AIM: To observe the changes of corneal densitometry(CD)in patients with keratoconus after corneal cross-linking(CXL).METHODS: Retrospective study. A total of 32 patients(43 eyes)with keratoconus in Ningxia Eye Hospital from April 2020 to April 2022 were selected. Pentacam analysis system divided the cornea into three layers: anterior 120 μm, middle layer and posterior 60 μm, and divides it into five regions with diameters of 0-2, 2-6, 6-10, 10-12 mm and full diameter according to the diameter, and measures the CD in different ranges. The changes of CD were compared before operation and at 1, 3 and 6 mo after operation.RESULTS: There were differences in uncorrected visual acuity, best corrected visual acuity and intraocular pressure before and 6 mo after operation(all P<0.05), and there was no difference in corneal endothelial cells(P=0.477). CD reached its peak at 1 mo after operation, and decreased at 3 mo and 6 mo after operation, but it was still higher than that before operation. There is a significant positive correlation between CD and Kmax in the anterior layer and the whole layer(r=0.164, P=0.016; r=0.152, P=0.023).CONCLUSION: The values of CD peaked at 1 mo after CXL, then it gradually decreased, tending to become stable at 6 mo postoperatively.

Objective:To investigate the occurrence of chronic pain in patients with inguinal hernia after herniorrhaphy, analyze the risk factors of pain occurrence and establish a nomogram model.Methods:Using the convenient sampling method, a total of 390 patients who underwent inguinal herniorrhaphy in Xinxiang Central Hospital from June 2021 to December 2022 were selected. They were divided into the chronic pain group and the non-chronic pain group based on whether postoperative chronic pain occurred. Logistic regression analysis was applied to identify risk factors for postoperative chronic pain, and the nomogram model was established using R4.2.3 software package and rms software package.Results:Among 390 patients with inguinal hernia, a total of 73 patients experienced postoperative chronic pain, with the incidence of 18.72%. Logistic regression analysis showed that recurrent inguinal hernia surgery, hernia ring defect diameter less than or equal to 37.5px, incarceration, use of repair materials and postoperative incision infection were risk factors for chronic pain ( P<0.05). Based on the above factors, a risk prediction model was established. The area under the receiver operating characteristic curve for the test subject was 0.751 (95% CI: 0.612-0.753), the Hosmer-Lemeshow test results showed χ 2=5.572, P=0.473, and the correction curves were all close to the ideal curve. Conclusions:Postoperative chronic pain is common in patients with inguinal hernia and there are many risk factors. The nomogram model established in this study can provide basis for formulating nursing strategies to some extent.

Objective To evaluate the effect of exercise-diet behavior intervention based on the transtheoretical model in patients undergoing weight loss surgery.Methods By convenience sampling,72 patients undergoing weight loss surgery in a tertiary general hospital in Xinxiang City,Henan Province from February 2021 to October 2022 were selected as the research subjects.By a random number table method,they were divided into a test group and a control group,with 36 cases in each group.The test group received exercise-diet behavior intervention based on the trans-theoretical model,while the control group received conventional intervention.The intervention began on the first day after admission and ended 6 months after surgery.The body mass index,body fat,lean body mass,diastolic blood pressure,systolic blood pressure,fasting blood glucose,insulin resistance index(HOMA-IR),Health Promoting Lifestyle Profile-Ⅱ(HPLP-Ⅱ)score,and Short-Form-36 Health Survey(SF-36)score were compared between the 2 groups before and after surgery for 3 and 6 months,as well as the complications within 6 weeks after surgery.Results The results of repeated measures analysis of variance showed that there was an interaction between the 2 groups in terms of anthropometric measurements,blood pressure and blood glucose,HPLP-Ⅱ scores,and SF-36 scores,with statistically significant differences(P＜0.001).After 6 months of surgery,the body mass index(23.32±2.32),body fat(24.10±3.46)kg,and lean body mass(41.64±3.24)kg in the test group were lower than(27.32±3.64),(28.46±4.18)kg,and(46.68±4.65)kg in the control group,and the differences were statistically significant(P＜0.001).At 3 and 6 months after operation,the diastolic blood pressure,systolic blood pressure,fasting blood glucose and HOMA-IR of the test group were lower than those of the control group,and the differences were statistically significant(P＜0.05).The HPLP-Ⅱ score of the test group was higher than that of the control group at 3 and 6 months after operation(P＜0.001).The SF-36 score of the test group was significantly higher than that of the control group at 6 months after operation(P＜0.05).The incidence of complications in the test group was 2.56％,which was not significantly different from 19.44％in the control group(P＞0.05).Conclusion The exercise-dietary behavior intervention based on the transtheoretical model can promote the formation of healthy behaviors in patients undergoing weight loss surgery,maintain weight loss effects,improve blood pressure and blood glucose levels,and enhance the quality of life of patients.

Objective:To explore the effectiveness of deep learning image reconstruction (DLIR) algorithm compared to adaptive statistical iterative reconstruction (ASIR-V) algorithm in improving the quality of low-dose brain CT images.Methods:Retrospective inclusion of patients who underwent brain CT examination in the People's Liberation Army General Hospital from November 2021 to August 2022. Four different algorithms were used to reconstruct low-dose CT scans of all patients to obtain 30% intensity ASIR-V (ASIR-V-30%) images, low intensity DLIR (DLIR-L) images, medium intensity DLIR (DLIR-M) images, and high intensity DLIR (DLIR-H) images. The regions of interest were selected from four sets of images, including superficial white matter, superficial gray matter, deep white matter, and deep gray matter, and their CT values and standard deviations were measured for calculating signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR).Subjective evaluation of image quality was conducted by three neuroimaging physicians based on the Likert 5-component scale. The objective and subjective scores of the 4 groups of images were analyzed using ANOVA or Kruskal Wallis. If there are overall differences, pairwise comparisons were conducted within the group.Results:A total of 109 patients were enrolled, including 104 males and 5 females, aged 65-110 years (89.16 ± 9.53) years. The radiation exposure of brain CT low-dose scanning was (0.93 ± 0.01)mSv, significantly lower than that of conventional scanning (2.92 ± 0.01) mSv ( t = 56.15, P < 0.05). The differences in objective image quality analysis of ASIR-V-30%, DLIR-L, DLIR-M, and DLIR-H images of low-dose CT in SNR deep gray matter, SNR deep white matter, SNR superficial gray matter, SNR superficial white matter, CNR deep gray white matter, and CNR superficial gray white matter were statistically significant( F =98.23, 72.95, 68.43, 58.24, 241.13, 289.91, P < 0.05). Among them, DLIR-H images had the lowest noise in deep gray matter, deep white matter, superficial gray matter, and superficial white matter, and had statistically significant differences compared to other image groups ( t = 167.43, 275.46, 182.32, 361.54, P < 0.05). The subjective score of DLIR-H image quality was superior to ASIR-V-30%, DLIR-L, and DLIR-M, with the statistically significant difference ( t = 7.25, 8.32, 9.63, P < 0.05). Conclusions:Compared with ASIR-V, DLIR algorithm can effectively reduce image noise and artifacts in low-dose brain CT, and improve SNR and CNR. The subjective and objective image quality evaluation of DLIR-H is the best.

Objective:To explore the path relationship among medical narrative competence and profession quality of life on professional identity of nurses, so as to provide reference for improving nurses ′professional identity. Methods:This study was across-sectional survey. From October 2022 to February 2023, totally 619 nurses in Shandong Provincial Hospital Affiliated to Shandong First Medical University were investigated using Self-designed Demographic Questionnaire, Medical Narrative Competence Scale, Professional Quality of Life Scale and Professional Identity Scale.Results:The score of nurses ′s medical narrative competence was (144.13 ± 22.09) points, compassion satisfaction was (34.82 ± 6.96) points, job burnout was (24.03 ± 5.48) points, secondary traumatic stress was (23.91 ± 5.89) points, and the scores of nurses ′ professional identity was (112.68 ± 19.05) points. Nurses ′ medical narrative competence was positively correlated with compassion satisfaction and professional identity ( r=0.585, 0.697, both P<0.01); nurses ′ medical narrative competence was negatively correlated with job burnout and secondary traumatic stress ( r=-0.516, -0.214, both P<0.01). Regression analysis showed that nurses ′ medical narrative ability, compassion satisfaction and job burnout were the influencing factors of nurses ′professional identity ( t=13.26, 10.52, -2.32, all P<0.05). Structural equation model indicated that medical narrative ability of nurses had an intermediary effect on professional identity through the dimension of compassion satisfaction, and the intermediary effect was 0.269, and the intermediary effect accounted for 36.88% of the total effect. Conclusions:Medical narrative ability of nurses can have positive emotional experience on nurses ′ psychology, and thus have an impact on professional identity. Nursing managers should pay attention to the level of nurses ′ medical satisfaction, and give full play to the intermediary effect of compassion satisfaction in nurses ′ medical narrative ability and professional identity.

Objective:To evaluate the changes in vitamins and trace elements in obese patients after laparoscopic sleeve gastrectomy (LSG).Methods:A systematic retrieval of the available literature was performed using Pubmed, Embase, Cochrane library, Web of Science, WanFang data and CNKI databases and studies were selected per predefined eligibility criteria. Statistical analysis was performed using Stata 13.0.Results:A total of 22 studies with 5320 individuals with obesity who underwent LSG were identified as eligible for inclusion. A significant increase was observed in serum 25(OH)D ( SMD = 0.59, 95% CI: 0.16 to 1.03, P = 0.007), phosphorus ( SMD = 0.28, 95% CI: 0.09 to 0.47, P = 0.004) and iron ( SMD = 0.46, 95% CI: 0.31 to 0.61, P < 0.01) after LSG. A significant decrease in serum zinc ( SMD = -0.41, 95% CI: -0.81 to -0.01, P = 0.044) was observed after LSG. But no significant changes in serum calcium ( SMD = 0.11, 95% CI: -0.14 to 0.36, P = 0.385), folate ( SMD = 0.27, 95% CI: -0.08 to 0.62, P = 0.133), vitamin B 12 ( SMD = 0.11, 95% CI: -0.25 to 0.47, P = 0.563) and magnesium ( SMD = 0.53, 95% CI: -0.08 to 1.14, P = 0.09) were observed. Conclusions:The changes of serum nutritional measurements in individuals with obesity who underwent LSG are uncertain. Therefore, it is recommended to monitor the nutritional laboratory values and add supplements when necessary to prevent postoperative malnutrition.

OBJECTIVE: To explore the correlation of different glucose metabolism statues with chronic kidney disease (CKD) in middle-aged and elderly individuals in Lanzhou. METHODS: Based on the baseline data of REACTION Study in Lanzhou area, we randomly sampled 10 038 residents aged 40-75 years in 3 communities in Lanzhou, who were classified into normal glucose tolerance (NGT), impaired glucose regulation (IGR) and diabetes groups. The estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (ACR) were used to assess the renal function and albuminuria, respectively. Binary logistic regression was performed to analyze the contribution of the risk factors to CKD. Polynominal regression was used to determine the trends of eGFR with the increment of ACR. RESULTS: Among all the participants, the prevalences of albuminuria, CKD and renal insufficiency (RI) were 26.2%, 27.4% and 2.5%, respectively. The prevalence of albuminuria, CKD and RI were significantly higher in the diabetes group than in IGR and NGT groups ( CONCLUSIONS Diabetes mellitus is a significant risk factor for albuminuria and RI, while IGR is not. Screening for albuminuria and eGFR is highly recommended for individuals with diabetes, hypertension, and obesity, especially in women and the elderly population.
Adult ; Aged ; Albuminuria/epidemiology* ; Diabetes Mellitus, Type 2/epidemiology* ; Female ; Glomerular Filtration Rate ; Glucose ; Humans ; Middle Aged ; Prevalence ; Renal Insufficiency, Chronic/epidemiology* ; Risk Factors

Objective To investigate the value of detrusor isovolumetric test(DIT)on female SUI with sus-pected detrusor contraction weakness. Methods A total of 86 SUI patients with suspected detrusor contraction weakness diagnosed by preoperative bladder cystometry(CMG)were enrolled in this study.DIT method was used to evaluate the bladder function. The difference of first sensation cystometry capacity, maximum cystometric capacity, bladder compliance and maximum detrusor pressure were compared between the two methods.Patients in group Ⅰwhowere diagnosed with normal detrusor function with DIT method underwent TOT surgery. Ninety normal SUI patients were selected as control group Ⅱ,who were diagnosed with normal detrusor function with CMG method. The surgery effect was compared between the two groups. Results By using DIT detection,there were 65 cases showed normal detrusor function of the 86 cases(75.6%).The maximum detrusor pressure with DIT was(31.2 ± 12.9)cm H2O versus(11.7 ± 3.1)cm H2O with cystometry(P＜0.05).No significant differences were observed in the first sensation cystometry capacity,maximum cystometric capacity and bladder compliance.The effective rate of TOT in both group Ⅰ and group Ⅱ was more than 95%,with no significantly difference between the two groups (P＞0.05). Conclusions DIT is a valuable method to evaluate the bladder function of female SUI patients with suspected detrusor contraction weakness.

Objective To explore the expression of aquaporin-2 (AQP-2) in human fetus kidney and amniotic fluid at different stages of pregnancy.Methods Twenty-two cases of aborted fetuses' kidneys were collected.They were divided into 3 groups according to the pregnancy age:8 cases in 17-23 + 6 weeks,8 cases in 24-31 +6 weeks,and 6 cases in 32-38 +6 weeks.Western blot was used to examine the expression of AQP-2 in the kidney.Twenty-four cases of the amniotic fluid were collected,and they were divided into 3 groups according to the pregnancy age:10 cases in 17-23 +6 weeks,6 cases in 24-31 +6 weeks,and 8 cases in 32-38 +6 weeks.Eight cases of healthy adult morning urine were collected as positive controls.The AQP-2 protein in the amniotic fluid was detected with the method of enzyme-linked immunosorbent assay (ELISA) and the osmotic pressure of amniotic fluid at different stages of the pregnancy was measured with the freezing point osmometer.Results The expression of AQP-2 was increased with the extending of pregnancy age,and the AQP-2 expressions in fetus kidney of 17-23 +6 weeks,24-31 + 6 weeks and 32-38 +6 weeks were 0.986 ± 0.335,1.566 ± 0.272,and 2.080 ± 0.246,respectively,and the difference was significant (P ＜ 0.05).The AQP-2 detected from amniotic fluid was positively correlated with the result of AQP-2 in the kidney(r =0.985,P ＜ 0.05),and the AQP-2 expression also increased with the extending of pregnancy age:17-23 +6 weeks,24-31 +6 weeks,32-38 +6 weeks and adult urine was (30.253 ±5.843) mg/L,(35.103 ±7.271) mg/L,and (42.580 ± 1.230) mg/L and (46.493 ± 0.450) mg/L,respectively.The osmolality of the amniotic fluid of 17-23 +6 weeks,24-31 +6 weeks,32-38 +6 weeks was (272.600 ± 4.827) mmol/L,(252.00 ± 15.360) mmol/L,and (261.750 ±5.560) mmol/L,respectively,and the difference was significant(P ＜0.05).Conclusions The AQP-2 expression in human fetus kidneys has good correlation with amniotic fluid,which indicates that the level of AQP-2 of the amniotic fluid may reflect the expression of AQP-2 in the fetus kidney.

Objective To investigate Chinese version of the Denver Emergency Department Trauma Organ Failure Score and examine its reliability and validity. Methods The original Denver ED TOF Score was translated into Chinese and back translated and modified for cultural adaptation according to guidelines.A survey using Chinese version of the Denver ED TOF Score was conducted on 313 trauma patients in order to verify its reliability and validity. Results Factor analysis extracted three common factors, which explained 63.327% of variance of the total scale, and each item had high factor loading quantity(>0.4).The item-level content validity index of Chinese Denver ED TOF Score were 0.80 to 1.00. and the scale-level content validity index was 0.93.Its sensitivity was 84.0% and specificity was 81.6% when score of Chinese Denver ED TOF Score was two or more. The area under receiver operator characteristic curve for Chinese Denver ED TOF Score prediction of multiple organ failure was 0.878 (95% CI 0.812-0.944, P<0.01). The Chinese version of Denver ED TOF Score had higher internal consistency, with Cronbach Alpha coefficient 0.738 and intra- class correlation coefficients 0.994. Conclusions The Chinese version of Denver ED TOF Score has a high reliability and validity, which could be used as a tool for predicting and diagnosing development of MOF in adults following trauma.