In order to evaluate the quality of life and affecting risk factors for the elderly populations, cluster sampling method was used to investigate 1731 elderly individuals at Shimenerlu Community in Shanghai. The results showed that the average quality of life of the participants was above medium level, and most elderly demonstrated good quality of life. Moreover, 1536 elderly individuals (88.9%) developed at least one chronic disease, and the incidence of depression was up to 17. 2%. Affecting factors of quality of life included daily life capability, severity of disease, age, depression symptom, marriage, community activities, care provider, gender, number of disease, diabetes, hobby, income, expense, family support, and living conditions. No correlation with education, career, health insurance, and partner's disease was found. Those data suggest that community heahhcare should pay more attention to the management of chronic diseases and mental health, the development of family resources, and the improvement of hobbies and social activities in the elderly populations.

Objective To investigate the clinical features of small bowel Crohn's disease(CD).Methods From January 2009 to September 2012,a total of 138 patients diagnosed as CD who underwent examinations of colonoscopy,digestive tract radiography,capsule endoscopy,double-balloon enteroscopy and computed tomography (CT) enterography were enrolled.According to the Montreal Classification criteria,the disease was typed by the age at diagnosis,location of the lesions and behavior of the disease.The clinical symptoms,laboratory examinations,diagnostic methods and recurrence condition were also evaluated.Through the comparison of the clinical features of ileocolonic and colonic CD,the clinical features of small bowel CD were analyzed.Measurement data were analyzed with t-test,analysis of variance or non parametric test.Chi square test was performed for count data.Spearman's correlation analysis was used for correlation analysis and multivariate Logistic regression analysis was used for risk factors screening.Results A total of 62 (44.9％) cases were simple small bowel CD.Fifty-three patients (85.5％) were male,and the mean age at diagnosis was 35.3 years old.The age of 67.7％(42/62) of small bowel CD patients were less than 40 years old when diagnosed.The ratio of stricture in small bowel CD group (35.5％,22/62) was significantly higher than that of ileocolonic (18.8％,6/32) and colonic CD group (13.9％,5/36) (x2=6.594,P=0.037).Jejunal involvement was an independent risk factor for structure in CD (OR=3.481,95％ CI:1.250 to 9.693).The patients with obstructive symptoms as primary symptom in small bowel CD (38.7％,24/62) were more than those with colonic CD (16.7％,6/36) (x2 =5.210,P=0.022).However,patients with diarrhea as primary symptom in small bowel CD (21.0％,13/62) were less than those with ileocolonic (37.5％,12/32) and colonic CD (44.4％,16/36) (x2=6.512,P=0.039).Patients with two or more extraintestinal manifestations in small bowel CD (3.2％,2/62) were also significantly less than those with ileocolonic (15.6％,5/32) and colonic CD (19.4％,7/36) (x2=7.957,P=0.019).The score of CD activity index was generally low,and with no statistical correlation to serum inflammation markers such as C reaction protein.The average time duration between induction of remission and clinical recurrence of small bowel CD ((23.64 ± 17.08) months) was shorter than that of ileocolonic type ((35.07±29.84) months,t=-4.285,P=0.002) and colonic CD ((32.35 ± 28.46) months,t =-3.700,P =0.004).However,there was no significant difference in the rate of clinical recurrence between small bowel CD and ileocolonic,colonic CD.Conclusions Patients with small bowel CD account for a large proportion in patients with CD,especially in males.Stricture is more common in jejunum CD.The time duration between induction of remission and clinical recurrence of small bowel CD is short.

Programmed cell death 5(PDCD5)is a novel gene which can promote and regulate apoptosis. The evidences of some studies show that PDCD5 displays reduced expression in a variety of tumor tissue. Increased expression of PDCD5 can improve the sensitivity of anti-tumor chemotherapy. Because of this feature with PDCD5,it is expected to become a new chemosensitizer.

The impelling mode of morality-oriented nursing education unites moral affection and moral volition by impelling the need for nursing morality, and enables nurses to play an active role in the nursing work. This mode also indicates that nursing morality is a humanistic and valuable scientific career, and of great importance for guaranteeing the human wellbeing. Therefore, the establishment of morality-oriented nursing is a necessity for the specialization of nursing career.

Objective To explore the methods in repairing the thenar wounds by microsurgical technique Methods Since 1989, thenar wounds were restored with transfer of superficial or deep palmar arch, recombine of thenar muscle flap Patch of nerve and transplantation of flap on 21 cases Results The thumb and flap were survived The two point discrimination was 5 to 10 mm The thenar muscle streugth reached MRC 4 with satisfactory oppones fuction Conclusion The thenal wounds cna be obtained good effect being repaired by microsurgical technique

[Objective]To approach the unique characteristics and the choice of surgery of low lumbar spine burst fractures.[Method]In this group 23 patients with low lumbar spine burst fractures were included.They were classified into three types : type one: single vertebral body fracture,were treated with short segmental pedicel screw system.type two:multiple vertebral body fracture,treated with long segmental pedicel screw system;type three:type one or type two combined with sacral vertebra fractures,treated with lumbar-sacral-ilio combination pedicel screw system.The intervertebral height of the fractured vertebral body and lumbar lordosis were evaluated both before and after operation on X-ray.The spinal impingement of bone was evaluated on CT scan,the neurofunction was evaluated with ASIA system and the clinical outcome were evaluated with Charles system.[Result]All patients were followed up for 1～5 years.The intervertebral height of the fractured vertebral body increased from preoperative 34%(20%～50%) to postoperative 88%(70%～95%).The lumbar lordosis angel increased from preoperative 35??7?to postoperative 38??10?.The spinal impingement of bone area decreased from preoperative 55%(35%～90%)to postoperative 6%(0%～10%).ASIA score increased by 1-3 degree,the clinical outcome reached 85% according to Charles classification.[Conclusion]Instable low lumbar spine burst fractures should be treated with surgery as early as possible,according to different fracture segment,it can be treated with short-long segmental pedicel screw system or lumbar-sacral-ilio combination pedicel screw system respectively.

Objective To investigate the clinical typing and staging in diagnosis of Severe Acute Respiratory Syndrome (SARS). Methods Retrospective study was designed to analysis the principal clinical characteristic of SARS and the standard of clinical typing and staging was raised. Comparisons with X-ray in lung, change of lymphocyte subset, PaO_2, SaO_2,and prognosis of disease were performed. Results The standard of SARS clinical typing and staging is four types (light type, ordinary type, heavy type, serious type)and four phases (prodromal period, progres phase, fastigium, recovery phase). The light type is 8/162(4.9%), ordinary type is 69/162 (42.6%), heavy type is 41/162 (25.3%), serious type is (27.2%). Comparisons SARS clinical typing and staging with X-ray in lung, change of lymphocyte subset were found that the more lesion in lung, the lower lymphocyte and its subset, and more serious in clinical typing. Conclusions The standard of clinical typing and staging summarized basic clinical characteristic in SARS, and coincided with progress of SARS. The standard will be help of clinical diagnosis, treatment and judging the prognosis of SARS.

Objective To set up the standard for the quality control of Chongcaojing Oral Liquid.Methods Radix Astragal-i,Radix Ginseng,Radix Angelicae Si nensis,Radix Rehmanniae were ident ified quantitatively by thin -layer chromatog-raphy(TLC)and astragalosideⅣcontent in Radix Astragali was determined by TLC scanning quantitiatvely.Results The TLC spots were highly specific,clea r and concentrated without the interference of negative controls.Linearity was ob-tained in the range of 1.03～6.15?g(r =0.9994).The average recovery was 99.2%with RSD =1.8%.Conclu-sion This method is sensitive,simple,sp ecific and accurate for the quality c ontrol of Chongcaojing Oral Liquid.

OBJECTIVE To explore the infection situation of surgical operation and enhance postoperative(observation) and rational use of antibiotics.METHODS Totally 11 208 cases after surgical operation were(investigated)(retrospectively).The diagnosis standard was based on the Diagnosis Standard of Hospital(Infection)(Draft) published by Ministry of Health,the People′s Republic of China in Jan 2001. RESULTS There were(11 208) cases after surgical operation from Jan 1,2000 to Dec 31,2004 in our hospital and 275 cases suffered(incision)(infection,) there(infection) rate was 2.45%.The pathogenic bacteria of incision infection were confirmed as G~-(bacilli)(72 strains,78.26%),and G~+ cocci(20 strains,21.74%).CONCLUSIONS The key points of prevention of incision infection are sterile operation,protection of operation field when incising cavity organ,inside(sterilization),flushing of abdominal cavity and incision,change of contaminated apparatus,gloves and dressing promptly,(selection) of suture line and suture technique,besides the serious operation preparedness and skin(sterilization).

Objective To evaluate the impact of acute hyperglycemia on the short-term prognosis in patients with primary intracerebral hemorrhage (ICH) with meta-analysis. Methods The prospective or retrospective cohort studies or case-control studies of the relationship between baseline blood glucose levels and short-term prognosis (at least were followed up to discharge or 1 month) in patients with ICH within 24 hours were searched and reported. A meta-analysis software package (RevMan 4. 2) was used to pool data for the literatures in accordance with the inclusion criteria. The publication bias was analyzed and the sensitivity analysis was used to evaluate the stability of the results. Results The risk of mortality at the end of the follow up in the normoglycemia group was significantly lower than that in the hyperglycemia group (odds ratio 0. 24,95% CI 0. 19-0. 30; P <0. 000 01); the baseline plasma glucose level was significantly lower than that in the survival group (weighted mean difference -2. 30,95% CI -2. 36- -2.23; P< 0.000 01). Conclusions Acute hyperglycemia can significantly increase the risks of short-term mortality in patients with primary ICH. It is necessary to conduct a prospective randomized trial in order to investigate the effect of intensive glucose control on the prognosis of the patients with ICH.