ObjectiveTo study the risk factors of childhood functional constipation.MethodsA cross-sectional analysis of risk factors associated with 182 cases of functional constipation in children was conducted from March 2013 to February 2014. ResultsThe male patients were more than females, mainly in preschool children. The risk factors were did not like fruits and vegetables (52.2%), drank less water (44.0%), did not develop the habit of daily bowel movement (39.5%), defecation fear (36.3%), inadequate food intake (25.8%). There were different risk factors in different age stages.ConclusionsFunctional constipation is related to gender, age, diet habits and mental psychology.

Objective To investigate the effect of α-keto acid combined with low protein diet on kidney function, calcium-phosphorus metabolism and adenosine deaminase activity in malnourished patients with long term peritoneal dialysis.Methods Forty-six cases malnourished patients with long term peritoneal dialysis were selected from May 2013 to August 2014 in the hospital and divided into two groups.The control group (n=23) were treated by conventional therapy, acceptable daily intake of protein 1.2 g/(kg? d).The experiment group (n=23) were treated by α-keto acid combined with low protein diet, acceptable daily intake of protein 0.8 g/(kg? d).Two groups were treated for three months.Serum calcium, phosphorus, nutritional status assessment, adenosine deaminase activity and renal function were observed and compared after treatment.ResuIts After twelve months ’ treatment, compared with control group, serum creatinine, blood urea nitrogen, serum uric acid of experiment group were lower ( P<0.05); serum calcium level was higher (P<0.05), serum phosphorus level was lower (P<0.05);ADA activity and white blood cell count were lower (P<0.05). The incidence of malnutrition rate had no significant difference between two groups(χ2 =3.136,P>0.05).ConcIusion α-keto acid combined with low protein diet could effectively increase serum calcium level, reduce serum phosphorus level, ADA activity and WBC count, and improve nutritional status in long-term peritoneal dialysis patients, which has important significance.

Objective To detect the relationship between XPD Lys751Gln polymorphism and the risk of adult acute leukemia (AL). Methods 100 adult AL patients and 100 controls were chose as case and Lys751Gln were genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCRRFLP) analysis in peripheral blood. Results The genotype frequency of Lys/Lys, Lys/Gln, Gln/Gln were 83 %, 16 %, 1% in case group and 90 %, 10 %, 0 in control group, respectively. The difference the two groups was no signficant difference (x2=1.44, P =0.49). No significantly increased risk for adult AL was observed for those carrying variant genotype with OR analysis (x2 = 2.10, P =0.15, OR =1.84; 95 % CI 0.80-4.25). Individuals with the variant genotype of XPD Lys751Gln might enhance the risk of adult AL (OR =2.77, 95 % CI 0.99-7.73). Conclusion XPD Lys751Gln polymorphism is found to have relationship with adult acute lymphocytic leukemia.

90 without intestinal canal whirl sign was used as the diagnostic standard for whirl sign.Two experienced physicians evaluated the mesenteric vessel whirl sign and its morphological characteristics(including its site,rotation direction,rotation angle,distance between the start and end points of rotating vessels,and rotation radius) and associated signs.The difference in characteristics of whirl sign was compared between volvulus and non-volvulus patients.Results Mesenteric vessel whirl sign was found in 72 out of the 626 patients,including 64(10.4% ) in volvulus group and 8(88.9% ) in non-volvulus group.Mesenteric vessel whirl sign was complicated by intestinal canal whirl sign in 8 volvulus patients,complicated by superior mesenteric artery stricture in 6 volvulus patients.Mesenteric vessel whirl sign complicated by intestinal canal whirl sign was observed in only 2 non-volvulus patients with no superior mesenteric artery stricture.A difference in rotation angle and the start and end points of rotating vessels was found between the two groups(P

At present,the graduate teaching of medical imaging and nuclear medicine is still facing many problems,such as paying more attention to the academic research while ignoring ideological and moral reconstruction,teaching arrangement being unreasonable,poor students' clinical practice ability,lack of scientific training system,and no mature evaluation system and so on.Therefore,in clinical teaching ideological and political education is needed as the guide,to enable students to understand the present medical environment,enhance their doctor-patient communication ability.Besides,in the clinical and scientific research ability cultivation,graduate students' learning enthusiasm should be fully mobilized to promote them to actively explore scientific problems.Furthermore the perfect clinical evaluation method and index system should be combined to assess the quality of training.

Objective To explore the clinical manifestation, imaging examination, treatment and prognosis of Alagille syndrome in a child combined with hepatocellular carcinoma. Method The clinical manifestation, assistant examination and diagnosis of Alagille syndrome combined with hepatocellular carcinoma were analyzed in the child, and the pertinent literature were reviewed. Results The 6-year-old girl was admitted to hospital for repeated jaundice, and had a history of cardiac surgery. After admission, the patient was found to have a typical face look such as frontal bossing, sunken eyes, pointed chin and hypertrophy of nasal tip. Blood biochemistry showed intrahepatic cholestasis and increased alpha-fetoprotein. Abdominal ultrasonography revealed diffuse multiple solid lesions in the liver. And magnetic resonance imaging of the liver indicated that the liver was enlarged and multiple solid space occupying masses. Jagged 1 gene detection showed heterozygosis mutation of c.1205delC. Conclusion Alagllie syndrome complicated with hepatocellular carcinoma in childhood is extremely rare, and early diagnosis and long-term follow-up are of positive significance for its treatment and prognosis.

Objective To investigate the clinical distribution and change in antimicrobial resistance of Acinetobact-er baumannii (A.baumannii)from a hospital between 2011 and 2013,so as to provide guidance for clinical treat-ment.Methods Sources and antimicrobial susceptibility testing results of A.baumannii from a hospital were ana-lyzed statistically.Results A total of 14 705 bacterial isolates were isolated in 2011 —2013,13.59%(n=1 999)of which were A.baumannii isolates,the percentage of A.baumannii in isolated pathogens in 3 years was 12.74%, 13.05%,and 14.85% respectively,which showed a rising trend (χ2 =9.458,P =0.002).The main specimen was sputum (n = 1 541 ,77.09%),bacteria were mainly isolated from patients in respiratory disease department (21 .71 %),surgical intensive care unit (16.26%),and emergency intensive care unit (8.26%).Antimicrobial re-sistance rates of A.baumannii increased year by year(all P <0.05);multidrug-resistant and extensively drug-resist-ant A.baumannii also increased year by year (all P <0.001).Conclusion Isolation rate and antimicrobial resistance rate of A.baumannii strains increase year by year,multidrug-resistant and extensively drug-resistant A.baumannii strains are obvious,which should be paid more attention in clinical department.

Objective To explore the effect of problem-based 1earning (PBL) combined with PICO model in clinical nursing internship teaching.Methods A retrospective case-control study was adopted,133 undergraduate nursing students in grade 2010 were selected as theexperimental group,and 128 undergraduate nursing students in grade 2009 were selected as the control group.The students in the experimental group received a teaching method which combined PBL with PICO model,while the students in the control group received traditional teaching methods.The two groups were evaluated by Objective Structured Clinical Examination (OSCE) and questionnaire survey.Results The OSCE grade and evaluation of teaching method in the experimental group students were higher than the control group,the difference was statistically significant.Conclusions PBL combined with PICO model teaching methods are not only beneficial to cultivate and improve the clinical nursing competency and comprehensive qualities of the nursing students,but also let the students gradually learn and permeate the ideas of any decision made by clinician should be based on the scientific research results,which from the main thought of the evidence-based practice.It can lay a good foundation for going to work in the future,and is also worthy of being popularized and applied in clinical internship teaching of undergraduate nursing students.

Objective To use the method of Meta-analysis to evaluate the effect of the evidencebased nursing in preventing the deep vein thrombosis after orthopaedic surgery,to provide the basis for clinical prevention of DVT.Methods The randomized controlled trials (RCT) on the evidence-based nursing in preventing the DVT were collected using the databases of China National Knowledge Infrastructure (CNKI),Wanfang Periodical Databases,Chinese Science Technology Periodical Databases (VIP) and PubMed and analyzed by RevMan 5.2 software.Results Nine RCTs were included in the study.The results of Meta-analysis revealed that the incidence of the DVT could be effectively prevented by evi-dencebased nursing.Conclusions The evidence-based nursing can reduce the incidence of the DVT after orthopaedic surgery.

Objective To evaluate the significance of human interleukin-31(IL-31)in the pathogenesis of atopic dermatitis and its correlation with pruritus in patients with atopic dermatitis(AD).Methods Twenty-two children with mild to severe atopic dermatitis and 22 age-matched healthy controls were included in this study.Patients and controls were randomly and equally assigned into stimulation and non-stimulation groups.Venous blood samples were obtained from all participants,peripheral blood mononuclear cells were isolated from these samples and cultured with(stimulation groups)or without(non-stimulation groups)staphylococcal enterotoxin B(SEB)for 24 hours.Then,the mRNA expression of IL-31 on PBMCs was assessed via real-time reverse transcription-PCR.ELISA was used to detect the total serum IgE level in these objects.The severity of AD in patients was rated according to scoring atopic dermatitis(SCORAD).The relationship between the mRNA expression of IL-31 and the level of serum total IgE.severity of atopic dermatitis,and degree of pruritus.was evaluated.Results The expression of IL-31 mRNA on non-stimulated PBMCs from patients was 23.2 folds as high as that from the healthy controls(P＜0.01).The stimulation with SEB upregulated the mRNA expression of IL-31 on PBMCs.and the increase on PBMCs from patients was 20.44 times of that from the controls.The total serum IgE level was 260.05 IU/mL(5.9-1131.01 IU/mL)and 17.7 IU/mL(5-140.7 IU/mL)in the Patients and controls respectively(P＜0.01).There was no significant correlation between the mRNA expression of IL-31 and disease severity or total serum IgE level(r=0.07.0.22respectively.both P＞0.05)in patients witll AD.Condusions IL.3 1 is involved in t11e pathogenesis of AD,which is unlikely to be IgE-dependent.SEB can induce the rapid expression of IL-31 on PBMCs of healthy human,and is an important modulator for the production of IL-31.