Objective: To investigate the risk factors of deep vein thrombosis after stroke. Methods: A retrospective analysis was made on the 420 cases patients with stroke in our hospital, according to the situation thrombosis were divided into thrombosis group and non-thrombosis group, compared two groups of patients with general information, and many factors with the significant indexes were retrospectively analyzed. Results: Age≥70 years old, bedridden, Wells score≥2 points lower limb NHSS score≥3, anticoagulant therapy, higher admission D-2 dimer, lower BI score and non-rehabilitation therapy were independent risk factor for stroke in patients with acute DVT. Age≥70 years old, bedridden, leg NHSS score≥3 points, the acute stage of DVT and BI score were the independent risk factor for stroke patients follow-up period of DVT. Conclusion:There are many related risk factors for stroke in patients with deep vein thrombosis, these factors should be used to carry out monitoring and preventing deep vein thrombosis, active rehabilitation and anticoagulant therapy should be taken to improve the prognosis of patients with stroke.

MicroRNAs (miRNAs) are a class of small,non-coding,single-stand RNA molecules which are composed of 21-25 ribonucleotides.They regulate gene expression at post-transcription and participate in many important biological processes including cell growth,apoptosis,viral infection and cancer development.At present,the studies on miRNAs in cervical lesion include miRNAs expression characteristic of cervical cancer and precancerous lesion,the association with HPV infection and prognosis of cervical lesion,cervical cancer development,diagnosis and therapy.

Objective Compare the efficacy of transvaginal cesarean scar pregnancy debridement surgery(treatment group) and the uterine artery embolization company with the curettage(control group) in the treatment of cesarean scar pregnancy and ana-lyze the related factors of the failure of the surgery .Methods Postoperative vaginal bleeding ,incidence of postoperative scar preg-nancy again ,and time of hospital stays after surgery were compared in two groups .Relationships between gestational age ,cesarean section ,the value of serum HCG ,B-mass size ,live births and surgical success rate were discussed .Results The mean amount of blood bleeding during operation of the treatment group was(85 .38 ± 13 .27)mL ,the rate of continue pregnancy after surgery was 2 .56% ,mean time of hospital stays was(5 .13 ± 0 .77)d ,Significantly lower than the control group[(163 .11 ± 34 .87)mL ,11 .90% , (8 .12 ± 1 .88)d ,all P< 0 .05] ;Blood HCG value ,B-mass size ,and live births were related with surgical success rate(P< 0 .05) ,But times of cesarean section and gestational age had no significant relationship with the surgical success rate(P> 0 .05) .Conclusion Tansvaginal cesarean scar pregnancy debridement surgery showed less damage on the treatment of cesarean scar pregnancy ,and re-duced the recurrence rate of the patient ,who had high blood HCG levels ,embryo survival and larger volume .

Objective To explore the effect of discharge planning mode on growth and development in prematures.Methods 62 premature cases were randomly divided into the control group and the observation group with 31 cases in each group respectively.The control group accepted routine nursing care,the observation group was given comprehensive detailed discharge planning mode on basis of conventional premature nursing.All the research objects were monitored about the height and body weight,and also the Bayley Infant Development Scale was adopted to evaluate the psychological behavior development when their corrected gestational age was 3,6,12 months respectively.Results The height,weight and Mentality Development Index (MDI),Psychomotor Development Index(PDI) of the prematures in the observation group when their corrected gestational age was 3,6,12 months respectively were all higher than those of the control group.Conclusions Application of discharge planning mode in premature infants is helpful to the physical and mental developmental of them.

Objective: To analyze the clinical value of modified endoscopic nipple resection in duodenal papillary adenoma resection Methods: 40 patients with duodenal papillary adenoma were randomly divided into observation group (20 cases) and control group (20 cases)according to the random number table. The patients of control group were treated by conventional resection of papillary adenoma, while the patients of observation group were treated by modified endoscopic nipple resection. The resection rate and the implantation of stent between the two groups were compared. Besides, the occurrence rate of complication and postoperative follow-up between the two groups also were compared. Results: The complete resection rate of observation group (95.00%) was not significant difference with that of control group (90.00%), while en bloc resection rate of observation group (85.00%) significant higher than that of control group (55.00%) (x2=4.28, P<0.05).There was not statistically significant difference between the two groups about the implantation of stent (x2=0.36, P>0.05). In postoperative three months, the difference of recently complication between the two groups was significant (x2=6.14, P<0.05). While the difference of long-term complication between the two groups was no significant (x2=0.36, P>0.05) in more than postoperative three months. After the follow-up of one year, the recurrence rate of observation group (10.34%) was no significant with that of control group (14.29%)(x2=0.17, P>0.05). Conclusion: The modified endoscopic nipple resection can enhance the en bloc resection rate, and reduce the incidence of complications and the recurrence rate. Besides, it has many dominances including higher feasibility in clinical practices. Therefore, its promotion is worthy.

Objective To observe the clinical efficacy and safety ofZhilou Lotion combined with modified Sihuang Ointment in treatment of anal cryptitis.MethodsOne hundred patients with anal cryptitis were randomly divided into observation group and control group, with 50 cases in each group. The control group was given propylene dispersible tablets oral and topicalHuazhi embolism. The observation group received steaming and hip bath with Zhilou Lotion combined with modifiedSihuang Ointment topical external application treatment, 7 days as a course of treatment and 2 courses successive. The TCM syndrome scores of two groups were compared before and after treatment to evaluate the clinical efficacy. The remission time of symptoms, hospitalization time, recurrence rate in 6 months and adverse reactions were observed.Results After treatment, the TCM syndrome scores of two groups were improved (P<0.01), and the scores in the observation group was lower than those in the control group (P<0.01). The total effective rate was 96.0% (48/50) in the observation group, and 80.0% (40/50) in the control group, with statistical significance (P<0.01). The remission time of anal edema, anal dampness, anal pain and anal fall-swell in observation group was obviously shorter than that in the control group, with statistical significance (P<0.01). The average hospitalization time was (15.25±2.78) days in the observation group and (18.46±3.41) days in the control group, the difference was significant (P<0.01). In the observation group, the recurrence rate was 0, 0 and 2.0% in 2, 4, 6 months follow-up, while that was 4.0%, 12.0% and 16.0% in the control group, respectively. The recurrence rates of the control group in 4 months and 6 months were higher than those of the observation group (P<0.05). No significant adverse reactions occurred in the two groups.Conclusion Zhilou Lotion combined with modifiedSihuang Ointment has good clinical efficacy in treatment of anal cryptitis, with low recurrence rate and high safety.

Objective To elucidate the significances of health education in the prevention and treatment of gout and hyperuricemia.Method Health education scientific knowledg was done through approaches of specific proclamation in clinic out patients,screening the directly-related members of patient family,training medical staffs and popular vehicle propaganda etc.Results Health education improved the diet structure and life mode of patients,promoted early diagnosis and treatment of patients.It also had favourness in timely detection of other patients in directly-related members of ones family.Conclusion Health education combined with conventional pharmacological therapy could produce a better efficacy than that of single pharmacological ones.

In 2012, the contracted service with the general practitioners ( rural doctors) was implemented in Zhejiang Province. This paper conducted an analysis on the existing problems in the contracted service from three as-pects of policy background, policy objective, main measures and the following suggestions have been put forward:Strengthening the whole family team of doctors and information construction, and improving the multi sectoral coopera-tion mechanism in order to establish the classified diagnosis and treatment system as targeted to lay a good foundation.

ObjectiveTo investigate the role of iNOS in the middle and late stage of pulmonary hypertension (PH) and the effect of L-Arginine(L-Arg) on these stage.MethodsThirty healthy male SD rats were randomly divided into five groups.All rats except those in control group were injected intraperitoneally (ip) with a single dose (50 mg/kg) of MCT to induce PH.Then the L3 and L5 groups were injected ip with 500 mg/kg L-Arg daily for 3 weeks and 5weeks respectively,the M3 and M5groups received a daily ip injection of the same amount of saline as L-Arg for 3 weeks and 5 weeks respectively; the same amount of saline was injected ip daily in control group for 5 weeks.Right ventricular systolic pressure(RVSP) was measured before lungs were excised for immunohistochemistry at the end of experiments. ResultsThe expressions of iNOS and elastin in M3 and M5 were higher compared to the control group,but L-Arg partly reduced the expressions of iNOS and elastin both at 3weeks and 5 weeks post-MCT.The reduction of eNOS expression in L3 and L5 groups were lower compared to M3 and M5 groups,but the eNOS expression in L3 and L5 groups were still lower than control group.ConclusionDuring the middle and late stage of PH,the expression of eNOS was decreased.The expression of iNOS was induced,which would produce numerous NO.However,these NO had no benefit on the development of PH.L-Arg could restore the balance of eNOS and iNOS,and could inhibit the development of PH,which may provide a new clues to explore the pathogenesis and treatment of PH.

Objective To study the expression levels of inducible costimulator (ICOS) on CD4+ T cells in peripheral blood in patients with chronic hepatitis B and its change after treated with interferon.Methods All 56 patients were divided into two groups (interferon group has 28 cases,lamivudine group has 28 cases),and interferon group treated by PEG-IFN-α 2a,lamivudine group treated by lamivudine,respectively.There were 20 healthy individuals as control group.The levels of ICOS on CD4+ T cells of patients with chronic hepatitis B were kinetically detected by flow cytometry.The copies of HBV DNA in sera were dynamically detected by real-time PCR.Results The levels of ICOS on CD4+ T cells in patients with chronic hepatitis B was higher than that of normal controls(P＜0.001 ).However,the expressions of ICOS on CD4+ T cells in patients could be deduced by PEG-IFN-α 2a and obviously decreased after treatment.There was significant difference between interferon group and lamivudine group (P＜0.05 in 24 weeks,and P＜0.01 in 48 weeks).After treatment,the change values of ICOS in interferon group was positively correlated with the change copies of HBV DNA (r =0.972,P＜0.001 ).However,the change values mentioned above that did not find correlation in lamivudine group(r=-0.101,P=0.608).Conclusion The study shows the patients with chronic hepatitis B have disordered in cellular immunity and increased with the expression of ICOS on CD4+ T cells.PEG-IFN-α 2a could decrease the expression of ICOS on CD4+ T cells in patients,and correct the Th2 type immune polarization to some extent,and that plays a positive role in antiHBV.