OBJECTIVE: To identify phytochemical constituents present in the extract of flowers of Xanthoceras sorbifolia and evaluate their anti-oxidant and anti-hyperglycemic capacities. METHODS: The AlCl₃ colorimetric method and Prussian Blue assay were used to determine the contents of total flavonoids and total phenolic acids in extraction layers, and the bioactive layers was screened through anti - oxidative activity in vitro. The Waters ACQUITY UPLC system and a Waters ACQUITY UPLC BEH C₁₈ column (2.0 mm × 150 mm, 5 μm) were used to identify the ingredients. And anti-oxidative ingredients were screened by off-line UPLC-QTOF-MS/MS-free radical scavenging. The ameliorative role of it was further evaluated in a high-fat, streptozotocin-induced type 2 diabetic rat model and the study was carried out on NADPH oxidase (PDB ID: 2CDU) by molecular docking. RESULTS: Combined with the results of activity screening in vitro, the anti - oxidative part was identified as the ethyl acetate layer. A total of 24 chemical constituents were identified by liquid chromatography-mass spectrometry in the ethyl acetate layer and 13 main anti-oxidative active constituents were preliminarily screened out through off-line UPLC-QTOF-MS/MS-free radical scavenging. In vivo experiments showed that flowers of X. sorbifolia could significantly reduce the blood glucose level of diabetic mice and alleviate liver cell damage. Based on the results of docking analysis related to the identified phytocompounds and oxidase which involved in type 2 diabetes, quercetin 3-O-rutinoside, kaempferol-3-O-rhamnoside, isorhamnetin-3-O-glucoside, and isoquercitrin showed a better inhibitory profile. CONCLUSION The ethyl acetate layer was rich in flavonoids and phenolic acids and had significant anti-oxidant activity, which could prevent hyperglycemia. This observed activity profile suggested X. sorbifolia flowers as a promising new source of tea to develop alternative natural anti-diabetic products with a high safety margin.

Objective To study the clinical characteristics and related factors affecting the severity of acute tinnitus in patients.Methods A retrospective analysis was conducted on the data of 319 patients with acute tinni-tus.All patients had detailed case history,including basic patient information,tinnitus location,course of disease,acoustic characteristics of tinnitus,hearing loss,combined headache,dizziness,aural fallness,earache and other symptoms,as well as accompanying clinical diseases.All patients completed the tinnitus handicap inventory(THI),generalized anxiety disorder(GAD-7),patient health questionnaire(PHQ-9),pittsburgh sleep quality index(PSQI),hyperacusis questionnaire(HQ),type D personality scale-14(DS-14),etc.The mild tinnitus group was determined based on a THI score of ≤36.The moderate tinnitus group was determined based on a THI score of 38～56.The severe to extremely severe tinnitus group was determinded based on THI 56～100.THI grouping was used as the dependent variable and the above factors as independent variables.The correlation between each factor and the severity of acute tinnitus was analyzed using ordered multinomial logistic regression.Results Among 319 patients with acute tinnitus,158(49.5％)were in the mild tinnitus group,and 72(22.6％)were in the moderate tinnitus group,and 89(27.9％)were in severe to extremely severe tinnitus group.Ordered multinomial logistic re-gression analysis found that hyperacusis(OR=3.921),anxiety(OR=2.495),depression(OR=2.921),and D-type personality(OR=0.349)were associated with the severity of acute tinnitus(P＜0.05),with more serere tin-nitus in these patients.Conclusion Hyperacusis,anxiety,depression,and D-type personality may be factors that affect the severity of acute tinnitus,so high attention should be paid when treating patients with acute tinnitus.

Objective: To investigate the sleep status among primary and middle school students in Zhoushan City, Zhejiang Province, so as to provide insights into improving the sleep quality among primary and middle school students. Methods: A district and a county was selected using the cluster random sampling method from Zhoushan City in October, 2019, and grades 4 to 6 primary school students, junior high school and high school students were sampled as the study subjects. Students' gender, grade, residing in schools, duration of homework and duration of extracurricular classes were collected using the questionnaires of the 2019 national program for common diseases and health risk factors surveillance and intervention program among Chinese students. According to the Plan for the Comprehensive Prevention and Control of Myopia among Children and Adolescents, daily sleep duration of 10 h and longer among primary school students, 9 h and longer among junior high school students and 8 h and longer among high school students were defined as adequate sleep, and the proportion of adequate sleep was estimated among primary and middle school students. Results: Totally 3 042 students were enrolled, including 1 587 boys (52.17%) and 1 455 girls (47.83%), 996 primary school students (32.74%), 1 030 junior high school students (33.86%), 758 ordinary high school students (24.92%) and 258 vocational high school students (8.48%). The mean sleep duration was (9.23±1.10) h among primary school students, (8.09±1.05) h among junior high school students, (7.20±1.26) h among ordinary high school students and (7.97±1.03) h among vocational high school students, respectively, and the proportion of adequate sleep was 26.31% among primary school students, 22.82% among junior high school students, 22.56% among ordinary high school students and 66.67% among vocational high school students, respectively. A relatively higher proportion of adequate sleep was seen among primary school students in Grade 4 (33.63%) and with homework duration of less than 1 h (34.53%); among junior high school students in Grade 1 (37.76%), residing in schools (40.00%), studying in county schools (30.87%), with homework duration of less than 1 h (34.69%) and less than 1 h duration of extracurricular classes (33.33%); among male ordinary high school students (28.03%), and ordinary high school students in Grade 1 (28.30%), residing in schools (26.18%) and studying in district schools (25.83%); among male vocational high school students (69.06%) and vocational high school students residing in schools (73.14%). Conclusion The proportion of adequate sleep is low among primary and middle school students in Zhoushan City. The homework duration and duration of extracurricular classes are recommended to be reduced to ensure adequate sleep among primary and middle school students.

Objective:To investigate the normal reference values of spinal bone mineral density measured by quantitative computed tomography (QCT) and the differences of bone mineral density (BMD) in different regions of in Chinese adult males.Methods:Men who underwent low-dose CT lung scan for cancer screening in regions of Northeast, North, East, South, Central and Southwest of China from January 2018 to December 2019 were selected. And the lumbar vertebrae BMD values in the male subjects were measured by the QCT system (Mindways Software, Inc.). The mean BMD values and their decline rates were calculated at an age interval of 10 years, and the prevalence of osteoporosis was calculated according to the American College of Radiology spine QCT osteoporosis diagnostic criteria.Results:A total of 50 682 males with a mean age of (50.22±12.79) years (ranged 20 to 98 years) were included in this study. The peak BMD of (173.11±28.56) mg/cm 3 in the healthy Chinese adult male population appeared in the age group of 20 to 29 years and then declined with age. Before the age of 70 years, the BMD was relatively higher in males in South China, and it was lower in Central China and Southwest China, and it was intermediate in Northeast, North and East of China, with statistically significant differences. There was no significant differences in BMD in the males in the two age groups of 70 to 79 years and 80 and older among the regions in China. The overall decline rate of spinal BMD in Chinese males under QCT was about 46.92% over the lifetime, and it declined obviouslyin the 40-49 age group. The overall prevalence of osteoporosis in Chinese male population aged 50 years and above was approximately 11.42%, with the highest prevalence in Southwest China and Central China (14.72% and 13.87%, respectively) and the lowest in North China and South China (8.53% and 7.71%, respectively). Conclusions:A reference of lumbar spine BMD values for healthy males in China based on QCT is established. BMD values were highest in South China and Lowest in Central China.

Objective:To investigate the relationship between the level of anti Mullerian hormone (AMH) and antral follicle count (AFC) and oocytes number in patients with in vitro fertilization (IVF). Methods:372 patients with primary infertility who received IVF and embryo transfer (IVF-ET) treatment in the Affiliated Hospital of Guizhou Medical University from January 2020 to December 2020 were prospectively selected as the study subjects. According to the oocytes obtained, the patients were divided into low ovarian response group (LOR group, the number of oocytes obtained ≤5, n=37), normal group (NOR group, the number of oocytes obtained was 6-15, n=292) and high ovarian response group (HOR group, the number of oocytes obtained >15, n=43). The levels of AMH and AFC in the three groups were observed. The relationship between AMH, AFC with LOR and HOR was observed by multivariate logistic analysis. The sensitivity, specificity, optimal cut-off value and area under the curve (AUC) of AMH and AFC for predicting LOR and HOR were calculated by receiver operating characteristic (ROC) curve. Results:There were significant difference in AMH, AFC and oocyte number among the three groups (all P<0.05). The AMH, AFC and oocyte number in NOR group were higher than those in LOR group, and AMH, AFC and oocyte number in HOR group were higher than those in LOR and NOR group (all P<0.05). The results of binary multivariate analysis showed that AFC and AMH were protective factors of LOR (all P<0.05), while AFC and AMH were risk factors of HOR ( P<0.05). The sensitivity and specificity of AMH and AFC in predicting LOR were 83.8% and 75.7%, 65.7% and 84.2%, respectively. The sensitivity of AMH or AFC positive as the standard for predicting LOR was 94.6%, and the specificity of AMH and AFC was 91.6%. The sensitivity and specificity of positive AMH and AFC in predicting HOR were 69.8% and 74.4%, 69.6% and 83.6%, respectively. The sensitivity of AMH or AFC positive as the standard for predicting HOR was 93.0%, and the specificity of AMH and AFC positive as the standard for predicting HOR was 93.0%. Conclusions:AMH and AFC are significantly correlated with oocyte number in patients with primary infertility. Flexible application of AMH and AFC is beneficial to better predict the number of oocytes obtained, which provides a reference for clinical development of individualized ovarian stimulation program.

Ethylene glycol, also known as glycol, is a common low-temperature antifreeze used in automobiles. It is a colorless, odorless, volatile, low-sweet, sticky liquid at room temperature. Ethylene glycol is easily decomposed and absorbed through the digestive tract. Toxic metabolites cause serious clinical symptoms such as central nervous system inhibition, metabolic acidosis, cardiopulmonary symptoms and renal insufficiency, and even death. Misuse and oral suicide are the main causes of ethylene glycol poisoning. This article reports a case of severe ethylene glycol poisoning admitted to the emergency department of the Affiliated Hospital of Hangzhou Normal University in December 2021. After treatment with V-V ECMO combined with blood purification, the patient was improved and discharged from hospital.

Ethylene glycol, also known as glycol, is a common low-temperature antifreeze used in automobiles. It is a colorless, odorless, volatile, low-sweet, sticky liquid at room temperature. Ethylene glycol is easily decomposed and absorbed through the digestive tract. Toxic metabolites cause serious clinical symptoms such as central nervous system inhibition, metabolic acidosis, cardiopulmonary symptoms and renal insufficiency, and even death. Misuse and oral suicide are the main causes of ethylene glycol poisoning. This article reports a case of severe ethylene glycol poisoning admitted to the emergency department of the Affiliated Hospital of Hangzhou Normal University in December 2021. After treatment with V-V ECMO combined with blood purification, the patient was improved and discharged from hospital.

PURPOSE: The purpose of this study is to investigate the impact of transitional care by a nurse-led multidisciplinary team (MDT) on clinical outcomes and quality of life of patients with ankylosing spondylitis. METHODS: A randomized control study design was used. Subjects were allocated randomly to an experimental group and a control group. The experimental group received intensive transitional care by a nurse-led MDT, whereas the control group received routine nursing care. Disease activity, spinal mobility, comprehensive function, health service utilization, and quality of life were assessed at the baseline and at six months with the Bath Ankylosing Spondylitis Metrology Index, the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI), a health service utilization questionnaire and version 2 of the Short Form-36 health survey. RESULTS: Compared with the baseline, the BASDAI, BASFI, emergency visits, hospitalizations, hospitalization days, and bodily pain, vitality, mental health, total score, and average score of version 2 of the Short Form-36 health survey were improved in the experimental group (p < .05), whereas only bodily pain, vitality, and role-emotional were improved in the control group p < .05). At six months, the experimental group exhibited significantly more improvement on the BASDAI, BASFI, hospitalizations, all domains except Role-physical as well as total score and average score p < .05) compared with the control group. CONCLUSION: A MDT-based nurse-led transitional care improves clinical outcomes and quality of life of patients with ankylosing spondylitis. Future research should be carried out on modes of follow-up and family support.
Baths ; Emergencies ; Follow-Up Studies ; Health Services ; Health Surveys ; Hospitalization ; Humans ; Mental Health ; Nursing Care ; Patient Care Team ; Quality of Life ; Spondylitis, Ankylosing ; Transitional Care

Objective To explore the effects of inhospital emergency process ~engineering for patients with acute poisoning.Methods Emergency Department of the Affiliated Hospital of Hangzhou Normal University implemented inhospital poisoning emergency process reengineering in March 2016.This implementation optimized original emergency process and applied it in patients with acute poisoning beginning with 6 aspects including refining precheck patients,assessment of poisoning emergency response group,fast gastrolavage,transportation,gastrolavage combined with blood purification group rapid preparation,emergency intensive care unit preparation.We compared the rescue efficiency of patients with acute poisoning before (from March 2015 to February 2016) and after (from March 2016 to February 2017) process reengineering.Results After process reengineering,the time from being admitted to hospital to beginning gastrolavage and the duration of gastrolavage was (8.91 ± 5.29)min and (31.86 ± 8.42)min respectively shorter than those before process reengineering with significant differences (t=3.397,4.028;P ＜ 0.01).After process reengineering,the time from being admitted to hospital to opening blood purification tubes (176.59 ± 88.73)min and from being admitted to hospital to starting blood perfusion (229.35 ± 108.79)min were significantly sooner than those before process reengineering (t=3.600,3.550;P ＜ 0.01).Conclusions The inhospital emergency process reengineering is scientific and convenient.It is propitious to improve rescue efficiency of patients with acute poisoning.

Objective To evaluate the feasibility of application of PBL method on otolaryngology education for medical undergraduates.Methods Totally 61 medical undergraduates of Class 2009 at Peking Union Medical College were enrolled into this study.There are 22 males and 39 females and aged 23-26 years old.They were grouped randomly into two groups: the PBL group (n=29) and the traditional teaching method group (n=32).Questionnaires were collected and statistical analyses were conducted.Results The scores of the evaluations for education of otolaryngology after teaching were much better than those before teaching in the PBL group in most aspects according to the questionnaires (P<0.05).In traditional teaching method group, there are only few aspects` scores much better than those before teaching.Comparing the two teaching methods shows, in most aspects, the scores of PBL group are much higher than those of the traditional teaching method group.ConclusionsCombination of PBL with other teaching method will be an ideal way for medical education in otolaryngology.