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 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 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.

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 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.

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 Helicobacter pyloric (Hp) infection in children who underwent gastroscopy in Nanjing area.Methods From Jan.2001 to Dec.2010,2 990 pediatric patients with gastrointestinal symptoms who underwent endoscopy and Hp rapid urease test of gastric mucosa specimens.Results There were 2 990 patients who underwent gastroscopy during the 10 years including 1 718 cases of male and 1 272 cases of female.The rate of Hp infection was 53.8％ (924/1 718 cases) and 52.4％ (667/1 272 cases) in male and female,respectively.There was no significant difference (x2 ＝ 0.532,P ＞ 0.05).From Jan.2001 to Dec.2005,611 patients were tested and the rate of Hp infection was 66.9％ (409/611 cases).From Jan.2006 to Dec.2010,2 379 patients were tested and the rate of Hp infection was 49.7％.There was significant difference(x2 =58.13,P =0.01) between the 2 groups.The rate of Hp infection were 49.6％,48.1％,55.2％,60.0％ in 0-6 years group,＞6-9 years group,＞9-12 years group,and ＞ 12 years group,respectively.There was significant difference among the 4 different age groups (x2 =23.66,P ＜ 0.01).The rate of Hp infection in nodular gastritis(61.4％) was higher than that in chronic superficial gastritis (50.6％).There was significant difference between the 2 groups (x2 ＝ 7.42,P ＜ 0.01).The rate of Hp infection in allergic purpura (46.2％) was higher compared with the children with normal gastroscopy results (15.9％).There was significant difference between the 2 groups (x2 =10.19,P ＜ 0.01).Conclusions There is gradually downward trend by year in the rate of Hp infection of children who underwent gastroscopy in Nanjing area by year.The rate of Hp infection is increasing with the age after the age of 6 years.Hp infection may play a role in the nodular gastritis and allergic purpura.

As a rising histological specimen carrier,digital slide has advantages of easy search and fast browse.By digital scanning and stitching of traditional slides and uploading traditional slides as well as pathological information to network servers,the construction of digital slides data can take its own superiority to assist forensic medicine teaching.Combined with our research and teaching experience,this article discussed the application prospects of digital slide technology and digital slides data so as to provide references for the improvement and reformation of forensic medicine education.