Objective: To investigate the prevalence and influencing factors of menopausal syndrome among postmenopausal women in Pan'an County, Zhejiang Province, so as to provide the basis for guiding the health management of postmenopausal women. Methods: From May 2023 to April 2024, the postmenopausal women aged 40 to 69 years in Pan'an County were selected using the random cluster sampling method. Demographic information, lifestyle and prevalence of gynecological diseases were collected through questionnaire surveys. The prevalence of menopausal syndrome was assessed by modified Kupperman Score Scale. Factors affecting menopausal syndrome were analyzed by a multivariable logistic regression model. Results: A total of 816 postmenopausal women were surveyed, with an mean age of (57.63±2.92) years and a mean natural menopause age of (49.85±2.13) years. There were 574 cases with menopausal syndrome, with a prevalence of 70.34%. Flashes and sweating, insomnia and irritability were common symptoms, accounting for 62.87%, 47.43% and 41.18%, respectively. Multivariable logistic regression analysis showed that monthly personal income of ≤5 000 yuan (<3 000 yuan, OR=3.124, 95%CI: 1.829-5.335; 3 000-5 000 yuan, OR=2.399, 95%CI: 1.370-4.201) and having gynecological diseases (OR=1.970, 95%CI: 1.292-3.004) were associated with a higher risk of menopausal syndrome, while average (OR=0.141, 95%CI: 0.072-0.276) or sufficient sleep quality (OR=0.095, 95%CI: 0.049-0.185) were associated with a lower risk of menopausal syndrome. Conclusion The prevalence of menopausal syndrome among postmenopausal women in Pan'an County is relatively high, and is mainly influenced by personal economic status, sleep quality and the presence of gynecological diseases.

Objective To compare the early outcomes of domestic third-generation magnetically levitated left ventricular assist device (LVAD) with or without concomitant mitral valvuloplasty (MVP). Methods The clinical data of 17 end-stage heart failure patients who underwent LVAD implantation combined with preoperative moderate to severe mitral regurgitation in Fuwai Central China Cardiovascular Hospital from May 2018 to March 2023 were retrospectively analyzed. The patients were divided into a LVAD group and a LVAD+MVP group based on whether MVP was performed simultaneously, and early outcomes were compared between the two groups. Results There were 4 patients in the LVAD group, all males, aged (43.5±5.9) years, and 13 patients in the LVAD+MVP group, including 10 males and 3 females, aged (46.8±16.7) years. All the patients were successful in concomitant MVP without mitral reguragitation occurrence. Compared with the LVAD group, the LVAD+MVP group had a lower pulmonary artery systolic pressure and pulmonary artery mean pressure 72 h after operation, but the difference was not statistically different (P>0.05). Pulmonary artery systolic pressure was significantly lower 1 week after operation, as well as pulmonary artery systolic blood pressure and pulmonary artery mean pressure at 1 month after operation (P<0.01). There was no statistically significant difference in blood loss, operation time, cardiopulmonary bypass time, aortic cross-clamping time, mechanical ventilation time, or ICU stay time between the two groups (P>0.05). The differences in 1-month postoperative mortality, acute kidney injury, reoperation, gastrointestinal bleeding, and thrombosis and other complications between the two groups were not statistically significant (P>0.05). Conclusion Concomitant MVP with implantation of domestic third-generation magnetically levitated LVAD is safe and feasible, and concomitant MVP may improve postoperative hemodynamics without significantly increasing perioperative mortality and complication rates.

This study aims to develop an improved cell screening system for farnesoid X receptor (FXR) agonists based on a dual luciferase reporter gene system. FXR response element (FXRE) fragments from FXR target genes were cloned and inserted into upstream of firefly luciferase (Luc) gene in the plasmid pGL4-luc2P-Hygro. In combination with the internal reference plasmid containing renilla luciferase, a dual luciferase reporter gene system was developed and used for high throughput screening of FXR agonists. After studying the effects of over-expression of RXR, mouse or human FXR, various FXRE fragments, and different ratio of FXR plasmid amount to reporter gene plasmid, induction efficiency of the screening system was optimized by the known FXR agonist GW4064, and Z factor for the system reached 0.83 under optimized conditions. In summary, an improved cell screening system based on double luciferase reporter gene detection system was developed to facilitate the discovery of FXR agonists, where a new enhanced FXRE element was formed by a superposition of multiple FXRE fragments from FXR target genes, instead of a superposition of traditional IR-1 (inverted repeats-1) fragments.
Humans ; Mice ; Animals ; Transcription Factors/genetics* ; DNA-Binding Proteins/genetics* ; Receptors, Cytoplasmic and Nuclear/genetics* ; Genes, Reporter ; Luciferases/genetics*

ObjectiveTo investigate the status of self-management in patients with spinal cord injury and the related factors. MethodsFrom May, 2020 to February, 2021, 255 patients from a spinal cord injury club were enrolled, and investigated with the general information questionnaire, self-management ability scale, Chronic Disease Self-efficacy Scale through internet. Multiple linear stepwise regression was used to explore the related factors. ResultsThe scores of disease symptom management, daily life management, intermittent catheterization behavior management, emotional management and social return were (40.458±9.122), (33.945±6.800), (36.709±8.736) and (25.011±4.932), respectively. The average score for the single question of daily life management was the highest (3.772±0.755), while emotional management and social return was the lowest (3.573±0.705). Duration of intermittent catheterization, family members' attitude, self-efficacy and occupation were the related factors of symptom management (R² = 0.135, F = 7.744, P < 0.001). Self-efficacy, duration of intermittent catheterization, use of hydrophilic coated catheters and complications were the related factors of daily life management (R² = 0.173, F = 13.042, P < 0.001). Self-efficacy, duration of intermittent catheterization, use of hydrophilic coated catheters and medical insurance were the related factors of intermittent catheterization behavior management (R² = 0.141, F = 10.259, P < 0.001). Self-efficacy, duration of intermittent catheterization, complications and frequency of intermittent catheter in the last week were the related factors of emotional management and social regression dimensions (R² = 0.282, F = 19.590, P < 0.001). ConclusionThe self-management of patients with spinal cord injury by clean intermittent catheterization is at medium level. Moreover, it may be affected by many factors. Some of them can be targets of intervention.

Antibodies, Antinuclear ; Autoantibodies ; China ; Cohort Studies ; Humans ; Scleroderma, Systemic

Objective:To study the clinical characteristics of hepatic injury following umbilical vein catheterization, so as to improve the safety and use of umbilical vein catheterization in the newborn.Methods:Data of infants undergoing umbilical vein catheterization during hospitalization in the neonatology department of the Third Affiliated Hospital of Guangzhou Medical University from Jan 1st, 2015 to Dec 31st, 2019 were collected retrospectively.The clinical characteristics, diagnoses and treatments of the infants with hepatic injury following umbilical vein catheterization were summarized and analyzed.And the relative literature was reviewed.Results:A total of 1 721 infants underwent umbilical vein catheterization, and seven cases(0.4%)had hepatic injury, including six cases of exudative necrosis in the liver and one case of hepatic hematoma.There was no significant difference in gestational age[(31.12±2.64)weeks vs.(30.62±2.75)weeks]or birth weight[(1 493±525)g vs.(1 374±473)g]between hepatic injury group and non-hepatic injury group( P>0.05). Clinically, it was found that the tip position of umbilical vein catheter was below the diaphragm(between the 9th and 11th thoracic vertebrae)in all seven cases.Except one case with no obvious clinical symptoms, the other six cases had clinical symptoms, mainly manifested as abdominal distension, repeated gastric retention, decreased bowel sounds, and additional with shock and anemia in hepatic hematoma.Blood sample tests showed elevated C-reactive protein, white blood cell count and transaminase.X-ray examination revealed cystic translucent shadow in the liver, and ultrasound and/or computed tomography examination showed the lesion in more detail.After removal of the catheter and administration of antibiotic, the hepatic injury recovered gradually. Conclusion:The hepatic injury following umbilical vein catheterization in neonates is not common.The catheter tip under the diaphragm is the main risk factor.And the diagnosis is dependent on imaging examination.

With the development of ultrasound technology, the needle position and local anesthetic diffusion can be observed in real time, and therefore, the accuracy and success rate of nerve block have been significantly improved. Ultrasound-guided fascial space block, such as transversus abdominis plane block and quadratus psoas block, has been widely used in postoperative analgesia in delivery woman. This paper reviews the application of ultrasound-guided fascial space block in postoperative analgesia of cesarean section in recent years, in order to provide reference for further clinical application.

Objective:To construct an early warning score model for the identification of hand-foot-mouth disease (HFMD) in children using the decision tree, and to provide scientific evidence for early recognition of critical HFMD in clinical practice.Methods:The medical records of 2 488 children with severe and critical HFMD hospi-talized in Qingdao Women and Children′s Hospital from January 2014 to December 2016 were retrospectively analyzed.Multivariate Logistic regression analysis was made to screen the independent risk factors of critical HFMD.An early warning score model for identifying children with HFMD was established by using the chi- square automatic interactive detection method in the decision tree, and the effectiveness of the model was evaluated by the receiver operating characteristic curve (ROC). Results:The multivariate Logistic regression analysis identified 5 independent risk factors of critical HFMD, including age<3 years old, blood sugar≥8.0 mmol/L, body temperature≥39.0 ℃, limb shaking and trembling, and hand-foot herpes.Two risk factors, i.e., blood sugar and body temperature, were included in the tree chart through the decision tree, and scoring criteria were established according to the tree chart.Combining the early warning scoring system for children, the warning model were finally set up, which consisted of 5 dimensions and inclu-ded 9 evaluation indicators: consciousness, skin color, heart rate, capillary refill time, respiratory frequency, participation of respiratory muscles, oxygen therapy, blood sugar and body temperature.Each dimension ranged from 0 to 3 points, totaling 0-15 points.The area under the ROC, sensitivity, specificity, maximum Youden index, and cut-off value of the model were 0.911, 0.910, 0.774, 0.684, and 6.5, respectively. Conclusions:The early warning score model established in this paper can accurately identify critical HFMD, with high sensitivity and specificity.

Objective:To construct evaluation index system of traditional Chinese medicine (TCM) nursing quality of tuberculosis bases on "structure-process-result" three-dimensional quality structure model as a framework so as to provide evaluation standards and basis for tuberculosis TCM nursing quality management.Methods:By the convenient sampling method, 12 doctors and nurses in tuberculosis department from 2 third-class grade-A hospitals of Traditional Chinese medicine or integrated traditional Chinese and western medicine hospital in Zhejiang province were selected from March 2019 to April 2019 in order to conduct semi-structured interviews. 26 nursing experts were selected for expert consultation. Through literature research, semi-structured interview, Delphi method and superiority chart, the evaluation index system of TCM nursing quality of tuberculosis and the weight of each index were established.Results:The effective recovery rates of the letter questionnaires were 84.62% (22/26) and 77.27% (17/22) , the expert authority coefficients were respectively 0.831 and 0.843 and the Kendall's W were respectively 0.236 and 0.335. The eventually established evaluation index system of TCM nursing quality of tuberculosis included 3 first-level indicators, 16 second-level indicators and 56 third-level indicators. Conclusions:In this study, the evaluation index system of TCM nursing quality of tuberculosis constructed by various methods is more scientific, complete and reliable, which can provide references for the evaluation of TCM nursing quality of tuberculosis and the formulation of standard.

An iceberg model for better understanding the patients was developed.In this model the seeking for consultation is visible part of illness behavior,but the thoughts,concerns and expectations toward his or her illness are the hidden parts.Through detailed history taking,using appropriate language skill (Leichester Assessment Package) and nonverbal communication skill (space distance,eye contact,listening,pronunciation,appropriate silence),physicians can acquaint comprehensive knowledge about the hidden thoughts,concern and expectation of patients about their illness.This model would help general practitioners to raise communication and consultation ability and skills in their practice.