Objective To investigate the clinical features, etiological classification and staging of epiretinal macular membrane(MEM). Methods Clinical materials of 194 cases of MEM diagnosed by fundus fluorescein angiography in outpatient department of eye clinic in this hospital from 1983 to 2000 were retrospectively analyzed. Results There were typical clinical symptoms and signs of MEM in all of this 222 eyes of 194 patients. Etiological classification revealed that 4 cases were congenital(2.12%), 22 cases were secondary(11.34%), and 168 cases were idiopathic(86.60%). Staging of course of disease indicated that 119 eyes were in early stage(53.60%), 72 eyes were in middle stage(32.43%), and 31 eyes were in late stage(13.96%). Conclusion MEM may be classified as congenital, secondary and idiopathic type according to its pathogenesis, as early, middle and late stage according to the clinical course of disease. This can be helpful in treating the disease.

Objective To analyze the clinical correlation between UU infection and tubal pregnancy in order to guide the correct clinical treatment. Methods Cultivation was used to detect UU in villi tissue of 30 tubal preg-nancy patients and natural aborted pregnant women respectively. Results There was remarkable difference(P0.05) between the positive rate of UU in tubal pregnancy(80 % ) and natural pregnancy(16.7 % ). Conclusion UU may be one of major pathogenic microorganisms in tubal pregnancy, and it's necessary to detect and treat UU con-ventionally.

Objective To evaluate the effectiveness of spiral stone dislodger combined with pneumatic lithotriptor under ureteroscopy for managing upper ureteral stones. Methods 106 patients with upper ureteral stones with spiral stone dislodger combined with pneumatic lithotriptor under ureteroscopy were treated. The transverse diameter of the stones was 4～12mm and the vertical length 6～15mm. Results 87.7% (93/106) stones were fragmented for one session of treatment. 8 cases were pushed upward then undergoing extracorporeal shock wave lithotripsy(ESWL) after surgical operations. Operations in 5 cases had to be changed to open surgery,and ureteral perforations happened in 1 case. Conclusion Successful entrance of the uretersocop is a prerequisite for crushing the stone,appropriate fixation of the stone is the key to their crushing,spiral stone dislodger is an effective means of fixing ureteral stones.

ObjectiveTo study the expression of interleukin-8 (IL-8) protein in villi and decidua of patients with recurrent spontaneous abortion(RSA). MethodsThe local and quantitative expressions of IL-8 in villi and decidua of 30 RSA patients were shown and measured by immunohistochemistry and Western blotting. Results IL-8 protein immunohistochemical signals were located in the chorioepithelium cytoplasm and decidual cells plasma in RSA group. While in control group the immunohistochemical staining was negative in decidul cells, but positive in glandular epithelium. The quantitative analysis of IL-8 protein by Western blotting, intensity of the immunostaining was higher in RSA group than that in the control group. Conclusion The higher expression of IL-8 in villi and decidua is releated to RSA, IL-8 might take part in the pathologic process of RSA.

Objective To understand the current cognition status of stroke rehabilitation nursing knowledge in young nurses of the department of neurology.Methods Self-designed questionnaires were used for investigating 273 young nurses between 20 and 30 years old of the department of neurology of 4 tertiary hospitals in Zhengzhou.Results The current status of stroke rehabilitation nursing knowledge of the nurses surveyed was generally at a low level.There were no significant differences among nurses with different education degrees,professional titles and whether their relatives suffered from stroke.However,there were significant differences among nurses with different professional lives and whether the department carried out rehabilitation care.Conclusions Nursing educators and managers need to find a new way to improve the level of stroke rehabilitation nursing knowledge of the young nurses.

Objective To investigate the infectious rates of 9 common pathogens and epidemiology in children with acute respira‐tory tract infections(ARI) in Maoming district .Methods The serum were collected from 6 241 children with acute respiratory in‐fection .IgM of 9 common pathogen including Mycoplasma pneumoniae (MP) ,Legionella pneumophila (LP) ,Coxiella burnetii (C .burnetii) ,Chlamydophila pneumoniae(CP) ,adenovirus(ADV) ,respiratory syncytial virus(RSV) ,type A and type B influenza virus(INFA and INFB) ,and parainfluenza virus(PIVS) ,were detected using immunofluorescence assay .Results Among 6 241 ca‐ses ,1 320 showed atypical pathogens infection ,and infection rate was 21% .The positive rate of MP was 15 .12% ,the highest infec‐tious pathogen;followed by the positive rate of INFB ,LP ,ADV and PIVS were 3 .03% ,1 .92% ,0 .54% and 0 .22% respectively . The pathogens with the lowest positive rate were RSV ,COX ,INFA and CP ,their infectious rates were 0 .14% ,0 .11% ,0 .048%and 0 .016% respectively .Conclusion The infection rate of atypical pathogen among children is high in this area ,which should be taken seriously .MP is the most common pathogen in children with ARI in Maoming district .The pathogen positive rate has rela‐tionship with season .

Objective:To investigate the relationship between previous bleeding history and poor prognosis of patients with acute upper gastrointestinal bleeding.Methods:This study was a prospective multicentre real-world study (Acute Upper Gastrointestinal Real-word study, AUGUR study). The data of patients with UGIB who were admitted to the emergency department of 20 tertiary hospitals in China from June 30, 2020 to February 10, 2021 were collected. According to the number of previous bleeding history, the patients were divided into three groups (0 time, 1-3 times, and≥4 times). Based on the patient’s demographic data, clinical characteristics, laboratory data, treatment, and outcomes, univariate and logistic regression analysis were performed to investigate the correlation between the number of previous bleeding and the 90-day mortality and rebleeding of patients with gastrointestinal bleeding.Results:A total of 1 072 patients with acute UGIB were included in this study. The all-cause mortality and rebleeding rate of all patients were 10.9% (117/1 072) and 11.8% (129/1 072), respectively. Among them, 712 patients (66.42%) had no previous bleeding, 297 patients (27.71%) had previous bleeding 1-3 times, and 63 patients (5.88%) had previous bleeding≥4 times. In univariate analysis, age, vital signs and consciousness on admission, history of liver cirrhosis, onset with hematemesis, admission hemoglobin, varicose veins bleeding, peptic ulcer bleeding, red blood cell infusion, tracheal intubation and the use of vasopressors after admission were risk factors for the 90-day mortality and rebleeding rate. Multivariate logistic regression analysis showed that patients with previous bleeding≥4 times had a higher risk of the 90-day mortality ( OR=2.17, 95% CI: 1.04-4.57, P=0.040) and rebleeding ( OR=2.32, 95% CI: 1.19-4.53, P=0.013). Conclusions:The history of previous bleeding≥ 4 times can be used as an independent risk factor for the 90-day mortality and rebleeding in patients with acute UGIB.

The expression of resistin protein in normal human abdominal, thigh, pregnant women abdominal, non-pregnant women abdominal subcutaneous adipose tissue and placenta and the relationship between obesity, type 2 diabetes mellitus (T2DM), pregnant physiological insulin resistance (IR) and gestational diabetes mellitus (GDM) was investigated. The expression of resistin protein in normal human abdominal, thigh, pregnant women abdominal, non-pregnant women abdominal subcutaneous adipose tissue and placenta was detected by using Western blotting method. Fasting serum glucose concentration was measured by glucose oxidase assay. Serum cholesterol (CHOL), serum triglycerides (TG), serum HDL cholesterol (HDL-C) and serum LDL cholesterol (LDL-C) were determined by full automatic biochemical instrument. Fasting insulin was measured by enzyme immunoassay to calculate insulin resistance index (IRI). Height, weight, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured to calculate body mass index (BMI) and body fat percentage (BF %). Resistin protein expression in pregnant women placental tissue (67 905 +/- 8441) (arbitrary A values) was much higher than that in subcutaneous adipose tissue in pregnant women abdomen (40 718 +/- 3818, P < 0.01), non-pregnant women abdomen (38 288 +/- 2084, P < 0.01), normal human abdomen (39 421 +/- 6087, P < 0.01) and thigh (14 942 +/- 6706, P < 0.001) respectively. The resistin expression in abdominal subcutaneous adipose tissue showed no significant difference among pregnant, non-pregnant women and normal human, but much higher than that in thigh subcutaneous adipose tissue (P < 0.001). Pearson analysis revealed that resistin protein was correlated with BMI (r = 0.42), fasting insulin concentration (r = 0.38), IRI (r = 0.34), BF % (r = 0.43) and fasting glucose (r = 0.39), but not with blood pressure, CHOL, TG, HDL-C and LDL-C. It was suggested that resistin protein expression in human abdominal subcutaneous adipose tissue was much higher than that in human thigh subcutaneous adipose tissue. Resistin was closely related with central obesity, leading to IR, subsequently obesity and T2DM. Resistin protein expression in placental tissue was much higher than that in subcutaneous adipose tissue in normal human abdomen, pregnant abdomen, non-pregnant women abdomen and thigh. It was indicated that resistin protein could be secreted from human placental tissue. Resistin might be one of the factors that lead to pregnant physiological IR and GDM.

Objective To explore the establishment of nursing work model and clinical application in anuria ward. Methods Established the nursing model of anuria ward in rehabilitation department, including the establishment of neurogenic bladder functional rehabilitation nursing specialist group. Define organizational structure, division of labor and responsibilities, conduct continuous personnel training, education and assessment, formulate standardized procedures for rehabilitation and nursing of neurogenic bladder function, implement bladder function assessment, bladder function training, health education, etc. Stage summary and continuous quality improvement. Results The scores of nurses' theoretical examination, skill assessment, nurses'own satisfaction and doctors'satisfaction were 79.6 ±2.1 and 78.5 ±3.5, 91.3 ±2.3, 93.2±1.8, 92.5 ±2.4, respectively. After the implementation of the model, the scores were 89.2 ±1.8, 87.6 ±2.7, 96.3 ±3.6 and 97.4 ±1.6, 98.6 ±1.3, respectively. Before and after the implementation of the model, the differences were statistically significant (t=-8.755--7.685, P<0.05). The number of days of indwelling urinary catheter, residual urinary volume of bladder, and urinary system infection cases before the implementation of the model were (31.63 ±8.47) days and (263.38 ±18.62) ml, (15.03±3.10) cases, (21.27 ±1.64) days, respectively; and (8.78 ±4.32) days, (79.39 ±17.36)ml, (5.36 ± 1.35) cases, (12.45 ± 1.78) days, respectively after the implementation. There was significant difference between the two groups (t =- 23.643--5.874, P < 0.05). Conclusions The establishment of nursing work model without urinary tube ward it can obviously improve the nurses'theory and skill operation level of bladder function rehabilitation nursing, nurses themselves and doctors, patients'satisfaction to nurses, and significantly reduce the number of days of indwelling catheter, urinary bladder residual urine, urinary tract feeling and hospitalization days. The nursing work mode of no urinary tube ward is normative and operable, and it is worth popularizing in clinic.

Objective To explore the clinical value of maternal and umbilical blood inflammatory markers,interleukin-6 (IL-6),neutrophil-to-lymphocyte ratio (NLR),C-reactive protein (CRP) and procalcitonin (PCT),in the diagnosis of histologic chorioamnionitis (HCA).Methods A total of 102 suspected chorioamnionitic cases were enrolled from January 2014 to July 2017.They were assigned into two groups based upon postpartum histopathological examination of placenta:HCA group (48 cases) and control group (54 cases).Maternal and umbilical blood samples were collected for routine blood test and tested for IL-6,NLR,CRP and PCT levels.T,Mann-Whitney U or Chi-square (or Fisher's exact) test was used for data comparison.Meaningful indicators in maternal and umbilical cord blood were analyzed by logistic regression analysis and correlation analysis.At the same time,receiver operating characteristic (ROC) curve was drawn to evaluate their diagnostic values.Results (1) IL-6 level and NLR in maternal blood in HCA group were higher than those in control group [6.95 (2.40-13.50) vs 3.90 (2.30-9.20) pg/ml,Z=-5.147;5.03 (1.92-9.20) vs 3.94 (1.85-11.17),Z=-3.097;both P＜0.05],and the levels of white blood cells,neutrophile granulocytes,CRP and IL-6 as well as NLR in umbilical cord blood were also higher [(9.4± 2.0)× 109/L vs (8.6 ± 1.4)× 109/L,t=-2.522;(6.87t1.62)× 109/L vs (5.99± 1.26)× 109/L,t=-3.071;12.30 (0.50-89.04) vs 3.18 (0.50-88.93) mg/L,Z=-4.519;(8.78±2.56) vs (4.78±1.45) pg/ml,t=-7.025;(4.45±1.36) vs (3.78±1.22),t=-3.020;all P＜0.05].(2) Logistic regression analysis showed that elevated levels of IL-6 and NLR in maternal blood and CRP and IL-6 in umbilical cord blood were independent risk factors for HCA [OR (95％CI):1.65 (1.32-2.06),1.34 (1.02-1.77),1.05 (1.00-1.11) and 2.39 (1.72-3.32),all P＜0.05].Positive correlations were found between the levels of IL-6 in maternal and umbilical cord blood,and between NLR in maternal blood and CRP level in umbilical cord blood (correlation coefficient:0.680 and 0.230,both P＜0.05).(3) IL-6 level in umbilical blood was of the greatest value in the diagnosis of HCA among all single markers,followed by IL 6 in maternal blood,CRP in umbilical blood and NLR in maternal blood [area under the ROC curve (AUC):0.904,0.796,0.760 and 0.678].When two indexes were combined,NLR in maternal blood+IL 6 in umbilical cord blood showed the highest diagnostic value,followed by,IL 6 in maternal blood+CRP in umbilical cord blood,IL-6+NLR in maternal blood and NLR in maternal blood+CRP in umbilical cord blood (AUC:0.917,0.870,0.823 and 0.791).When three indexes was used in combination,the diagnostic value of IL-6 in maternal and umbilical cord blood+NLR in maternal blood was higher than that of IL-6 and NLR in maternal blood+CRP in umbilical cord blood (AUC:0.919 and 0.836).(4) There were 13 cases (27.1％) with neonatal complications in HCA group and two (3.7％) in control group (P＜0.05).Conclusions Changes in NLR and IL-6 levels in maternal blood and NLR,IL-6 and CRP levels,and white blood cells and neutrophile granulocytes counts in umbilical cord blood are associated with HCA.The diagnostic efficacy of two indexes combined is superior to that of single index,while the combination of three indexes can significantly improve the diagnostic accuracy and authenticity.