Objective To explore the clinicopathology characteristics of endometrial adenocarcinoma and non-endometrial adenocarcinoma.Methods The clinical data of 306 patients with endometrioid cancer were analyzed retrospectively.Results The patients with endometrial adenocarcinoma accounted for 90％ of all patients,and the patients with non-endometrial adenocarcinoma accounted for 10％.Compared with the patients with endometrial adenocarcinoma,the average age of the patients with non-endometrial adenocarcinoma was older[(59.32 ± 7.77)years],the constitution ratio of postmenopausal patients was higher(90％),the clinicopathologic stage was later(P =0.000),the grade of histology was higher(P =0.000),the myometrial invasion was deeper(P =0.014).The patients with nonendometrial adenocarcinoma were prone to occur lymph metastasis(P =0.006),and the recurrence rate was higher(P =0.000).Conclusion There is significant defference between endometrial adenocarcinoma and non-endometrial adenocarcinoma,the patients with non-endometrial adenocarcinoma has poor pronosis,and we should pay more attention to it.

BACKGROUND:Currently, the treatment of proximal humeral fractures mainly contains joint preservation (conservative treatment, open reduction and internal fixation) and arthroplasty, but how to choose the treatment is stil controversial. OBJECTIVE:To evaluate and compare the clinical outcomes of joint preservation versus arthroplasty in the treatment of displaced 3-or 4-part humeral fractures in randomized control ed trials using meta-analysis. METHODS:Medline (January 1966 to December 2013), PubMed (January 1980 to December 2013), Embase (January 1990 to December 2013), Science (January 1990 to December 2013), Springer (January 1990 to December 2013), China National Knowledge Infrastructure (1994 to 2013), and Wanfang database (1982 to 2013) were searched for randomized control ed trials addressing joint preservation and arthroplasty for 3-or 4-part proximal humeral fractures. Articles meeting the inclusion criteria were included. The related data were extracted and loaded onto Comprehensive Meta-Analysis Software for meta-analysis. RESULTS AND CONCLUSION:Seven articles with 320 patients (165 patients undergoing joint preservation and 155 patients receiving arthroplasty) were accepted in this mete-analysis and al of them were high-quality English researches by modified Jadad Scale. Meta-analysis results displayed that the random-effects mean Constant score across al types was 55.9 (95%CI:50.7-61.1;P<0.001). Constant score was higher in the joint preservation group than in the arthroplasty group (P<0.01). The study displayed significant heterogeneity (I2 0.001). In the meta-analysis, Constant scores were decreased with increasing rate of male to female and rate of tuberosity resorption. These results suggested that 3-or 4-part proximal humeral fractures demonstrate improved Constant scores when treated with joint-preserving options compared with arthroplasty. Moreover, age, fracture pattern, gender ratio and complication rate are significant predictors of the Constant score. Given the observed heterogeneity and variance in treatment techniques in the included studies, more randomized control ed trial studies are needed to definitively recommend joint-preserving techniques versus arthroplasty for treatment of 3-or 4-part proximal humeral fractures.=88%, Q statistic=107.6, Q=13;P<0.001). In the meta-analysis, Constant scores were decreased with increasing rate of male to female and rate of tuberosity resorption. These results suggested that 3-or 4-part proximal humeral fractures demonstrate improved Constant scores when treated with joint-preserving options compared with arthroplasty. Moreover, age, fracture pattern, gender ratio and complication rate are significant predictors of the Constant score. Given the observed heterogeneity and variance in treatment techniques in the included studies, more randomized controlled trial studies are needed to definitively recommend joint-preserving techniques versus arthroplasty for treatment of 3- or 4-part proximal humeral fractures.

BACKGROUND:Tissue-engineered biomaterials have the similar structure and function with autologous tissues. OBJECTIVE:To explore the osteoinduction of the bone biomaterial composited with rat bone marrow mesenchymal stem cel s in the treatment of large costal defects. METHODS:Forty Wistar rats were enrol ed used for the preparation of right large costal defect models, and then randomized into two groups, fol owed by the implantation of calcium chloride-sodium alginate gel (control group) or chloride-sodium alginate-bone marrow mesenchymal stem cel s (experimental group). At 2, 4 and 8 weeks after implantation, chest X-ray radiograph and histological examination of the defect region were conducted. RESULTS AND CONCLUSION:X-ray showed that in the experimental group, the defect area had no significant changes at the 2nd week after implantation until the formation of few bones at the 4th week;and at the 8th week, both ends of the defect region gradual y connected, and newly formed bones were ful of the defect. In contrast, the defect region in the control group showed no obvious bone healing, and both ends of the defect closed and osteosclerosis occurred. In the experimental group, there were a smal amount of fibrous tissues and numerous inflammatory cel s infiltratied in the material compartment, and no connection occured between the material and broken ends;there were numerous inflammatory cel s but no bone tissues in the control group at the 2nd week. At the 4th week, the scaffold degraded gradual y and abundant bone tissues were seen in the experimental group;the scaffold degraded little, and bone tissues aggregatied at the both defect ends in the control group. Up to the 8th week, the two kinds of scaffolds degraded mostly. A large number of bone tissues and trabeculae formed and the both defect ends were connected with the newly formed bones in the experimental groups, while in the control group, osteosclerosis appeared at both ends of the defect. To conclude, the bone biomaterial composited with rat bone marrow mesenchymal stem cel s promotes the repair of large costal defects.

Objective To analyze the clinical features and risk factors of migraine patients with white matter le-sions (WMLs). Methods One hundred ten clinically diagnosed migraine patients who underwent magnetic resonance im-aging (MRI) scans from October, 2010 to August, 2013 were enrolled in Shandong Provincial Hospital. One hundred ten migraine patients were divided into two groups:WMLs group and non-WMLs group based on the presence or absence of WMLs in MRI scans. The clinical features of the patients and location and number of WMLs were investigated. Noncondi-tional multivariate stepwise logistic regression after univariate analysis was used to analyze the data. Odds ratio (0R) and 95 confidence interval after adjustment for possible confounding variables were calculated. Results①There were 36 patients with WMLs among the 110 migraine patients. The incidence of WMLs in migraine patients was 32.7%. The WMLs in migraine patients were predominantly present in the frontal and parietal lobes (59.1%). ② Compared with non-WMLs group, there were significant increases in disease duration (5.3±3.7 vs. 7.6±4.9, P﹤0.01), frequency of head-ache attack (3.5 ± 2.3 vs. 4.6 ± 2.2, P﹤0.05), aura (18.9%vs. 36.1%, P﹤0.05) and family history of migraine (12.2%vs. 44.4%, P﹤0.01) in WMLs group.③The independent risk factors of WMLs in migraine patients were family history of mi-graine (OR=5.995), aura (OR=3.067) and long disease duration (OR=1.165). Conclusions Family history of migraine, au-ra and disease duration are the predictive risk factors of WMLs in migraineurs.

Objective To investigate the incidence and clinical characteristics and look for assay or examination indexes or indicators with higher sensitivity and specificity of heart damage induced by exhaustive exercise in order to establish its preliminary clinical classification and diagnostic criteria. Methods In a military region for training staff,the clinical data of 88 soldiers who were admitted to the departments of cardiology in 6 general or central hospitals because of exhaustive exercise from January 2000 to December 2010 were analyzed. The myocardial enzyme, electrocardiogram(ECG),echocardiography and other related examination indexes or indicators were observed,and the changes of symptoms,signs and other relevant assay and examination indexes before and after treatment were recorded. Results Exhaustive exercise could cause the symptoms such as chest tightness,palpitations,chest pain, dizziness,shortness of breath,fatigue,syncope and other symptoms,as well as cardiac auscultation abnormalities. After treatment, aspartate aminotransferase〔AST(U/L):20.34±6.33 vs. 35.43±25.25〕,α-hydroxybutyrate dehydrogenase〔α-HBDH(U/L):130.47±9.04 vs. 168.93±62.69〕,lactate dehydrogenase〔LDH(μmol?s-1?L-1):2.48±0.62 vs. 3.58±1.34〕,creatine kinase〔CK(U/L):125.58±67.56 vs. 556.42±381.89〕,creatine kinase isoenzyme〔CK-MB(U/L):11.20±4.08 vs. 23.09±15.61〕were significantly lower than those before treatment(P<0.05 or P<0.01);cardiac troponin T(cTnT)was detected in 5 patients,its level after treatment was significantly lower than that before treatment(μg/L:0.07±0.05 vs. 1.26±0.78,P<0.05). The ECG abnormalities included primarily sinus bradycardia (16 cases),sinus arrhythmia (13 cases) and premature ventricular contractions (11 cases). Echocardiographic abnormalities appeared in 18 cases,they were chiefly as follows:valvular regurgitation, cardiac dysfunction,cardiac enlargement,etc,among which the most common one was valvular regurgitation(all the refluxes were of small amount). Based on the above clinical manifestations and examination results,the exhaustive cardiac injuries were preliminarily divided into common type(20 cases),arrhythmia type(56 cases),heart failure type(2 cases)and sudden death(10 cases). Conclusions The clinical manifestations of exhaustive heart damage may appear in different types. Abnormal changes of myocardial enzymes,ECG and echocardiography are the strong evidences for the damage. Clinicians should pay attention to its prevention and treatment.

Objective To explore the relationship between organizational justice and turnover intention among nurses of tertiary hospitals and to provide implications for human resource management.Methods Totally 511 nurses were recruited from four tertiary hospitals of Jinan City and investigated with Organizational Justice Questionnaire and Turnover Intention Scale.Results The average scores of turnover intention and organizational justice were (2.46±0.61) and (3.55±0.62),respectively.Distributive justice and informational justice were significant predictors of turnover intention.Conclusions The turnover intention of nurses in tertiary hospitals is high.It is beneficial for mitigating nurses' tumover intention to improve their organizational justice,apply post management and performance appraisal model.

Objective:To observe the clinical efficacy of back-Shu and front-Mu points combination needling on balance and walking function in patients after stroke and its mechanism. Methods:A total of 79 patients with post-stroke balance and walking dysfunction were randomly divided into a control group and an observation group.Both groups received conventional treatments such as dietary guidance and oral medications as well as rehabilitation training.On this basis,the control group was treated with additional conventional acupuncture,and the observation group was treated with additional back-Shu and front-Mu points combination needling.Both groups were treated for 4 consecutive weeks.The thickness of abdominal muscle group(transverse abdominal muscle,rectus abdominis,obliquus internus abdominis,and obliquus externus abdominis),the scores of Berg balance scale(BBS),Fugl-Meyer assessment(FMA),and functional ambulation categories(FAC),and walking velocity and stride were compared between the two groups. Results:During the trial,there was 1 dropout case in the control group and 4 dropout cases in the observation group.Before treatment,there were no statistical differences in the abdominal muscle group thickness,scores of BBS,FMA,and FAC,and walking velocity and stride between the two groups(P>0.05).After 4 weeks of treatment,the thickness of abdominal muscle groups,scores of BBS,FMA,and FAC,and walking velocity and stride in both groups were improved(P<0.01),and the observation group was superior to the control group(P<0.05). Conclusion:Both conventional acupuncture and back-Shu and front-Mu points combination needling are conducive to the improvement of balance and walking function in patients after stroke.The back-Shu and front-Mu points combination needling method has better curative efficacy.Strengthening the core muscle group strength may be one of the mechanisms of back-Shu and front-Mu points combination needling treatment.

Objective To understand the epidemical patterns of schistosomiasis in Guichi District of Chizhou City，Anhui Province，in order to provide the reference for schistosomiasis control. Methods The annual data of schistosomiasis endemic situation in Guichi District from 1991 to 2011 were collected. The descriptive analysis was first conducted to describe the changes of schistosomiasis in local residents and the status of Oncomelania hupensis. An autoregressive integrated moving average （ARIMA）model was applied to fit and predict the tendency of schistosomiasis incidence in this region. Results The humanmorbidity increased with the increasing of the areas with snail habitats（P < 0.05），and four peaks（in 1992，1995，2005，2008）were detected. The difference of the area with snails among different types of snail habitats was statistically significant（F = 256.79，P < 0.05）. ARIMA（1，1，1）was determined to be the optimal model for analyzing the morbidity of schistosomiasis，and the short⁃term forecast of the morbidity in Guichi District from 2012 to 2015 showed that the predicted values were 0.017%，0.007%，0.012%，and 0.010%，respectively. Conclusions The endemic situation of schistosomiasis in Guichi District is controlled relatively well in the past two decades. However，the surveillance in the lake and marshland regions should be strengthened continuously to prevent the rebounding of the schistosomiasis endemic situation.

Knee osteoarthritis (KOA) is a kind of degenerative osteoarthrosis, which usually involves articular cartilage, subchondral bone, meniscus and quadriceps femoris, which is equivalent to the change of "tendon" in traditional Chinese medicine. The occurrence and development of the change of "tendon" can be explained by the theory of "bone-restoration and tendon-softening" in traditional Chinese medicine. If the force line of the lower limb of the knee joint is normal, it can be indicated by "bone-restoration" in traditional Chinese medicine, that is, the blood around the knee joint runs smoothly, and the "tenons" such as meniscus, ligaments, cartilage, etc. are softened by the blood. This condition of the knee joint can be manifested by the balance of the surrounding soft tissue state. If the force line of the lower limb of the knee joint changes, showing a medial offset and misalignment of the knee joint, it can be indicated by "bone is out of alignment" in traditional Chinese medicine, that is, the structure of the soft tissue around the knee joint and its mechanical characteristics have changed. This condition of the knee joint can be manifested by "the tendons lose their flexibility". In this paper, the theories of modern biomechanics and "bone-restoration and tendon-softening" in traditional Chinese medicine were comprehensively analyzed, the characteristics of the "tenons" when knee osteoarthritis occurs were analyzed, and the characteristics of the occurrence and development of knee osteoarthritis from the perspective of Chinese and Western medicine were discussed.

Objective:To investigate the applicability of time series model in predicting incidence of nosocomial infection in a cancer center in Shanghai, and to provide the references for early warning and prevention.Methods:The nosocomial infection data of inpatients of a tertiary oncology hospital in Shanghai from 2013 to 2018 were collected. The autoregressive integrated moving average (ARIMA) model and the exponential smoothing model were established by SPSS 22.0 expert modeler. The fitting predictions were compared between these two time series models to select the optimal one. The nosocomial infection data from January 2019 to June 2019 were used to test the predictive effect of the model.Results:A total of 379 477 cancer inpatients were studied, 3 170 of which acquired nosocomial infection and the incidence was 0.84% from 2013 to 2018. Additive Holt-Winters method exponential smoothing model was the better model with R2of 0.82. Using this model, the predicted value fitted well with observed value from January 2019 to June 2019, and the mean relative percentage error was 15.22%. Conclusion:Additive Holt-Winters method exponential smoothing model could be used to fit and predict the tendency of nosocomial infection among cancer patients, which can provide reference for surveillance of nosocomial infection in oncology hospitals.