Objective To investigate the change of adiponectin level with menopause status in women aged 40 to 65, and its relationship with androgen. Methods A cross-sectional study included woman (aged from 40 to 65) who were in hospital for routine check-up at the Sun Yat-sen Memorial Hospital from August to October in 2013. All subjects underwent laboratory examinations of adiponectin, sex hormone binding globulin (SHBG), dehydroepiandrosterone-sulfate (DHEA-S), total testosterone (TT), collected anthropometric measurements and then calculated free androgen index (FAI) and body mass index (BMI). According to their menstrual status, the subjects were divided into 4 groups: premenopausal group with 119 subjects, perimenopausal group with 60 subjects, early postmenopausal group with 62 subjects, late postmenopausal group with 64 subjects. Results (1) Adiponectin levels declined to its lowest level in menopausal transition and gradually becoming higher after menopause, which showed a U-shaped trajectory. When compared adiponectin levels in late postmenopausal group [(13 ± 5) mg/L] with those in perimenopausal [(8 ± 6) mg/L] or early postmenopausal group [(9 ± 6) mg/L], it all showed significantly difference (P<0.05). (2) Both the adiponectin levels were negatively correlated with waistline in the 4 groups (premenopausal group, r=-0.276;perimenopausal group, r=-0.334;early postmenopausal group, r=-0.211;late postmenopausal group, r=-0.218; all P<0.05). Levels of adiponectin were positively correlated with SHBG (r=0.536, P<0.05) and negatively with FAI (r=-0.363, P<0.05) in menopausal transition, while in late postmenopausal group, negatively correlated with level of DHEA-S (r=-0.450, P<0.05). When adjusted for age, BMI and waistline, the above correlations still exist. Conclusions Adiponectin levels declined to its lowest level in menopausal transition and gradually becoming higher after menopause, which showed a U-shaped trajectory during the sequential menopause status transition in middle aged women. Low level of adiponectin in menopausal transition is closely associated with the relative excess androgen occurred during this stage.

OBJECTIVE To investigate the value of acute phase protein in the diagnosis and therapy for nosocomial infection monitoring. METHODS The levels of serum C-reactive protein(CRP),serum amyloid A(SAA),?_1-acid glycoprotein(AAG),and ?_1-antitrypsin(AAT) were measured in 71 gynecological patients with nosocomial infection during chemotherapy,Thirty normal controls and 33 chemotherapy patient controls were detected by nephelometry and compared with white blood cell counts. RESULTS The nosocomial infection rate of chemotherapy patients was 16.7%.Main pathogens were Gram-negative bacteria(60.6%).Fungi infection rate was 19.7%.The most frequent hospital infection sites were respiratory tract,gastrointestinal tract and wound.Compared with controls,the levels of serum CRP,SAA,AAG and AAT were significantly higher in chemotherapy patients with bacteria infection(P

In order to implement the 'excellent doctor education training plan' for clinical medicine majors,a series of principles and measures were adopted to train medical students.On the basis of clearing ideas and goals of ‘excellent doctor education training plan',constructing cmriculum system based on basic clinical skills,innovatively constructing the practical teaching platform,optimizing practical teaching system,improving teaching methods,revising assessment and evaluation methods and employing an outstanding teaching team with reasonable structure,we constructed the talent training mode with ‘one goal,two processes,three combinations'.In conclusion,the talent training mode played an important role in the cultivation of medical talents in clinical medicine.

Objective To investigate clinical interns' mastery and understanding status of medical core systems in order to provide reference for formulating training programs. Methods The questionnaires including medical core systems trained and self-assessment and test paper were de-signed. Then survey was carried out among 188 clinical interns of Grade 2009 of Zunyi Medical Col-lege at the end of training. All data were obtained, collected and analyzed with Excel and a SPSS 17.0. The result was described with percentage. Results ①78/41.34% and 117/62.33% clinical interns accepted training of medical core systems respectively before or during clinic training. 74/39.43%hos-pitals or 70/37.30% departments were systematically trained by medical core systems and the propor-tion of teachers who systematically or non-systematically explained medical core systems for clinical interns was 42/22.29%and 61/32.37%respectively.②The clinical interns who mastered first diagnosis responsibility systems, patient communication system, and systems of discussing difficult cases were 178/94.68%, 178/90.43%or 168/89.36%. The clinical interns who mastered rescue systems in critically ill patients, surgical classification management systems and audit system in clinical blood transfusion were 84/44.68%, 67/35.64%or 34/18.28%respectively.③8/6.90%interns fully grasped the core system of the medical situation. 165/87.71% and 165/83.43% clinical interns believed medical core systems should be mastered and 157 interns (83.43%) thought that mastering medical core system can help them better adapt to clinical medical work. Conclusion Systematic training of medical core system should be enhanced for clinical interns and mastering medical core systems is better for their future.

ObjectiveTo systematically and objectively evaluate the therapeutic efficacy of comprehensive acupuncture treatment in managing wet age-related macular degeneration (ARMD), and to seek a standard acupuncture protocol for this disease, for promoting the application in clinic.MethodTotally 37 patients (67 eyes) were observed to compare the vision, Amsler grid and rating scale of quality of life for visual impairment before and after the 3-month treatment. The clinical efficacy was then evaluated. ResultThe vision and score of quality of life were significantly changed after intervention (P<0.05); according to Amsler grid, the total improved rate was 79.2% and the total effective rate was 77.6%; age and disease duration were negatively correlated with the therapeutic efficacy (P<0.05).ConclusionComprehensive acupuncture treatment can significantly improve the vision and quality of life in patients with wet ARMD, and the younger the patients and the shorter the disease duration, the higher the therapeutic efficacy.

Inductive diagram material database is a branch material database to complement the multimedia courseware material database.It has a lot of advantages such as brief,explicit and emphasis characteristics,could enhance teaching efficiency and quality.This paper would discuss the advantage of application of inductive diagram in rehabilitation education.

Objective: To analyze the relationship between the serum levels of low density lipoprotein cholesterol (LDL-C) and achilles tendon thickness (ATT).
Methods: We studied 154 patients with high serum level of LDL-C (LDL-C≥3.37 mmol/L) from 2014-03 to 2015-03, the patients were at (18-75) years of age. According to《Guidelines on Prevention and Treatment of Blood Lipid Abnormality in Chinese Adults 2007》, the patients were divided into 2 groups:Borderline high LDL-C (3.3-4.12 mmol/L) group n=50 and High LDL-C (≥4.14 mmol/L) group, n=104;in addition, there was a Normal control group (LDL-C<3.37 mmol/L), n=51. ATT values were measured by standard digital radiography and the results were compared among 3 groups;the relationship between serum levels of LDL-C and ATT was studied.
Results: ATT levels in High LDL-C group (9.42 ± 3.63) mm was higher than Borderline high group (8.24±1.73) mm and Normal control group (6.05±0.28)mm, all P<0.05. The liner correlation coefifcient of serum level of LDL-C and the mean ATT was (r=0.346, P<0.001).
Conclusion: Our preliminary research showed that the higher serum level of LDL-C associated with thicker ATT, they had positive correlation. This phenomenon should be further conifrmed by large sample and multi-center investigation.

Objective The drug resistance and risk factors of methicillin resistant Staphylococcus aureus (MRSA) infected in the pediatric ward of the hospital were analyzed to provide a scientific basis for the con-trol of MRSA paediatric infection .Methods Totally 306 strains of Staphylococcus aureus were isolated from the pediatric wards in the Affiliated Hospital of Southwest Medical University from July 2015 to June 2016 , the bacterial species identification and drug susceptibility tests were performed by MicroScan WalkAway 96SI and the statistical analysis was carried out by WHONET 5 .4 softwate .The clinical data of 306 children were infected with staphylococcus aureus collected by retrospective survey ,the risk factors of MRSA infection were analyzed by the method of χ2 test and non-condition Logistic regression .Results A total of 90 strains of M R-SA were detected ,with a detection rate of 29 .41％ .MRSA was mainly isolated from sputum ,accounting for 74 .44％ ,followed by blood ,accounting for 10 .0％ .MRSA was mainly resistant to amikacin ,ampicillin ,eryth-romycin ,clindamycin and other antimicrobial agents (P< 0 .05) .Age< 1 years ,venous catheterization ,me-chanical ventilation ,tracheal intubation ,ventilator ,stay in ICU ,hospitalization time >7 d ,use of corticoste-roids ,low albumin ,and antibiotic use time >7 d were the main risk factors of MRSA in children (P<0 .05) . Admission to NICU ,venous catheterization ,mechanical ventilation and tracheal intubation were independent risk factors .Conclusion MRSA isolated from pediatric wards is resistant to many kinds of antibiotics .Infec-tion with MRSA is related to many factors .Hospitals should take corresponding measures to reduce the inci-dence of M RSA infection .

Objective:To explore the research trends and hot spots of atrial fibrillation and cognitive impairment.Methods:Research papers and review articles related to atrial fibrillation and cognitive impairment was retrieved from the Web of Science core collection database from inception to November 17, 2021. The bibliometric and visualization analysis on the publishing times,journals and countries,related disciplines and key words was conducted with Excel and VOSviewer software.Results:A total of 1 496 articles were collected,showing a parabolic rise in the number of published articles in recent years. During this period,journal Stroke published more high quality articles in the field than others. The academic areas with the most publications were neurology, cardiovascular research, peripheral vascular disease and geriatrics. "Stroke" and "risk factors" were the keywords with the highest frequency. The research hot spots of atrial fibrillation and cognitive impairment mainly focused on anticoagulant drugs, mechanism research, epidemiology catheter ablation and status quo investigation. Conclusion:Through visualization, the development trend and research hot spots on atrial fibrillation and cognitive dysfunction are displayed intuitively, to provide reference for future studies.

Objective:To analyze the paradigm and changes of enteral nutrition support for hospitalized children in Shanghai Children's Medical Center affiliated to School of Medicine of Shanghai, Jiao Tong University in last ten years, so as to provide guidance for nutritionists and dietitians on the application and management of enteral nutrition.Method:Relevant data were collected and analyzed from 2011 to 2020 in the Clinical Nutrition Department of Shanghai Children's Medical Center, including the implementation status of parenteral and enteral nutrition as well as the types and distribution of different enteral nutrition formulas and diet.Results:The Clinical Nutrition Department of our hospital provided seventy-five types of diet for hospitalized children. The utilization of ordinary diets and specialized diets has been stable at about 76,000 cases per year. In the past decade, twenty-one ordinary formulas and special formulas were provided every year by the Clinical Nutrition Department in our hospital and the utilization has been stable at 46,000 cases per year. The total consumption of ordinary formulas and the proportion of ordinary formulas users showed a descending trend. The proportion of specialized formulas users among discharged patients remained at 10%, with an upward trend in the proportion of high-calorie formulas and extensively-hydrolyzed formulas.Conclusions:The enteral nutrition formulas and inpatient diets are important components of nutritional treatment. The evolution of its clinical application to some extent reflects the changes of disease spectrum and the development of clinical disciplines. In short, the dietitians play a significant role in the nutrition support team.