[Objective] To investigate the protective effect of Salvia miltiorrhiza injection (SMI) on the kidneys of HBOC-CHP01 resuscitated haemorrhagic shock rats. [Methods] A 50% haemorrhagic shock rat model was established, with 12 rats divided into two groups: SMI + HBOC-CHP01 group and HBOC-CHP01 group, with 6 rats in each group. The rats in the SMI+ HBOC-CHP01 group were given an equal volume of HBOC-CHP01 for resuscitation after haemorrhagic shock, and an 8 mL/kg dose of SMI. Rats in the HBOC-CHP01 group were resuscitated by administering an equilibrium blood loss volume of HBOC-CHP01 and given an 8 mL/kg dose of 0.9% NaCl solution. Blood was taken from rats at five points: before bloodletting (baseline), during haemorrhagic shock (HS), immediately after resuscitation (RS0h), 1 h after resuscitation (RS1h), and 24 h after resuscitation (RS24h). A blood gas analyser was used to detect the lactate level (Lac), glucose content (Glu), residual base (BEecf), pH, bicarbonate (HCO3-), high iron haemoglobin (MetHb). White blood cells (WBC), platelets (PLT), haemoglobin content (Hb), carboxyhaemoglobin (COHb) were detected using a quintuple classification. Blood creatinine (SCr), uric acid (UA), kidney-related indexes were detected using biochemistry instrument. Kidney tissues of the rats were taken after 24 h of resuscitation and after execution, and the inflammation of kidneys of the rats of the two groups was analyzed using HE staining. Fluorescence staining was used to detect the level of ROS in the kidneys of rats in both groups. [Results] At RS 0h, the Beecf, Glu and Lac levels of rats in the SMI+HBOC-CHP01 group were significantly lower than those of rats in the HBOC-CHP01 group, and the pH level of rats in the SMI+HBOC-CHP01 group was significantly higher than that of rats in the HBOC-CHP01 group, and the Glu levels of rats in the SMI+HBOC-CHP01 group were significantly lower than those of rats in the HBOC-CHP01 group at RS 1h. At RS 0h, the WBC, PLT and COHb contents of rats in the SMI+HBOC-CHP01 group were all significantly higher than those of rats in the HBOC-CHP01 group, and at RS 1h, the WBC content of rats in the SMI+HBOC-CHP01 group was significantly higher than that of rats in the HBOC-CHP01 group; at RS 1h, the UA content of rats in the SMI+HBOC-CHP01 group was significantly lower than that of rats in the HBOC-CHP01 group; at RS 24h, the SCr content of rats in the SMI+HBOC-CHP01 group was significantly lower than that of rats in the HBOC-CHP01 group; at RS 24h, the inflammation level of kidney tissues of rats in the SMI+HBOC-CHP01 group was significantly lower than that of rats in the HBOC -CHP01 group rats, and the ROS and MPO levels in the kidney tissues of rats in the SMI+HBOC-CHP01 group were significantly lower than those of rats in the HBOC-CHP01 group. [Conclusion] The combination of Salvia miltiorrhiza injection during the resuscitation of rats with severe haemorrhagic shock by HBOC-CHP01 can alleviate renal injury by reducing inflammatory response and oxidative stress.

[Objective] To extract hemoglobin (Hb) from red blood cells using osmotic pressure swelling method, expected to achieve a hemoglobin dissolution rate of ≥80% and a cell membrane integrity rate of ≥70%. [Methods] Human umbilical cord blood red blood cells were used as raw materials and phosphate buffer solution was used as the swelling solution for red blood cells. A three factor three-level orthogonal experiment (n=3) was conducted to determine the optimal matching conditions for selecting the osmolality molar concentration of phosphate buffer solution, pH value of hypotonic phosphate buffer solution and volume ratio of hypotonic phosphate buffer solution to washed red blood cells. Red blood cell swelling solution samples (n=6) were prepared by the optimal matching conditions and the original process conditions. The hemoglobin dissolution rate and cell membrane integrity rate were checked. In the expanded comparative experiment, red blood cell swelling solution samples (n=6) were prepared by the optimal matching conditions and the original process conditions, which was filtered by ultrafiltration membranes. The filtration time and hemoglobin yield were checked. [Results] The optimal matching conditions for preparing red blood cell swelling solution were obtained through orthogonal experiment as follows: osmotic pressure molar concentration was 30 mOsmol/Kg, pH was 7.8, and phosphate buffer to red blood cell volume ratio was 6∶1. On the basis of the above conditions, the red blood cell swelling solution sample was compared with the original process sample: the hemoglobin dissolution rate was (82.4±1.8)% vs (78.6±3.0)% (P<0.05), and the cell membrane integrity rate was (65.8±4.0)% vs (28.7±2.3)% (P<0.05). In the expanded comparative experiment, the optimal matching conditions were compared with the original process conditions: filtration time(s) (327±9) vs (434±13) (P<0.05), and hemoglobin yield was (72.3±1.2)% vs (66.0±1.4)% (P<0.05). [Conclusion] Compared with the original preparation process, the hemoglobin extraction process which optimized through orthogonal experiments greatly reduces the cell membrane fragmentation rate and minimizes the entry of cell membrane matrix into the target solution, ensuring a slightly higher hemoglobin dissolution rate, and reducing the preparation difficulty for the subsequent cell membrane separation and further purification.

Objective To investigate the population distribution,biofilm formation and drug resistance of Staphylococcus aureus isolated from pressure ulcers infected patients in the hospital,and to provide important clinical evidence.Methods From May 2019 to May 2022,a total of 126 strains of Staphylococcus aureus relat-ed to pressure ulcer infections were collected in the hospital.The bacteria were identified by Vitek MS mass spectrometer,and the drug susceptibility test was performed by disk diffusion method(K-B method).The drug susceptibility results were analyzed according to the standards of the American Association for Clinical Laboratory Standardization(ACLA),2016-M100.The crystal violet staining method was used to detect the biofilm of Staphylococcus aureus and determine its formation ability.Glucose and silver ion powder were add-ed to the biofilm respectively,and their effects on biofilm formation were observed.Results From May 2019 to May 2022,126 strains of Staphylococcus aureus related to pressure ulcer infection were collected from the hospital.Pressure ulcer was detected at all ages and levels.The proportion of strains forming biofilm was 73.00％,and the proportion of strains forming biofilm was 81.81％in the strain isolated from stage Ⅳ pres-sure ulcer,which was higher than that in the strain isolated from other stages(Ⅱ and Ⅲ)(63.33％),and the differences were statistically significant(P＜0.05).Strains with different biofilm formation ability had higher resistance rates to penicillin G,tetracycline,ciprofloxacin,sulfamethoxazole/trimethoprim,but lower resist-ance rates to teicoplanin and levofloxacin.No Gram-positive bacteria resistant to vancomycin were detected.There were no significant differences in drug resistance of Staphylococcus aureus in different biofilm levels(P＞0.05).11.10 mmol/L glucose could promote the formation of biofilm,10.00 μg/mL silver ion antibacte-rial gel could inhibit the formation of biofilm.Conclusion The biofilm formation ability of Staphylococcus au-reus to cause stage Ⅳ pressure ulcer infection is strong and the formation of biofilm is related to the stage of pressure ulcer.The antimicrobial resistance of Staphylococcus aureus producing membrane has no obvious re-lationship with the grade of biofilm.The use of silver ions and the reduction of blood glucose level have a cer-tain inhibitory effect on biofilm formation.

Objective To investigate the level of finger systolic blood pressure (FSBP) in healthy young adults. Methods A total of 28 healthy young adults were selected as the study subjects by convenient sampling method. The FSBP of the study subjects was detected at 30 and 10 ℃, and the FSBP index (F_i) was calculated. Results The FSBP of the study subjects at 30 and 10 ℃ were (102.0±16.5) and (104.4±15.2) mmHg, respectively. The FSBP in male group at 30 and 10 ℃ was (99.6±18.6) and (107.2±17.0) mmHg, respectively. The FSBP in female group at 30 and 10 ℃ was (104.4±13.9) and (101.5±2.8) mmHg, respectively. The results of factorial analysis showed that the interaction between gender and temperature on FSBP was statistically significant (P<0.05). FSBP in male group was higher at 10 than 30 ℃ (P<0.05) and higher than female group at 10 ℃ (P<0.05). There was no statistical significance for the main effect of gender, temperature, finger, or the interaction effect of gender and finger, temperature and finger for FSBP (all P>0.05). The average F_i of the study subjects was (98.0±16.6)%, with males and females having the average F_i of (100.7±20.7) % and (95.2±10.6) % respectively. The results of factorial analysis of variance showed that there was no significant difference on F_i in the main effect gender and fingers or the interaction effect between them(all P>0.05). Conclusion The FSBP test could be used as a detection method for assessing peripheral microcirculation function in Chinese population. However, further research is needed to establish reference ranges and influencing factors.

【Objective】 To study the red blood cell substitute preparation method of glutaraldehyde(GDA) and Bis(3, 5-dibromosalicyl) fumarate(DBBF) double polymerized, and also observe its curative effect. 【Methods】 The affecting factors of the crosslink of DBBF and human placental hemoglobin(Hb) were selected, including solution pH, inositol hexaphosphoric acid concentration, and molar ratios of DBBF/Hb. The changes of P50, Hill Co and methemoglobin(MetHb) content during the preparation process were studied and the molar ratio of GDA to DBBF-Hb were determined. The final product was obtained through the steps of ultrafiltration, filtration, and deoxygenation, etc., and the final product was subjected to a study on the curative effect of anti-hemorrhagic shock in rats. 【Results】 Under the condition of pH 8.0, the concentration of inositol hexaphosphoric acid was 10mM/L, the molar ratio of DBBF/hemoglobin was 6∶1, the content of dimer was(22.67±3.28)%, the content of tetramer was (74.64±7.05)%, and its P50 was (25.25±2.31) mmHg. As the molar ratio of DBBF/Hb increased, P50 and MetHb content would gradually increase, while the Hill Co will gradually decrease. The molar ratio of GDA and DBBF-Hb was 7∶1, the content of dimer was (8.23±0.79)%, the content of tetramer was (27.87±3.63)%, the content of super-macromolecule was (1.05±0.31)%. As the molar ratio of GDA and DBBF/Hb increased, MetHb content would increase, while the P50 and Hill Co would gradually decrease. The 24h survival rate of the product in rats with hemorrhagic shock was 83.33%(10/12), which was significantly higher than that in the negative control group[41.67%(5/12)], while similar with the positive control group [91.67%(11/12)]. 【Conclusion】 The red blood cell substitutes with GDA and DBBF double polymerized can effectively reduce the dimer content, which is more conducive to industrial production, and has a positive effect on the treatment of hemorrhagic shock.

Abstract Obesity is a major global public health problem. Long-term sleep deprivation has been identified as a major risk factor of obesity among adults, and oversleeping is found to correlate with the increased risk of obesity. Based on systematic reviews, meta-analysis and prospective cohort studies of the association between sleep and obesity among adults published during the period between 2017 and April, 2022, this review summarizes the direct impact of sleep on obesity among adults, the improvements of adult obesity by sleep and the immune, endocrine, energy metabolism, dietary habit and psychological mechanisms of obesity affected by sleep, so as to provide insights into the development of interventions against adult obesity.

Objective: To investigate the association between obesity and insomnia among adults, so as to provide insights into obesity control and sleep health improvements among adult populations. Methods: Sixteen communities were randomly sampled from Longgang District, Shenzhen City using a multistage cluster sampling method, and permanent residents at ages of 18 years and older living in these communities were recruited as study subjects. Subjects' gender, age, educational level and marital status were collected using a self-designed questionnaire, and the body mass index ( BMI) was calculated. The sleep quality was evaluated using the Insomnia Severity Index ( ISI ), and the correlation between obesity and insomnia was evaluated using a multivariable logistic regression model. Results: A total of 10 434 questionnaires were allocated, and 9 425 valid questionnaires were recovered, with an effective recovery rate of 90.33%. The respondents included 3 448 men ( 36.58% ) and 5 977 women ( 63.42% ), and 6 940 respondents ( 73.63% ) were at ages of 18 to 44 years. There were 778 respondents with underweight ( 8.25% ), 5 522 with normal weight ( 58.59% ), 2 209 with overweight ( 23.44% ) and 916 with obesity ( 9.72% ). Among all respondents, 1 149 respondents were detected with insomnia, with a detection rate of 12.19%, including 839 subjects with mild insomnia ( 8.90% ), 247 subjects moderate insomnia ( 2.62% ) and 63 subjects with severe insomnia ( 0.67% ). Multivariable logistic regression analysis showed a statistically significant correlation between obesity and insomnia ( OR=2.179, 95%CI: 1.824-2.603 ). Conclusions There is a significant correlation between obesity and insomnia. Body weight management and sleep health education shall be intensified among adults.

【Objective】 To explore the protective effects of hemoglobin base on oxygen carries (HBOCs) with different oxygen affinity on isolated rat hearts. 【Methods】 Using Langendorff isolated heart perfusion model, 45 adult male SD rats (SPF grade), perfused with 30 min KH solution baseline, were randomly divided into sham operation group and control group: St. Thomas (STS) solution perfusion volume was 3mL/100g body weight; high P50 HBOCs group: [STS + high P50 HBOCs (P50=35.0 mmHg, 2.5 mg/100 g) product] perfusion volume was 3mL/100g body weight; medium P50 HBOCs group: [STS + medium P50HBOCs (P50=26.5.0 mmHg, 2.5 mg/100 g) product] perfusion volume was 3 mL/100 g body weight; low P50 HBOCs group: [STS + low P50 HBOCs (P50=11.0 mmHg, 2.5 mg/100 g) product] perfusion volume was 3mL/100g body weight, and the heart was arrested and placed in a 37℃ water bath to make the heart ischemic for 35 minutes, and then reperfused for 2 hours. The left ventricular development pressure (LVDevP), left ventricular end diastolic pressure (LVEDP), the rate of change of left ventricular pressure (LVPCR) and heart rate (HR) in the rat heart during reperfusion were observed and recorded. 1 min perfusion fluid from each rat in the basic and reperfusion phase was taken, and blood gas analyzer was used to measure the blood gas indexes of rats, and the myocardial injury marker enzymes [cardiac enzyme creatine kinase (CK-MB), lactate dehydrogenase (LDH) and the release of α-hydroxybutyrate dehydrogenase (α-HBDH)] were measured by ELISA kit. 【Results】 The cardiac function and the release of myocardial enzymes in the 5 groups of rats in the basal cardiac perfusion stage were similar (P>0.05). However, in the reperfusion stage, except for the insignificant changes in HR (P>0.05), the heart LVDevP (mmHg) of the three P50 HBOCs groups and the control group were 10.69±3.65 vs 8.50±2.88, 23.26 ±5.62 vs 8.50±2.88, 35.60±3.82 vs 8.50±2.88, LVEDP (mmHg) were 43.34±8.08 vs 54.64±7.42, 39.43±8.30 vs 54.64±7.42, 31.46±4.11 vs 54.64±7.42, dp/dt were 12.09±9.96 vs 6.09±0.98, 25.65±8.87 vs 6.08±0.98, 35.32±9.33 vs 6.09±0.98, -dp/dt were 17.53±11.28 vs 11.39±2.16, 28.80±13.70 vs 11.39±2.16, 43.36±3.83 vs 11.39±2.16, respectively (all P<0.05); the rebound situation and the release of CK-MB, LDH, and α-HBDH in the three P50 HBOCs groups were better than those in the control group (P<0.05). Among the three P50HBOCs products, the low P50HBOCs group had the best cardiac function indexes. The myocardial enzyme indexes of the high, medium and low HBOCs groups were CK-MB (ng/mL): 110.47±4.04, 90.2±2.46, 77.1±3.51; LDH (U/L): 162.23±7.71, 135.13±23.69, 92.20±4.21; a-HBDH (U/L): 228.00±8.03, 172.30±8.99, 131.00±2.02. 【Conclusion】 STS solution containing HBOCs products can improve the function of the reperfused heart at normal temperature ischemia for 35 min and 2 h reperfusion, and reduce heart damage. The STS solution containing low P50 HBOCs has the most obvious protective effect in rat isolated heart perfusion.

Objective:To investigate the turnover intention and its influencing factors in rural general practitioners in southwest Shandong province.Methods:In May 2020, a survey with self-designed questionnaire was conducted among 2 805 rural general practitioners in southwest Shandong province selected by multi-stage sampling method. Pearson chi square test (χ2) and binary logistic regression were used to analyze the factors influencing the turnover intention of rural general practitioners.Results:A total of 2 805 questionnaires were sent out, 2 693 were collected and 2 272 were valid, with an effective rate of 84.4%. Among 2 272 participants, 1 076 (47.4%) had medium to high level turnover intention. Binary logistic regression showed that part-time job ( OR=1.443, 95% CI: 1.105-1.884, P<0.01), average monthly night shifts ≥20 times ( OR=1.340, 95% CI: 1.106-1.623, P<0.01), daily working time ≥13 hours ( OR=1.358, 95% CI: 1.107-1.666, P<0.01), insomnia ( OR=2.075, 95% CI: 1.755-2.454, P<0.01), feeling depressed at work ( OR=2.987, 95% CI: 2.516-3.546, P<0.01), degree of emotional exhaustion ( OR=3.801, 95% CI: 3.188-4.533, P<0.01) and degree of de-personalization tendencies ( OR=2.493, 95% CI: 2.086-2.981, P<0.01) were the significant factors influencing the turnover intention of rural general practitioners. Conclusions:Rural general practitioners in southwest Shandong have a high-level turnover intention, part-time jobs, average number of night shift per month, working time, insomnia, depression and job burnout are the main factors affecting the turnover intention. Necessary measures should be taken by relevant departments to enhance the stability of rural general practitioners.

Objective:To explore the application of 3D printing technology combined with CPBL teaching mode in the teaching of master's degree in spine surgery.Methods:42 postgraduates in our department were randomly divided into two groups: experimental group (21) and control group (21). The experimental group used 3D printing technology combined with CPBL teaching mode as teaching techniques. Before class, the teacher would select some typical cases and design related problems. During class, 3D models were used to guide students to think and solve related problems; The control group used traditional teaching mode. Students in the two groups were compared for the theoretical knowledge and operational techniques they have mastered, and the students' satisfaction and recognition towards different teaching modes were obtained through questionnaire survey. Independent sample t-test was performed using SPSS 25.0.Results:The scores of the theoretical knowledge, operational techniques, teaching satisfaction and recognition of postgraduates were (84.7±3.4), (87.1±3.7), (9.7±0.3), (9.3±0.4) in the experimental group, and (79.7±3.3), (80.4 ± 4.0), (8.4±0.7) and (8.3±0.6) in the control group. The difference between the two groups was statistically significant ( P<0.05). Conclusion:The new teaching mode of combining 3D printing technology with CPBL teaching mode is better than the traditional teaching mode, which is worth further promotion and application.