Objective To examine the status of and factors influencing medical students' mental health.Methods The China undergraduates' mental health scale and an information questionnaire developed by the authors were administered on 1 205 students selected from Grade 1-3 in chnical medicine,anesthesia,and medical diagnostic programs using cluster sampling.Results The level of medical students' somatization,a~nxiety,depression,social withdrawal,irritabihty,and obsession was higher as compared to the norms for general undergraduates in China.Female medical students showed higher scores than males on 4 aspects:somatization,anxiety,depression,and obsession.Additionally,those belonging to minority nationalities showed higher scores on social withdrawal,irritability,and impulse as compared to those with the Han nationality.Further,students with low professional identity had higher scores on somatization,anxiety,depression,inferiority,irritability,and social withdrawal as compared to those with high professional identity.Conclusion Medical students' mental health is not optimal;therefore,it needs to be addressed by educational departments and educational works.Thus,mental health education,professional counseling,and appropriate interventions need to be conducted for medical students.

Objective To investigate the effects of hysteroscopic resection for mild-to-moderate uterine incision diverticulum after cesarean section.Methods From September 2010 to September 2014, hysteroscopic resection was performed under B-ultrasonography in 102 cases of mild-to-moderate uterine incision diverticulum after cesarean section.Results The operation was completed successfully in all the cases, without surgical complications.Outcome evaluation at 1 year after surgery showed cured in 89 cases (87.3%, complete disappearance of symptoms and recovery of normal menstruation), improved in 7 cases (6.9%, menstrual period shortened by 5-7 d, with or without lower abdominal dull pain and menstrual exacerbation), and ineffective in 6 cases (5.9%, no or slight symptom improvement).Conclusion Hysteroscopic resection is a safe, effective, and minimally invasive method for mild-to-moderate uterine incision diverticulum after cesarean section in patients demanding clinical symptom improvement without desire of fertility.

Background It is determined that the patients with thyroid-associated ophthalmopathy (TAO) often occur dry-eye related symptoms due to increasing tear evaporation caused by exophthalmos.However,more than half of thyroid dysfunction patients without TAO appear ocular surface inflammation.It is very important for us to understand the association of thyroid dysfunction patients without TAO with ocular damage.Objective This study was to observe the ocular surface changes in thyroid dysfunction patients without TAO.Methods A prospective cohort study was performed.Thirty-one patients who were initially diagnosed as thyroid dysfunction without TAO were included in the Second Hospital of Tianjin Medical University from January 2015 to May 2016 as the thyroid dysfunction group,and 16 helthy subjects were simutenniously selected as the control group under the informed consent of all the individuals.The peripheral blood was collected to detect the thyroid function-related indexes.Then the patients with thyroid dysfunction were divided into thyroid stimulating hormone (TSH) reduced group (18 patients) versus TSH elevated group (13 patients) and thyrotrophin receptor antibody (TRAb)+ group (20 patients) versus TRAb-group (11 patients).Exophthalmos degree,Schirmer I test (S I t),tear film break-up time (BUT),fluorescent integral,ocular surface disease index (OSDI) and corneal inflammation index were examined and intergrouply compared.The correlations of thyroid function indexes with ocular surface examination results were analyzed.Results There were no significant differences in exophthalmos degree and S I t values between thyroid dysfunction group and control group (t =0.037,P =0.971;t =0.815,P =0.419).The BUT values were (7.74 ± 1.45) seconds and (10.56± 1.40) seconds,fluorescent integral scores were 5.00 (1.50) and 2.50 (2.38),OSDI scores were 45.58 ± 9.23 and 19.47 ± 6.25,and corneal inflammation index scores were 0.11 (0.22) and 0.00 (0.06) in the thyroid dysfunction group and the control group,respectively,showing significant differences between the two groups (all at P＜0.01).There were not significant differences in exophthalmos degree,S I t,BUT and corneal inflammation index scores between the TSH elevated group and TSH reduced group (t =0.473,P =0.640;t =0.650,P=0.521;t=1.634,P=0.l13;Z=0.270,P=0.787).The fluorescent integral scores were 4.00 (2.00) and 5.00 (1.00),and OSDI scores were 40.08±9.91 and 47.11±9.75 in the TSH elevated group and TSH reduced group,repectively,with statistically significant differences between these two groups (all at P＜0.01).The exophthalmos degrees,S I t,BUT and corneal inflammation index scores were not considerably different between TRAb-group and TRAb+ group (all at P＞0.05);and significant differences were seen in fluorescent integral scores (4.00[1.50] vs.5.50 [1.50]) and OSDI scores ([39.18±6.25] vs.[46.78±8.76]).Corneal inflammation index scores were positive correlated with serum TSH (R2 =0.520,P =0.000),and fluorescent integral scores,OSDI scores and corneal inflammation index scores were positive correlated with serum TRAb (R2 =0.587,P =0.000;R2 =0.329,P =0.024;R2 =0.400,P=0.005).Conclusions Thyroid dysfunction patients without TAO have ocular surface dysfunction,which probably is associated with abnormal serum TSH and TRAb.

Objective To observe the inflammatory state and residual renal function (RRF) of the patients with maintenance hemodialysis treated through Shenkangling. Methods Sixty patients with maintenance hemodialysis were randomly divided into two groups, the observation group (30 cases) and the control group (30 cases). They were treated through hemodialysis and hemodiafiltration. The patients in the observation group were treated with Shenkangling 8 tablets/time, 3 times/day. RRF and urine volume after six months were evalued. Serum high-sensitivity C reactive protein (hs-CRP), tumor necrosis factor alpha (TNF-α), and leukocyte mediated IL-6 (IL-6) before and after treatment were detected. Results There were no statistical differences in RRF and urine volume between the two groups before treatment (P>0.05). After six months, RRF and urine volume in the two groups were significantly reduced (P<0.05), and those of the observation group were significantly higher than those of the control group (P<0.05). There was no statistical significance in serum hs-CRP, TNF-α and IL-6 between the two groups before treatment (P>0.05). After treatment, the serum levels of hs-CRP, TNF-α, IL-6 significantly decreased in the observation group, and lower than those of the control group (P<0.05). Conclusion Shenkangling can protect the residual renal function of hemodialysis patients, and reduce the inflammatory reaction.

OBJECTIVE To investigate the distribution and resistance of pathogenic becteria isolated from inpatients with lower respiratory tract infection in Department of Gerontal Respiratory Medicine during from Aug 2006 to Aug 2007.METHODS All the clinical isolates from sputum were analyzed retrospectively.RESULTS There were 211(79.8%) strains of Gram-negative bacilli,40(15.2%) strains of Gram-positive bacteria and 12(6%) strains of fungi.The most important Gram-negative pathogens were Klebsiella pneumoniae.Pseudomonas aeruginosa,Enterobacter cloacae and Escherichia coli.Strains of Gram-negative bacteria were susceptible to imipenem,cefoperzone/sulbactam and amikacin,strains of Gram-positive pathogens were susceptible to vancomycin,nitrofurantoin,cefazolin and imipenem.CONCLUSIONS Gram-negative bacilli are the major pathogens in lower respiratory tract infection in Department of Gerontal Respiratory Medicine and the dominant is conditional pathogen.Rational use of antibiotics is important for the containment of bacterial resistance.

Objective To explore the significance of the main effect factors of Th17/Treg for children's gastritis with Hp infection.Methods By prospective study method,40 cases of helicobacter pylori infection related gastritis children were collected as observation group from January 2015 to June 2016,40 cases of children with Hp negative were selected in the same period by physical examination as healthy controls.The main effect factors of Th17/Treg of the two groups were compared.Before and after the treatment,the main effect factors of Th17/Treg of observation group were compared.The main effect factors of Th17/Treg had a correlation analysis.Results The serum IL-17,IL-10 and TGF-beta levels of two groups were compared,and the difference was statistically significant (P ＜ 0.05).Before and after 10 days treatment,serum IL-17,IL-10 and TGF-beta levels of the observation group were compared,and the difference was statistically significant (P ＜ 0.05).Before the treatment,the serum IL-17,IL-10 and TGF-beta levels of observation group had a correlation analysis,and IL-17 and IL-10 were negatively correlated (r =0.778).IL-17 and TGF-beta were also negatively correlated(r =0.767).Conclusion In development process of Hp infection related gastritis for children,the related factors of Th17 and Treg cells involved in the immune pathological process.Immune prevention for children's gastritis with Hp infection provides new train of thought.

The infratemporal fossa abscess is an irregularly shaped cavity, situated below and media to the zygomatic arch. It consists of masseter and nervus vascularis, etc. Comparatively speaking, the low position of the infratemporal fossa has almost freed the patient from dental, nasal,ocular and aural source of pain. So facial acupuncture is more likely to cause the infection. But it is also possible that the patient get cryptogenic infection of maxillofacial cavity, the treatment of which needs further study.
Abscess ; pathology ; Acupuncture Therapy ; adverse effects ; Face ; Head ; Humans ; Masseter Muscle ; Tomography, X-Ray Computed ; Zygoma

Objective To observe the variation of helper T cell (Th)9/regular T cell (Treg cell) balance in the inflammatory process of hepatitis B virus (HBV) infection.Methods Two hundred patients with chronic HBV infection in Zhejiang Hospital of Integrated Traditional and Western Medicine during August 2011 to June 2012 were divided into four groups according to alanine aminotransferase (ALT) levels.:chronic HBV carriers,chronic hepatitis B (CHB) with mildly [upper limit of normal (ULN)＜ALT＜3 × ULN],moderately (3 × ULN＜ALT＜5 × ULN),or significantly (ALT＞5 × ULN) elevated ALT,with 50 subjects in each group.In addition,30 healthy volunteers were enrolled as healthy controls (HC).ALT levels,HBV DNA,and Th9/Treg levels were measured by automatic biochemical analyzing equipment,real-time fluorescent quantitative polymerase chain reaction and flow cytometry,respectively.Th9/Treg levels of each group were observed.Means between groups were compared by t test,means of multiple groups were compared by one-way analysis of variance.Spearman rank correlation was used for correlation analysis.Results Age,sex distribution and HBV DNA levels of the four groups were comparable (P＞0.05).ALT levels of HC were significantly different from those of mildly,moderately,or significantly elevated ALT (t=8.48,18.41,28.93; all P＜0.05).Th9 cell levels,Treg cell levels and Th9/Treg ratio of HBV infected individuals were significantly different from those of HC (P＜0.05).With the increasing degree of inflammation,proportion of Th9 cells increased and Treg cells decreased gradually.The differences among the four groups were of statistical significance (P＜ 0.05).Th9 cell level was positively correlated with ALT (r=0.804,P=0.01),while Treg cell level was negatively correlated with ALT (r=-0.828,P=0.01).Conclusions Th9/Treg is imbalanced in patients with HBV infection,and closely correlated with ALT levels.

Objective To explore the effects of PBL teaching method on classroom atmosphere of basic nursing course.Methods Two classes of nursing sophomore were enrolled and were divided two groups,60 as PBL group and other 60 as traditional group.Students in two groups were evaluated by questionnaire of classroom atmosphere.Data were statistically analyzed through t-test,P＜0.05 standing for statistical significances.Results There were statistical differences in classroom atmosphere between two groups (P ＜ 0.05) ; class democracy,elicitation in teaching and student cooperation in PBL group were significantly better than those of traditional mode (P ＜ 0.05).There was no significant difference in learning autonomy between the two groups (P ＞0.05).Conclusions PBL teaching is conductive to stimulating students' learning potentials,culturing their cooperative learning,raising the efficiency of classroom learning and improving the classroom atmosphere.But learning autonomy of students needs to be further improved.