Objective To investigate the effects of nutritional risk on incidence of pressure ulcer in hospitalized elderly patients,and to provide a basis for medical staff to carry out effective preventive measures.Methods Nutritional Risk Screening 2002 (NRS-2002) and nutrition index were applied in 150 elderly patients in the department of neurology for screening and evaluation of nutritional risk.Then the effect of nutritional risk on incidence of pressure ulcer in elderly patients was analyzed.Results 86 cases with nutritional risk and 64 cases without nutritional risk were found.The incidence of pressure ulcer was 16.67％ and 42.67％ respectively.The comparison was made among hemoglobin,serum albumin,pre-albu-min and total lymphocyte count,the difference was statistically significant between the two groups.The incidence of pressure ulcer in elderly patients with nutritional risk was 6.99 times higher than those without nutritional risk.Conclusions To given nutritional risk screening,active and reasonable nutritional support plan to hospitalized elderly patients can reduce the incidence of pressure ulcer.

Objective To observe the clinical effect of Shuguanling(Chinese medicine for dredging the oviduct) on salpingemphraxis sterility and to study its mechanism.Methods The diagnosed patients were randomized into 3 groups with 52 in each.The treatment group was administered Shuguanling p.o.and clyster.The control group A was given Xuefu Zhuyu Oral Liquid(Oral liquid for removing blood stasis in the abdomen),and Kangfu Xiaoyan Pills(Pills for recovery of gynecological inflammation) suppository into recta.The control group B was prescribed Xuefu Zhuyu Oral Liquid and vaginal culdocentesis with the mixture of dexamethasone,chymotrypsin,gentamicin and normal saline.After three months,the effect was evaluated and the pelvic blood flow,blood viscosity,plasma collagenase,fibrinogen and fibrinolytic activity of the treatment group were tested for comparison.Results The tubal patency rate and pregnancy rate of treatment group were significantly higher than those of control groups(P

Objective To investigate the effect of case simulation and participatory feedback teaching used for neonatal resuscitation training. Methods One hundred and twenty medical staff was selected as subjects from Obstetric and Pediatric department and were randomized into 4 batches to receive a neonatal resuscitation training program that consisted of theoretical lectures and skill practice. In the control group (first two batches), the teacher demonstrated procedures of neonatal resuscitation, then trainees practiced alone and the teacher corrected their wrong procedure. In the observation group (last two batches), interactive teaching was employed and the training was performed into three steps:practice of skill in teams, watch the procedure of their practice, the feedback. The theoretical exami-nation score, practical examination score, teamwork ability and satisfaction were compared between two groups. SPSS 16.0 was employed for statistical analysis, with α=0.05 as detection level. Results The theoretical examination scores of control group and observation group were (34.27 ±2.26) vs. (33.68±2.32). There was no significant difference in theoretical examination score between the two groups ( P=0 . 166 ) . The practice examination score s of control group and observation group were (36.15±1.46) vs. (34.79±2.43), with significant differences (P=0.000). The teamwork ability of control group and observation group were (35.78 ±1.26) vs. (33.63 ±1.98), with obviously significant differ-ences (P=0.000). The trainees individual study interest, practice intent, knowledge and satisfaction with the training in the observation group were significantly higher than the control group. These results were (8.45±2.75) vs. (6.24±2.28), P=0.001;(8.25±2.05) vs. (6.48±2.75), P=0.003;(7.23±1.37) vs. (5.75 ±1.74), P=0.000; (8.21 ±1.45) vs. (6.34 ±1.69), P=0.000. Conclusion Application of the teaching in neonatal resuscitation training can enhance comprehensive practical skills and team coop-eration ability in med-ical staff, and it improves trainee's satisfaction with the training.

Objective To observe the effect of triptolide on destruction of bone and joint of collageninduced arthritis (CIA) mouse. Methods Female DBA/1 mice were double immunized at the base of the tail with bovine type Ⅱ collagen (C Ⅱ). CIA mice were randomly divided into model group, methotrexate-treated group and 8.18, 16.36, 32.72 ?g/kg triptolide-treated groups. Performance of arthritis were observed regularly. Combined with radiologieal, histological methods were used, and the number of osteoelasts in bone was evaluated and analyzed with TRAP stainning. Results The clinical score and arthritis incidence of CIA mice were significantly decreased, and the number of osteoelasts in bone cavity reduced by treatment of triptolide. X-ray showed that the surface of bone of each articular was eroded, the joint space was narrow, BMD values of lumbar and knee were decreased compared with normal mice. Triptolide could significantly inhibit the damage of bones and joints of CIA mice, and increase the BMD values of lumbar and knee. Conclusion Triptolide can inhibit the damage of bones and joints of CIA mice.

The numbers of binucleated nerve cells in the rabbit superior cervical ganglionwere investigated.We found that in the neonatal rabbit the binucleated nerve cellsare 31.4% of the total number of nerve cells,and in the 100-day rabbit,thebinucleated nerve cells increase to 41.4%.We infer that the binucleated sympatheticnerve cells are formed either by the fusion of uninucleated sympathetic nerve cellsor by amitosis of the uninucleated cells.

Objective To observe the clinical efficacy of external -rou te microsurgery for retinal detachment (RD). Methods In 36 patie nts (36 eyes) with single rhegmatogenous RD, the silica gel piece and/or bucklin g bands were preplaced, and drainage of subretinal fluid, retinal cryotherapy, e xamination of locating the holes, and intraocular injection of gas were performe d under surgical microscope. The surgical effects were compared with those of ot her simultaneous 37 patients with rhegmatogenous RD who underwent surgery under binocular indirect ophthalmscope. Results The simultaneous int raoperative observation of the fundus details and the sclera through the microsc ope was excellent in all cases. Under the surgical microscope, the reaction of r etinal cryotherapy was clearly visible without any serious surgical sequela. The observation of reaction of retinal cryotherapy and the orientation of the holes were not affected by mild opacity of the refractive media. Retinal reattachment was achieved in 31 eyes after the primary surgery and in 3 eyes after the secon dary surgery, with the final rate of reattachment of 94%. The best-corrected vi sual acuity was

Objective:To analyze the prognostic factors in patients with metastatic breast cancer (MBC). Methods:A total of 205 patients with pretreated MBC were included in this study. These patients were admitted to the Tianjin Medical University Cancer Insti-tute&Hospital and had undergone radical surgery of breast cancer between January 2008 and December 2010. The clinicopathologic information of the patients was collected in this retrospective analysis. Results: The median overall survival of the patients was 32 months (1 month to 132 months). Luminal A, Luminal B, HER-2 overexpression, and triple-negative patients had a median overall sur-vival of 36 months (4 months to 132 months), 32 months (7 months to 122 months), 29 months (1 month to 85 months), and 24 months (1 month to 98 months), respectively. Univariate analysis showed that lymph node metastases, clinical stage, molecular type, visceral disease, first multiple metastatic sites, and shorter metastasis-free interval were significantly associated with poor outcomes. In multivar-iate analysis, lymph node metastases, clinical stage, molecular type, visceral metastasis, and the number of first metastatic sites were significant predictors of patient survival. Conclusion:Lymph node metastasis, clinical stage, triple-negative breast cancer, and visceral metastasis were used as independent poor prognostic indicators for survival in patients. Results of this study may assist physicians in evaluating the survival potential and determining the appropriate therapeutic strategy for MBC patients.

Objective To analyze the natural changes of maternal thyroid function among women with subclinical thyroid dysfunction and euthyroid women during pregnancy.Methods A total of 4 042 singleton pregnant women received routine antenatal care in the Obstetrics and Gynecology Hospital of Fudan University between April and November 2012 were enrolled.Thyroid-stimulatinghormones (TSH),freetriiodothyronine (FT3) and free thyroxine (FT4) of 7 136 samples from 4 042 singleton pregnant women were tested at 8-12+6,13-19+6,20-27+6,and 28-40 weeks of gestation and were used to establish the normal gestationalspecific reference values of thyroid function.Among 3 895 women having thyroid function tested at 8-19+6 weeks of gestation with negative thyroid antibodies,there were 93 cases of subclinical hyperthyroidism,91 cases of subclinical hypothyroidism (SCH),three cases of hyperthyroidism and 3 708 cases euthyroid.There were 1 118 women [1 607 euthyroid cases,17 cases of subclinical hypothyroidism (SCH) and 34 cases of subclinical hyperthyroidism] had thyroid function retested at 20-27+6 and 28-40 weeks of gestation,and without medicinal intervention.Analysis of variance and LSD test were used to analyze the changes of maternal thyroid function.Results (1) The reference ranges of TSH at 8-12+6,13-19+6,20 27+6 and 28-40 weeks of gestation [median (Pz5-P97.5)] were 1.32 (0.03-4.17),1.83 (0.19-4.94),2.27 (0.70-5.42) and 2.34 (0.63-5.52) mU/L respectively.(2) Without medicinal intervention,thyroid function became normal in 80％ (45/56) SCH women at 20-27+6 weeks,but 20％ (9/45) of them developed SCH again at 28-40 weeks.The thyroid function became normal in 75％ (70/93) women with subclinical hyperthyroidism at 20-27+6 weeks,but in 15％ (14/93) of them,thyroid function remained abnormal at 28-40 weeks.9.40％ (30/319) and 6.25％ (21/336) euthyroid women with TSH ≥ 3 mU/L at 8-19+6 weeks of gestation developed SCH at 20-27+6 weeks and 28-40 weeks,while 0.42％ (5/1 202) and 0.86％ (10/1 163) euthyroid women with TSH ＜3 mU/L had SCH.1.66％ (20/1 202) and 1.98％ (23/1 163) euthyroid women with TSH＜3 mU/L at 8-19+6 weeks of gestation developed subclinical hyperthyroidism at 20-27+6 weeks and 28-40 weeks of gestation.(3) In comparison between 8-19+6 weeks and 20-27+6 weeks of gestation,TSH levels increased by (0.47±0.03) mU/L in euthyroid women,and more significantly in subclinical hyperthyroidism women [(0.82±0.06) mU/L],but decreased by (1.67±0.25) mU/L in SCH women (LSD test,all P＜0.05).The FT3 levels decreased by (0.47±0.02) pmol/L in euthyroid women,and more significantly in subclinical hyperthyroidism and SCH groups [(1.02± 0.18) and (0.72±0.08) pmol/L,LSD test,all P＜0.05].FT4 decreased by (2.31 ±0.04) pmol/L in euthyroid women,and more significanly in subclinical hyperthyroidism women [(4.63± 0.62) pmol/L] (LSD test,P＜0.05),but the decrement in SCH group [(1.78±0.28) pmol/L] was similar to euthyroid women (LSD test,P＞0.05).There were no significant differences in changes of TSH,FT3 and FT4 at 20-27+6 weeks and 28-40 weeks among euthyroid women,SCH and subclinical hyperthyroidism groups (F=1.01,1.14 and 2.04,all P＞0.05).Conclusions Women with subclinical thyroid dysfunction with negative thyroid antibodies experience significantly different natural changes when compared with euthyroid women,especially before 28 weeks of gestation.

Objective To investigate the influencing factors of chronic brucellosis.Methods Nested case control method was used to study newly diagnosed patients (n =600) with brucellosis in a cohort study in 2012.Data of general characterstics,clinical presentation,treatment and prognosis of those patients were collected.These patients were followed up for one year,and the chronic patients as the case group (n =248) and the healed patients as a control group (n =260).By means of Logistic multivariate analysis,factors turned brucellosis into chronic were screened.Result The chronic brucellosis-related factors were:gender,veterinary or epidemic prevention staff,muscle and joint pain,fatigue symptoms,and substandard treatment (x2 =5.163,16.445,14.977,17.154,8.813,all P ＜ 0.05).Conclusion Gender (female),veterinary or epidemic prevention staff,muscle and joint pain,fatigue symptoms,and substandard treatment are probably the chronic brucellosis-related factors

Objective To investigate the clinical significance of gastric cracks by investigating the relationship between stomach cracks under gastroscopy and H.pylori infection as well as its pathological manifestation,in order to improve the detection rate of H.pylori.Methods Gastroscopy patients were enrolled as our subjects excluding those with tumors,major diseases and under 18 years old.Mucosal biopsies were obtained from the lesser curvature of antrum and the greater curvature of body in each patient,then by HE staining,pathological and HP examination.The information including the pathological diagnosis,HP antibody,rapid urease test,endoscopic diagnosis and endoscopic gastric body cracking phenomenon were collected from all patient.H.pylori positivity was defined as a patient who showed two or more positive results in the Rapid Urea's Test,pathohistological examination and H.pylori antibody detection.Results (1) 437 patients with gastroscopy were included between December 2009 and December 2011,among whom 210 were male and 227 were female.There were 32 cases with gastric ulcer,59 cases with duodenal ulcer,51 cases with duodenitis,62 cases with reflux esophagitis,and 276 cases with chronic gastritis.(2) H.pylori distribution in stoma of all patients:160 of 437 patients(36.61％) are H.pylori positive,of which 68.75％ (110/160) was found H.pylori positive in both of gastric antrum and body,25.63％ (41/160) was H.pylori positive only in antrum,and 3.13％ (5/160) was H.pylori positive only in the body of stomach.(3)Relationship between the presence of cracks in gastric body and H.pylori infection:the H.pylori positivity was 62.58％ (97/155) and 22.34％ (63/282) respectively in the group with or without the presence of cracks in body.Cracks in gastric body examined by gastroscopy was related to H.pylori infection(x2 =69.788,P =0.000).(4) Relationship between the presence of cracks in gastric body and patho-histology:the presence of cracks in gastric body was related with severity of gastric inflammation by Wilcoxon rank sum test (P ＜ 0.0001),while there was no relationship between gastric body cracks and atrophy,intestinal metaplasia and atypical hyperplasia(P ＞ 0.05).(5) Relationship between the presence of cracks in gastric body and diseases:the presence of cracks in body was related with duodenitis,bile reflux under gastroscopy while there was no difference among in gastric body and gastric ulcer,esophagitis and chronic gastritis in terms of cracking appearance (P ＞ 0.05).Conclusion Our finding showed that cracking appearance in the gastric body is related with severity of inflammation in gastric mucosa bile reflux and duodenitis,suggesting that it can be one of the gastroscopic manifestations of more severe gastritis.