Objective To know the self-perceived burden (SPB) of young and middle-aged patients with first-attack of ischemic stroke and to analyze the influential factors of SPB as well as its relevance to the quality of life.Methods The patients' general information questionnaire,SPB Self-evaluation Scale,QOL-BREF were adopted to investigate young and middle-aged patients with first-attack of ischemic stroke.Results 100 patients were included,66 were male,34 were female.The Minimum age was 19.4 years old.The maximum age was 59 years old.The mean age was (50.80 ± 7.98) years old.The average SPB score was (24.21 ± 7.39) points,which was in the medium level.31 cases (31％) didn't have obvious SPB; 65 cases (65％) suffered mild-to-moderate SPB; 4 cases (4％) claimed they had severe SPB.There was negative correlation between the SPB and their quality of life.The multi-factor analysis showed that gender,the patients' understanding of disease,and caregivers' health situation were the influential factors of SPB.Conclusions Since self-perceived burden is common in young and middle-aged patients with ischemic stroke,clinical nurses should assess patients' self-perceived burden so as to provide targeted nursing intervention and health education,thereby to ease the burden on patients' self feeling,eventually to improve the level of their mental and physical health.

Objective To investigate the clinical application of the emergency triage criteria in the Hospital Emergency De‐partment Standardization Process by comparing it with the 5 level national triage system (5L NTS) .Methods Totally 984 patients visiting the emergency department of the Wushan County People′s Hospital from January 1 to January 31 ,2015 were chosen to con‐duct the evaluation of 4‐grade classification standard triage with 5L NTS as the control evaluation criteria .The error rate ,evaluation time and degree of difficulty or ease were compared between the two criteria .Results The error rate of 4‐grade triage standard was 4 .7% ,which of 5L NTS was 3 .6% ,the difference was not statistically significant (χ2 =1 .220 ,P=0 .269) .The triage time had sta‐tistical difference between the two criteria (t= -2 .291 ,P=0 .04) ,while the degree of difficulty or ease in using criteria had no sta‐tistical difference(χ2 =1 .143 ,P=0 .285) .Conclusion The 4‐grade triage criteria recommended by the Hospital Emergency Depart‐ment Standardization Process has no obvious differences in the aspects of triage error rate ,degree of difficulty or ease in use com‐pared with the widely recognized 5L NTS in the world ,and has the clinical promotion value .

There are increasing experimental evidences and clinical data showing that inflammatory reaction plays an important role in the production and development of atherosclerosis. Inflammatory process promotes the production and release of inflammatory factors by activation of monocytes and stimulation of endothelial cells, which stimulate the migration and proliferation of vascular smooth muscle cells. Hydrolases and cytokines are released from the activated and stimulated cells to increase local lesion and form atherosclerotic plaque with the development of inflammation. So, on the basis of the new pathogenesis of atherosclerosis,scientists try to interfere with atherosclerosis by anti-inflammatory pathway. This paper reviews the progress of drugs against atherosclerosis by the modulation of C reaction protein ,CD40-CD40L,infection and NF-?B.

AIM To observe the protective effect of quercetin on vascular endothelial cells injured by homocysteine in rabbits. METHODS The model of the vascular endothelial cells of rabbits injured by homocysteine was established; 50 mg?kg -1, 100 mg?kg -1 and 200 mg?kg -1 of quercetin were orally adminstered. After 30 days, the number of CEC, levels of MDA and NO,SOD activity in the serum were determined; ET concentration in the plasma was detected. The thoracic aorta was isolated to observe the vascular reactivity to nitroglycerin and ACh and tissue change. RESULTS The number of CEC, levels of MDA and ET were decreased and levels of SOD and NO were significantly increased in the quercetin-administered group compared with the injured group.Non-endothelium dependent relaxation of vessel caused by nitroglycerin was similar in all groups. Endothelium dependent relaxation caused by ACh was reduced in the injured group,whileas the relaxation trended to the normal degree in the quercetin-administered group. Pathological examination showed that quercetin was effective on the injured endothelial cells. CONCLUSION Quercetin produces protective effect on the injured vascular endothelial cells by homocysteine in rabbits.

Infantile spasms constitutes an unique,age-specific epilepsy syndrome of early infancy characterized by epileptic spasms often accompanied by neurodevelopmental regression and an electroencephalograph finding of hypsarrhythmia.For the complex and various etiologies,the pathogenesis remains unclear.Although the relevant guidelines and consensuses are being updated all the time,but proven therapies are still limited because of efficacy,tolerability,at times even availability.In this paper,the current findings regarding up-to-date advances in the treatment of infant spasms were reviewed,especially in use of the corticosteroid and vigabatrin as well as the quality-of-care indicators for infantile spasms.

Objective To investigate the clinical significance of thyroglobulin antibody (ATG) and thyroid peroxidase antibody (ATPO) in patients with vitiligo. Methods Venous blood samples were obtained from 87 patients with vitiligo and 90 age- and sex-matched normal human controls. Chemiluminescence was applied to measure the serum levels of ATG, ATPO, free triiodothyronine, free tetraiodothyronine and thyroid stimulating hormone (TSH). Results There was a significant increase in the positivity rates of ATG (23.0% vs 6.7%, P < 0.01) and ATPO (24.1% vs 7.8%, P < 0.01) as well as the serum level of TSH (3.4 ± 2.4 vs 2.4 ± 1.2 pmol/L, P < 0.05) in the patients with vitiligo compared with the normal human controls. It is worth mentioning that all patients positive for ATG or ATPO were diagnosed with vitiligo vulgaris. The positivity rates of ATG and ATPO in patients with vitiligo aged from 11 to 20 years and 21 to 40 years were significantly higher than those in age-matched normal controls (all P < 0.05). Also, female patients had a higher positivity rate of ATG and ATPO than female controls did (34.1% vs 8.5%, χ2 = 8.90, P < 0.01; 34.1% vs 10.6%,χ2 = 7.29, P < 0.05). The highest positivity rates of both ATG and ATPO were 53.3%, which were observed in vitiligo patients aged from 11 to 20 years, followed by patients from 21 to 40 years (ATG 34.5%, ATPO 34.5%). In patients with vitiligo positive for both ATG and ATPO, the occurrence of autoimmune thyroid disease was 70% (14/20), significantly higher than that in ATG- and ATPO- positive healthy controls (16.7%, χ2 = 5.4, P < 0.05). Conclusions ATG and ATPO were observed in young female patients with vitiligo vulgaris, and they may be associated with the development of autoimmune thyroid diseases.

Electroencephalography (EEG) is an important instrument for the evaluation of brain function, and an irreplaceable diagnostic technique for nervous system diseases. At present, China still lacks professional child-EEG talents. Therefore, it is a task of great priority to establish an effective and practical training method and foster more child-EEG physicians. As most trainees have not learned EEG before and only have limited time for learning, we divide the child-EEG training into three phases, includ-ing theory learning, practice training, and EEG reading and interpretation on the basis of the general rules in learning EEG. In the theory learning phase, basic EEG knowledge is taught comprehensively to form a solid foundation for future study. In practice training phase, the trainees acquire important skills of EEG by carrying out complete EEG monitoring, eliminating EEG artifacts, observing seizures, and read real-time EEG. In the phase of EEG reading and interpretation, the trainees learn to analyze EEG gradually by read-ing and report EEG under the guidance of the senior physician. Strict examination is arranged for each phase to evaluate study results objectively. The phased model is designed to implement a step-by-step training of child-EEG and foster the trainee's independent ability to carry out EEG inspection.

Objective It is the first time that co -word analysis method was used throughout this study,which was based on all the Chinese research papers on childhood epilepsy published during the last two years.This study aimed to understand the current research status and progress in this field in China,and try to formulate the foundations for further study.Methods All the papers in database of Chinese National Knowledge Infrastructure,VIP database, Wanfang as well as PubMed were retrieved by using childrenand epilepsyas keywords.Publication date range was set from January 201 4 to June 201 5 and qualified papers were included in the research.Excel,Ucinet 6.0 and Net-draw software were used to analyze of the relationship between different key words and to generate diagrammatic repre-sentation.Results A total of 698 articles were identified and 41 high -frequently used keywords were extracted. Within the network planning of co -word relationship of high -frequency keywords,pediatric epilepsy was in the core rank,antiepileptic drugs,electroencephalogram,infantile spasm and treatment were hot topic issues.Pediatric epilepsy and electroencephalogram kept close relationships,so were pediatric epilepsy and antiepileptic drugs.Research status of Chinese childhood epilepsy was successfully represented and the possible future research was predicted through co -word analysis of these high -frequently used keywords.Conclusions At present,studies on childhood epilepsy are mostly focused on electroencephalogram,drug therapy,cognitive function,refractory epilepsy,pathogenesis as well as in-fantile spasms,but further research is needed to investigate the rehabilitation,comorbidity and immunity.

Objective To investigate the intervention ways of endoscopes in the treatment of esophagus stenosis due to carcinoma of esophagus and improvement of quality. Method 11 cases of advanced carcinoma of esophagus were included in this study. Operation and chemical therapy were unavailable for these patients. Memory trestle with membrane and made of alloy of Nickel－ titanium was inserted under intervention of endoscope. Trestle was posed in stenosis part of esophagus under direction of X－ ray. Trestle could be dilated 3－ 7 days after operation due to its reaction characteristics to temperature. So, redilated therapy was unnecessary. Trestle could reconstruct swallowing tract and made feeding through mouth become available during limited survival time.Results All trestles were successfully inserted.Half－ fluid feeding was available after operation. Obstruction was removed in all patients(100％ ).Conclusion Method described in this study was safe and effective .Effective swallowing tracts were reconstructed in all patients after trestle was planted and quality of life and survival time were both improved.

OBJECTIVETo introduce different surgical treatment for gyncomastia at different grades.

METHODS37 cases with gynecomastia were divided into three grades as: grade I with fat as main tissue, grade II with proliferated fibro-gland as main tissue, grade III with big and ptosis breasts and sagging skin. Different surgical methods were chosen according to the different grades of gyncomastia. These include liposuction, subareolar fibroglandular tissue removing, combined technique of the two methods, and breasts resection with free transplantation of nipple-areola complex.

RESULTSAll patients were satisfied for the appearance of post-operative flat male chest. Complications, such as scar, numbness of nipple and areola were acceptable for them.

CONCLUSIONSDifferent surgical methods should be chosen for the gynecomastia at different grades. It can improve both the physical and psychological problems for patients.

Adolescent ; Gynecomastia ; classification ; surgery ; Humans ; Lipectomy ; Male ; Mammaplasty ; methods ; Nipples ; transplantation ; Retrospective Studies