Objective To study the characteristics and prognostic analysis of 83 cases of pulmonary infection in elderly patients in emergency department.Methods Thirty-eight elderly patients with pulmonary infection from January 2013 to December 2015 in our hospital were retrospectively analyzed.Results The number of neutrophils increased in 56 patients(67.46%), the neutrophil-lymphocyte ratio increased in 69 patients(83.13%), and C-reactive protein increased in 74 patients increased(89.16 %).There was significant difference between C-reactive protein detection and neutrophil count(P<0.05).61 cases(73.49%) were complicated with other diseases.While the effect of a single antibiotic treatment is less effective.Conclusion The early symptoms of pulmonary infection in the elderly are easy to ignore, and often associated with other diseases.C-reactive protein, neutrophil-lymphocyte ratio combined with lung imaging can be more accurate response to the elderly pulmonary infection.Early detection and early treatment, combined use of antibiotics can improve the prognosis.

Objective To find out about the causes of death of child-bearing women in Shenyang so as to provide basis for the improvement of child-bearing women's reproductive health. Methods A retrospective statistical survey into the death reporting system of Shenyang was conducted and a comparison was made between various age groups of child-bearing women from 1996 to 2000 with regard to the trends of changes in death, the rank order of causes of death and deaths due to malignant tumors. Results From 1996 to 2000, the death rate of child-bearing women in Shenyang was in a state of fluctuation. The case-death ratio in urban areas was 67.24 per 100 thousand people while the case-death ratio in rural areas was 45.97 per 100 thousand. Urban women aged 35 to 49 accounted for most of the deaths among child-bearing women. The rate of death due to cancers in urban areas was markedly higher than that in rural areas. The deaths of child-bearing women due to mammary and reproductive system cancers accounted for one fourths of deaths caused by cancer, with their incidence rate in rural areas being higher than in urban areas. Conclusion More work needs to be done to improve the healthcare of child-bearing women.

Background Measurement of corneal thickness is of great significance for the design of refractive surgery and the diagnosis of eye diseases,measuring equipments and technology develop rapidly in recent years.Optovue iVue OCT is a new frequency-domain optical coherence tomography (OCT),to compare its results with those of Pentacam and Visante OCT is helpful to objectively assess the clinical value of Optovue iVue OCT.Objective This study was to investigate the repeatability of corneal thickness measurement with Optovue iVue OCT and the comparatbility with Pentacam three-dimensional anterior segment analysis diagnostic system and Visante OCT.In addition,this study attempted to analyze the distribution of average corneal thickness in each quadrant by Optovue iVue OCT.Methods The corneal thicknesses of the corneal thinnest point,the central point and 3:00,6:00,9:00,12:00 zones 1 mm away from the center of the cornea were measured in 45 right eyes of 45 subjects with myopia using Optovue iVue OCT,Pentacam and Visante OCT in Tianjin Eye Hospital.Interclass correlation coefficient (ICC) was used to analyze the repeatability of measurement by Optovue iVue OCT.The agreements between Optovue iVue OCT and Pentacam or Visante OCT were evaluated by Bland-Altman test.The corneal area of 1.0-2.5 mm away from the center was divided into eight quadrants and the average corneal thickness of each quadrant was measured and analysis with Optovue iVue OCT.Results No significant difference was found in corneal thickness values for 3 times by Optovue iVue OCT (P=0.546).The ICC by Optovue iVue OCT was 99.92％,99.99％,99.96％,99.99％,99.99％ and 99.97％ at the corneal thinnest point,the central point and 3:00,6:00,9:00,12:00 zones respectively.There were significant differences among the 3 kinds of methods (P =0.000,0.001,0.000,0.003,0.002,0.000).The measured values of Optovue iVue OCT were significantly lower mean 24.20 μm than those of Pentacam (P=0.000,0.001,0.000,0.003,0.004,0.000),but only the value at 12:00 zone of Optovue iVue OCT was evidently declined in comparison with that of Visante OCT (P =0.016),there were no significant differences between all the other zones (P =1.000,0.447,0.239,1.000,1.000).While the mean corneal thickness value from Pentacam lowed by 14.01 μm in comparison with Visante OCT,all zones had significant differences (P =0.009,0.005,0.034,0.017,0.008) except the central point (P =0.056).Based on the Optovue iVue OCT,the thinnest zone was at temporal quadrant in 23 eyes (accounting for 51.11％) and at superior quadrant or super nasal quadrant in 21 eyes (both at 46.66％).Conclusions Optovue iVue OCT measurement of corneal thickness is of high repeatability and is consistent with Visante OCT in myopic eye.Optovue iVue OCT shows evident difference from Pentacam in the measurement of corneal thickness.The thinnest point of the cornea is mainly in the inferior temporal quadrant and the thickest point is commonly in superior quadrant and nasal superior quadrant based on Optovue iVue OCT.

Objective To investigate the effects of WeChat follow-up of relatives on knowledge cognition, change of behavior, visual acuity and blood glucose for diabetic retinopathy (DR) patients.Methods Totally 107 typeⅡdiabetic patients from January 2014 to December 2015 in the Department of Endocrinology were enrolled in the study, with the inclusion criteria of 60 years of age and older and diagnosed with diabetic retinopathy. Subjects were divided into the WeChat group (53 cases) and the control group (54 cases) based on the order of enrollment. The control group was given routine care and health education, while the WeChat group was given additional follow-up of relatives through WeChat with distribution of health education messages for the management of DM and DR once each week for 12 months. Questionnaires were used to collect information on patient's knowledge of DR prevention & treatment and behavior change, FBG, PBG, and HbA1c, and visual acuity were also collected to assess the effectiveness of the intervention. Chi-square test was used to compare the patients' cognitive rate, behavioral change and stage of retinopathy. The t-test was used to compare fasting blood glucose, 2 hours postprandial blood glucose, glycosylated hemoglobin and visual acuity. Results Cognitive Knowledge change on DR were analyzed for the following questions:the time of the first fundus examination after diagnosis of diabetes and occurrence of systemic complications; what are key measures for prevention of early blindness in patients with DR;fundus checkup requirements while blood glucose control is ideal;types of major eye complications for diabetic patients; when laser treatment should be done for DR patients; how long apart should patients check the fundus;what is the normal range of blood glucose;and the types of server damages of DR;etc. The cognitive rates of WeChat group after follow-up were as follows 88.7%, 67.9%, 56.6%, 96.2%, 79.2%, 67.9%, 69.8%, 94.3%, 75.5%. WeChat group compared with the Control group after follow-up (χ2 values were 16.77, 30.76, 16.30, 7.75, 9.68, 36.03, 9.25, 10.57and 9.41, respectively, all P<0.01), the difference was statistically significant. The results of WeChat group before and after the follow-up were (χ2 values were 19.41, 38.22, 17.90, 8.23, 9.34, 38.22, 21.81, 12.08 and 25.52, respectively, all P<0.01), the difference was statistically significant. The cognitive rate for DR risk factors for the WeChat group was 24.5% before follow-up and 43.4%after follow-up;the after follow-up difference between WeChat group and the Control group was statistically significant (χ2=5.33, P<0.05). WeChat group before and after follow-up comparison (χ2=4.21, P<0.05) was also statistically significant. For values of fasting blood glucose, 2 h postprandial blood glucose and glycosylated hemoglobin, results of WeChat group before follow-up were as follows (13.18± 4.46) mmol/L, (16.17 ± 3.97) mmol/L, (10.18 ± 2.76)%;results of WeChat group after follow-up were (8.45 ± 2.26) mmol/L, (11.34 ± 2.34) mmol/L,(7.83 ± 1.40)% respectively. The after follow-up comparison between WeChat group and the Control group showed statistically significant differences (t values were-7.06,-7.30, and-6.37, respectively, all P<0.01). Within the WeChat group, before and after follow-up comparison were all significantly different (t values were 6.83, 7.59 and 5.54, respectively, all P<0.01). The vision of WeChat group before follow-up was 0.68 ± 0.18, after follow-up was 0.71 ± 0.20. There were no significant differences in the two groups after follow-up, before and after follow-up WeChat group, the Control group before and after follow-up about visual acuity comparison (t values were 1.02,-1.10, and 0.57, respectively, all P>0.05). The two groups of patients were compared in balanced diet, regular eating time, meal volume, wearing loose clothing and exercise shoes and socks before each exercise, exercising for more than 30 min, weekly checkup of blood glucose, blood sugar test before and after the exercise and other measurements of behavior changes were significantly different (χ2 values were 11.54, 11.77, 13.68, 5.89, 10.23 and 8.72, respectively, all P<0.01 or 0.05). There were no significant differences in self-withdrawal of medication and Retinopathy stageⅠand stageⅡpatients and between these two patient groups (χ2 values were 1.20, 0.01 and 0.01, respectively, all P>0.05). Conclusions The practice of WeChat follow-up of relatives can improve cognition ability for DR patients aged 60 years and older, it can promote the healthy behavior and the BG monitoring effectively.

The proper orthogonai decomposition (POD) method for the instatiouary Navier-Stokes equations is considered. Several numerical approaches to evaluating the POD eigenfunctions are presented. The POD eigenfunctions are applied as a basis for a Galerkin projection of the instationary Navier-Stokes equations. And a low-dimensional ordinary differential models for fluid flows governed by the instationary Navier-Stokes equations are constructed. The numerical examples show that the method is feasible and efficient for optimal control of fluids.

Objective To observe the efficacy of continuous ultrasonic wave therapy on post-stroke gastrocnemius spasticity. Methods 26 patients with gastrocnemius spasticity after stroke were randomly divided into ultrasonic group and control group. The stretch therapy was used in the two groups,and the continuous ultrasonic wave therapy was added on ultrasonic group for 4 weeks. The scores of modefied Ashworth scale (mAS),the ratio of Hmax and Mmax,and the fascicle length of gastrocnemius pre and post treatment were observed and compared respectively in the two groups.Results Compared with pre treatment,the score of mAS and the value of Hmax/Mmax in ultrasonic group wrer significantly reduced post treatment(all P

Objective To evaluate the influence of preoperative MRI on tumor-positive rate of resection margins in breast cancer patients eligible for breast-conserving surgery.Methods Study group consisted of 64 consecutive patients with breast cancer eligible for breast-conserving surgery,while 73 cases as history control group.For the two groups,a first plan for breast-conserving surgery was made on the basis of conventional imaging and clinical evaluation.Study group underwent preoperative breast MRI and re-evalu-ated before final surgical plan was made.Rates of tumor-positive resection margins were compared between the 2 groups.Surgical plan alteration was recorded in the study group.Results Study group had lower rate of tumor-positive resection margin compared with control group (9.6% vs 24.7%,P =0.04).Furthermore,18.8% of study group altered the finial surgical plan to mastectomy after breast MRI.Conclusion Preoperative breast MRI can more acurately evaluate the extent of breast cancer,therefore decrease rate of tumor-positive resection margin in breast cancer patients eligible for breast-conserving surgery.

Background Small incision lenticule extraction (SMILE) was a new procedure which is miniinvasion and flapless,but few attentions were paid to the visual quality after SMILE.To understand the changes of intraocular straylight after SMILE is of important significance for the assession of the visual quality after the procedure.Objective This study was to compare the characteristic of straylight between SMILE and femtosecond laser assisted laser in situ keratomileusis (FS-LAISK) after surgery.Methods A retrospective study was designed.Written informed consent was obtained from each patient prior to accepting the surgery.One hundred and twenty-seven eyes of 68 patients with myopia and myopic astigmatism were included in Tianjin Eye Hospital from January 2011 to July 2013.SMILE was performed on 64 eyes of 35 patients and FS-LASIK was carried out in 63 eyes of 33 patients at the same period.Stray light was detected with C-Quant stray light meter before and 1 week,1 month and 6 months after surgery.The changes of stray light values following the surgery were compared between the two groups,and the correlations between postoperative stray light values with operative parameters were analyzed.Results The mean stray light values were (1.03 ±0.19)D and (0.95±0.16)D at 1 week and 1 month after surgery,which were higher than (0.88 ±0.18)D at preoperation in the FS-LASIK group (P =0.000,0.012).The stray light values were (0.98±0.16),(0.95±0.14) and (0.94±0.16)D at 1 week,1 month or 6 months after surgery,and no statistically significant differences were found in comparison with (0.91 ±0.15)D in preoperation in the SMILE group (all at P＞0.05).No significant intergroup difference was seen in the stray light values (Fgroup =0.077,P=0.781).The stray light differences of various time points after surgery and before surgery were increased in the FS-LASIK group compared with SMILE group (Fgroup =14.798,P＜0.001),with the significant difference in postoperative 1 week between the two groups (P＜0.01).The negative correlations were found between stray light values at 1 week,1 month and 6 months after SMILE with the lenticule thickness/central corneal thickness (CCT) (R2=0.123,0.145,0.098,all at P＜0.05) or between stray light change.Conclusions Intraocular stray light appears less change in operative eyes after SMILE.However,intraocular stray light increases in the eyes received FS-LASIK,especially at early stage after operation.The stray light shifts return to normal with the lapse of postoperative time.

Objective: To investigate the mental health status and its influencing factors among guardians of patients with severe mental disorders, so as to provide the evidences for improving mental health services among guardians. Methods: The first guardians of patients with severe mental disorders registered and managed in Zhujing Township, Jinshan District, Shanghai Municipality were enrolled. Participants' demographics, economic status, health status and relationships with patients were collected using self-designed questionnaires from January to June 2021. Participants' mental health was assessed with twelve-item General Health Questionnaire (GHQ-12), and factors affecting guardians' mental health were identified with a multivariable logistic regression model. Results: A total of 650 questionnaires were allocated, and 606 valid questionnaires were recovered, with an effective recovery rate of 93.23%. The participants included 356 men (58.75%), and had a mean age of (59.61±12.61) years. Among all participants, 256 were patients' spouse (42.24%), and 516 lived with patients (85.15%). The mean GHQ-12 score was (3.18±2.48), and there were 171 participants with mental health problems (28.22%). Multivariable logistic regression analysis identified educational level of junior high school and below (OR=2.715, 95%CI: 1.076-6.850), married (OR=0.374, 95%CI: 0.184-0.761), patients' parents (OR=0.303, 95%CI: 1.114-0.806), living with patients (OR=0.481, 95%CI: 0.237-0.974), having basic medical insurance for urban employees (OR=0.489, 95%CI: 0.254-0.942), receiving government subsidy (OR=3.788, 95%CI: 1.734-8.276), self-rated health status (good, OR=0.105, 95%CI: 0.037-0.299; average, OR=0.126, 95%CI: 0.049-0.325), considering that caring patients has an impact on family (OR=3.689, 95%CI: 1.807-7.531), being hopeful about the patient's future (OR=0.372, 95%CI: 0.139-0.994) and patients' need for accompanying/surrogate care (OR=1.606, 95%CI: 1.006-2.565) as factors affecting mental health among guardians of patients with severe mental disorders. Conclusion Mental health problems are found among 28.22% of guardians of patients with severe mental disorders, and the development of mental health problems is affected by educational level, economic status, health status and patient's need of caring.

Objective To evaluate the clinical value of color ultrasound guided coarse needle bioptic histo-pathology in the diagnosis of retroperitoneal solid mass. Methods 32 cases with retroperitoneal solid mass accepted coarse needle biopsy (CNB) guided by color ultrasound, and followed to surgical mass resection. The histopathologi-cal result of CNB was compared to the post-operative pathological diagnosis. Results CNB were successful in all ca-ses and no complications occurred. Compared with the pest-operative pathology,the accuracy of CNB was 93.75% (30/32). There was no false-negative and very low rate of false-positive (3.13% ,1/32) of CNB in diagnosing ma-lignant tumor. Conclusions CNB guided by color ultrasound is a safe and an effective method in diagnosis of retro-peritoneal solid mass.