Objective To investigate the application of the parenteral nutrition prescriptions for tumor patients in a tertiary hospital .Methods In this cross-sectional study , the parenteral nutrition prescriptions of all tumor inpatients in a tertiary hospital were collected from May to June in 2015 .The general data of patients who had used parenteral nutrition , the types of parenteral nutrition products , as well as the ratio of energy to ni-rogen ( E/N) , glucose/lipid ( G/L) ratio, non-protein energy to nitrogen ratio , and liquid volume were recor-ded and analyzed .Results Parenteral nutrition prescriptions were collected from 528 patients and showed high irrationality.The nutrient insufficiency rate was nearly 58.3%.The E/N (100:1 ~200:1) accounted for 32.3%and the G/L ( 1:1 ~2:1 ) 20.6%.Conclusions The rational application of parenteral nutrition should be a priority in clinical settings .A clinical nutrition supporting team may be established in tertiary hospi-tals to guide the appropriate use of parenteral nutrition .

OBJECTIVE To study characteristics of changing T lymphocytes in epidemic hemorrhagic fever(EHF) patients during acute phase and find out the pathogenesis,in order to elevate the level of early diagnosis.METHODS The anticoagulant blood from 30 cases of EHF patients and 50 normal healthy blood donors was collected.T lymphocyte subsets were detected by flow cytometry.RESULTS Compared with those of normal persons,CD4+ T cell counts of EHF patients decreased,CD8+T cell and double CD4+CD8+ cell(double positive cells,DP cell) counts of EHF patients increased obviously,and 25 cases of EHF in recovery stage returned to normal.And in comparison with HIV,CMV and EBV patients,DP cell counts of EHF patients increased obviously.CONCLUSIONS T lymphocytes of EHF decrease obviously but could be resumed,detection of amounts of lymphocyte subsets and CD4+CD8+ cells can provide an early diagnosis method to EHF.

Objective BRAFV600E mutation, RET/PTC rearrangement, and the concomitant of Hashimoto's thyroiditis(HT) could influence clinicopathological features of papillary thyroid carcinoma (PTC).This study is to investigate the distribution of three factors in PTC and to analyze their associations with clinicopathological characteristics.Methods Fine-needle aspiration samples were collected in a total of 122 conventional PTC patients, who were confirmed by surgery.The clinicopathological features were collected to analyze its association with different factors.BRAFV600E mutation and RET/PTC rearrangement were detected by pyrosequencing and Taqman-qPCR, respectively.Results BRAFV600E mutation was significantly correlated with an older age and a less coexistence with HT(P＜0.05).In contrast, RET/PTC rearrangement was more prevalent in young patients and was associated with the concomitant of HT(P＜0.05).In the age of ≥20 year and＜45 year groups, BRAFV600E mutation was significantly associated with extrathyroidal invasiveness.RET/PTC rearrangement was significantly associated with bilateral lymph node metastasis and the number of metastatic lymph node.Conclusions The distribution of three factors were different in PTC patients.In addition to the age at diagnosis, all of three factors should also be considered together to analyze the association of clinicopathological features of PTC.

ObjectiveTo study the relationship between fasting plasma glucose (FPG) level and the first cerebral infarction event in the population with diabetes.Methods This was a prospective cohort stndy.8 306 diabetic subjects who determined FPG ≥ 7.0 mmol/L or treated with insulin or hypoglycemic drugs and FPG ＜7.0 mmool/L as the observation population and were followed-up for (48.01 ± 3.14) months.During the course,cerebral infarction events were determined every 6 months.Results( 1 ) By the end of following-up,with the increasing levels of the baseline FPG,the total cholesterol (TC),triglyceride (TG) levels were gradually increased in the diabetic population,the differences were significant [ TC:( 4.93 ± 1.15,5.10 ± 1.20,5.15 ± 1.28,5.33 ± 1.35 ) mmol/L,TG:( 1.70 ± 1.26,1.83 ± 1.29,2.18 ± 1.76,2.41 ± 2.08 ) mmol/L,P＜0.05 ] ; the plasma low density lipoprotein-cholesterol (LDL-C),systolic blood pressure ( SBP),diastolic blood pressure ( DBP),and body mass index (BMI) levels were also increased significantly ( P＜0.05 ).(2) The ineidence of cerebral infarction event in the group of patients with 7.0 mnol/L ≤ FPG ＜ 9.0 mmol/L was the lowest,the differences were significant ( 2.1％,P ＜0.01 ).Compared with the group of 7.0 mmol/L≤ FPG＜9.0 mmol/L,after adjusting for age,sex,BMI,SBP,DBP,TC,TG,low density lipoprotein-cholesterol,high density lipoprotein-cholesterol,smoking,diabetic duration and treatment,the relative risk for cerebral infarction events were 1.85 (95％ CI 1.09-3.15,P＜0.05) and 1.54 (95％CI 1.16-2.05,P ＜ 0.01 ) for those groups with 6.1 mmol/L ≤ FPG ＜ 7.0 mmol/L and FPG ≥ 9.0 mmol/L respectively.ConclusionThe risk of new in cidence of cerebral infarction events seems to be the lowest in the group of diabetic patients whose FPGs are wihin 7.0-9.0 mmol/L range.

Objective To evaluate the growth inhibition of human gastric carcinoma cell lines SGC 7901 in vitro and the expression of bcl-2, bcl 2l12 and bax with docosahexaenoic acid (DHA) and 5-fluorouracil (5-FU). Methods The effect of DHA and 5-FU was measured by trypan blue, and the interaction between two agents was judged by combination index (CI). Cells were observed by inverted microscope. Flow cytometry was used for analysis of apoptosis by PI staining and Annexin-V/PI. RT-PCR was used to analyze the levels of bcl-2, bcl 2l12 and bax mRNA. Results DHA significantly inhibited the growth of SGC 7901 cells in a dose- and time-dependent way ( P < 0. 05 ), the IC50 of 24 h and 48 h was 67. 81 μg/ml and 45.76 μg/ml, and a strong synergism was found in the combination of DHA and 5-FU (CI < 1 ,P <0. 01 ). Treated by DHA and 5-FU for 48 h, cells became sparse under inverted microscope. DHA or 5-FU was able to induce apoptosis and the effect became even more significant by the combination of DHA and 5-FU. Cells were holted in phase of G01/G1 and S. RT-PCR showed that DHA or 5-FU down-regulated the expression of bcl-2 and bcl 2l12 mRNA, while bax mRNA expression was not downregnlated. Conclusions DHA could inhibit the growth of gastric carcinoma cells, DHA and 5-FU had synergetic effect in the inhibition of the cells growth and blockage of the cell cycles possibly by down-regulating the expression of bcl-2 and bcl 2l12.

Objective To investigate the risk factors and establish the Cox's regression model and the personal prognosis index for the recurrence of ischemic stroke in 3-year follow-up.methods 1058 patients were retrospectively reviewed consecutively diagnosed with ischemic stroke admitted to the Neurology Department of the Hebei united University Affiliated Hospital from January 1,2013 to December 31,2013.Cases were followed up since the onset of ischemic stroke.The follow-up was finished in January 1,2016.Kaplan-Meier methods were used for recurrence rate description.Monovariant and multivariate Cox's proportional hazard regression model were used to analyze risk factors associated with recurrence.Thus,a recurrence model was set up.Result sDuring the period of follow-up,184 cases relapsed.The 1-year recurrence rate was 29.9 person-year,2-year recurrence rate was 46.6 person-year,3-year recurrence rate was 52.7 person-year.Monovariant and multivariant Cox's proportional hazard regression model showed that the independent risk factors associated with recurrence were age(X1)(RR=1.303;95%CI:1.019~1.666)history of heart disease(X2)(RR=1.788;95%CI:1.127~2.836),hypertension(X3)(RR=1.897;95%CI:1.097~3.280),diabetes(X4)(RR=1.674;95%CI:1.015~2.760),total cholesterol(X5)(RR=2.136;95%CI:1.396~3.266).The personal prognosis index(PI)of recurrence model was as the following: PI=0.265X1+0.581X2+0.640X3+0.515X4+0.759X5.Conclusion sAge,history of heart disease,hypertension,disease progression,and total cholesterol are the independent risk factors associated with recurrence of ischemic stroke.The recurrence model and the personal prognosis index equation are successful constructed.

Objective:To evaluate the diagnostic value of endoscopic ultrasonography (EUS) in colorectal submucosal lesions, and provide evidence for clinical diagnosis and treatment strategies.Methods:A retrospective analysis was performed on data of 229 patients with colorectal submucosal lesions discovered by electronic colonoscopy and EUS. The diagnosis was confirmed by pathology. The location, type, EUS features of lesions and the coincidence rate of EUS and histopathological diagnosis were analyzed.Results:Colorectal submucosal lesions were common in the rectum (44.98%, 103/229) and ascending colon (15.28%, 35/229). Lipoma was the most common pathological type of colorectal submucosal lesions (34.93%, 80/229), which was commonly located in transverse colon (22.50%, 18/80) and ascending colon (20.00%, 16/80). Neuroendocrine tumor was the second one, accounting for 33.63% (77/229), and was commonly located in rectum (96.10%, 74/77), followed by cyst (18.78%, 43/229). Under EUS, 229 cases of lesions originated from submucosa in 215 cases, muscularis mucosa in 11 cases, and muscularis propria in 3 cases. The overall coincidence rate of EUS and pathological diagnosis was 89.08% (204/229). The coincidence rate of EUS diagnosis was 100.00% (80/80) for lipoma, 5/5 for air-cyst, 3/3 for intestinal stromal tumor, 81.82% (72/88) for neuroendocrine tumor, 89.13% (41/46) for cyst, 1/4 for leiomyoma, 2/5 for lymphangioma, and granulosa cell tumor and neurofibroma were both 0.Conclusion:EUS has a more accurate diagnosis of the origin, echogenicity and pathological properties of colorectal submucosal lesions, but it has certain limitations for the diagnosis of rare tumors such as granulosa cell tumor and neurofibroma.

Objective Observed the characteristics and influence factors of blood pressure circadian rhythm in continuous ambulatory peritoneal dialysis patients.To investigate the effect of residual renal function and cardiac function.Methods Prospectively collected 120 cases of continuous ambulatory peritoneal dialysis from June 2016 to March 2017 in Tangshan renal medicine dialysis centers,who combined with hypertension were treated with peritoneal dialysis for more than 3 months.According to the dynamic monitoring blood pressure circadian rhythm of blood pressure,120 cases were divided into the normal rhythm of blood pressure and the abnormal blood pressure rhythm group.Collected medical history;Tested related test index respectively;Cardiac ultrasound.According to the formula to calculate residual renal function,left ventricular mass index,Eingabe/Ausgabe,Ejection Fraction.Univariate and multivariate unconditional logistic regression analysis was used to analyze the risk factors of circadian rhythm of blood pressure.Stepwise multiple linear regression analysis was used to analyze the risk factors of residual renal function and cardiac function.Results CAPD patients with normal blood pressure rhythm in 14 cases(11.7％),abnormal blood pressure rhythm in 106 cases(88.3％),Among them,non dipper blood pressure accounted for 75 cases(62.5％).Single factor and multiple factors unconditioned logistic regression analysis revealed that after the comparison of gender and age,Risk factors for abnormal circadian rhythm of blood pressure were:UA(OR=1.197,95％CI:1.099-1.441),CRP(OR=1.170,95％CI:1.061-1.331),RRF(OR=1.389,95％CI:1.160-1.779).Using stepwise multiple linear regression analysis of dangerous factors affecting residual renal function and cardiac function,we found:Residual renal function negatively correlated with left ventricular myocardial mass index,systolic blood pressure drops at night rate,and ultrafiltration volume;LVMI (cardiac function) Positively correlated with 24 h average systolic blood pressure,and negatively correlated with systolic blood pressure drop ratio and residual renal function at night.Abnormal circadian rhythm of blood pressure may lead to the decline of residual renal function and cardiac function.Conclusions UA,CRP and RRF may affect the CAPD patients blood pressure circadian rhythm.At the same time,abnormal circadian rhythm of blood pressure may lead to the decline of residual renal function and cardiac function.Therefore,pay attention to the monitoring and control of ABPM,can better protect the residual renal function and improve cardiac function,so as to prolong and improve the survival time and quality of life of patients with CAPD.

Objective: To explore prevalence and associated factors of neglect among left-behind middle school students in undeveloped area of Guangdong, and to provide scientific basis for effective intervention measures. Methods: A total of 1 105 middle school students were selected from Yangjiang and Qingyuan by random cluster sampling, neglect and left-behind was assessed by a self-reported questionnaire. Results: The prevalence of neglect was 70.9% among left-behind middle school students aged 11-17 years in Yangjiang and Qingyuan areas. Univariate analysis suggested that high parental education, democratic and strict parenting, and frequent contacts with parents associated with low rate of neglect (P<0.05). After adjusted for gender, parental education, parenting style, contact frequency, Logistic regression analysis revealed that parenting discipline(rough, cold, capricious)(OR=2.01, 95%CI=1.23-3.26), contact with parents more than once every two weeks (OR=1.75, 95%CI=1.12-2.72) , peer or self-care (OR=1.85, 95%CI=1.04-3.30) were positively associated with neglect, while higher mother education was negatively associated with neglect. Conclusion The prevalence of neglect is high among left-behind students in Yangjiang and Qingyuan, which deserves further attention from family, community, school and government to promote healthy development.

OBJECTIVE: To observe the therapeutic effect of tympanoplasty with soft-wall reconstruction of ear canal for chronic otitis media with cholesteatoma. METHOD: Seventy-three patients (76 ears) suffering from chronic otitis media with cholesteatoma were treated with canal wall down mastoidectomy with tympanoplasty. Postauricular myo-periosteal flap was used to the soft-wall reconstruction of ear canal, and the cavityplasty of auricular concha was not performed. The auricular bone prosthesis was made of the autogeneic mastoid cortical bone or residual incus. The postoperative modality and the function of external auditory canal and the postoperative hearing and the postoperative complications were observed. RESULT: The mean dry ear time was (21.1 +/- 3. 1) days after surgery in this study. The postoperative modality of external auditory canal was normal on the whole. The patients were followed up between 6 months and 24 months after surgery. The postoperative average air conduction hearing was improved by (14.5 +/- 6.1) dB HL. CONCLUSION Tympanoplasty with soft-wall reconstruction of ear canal using the postauricular myo-periosteal flap can recover the modality and function of external auditory canal on the whole, and the cavityplasty of auricular concha is not needed. The postoperative hearing can be improved by this technique satisfactorily.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bone Transplantation ; Child ; Cholesteatoma, Middle Ear ; surgery ; Ear Canal ; surgery ; Female ; Humans ; Male ; Middle Aged ; Treatment Outcome ; Tympanoplasty ; methods ; Young Adult