OBJECTIVES: To study the correlation of intestinal dominant flora with hyperuricemia, and to explore influencing factors of hyperuricemia. METHODS: Data of gut dominant microbiota were collected from subjects who underwent health check-up in Shulan (Hangzhou) Hospital from January 2018 to April 2020. Subjects with high uric acid and normal uric acid were matched by propensity score matching method according to age, gender and body mass index (BMI). This resulted in 178 pairs as hyperuricemia group and control group. The gut dominant microbiota between hyperuricemia and normal control group were compared. Pearson or Spearman correlation coefficient method was used to analyze the correlation between blood uric acid and intestinal dominant flora. Univariate and multivariate logistic regression were used to analyze the influencing factors of hyperuricemia. RESULTS: The abundance of Atopobium, Lactobacillus, Bacteroides, Enterococcus, Clostridium leptum, Fusobacterium prausnitzii, Bifidobacterium, Clostridium butyricum and the ratio of Bifidobacterium to Enterobacter (B/E) in the hyperuricemia group were significantly lower than those in the control group (all P<0.01). The correlation analysis showed that serum uric acid were negatively correlated with the abundance of Atopobium (r=－0.224, P<0.01), Bacteroides (r=－0.116, P<0.05), Clostridium leptum (r=－0.196, P<0.01), Fusobacterium prausnitzii (r=－0.244, P<0.01), Bifidobacterium (r=－0.237, P<0.01), Eubacterium rectale (r=－0.125, P<0.05), Clostridium butyricum (r=－0.176, P<0.01) and B/E value (r=－0.127, P<0.05). Multivariate logistic regression analysis showed that glutamyl transpeptidase was an independent risk factor for hyperuricemia (OR=1.007, 95%CI: 1.002-1.012, P<0.05), and the Atopobium was an independent protective factor for hyperuricemia (OR=0.714, 95%CI: 0.605-0.842, P<0.01). CONCLUSIONS There are alterations in abundance of gut dominant microbiota in patients with hyperuricemia, and Atopobium abundance appears as a protective factor for hyperuricemia.
Humans ; Uric Acid ; Hyperuricemia ; Body Mass Index ; Risk Factors ; Microbiota

Objective:To focus on the physical activity strategy to maintain the activity ability of the elderly in the community, comprehensively retrieve and integrate the best evidence, form practical suggestions with the goal of the transformation and practice of evidence, so as to provide scientific, reliable and up-to-date basis for the implementation of relevant evidence.Methods:According to the 6S pyramid model, the British Medical Journal (BMJ) Best Practice, UpToDate, DynaMed, World Health Organization, Chinese Medical Association, National Institute for Health and Care Excellence, Scottish Intercollegiate Guidelines Network, New Zealand Guidelines Group, PubMed, SinoMed and other databases were retrieved layer by layer from top to bottom. This study obtained all articles of evidence-based knowledge base resources, clinical practice guidelines, expert consensus, systematic review and other types related to physical activity strategies to maintain the activity ability of the elderly in the community from January 1, 2017 to March 1, 2022. According to the inclusion and exclusion criteria of the article, 2 to 4 researchers conducted independent methodological quality evaluation on different types of article according to the tool requirements, extracted and summarized the best evidence, and formed practical suggestions.Results:A total of 14 articles were included, including 2 evidence-based decision-making, 6 guidelines, 1 expert consensus, 3 systematic reviews, and 2 overviews of systematic review. Seven dimensions such as "overall advice, health benefits, diversified sports training, aerobic training, balance training, muscle strengthening/resistance training, flexibility training" and 22 best pieces of evidence were extracted and summarized, and practical suggestions were formed.Conclusions:Medical and nursing staff should adopt evidence-based methodological practical suggestions to provide management guidance and consultation for the maintenance of physical activity ability of the elderly in the community, so as to help the elderly to maintain physical activity ability and gain health benefits.

Objective: To understand the awareness of palliative care and its influencing factors in community residents in Hangzhou,so as to provide basis for the development of palliative care service. Methods: By convenient sampling method,the residents in the urban-rural junction of Xihu District were recruited. A self-designed questionnaire was used to investigate their awareness of palliative care. The logistic regression model was employed to analyze the influencing factors. Results : A total of 519 questionnaires were recovered,with a response rate of 97.92%. There were 227 males and 292 females,accounting for 43.74% and 56.26%,respectively. There were 43,218 and 258 residents with more,basic and little understanding about palliative care, accounting for 8.29%,42.00% and 49.71%. The residents learned about palliative care mainly through television and radio,with 245 cases accounting for 47.21%;and they thought that the main reason for low awareness of palliative care was a lack of related knowledge,with 396 cases accounting for 76.30%. The results of multivariate logistic regression analysis showed that 50-59 years old（OR = 0.467,95% CI：0.285-0.767）,primary school education and below（OR = 2.248,95%CI：1.239-4.079）and experience of caring for dying patients（OR = 1.551,95% CI：1.094-2.199）were the influencing factors for the awareness of palliative care. Conclusion The residents in Hangzhou had relatively low awareness of palliative care,which were associated with age,education level and experience of caring for dying patients.

Objective: To investigate the attitude to death, work engagement and organizational citizenship behaviors (OCB) in emergency nurses, and to analyze the relationships among them. Methods: Two hundred and fifty-one emergency nurses were investigated with Chinese version of Death Attitude Profile-Revised (DAP-R), the Medical Personnels Work Engagement questionnaire and Medical Staffs, Organizational Citizenship Behavior questionnaire. Results: The attitude to death in emergency nurses was relatively positive and the total score of DAP-R was 103.49±14.76.There were significant differences on the score of nursing ages, emergency working years and religious beliefs (F=4.584, 6.159, 5.251, P<0.01). The neutral acceptance to death was positively correlated with the work engagement (r=0.098, P<0.01) , the work engagement was negatively correlated with death avoidance (r=-0.177, P<0.01) .The neutral acceptance to death was positively correlated with the OCB, civic responsibility and responsible behavior (r=0.155, 0.161, 0.202, P<0.05 or 0.01). Conclusion The attitude to death has significant influence on work engagement and OCB in emergency nurses. Nursing administrators should through establishing an effective strategies to improve the positive attitude to death and OCB level. Ultimately, give full play to the role of the emergency department nurse in terminal care and quality of emergency medical care can be improved.

Objective To investigate the current status and influencing factors of work engagement in emergency nurses, put forward a feasible strategy, improve the emergency department nurses work engagement for the emergency department to build effective human resource management to provide the reference. Methods A total 226 emergency nurses from 8 hospital of first-class in Tianjin city were recruited by the convenience sampling method and investigated with a self designed, the Medical Personnel′s Work Engagement Questionnaire. Results The total score of Medical Personnel′s Work Engagement Questionnaire was 111-166(137.32 ± 12.48) points and the scores were the highest in interpersonal concordance (4.20 ± 0.46) points and the lowest in work vigor (3.01 ± 0.61) points. Variance analysis and multiple linear regression analysis showed that gender, employment category and number of years as an emergency nurses were the influencing factors of work engagement, which could explain 51.3%of the variance. Conclusions Work engagement emergency of nurses is at a relatively moderate-to-high level, through establishing an effective incentive mechanism, increasing social benefits, accelerating the construction of emergency specialist nurse training system and paying attention to occupational development, work engagement level and quality of emergency medical care can be improved.

Objective To explore the enhancement effects and mechanisms of IL-32β on human cervical carcinoma cells C33A to hypoxic/hypoglycemic condition.Methods After cultured in hypoxia/hypoglycemic circumstance and normal circumstance for 20 hours respectively, the mRNA and protein expression of IL-32β in C33A cells were detected by real time-polymerase chain reaction (RT-PCR) and Western blotting respectively.Trypan blue stain was used to detect C33A cells viability in hypoxia/hypoglycemic circumstance and adding 10, 100,500 ng/ml IL-32β circumstance.The xenografted tumor of nude mice was established by intraperitoneal injection, and their volumes were tested for a given time after injecting 0, 1.0 mg/kg IL-32β.siRNA was used to construct IL-32β knockdown cells and detect the expression of VEGF.Results Under the hypoxia/hypoglycemic circumstance, the expressions of IL-32β mRNA were (6.12 ± 0.03) times of the normal circumstance (F =43.16, P ＜ 0.05), the expressions of IL-32β protein were (2.23 ± 0.04) times of the normal circumstance (F =22.32, P ＜ 0.05).The C33A cells viability in hypoxia/hypoglycemic circumstance was (51.92 ± 3.41) ％, whereas, viability in 10 ng/ml IL-32β group was (55.23 ± 3.92) ％ (F =14.25, P ＜ 0.05), viability in 100 ng/ml IL-32β group was (62.52 ± 4.14) ％ (F =35.53, P ＜ 0.01), viability in 500 ng/ml IL-32β group was (69.14 ± 2.45) ％ (F =56.28, P ＜ 0.01).After 28 days, the volume of xenografted tumor of 0 mg/kg IL-32β group was (578 ± 64)mm3, and 1.0 mg/kg IL-32β group up to (1 402 ± 142) mm3 (F =27.84, P ＜ 0.01).In addition, compared with control group, the expression of VEGF in IL-32β knockdown C33A cells was significantly decreased (F =36.85, P ＜ 0.05).Conclusion IL-32β can enhance the resistance to hypoxic/hypoglycemic condition of C33A cells, which is associated with the increase of VEGF.

Objective To define the patterns of local extension and nodal involvement in patients with early stage nasal NK/T-cell lymphoma, and to improve the delineation of clinical target volume.Methods Two hundred and twenty-two patients consecutively diagnosed with nasal NK/T-cell lymphoma were reviewed.All patients had stage Ⅰ E/Ⅱ E diseases.CT/MRI images were reviewed to determine the local invasion of adjacent organs or structures and involvement of lymph node.Results 143 of 222(64%) patients had primary tumor extended into adjacent organs or structures from nasal cavity.According to the incidence rates of tumor extension, the involved organs or structures were subclassified into three subgroups:high risk (≥40%):ethmoid sinus (60%) and maxillary sinus (55%);intermediate risk (5%-40%):nasopharynx (39%), skin (22%), oropharynx (12%), orbit (10%), and hard palate (10%);and low risk (≤5%):sphenoid sinus (3%), soft plate (3%),frontal sinus (3%) and skull base (1%).Cervical lymph node metastasis occurred in 16%(36/222) of the patients and these patients were staged as Ⅱ E.Thirty-three patients with stage Ⅱ E disease had available images and were analyzed for the pattern of nodal involvement.Submandibular or submental (57%) and the upper cervical lymph nodes (57%) were the most commonly involved sites of nodal region.For the 24 patients with primary tumor located in the unilateral nasal cavity, 54% presented with contralateral cervical lymph node metastasis.Whereas for the 9 patients with primary tumor located in the bilateral nasal cavity, 57% had bilateral cervical lymph node metastasis.For the 88 patients with extensive stage Ⅰ E disease who did not receive irradiation to the cervical lymph node, only one patient (1%) had disease relapse in cervical lymph node.Furthermore, all patients with disease extended to nasopharynx (n= 23) or oropharynx (n= 8) did not receive prophylactic cervical lymph node irradiation, and none of them developed cervical lymph node relapse.Conclusions The delineation of clinical target volume for early stage nasal NK/T-cell lymphoma should be determined by the risk of involvement of paranasal structures and cervical lymph node.Prophylactic neck irradiation is not recommended for patients with stage Ⅰ disease.

Objective To establish a method for rapid determination of the lead in air by water phase of solubilisation dithizone photometry. Methods The lead in air was determined by water phase solubilisation dithizone photometry with Tween20 as the solubilizer. Results The linear range was 1.0-100 mg/L(r≥0.999),RSDs were 1.36%～9.57%,the recovery rates were 97.4%-98.3%,the lowest detected concentration was 0.003 mg/m3. There was no significant difference between the result of this method and that of colorimetry. Conclusion The method was rapid,accurate and sensitive,this method is suitable for rapid determination of lead in the air.

Objective To determine the incidence of pregnancy complicated with heart disease and assess the current obstetric management principles of pregnancy complicated with heart disease. Methods 428 cases of pregnancy complicated with heart disease were reviewed.54 cases were sur- gically corrected heart disease.Results:The incidence of pregnancy complicated with heart dis- ease,during January,1973 to December,1982 and January,1983 to December,1992,were 1.2% (254/21 221) and 0.9% (174/18 726)respectively.The ratio of rheumatic heart disease and congenital heart disease were 4:1 and 1:2 in two periods.There were 37 cases of heart failure and 4 cases of ma- ternal deaths occured.No heart failure and maternal death occured in cases with surgically corrected heart disease.In the two periods,the cesarean section rate were 16.9%(43/254),and 33.3% (58/74) ,P