Search

Objective To investigate the effect of melanoma associated antigen D1 (Mage-D1) on mouse femoral bone mass and mineralization ability of mouse bone marrow mesenchymal cells (BMSCs) and its potential molecular mechanism. Methods Female Mage-D1 gene knockout heterozygous mice and male wild-type (WT) mice were subjected as parent mice to breed Mage-D1 gene knockout homozygous (Mage-D1 KO) mice. PCR and agarose gel electrophoresis were used to identify male Mage-D1 knockout (Mage-D1 KO) mice and littermate male wild-type (WT) mice. Micro-CT scanning was performed to observe mouse femoral bone mass, and ELISA and chemical assay were employed to detect serum levels of calcium, phosphorus, calcitonin, and parathyroid hormone in mice. After primary cultured BMSCs were identified with flow cytometry, immunofluorescence staining was utilized to detect the expression of Mage-D1 in BMSCs. BMSCs were infected by Mage-D1 silencing lentivirus, and then the cells were divided into negative control group (sh-NC) and silencing group (sh-Mage-D1). Cell scratch assay was conducted to detect the migration ability of BMSCs, and flow cytometry and CCK-8 assay were conducted to detect the cycle change and proliferation ability of BMSCs. After mineralization induction, alkaline phosphatase (ALP) staining and alizarin red staining were performed; RT-qPCR and Western blotting were used to measure the expression levels of ALP, Runx2 and Col1. RT-qPCR was used to detect mineralization-related genes p75NTR and Msx1. Results Compared with the WT mice, the femoral cortical bone thickness, cortical bone mineral content, cancellous bone mineral content, trabecular number, and cancellous bone surface density were decreased, and trabecular separation was increased in the Mage-D1 knockout homozygous mice (P

Objective To evaluate the application effect of home-based exercise therapy in community-dwelling elderly patients with mild cognitive impairment (MCI) and depression. Methods From January 2021 to December 2022, 60 community-dwelling elderly patients with MCI and depression who were screened at medical institutions were randomly divided into the control group and the intervention group. According to the basic requirements of national public health service, community medical staff carried out group follow-up once every quarter, and patients were intervened by general lifestyle interventions and health education for 6 months. On the basis of routine interventions, the intervention group received home-based exercise therapy for 6 months. The Geriatric Depression Scale(GDS), The Montreal Cognitive Assessment (MoCA), Brathel Index (BI) for Activity of Daily Living were adopted for effectiveness assessment of exercise therapy on cognitive function, depression level and daily living ability of patients. Results After 6 months of intervention, the score ofGDS in the intervention group was lower than that in the control group, with a significant difference (P＜0. 01); The total score of MoCA and subscale scores of Visuospatial/Executive, Attention, Language, Abstraction, Delayed recall and Orientation in the intervention group were higher than those in the control group (P＜0. 01); The score of BI in the intervention group was higher than that in the control group, with a significant difference (P＜0. 01). Conclusion Home-based exercise therapy can alleviate the depressive symptoms, improve the cognitive function and activity of daily living among community-dwelling elderly patients with MCI and depression (目的 探讨以家庭为基础的运动疗法对社区老年轻度认知障碍(MCI)伴抑郁患者的影响。方法 选取2021年1月—2022年12月, 经医疗机构筛查并居住在上海市奉贤区社区的60名MCI伴抑郁症状的患者, 随机分为对照组和干预组。对照组依据国家基本公共卫生服务要求, 由课题组成员在相应社区每季度开展团体讲座, 普及MCI相关健康教育知识, 饮食、运动等生活方式, 干预6个月; 干预组在对照组的基础上, 增加了以家庭为基础的运动疗法, 干预6个月。对比两组患者老年抑郁量表(GDS)、蒙特利尔认知评估量表(MoCA)和Barthel指数评定量表(BI)得分情况。结果 干预后, 干预组GDS量表评分低于对照组, 差异有统计学意义(P＜0. 01); 干预组MoCA量表视空间与执行能力、注意力、语言功能、抽象思维、延迟回忆和定向力维度评分以及总分高于对照组, 差异有统计学意义(P＜0. 01); 干预组患者BI量表评分较对照组提高, 差异有统计学意义(P＜0. 01)。结论 以家庭为基础的运动疗法可以缓解社区老年MCI伴抑郁患者的抑郁症状, 改善认知功能, 提高日常生活能力, 并延缓MCI病情进展。)

Objective To explore the effect of teach-back method on exercise compliance and quality of life in elderly patients with hemiplegia after stroke. Method Using the convenient sampling method, a total of 80 elderly patients with hemiplegia after stroke were randomly divided into control group (n = 40) and intervention group (n = 40). The control group adopted the routine health education method, and the intervention group adopted the teach-back method on the basis of routine care. After a 3-month follow-up, the rehabilitation exercise compliance scale, National Institutes of Health Stroke Scale (NIHSS) score, Fugl-Meyer Assessment (FMA), Modified Barthel Index scale (MBI) and Stroke Specific Quality of Life Scale (SS-QOL) were used to compare the effects of exercise compliance, neurological function, limb motor function, self-care ability and quality of life between the two groups. Results The compliance rate was 85. 00%(34/40)in the intervention group, which was significant higher than 72. 50%(29/40)in the control group(P＜0. 01). The NIHSS score decreased in both two groups after intervention, and NIHSS score in the intervention group were significantly lower than that in the control group (P＜0. 01). Scores of FMA and MBI increased in both two groups after intervention, and scores of FMA and MBI in the intervention group were significantly higher than those in the control group (P＜0. 01). The total score of SS-QOL in the intervention group was significantly higher than that in the control group after intervention(P＜0. 05). Conclusion The application of teach-back method in health education is potentially effective to improve the patients’ compliance with limb exercise, promote healthy behavior and improve the quality of life of elderly patients with hemiplegia after stroke. (目的 探讨回授式教育对老年脑卒中后偏瘫患者锻炼依从性和生活质量的影响。方法 采用方便抽样法, 选取2020年9月—2021年2月医院收治的80例老年脑卒中后偏瘫患者为研究对象, 按照入院先后顺序给予编号, 随机分为对照组和干预组, 每组40例。对照组采用常规健康教育方法, 干预组在常规基础上, 结合回授法进行教育。通过3个月的随访, 采用康复锻炼依从性量表、美国国立卫生院卒中量表(NIHSS)、Fugl-Meyer运动功能量表(FMA)、Barthel指数量表(MBI)、脑卒中生活质量量表(SS-QOL), 比较两组患者锻炼的依从性、神经功能、肢体运动功能、自理能力及生活质量的影响。结果 干预组锻炼依从率85. 00%(34/40), 高于对照组的72. 50%(29/40), 差异有统计学意义(P＜0. 01)。干预后, 两组患者NIHSS评分均较干预前降低, 且干预组NHISS评分低于对照组(P＜0. 01)。两组FMA评分和MBI得分较干预前提高, 且干预组高于对照组, 差异有统计学意义(P＜0. 01); 干预组生活质量(SS-QOL)总分高于对照组, 差异有统计学意义(P＜0. 05)。结论 将回授式教育运用到患者健康教育中, 对提高老年脑卒中后偏瘫患者肢体锻炼的依从性、促进健康行为和提高生活质量水平具有重要的临床意义和推广价值。)

Objective To investigate the dynamic expression profile of mdanoma associated antigen D1 (Mage-D1) at different tooth development stages in mice after birth, and explore the effect of Mage-D1 knockout on tooth development in vivo. Methods C57-BL/6 wild-type suckling mice were grouped according to their age (1, 4, 7, 11 and 15 d after birth, n=3 in each group). Tissue samples were prepared and the developmental dynamics of the first mandibular molars in mice were observed by HE staining. Immunohistochemical staining was used to observe the expression of Mage-D1 as well as the homologous box genes Dlx1 and Msx1 at different stages of postnatal tooth development in mice. The Mage-D1 homozygous knockout mice (KO) and wild-type mice (WT) aged 1 and 3 months (n=6 in each group) were selected for phenotypic observation, and micro-CT scanning for mandible was performed to analyze the data of teeth and mandible. Results Morphological observation showed that on postnatal day 1, the first mandibular molar was in the late bell-shaped stage without obvious hard tissue formation; on day 4, dentin and enamel alternatively formed and crown began to develop; on day 7, epithelial root sheaths shaped and root development initiated; on day 11, the enamel and crown dentin were almost completed, with the root about half developed; on day 15, the root of the tooth further developed, reaching more than 2/3, and the cementum was formed. Mage-D1 and the homeobox genes Dlx1 and Msx1 were positively expressed in both ameloblasts and odontoblasts of mice throughout the period from 1 d to 15 d after birth. As compared with WT mice, the body weight of KO mice was increased (P < 0.05); though the number of teeth was the same in the 2 groups, the teeth appearance in KO group was slightly different, with incisors less stained and molars more easily worn. Scanning results indicated no significant difference in the density of teeth and alveolar bone. Conclusion Mage-D1, Dlx1 and Msx1 may contribute together to the formation of tooth enamel and dentin in mice, and the mice with Mage-D1 gene knockout present obesity signs and altered tooth phenotype.

Objective To explore the effect of combined health care management by doctor-nurse cooperation in community-dwelling elderly patients with chronic diseases. Methods A total of 80 community-dwelling elderly patients with chronic diseases were selected as the research objects, and were given health management based on a doctor-nurse cooperation model. After 1 year of intervention, patient anxiety status, quality of life and medical compliance behavior were evaluated. The blood glucose level, blood pressure and body mass index were measured. Results The Self-rating Anxiety Scale sore dropped form (40. 31±8. 34) before intervention to (37. 93±6. 29) after intervention, with a significant difference (P＜0. 05). The scores of medical compliance behaviors including dietary, exercise and lifestyle increased significantly after intervention (P＜0. 05). Patients achieved higher dimensional scores and total score of SF-36 after intervention (P＜0. 05). The blood glucose level, blood pressure and body mass index were improved after intervention. Conclusion The health management based on doctor-nurse cooperation model is potentially effective to relieve the anxiety status of community-dwelling elderly patients with chronic diseases, improve their treatment compliance and quality of life. (目的 探讨医护联合健康管理在社区老年慢性病患者中的应用效果。方法 选取2019年4月—2020年4月收治的80例老年慢性病患者为研究对象, 均予以医护联合健康管理。比较患者干预前后焦虑程度、遵医行为变化以及生活质量, 记录干预前后患者的血糖、血压以及体质量指数变化。结果 干预后, 本组患者焦虑自评量表(SAS)评分为(37. 93±6. 29)分, 低于干预前的(40. 31±8. 34)分, 差异有统计学意义(P＜0. 05)。干预后, 患者饮食、运动、生活方式3个维度的遵医行为评分及总分均高于干预前, 差异有统计学意义(P＜0. 05)。干预后患者SF-36量表各维度评分以及总分均高于干预前, 差异有统计学意义(P＜0. 05)。干预后患者的血糖水平、血压以及体质量指数较干预前均有改善。结论 医护联合对社区老年慢性病患者进行健康管理, 能够缓解老年慢性病患者的焦虑状况, 提高患者治疗依从性, 改善患者生活质量。)

Objective To investigate the regulative effect of neurally differentiated EC-cell-derived protein, Necdin, on the odontogenic differentiation and mineralization of rat dental germ ectomesenchymal stem cells (EMSCs). Methods Immunofluorescence staining was used to detect the expression and distribution of Necdin in E13.5d and E19.5d rat dental germ. EMSCs derived from E19.5d rat dental germ were isolated and cultured, and identified with flow cytometry for cell surface antigens. The EMSCs were stably transfected with lentiviral vector of Necdin silencing. Then, the apoptosis of EMSCs was detected by flow cytometry in the negative control group (sh-NC) and silenced group (sh-Necdin). The proliferation capacity of EMSCs was detected by CCK-8 assay, and the migration ability of EMSCs was detected by cell scratching assay. After mineralization induction, the regulative effect of Necdin on the odontogenic differentiation and mineralization of EMSCs was observed by alkaline phosphatase staining, alizarin red staining, RT-PCR and Western blotting. Results The immunofluorescence results showed that Necdin was strongly expressed and concentrated in the inner enamel epithelium, outer enamel epithelium and in the contact area between epithelium and mesenchyme. After Necdin silencing, the EMSCs showed higher apoptotic rate, enhanced proliferation ability but weaker migration ability when compared with the cells from the sh-NC group (all P < 0.01). What's more, Necdin silencing also resulted in lighter alkaline phosphatase stain and less mineralized nodule formation, and up-regulations of the molecules related to tooth differentiation and mineralization at mRNA and protein levels (P < 0.05) in the cells from the sh-Necdin group than those from the sh-NC group. Conclusion Necdin is specifically expressed in the future odontogenic differentiation and mineralization regions in rat dental germ. Its silencing promotes the apoptosis and proliferation, but inhibits the migration and the abilities of odontogenesis differentiation and mineralization in EMSCs. Necdin might play an important role in tooth development and mineralization.

(目的 了解上海市普陀区患者对于“互联网+护理服务”需求度及其影响因素, 为“互联网+护理服务”的推广提供有效信息。方法 对212例患者开展问卷调查, 了解研究对象对 “互联网+护理服务”的需求情况及其影响因素。结果 78. 77%的研究对象表示有必要开展“互联网+护理服务”, 且需求情况受研究对象婚姻状况、文化程度、居住情况以及月收入水平的影响(P＜0. 05)。73. 58%的研究对象表示愿意接受“互联网+护理服务”, 且不同年龄、婚姻状况、文化程度、月收入水平人群在“互联网+护理服务”接受度上差异有统计学意义(P＜0. 05)。结论 上海市普陀区患者对“互联网+护理服务”需求度较高, 但仍需要做好相关服务模式的宣教工作, 完善相关法规制度, 确保服务质量。)

Objective To understand the status quo of clinical nurses' cognition of urinary incontinence knowledge and the demand for specialized training of urinary incontinence in medical institutions at all levels in a certain region in Shanghai. Methods A questionnaire was designed based on the literature method, and a total of 384 clinical nurses were selected from 2 tertiary hospitals, 2 secondary hospitals and 4 community health service centers in a district of Shanghai by cluster sampling method. Results The knowledge of urinary incontinence in clinical nurses was generally inadequate, and the overall awareness rate was only 43. 23%. Different institutions, departments, education background, and whether or not they have participated in training have differences in knowledge cognition of urinary incontinence among nurses (P < 0. 05). Nurses in tertiary hospitals (14. 42%) preferred to decompose the relevant assessment form to understand the latest development of incontinence care. Nurses in level II hospitals (29. 82%) preferred to strengthen training on functional exercise, such as rehabilitation and guidance of pelvic floor muscles. Nurses in community health service centers (22. 56%) were more concerned with the care of patients with urinary incontinence and the cooperation of family members. Conclusion The overall awareness rate of the knowledge of urinary incontinence among clinical nurses in the region is low, and the need for training is strong. (目的 了解区域内各级医疗机构临床护士对尿失禁知识的认知现状及对尿失禁专科培训的需求。方法 根据文献法, 自行设计问卷, 采用整群抽样法抽取上海市某区内2家三级医院、2家二级医院、4家社区卫生服务中心共计384名临床护士进行问卷调查。结果 临床护士尿失禁知识普遍掌握不足, 整体知晓率仅为43. 23%; 不同机构、科室、学历及是否参加过培训在护士尿失禁知识认知方面存在差异(P

Objective: To explore the risk factors of acute respiratory distress syndrome (ARDS) in patients with sepsis and to construct a risk nomogram model., Methods: The clinical data of 234 sepsis patients admitted to the intensive care unit (ICU) of Tianjin Hospital from January 2019 to May 2022 were retrospectively analyzed. The patients were divided into non-ARDS group (156 cases) and ARDS group (78 cases) according to the presence or absence of ARDS. The gender, age, hypertension, diabetes, coronary heart disease, smoking history, history of alcoholism, temperature, respiratory rate (RR), mean arterial pressure (MAP), pulmonary infection, white blood cell count (WBC), hemoglobin (Hb), platelet count (PLT), prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB), D-dimer, oxygenation index (PaO 2 /FiO 2 ), lactic acid (Lac), procalcitonin (PCT), brain natriuretic peptide (BNP), albumin (ALB), blood urea nitrogen (BUN), serum creatinine (SCr), acute physiology and chronic health evaluation II (APACHE II), sequential organ failure assessment (SOFA) were compared between the two groups. Univariate and multivariate Logistic regression were used to analyze the risk factors of sepsis related ARDS. Based on the screened independent risk factors, a nomogram prediction model was constructed, and Bootstrap method was used for internal verification. The receiver operator characteristic curve (ROC curve) was drawn, and the area under the ROC curve (AUC) was calculated to verify the prediction and accuracy of the model., Results: There were no significant differences in gender, age, hypertension, diabetes, coronary heart disease, smoking history, alcoholism history, temperature, WBC, Hb, PLT, PT, APTT, FIB, PCT, BNP and SCr between the two groups. There were significant differences in RR, MAP, pulmonary infection, D-dimer, PaO 2 /FiO 2 , Lac, ALB, BUN, APACHE II score and SOFA score (all P < 0.05). Multivariate Logistic regression analysis showed that increased RR, low MAP, pulmonary infection, high Lac and high APACHE II score were independent risk factors for sepsis related ARDS [RR: odds ratio (OR) = 1.167, 95% confidence interval (95%CI) was 1.019-1.336; MAP: OR = 0.962, 95%CI was 0.932-0.994; pulmonary infection: OR = 0.428, 95%CI was 0.189-0.966; Lac: OR = 1.684, 95%CI was 1.036-2.735; APACHE II score: OR = 1.577, 95%CI was 1.202-2.067; all P < 0.05]. Based on the above independent risk factors, a risk nomograph model was established to predict sepsis related ARDS (accuracy was 81.62%, sensitivity was 66.67%, specificity was 89.10%). The predicted values were basically consistent with the measured values, and the AUC was 0.866 (95%CI was 0.819-0.914)., Conclusions: Increased RR, low MAP, pulmonary infection, high Lac and high APACHE II score are independent risk factors for sepsis related ARDS. Establishment of a risk nomograph model based on these factors may guide to predict the risk of ARDS in sepsis patients.