Objective To summarize the experience in nursing patients with pelvic fractures complicated with Morel-Lavalle'e lesions (MLL). Method Thirteen cases of pelvic fractures combined with MLLs were reviewed for retrospective analysis of the nursing experience. Results After subcutaneous effusion disappeared from the treatments, 13 patients underwent successfully pelvic fracture surgery. The average hospital stay was (16.0 ± 4.0) days. Conclusion The nursing measures including careful observation, tender care to patients at decubitus position, implementation of the negative pressure drainage and care at perfusion and functional exercises, can help to improve the curative effects for patients with pelvic fractures combined with MLLs.

Objective To investigate the correlations of plasma total homocysteine (tHcy) level and the C677T methylene tetrahydrofolate reductase (MTHFR) polymorphism with vascular dementia (VaD) and Alzheimer's disease (AD).Methods A case control study in 64 AD patients (AD group),72 VaD patients (VaD group) and 56 healthy controls (control group) was under taken.Plasma tHcy level was determined by enzymatic cycling assay.The MTHFR677C/T polymorphism was analyzed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP).Results tHcy levels were significantly higher in AD and VaD groups than in control subjects(P＜ 0.05).VaD patients also showed increased levels of tHcy as compared to AD patieuts,but no statistic significance was found(P＞0.05).Logistic regression analysis indicated that tHcy level was a risk factor for dementia (including AD and VaD together)[(OR=1.15),VaD (OR=1.23),AD (OR=1.328)].MTHFR677 TT genotype represented higher plasma tHcy concentrations than CC and CT genotypes(both P＜0.05).The distribution frequency of the T allele of MTHFRC677T was 45.3 ％ (58/128)in AD group,49.0％(51/104)in VaD group and 33.0％(37/112)in control group,and it had significant differences between the three groups (P＜0.05).There was a significant difference in distribution frequency of the T allele of MTHFRC677T between VaD and control group (P＜0.01).The distribution frequency of MTHFR677 genotype (CC/CT/TT) had a significantly difference between the VaD group and the control group(P＜0.01).Conclusions High plasma level of tHcy is closely correlated with AD and VaD.tHcy level is the risk factor for dementia (including AD and VaD together).The polymorphism of MTHFR677C/T affects the plasma tHcy level.The T allele of MTHFRC677T may correlate with VaD,while has no direct correlation with AD.

Objective To study the effect application,method,time, and indwelling double J internal tube in the operation of upper urinary tract.Methods The double J of tubes were used as internal drainage and internal stent for 1～2 months in the operation of upper urinary tract in 104 patients with nephrolithiasis, ureteral calculi,PUJ obstruction,megaloureter syndrome and bladder tumor.Result No complications such as wound infection,leakage of urine occurrence after operation.Conclusions The double J tubes had the dual functions of internal sent and internal drainage. The double J tubes can be indwelled easily and safely.

Objective To investigate transfusion transmitted virus (TTV) infection among population of different groups in Shaanxi Province. Methods A nested polymerase chain reaction (PCR) with primers from ORF1 of TTV genome was established to detect TTV-DNA in serum of the patients. ResultsTTV-DAN was detected in the sera of 3 of 50 cases of general population(6％), 2 of 30 cases of vocational blood donors(6.7%),21 of 97 cases with Type B hepatitis (21. 6％), 9 of 35 cases of Type C hepatitis (25. 7％),and 23 of 40 cases with non-A～ non-G hepatitis (57.5 ％ ). ConclusionThere is TTV infection among general population in Shaanxi Province. TTV may be an impor- tant agent to cause non-A～non-G hepatitis. And the patients with HBV or HCV can have overlapping TTV infection.

BACKGROUND:The laser applied in the clinical oral medicine is mainly for early diagnosis of caries, removal of carious tissue, pulpotomy for pulp bleeding, dentin hypersensitivity treatment, disinfection of infected root canals, and periodontitis treatment. OBJECTIVE:To explore the changes of basic fibroblast growth factor in inflammatory pulp after laser treatment. METHODS:Five healthy adult beagle dogs were enroled, and six teeth were randomly selected from each dog. Then, these teeth were randomly divided into three groups, 10 teeth in a group, and they were treated with laser irradiation, saline and gentamicin irrigation respectively. At days 1, 2, 3 after operation, exudates from the pulp were colected for detection of basic fibroblast growth factor expression. Meanwhile, the dental pulp was detected by hematoxylin-eosin staining and immunohistochemistry method. RESULTS AND CONCLUSION:In the al three groups, the expression of basic fibroblast growth factor at day 3 was significantly higher than that at days 1 and 2, and there were no differences between days 1 and 2. Moreover, these three groups also showed no significant differences. Under hematoxylin-eosin and immunohistochemical staining, blood vessels in the pulp cavity were in good condition and the pulp arranged tightly. These findings suggest that the laser is safe, convenient and effective for oral clinical application, and has no injury to the inflammatory pulp.

Objective To investigate the score changes of graduates majoring in clinical medicine after using the method of “role of identification”. Methods Sixty students who were undertaking internship in Endocrinology Department of Shanghai Traditional Chinese Medicine Hospital received three-week clinical teaching and examination. Then they got into one-week “role of identification”, and were appointed as clinical teachers to teach what they have learned during the last 3 weeks to the next batch of interns and make another examination. Scores of the two examinations were compared. Results Scores of the examination after received the method in“role of identification”improved significantly (P<0.01). Conclusion The method of“role of identification”can enhance clinical medicine graduates’ mastery of professional knowledge.

Objective To understand the distribution situation of respiratory viral infection among adult inpatients with respiratory infection in the emergency department.Methods The detection results data of 5 kinds of viruses RSV,IVA,IVB,PIV1,PIV2,PIV3 and ADV by indirect immune fluorescence assay in 384 adults patients with respiratory infection in the emergency department of our hospital from January 2014 to December 2015 were collected.The epidemic characteristics of different viruses were analyzed.Results Among 384 specimens,208 cases were positive in respiratory virus IgM antibody,the viral infection positive rate was 54.17%.The mixed virus infection and influenza B virus infection were most common,their viral positive rates were 26.56% and 23.44% respectively,In the mixed viral infection,the positive rate of IVA + IVB mixed infection was highest,accounting for 87.25%,which was higher than that of other kinds of mixed viral infection.The viral infection positive rate had no statistical difference between different genders(P>0.05).The viral infection rate was higher in autumn and winter,which were 66.06% and 68.37% respectively and higher than 42.31% and 34.25% in spring and summer,the difference was statistically significant(P<0.05).The viral infection rates of youth (18-45 years old) and middle-aged (>45-60 years old) were 64.94% and 63.86% respectively,which were higher than 48.45%,44.92% and 55.56% in pre-elderly (>60-75 years old),elderly (>75-90 years old) and longevous elderly (>90 years old),the differences were statistically significant(P<0.05).Conclusion The respiratory virus mixed infection and IVB infection are most common in the emergency wards,moreover the viral infection situation shows the seasonal and age characteristics,but which is not affected by sex factor.

Objective To intervene hand hygiene(HH)of health care workers (HCWs)in an intensive care unit(ICU)of a hospital,and evaluate HH compliance of HCWs and influencing factors.Methods 37 HCWs from an ICU of a teaching hospital were chosen as studied subjects,HH status before and after intervention was observed and analyzed by direct and indirect methods.Results In the first monitoring stage,HH rate in baseline and post-intervention survey stage was signifi-cantly different (46.96% vs 63.30%,χ2 =7.344,P =0.007);in the second monitoring stage,HH compliance rate in-creased from 57.85% to 88.58%.HH compliance rate was positively correlated with consumption of HH product per bed-day(r=0.725,P <0.001),but negatively correlated with incidence of healthcare-associated infection(HAI)and case rate of HAI(r=-0.983,-0.990,respectively,both P <0.001),HH rate to alcohol-based hand sanitizers was positively correlated with consumption of HH product per bed-day (r=0.391,P <0.001 ).Conclusion Long-term monitoring and intervention of HH compliance is necessary,combination of direct observation and indirect assessment of HH product con-sumption is helpful for effective monitoring and intervention of HH compliance among HCWs.

Objective To investgate the value of various parameters obtained from monoexponential, biexponential, and stretched exponential diffusion?weighted imaging models in the differential diagnosis of breast lesions. Methods A retrospective study performed in 54 patients with pathologically confirmed malignant tumors(n=30), benign lesions(n=34) and normal fibroglandular tissues (n=30). All patients underwent T1WI, T2WI, dynamic enhancement and diffusion weighted MRI with multi?b values at a 3.0 T magnetic resonance imaging unit. All parameters were measured at a workstation. ADC was calculated by using monoexponential analysis(b=0, 800 s/mm2). Slow apparent diffusion coefficient (ADC?slow), fast apparent diffusion coefficient (ADC?fast), and perfusion fraction (f) were calculated using the biexponential model. Distributed diffusion coefficient (DDC) and water molecular diffusion heterogeneity index (α) were obtained from diffusion?weighted images using the stretched exponential model. All parameters were statistically compared among normal fibroglandular tissues, benign lesions and malignant tumors using Kruskal?Wallis rank sum test. Mann?Whitney U test were used for further comparisons between specific group pairs. ADC values were compared with ADC?slow and DDC for different groups by paired Wilcoxon test. Correlations between ADC?value, ADC?slow and DDC were assessed by using Spearman rank correlation coefficient. Receiver operating characteristic curve was used to analyze and compare the ability of these parameters in differentiation of benign and malignant breast lesions. Results The ADC, ADC?slow, f, DDC and α values were significantly different among the normal fibroglandular tissues, benign tumors and malignant tumors (P<0.05). Further differential comparisons of the four parameters between each pair showed that the ADC, ADC?slow, f, DDC and α values were significantly lower in malignant tumors than both in normal fibroglandular tissues and benign tumors(P<0.016 7). The ADC values of normal fibroglandular tissues, benign tumors and malignant tumors were significantly higher than ADC?slow and DDC (P<0.05). The f and DDC had higher area under the receiver operating characteristic curve (0.688 and 0.657 respectively). The optimal cutoff values for ADC, ADC?slow, f, DDC and α were 1.235 × 10-3mm2/s, 0.428 × 10-3mm2/s, 57.8%, 1.175 × 10-3mm2/s and 0.721, respectively. Theαvalue showed higher specificity (65.5%) and the f value had higher sensitivity (82.9%). Conclusion The parameters derived from biexponential and stretched exponential DWI could be helpful for differentiation between benign and malignant breast tumors.