Hand grip strength as a predictor of recovery from low back pain in the pregnant women-a prospective study

BackgroundLow back pain (LBP) is a common musculoskeletal problem during pregnancy with an estimated prevalence ranging from 30% to 78%. The symptoms usually disappear gradually after delivery, but some women may have persistent problems even later in their lives. The definite mechanism behind LBP during pregnancy remains unknown. Therefore, the purpose of this study was to investigate whether hand grip strength (HGS), which is a straightforward and reliable indicator of overall muscle strength, is associated with unrecovered LBP after delivery.Methods257 pregnant women who registered at obstetrics units in two tertiary hospitals from January 2016 to June 2017 and meanwhile suffered the LBP during pregnancy were included. They were grouped based on whether they recovered from LBP after delivery (recovery was de?ned as a pain rating of ≤3). The variables such as age, HGS, and education level were recorded and examined for the risk analysis of unrecovered LBP. Also, the Pearson correlation between HGS levels and pain intensities was investigated.ResultsLBP without recovery at two years after delivery was reported among 22.7% of the subjects. Women with increasing age, low HGS (<25 kg), LBP in a previous pregnancy, back pain, sick leave, and a large amount of physical demand (all p < 0.05), were more likely to report LBP without recovery. Besides, there was a significant correlation between HGS values and the intensities of LBP (r = ?0.525; p = 0.003).ConclusionsLow HGS has the highest OR value (adjusted OR = 9.12, P < 0.001) among these factors. The present findings may be used to design and encourage a specific stabilization exercise regime to build well stability of the lumbar spinal column and thus alleviating the LBP.     

完全腹腔镜根治性膀胱切除加体内改良回肠通道术的学习效果分析

目的分析术者对完全腹腔镜根治性膀胱切除(LRC)+改良回肠通道术(MIC)的学习效果。方法回顾性分析首都医科大学附属北京朝阳医院2014年4月至2019年10月42例接受完全LRC+MIC患者的临床资料。男34例,女8例;年龄(63.4±9.1)岁。其中术者1行34例手术,术者2行8例。将术者1的34例按时间顺序分为3组,第1~12例为A组,第13~23例为B组,第24~34例为C组;术者2实施的8例为D组。4组中有腹部手术史者分别为0、1、4、3例,差异有统计学意义(P<0.05);4组年龄、体质指数、美国麻醉医师协会评分等差异均无统计学意义(P>0.05)。改良术式的重要步骤包括光源透射下离断肠系膜、输出袢固定的条件下行输尿管-输出袢反流性对端吻合、缝合后腹膜缺口。比较各组患者手术时间、构建回肠通道时间、出血量、并发症发生比例、淋巴结清扫数量、切缘阳性比例等重要手术指标。结果各组手术均顺利完成,均无中转开放手术。A~C组手术时间分别为330.0(320.0,360.0)、300.0(250.0,308.0)、270.0(216.0,324.0)min,差异有统计学意义(P=0.010);3组构建回肠通道时间分别为136.5(131.3,147.5)、92.0(79.0,119.0)、79.0(72.0,115.0)min,差异有统计学意义(P<0.001)。手术时间和构建回肠通道时间组间两两比较,A、B组,A、C组差异均有统计学意义(P<0.05),B、C组差异无统计学意义(P>0.05)。3组出血量[200.0(125.0,300.0)、100.0(100.0,150.0)、200.0(100.0,400.0)ml]、并发症发生比例[4/12、4/11、3/11]、淋巴结清扫数量[(19.0±10.7)、(16.0±9.8)、(23.3±8.5)枚]、切缘阳性比例(1/12、1/11、2/11)的比较,差异均无统计学意义(P>0.05)。D组手术时间420.0(350.0,450.0)min,与A组比较差异有统计学意义(P<0.05)。D组出血量200.0(112.5,350.0)ml,并发症发生比例2/8,淋巴结清扫数量(13.8±7.1)个,切缘阳性比例1/8,与A组比较差异均无统计学意义(P>0.05)。结论完全LRC+MIC学习效果明显,随着手术例数的增加,手术时间及构建回肠通道时间显著下降;该术式具有较好的可重复性和安全性。     

Podocyte EGFR Inhibits Autophagy Through Upregulation of Rubicon in Type 2 Diabetic Nephropathy

Renal epidermal growth factor receptor (EGFR) signaling is activated in models of diabetic nephropathy (DN), and inhibition of the EGFR signaling pathway protects against the development of DN. We have now determined that in cultured podocytes, high glucose led to increases in activation of EGFR signaling but decreases in autophagy activity as indicated by decreased beclin-1 and inhibition of LC3B autophagosome formation as well as increased rubicon (an autophagy inhibitor) and SQSTM1 (autophagy substrate). Either genetic (small interfering [si]EGFR) or pharmacologic (AG1478) inhibition of EGFR signaling attenuated the decreased autophagy activity. In addition, rubicon siRNA knockdown prevented high glucose–induced inhibition of autophagy in podocytes. We further examined whether selective EGFR deletion in podocytes affected the progression of DN in type 2 diabetes. Selective podocyte EGFR deletion had no effect on body weight or fasting blood sugars in either db/db mice or nos3^−/−; db/db mice, a model of accelerated type 2 DN. However selective podocyte EGFR deletion led to relative podocyte preservation and marked reduction in albuminuria and glomerulosclerosis, renal proinflammatory cytokine/chemokine expression, and decreased profibrotic and fibrotic components in nos3^−/−; db/db mice. Podocyte EGFR deletion led to decreased podocyte expression of rubicon, in association with increased podocyte autophagy activity. Therefore, activation of EGFR signaling in podocytes contributes to progression of DN at least in part by increasing rubicon expression, leading to subsequent autophagy inhibition and podocyte injury.     

补中益气汤调控JAK2/STAT3信号通路对气虚发热证大鼠肠道菌群、免疫功能及神经功能的影响

目的:分析补中益气汤调控Janus激酶2(JAK2)/信号传导与活化转录因子3(STAT3)/STAT3信号通路对气虚发热证大鼠肠道菌群、免疫功能及神经功能的影响。方法:将30只大鼠随机分为正常组、气虚发热模型组、补中益气汤组,每组10只。气虚发热模型组、补中益气汤组大鼠用于建立气虚发热模型,第18天开始,补中益气汤组给予补中益气汤灌胃治疗5 d,气虚发热模型组给予等体积蒸馏水。16SrRNA基因序列分析技术检测大鼠肠道菌群;ELISA法检测CD4⁺、CD8⁺、补体C3水平、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)水平;放免法测定乙酰胆碱(Ach)、环磷酸腺苷(cAMP)和环磷酸鸟苷(cGMP)水平;蛋白质印迹法(Western blot)检测p-JAK2、p-STAT3蛋白表达水平。结果:补中益气汤可改善气虚发热所致的疣微菌门、互养菌门菌落减少,螺旋体门、埃普西隆杆菌门菌落增多情况(P<0.05)。补中益气汤可改善气虚发热所致的血清CD4⁺、C3、IgM、IgG水平及淋巴细胞转化率降低,血清CD8^...     

机器人辅助腹腔镜下婴幼儿肾盂输尿管成形术的护理配合

目的:总结机器人辅助腹腔镜下婴幼儿肾盂输尿管成形术的手术室护理配合经验,进一步优化、细化手术配合流程,为该手术护理流程标准化提供借鉴.方法:回顾性分析2016年3月21日～2018年3月21日175例患者在中国人民解放军总医院第七医学中心行机器人辅助腹腔镜下婴幼儿肾盂输尿管成形术的手术配合情况.?结果:175例患儿手术效果良好,术中均未发生中转开放手术,无手术并发症发生.结论:机器人辅助腹腔镜下婴幼儿肾盂输尿管成形术安全可行,具有视野清晰、操作精准、恢复快、美容效果好等优点.手术室护士的专业化技术培训、完善的术前准备、仪器设备的有效管理、安全合理的手术体位安置是确保手术顺利进行和成功的关键,同时应注意患儿的术中体温及皮肤管理.     

流动人口职业病防治教育现状及影响因素分析

目的 了解流动人口职业病防治教育现状及影响因素。方法 运用SPSS 25.0软件对2017年全国流动人口卫生计生动态监测中的154586名流动人口的相关数据进行分析,主要分析方法有统计描述、χ2检验和二元logistic回归等。结果 154586名流动人口中,51578人接受过职业病防治教育,接受率为33.4%。二元logistic回归分析表明,男性（OR=1.165,95%CI:1.137~1.193）、30～44岁（OR=1.169,95%CI:1.088~1.256）、文化程度高中或中专（OR=1.278,95%CI:1.227~1.330）、在婚（OR=1.172,95%CI:1.134~1.211）、流动原因为经济性质（OR=1.283,95%CI:1.115~1.475）、流入西部地区（OR=1.749,95%CI:1.700~1.799）、有稳定工作（OR=1.071,95%CI:1.016~1.128）、机关或国企或股份联营企业（OR=1.765,95%CI:1.666~1.870）、自评状况为健康（OR=1.479,95%CI:1.363~1.606）的流动人口职业病防治教育接受率较高;未签订劳动合同（OR=0.684,95%CI:0.661~0.708）、未听过“国家基本公共卫生服务项目”（OR=0.231,95%CI:0.225~0.237）的流动人口职业病防治教育接受率较低。结论 流动人口职业病防治教育接受率较低,需加强流动人群职业病防治教育的宣传力度,提高职业病防治教育的覆盖面。     

小型中医经络检测仪的研制

在传统中医经络理论的基础上，结合先进的电子技术设备，设计了一种小型中医经络检测仪。此检测仪通过采集人体穴位经电流测试(给一定电流刺激)所反射出来的信息，经微控制器处理后，能够精确显示或打印出人体的健康状况。检测仪具有方便、快捷等优势，易推广普及。     

新生儿缺氧缺血性脑病CT诊断对评估疗效的影响

目的：分析新生儿缺氧缺血性脑病（ＨＩＥ）治疗前后ＣＴ分度的变化,探讨ＨＩＥＣＴ诊断在评估疗效中的作用和影响。方法：选取１９９２－１９９９年在我院住院的ＨＩＥ患４００例,按不同的年龄段分组,所有病例均在发病时和治疗后分别行薄层ＣＴ扫描,对ＨＩＥ进行ＣＴ诊断分度,分析其统计数据。结果：不同程度、不同年龄组的ＨＩＥ患儿治疗后加重或减轻的比例也明显不同,结论：新生儿缺氧缺血性脑病按不同的年龄段分组,及其ＣＴ诊断严格分度,是对准确判断ＨＩＥ疗效的有力补充。