Objective: To evaluate the effectiveness of the Demin Circle in on-site first-aid training among fishermen, so as to provide insights into improving the on-site first-aid knowledge and skills among fishermen. Methods : Deep-sea male fishermen were sampled from Putuo District of Zhoushan City, Zhejiang Province and randomly assigned to the intervention and control groups. Participants in the control group received training pertaining to conventional first-aid knowledge, while participants in the intervention group were given the Deming Circle. The knowledge, awareness and skills of on-site first-aid, and satisfaction with the first-aid training were evaluated among fishermen before and after the training using questionnaire surveys and on-site first-aid skill operations. Results: A total of 327 questionnaires were allocated, and 273 valid questionnaires were recovered, with an effective recovery rate of 83.49%. There were 132 respondents in the control group and 141 in the intervention group, and there were no significant differences between the two groups in terms of age or educational level ( P>0.05 ). The increase of the score of on-site first-aid knowledge, proportion of active learning of on-site first-aid knowledge, proportion of active elimination of potential dangers and proportion of active implementation of on-site first-aid, and seizing the skills of cardiopulmonary resuscitation, trauma first-aid, airway foreign body disposal and calling the police were all higher in the intervention group than in the control group ( P<0.05 ). Following training, the score of satisfaction with the training was significantly higher in the intervention group than in the control group [( 9.13±0.49 ) vs. ( 7.08±0.72 ) points, P<0.05 ], and the score of willingness to continue the enrollment in the Deming Circle was significantly greater in the intervention group than in the control group [( 65.13±3.11 ) vs. ( 43.62±3.79 ) points, P<0.05 ]. Conclusion Deming Circle is superior to conventional first-aid training for improving the effectiveness of on-site first-aid training among fishermen.

Objective To study the relationship between CCAAT/enhancer-binding proteins (C/EBPs) and circadian genes expression in mammals.Methods C/EBP-a 240,280,650,1300 and Rev erb-a promoter-luciferase reporter gene expression vectors were set up,as well as the corresponding report gene stable transfection cell lines were established.The intensity and/or rhythm of report gene expression were observed by testing the biological fluorescent.Results The transcription factor CLOCK/BMAL1 heterodimer activated C/EBP-a via a conserved E-box element in its promoter,and the latter showed circadian oscillation which was E-box dependent.On the other hand,C/EBP-a suppressed Rev-erba transcription.Moreover,GR signaling,a known resetting signal for circadian clock,suppressed C/EBP-a transcription.Conclusion The data highlight the reciprocal feedback regulation between a key transcription factor C/EBP-a and the timing mechanism in cells.

Objective To observe the clinical characteristics and therapeutic effect of aphakic retinal detachment (ARD) eyes and pseudophakic retinal detachment (PPRD) eyes.Methods The clinical data of 805 patients,including 321 ARD and 484 PPRD eyes were retrospectively analyzed.The patients'visiual acuity,refraction,intraocular pressure were examined,and the patients also underwent slit-lamp microscopy and direct and (or) indirect ophthalmoscopy.The preoperative best-corrected visual acuity (BCVA) was between light perception (LP) and 0.6.Mainly according to the PVR grade and retinal holes position to take the scleral buckling or vitrectomy combined with scleral buckling.The 805 eyes were divided into 1995-1999 group (243 eyes) and 2000-2007 group (562 eyes) according to operative time.The follow-up ranged from 3 to 25 months,with an average of 12.3 months.The success standard of surgery was set as anatomic retinal reattachment and the last follow-up time was considered as the judgment time.The surgical complications were recorded at each follow-up time points.The composition of PPRD,the visual acuity,ocular lesions,surgical methods and results before operation and visual acuity after operation in two groups were analyzed and compared by Mantel-Haenszel chi-square test.Results The average interval from lens extraction to RD occurrence was 15.4 months in PPRD eyes and 39.1 months in ARD eyes.The final total anatomic success rate was 95.9%,and was 93.5% in the scleral buckle eyes and 97.2% in vitrectomy eyes.The BCVA was better than 0.3 after operation only in 11.9% of the 805 patiens,and the visual acuity increased more than 2 lines in 67.3%.Compared with the ARD eyes,early onset,high proportion of total posterior vitreous detachment,severe PVR,wide RD range,low detection rate of retinal hole and low antomic success rate were found in PPRD eyes.Compared with the 1995-1999 group,the proportion of vitreous surgery,anatomic success rate and better visual acuity were found in 2000-2007 group.Conclusions The ocular lesions of ARD and PPRD is more complicated,the therapeutic effect are improving in recent years.

[Objective]To test and prove the mushroom shaped surface prosthesis of femoral head not only can be a weight-bearing device,but also could reduce stress-shelter and achieve long-term stability.[Method]A simplified three-dimensional model of femoral head was made.And the biomechanics of femoral head were compared by finite element analysis in two states:with and without the replacement.[Result]It showed that the maximum of strees in famoral head was less than 40Mpa,consequently the replacement had sufficient strength to meet its basic function.Furthermore,the prosthesis bear the force both at up part and down.Therefore it reduced stress-shelter.[Conclusion]This prosthesis can achieve immediate and long-term stability.And it provides new ideas for designing the femoral head resurfacing prosthesis.

Objective To investigate the incidence and the correlative factors of diabetic retinopathy (DR) in patients with diabetes mellitus(DM)who lives in Beixinjing blocks, Shanghai. Methods Residents with DM were enrolled according to resident health archives. The data of disease history, visual acuity, eye disease and introcular pressure were collected by inquiry and examination. Photography of ocular fundus was used to confirm the diagnosis of DR. Results A total of 535 residents excepted the examination with the participating rate of 90.68%, in whom 146 (27.29%) were identified as with DR. The incidence of single and proliferative DR was 22.29% and 4.30%, respectively. Duration of DM was the independent risk factor of DR, while long duration of DM, accompanied with peripheral neuropathy and body mass index was the in-order independent factor of proliferative DR. Conclusions The incidence of DR is high in residents with DM. Monitoring DR progress in DM residents with risk factors is recommended.

Objective To investigate the vision-related quality of life (VRQoL) of patients with monocular rhegmatogenous retinal detachment (RRD) before and after relative surgery, and analyze its influencing factors. Methods A total of 92 patients with monocular RRD were asked to complete the Chinese-version low vision quality of life questionnaire (CLVQOL) preoperatively and at the end of the follow-up time. Results The Cronbach ? coefficient of the questionnaire was more than 0.7. The lowest scores were at the item of "adjustive ability" before the surgery, and the scores of the questionnaires were significantly higher at the end of the follow-up time. The item whose score changed most caused by the surgery was "adjustive ability". The visual acuity in RRD eyes before the operation and the changes of the visual acuity was the chief independent risk factor of the questionnaire score before surgery and the changes of scores due to surgery, respectively. Conclusions CLVQOL can be used to assess the VRQoL of patients with monocular RRD after surgery. The qualities of life of patients with monocular RRD decrease sharply. VRQoL, especially the adjustive ability, improves obviously after operation, but the patient would be inconvenient for doing some precision work or daily house work. Improving the visual acuity of the RRD eye, giving early surgery and avoiding complications help to improve the VRQoL of the patients with monocular RRD.

Objective To investigate oxidative stress in the kidney of diabetic rat in order to tobserve the effect of Tianli Decoction(TLT) on diabetic nephropathy. Methods The rats were devided into five groups:TLD-High dose group,TLD-Low dose group,Captopril(Cap) + HB419 group,pathologic control group,normal control group. Alloxan was used to induce the diabetic model of rats. After 8 weeks,blood glucose,blood lipid,urinary protein and the ratio of kidney weight to body weight in the rats of five groups were measured. The content of MDA and the renalintrinsic anti-oxidatantenzyme activities such as SOD and GSH-Px were evaluated. Results Comparing with normal group,the level of blood glucose,blood lipid,urinary protein and the ratio of kidney weight to body weight in diabetic group were significantly increased. The content of MDA in renalortex was increased,whereas the activities of anti-oxidatantenzyme were decreased. Conclusion Oxidativestress existed in the kidney of diabeticrats. The deficiency of intrinsic anti-oxidatantenzyme may contribute to the development of diabetic nephropathy. TLT can revers the obove changes.

Humans ; Surgeons ; Thyroid Neoplasms ; surgery ; Thyroidectomy

Objective To evaluate the clinical characteristic,diagnosis and treatment procedures for renal oncocytoma and chromophobe cell renal carcinoma.Methods Eight cases of renal oncocytoma and 5 cases of chromophobe cell renal carcinoma were analysed.The average of oncocytoma was 58.8 years old(23～74),and mean tumor size was 5.1 cm(range,3～7 cm);The mean age of chromophobe cell renal carcinoma was 54.5 years old(35～72),and mean tumor size was 5.8 cm(range,3～8 cm).Doppler ultrasonography and CT scan were performed in all patients.All cases accepted surgical operation and were confirmed by pathology.Results Renal oncocytoma was characterized by homogeneous round cell containing aboundant axyphil pellets.Color Doppler ultrasonography show isoechoic or hypoechoic masses.CT scan revealed that the tumors were homogeneous solid masses,and most of them were visualized as homogeneous enhancement.All the patients were followed up for 10 to 53 months,and no recurrence or metastasis was noted.Color Doppler ultrasonography show mainly hyperechoic masses,CT scan revealed most of the tumors were heterogeneous enhancement.All the patients were followed up for 12 to 49 months,and 1 case died from metastasis after 1 year.Conclusion Renal oncocytoma and chromophobe cell renal carcinoma can be differentiated by clinical characteristic,ultrasonic and CT scan examination.The diagnosis is confirmed by pathology.Partial nephrectomy is good for renal oncocytoma,while radical nephrectomy is still the first choice for chromophobe cell renal carcinoma.