Objective To study the clinical features of upper gastro-intestinal hemorrhage in aged patients and provide information for timely and reasonable treatment for these patients. Methods The clinical data of 100 aged patients with upper gastro-intestinal hemorrhage (group A) were analyzed retrospectively. As control, 101 cases of non-aged patients with the same condition were selected for comparison ( Group B). Results The main cause of upper gastro-intestinal hemorrhage in aged patients was peptic ulcer(39% ) ,but the rate of hemorrhagein gastric ulcer(24. 00% ) was higher than that of duodenal ulcer(15. 00% ). However, in the non-aged patients,duodenal ulcer caused higher chance of upper gastro-intestinal hemorrhage than gastric ulcer. Aged group has higher complications ( 70.00% ) , which was significantly higher than that in non-aged group ( 24.75% ) ( x2 = 41. 27, P < 0. 01). Haematemesis occurred more frequently in aged group ( 28.00% ) thanthat of 7.92% in the non-aged group(x2 = 13.78 ,P <0.01). Most patients in aged group received NSAIDs and anticoagulant to treat complications. Conclusion The primary cause of upper gastrointestinal haemorrhage in aged patients was peptic ulcer,with relatively high incidence in gastric ulcer patients,and frequent incidence of haematemesis and complications. Aged patients were recommended to receive PPI therapy.

The levels of ?_2-m、IgG and Alb in CSF of 13 patients with cerebral haemorrhage and 20 patients with cerebral thrombosis and the levels of ?_2-m in CSF of control group consisting of 14 eases were measured. It Was showed that the levels of ?_2-m in CSF of the two groups of the patients with cecrebrovascular disease were obviously higher than that of the control group and the levcls of ?_2-m in CSF of the two groups of the patients with cerebrovascular discase also had rclation to the levels of ?_2-m in serum of the groups of the patients themselves, the valucs of ?_2-m did not corre- lated with the valucs of IgG or Alb in CSF of the paticnts with cerebral hacmorrhage, but there existed a strong correlation between IgG and Alb in CSF of these patients. The values of ?_2-m, IgG and Alb in CSF of patients with cerebral thrombosis were exactly inversdy correlated with that of patients with cerebral haemorrhage. Reviewing some other data about ?_2-m the authors suggest that the clevated ?_2-m in CSf may indicate an increased cell-mediated immune phenomenon of central nervous system in teh pathological process of cerebral haemorrhage, but this phenomenon in the pathological process of cerebral thrombosis is not obviuos.

Seasickness is a leading factor causing reduction in battle efficiency, and psychological factor is one of the important factors influencing the development and progression. This article reviews the mechanism, affecting factors, predictive indications, prevention and treatment of seasickness from a psychological perspective, in an attempt to provide psychological guidelines for military training, enhance the anti-seasickness ability of military staff and decrease its incidence.

A total of 180 community medical staff in Jiangning District of Nanjing received continuous education in practical emergency medicine through theory teaching,practice and scene simulation once a year from 2011 to 2013.And the training outcomes were evaluated before and after training and the feedbacks of community medical staff collected each time.The assessment results of theory and practical skills after training in 2013 were better than before training in 2011 [theory:(61.72 ± 5.03) vs.(92.11 ± 5.56) points ; operation skills (55.28 ± 6.18) vs.(93.33 ± 3.45) points] (P ＜ 0.05).And the total satisfaction rate was 98.0％.

Objective To maintain the good psychological state of new nurses, stabilize nursing troop and improve nursing quality, we investigate the work pressure source and mental health of new nurses and analyze the correlation among work pressure, mental resilience and mental health. Methods According to the principle of convenience sampling,a total of 116 new nurses who get the job less than one year in the first hospital of Jilin university were investigated using the method of questionnaire survey. The Conner Davidson Resilience Scale (CD-RISC), Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) were involved in the questionnaire. Results Mental resilience scores of new nurses were (63.73±15.11), the scores of anxiety and depression were (34.49±6.45) and (35.59±7.24). Work pressure was negatively correlated with mental resilience (P<0.01) and positively correlated with anxiety and depression (P<0.01). New nurses worried about making mistakes in the work accounted for 89.42 percents (93/104), which was the highest score in the stress source. Conclusions New nurses have good mental resilience and psychological health level, but work pressure has certain impact on mental resilience and mental health. Hospital managers should take active measures which include reducing pressure and improving the ability to help the new nurses through the adaptation as soon as possible.

Background and purpose:Hepatocellular carcinoma(HCC) is one of the most common malignancies in the world,It has a poor prognosis due to its rapid infiltrating growth and complicating liver cirrhosis.Surgical resection is considered the best curative option,the 5-year survival rate could reach 50%,especially in the patients with lesions less than 5 cm in diameter and good residual liver function.However curative surgery is feasible for only about 20% of patients.Transcatheter arterial chemoembolization(TACE) has been demonstrated that its short-term curative effect is better than the other nonsurgical treatments.However,it has not provided any survival benefit.Many studies have been done to improve the overall therapeutic effects of HCC with multi-modality approaches.The purpose of our trial was to evaluate the effects of TACE combined with 3-dimensional conformal radiation therapy(3-DCRT) for primary hepatic carcinoma.Methods:90 patients with primary hepatic carcinoma were randomly divided into two groups :45 were treated with 3-DCRT plus TACE and the others were treated with TACE alone.For TACE,80-120 mg cisplatin and 1 000 mg 5-Fluorouracil or 30 mg hydroxycamptothecine)were perfused into the hepatic arteries,then 50-100 mg adriamycin(or epirubicin) or 16 mg mitomycin C and iodized oil 10-30 ml were given to embolize the hepatic arteries,and followed by 1-2 mm gel form particles.TACE of 1-3 sessions was given to both groups.For the combined group,3-DCRT was given by 6MV X-ray.The patients with planned target volume(PTV) lesser than 512 cm~(3) received a total dose of 45-56 Gy,4.5-7 Gy per fraction,and the patients with PTV larger than 512 cm~(3) received a total dose of 45-56 Gy,2.5-4.5 Gy per fraction,5 times every week.Results:The response rates (CR+PR)of 3-DCRT plus TACE group and TACE alone group were 91.1% and 60%,respectively(?~(2)=11.79,P

Objective To establish human embryonic stem cells (hESCs) feeder-independent and cell factor-free culture system. Methods Effect of high and low clone densities of hESCs culture was compared and impact of the clone densities to hESCs culture media was analyzed. Results HESCs could maintain their undifferentiated states at high clone density (34 clones/cm2) without cell factors. At the same time,the bone morphology protein (BMP)-like induction of N2 and B27 supplements (NB) medium could be modulated by the clone density,and high level of BMP-like induction was accompanied by high clone density. Conclusion High clone density of hESCs can change the environments by themselves to maintain the undifferentiated states,which provides a new clue to explore the mechanism of undifferentiated states of hESCs and simplify the culture medium.

Objective To explore the prognosis of endoscopic tissue adhesives injection in treating liver cirrhosis patients with esophageal gastric varices (GOV),and to evaluate the effects of various factors on bleeding after treatment.Methods A total of 157 liver cirrhosis patients with GOV treated by endoscopic tissue adhesives injection with or without ligation therapy were retrospectively analyzed.The basic information,liver function and blood biochemical values of patients at enrollment were investigated.The analysis of bleeding after treatment was conducted by Kaplan-Meier.The survival curves comparison was conducted by Log-rank test.Logistic regression model was used for multivariate analysis.The prognosis predictors were evaluated by receiver operating characteristics (ROC) curves and the area under the curve (AUC).Results Rebleeding happened in 26 of 157 patients.The median rebleeding time was 3.4 months.The results of univariate analysis indicated that there were statistical differences in FIB4 scores (Z=-1.282,P=0.100) and the inner diameter of the right portal vein (Z=-1.812,P=0.035) between bleeding group and no bleeding group.The results of multivariate analysis showed that the inner diameter of the right portal vein was independent prognostic factor of rebleeding (OR =1.733,95％ CI:1.045 to 2.874,P =0.033).Optimal diagnostic threshold was 8.5 mm (AUC=0.724,95 ％CI:0.537 to 0.910),sensitivity and specificity was 77.8％ and 66.6％ respectively.Conclusions The inner diameter of the right portal vein was one of the important factors that affected the efficacy of tissue adhesives injection in preventing bleeding and the prognosis.FIB4 score had certain reference value in predicting recurrence or bleeding after treatment.

Objective: To evaluate the effects of the intervention based on WeChat on blood pressure control in patients with essential hypertension. Methods: The databases of CNKI，Wanfang，VIP，PubMed and the Cochrane Library were researched for the literatures about effects of the intervention based on WeChat on blood pressure control in patients with essential hypertension published from 2011 to 2018. These papers were retrieved and evaluated according to inclusion and exclusion criteria. Stata 12.0 software was used for meta analysis. Results: Eleven out of 880 papers were included into meta analysis. There were 1 174 cases，with 587 cases in the experimental group and 587 cases in the control group. The results of the meta analysis showed that compared with traditional health intervention method，the intervention based on WeChat significantly reduced the level of systolic blood pressure（WMD=14.77，95%CI：11.76-17.77）and diastolic blood pressure（WMD=8.17，95%CI：5.67-10.67）of hypertensive patients. Subgroup analysis showed that the longer the intervention，the better the effects（P<0.05）. Conclusion The intervention based on WeChat is more helpful than traditional health intervention for blood pressure control of patients with essential hypertension.

Patent foramen ovale(PFO)is a common congenital heart disease.The clinical manifestations of PFO are heterogeneous,which can easily lead to missed diagnosis and misdiagnosis.In recent years,people found PFO is related to a variety of nervous system diseases such as TIA,migraines,dizziness,syncope,seizures.This paper reviews the relationship between PFO and nervous system paroxysmal disease and its possible mechanism.This review aims to improve clinicians'understanding of PFO and provide ideas for the diagnosis and treatment of PFO.