ObjectiveTo assess the impact of nutrition education on the outcomes and dietary intake during pregnancy.MethodsFrom January 2007 to December 2008,240 healthy pregnant outpatients were selected from Jining First People's Hospital.Subjects were randomly and equally divided into the intervention group and control group,and the intervention group received nutrition education till labor.Through the comparison of two groups,the impact of nutrition education on the outcomes and dietary intake was assessed.ResultsBirth weight of the newborn infauts was significantly lower in the intervention group than the control group( (3.15 ±0.81 )kg vs (3.33 ± 0.56)kg,t =2.04,P ＜ 0.05).Compared with the control group,the incidence rate of anemia was lower in the intervention group (45.8％ vs 59.8％,x2 =4.56,P ＜0.05).The intervention group had higher proportion of supplementation in iron,folic acid and compound vitamins (P ＜ 0.05).Significant differences were also observed in the frequency of intake fried food,pork,poultry,milk,soybean milk and fresh fruits (P ＜ 0.05).ConclusionNutrition education can improve the outcomes and dietary intake during pregnancy.

Objective To investigate the clinical experiment of arthroscopically assisted debridement and tibiotalar arthrodesis with half-ring sulcated external fixator for treatment of total ankle joints tuberculosis. Methods From January 2001 to April 2005, 6 patients (4 males and 2 females), with a mean age of 33 years old (range, 28 to 44 years old) and mean duration of 13 months, received arthroscopically assisted debridement and tibiotalar arthrodesis with half-ring sulcated external fixator. All patients had received at least 3 weeks standard drug treatment for tuberculosis before the operation. After thoroughly debridement under arthroscopy using anterolateral and anteromedial approaches, a half-ring sulcated external fixator was used to fix the ankle joint at the neutral position. 4 days (2-7 days) after the operation, patients could walk with partially weight bearing. All patients replied to our questionnaire and the average follow-up was 21.3 months, with a range of 6-42 months. Patients returned for a clinical and radiolographic evaluation every week before the tibiotalar joints union. The external fixator apparatus were removed after the joint fused. Results Fusion occurred in all patients, the average time to clinical and radiographic union was 12.5 weeks (9-17 weeks). 3 patients were graded as excellent: no pain with a stable fusion. The others were graded as good: mild pain, occasional limp with a stable fusion. There were no sinus or other complications occurred. Conclusion There are considerable advantages using arthroscopically assisted debridement and tibiotalar arthrodesis with half-ring sulcated external fixator for treatment of total ankle joints tuberculosis without serious bone defect, include: limited invasion, quickly recovery, thoroughly debriding the tuberculose focus. And the half-ring sulcated external compression fixator could achieve stable and elastic fixation with adjustable rigidity. And patients can walk earlier to promote ankle fusion and decrease related complications.

Objective:To explore the associations of menopause with cardiovascular disease (CVD) and related metabolic disorders (including hypertension,diabetes or higher blood sugar,obesity,dyslipi-demia)in Chinese females aged 45 -59 years .Methods:Data were acquired from a national cross-sectional survey conducted in 201 3,China,which was also the second follow-up survey of China Health and Retirement Longitudinal Study (CHARLS).In the study,4 702 Chinese perimenopausal women aged 45 -59 years were enrolled,including 1 769 premenopausal women and 2 933 postmenopausal women.Information was collected from questionnaires of health status and functioning and physical exa-mination.General liner models were employed to calculate age-adjusted or age-and-body-mass-index-adjusted or multiple-factor-adjusted means and their 95% confidence intervals (95% CIs)of cardiovas-cular risk factors (CRFs).The comparisons of CVD and its risk factors according to menopausal status, and calculation of adjusted odds ratios (ORs)and their 95%CIs for the associations of menopause with CVD and its risk factors were performed by multivariate Logistic regression models separately.Results:After adjustment for age and other confounders (including body mass index,marriage,education,current smoking,drink alcohol more than once per month),statistically significant associations of menopause with cardiovascular disease,which referred to having a history of heart disease or stroke in this study, were observed in the participants (OR =1 .34,95% CI:1 .04 -1 .74);prevalence of hypertension (OR =1 .42,95%CI:1 .1 0 -1 .84),prevalence of CRFs clustering number≥2 (OR =1 .31 ,95%CI:1 .02 -1 .68)and average waist circumference level (87.1 1 cm,95%CI:86.81 -87.42 cm in post-menopausal group vs.86.41 cm,95%CI:85.99 -86.84 cm in premenopausal group)were presented higher in postmenopausal group,compared with the premenopausal one.However,diabetes or higher blood sugar (OR =0.96,95%CI:0.60 -1 .52),dyslipidemia (OR =0.84,95%CI:0.59 -1 .20) and obesity (OR =1 .06,95%CI:0.86 -1 .32)were not shown significantly statistically related to me-nopause,after excluding effect of age and other confounders.Conclusion:Postmenopausal women in China had worse CRFs profile than the premenopausal ones,which implied menopause might aggravate the CRFs epidemic and increase the risk of cardiovascular disease beyond effects of aging,which would increase the CVD burden during and after their middle ages.

Objective To discuss the clinical curative effect of pleating of levator palpebrae superioris in treating semiptosis. Design Retrospective case series. Participants Forty-three eyes from 30 patients with semiptosis of upper eyelid. Methods By using pleating of levator palpebrae superioris through the skin,isolating the levator muscle was skipped in rectification. Position of upper eyelid-margin before and after operation was observed. Main Outcome Measures The position change of upper eyelid-margin in the first position of eye in 3-6 months after surgery. Results The mean follow-up period was 13.1 months (6 months to 2 years),26 cases (39 eyes) got cured with normal eyelid-margin position,3 patients were below rectification and 1 patient over-rectification. Conclusion Pleating of levator palpebrae superioris is suitable for the treatment of semiptosis of upper eyelid.

Objective: To examine the correlation of symptomatic feature and exploratory eye movements in schizophrenia. Methods: The eye movements of 60 patients with schizophrenia and 30 healthy control subjects were measured by the eye-mark recorder (model IV, Japan) and symptom profiles of patients were assessed using the Positive and Negative Syndrome Scale (PANSS) . Pearson correlation analysis was performed to examine the relationship between five-factor scores of PANSS, positive symptoms, negative symptoms and exploratory eye movements respectively. Results: The differences of all indices of eye movements between schizophrenic groups and normal control group had statistical significance ( P

To investigate the correlation between p16 gene mutation and laryngeal cancer biological behavior as well as its prognosis in laryngeal cancer.Method:24 speciments of primary laryngeal cancer and 10 speciments with benign lesion in larynx were examined for mutations in exon2 of p16 by using PCR-SSCP silver stainning technique.Result:Mutations frequency of laryngeal cancer was62.5% (15/24).Nothing was found in 10 cases with laryngeal benign lesion.Conclusion:There is a strong correlation between p16 gene mutation and the biological behavior of chinese laryngeal cancer, such as histologic differentiation, invasion stage, and regional lymph nodes metastasis(P≤0.05).PCR-SSCP silver tainning technique is one of the most sensitive and simplest measure for detecting genetic mutation.It is worth using in clinical laboratory because of its readiness, repetition and lower cost.

Objective To explore the risk factors of lower limb deep vein thrombosis (DVT) in patients with traumatic fractures so as to provide references for prevention of DVT. Methods A total of 1 068 patients with traumatic fractures were involved in the study to analyze the incidence of DVT under 43 risk factors including general state, injury type, fracture condition and operation and screen significant factors for multiple factor analysis. Results The total incidence rate of DVT in 1 068 patients was 12.0%. The univariate analysis showed that male patients at age ＞60 years, with BMI≥25 kg/m2, history of smoking, lack of exercises, history of diabetes, hypertension, coronary artery disease and cerebrovascular disease had higher incidence rate of DVT. In different injury types, the fall injury caused the highest incidence rate of DVT (45.6%). There were different DVT rates for different fracture position,with the highest incidence rate of DVT for femur shaft fracture (20.5%). The incidence rate of DVT was 51.7% for fractures of more than three parts, 14.2% for fractures of two parts and only 3.7% for sole part. The incidence rate of DVT for comminuted fractures was higher than the overall rate. The operation duration, massive transfusion during operation and epidural anesthesia were related with the increase of incidence of DVT. Multivariate analysis found nine independent risk factors and showed that the more risk factors were, the higher incidence of DVT was. Conclusions The risk factors of DVT for traumatic fractures include age ＞60 years, BMI≥25 kg/m2, history of smoking, fall injury, more than three parts of fractures, comminuted fractures, operation duration ＞ 2 hours, massive transfusion during operation and epidural anesthesia.

Objective To comparethe effects of four different emergency fixation methods for the open tibiofibular fractures on the treatment and prognosis of the multiple trauma patients. Methods A comparative study was carried out on the effect offour different early fixation methods on the fracture and the multiple trauma in aspects of the short-term indicators including mortality rate,acute respiratory distress syndrome(ARDS),fat embolism syndrome(FES),multiple organ dysfunction syndrome (MODS),ICU stay and the long-term indicators including wound healing time,fracture healing time,rate of joint function recovery and fracture complications in 43 multiple trauma patients. Results The locked intramedullary nail wag better than the other fLxation methods including the calcaneal traction,the gypsum external fixation and the internal fixation with steel plate and extemal fixation support in most indexes(P<0.05,0.01). Conclusion The locked intramedullary nail can significantly decrease the incidence rate of complications and obtain sound fracture healing for the patients with multiple trauma combined with open tibiofibular fractures(types Gnstilo Ⅰ,Ⅱ and Ⅲa).

Objective To explore the case management model of return to work injured workers. Methods A retrospective cohort wasformed with 523 injured workers in rehabilitation centre. The social demographic information, medical data and intervention process wereextracted from the medical records. A Cox Regression Model was used to examine the effect of case management on work processes and otherrelevant factors affecting RTW. Results 275 cases (82.1%) out of the 335 subjects successfully returned to work after median absence durationof 36.0 days. Computer training prompted RTW outcomes (P<0.01), while disability adjustment activity showed an opposite effect(P<0.05). It showed that education level, family attitude to RTW and level of injury were significantly associated with outcomes of RTW.Conclusion Specific skills reconstruction and training would is one of the most important components of the case management interventionprogram on RTW. Although disability adjustment did not specifically benefit RTW, it might help in improving workers' general health status,and it should not be ignored in any case.

Objective To evaluate the clinical value of double-balloon enteroscopy( DBE)in as-sessing the effect of mucosal healing in patients with moderate small bowel Crohn's disease( CD)treated with low-dose azathioprine. Methods CD patients who were naive to any immunomodulators or biological a-gents with lesions mainly located in ileu were screened by multislice CT enterography and anal-route DBE at baseline. Lesions at 150 cm proximal to ileocecal valve were assessed by DBE with Simple Endoscopic Score for CD( SES-CD)after 12 and 24 months of low-dose azathioprine treatment,respectively. Results A total of 36 patients were enrolled and the average tolerated dose of azathioprine was(61. 8 ± 17. 2)mg/day. The total rates of complete,near-complete,partial and no mucosal healing in 36 patients were 19. 4%(7/36), 5. 6%(2/36),27. 8%(10/36),and 47. 2%(17/36)at month 12 and 30. 6%(11/36),25. 0%(9/36), 33. 3%(12/36),and 11. 1%(4/36)at month 24,respectively. The baseline SES-CD score(OR=2. 71, 95%CI:1. 11-6. 63,P=0. 029)and duration of disease(OR=1. 27,95%CI:1. 10-1. 47,P =0. 001) were two relevant factors associated with mucosal healing of small bowel CD. Conclusion DBE has a signif-icant advantage in assessing post-therapy mucosal healing for patients with small bowel CD. The optimal time point for the first follow-up by DBE is at least 12 months after low-dose azathioprine treatment.