Objective To study the curative effect of continuous alternant drainage surgery on improved central venous catheter cerebellomedullary cistern and continuous alternative drainage of ventricle in treating cerebroventricular hemorrhage.Methods 118 cases of patients with cerebroventricular hemorrhage were randomly divided into two groups:the improve group(n=59)was applied with continuous alternative drainage of ventricle and improved central venous catheter cerebellomedullary cistern,and the control group(n=59)was applied with traditional drainage of ventricle combined with lumbar centesis.Results In the improved group 3 cases(5.1%)died,and 7 cases(11.9%)developped with obstructive waterhead.In control group 8 cases(13.6%)died,and 15 cases(25.4%)developped with obstructive waterhead.The cleanup speed of cerebroventricular hemorrhage for patients in the improved group was much faster than that in the control group(P＜0.01).The curative effect of the improved group was distinctly better than that of the control group(P＜0.05).Conclusion Cerebroventricular hemorrhage treated by continuous alternative drainage of ventricle and the improved central venous catheter cerebellomedullary cistern and and continuous alternative drainage of ventricle can distinctly reduce mortality,deformity,complication and sequelae.

Objective: To survey mental health knowledge and its influence factors among undergraduates in Henan provenience and to provide a scientific evidence for further formulating the targeted strategies. Methods: Totally 840 agriculture and forestry college students, literature and history students, science students and medical students were selected with stratified multistage random sampling from 45 colleges and universities in Henan provenience,investigation of Mental Health related knowledge by self-designed questionnaire. Results: The awareness rate of mental health knowledge was 75.86%(32 806/43 248). Multivariate linear regression analysis showed that score of mental health knowledge of femal students was 1.03 of the of male students; score of medical students was 5.19,3.65,2.65 of that of students in the other majors; score of students who obtained mental health knowledge through other channels(television/movie/network/talking) was 1.42 of that of than those who obtained through formal approaches(slogans/manuals/broadcast/cathedra)(P<0.05). Conclusion The awareness rate of mental health knowledge among undergraduates in Henan provenience need to be improved, the education of male, senior students, non-medical students and the explore of diversified forms should be strengthened.

Objective To investigate the clinical value of tumor marker combined with cytokeratin 18 and 19 in the diagnosis of malignant tumors .Methods 264 patients with malignant tumor were selected as the observation group.During the same period,136 patients with benign tumor were selected as the control group .The tumor markers, cytokeratin 18 (CK18) and cytokeratin 19 (CK19) levels were compared between the two groups ,and the positive detection rate of tumor markers combined with CK 18 and CK19 were analyzed .Results The serum CK18 and CK19 levels of the observation group were (25.48 ±75.14) U/L,(18.67 ±64.85)U/L,respectively,which were signifi-cantly higher than those of the control group [(0.56 ±1.52)U/L,(0.76 ±0.43)U/L],the differences were statisti-cally significant (t=17.38,15.75,all P<0.05).The serum levels of CEA,CA125,CA50,CA19-9 and TSGF of the observation group were (21.24 ±30.16) μg/L,(69.85 ±112.75) mU/L,(47.32 ±121.81) mU/L,(41.87 ± 20.65) mU/L,(91.64 ±43.84) mU/L,respectively,which were significantly higher than those of the control group [(1.27 ±0.85) ng/mL,(15.82 ±3.87) mU/L,(12.85 ±31.65) mU/L,(6.89 ±4.85) mU/L,(38.35 ± 8.01) mU/L],the differences were statistically significant (t=15.73,16.89,14.86,17.79,16.73,all P<0.05).The positive detection rates of CK18 and CK19 for gastric cancer (66.67％) and lung cancer (77.14％) were signif-icantly higher than tumor markers ,and the differences were statistically significant (χ2 =5.67,6.78,all P<0.05). The positive detection rate of tumor markers combined with CK 18 and CK19 for malignant tumors ( 75.00％) was significantly higher than CK18 and CK19 joint detection (65.91％),tumor markers (46.97％),the differences were statistically significant (χ2 =6.78,7.12,all P<0.05).Conclusion Tumor markers combined with CK18 and CK19 detection is helpful to improve the detection rate of malignant tumors and provide effective basis for following treatment.

Objective To analyze the genotypes and homology of MSP?1 and CSP gene of Plasmodium vivax in Shandong Province,so as to provide the evidence for case traceability. Methods A total of 12 blood samples were collected from P. vivax?infected cases in Shandong Province in 2011. Parasite genomic DNA was extracted. Primers were designed according to MSP?1 and CSP gene sequences of P. vivax. Then Nested PCR,enzyme digestion,sequencing and sequence alignment,and homolo?gous analysis were performed. Results The MSP?1 gene of all the 12 samples from P. vivax?infected cases were detected with a 470 bp PCR amplification band,and 350 bp and 120 bp enzyme digestion fragments,which were identified as type Sal?1. An analysis of phylogenetic tree of MSP?1 gene showed that the sequences of 9 indigenous case samples in Shandong Province were located in the same branch,one case sample infected from India was located in the same branch with India strains. All the 12 P. vivax?infected samples covered GDRA(D/A)GQPA sequences in CSP gene,which were identified as type PV?Ⅰ. Of the CSP gene among 12 P. vivax?infected samples,10 samples of indigenous case in Shandong Province and one sample of the case in?fected in Guangdong Province were detected with both 560-840 bp and 150-230 bp PCR amplification bands,which were iden?tified as temperate zone family strain of type PV?Ⅰ. However,one sample from the case infected in India was detected only with a 560-840 bp band,which was identified as tropical zone family strain of PV?Ⅰ. An analysis of phylogenetic tree of CSP gene showed that the sequences of 10 samples from the indigenous cases in Shandong Province and one sample from the case infected in Guangdong Province were located in the same branch,one sample from the case infected in India was located in the same branch with India and Indonesia strains. Conclusion Of all the indigenous isolates in Shandong Province,MSP?1 gene is geno?typed type Sal?1,CSP gene is genotyped temperate zone family strain of type PV?Ⅰ,with a high homology found among the in?digenous isolates.

Objective To explore the current status and influence factors of intraoperative hypothermia nursing intervention .Methods A total of 617 nurses in operation room from 17 hospitals were randomly selected by stratified cluster sampling method .The current status and influence factors of intraoperative hypothermia nursing intervention were analyzed with 6 scales.Results A total of 617 questionnaires were issued , and there were 607 valid questionnaires collected , with 98.4% recovery rate.The scores of cognition status scale , self-efficacy scale , safety culture assessment scale , Maslach Burnout Inventory , management status scale and behavior status scale were (77.02 ±8.40), (59.96 ±7.84), (87.84 ±9.67), (61.05 ±15.68), (38.28 ± 5.97) and (45.97 ±8.66), respectively.The single factor correlation analysis showed that job burnout was only related to behavior status (P<0.05), and there were correlations among all the other factors (P<0.05). The multiple linear regression analysis showed that the cognition status , safety culture, job burnout and management status were influence factors of behavior status of intraoperative hypothermia nursing intervention (P<0.05).Conclusions Besides providing cognitive training and belief intervention , the nursing managers should enhance the humanistic care for nurses in order to improve the implementation of intraoperative hypothermia nursing intervention and nursing service quality .

Objective:To understand the current status of depression in older people aged 65 and over in Henan Province, and to study its influencing factors, with a focus on depression in older adults in grandparent families.Methods:A multi-stage stratified cluster sampling method was used.Baseline data about older people aged 65 and over were collected by self-designed questionnaires, the 15-item Geriatric Depression Scale(GDS-15)was used to assess depression.Results:A total of 7673 valid questionnaires about older adults aged 65 and over were collected, and the rate of depression was 29.52%(2265). Logistic regression analysis showed that 15 factors, such type of parenting, religious belief, region, degree of self-care, affected depression in older people aged 65 and above.Compared with regular parenting, grandparenting alone was a protective factor for depression[ OR(95% CI)=0.613(0.499-0.755), P<0.01]; compared with religious belief, no religious belief was a risk factor for depression[ OR(95% CI)=1.281(1.102-1.488), P<0.01]; compared with income ≥￥4000, incomes between ￥1000-1999[ OR(95% CI)=0.638(0.464-0.877), P<0.01], between ￥2000-2999[ OR(95% CI)=0.567(0.432-0.744), P<0.01]and between￥3000-3999[ OR(95% CI)=0.584(0.448-0.761), P<0.01]were protective factors for depression, with higher income showing stronger protection; compared with retirement, working had a protective effect, but the protective strength decreased in the order of working as urban labor, [ OR(95% CI)=0.332(0.273-0.405), P<0.01], as farmers[ OR(95% CI)=0.391(0.296-0.516), P<0.01], and as professionals or managers[ OR(95% CI)=0.514(0.402-0.656), P<0.01]; living in rural areas[ OR(95% CI)=0.686(0.586-0.804), P<0.01]and female[ OR(95% CI)=0.820(0.734-0.917), P<0.01]were risk factors for depression. Conclusions:There is currently a high rate of depression in older people aged 65 and over in Henan Province.Its influence factors are complicated and variable.Intervention measures taken by institutions need to adapt to specific circumstances.

Objective:To evaluate the effect of job-transfer training for psychiatrists in Henan province in 2018 and to compare them with the results of 2016.Methods:Data of the trainees were collected through questionnaires in 2017 and 2019 respectively. The influencing factors of knowledge and skills were determined by Multiple linear regression analysis; baseline data, training intention, training feedback and the proficiency of knowledge and skills were compared by independent sample t test and chi-square test. Results:The overall satisfaction rate for training was 98.3%, and the overall mastery rate of training knowledge and skills was 59.2% in year 2018. Compared with 2016, the willingness to participate in training, the satisfaction rate, the recognition degree of " 1+ 10+ 1" training mode, the degree of mastery and practical application of training knowledge and skills increased( P<0.05). There were statistically significant differences in the distribution of the primary reasons for participating in the training, factors hindering their participation in the training, and the causes for their failure to fully apply their learning to practice( P<0.01). The results showed that scope of practice, title, intention, and interest in psychiatry was related to the mastery of training knowledge and skills( P<0.05). Conclusions:The effect of training in 2018 is better than 2016, and the degree of mastery and practical application of training knowledge and skills should be increased.

Breast cancer is the most common cancer for Chinese women. Early screening is the best way to improve the rates of early diagnosis and early treatment of breast cancer. The peak ages of breast cancer in Chinese women are obviously different from those in the European and American countries. It is imperative to develop a guideline for breast cancer screening that is suitable for Chinese women. Based on the analysis and summary of breast cancer screening data in China, and the latest guidelines and consensus on breast cancer screening in Europe, the United States and East Asia, China Anti-Cancer Association and National Clinical Research Center for Cancer (Tianjin Medical University Cancer Institute and Hospital) has developed a population-based guideline for breast cancer screening in Chinese women. This guideline has provided detailed recommendations on the screening starting age, screening modalities, and screening interval in Chinese women with average risk and high risk of breast cancer, respectively. This article aims to interpret the above guideline, providing references for professionals in breast cancer screening.

Objective:To analyze the imaging characteristics of Stanford B aortic dissection in aortic CT angiography, in order to explore the possible related factors of aortic dissection combined with renal malperfusion and to analyze the morphological changes in each involved vessel after TEVAR.Methods:From January 2018 to December 2019, totally 148 patients of Stanford B aortic dissection underwent TEVAR in our hospital. The preoperative aortic CTA was analyzed, and all cases complicated with renal malperfusion were determined according to the clinical manifestation, laboratory examination and imaging results. The differences of morphological features between the patients with and without renal malperfusion and the possible correlative factors were analyzed.The different ischemic types of the involved renal arteries were analyzed, and the morphological changes of the involved vessels before and after the operation of TEVAR were compared.Results:The logistic regression analysis showed that the concave configuration of the tear at the renal artery level was the independent risk factor for renal malperfusion (right kidney OR=5.319, P=0.032; left kidney OR=12.879, P=0.007). The diameter of renal artery was the independent protective factor for renal malperfusion (right kidney OR=0.464, P=0.018; left kidney OR=0.685, P=0.016). Compared with preoperative CTA, the diameter of the involved renal artery was significantly enlarged after TEVAR, no matter which type of ischemia. Most of the dynamic ischemia (15/16) was improved after TEVAR; while static and mixed ischemia only partially improved after TEVAR (static 22/36, mixed 11/19) . Conclusion:The concave configuration of the renal artery level, and the diameter of renal artery are associated with renal malperfusion.The malperfusion can be improved in most cases of dynamic ischemia type vessels, while only can be partially improved in static and mixed types vessles.

Concurrent chemoradiotherapy (CCRT) refers to the simultaneous treatment of chemotherapy and radiotherapy, and the effect of radiotherapy is enhanced with low-dose chemotherapy, which can reduce tumor recurrence and metastasis and improve clinical prognosis of patients. At present, the main factors for the increase of radiosensitivity of concurrent chemotherapy is that concurrent chemotherapy prevents the repair of tumor cells, and chemotherapy and radiotherapy act on different cell cycles and have synergistic effects. However, even for patients with locally advanced cervical cancer (LACC) who have undergone CCRT, the 5-year survival rate is only 60%, which is still not ideal. In order to improve the efficacy, researchers have conducted a series of exploratory studies, which consist of the combination of targeted drugs and immunodrugs, and neoadjuvant regimens before CCRT, etc. Although targeted or immunologic drugs are effective treatment of LACC, in view of the lack of large-scale evidence-based medical evidence, multi-center prospective and randomized phase III clinical trials and high-level articles are needed to improve the level of evidence-based medicine. This consensus summarizes several key evidence-based medical studies published recently, especially the clinical research progress in targeted and immunological therapies, providing reference for domestic peers.