Objective To observe the clinical efficacy of umbilicus application withDa Huang (Rheum Officinale) during 5-7 a.m. in treating senile constipation after hip fracture.Method Fifty-nine elderly patients with constipation after hip fracture were randomized into a treatment group of 30 cases and a control group of 29 cases. The treatment group was intervened by umbilicus application withDa Huang (Rheum Officinale) during 5-7 a.m, while the control group was by umbilicus application withDa Huang (Rheum Officinale) at any time but avoiding 5-7 a.m. period. After a treatment course, the therapeutic efficacy was evaluated based on bowel movement frequency and shape of stool, and the two groups were compared with each other.Result The total effective rate and markedly-effective rate were respectively 93.3% and 70.0% in the treatment group versus 82.8% and 37.9% in the control group. The between-group difference in the total effective rate was statistically insignificant (P>0.05); there was a significant difference in comparing the markedly-effective rate between the two groups (P<0.01).Conclusion Umbilicus application withDa Huang (Rheum Officinale) during 5-7 a.m. is an effective method in treating senile constipation after hip fracture.

Objective To study the anti-inflammatory, antipyretic and analgesic effects of Rhizoma Zingiberis alcoholic Extract (RZE) and to explore its in-vitro antibacterial actions. Methods Auricular swelling method in mice, typhoid and paratyphoid vaccines-induced fever in rabbits and bodytwisting test in mice were used respectively to observe the anti-inflammatory, antipyretic and analgesic effects of RZE. Results RZE could inhibit xylene-induced auricular swelling and bodytwisting response reaction induced by acetic acid in mice; RZE also reduce the vaccines-induced fever in rabbits. MIC of RZE for 8 bacterial strains ranged 13.5 mg/mL to 432 mg/mL. Conclusion RZE has a significant anti-inflammatory, antipyretic and analgesic effects and exert in-vitro antibacterial action.

Objective To study the quality and effect of root cause analysis (RCA) on long-range video EEG monitoring on epilepsy patients.Methods The process of RCA long-range video EEG monitoring on patients with epilepsy was investigated to find out the root causes for quality of epilepsy capturing from pseudo differential of EEG and video effects.Then the measures were taken to improve the quality of monitoring.Result After the intervention,except canmera not clear enough,the incidences were significantly decreased compared with pre-intervention (all P ＜ 0.001).Conclusions Root cause analysis is effective in improving the quality of long-range video EEG monitoring on epilepsy patients.It is worth clinically promoting.

Objective To evaluate the echocardiographic findings and clinical application in the rupture of sinus of Valsalva aneurysm(SVA).Methods Typical transthoracic echocardiographic appearance of 62 patients with SVA and accompanied abnormality were reviewed and compared with operative results.Results Fifty-eight (93.5%) cases SVA were preoperatively discovered by echocardiography, while 2 (3.2%) misdiagnosed as tetralogy of Fallot and tricuspid regurgitation and 2 (3.2%) missed diagnosis.Accompanying teratisms included frequently ventricular septal defect (VSD) (33 cases, 53.2 %) and aortic valve dysplasia(11 cases, 17.7%).The rupture site and the drainage chamber were essentially consisted with surgery,while the size of VSD measured by echocardiography was significantly smaller than that measured in operation.Conclusions Transthoracic echoeardiography is valuable in diagnosing of the site, drainage chamber and the accompanied abnormality of SVA.

Objective To explore the relationship between expressions of C-type lectin receptors on natural killer(NK) cells and infant human cytomegalovirus (HCMV) infection. Methods Seventynine cases of HCMV infection infants and 39 cases of HCMV non-infection control infants admitted during January 2006 to June 2008 were recruited in this study. According to HCMV pp65 antigenemia levels in the peripheral blood, 79 cases of HCMV infection infants were divided into two groups: 48cases of active HCMV infection and 31 cases of inactive HCMV infection. The 48 cases of infants with active HCMV infection were treated with ganciclovir for 2 weeks. The expressions of NKG2A,NKG2C, and NKG2D receptors on NK cells in the peripheral blood were examined by flow cytometry.Data analysis was done using SPSS 17.0 software. Comparisons among 3 groups were performed by Kruskal-Wallis nonparametric test for independent samples and comparisons between groups were done by Mann-Whiteney nonparametric test for paired samples. Results There was no difference of the inhibitory receptor NKG2A expression on NK cells among groups of active HCMV infection, inactive HCMV infection and HCMV non-infection controls (x2 = 3. 95, P＞0. 05). However, there was obvious difference of activating receptors of NKG2C and NKG2D expressions on NK cells among the three groups (x2 =24.91 and x2 =47. 80, respectively; both P＜0.01). The expressions of NKG2C and NKG2D on NK cells in the HCMV infection group were both higher than the control group (Z=-4.72 and Z=-5.15, respectively; both P＜0.01). The expression of NKG2D on NK cells in the active HCMV infection group was higher than that in the inactive HCMV infection group (Z= -5.08,P＜0.01). The expression of NKG2D on NK cells decreased after ganciclovir treatment (Z= - 1.34,P=0. 07). Conclusion Expressions of NKG2C and NKG2D on NK cells might play a significant role in regulating NK cell function and anti-HCMV immunity in infants.

Objective To explore the appropriate nursing care of acute hyperlipidemic pancreatitis and increase nursing level.Methods The clinical data of 3 cases of hyperlipidemic pancreatitis misdiagnosed as acute appendicitis were analyzed retrospectively and the nursing experience was summarized.Results The blood sample of all 3 cases represented dramatically high level of serum triglyceride (14.1～61.0 mmol/L).Obvious inducing factors were observed in one case.Besides upper abdominal symptom and physical sign continued in spite of the right lower abdominal discomfort,ascites was discovered by early B-ultrasound.There was no significant increase of serum or urine amylase.After correct diagnosis,all of the 3 cases recovered well by close observation,mental nursing,anti-hyperlipidemic nursing,drainage nursing and health education.Conclusions The knowledge of hyperlipidemic pancreatitis should be well understood during nursing practice.Comprehensive nursing evaluation and close observation can help doctors to analyze and estimate the disease.Integrated nursing techniques can accelerate the recovery of the patients.Health education,anti-hyperlipidemic therapy,and removal of the inducing factors are the keys of prevention.

Professional postgraduates in geriatric medicine are one of the most important re-courses of geriatric specialists. However, training model for geriatric postgraduates is still unclear in China. In general, geriatric medicine has no independent training plan, and is included in internal medicine training. Such model cannot represent the feature of geriatric medicine. The present paper aimed to discuss the ability construction for geriatric postgraduates based on the geriatric medicine specialist training experience both at home and abroad, including diagnosis and treatment of multi-system diseases, ability of geriatric assessment, management of geriatric syndromes, consultation for geriatric rehabilitation and ability for continuity health service in order to cultivate the compound tal-ents suitable for the aging society requirement for geriatric medicine in China.

Objective: To investigate the causal relationship between gut microbiota and constipation using Mendelian randomization (MR) method. Methods: Genetic variation data of gut microbiota were obtained from the MiBioGen Consortium database. The genetic variation data of constipation were sourced from the IEU Open GWAS database. A forward MR analysis was performed using the inverse-variance weighted (IVW) method with 2 511 SNPs associated with gut microbiota as instrumental variables, and constipation as study outcome, and a reverse MR analysis was performed with 13 microbiota-associated SNPs as instrumental variables and gut microbiota as study outcome. The heterogeneity was assessed using the Cochran test, reverse causation of SNP were examined using MR Steiger test, and the horizontal pleiotropy was assessed using the MR-PRESSO test and MR-Egger regression. In addition, the robustness of the results was verified with the leave-one-out. Results: Forward MR analysis results showed that an increased abundance of genus Coprococcus1 driven by host genetics was associated with a decreased risk of constipation (OR=0.791, 95%CI: 0.709-0.884), and increased abundance of phylum Bacteroidetes driven by host genetics was associated with an increased risk of constipation (OR=1.240, 95%CI: 1.102-1.394). Cochran test detected no heterogeneity (both P>0.05), MR Steiger test was not revealed reverse causation of SNP, and neither the MR-PRESSO test nor the MR-Egger regression revealed horizontal pleiotropy of instrumental variables (all P>0.05), and the leave-one-out method confirmed the robustness of results. Reverse MR analysis showed no association between gut microbiota and constipation (both P>0.05). Conclusion Genus Coprococcus1 and phylum Bacteroidetes in the gut microbiota are associated with constipation.

Objective To investigate subtle structural changes of white matter in patients with amnestic mild cognitive impair-ment (aMCI)using a tractography-based method.Methods Thirty patients with clinical diagnosis of aMCI and thirty-one cases of normal control(NC)and undergone diffusion tensor imaging.Cingulum (CG),corpus callosum (CC),uncinate fasciculus (UNC) and inferior occipitofrontal fasciculus (IOFF)were reconstructed,and fractional anisotrophy (FA)values were measured along these tracts using dTV II software.Differences of white matter tracts’FA values were explored between aMCI group and NC group.In addition,correlation analyses were also done between FA values and the MMSE(mini-mental state examination)scores in the aMCI patients.Results ① aMCI patients exhibited significant lower FA values in the bilateral CG,bilateral UNC and CC than NC group. Although there were no statistically significant differences,aMCI patients exhibited lower FA values than NC group in the left IOFF.② The FA values of right CG were positively correlated with MMSE scores.Conclusion Abnormal changes of FA values in CG,UNC and CC of aMCI patients suggest that subtle damages of white matter tracts related to memory exist in the prodromal phase of Alzheimer’s disease (AD).Fiber tractography has high sensitivity in detecting early damages of white matter.

Objective To study whether there is a correlation between the content of neutrophil gelatinase-asociated lipocalin (NGAL) and extravascular lung water index (EVLWI) in patients with acute lung injury (ALI) induced by septic shock.Methods We prospectively collected 110 patients with septic shock from December 2013 to June 2015,who had already completed the initial fluid resuscitation within 6 hours according to the guide.In accordance with whether combined with ALI,patients were divided into two groups:non ALI group was A group (n =61),and ALI group was B group (n =49).Baseline information,EVLWI and other indexes of hemodynamic monitored by PICCO of each group was collected prior to admission in intensive care unit.EVWI and the content of NGAL in alveolar lavage fluid,which detected by ELISA,were gathered after the initial fluid resuscitation.Results There were no significant differences at the baseline level between the two groups (P ＞ 0.05).The risk factors of EVLWI in patients with septic shock were analyzed by multivariate linear regression analysis.The risk factors contained fluid balance,NGAL,cardiac index (CI),Global end diastolic volume index (GEDI),human albumin (ALB),globulin (GLO).The results showed that EVLWI had linear regression with NGAL and GEDI.The equation of linear regression were Y(NGAL) =2.017 + 0.035X,and Y(GEDt) =-0.671 + 0.004X,respectively.Correlation analysis indicated that there was significantly positive correlation between EVLWI and GEDI (r=0.835,P=0.000)and between NGAL and GEDI (r=0.489,P=0.000).In contrast,after immobilization of GEDI,we did not find any significant correlation between EVLWI and NGAL (r =0.381,P =0.060).Conclusions In case of fluid infusion volume is relatively too much,there is a strong correlation between NGAL in alveolar lavage fluid and EVLWI levels for early fluid resuscitation in patients with sepetic shock.