ObjectiveTo investigate risk factors for colorectal adenoma.Methods1260 subjects who received health check-ups were included.A questionnaire on life style was answered and anthropometric measurements including height, weight, waist circumference and blood pressure were taken.Fasting venous blood was obtained and fasting plasma glucose, total cholesterol, triglycerides(TG), highdensity lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) were measured.Fatty liver was diagnosed by ultrasonography. Colonoscopy was performed on each subject. Categorical data were compared using Pearson's chi-squared test, and multivariate logistic regression analysis was used to estimate the strength of association between the colorectal adenoma and various factors. ResultsThe frequency of colorectal adenoma was significantly higher among males, older patients( ≥55 years), current smokers and subjects with less physical activity, abdominal obesity, fasting hyperglycemia or fatty liver (x2 =4.355, 11.549, 4.440, 4.608, 6.211, 4.510, 4.156, P＜0. 05). Male sex (OR: 1.61,CI:1.13 -2. 57), old age (OR: 4.41,CI:3.32- 10.27)and abdominal obesity (OR: 1.75,CI:1.21 -2.86)were independent risk factors for colorectal adenoma. However, the frequency of colorectal adenoma was not different in subjects above 55 years old according to gender and abdominal obesity( x2 = 1. 139, 3. 413 ,P ＞0. 05 ). ConclusionsAbdominal obesity, old age and male sex were significantly associated with colorectal adenoma. However, the effect of abdominal obesity and male sex on the development of colorectal adenoma is less significant in subjects above 55 years of age. It is especially important for people under 55 years old to prevent colorectal adenoma by avoiding abdominal obesity.

Objective To find out the nurse's cognitive level of the postoperative pain management and its relevant elements,and influence of intervention measures on their postoperative pain management,so that can provide a theoretic basis for a more effective postoperative pain management.Methods The grounded theory research method taken from qualitative research Was mainly used,and triangulation was applied in collecting the information,such as observational method,interviewing method among nurses and collecting questionnaire among nurses and patients.In addition,the information was analyzed by using the constant tomparative method,generalized the relative elements influencing the postoperative pain managemen,summarized the intervention measure.In the end.analyzed comparatively the change of the nurses'knowledge and behavior of the postoperative pain management before and after intervention.Results Surgical nurses'knowledge and behavior of the postoperative pain management was improved in various degrees.The difference of the data has statistical significance.Satisfaction degree of patients improved and the theoretical model included conceptual structure,contributory factors and results.Conclusions The advance of the surgical nurse's self-awareness can improve the level of the postoperative pain management.

Objective To compare the model for end-stage liver disease (MELD) and PT in survival prediction of hepatitis B patients with acute-on-chronic liver failure. Methods One hundred and thirty-nine hepatitis B patients with acute-on-chronic liver failure were divided into survival and death group, and evaluated by MELD and FT. The area under ROC curve was used to compare the MELD and PT. The mortality was observed within 3 months. Results The MELD score and PT of survival group was 25.09 ± 3.92 and (26.46 ± 6.46) seconds respectively, and those for the death group were 36.25 ± 6.42 and (40.78 ± 10.80) seconds. The differences were of statistical significance ( P < 0.01 ). MELD score showed significant correlations with PT(r =0.824, P <0.01). The area under ROC curve was 0.936 (95% CI 0.895 ± 0.977 ) on MELD score and 0. 890 (95 % CI 0.839 ± 0.941 ) on PT, and there was no significant difference between them. Conclusions Both MELD score and PT can accurately predict the short-term prognosis of hepatitis B patients with acute-on-chronic liver failure. The validity of prognosis by MELD is similar to PT. The mortality increases with the MELD score and PT increasing.

The incidence of biochemical recurrence after radical prostatectomy varies significantly and depends on numerous well-known prognostic factors. It likely occurs in at least 30%~40% of patients who were diagnosed as localized disease and received radical prostatectomy. Because the clinical significance of biochemical recurrence is often unclear and other predictive factors relative to the recurrence are uncertain, it is difficult to select the best treatment for the patients who might relapse in the future. This review examines some of the issues associated with biological recurrence and attempts to shed some light on this common but controversial clinical scenario. Some treatment strategies were discussed in this article including salvage radiotherapy after radical prostatectomy, watchful waiting, and hormonal therapy.

Henoch-Sch?nlein purpura nephritis (HSPN) is the most common secondary glomerular disease in children. The clinical manifestations of HSPN vary from microscopic hematuria, microalbuminuria to renal dysfunction even end stage renal disease which is needed to rely on long-term renal replacement therapy, thus affecting the quality of children life seriously. In recent years, the incidence of Henoch-Sch?nlein purpura continues to increase, which should be paid more attention. There are many studies about the treatment of HSPN both at home and abroad, yet no certain conclusion is drawn because of the inconsistent results. We advocate stepped therapies, that is, the appropriate regimens are chosen based on the clinical manifestations and renal pathology in children. For severe HSPN, we recommend multi-drug intensive therapy combined with other methods such as plasma exchange to alleviate the symptoms.

Objective To explore the quality of life (QoL) among the female condyloma acuminatum patients.Methods 118 female condyloma acuminatum patients were interviewed face-to-face by the well-trained nurses with questionnaire including SF-36 Chinese version,the t-test and x2 test were used to compare the scale scores of SF36 between the patient and control groups.Results There were 101 eligible questionnaire,the scale scores of physical function(PF) and bodily pain(BP) were highest in the patient group,the scale score was (92.9 ± 10.5)points and (75.0 ± 1 1.2) points,respectively.Role limitations due to emotional problems (RE) was the lowest with the scale score only(50.8 ± 13.7)points.All scale scores of SF-36 in patient group,except PF(no statistical significant),were lower than that in the control group (all P ＜ 0.01).Conclusion In the female condyloma acuminatum patients,the QoL is lower significantly than that in the control group,especially in emotional scales.

Objective To investigate the knowledge of osteoporosis and its related behavior in middle-aged and elderly people.Methods A total of 1199 residents aged≥45 years in Hangzhou community were investigated by health survey questionnaire of osteoporosis.Results There were statistically significant differences in osteoporosis symptom scores according to ages (aged 45 to 59 years,6.38±2.64; aged 60 to 74 years,5.69±2.83; aged over 75 years,4.43±2.54),and according to education background (middle school or below.4.56± 2.01; secondary school,6.07±2.45; university or higher,8.25±2.69),and according to occupation (mental labour,5.89±3.21;manual labour,4.57 ± 2.36),and residence (city,6.12 ± 3.32 ; countryside,4.34 ± 2.25) (F/t =14.59,26.94,6.29,8.35,respectively,P＜0.01).There were significant differences in types ofexercise between rural and urban population (no exercise or little exercise,30.4％ vs.32.9％; light burden movement,64.4％ vs.53.5％; weight-bearing exercise,5.2％ vs.13.6％; x2 =22.13,P＜0.01).The significant food intake differences were found between rural and urban residents (milk,30.2％ vs.38.3％ sea-food,28.2％ vs.35.7％; bean-products,48.3％ vs.56.1％; fruit,52.6％vs.62.5％; coffee,3.2％ vs.7.4％; x2=8.55,7.77,7.21,19.37,10.14,respectively,all P＜0.01).Conclusions Health education should be individualized based on age,education level and occupation.The elderly and low education groups should be concerned.We should shift the focus of publicity and education to the countryside and enhance the awareness of osteoporosis prevention in order to build a healthy lifestyle.

[Objective] To observe the therapeutic effect of Shoutai Pill and Shixiao Powder for the treatment of threatened abortion with kidney deficiency and blood stasis. [Methods] Sixty inpatients and outpatients for quieting fetus in gynecology department of the First Affiliated Hospital of Guangzhou University of TCM were equally divided into 3 groups: group A was treated with Shoutai Pill and Shixiao Powder, group B with human chorionic gonadotropin (HCG) and group C with Shoutai Pill, Shixiao Powder and HCG. The effect on quieting fetus was evaluated by observing the disappearance time of symptoms such as vaginal bleeding, abdominal pain, lumbar ache, lower abdominal heaviness and distension. Changes of blood and urine HCG level and type B ultrasonic image were also examined to observe the effect and safety of Chinese medicine. [Results] The effective rate was 95% in group A, 70% in group B and 100% in group C, the difference being significant ( P0.05) . The result of follow-up showed that no terata was found in the three groups. [Conclusion] Chinese medicine with the actions of tonifying kidney and activating blood-stasis can prevent miscarriage and is safe without toxic and side effects.

Introduced and analyzed in the paper are a reform made in Suichang county of Zhejiang province,in which a general community health center is established as an affiliate to the county TCM hospital which oversees the medical personnel,financial and properties of primary health centers in the country.An analysis of the merits and setbacks of the practice,the authors hold that the reform to build vertical medical consortiums between county-level public hospitals and primary health centers should emphasize the principles of “Consolidating the primary level and benefiting the people”,keep the rights and obligations consistent,and emphasize functional integration and resources sharing in terms of patient flow,personnel,facilities,technology,information and management.

OBJECTIVE:To evaluate the application of cost-utility analysis in health area of China in recent year. METH-ODS:From CNKI,Wanfang and VIP database,settingcost utilityorcost-utilityastitleorkeyword,related literatures were retrieved during Jan. 2011-Dec. 2015,with subject field ofmedical science and technologyin CNKI,medical sciencein Wanfang database,clinical medicineChinese medicinepreclinical medicinepreventive medicine hygieneorpharmacyin VIP. The comprehensive evaluation involved research design,research perspective,cost measurement,utility index and measure-ment method,cost-utility analysis index,discount and sensitivity analysis. RESULTS:A total of 31 literatures meeting inclusion cri-teria were selected,including 12 prospective studies,9 retrospective studies,9 Markov model studies,1 mixed study. Thirteen lit-eratures worked in medical institutions. Seven literatures explicitly mentioned research perspective;most literatures only measured direct cost(19 literatures)and adopted QALY as utility index(27 literatures). Twenty eight literatures described measurement meth-od of utility index(direct measurement,indirect measurement or literature method)in detail. More than half(16 literatures)analyzed cost-utility by using cost-utility ratio(CUR);7 literatures adopted incremental cost-utility ratio(ICUR)and 6 literatures adopted both CUR and ICUR. Five literatures used the threshold of ICUR. Eleven literatures described discount,and the majority was Markov mod-el study. Sensitivity analysis was conducted in 16 literatures,among which 11 literatures adopted single factor analysis. The most com-monly involved influential factor was cost,followed by utility value and discount rate. CONCLUSIONS:Cost-utility analysis has been widely used in China,but the quality and normalization of studies have much room for improvement. Learning more experiences from international researches can help to promote the quality of domestic studies,guide the practice of clinical rational use of drugs and sup-port the government decision-making process and medical insurance payment in the future.