Objective To explore the prognostic role of nutritional benefit assessment (NUTRIC score), nutritional risk screening 2002 (NRS 2002), traditional nutritional laboratory indicators albumin (ALB) and prealbumin (PA) in critically ill patients. Methods A historical-prospective cohort study was conducted. The data of 427 patients admitted to Department of Critical Care Medicine of the Affiliated Hospital of Guizhou Medical University from February 2014 to October 2014 were retrospectively analyzed, and thereafter a follow-up of 275 critically ill patients from November 2014 to April 2015 prospectively enrolled was performed. 261 patients were enrolled finally. Patients were divided into death group and survival group according to 28-day and 90-day outcome, the baseline data, acute physiology and chronic health evaluationⅡ (APACHE Ⅱ) score, sequential organ failure assessment (SOFA) score, NRS 2002, NUTRIC score, ALB and PA were compared between the two groups. Logistic regression analysis was used to find risk factors for 28-day and 90-day prognosis. Results ① NRS 2002 score of all the 261 patients were greater than or equal to 3 with 100% nutritional risk. The patients in NUTRIC score 5-9 group had lower ALB and PA, higher NRS 2002 score, longer mechanical ventilation time and length of intensive care unit (ICU) stay, which indicated they were more serious. ② Twenty eight-day mortality was 20.7% (54 died from 261). Compared with survival group, the patients in death group had higher APACHE Ⅱ, SOFA, and NUTRIC scores [29.00 (22.75, 34.25) vs. 24.00 (20.00, 28.00), 10.0 (8.0, 13.0) vs. 9.0 (7.0, 11.0), 6.37±1.84 vs. 5.59±1.64, all P < 0.01], and longer days from hospital to ICU admission and mechanical ventilation time in ICU [1.5 (0, 9.2) days vs. 0 (0, 4.0) days, 6.0 (4.0, 11.0) days vs. 4.2 (2.5, 7.8) days, both P < 0.05]. It was revealed by logistic regression analysis that APACHE Ⅱ score [odds ratio (OR) = 1.089, 95% confidence interval (95%CI) = 1.039-1.141, P = 0.000] and days from hospital to ICU admission (OR = 1.042, 95%CI = 1.014-1.071, P = 0.003) were the independent risk factors for 28-day death in critically ill patients. ③ Ninety-day mortality was 42.5% (111 died from 261). Compared with the survival group, the death group patients were older with higher APACHE Ⅱ, SOFA, NRS 2002, and NUTRIC scores [age (years): 64.44±18.11 vs. 54.25±19.66, APACHE Ⅱ: 27.00 (23.00, 31.00) vs. 23.00 (20.00, 27.00), SOFA: 10.0 (8.0, 12.0) vs. 9.0 (7.0, 11.0), NRS 2002: 5.08±1.47 vs. 4.67±1.41, NUTRIC: 6.32±1.58 vs. 5.33±1.68], ALB was significantly reduced [g/L: 27.70 (23.05, 32.00) vs. 30.73 (26.90, 34.20)], and mechanical ventilation time in ICU was extended obviously [days: 5.7 (3.6, 11.0) vs. 3.9 (2.4, 7.0), all P < 0.05]. It was revealed by logistic regression analysis that old age (OR = 1.019, 95%CI = 1.002-1.037, P = 0.029) and NUTRIC score (OR = 1.211, 95%CI = 0.983-1.491, P = 0.072) were the independent risk factors for 90-day death probability, and ALB probability was the protect factor for 90-day death (OR = 0.954, 95%CI = 0.916-0.994, P = 0.024). Conclusion It was NUTRIC score but not NRS 2002, ALB and PA predicted 90-day mortality in critically ill patients.

To foster interdisciplinary talents with the highly fusion of clinical skills and the capacity for scientific research, a preliminary exploration of teaching for the cultivation of scientific innovation ability was carried out for clinical postgraduate students. In the cultivation of clinical post-graduate students' innovation consciousness and innovative spirit, we focused on the transformation of attaching more importance to the clinical skills than to the capacity for scientific research to establish the foundation of the competitive compound talents. Then in the early stage of medical project writing, basic knowledge learning and exchange, we stressed clinical postgraduate students' solid grasp of basic knowledge of medical science to consolidate the way of enhancing the scientific research ability. Furthermore , under the guidance of the second research supervisors allocated by the department , we strengthened the clinical postgraduate students' writing of scientific research project bid and pro-fessional paper to promote the organic combination of the clinical practice and scientific research innovation and enhance their scientific research ability.

Objective To explore the effects of wearing ankle-foot orthoses (AFOs) on motor function in children with spastic cerebral palsy (SCP). Methods Fifty-two children with SCP were randomly divided into a wearing-for-training group (n = 16, group 1 ), a day-wearing group (n = 19, group 2) and a day-night-wearing group (n = 17, group 3). In addition to the conventional rehabilitative treatment given to all participants, the children in group 1 wore AFOs during movement training, and children in group 2 wore AFOs in the daytime for 6-8 h per day, while AFOs were applied to the children in group 3 for 24 hours a day except for cleaning and during certain training routines. All the treatments were continued for 2 months. Clinical assessments included the range of passive ankle dorsi-and plantarflexion (APROM) , modified Ashworth scale (MAS) ratings, and the D and E dimensions of the Gross Motor Function Measure (GMFM). All were performed before and after treatment. Results Before treat-ment, no statistically significant differences were found among the three groups in terms of APROM, MAS, or GM-FM. There were significant subsequent improvements in groups 2 and 3 when compared with group 1 in terms of APROM, MAS and GMFM results. Group 2's improvements in APROM and MAS results were not significantly better than those of group 3, but their average GMFM score improvements were significantly better. Conclusion Wearing AFOs in the daytime 6-8 hours per day is more effective in reducing spasticity and improving functional performance in children with SCP.

Objective To compare the effectiveness and safety of Onyx and n-butyl-2-cyanoacryhte (NBCA) for the embolization of cerebral arteriovenous malformations (AVMs).Methods The clinical data of 53 patients with cerebral AVMs (31 in the NBCA group and 22 in the Onyx group) were analyzed retrospectively.The safety and effectiveness of the 1-year follow-up were compared.The size of AVMs (diameters ＜3 cm,3-6 cm,and ＞6 cm) and the Spetzler-Martin grade were used to conduct subgroup analysis.Results There were no significant differences in the baseline data and AVM morphologies.The embolization rate in the Onyx group was significantly higher than that in the NBCA group (P ＜ 0.05),but there were no significant differences in the incidences of postoperative hemorrhage (1/22 vs.1/31;P=1.000)and neurological deficit (1/22 vs.3/31;P=0.633) in the 1-year follow-up after procedure.The subgroup analysis showed that the embolization rates of the small and medium-sized cerebral AVMs in the Onyx group were significantly higher than those in the NBCA group (all P ＜ 0.05),and the embolization rates of cerebral AVMs with different Spetzler-Martin grades in were significantly higher than those in the NBCA group (all P ＜0.05).Conclusion Onyx is equivalent to NBCA in safety but better in efficacy.

Objective To explore the prevalence of anxiety and depression among the medical staff of a children's hospital, and to understand their relationship with age, gender, educational background, family income, family harmony, position, marital status, experience, title, work pressure, weekly working hours, chronic diseases and stressful events.Methods The medical staff of a children's hospital were evaluated using Zung's self-rating anxiety scale (SAS) and self-rating depression scale (SDS).The scores were correlated with age, gender, educational background, family income, family harmony, position, marriage, working years, title, work pressure, weekly working hours, chronic diseases, and stressful events data collected about the same respondents.Results There were 320 respondents suffering from anxiety disorders and 392 experiencing depression among the 677 medical staff surveyed.There were 288 who suffered from anxiety associated with depression.There was a significant difference between the males and the females.Marital status, family harmony, chronic disease and stress events were all significant predictors of anxiety or depression.A univariate analysis showed that neither education nor family income had significant predictive power, but age, professional title,working years, working pressure and working in different departments were all significant predictors.Medical staff with different weekly working hours showed significantly different average levels of anxiety, but position had no such effect.Position was, though, significantly correlated with depression score, while weekly working hours were not.Multivariable logistic regression models showed that educational background, working pressure, family harmony, chronic disease and stressful events were all significant predictors of anxiety.Working pressure, family harmony and chronic disease were related to depression.Conclusion Significant anxiety and depression were observed among the medical staff of this children's hospital.Working pressure, family harmony and chronic disease are strong predictors of anxiety and depression.

Objective To investigate the effects of continuous positive airway pressure (CPAP) on the levels of hemorheology and C-reactive protein in patients with obstructive sleep hypopnea apnea syndrome (OSAHS). Methods 58 moderate to severe OSAHS subjects were selected as treatment group and 32 healthyadults were selected as control group. Hemorheology and C-reactive protein in all subjects were examined and compared. The levels of hemorheology and C-reactive protein were also examined and compared before and after 3 months CPAP treatment in treatment group. Results In treatment group, the levels of the whole blood viscosity and hs-CRP were significantly higher than those in control group (P < 0.01). After treatment of CPAP for three months, the levels of the whole blood viscosity and hs-CRP obviously decreased (P < 0.01). Conclusion Levels of hemorheology and hs-CRP are elevated in patients with OSAHS and CPAP therapy could effectively decrease serum levels of hemorheology and hs-CRP in patients with OSAHS.

Aryl hydrocarbon receptor ( AhR) is a ligand-depend-ent transcription factor that mediates the toxicity of xenobiotic ligands like 2,3,7,8-tetrachlorodibenzo-p-dioxins(TCDDs). AhR influences tumor growth, survival, migration and invasion by regulating proliferation, apoptosis and immune metabolism of tumor cells. AhR has two ways to regulate tumor development, and ligands like polycyclic aromatic hydrocarbons( PAHs) , hal-ogenated aromatic hydrocarbons( HAHs) can induce tumorigene-sis. However, some compounds such as benzothiazole and amin-oflavone can activate AhR, which suppresses the tumor progres-sion and suggests that AhR may be a novel drug target for anti-tumor therapy. The paper discussed the role of AhR in tumori-genesis, the mechanism of the drugs targetting AhR and the sta-tus of studying AhR as a potential target in anticancer therapy.

ObjectiveTo study the teaching method of childbirth turning point and enhances teaching effect in the normal birth of the gynecology and obstetrics department teaching. MethodsAfter carting on the different form the teaching, to 382 students of Qujing medical high school, we carry on the one-to-one skill operation inspection and make the contrastive analysis of the achievement test scores of the students in the experimental group and the control group. Results There is remarkable difference between the conventional experiment teaching and the experiment teaching of adding giant pelvis ( P＜0.01 ). ConclusionThe giant pelvis's application can enhance the teaching effect enormously in the childbirth turning point teaching, and this method has the application and the promoted value.

Objective To track the effects of hyperbaric oxygen (HBO) therapy on neonatal rats with hypoxic-ischernic brain damage (HIBD).MethodsA total of 126 healthy,seven-day-old SD rats were used to model the HIBD and then randomly divided into seven groups of 18:a sham group,a hypoxic-ischemic (HI) group,a 6 h HBO group,a 24 h HBO group,a 48 h HBO group,a 72 h HBO group and a 1 week HBO group.One hour of HBO treatment at 2 atmospheres absolute pressure was administered once daily for a week to the rats in the latter 5groups,starting at 6,24,48,72 hours and 1 week post the HIBD modeling,while no HBO was administered to the sham and HI groups.The effects were assessed in terms of histological changes ( the neuron density and the percentage of neuron apoptosis in the CA1 region of the hippocampus) and nitric oxide (NO),malondialdehyde (MDA) and superoxygen dismustase (SOD) concentrations after 15 days.ResultsIn the 6 h HBO,24 h HBO,48 h HBO and 72 h HBO groups,average neuron density in the CA1 region was significantly higher than in the HI group.But in the 1 week HBO group the average density was not significantly different than in the HI group.In the 6 h HBO,24 h HBO,48 h HBO and 72 h HBO groups the average percentage of neuron cell apoptosis in the CA1 area of the hippocampus was significantly lower than in the HI group,but the 1 week HBO group again showed no significant difference.There were significant differences in average NO,MDA or SOD levels among the 6 h HBO,24 h HBO,48 h HBO,72 h HBO and HI groups,but the 1 week HBO group showed no significantly higher average levels than the HI group.ConclusionsThe optimal therapeutic window for using HBO to protect against HIBD is within the first week.The best effect can be obtained in the first 6 hours,but after 1 week HBO no longer has a significant effect.The earlier the HBO is administered,the better the effect obtained.

Objective To investigate the occurrence and severity of behavioral and psychological symptoms of dementia(BPSD)in elderly dementia patients,and to explore the relationship of the degree of dementia and the severity of BPSD with the burden of caregivers in pension agency.Methods Using a convenient sampling method,the Clinical Dementia Rating (CDR) scale,neuropsychiatric scale (NPI)and Zarit caregiver burden scale(ZBI)were used to evaluate 145 patients with Alzheimer's disease and caregiver burden in Hangzhou.Results The incidence rate of BPSD was 51.8 ％ (72 cases),with a higher incidence rate of delusions of 22.3％ (31 cases),a higher severity of sleep disorder/nocturnal behavior [NPI symptom score (5.95 ± 4.60) points].The symptom making a greatest burden on the caregivers was delusion [ZBI score (32.81 ± 17.66) points].There were positively correlations of the burden of caregivers with the degree of dementia and the severity of BPSD (r=0.434,0.710,all P＜0.01)in patients with senile dementia.Conclusions The incidence rate of BPSD in dementia patients is higher,and the occurrence of BPSD is associated with the severity of mini mental state examination(MMSE)and dementia,which increases the burden of caregivers.More attention should be paid to BPSD in patients with senile dementia.And the social support system serving patients with senile dementia and their caregivers should be further improved.