Objective This study aims to develop and validate a dynamic web-based nomogram for predicting kinetophobia in patients following percutaneous coronary intervention(PCI).Methods A prospective design was employed to selectively enroll 330 PCI patients admitted to a hospital in Hangzhou from December 2022 to July 2023.Single-factor analysis and Lasso regression were utilized to identify independent risk factors for kinesophobia post-PCI.Logistic regression was performed using R software,and a nomogram was constructed.The model was assessed through the area under the receiver operating characteristic curve(AUC)and Hosmer-Lemeshow tests.Results There were 206 cases of kinesiophobia in 330 patients after PCI,and the incidence was 62.4％.Logistic regression analysis identified combined heart failure,emergency surgery,NYHA cardiac function grade,ADL level,sedentary behavior,Chinese version of PROMIS Physical Function Summary Table score,and Chinese version of Perceptive Social Support Scale score as independent influencing factors for kinesophobia after PCI(P＜0.05).The AUC value of the model was 0.821,with a sensitivity of 70.4％and specificity of 82.0％.The Hosmer-Lemeshow fit test yielded a non-significant result(x2=9.350,P=0.314).Calibration and decision curves demonstrated the model's favorable calibration and clinical practicability.The C-index of the nomogram prediction model was 0.778,0.774,and 0.800,respectively,by 5-fold cross-validation,10-fold cross-validation,and the Bootstrap method.Conclusion The dynamic nomogram model developed in this study effectively predicts kinesophobia in patients after PCI.It provides valuable references and support for clinical staff in early identification of high-risk patients,enabling the formulation of individualized health education strategies and exercise rehabilitation plans.

Objective:To evaluate the immunogenicity and protective effect of a multicomponent recombinant protein vaccine EPRHP014 constructed independently and provide a scientific basis for developing new tuberculosis (TB) vaccine and effective prevention and control of TB.Methods:Three full-length Mycobacterium ( M.) tuberculosis protein antigens (EsxH, Rv2628, and HspX) and two epitope-predicted and optimized epitope-dominant protein antigens (nPPE18 and nPstS1) were selected, from which five protein antigens were used to construct a protein antigen composition EPRHP014, including a fusion expression multi-component protein antigen (EPRHP014f) and a multi-component mixed protein antigen (EPRHP014m) formed with the five single protein using clone, purification, and purification respectively. Multicomponent protein vaccines EPRHP014f and EPRHP014m were prepared with aluminum adjuvant, and the BCG vaccine was used as a control. ELISA detected the titer of serum-specific antibodies, the secretion of various cytokines was detected by ELISpot and Luminex, and immune protection was observed by the M.tuberculosis growth inhibition test in vitro. The results were statistically analyzed by t-test or rank sum test, and P<0.05 was considered a statistically significant difference. Results:Mice Immunized with EPRHP014m and EPRHP014f could produce highly effective IgG antibodies and their subtypes IgG1 and IgG2a, and the antibody titers were similar to those of mice immunized with BCG, with no statistical significance ( P>0.05). The number of spot-forming cells (SFC) secreting IFN-γ and IL-4 induced by EPRHP014f group was significantly higher than those by EPRHP014m group and BCG group ( P<0.05), but there was no significant difference in the number of SFC for IFN-γ and IL-4 induced between EPRHP014m group and BCG group ( P>0.05). The secretion levels of GM-CSF and IL-12p70 induced by the EPRHP014m group were higher than those of the BCG group ( P<0.05), but there was no significant difference in the levels of IL-6 and IL-10 induced between EPRHP014m group and BCG group ( P>0.05). There was no significant difference in the secretions of IL-6, IL-10, IL-12, and GM-CSF between the EPRHP014f and BCG groups ( P>0.05). EPRHP014m group, EPRHP014f group, and BCG group had obvious antibacterial effects in vitro, and the difference was insignificant ( P>0.05). Conclusion:Both EPRHP014f and EPRHP014m can induce strong humoral and cellular immune responses in mice after immunization, and have a strong ability to inhibit the growth of M. tuberculosis in vitro, indicating that the antigen composition EPRHP014 has good potential in the development and application of TB vaccine.

Objective:To retrieve and obtain relevant evidence of intra-abdominal pressure-oriented enteral nutrition assessment and management in patients with intra-abdominal hypertension, in order to provide evidence-based evidence for clinical medical staff to make enteral nutrition-related clinical decisions for patients with intra-abdominal hypertension.Methods:Systematic retrieval of Chinese National Knowledge Infrastructure, Wanfang, Chinese Biomedical Literature, UpToDate, PubMed, Cochrane Library, BMJ Best Practice and other English data, as well as domestic and foreign guidelines such as American Society for Parenteral and Enteral Nutrition, Scottish Intercollegiate Guidelines Network, etc. All evidence available on the Internet in both Chinese and English on intra-abdominal pressure-guided enteral nutrition strategies in adults with intra-abdominal hypertension, study types including clinical decision-making, systematic reviews/meta-analyses, evidence summaries, expert consensus, guidelines or related to the subject of this study closely related high-quality original research. The retrieval time was from the establishment of the database to November 2021. The literature evaluation tool was selected according to the research type. Two researchers trained in the evidence-based system independently evaluate the quality of the included literature, fully considering the clinical situation and expert opinions, and completed the evidence. Extracted and summarized.Results:Totally 13 articles were finally included, including 5 guidelines, 3 expert consensuses, 1 evidence summary and 4 original studies, and 29 evidence-based practice evidence of enteral nutrition in patients with intra-abdominal hypertension were collected, including the monitoring timing of enteral pressure, the pressure of enteral high pressure and the way of enteral nutrition, the pressure measurement of the abdominal cavity, the setting of abdominal pressure, the temperature conditions for early start of enteral nutrition, the selection of enteral pressure, the temperature setting of enteral nutrition nine aspects such as speed and regulation of internal nutrition and abdominal compartment syndrome prevention.Conclusions:This study summarizes the best evidence of intra-abdominal pressure management and enteral nutrition therapy in patients with intra-abdominal hypertension, and provides evidence-based basis for risk management, standardizing clinical practice, and ensuring treatment safety. In the stage of evidence transformation, clinical medical staff need to comprehensively weigh the benefits and risks of early enteral nutrition, and integrate evidence in combination with clinical practical application scenarios, so as to form a standardized early enteral nutrition management plan suitable for patients with intra-abdominal hypertension.

OBJECTIVE：To systematically evaluate the effects of phenytoin on 3 kinds of cardiovascular disease-related factors （Folic acid ，vitamin B 12 and homocysteine）in epilepsy patients ，and to provide evidence-based reference for clinical treatment of epilepsy. METHODS ：Retrieved from PubMed ，Google scholar ，CJFD，VIP and Wanfang database ，observational studies about using phenytoin （trial group ） versus using no antiepileptics （control group ） on the levels of folic acid ，vitamin B 12 and homocysteine in serum were collected during Jan. 1991-Jan. 2019. After data extraction of included literatures ，quality evaluation with evaluation criteria for cross-sectional study （AHRQ）scale，Rev Man 5.3 and Stata 11 softwares were used for statistical analysis. RESULTS ：A total of 10 studies were included ，involving 745 patients. Meta-analysis showed that the folic acid level of trial group was significantly lower than control group [SMD ＝－0.90，95％CI（－1.18，－0.62），P＜0.001]；the level of homocysteine in trial group was significantly higher than control group [SMD ＝1.22，95％CI（0.73，1.71），P＜0.001]. There was no significant difference in the levels of vitamin B 12 between 2 groups [SMD ＝－ 0.19，95％ CI（－ 0.39，0.02），P＞0.05]. CONCLUSIONS：Phenytoin can reduce the level of folic acid and increase the level of homocysteine in epilepsy patients.

Objective:To investigate the drugs-sensitivity spectrum of multidrug-resistant tuberculosis (MDR-TB) in China and provide a scientific evidence for the drug selection in clinical therapy and the control of MDR-TB.Methods:A total of 167 strains of MDR-TB were included in this study. Every strain was genotyped by lysX gene sequencing and their sensitivity to 13 different anti-TB drugs was tested by using MicroDST TM and BACTEC TM MGIT 960 TM liquid-culturing method. The association between drug resistance and genotypes as well as cross drug resistance was also analyzed. The results were analyzed by means of the comparison of enumeration data between two groups with χ2 test. Results:The overall resistance rate of 167 MDR-TB strains to 11 anti-TB drugs, except isoniazide and rifampicin, was 95.81%, the rates of pre-extensive drug-resistance (pre-XDR) and extensive drug-resistance were 31.14%(52/167) and 6.59% (11/167), respectively. The streptomycin resistance rate of Beijing genotypes was significantly higher than that of the non-Beijing genotypes ( χ2=30.682, P<0.05), while the pre-XDR proportion in Beijing genotypes was lower than that in non-Beijing genotypes ( χ2=5.332, P<0.05). The resistance rates of Ofloxacin and Pyrazinamide in the modern Beijing genotype were significantly higher than those in classical ones ( χ2=4.105 and χ2=3.912, P<0.05). In addition, the cross-resistance rate to rifampicin and rifabutin was 86.23%. A significant difference in drug-resistance rate to rifabutin was seen among groups with different levels of rifampicin resistance ( χ2=45.912, P<0.05). There was positive correlation not only between ofloxac resistance and moxifloxac resistance, but also between amikacin resistance and kanamycin resistance, with the coefficient of 0.87 and 0.91, respectively. Conclusions:In this study, we observed that there were high incidences of the resistance to 11 anti-TB drugs in 167 clinical MDR-TB strains and the cross resistance phenomena between drugs of the same type were quite serious. The majority of MDR-TB strains belonged to Beijing genotype, which was highly associated with streptomycin resistance.

Objective To compare the differences of optic disc parameters and the thickness of circumpapillary retinal nerve fiber layer (CP-RNFL) in acute uveitis Vogt-Koyanagi-Harada (VKH) syndrome with different degrees of optic disc edema. Methods This is a retrospective study including 40 eyes of 23 VKH patients. The eyes were divided into 2 groups according to the results of fluorescein fundus angiography (FFA). The discs with hyperfluorescence but no leakage were in mild optic disc edema group (group A, 13 patients and 25 eyes), and the discs with hyperfluorescence and leakage were in severe optic disc edema group (group B, 10 patients and 15 eyes). The patients were significantly older in group B than in group A (t=-2.17, P<0.05). The differences of gender, diseased time (t=-1.67) and corrected visual acuity (t=-0.76) between 2 groups were not significant (P>0.05). Eighty eyes of 46 normal healthy subjects, matching group A and group B with age and gender, were divided into group C (26 subjects and 50 eyes) and group D (20 subjects and 30 eyes) respectively.All subjects underwent three dimensional optical coherence tomography examinations. The parameters included average thickness of entire circumpapillary retinal nerve fiber layer (CP-RNFL), thickness of nasal, superior, temporal and inferior quadrant of CP-RNFL, disc area, disc cup area, rim area, cup/disc (C/D) area ratio, C/D horizontal diameter ratio and C/D vertical diameter ratio. Results The disc area, disc cup area and rim area were bigger, the thickness of mean CP-RNFL and the nasal and temporal quadrants of CP-RNFL were thicker in group A than those in group C (P<0.05). The disc area and rim area were bigger, the thickness of mean CP-RNFL and the nasal, superior, temporal and inferior quadrant of CP-RNFL were thicker, C/D area ratio and C/D diameter ratio were smaller in group B than those in group D (P<0.05). The disc area was bigger, disc cup area, C/D area ratio and C/D diameter ratio were smaller, the thickness of mean CP-RNFL and the nasal , superior and inferior quadrants of CP-RNFL were thicker in group B than those in group A (P<0.05). Conclusions Acute VKH uveitis with mild optic disc edema has thicker CP-RNFL in the nasal and temporal quadrants; with severe optic disc edema has thicker CP-RNFL in all 4 quadrants. Acute VKH uveitis also has smaller C/D area ratio and C/D diameter ratio.

OBJECTIVETo understand status of health literacy among diabetics and their health management behaviors, and analyze the relationship of health literacy and health management.

METHODSA two-staged cluster randomized sampling method was used to investigate 1 130 diabetics in Beijing, Ningbo and Xiamen from October to November in 2012. All participants should be diagnosed by primary hospital and above and have lived in the community over six months. Diabetic patients who indicated that they had severely impaired vision or cognitive disorder, or had severe physical deterioration, or did not live in the address provided were excluded. A total of 1 130 questionnaires were sent out and 1 083 eligible questionnaires were taken back, accounting for 96.87%. Multivariate logistic regression was adopted to analyze the association between health literacy and health management behaviors and blood glucose level.

RESULTSAmong those participants, 47.7% (517) were men, 52.3% (566) were women, the age was (67.0 ± 9.5). According to diabetes health literacy scores, 73.7% (798/1 083) of them were classified as poor health literacy and 26.1% (283/1 083) as essential health literacy. Health literacy was associated with health management behaviors independently, demonstrating that the probability of utilizing health education, free physical examination, lifestyle guidance, monitoring blood glucose on their own, measuring blood glucose more than once a week and taking hypoglycemic agent regularly among diabetics with essential health literacy were 1.40 (95%CI:1.03-1.91), 1.65 (95%CI: 1.19-2.28), 2.70 (95%CI:1.98-3.69), 2.05 (95%CI:1.34-3.15), 2.56 (95%CI:1.85-3.56) , 1.48 (95%CI:1.07-2.06) times of those in diabetics with poor health literacy (P < 0.05).

CONCLUSIONHealth literacy may affect health management behaviors among diabetics. More activities targeted on diabetics with low health literacy were suggested to improve their' health literacy and their skills about diabetes mellitus management.

Aged ; Blood Glucose Self-Monitoring ; statistics & numerical data ; Diabetes Mellitus ; therapy ; Female ; Health Behavior ; Health Literacy ; statistics & numerical data ; Humans ; Logistic Models ; Male ; Medication Adherence ; statistics & numerical data ; Middle Aged ; Surveys and Questionnaires

Objective This study aimed to survey students' satisfaction and cognitive attitude of elaborate course of social medicine to provide a basis for exploring appropriate teaching mode. Methods Purposive sampling was used with questionnaire to survey 646 students who had learned social medicine in 5 universities in Guangdong province. The survey included the social medicine curriculum, teaching situation, students' satisfaction and cognitive attitude of elaborate course of so-cial medicine. Descriptive statistical analysis was used to describe the demographic characteristics and curriculum. The t test and one-way ANOVA were used to compare the means of students' satisfaction and cognitive attitude of elaborate course in different universities, using the test level of 0.05. Results The lecture-based learning was the main teaching mode. 335(52.7%) students thought it necessary to learn social medicine, but only 27.2%of the students(173 students) were interested in social medicine and 65(10.2%) students could take the initiative to read about extracurricular books. Overall satisfac-tion with using network resources of elaborate course in two universities that had university-level elab-orate course of social medicine were (2.78 ± 0.55) and (3.01 ± 0.30) respectively and the difference was statistically significant(t=-3.97,P<0.01). The cognitive attitude of the students in 5 universities with using network resources of elaborate course was (3.09±0.66) and the difference was statistically significant(F=3.70,P<0.01). Conclusion Social medicine teaching has been paid attention to in 5 universities, but there were some common problems: ①putting emphasis on theory and ignoring prac-tice in teaching mode; ②putting emphasis on credit and ignoring effectiveness in learning; ③and putting emphasis on construction and ignoring using in network resources of elaborate course of social medicine.

Objective To compare the expression level of miR-92b in SHanG-44 glioma cells and glioma stem cells .Methods The tumor stem cells were screened from the SHG-44 glioma cells and identified by immunofluorescence .Then it was induced to differentiate .The transcription level of miR-92b was determined by RT-PCR and real-time quantitative PCR before and after differ-entiation .Results The miR-92b expression level in differentiated tumor cells was about 3 times higher than in tumor stem cells . Conclusion T he miR-92b gene is involved in the process of differentiation of glioma stem cells .

Objective To study the current status of antimicrobial resistance of clinical Neisseria gonorrhoeae isolates in China by analyzing the surveillance results in 2008.Methods N. gonorrhoeae strains were collected from 951 eligible patients at national monitoring sites for resistance of N. gonorrheae,including 156 patients from Jiangsu province,71 from Zhejiang province,102 from Fujian province,207 from Guangdong province,77 from Guangxi province,43 from Hainan province,80 from Sichuan province,44 from Chongqing,45 from Xinjiang Uygur Autonomous Region,72 from Shaanxi province,and 54 from Tianjin.The production of β-lactamase was detected by paper acidometric testing,and minimum inhibitory concentrations(MICs)were determined by agar dilution method for spectinomycin,ciprofloxacin,cefiriaxone,tetracycline,respectively.Results Among the 951 N. gonorrhoeae isolates,2(0.21%)were resistant to spectinomycin,451(47.42%)showed reduced sensitivity to ceflriaxone,928(97.58%)were resistant to ciprofloxacin.Penicillinase-producing N.gonorrhoeae (PPNG) and plasmid mediated tetracycline-resistant N. gonorrhoeae (TRNG) accounted for 34.91%(332/951)and 51.21%(487/951) of these isolates respectively.Kendall rank correlation analysis showed that there was a positive correlation between the positivity rate of TRNG and PPNG(r=0.20,P<0.01),but a negative correlation between the susceptibility to cefiriaxone in N.gonorrhoeae and positivity rate of PPNG(r=-0.09,P<0.01).No correlation was observed between the susceptibility to cefiriaxone and susceptibility to ciprofloxacin or the positivity rate of TRNG,or between the susceptibility to ciprofloxacin and positivity rate of PPNG or TRNG.Chi-square analysis showed a marked increase in the percentage of N.gonorrhoeae isolates with reduced susceptibility to ceftriaxone in Guangxi province,Hainan province,Xinjiang Uygur Autonomous Region and Shaanxi province,the percentage of N.gonorrhoeae isolates with resisitance to spectinomycin in Shaanxi province,prevelance of TRNG in Guangdong province,and prevelance of PPNG in Sichuan and Zhejiang provinces compared with the average level (all P<0.05).Conclusions Thero is a significant diffefence in antimicrobial susceptibility of N.gonorrhoeae from difierent areas of China.A significant elevation is observed in the percentage of N.gonorrhoeae with reduced susceptibihty to cefifiaxone and resistance to spectinomycin in Shaanxi province.to which close attention should be paid.