ObjectiveTo observe the clinical effect of modified Huanglian Wendantang on cardiovascular risk factors in patients with metabolic syndrome under the guidance of treating disease before its onset. MethodsA total of 82 patients with metabolic syndrome treated in the First Affiliated Hospital of Heilongjiang University of Chinese Medicine from July 2023 to July 2024 were selected and allocated into an observation group （41 cases） and a control group （41 cases） by the random number table method. The control group received routine treatment， and the observation group was treated with modified Huanglian Wendantang on the basis of routine treatment. Both groups were treated for 8 weeks. The therapeutic effects on TCM symptoms after treatment in the two groups were evaluated. The levels of obesity degree indicators， blood pressure indicators， glucose and lipid metabolism indicators， inflammatory factors， and vascular endothelial function indicators before and after treatment in the two groups were measured， and the treatment safety was evaluated. ResultsAfter treatment， the total response rate of TCM symptoms in the observation group was 97.56% （40/41）， which was higher than that （87.80%， 36/41） in the control group （χ²=5.205， P<0.05）. After treatment， both groups showed declines （P<0.05） in systolic blood pressure （SBD）， diastolic blood pressure （DBP）， triglyceride （TG）， total cholesterol （TC）， low density lipoprotein cholesterol （LDL-C）， fasting blood glucose， 2-hour postprandial blood glucose （2 h PG）， glycosylated hemoglobin （HbA1c）， fasting insulin （FINS）， Homeostatic Model Assessment for Insulin Resistance （HOMA-IR）， body mass index （BMI）， waist circumference （WC）， waist-to-hip ratio （WHR）， leptin （LEP）， interleukin-6 （IL-6）， tumor necrosis factor-α （TNF-α）， endothelin-1 （ET-1）， and inducible nitric oxide synthase （iNOS）. Moreover， the declines in the observation group were more obvious than those in the control group （P<0.05， P<0.01）. After treatment， both groups showed elevated levels of high density lipoprotein cholesterol （HDL-C）， adiponectin （ADP）， nitric oxide （NO）， and endothelial nitric oxide synthase （eNOS） （P<0.05）， and the above indexes in the observation group were higher than those in the control group （P<0.01）. ConclusionUnder the guidance of the thought of treating disease before its onset， modified Huanglian Wendantang was used to treat patients with metabolic syndrome. The decoction improved the clinical efficacy by ameliorating IR to improve insulin sensitivity， reducing inflammation， and protecting the vascular endothelial function. It inhibits cardiovascular risk factors without inducing adverse reactions， being worthy of clinical application and promotion.

Objective:To explore the effect of self-made simple gastric simulation in nursing clinical teaching of machine gastric lavage.Methods:A total of 90 subjects were selected from the four-year nursing undergraduates of Dalian Medical University from July 2018 to December 2019 by the convenience sampling method. According to the chronological order, they were divided into the control group and the experimental group by different teaching modes with 45 cases in each group.Control group from July 2018 to March 2019 received the traditional teaching mode, experimental group from April 2019 to December 2019 received the self-made simple simulation of the stomach in gastric lavage machine surgery nursing clinical teaching pattern.After the internship, teaching quality was evaluated by gastric lavage machine theory and operation of nursing students, and the teaching effect of nursing students' satisfaction questionnaire was investigated.Results:The theoretical and operational scores of the students were (86.89±3.79), (91.33±2.15) points in the experimental group,and (74.64±7.78), (76.84±5.71) points in the control group, the differences between the two groups were statistically significant ( t values were 9.48, 15.92, P<0.01). Students to stimulate interest in learning, students participate in the trial group, ability, improve the learning initiative, increase the clinical thinking ability, empathy and compassion, deepen nursing connotation, like teachers teaching form seven dimensions of satisfaction score were (4.26±0.53), (4.18 ±0.57), (4.16±0.55), (4.21±0.51), (4.13±0.54), (4.06±0.59), (4.24±0.54) points in the experimental group, and (2.66±0.92), (2.61±0.85), (2.35±0.83), (2.72±0.89), (2.45±0.81), (2.70±0.89), (2.59±0.86) points in the control group, the differences between the two groups were statistically significant ( t values were 8.55-11.99, P<0.01). Conclusions:The clinical teaching application model of self-made simple gastric simulation in machine gastric lavage can significantly improve the quality and satisfaction of clinical nursing teaching.

Objective:To evaluate the prognostic effects of two comprehensive geriatric assessment (CGA) methods in elderly patients with acute myeloid leukemia (AML).Methods:Ninety-seven patients with newly diagnosed AML at Beijing Hospital from August 2008 to December 2019 were included (≥60 years old). All patients were evaluated by two methods of CGA. One was IACA index proposed by Beijing Hospital, including instrumental activities of daily living (IADL), age, Charlson comorbidity index (CCI), albumin; the other was proposed by Italian FIL study group (FIL-CGA), including activities of daily living (ADL), IADL, age, and modified cumulative illness rating score for geriatrics (MCIRS-G).Results:Among 97 patients, 54 patients received standard chemotherapy, 16 with decitabine, 2 with targeted therapy and 25 with the best supportive therapy. The overall response rate (ORR) in 72 treated patients were 67.7%, 33.3% and 0 respectively in fit, unfit and frail groups according to IACA index ( P=0.001). Based on FIL-CGA, the ORRs of fit, unfit and frail groups were 52.5%, 41.7% and 35.0% respectively ( P=0.418). The 1-year OS rates of fit, unfit and frail groups regarding IACA method were 78.7%, 27.7% and 0 respectively ( P<0.01). The 1-year OS rates of fit, unfit and frail groups regarding FIL-CGA method were 67.8%, 28.2% and 13.9% respectively ( P<0.01), while no significant difference was seen between unfit group and frail group ( P=0.111). The early death rates of fit, unfit and frail groups by IACA were 0, 6.0% and 28.6% respectively ( P=0.006), while those by FIL-CGA were 2.3%, 5.9%, 13.9% respectively ( P=0.123). Conclusion:Compared with FIL-CGA method, IACA predicts more effectively the treatment response, survival and early mortality in elderly patients with AML.

Chloroquine (CQ) phosphate has been suggested to be clinically effective in the treatment of coronavirus disease 2019 (COVID-19). To develop a physiologically-based pharmacokinetic (PBPK) model for predicting tissue distribution of CQ and apply it to optimize dosage regimens, a PBPK model, with parameterization of drug distribution extrapolated from animal data, was developed to predict human tissue distribution of CQ. The physiological characteristics of time-dependent accumulation was mimicked through an active transport mechanism. Several dosing regimens were proposed based on PBPK simulation combined with known clinical exposure-response relationships. The model was also validated by clinical data from Chinese patients with COVID-19. The novel PBPK model allows in-depth description of the pharmacokinetics of CQ in several key organs (lung, heart, liver, and kidney), and was applied to design dosing strategies in patients with acute COVID-19 (Day 1: 750 mg BID, Days 2-5: 500 mg BID, CQ phosphate), patients with moderate COVID-19 (Day 1: 750 mg and 500 mg, Days 2-3: 500 mg BID, Days 4-5: 250 mg BID, CQ phosphate), and other vulnerable populations (.., renal and hepatic impairment and elderly patients, Days 1-5: 250 mg BID, CQ phosphate). A PBPK model of CQ was successfully developed to optimize dosage regimens for patients with COVID-19.

Objective To evaluate the performance of axial-pattern composite tissue flap in the repair of skin defects after lip cancer resection.Methods From July 2012 to December 2017,8 patients with lip cancer were enrolled from Department of Dermatology,the Second Hospital of Jilin University.After lip tumor resection,the full-thickness defects were as long as 1/3 to 1/2 length of the lip,and were repaired with axial-pattern composite tissue flaps based on labial arteries.Results All the axial-pattern composite tissue flaps survived after the surgery.During the follow-up of 6 months to 5 years,no tumor recurrence was observed in the 8 patients,the shape and function of lips were improved,and the patients were satisfied.Conclusion Skin defects after lip cancer surgery can be repaired with axial-pattern composite tissue flaps based on labial arteries,which can restore the anatomical structure and aesthetic function of the lip well.

Objective To assess the theoretical knowledge and practical skills of parasitic diseases among technicians from disease control and prevention institutions. Methods The Assessment on National Parasitic Disease Control and Prevention Techniques was organized in September,2015. Together,124 subjects from disease control and prevention institutions at prov-ince,prefecture or county levels in 31 provinces joined the assessment. A database was built consisting of subjects'basic infor-mation and assessment scores. Statistical analysis was used to analyze the scores by gender,age,professional title,institutions and places of participants. Results The average total score of all the subjects was 123.3,with a passing rate of 57.3%. The av-erage scores of male subjects(48 subjects)and female subjects(76 subjects)were 125.9 and 121.7 respectively;the average scores of the subjects aged under 30 years(57 subjects),between 30 and 40 years(61 subjects)and above 40 years(6 sub-jects)were 119.6,128.1 and 111.2 respectively;the average scores of persons with junior(94 subjects),intermediate(28 sub-jects)and senior(2 subjects)professional titles were 119.2,135.9 and 140.5 respectively. The average theoretical assessment score of all the subjects was 61.9,with a passing rate of 62.9%. The average practical skill assessment score of all the subjects was 61.4,with a passing rate of 58.1%. Conclusions The theoretical assessment results range widely. The theoretical knowl-edge results of technicians from disease control and prevention institutions are low in general. Therefore ,the specific training based on daily work needs to be enhanced.

Objective To explore perioperative nursing of excision with vertical and horizontal incision and repair of palpebral margin pigmented nevus.Methods Ten patients with palpebral margin pigmented nevus excision of vertical and horizontal incision and repair were selected as research objects,perioperative nursing and effect of palpebral margin pigmented nevus excision.Results The pathological examination showed it was benign lesions and postoperative incision of 10 patients was successful with eyes symmetrical in shape,normal eyes'open and close function,no complications,and no deformity.After followed up for 1 year after operation,there was no recurrence and obvious scar.Conclusion Excision with vertical and horizontal incision and repair of palpebral margin pigmented nevus is characterized by smaller wound surface,less complications,and better postoperative recovery.And it is crucial for success of surgery and postoperative recovery to carry out perioperative nursing.

Objective To explore perioperative nursing of excision with vertical and horizontal incision and repair of palpebral margin pigmented nevus.Methods Ten patients with palpebral margin pigmented nevus excision of vertical and horizontal incision and repair were selected as research objects,perioperative nursing and effect of palpebral margin pigmented nevus excision.Results The pathological examination showed it was benign lesions and postoperative incision of 10 patients was successful with eyes symmetrical in shape,normal eyes'open and close function,no complications,and no deformity.After followed up for 1 year after operation,there was no recurrence and obvious scar.Conclusion Excision with vertical and horizontal incision and repair of palpebral margin pigmented nevus is characterized by smaller wound surface,less complications,and better postoperative recovery.And it is crucial for success of surgery and postoperative recovery to carry out perioperative nursing.

OBJECTIVETo analyze the associations between pregnancy-related anxiety and the prevalence of subthreshold autism trait (SAT) in preschool children.

METHODSBaseline data came from the Ma'anshan Birth Cohort Study, a part of the China-Anhui Birth Cohort Study (C-ABCS). All the participants were enrolled among pregnant women who received prenatal health care in 4 municipal medical centers during Oct. 2008 to Oct. 2010. A total of 5 084 pregnant women were recruited at the beginning and 4 669 singleton live births were included until childbirth. The situation about pregnancy-specific anxiety during trimester and third trimester of women were evaluated by Pregnancy-specific Anxiety Questionnaire (PAQ). Between April 2014 and April 2015, the cohort was followed up again, and the Clancy Autism Behavior Scale (CABRS) filled out by parents was used for telling the SAT children from the healthy children among 3 663 preschool children. Univariate and binary regression model was used to estimate associations between the pregnancy-related anxiety during trimester and third trimester and the subthreshold autism trait in children.

RESULTSDuring the pregnancy, the detected rates of women with pregnancy-specific anxiety in trimester and the third trimester were 25.5%(935/3 663), 13.9%(501/3 592) respectively, and the detected rate of maternal pregnancy-specific anxiety in both periods was 7.7%(278/3 592). There were 290 positive children with SAT and the detection rate was 7.9%. After controlling possible confounding factors including children's genders, place of residence, supplement folic acid during pregnancy, preterm birth, exposure to second-hand smoke during pregnancy, the father (mother) cultural levels, the father (mother) nature of work and family income, the results of multinomial logistic regression analysis showed that maternal pregnancy-specific anxiety in trimester was the risk factor for SAT in preschool children (OR=1.51, 95% CI: 1.11-2.04), and there was no association between maternal pregnancy-specific anxiety in the third trimester and SAT in preschool children (OR=1.36, 95% CI: 0.82-2.22). Compared with the single function of maternal pregnancy-specific anxiety in trimester or the third trimester for SAT in preschool children, maternal pregnancy-specific anxiety in both periods presented a joint action that increasing the risk for SAT (OR=2.02, 95% CI: 1.36-2.98).

CONCLUSIONMaternal pregnancy-related anxiety was a risk factor for subthreshold autism trait in preschooler children. Pregnant women should try to keep a good mental state to create a good environment for fetal growth.

Anxiety ; epidemiology ; Autistic Disorder ; epidemiology ; Child ; Child, Preschool ; China ; Cohort Studies ; Dietary Supplements ; Female ; Humans ; Infant, Newborn ; Pregnancy ; Pregnancy Complications ; psychology ; Pregnancy Trimester, Third ; psychology

Objective To analyze the relationship between pulse wave velocity (PWV)in young and middle-aged normal body mass patients with mild -moderate hypertensive and risk factors of cardiovascular diseases,and to explore the main factors influencing large arterial elasticity.Methods PWV were measured by Complior (Colson, France).Systolic blood pressure (SBP)and diastolic blood pressure were measured and fasting blood glucose,blood lipid were tested at the same time.The results was analyzed by correlation and multiple regression method.Results (1)Patients with hypertension had statistically significant higher cfPWV than nonhypertensive cases(P <0.01).(2) Correlation analysis showed that the cfPWV were positively related to age,systolic pressure,diastolic pressure,pres-sure difference(r =0.401,0.467,0.289,0.278,P =0.001,0.000,0.020);Deleting the factors of age,abdomen circumference and BMI,the cfPWV was still positively related to systolic pressure,diastolic pressure and pressure differences(r =0.417,0.297,0.315,P =0.001,0.018,0.012).Multiple regression analysis showed that age,systol-ic pressure were mostly related to cfPWV(t =3.945,3.481,P =0.000,0.001).Conclusion Artery elastic function in young and middle aged people is obviously lower in patients with hypertension.cfPWV has strong positive relation with age and systolic pressure.