Objective To summarize the effective managements of cardiopulmonary bypass (CPB) duing open heart surgery in the elderly patients by comparing with that of the non-elderly groups. Methods Pre-operative common data and the managements for 84 elderly patients during the cardiopulmonary bypass from January 1998 to June 2000 were analyzed retrospectively, and the same data of 80 non-elderly patients(40-60 years old) who underwent CABG during the same period were also randomly selected and compared. Results The elderly patients were usually combined with hypertension, diabeties, chronic kindney failure and abnormal pulmonary function. The average time for CPB and clamping time for the ascending aorta were (115.6?27.0)min and (80.4?32.2)min, respectively. The average lowest nasopharyngeal and anal temperature was (29.8?1.4)℃ and (30.7?0.8)℃, respectively, showing no significant difference comaparing with those of the non-elderly patients. There was significant difference between the two groups in the transfusion of shed blood(P

Objective　To probe the curative effect of thiotepa and mitomycin C for the prevention of the relapse of pterygium after its operation.Methods　One hundred and eighty-two cases with pterygium were randomly divided into two groups:one group of thiotepa(158 cases with 169 eyes)and the other group of mitomycin C (24 cases with 24 eyes) and a comparative study was conducted.Thiotepa was used through dropping on the third day after the operation(1∶2 000),while MMC was used in the same way during the operation and on the third day after the operation respectively(0.2g*L-1).Results　In the group of thiotepa,the wounded skin on the cornea was repaired significantly more rapidly than that in the group of mitomycin C,and the rate of the relapse of pterygium was lower in the former group than that in the latter one.Conclusion　Applying thiotepa by dropping after the excision of pterygium is a safe,simple and effective supplementary measure for the prevention of pterygium relapse and also effective for recurring cases.

Objective To investigate the effect of virtual simulation teaching method in the comprehensive experimental teaching.Methods In experimental teaching of nursing,simulation medical records were compiled,plans were implemented,experiment guidance materials were preliminarily formed and teaching effect was evaluated.Results The application of virtual simulation teaching in nursing comprehensive experiments reflected the comprehensiveness of teaching content,and the comprehensiveness of knowledge,ability and capacity.It could train students creative ability,exploring spirit,enhance the sense of professional and humane care consciousness,train the communication skills and strain capacity,make active teaching atmosphere,improve the quality of teaching.Conclusions This teaching method can make students achieve mastery through a comprehensive multi-disciplinary knowledge,improve the ability of solving practical problems,help nurses to develop the comprehensive professional quality.

Objective To evaluate the clinical value of hs-CRP,Tbil and BUA in the diagnosis of coronary atherosclerosis on 320 slice dynamic volume computed tomography(320-DVCT).Methods 160 patients with stable angina pectoris were included.All patients underwent 320-DVCT coronary artery imaging and laboratory testing including plasma hs-CRP,Tbil and BUA.The plaques of coronary artery were classified as soft plaque,fibrous plaque and calcified plaque on CT values.The three indicators were used to confirm the ability of diagnosis on number of lesions,plaque character and the degree of stenosis.100 healthy persons served as the control group.Results With the concentration of hs-CRP,BUA increased and Tbil concentration decreased,the number and the stenosis degree of coronary lesions became increased,and easier to form a soft plaque.Conclusion The hs CRP,Tbil and BUA can offer the accurate diagnosis of lesions number,plaque character and stenosis degree of the coronary artery,which is showed on 320-DVCT.The hs-CRP,Tbil and BUA are conducive to the risk assessment of coronary atherosclerosis.

Abstract In recent years, the research perspective of the prevention and intervention of children s sexual assault abroad has expanded from the victim s perspective of children s self protection education and post mortem remedy to the screening and intervention education of perpetrators in advance, so as to implement the primary prevention of children s sexual assault from the source. The article will summarize the current situation of foreign research on child sexual assault prevention from the perspective of perpetrators, including the target population, prevention practice and forms, so as to provide a reference for the primary prevention of child sexual assault from the perspective of perpetrators in China.

Objective:To investigate the efficacy and safety of fecal microbiota transplantation (FMT) in the treatment of irritable bowel syndrome (IBS), and to explore the effects of FMT on the gut microbiota of IBS patients.Methods:From September 2016 to August 2017, at Guangzhou First People′s Hospital, 28 hospitalized IBS patients who underwent FMT treatment were enrolled. Before FMT, four and 12 weeks after FMT, all the IBS patients completed the irritable bowel syndrome quality of life scale (IBS-QOL), irritable bowel syndrome severity scoring system (IBS-SSS) and gastrointestinal symptom rating scale (GSRS). 16S rDNA sequencing was performed before FMT and four weeks after FMT. The effects of FMT on gut microbiota diversity and microbiota structure of IBS patients were analyzed respectively from the level of phylum, family and genus, and linear discriminant analysis effect size (LEfSe) was further used to screen the different bacteria. Paired t test and paired rank sum test were used for statistical analysis. Results:Twelve weeks after FMT, the scores of the six dimensions of IBS-QOL including dysthymia, behavioral disorder, auto imagery, health concerns, eating avoidance, and relationship expansion were all lower than those before FMT (43.750, 22.656 to 56.250 vs. 48.438, 32.031 to 60.938; 37.500, 18.750 to 56.250 vs. 46.429, 21.429 to 62.500; 31.250, 14.063 to 42.188 vs. 31.250, 18.750 to 50.000; 41.667, 27.083 to 56.250 vs. 50.000, 41.667 to 66.667; 54.167, 43.750 to 72.917 vs. 66.667, 58.333 to 83.333; 8.333, 0.000 to 33.333 vs. 16.667, 8.333 to 33.333, respectively), and the differences were statistically significant ( Z=-2.157, -3.429, -2.274, -3.197, -3.042 and -2.329, all P<0.05). Twelve weeks after FMT, the scores of the two dimensions of IBS-QOL including behavioral disorder and relationship expansion were both lower than those of four weeks after FMT (37.500, 18.750 to 56.250 vs. 39.286, 19.643 to 62.500 and 8.333, 0.000 to 33.333 vs. 16.670, 2.083 to 41.667, respectively), and the differences were statistically significant ( Z=-1.998 and -2.110, both P<0.05). Four and 12 weeks after FMT, the scores of IBS-SSS and GSRS were both lower than those before FMT ((190.32±106.51), (201.43±102.48) vs. (245.93±86.10) and 5.50, 4.00 to 9.00 and 5.50, 4.00 to 8.75 vs. 7.00, 6.00 to 9.75), and the differences were statistically significant ( t=4.402 and 3.848, Z=-3.081 and -3.609; all P<0.01). No serious adverse reactions occurred in the patients after FMT. At the phylum level, after FMT the abundance of Verrucomicrobia in the feces of IBS patients was richer than that before FMT (6.74% vs. 0.37%); at the family level, after FMT the abundance of Verrucomicrobiaceae in the feces of IBS patients was richer than that before FMT (6.74% vs. 0.37%); at the genus level, after FMT the abundance of Akkermansia was richer than that before FMT (6.74% vs. 0.37%); and the differences were statistically significant (all Z=-2.589, all P=0.010). The results of LEfSe method indicated that four weeks after FMT the abundance of Akkermansia in the gut microbiota of IBS patients was richer than that before FMT (6.74% vs. 0.37%), and the difference was statistically significant (linear discriminant analysis value=4.5, P=0.049). Conclusions:FMT is safe and effective in the treatment of IBS. The mechanism may be through upregulating the diversity of gut microbiota and changing the structure of gut microbiota of IBS patients.

Objective:To investigate the infection incidence of women with high-risk human papillomavirus(HPV) A9 in Quzhou, and to analyze its clinical significance in cervical cancer screening by combining with liquid-based cytology(TCT).Methods:A total of 9 010 patients were collected from January 2017 to May 2018 in the Maternal and Child Health Hospital of Quzhou.HPV detection was performed by Cervista method.In combination with TCT, cervical biopsy was carried out under vaginal microscopy.Results:Among 9 010 patients, 1 401 patients were HPV positive, and the A9 group had the highest rate for inspection(6.98%). The experiment data of the A9 group indicated that the portions of cervical intraepithelial lesions in liquid-based cytology NILM, ASC-US, LSIL, ASC-H, HSIL, SCC were 5.96%, 80.10%, 100.00%, 100.00%, 100.00%, respectively.Its coincidence rate with histology increased as liquid-based cytology increased, associated with high-grade lesions.Conclusion:A9 group infection is the most important cause of cervical intraepithelial lesions in Quzhou.High-risk HPV test, especially A9 group infection combined with TCT, can effectively improve the accuracy of cervical cancer screening.

Objective To investigate the problems during using, standard and quality management of the POCT glucose meters in hospital, to analyze the solutions, and to provide reference data for improving the test level of POCT in hospital.Methods The amount, brand and application of portable glucose meters in the hospital were obtained by 3 rounds of surveillance from May to July in 2013.All of those glucose meters were taken part in external quality assessment of Clinical Laboratory Center of National Health and Family Planning Commission.The test results of those glucose meters were compared with that of automatic biochemical analyzer, the comparison results were then analyzed.Results The POCT glucose meters possessed 5 brands in our hospital, and the amount and type of glucose meters in some clinical departments were often changed.When 4 brands which were detected as quality control samples by ministry of health, the accuracy of detection results of 3 concentration of brand Ⅲ were substandard, the CV% of two levels were 11.9%and 10.1%respectively, the remaining 3 brands were in line with the requirements.The qualified percentages of 3 times of comparison were 85.0%, 92.0%and 97.4%.Conclusions The hospital should select the brand of portable glucose meters reasonably, correct use of glucose meters, and it is very necessary to build indoor and interstitial quality evaluation system, at the same time, suggesting the hospital to establish the POCT quality management team, to carry out the instrument comparison periodically, so to guarantee the accurate, reliable results of POCT in hospital.

Objective To evaluate the value of endorectal ultrasonography (ERUS) in assessment of mesorectal fascia (MRF) invasion in rectal cancer.Methods Data of 44 patients who accepted preoperative ERUS and total mesorectal excision surgery within a week were retrospective analyzed.There were 18 patients who accepted preoperative neoadjuvant chemotherapy and 26 patients didn't acceped.Taking the pathological diagnosis of circumferential resection margin (CRM) as the gold standard,the diagnostic efficiency of ERUS for the MRF invasion in rectal cancer was evaluated.Results The final pathological T staging was T1 in 2 cases,T2 in 17 cases and T3 in 25 cases.There were 2 cases of CRM positive results,and 42 cases of CRM negative results.With regard to the location of tumor,there were 16 cases located in low,and 28 cases in mid rectum.There were 26 cases located in anterior or antero-lateral wall of rectum,13 cases in posterior or postero-lateral wall,and 5 cases with a circle of rectum.The diagnostic accuracy were 83.33 ％ (15/18) and 92.31％ (24/26) for cases of accepting and not accepting the preoperative neoadjuvant chemotherapy;80.77％ (21/26) for cases located in anterior or antero-lateral wall,and 100％ (13/13) for cases located in posterior or postero-lateral wall;75.00％ (12/16)and 96.43 ％ (27/28) for low position and mid position tumors.The total diagnostic accuracy was 88.64％ (39/44).Conclusion ERUS can be an effective method in preoperative assessment of the MRF invasion in rectal cancer.

The prevalence of metabolic syndrome among the 2057 urban adults in Wuhan was 10.74%, being 13.47% in males and 4.99% in females.The prevalence increased with aging,blood uric acid level and insulin resistance index.