAM-1), global registry of acute coronary events (GRACE) scores and percutaneous coronary intervention (PCI) numbers in STEMI group were significantly higher than those in the NSTE-ACS group, which were as opposite as left ventricular ejection fraction (LVEF). However, there were no significant differences in levels of serum N-terminal pro-brain nitric peptide (NT-proBNP), Fibrinogen (Fib), readmission rate and incidence of MACE between STEMI and NSTE-ACS groups. ③ According to GRACE, patients with ACS were divided into low risk group (≤ 108 scores, 26 cases), intermediate risk group (109-140 scores, 61 cases) and highest group (> 140 scores, 83 cases). TnT and sICAM-1 in intermediate risk group were significantly increased as compared with low risk group. Levels of TnT, sICAM-1, C3, C4 and C5b-9 in the highest group were significantly higher than the low and intermediate risk groups, however the lowest LVEF was found in the highest group. ④ It was shown by Pearson correlation analyses that levels of serum C3, C4, C5b-9 were positively correlated with TnT (r value was 0.481, 0.367, 0.292, respectively, all P <0.01), sICAM-1 (r value was 0.298, 0.249, 0.365, respectively, all P < 0.01), but negatively correlated with LVEF (r value was -0.384, -0.260, -0.200, respectively, all P < 0.01). In addition sICAM-1 positively correlated with TnT (r = 0.536, P = 0.000), but negatively correlated with LVEF (r = -0.341, P = 0.001). Conclusions Serum complements activation was found in the acute phase of ACS patients. Serum complement C3, C4 and C5b-9 are involved in the process of myocardial injury, and may reflect severity of myocardial injury and cardiac dysfunction.

Objective:To establish a trace chromogenic substrate method for the determination of anti-FIIαactivity in compound heparin sodium cream .Methods: The anti-FIIαactivity in compound heparin sodium cream was determined by a trace chromogenic substrate method according to the completely random design of experiment based on the amount reaction principle of 4*4 parallel lines in the biological test statistics method .Results:The calibration curve was linear within the range of 0.005 04 IU· ml-1-0.021 IU· ml-1(r=0.992).The average recovery was 101.6% with RSD of 2.76% (n=9).Conclusion: The method is accurate, reliable and reproducible , and can be used for evaluating the quality of compound heparin sodium cream .

Objective To explore the training method early, in order to make elderly to adopt the pipeline and reduce the incidence of postoperative unplanned extubation ( UEX). Methods A total of 216 patients who would have general anesthesia operation during July 2013 to July 2014 were divided into control group (n =106) and experimental group (n = 110). The elderly underwent routine education method and postoperative key points in the control group while elderly received preoperative pipeline simulation training according to all postoperative pipeline, its position of skin by patients touching each pipeline position, texture, pull strength of pipeline guided by nurses and was familiar with pipeline′s running position, effects and adverse effects in the experimental group. We compared the recognition of postoperative pipeline, the incidence rate of UEX, complications and nursing satisfaction. Results The pipeline recognition of experimental group was higher than that of control group, and the incidence rate declined 8. 5% , complications dropped off 11. 28% and nursing satisfaction climbed 17. 81% in the control group. Conclusions The application of preoperative simulation training for pipeline greatly improves patient recognition of the pipe, the awareness of pipeline protection, which will help nurses educate patients targeted and carry out perioperative health education. This method has a broad prospects for elderly community.

Objective To investigate the influence of experience teaching used in clinical nursing on the comfort feeling of bedridden patients .Methods Totals of 46 nurses from four wards of cardiology were applied the experiential education .Totals of 228 cardiovascular patients met the inclusion criteria were recruited from February to December 2011.Totals of 115 patients, from July to December 2011, were in the intervention group, while 113 patients, from February to June 2011, were in the control group.General information questionnaire and the comfortable status scale were used .Results In the control group , the scores of each dimension of physical comfort , psychological comfort , social comfort , comfortable environment and the total score were (13.04 ±2.512), (20.27 ±5.184), (19.92 ±2.991), (18.58 ±3.017) and (71.81 ±9.570), respectively.Those scores in the intervention group were (15.76 ±2.258), (29.87 ±3.582), (23.21 ± 1.935), (20.37 ±1.903) and (89.21 ±7.283),respectively.There were significant differences between the two groups (t=8.577, 16.298, 9.872, 5.367, 15.461, respectively;P<0.05).Conclusions It is feasible and effective for the hospital to apply experience teaching .

Objective To investigate the application of the risk management information system in the nursing management .Methods On the basis of our large-scale integrated nursing information system , the nursing department and information center of nursing risk management information system was developed . Results The rates of nursing evaluation , admission assessment , pressure sores risk assessment , fall risk assessment, catheter slippage assessment and self-care capacity assessment were 93.0%, 96.0%, 95.0%, 98.0%, 95.0%and 96.0%, which were all significantly higher than 78.0%, 75.0%, 71.0%, 83.0%, 80.0%and 75.0% before the intervention (χ2 =9.074, 15.686, 10.286, 13.885, 20.411, 17.786, respectively;P<0.05).The scores of work satisfaction of nurses and the patients satisfaction were (95.14 ± 0.46) and (96.17 ±2.03), which were significantly higher than (82.13 ±1.78) and (84.10 ±4.79) before the intervention (t=79.92, 23.20, respectively;P<0.05).Conclusions Nursing information system applied in risk management can ensure patient safety and improve the quality of nursing management .

Multidrug resistance (MDR) is one of the main causes leading to the failure in cancer treatment. Differential proteins between esophageal squamous cell carcinoma (ESCC) cell line EC9706 and its cisdiamminedichloroplatinum (CDDP)-resistant subline EC9706/CDDP revealed by quantitative analysis may provide deeper insights into the molecular mechanisms of MDR implicated in ESCC. EC9706/CDDP was generated by exposure of its parental sensitive EC9706 to a step-wise increase of CDDP concentration during EC9706 cultivation. The stable isotope labeling with amino acids in cell culture (SILAC) was used to label EC9706 and EC9706/CDDP with heavy and light medium, separately. Mixed peptides derived from EC9706 and EC9706/CDDP were analyzed by high performance liquid chromatography-electrospray ionization-mass spectrometry (HPLC-ESI-MS/MS) and subsequently subjected to bioinformatics analysis to identify differential proteins between EC9706 and EC9706/CDDP. Compared to parental EC9706, EC9706/CDDP manifested phenotypes of slow proliferation, cell pleomorphology, atypia and increased resistant-index 3.23. Seventy-four differential proteins identified in the present study belongs to various families with multiple functions, such as cytoskeleton (20%), energy metabolism (11%), transcription regulation and DNA repair (11%), redox homeostasis (9.5%), protein biosynthesis and mRNA processing (12%), ribosome constituent (8.1%), molecular chaperone (8.1%), immunity/inflammation (5.4%), intracellular transport (5.4%) and nucleosome assembly (2.7%), which indicated that development of MDR is a complicated process involving dysregulation of multiple molecules and pathways. The data is of great value for in-depth elucidation of molecular mechanisms of the MDR implicated in ESCC and may represent potential molecular targets for future therapeutic development.