Objective To evaluate the effect of stage health education on living-relative donor kidney transplantationrecipients.Methods Forty-eightliving-relativedonorkidneytransplantation recipients were randomly assigned to receive stage ( study group,n =24 ) or conventional health education (control group,n =24 ).ResultsIn comparison with the control group,the study group showed better awareness of kidney transplantation and improved satisfaction with nursing ( x2 =8.83,x2 =10.32,P ＜0.05).Conclusions Stage health education improves the awareness of renal transplantation and promotes mental and physical recovery,thus resulting in better quality of life of living-relative donor kidney transplantation recipients.

Objective To evaluate the effect of health education on blood glucose level in patients undergoing renal transplantation.Methods Two hundred and four patients who underwent renal transplantation were randomly assigned to the control group(n =102)and the intervention group(n =102).Participants of the control group received traditional health education,and those in the intervention group received general health education.Food intake,physical exercises.disease-related knowledge,treatment satisfaction,fasting plasma glucose and 2 h blood glucose were assessed at 6 months.Results Daily diet,physical exercises,disease-related knowledge,treatment satisfaction,and blood glucose control were significantly improved in the intervention group(all P＜ 0.05).Conclusion General health education may contribute to the control of hyperglycemia and improve long-term survival of renal transplantation receivera.

PurposeTo evaluate the value of dual-source CT angiography (DSCTA) in the diagnosis of carotid atherosclerosis, and to explore the relationship between carotid atherosclerosis and diabetes mellitus (DM).Materials and Methods 145 patients with ischemic stroke were divided into DM group (n=80) and non-DM group (n=65). All patients underwent DSCTA. The location and characteristic of carotid atherosclerosis were analyzed using curve planE reconstruction (CPR), maximum intensity projection (MIP), multi-plane reformation (MPR) and volume rendering (VR). The differences between two groups were analyzed.Results Compared with non-DM group, the body mass index and high blood cholesterol were higher in DM group (t=6.197,P<0.05;χ2=8.372,P<0.01). The incidence of carotid atherosclerosis and vulnerable plaques were also higher in DM group than non-DM group (χ2=11.617 and 9.388,P<0.01). There was no significant difference between DM group and non-DM group in the location of carotid atherosclerosis (χ2=0.160, 0.509, 0.419 and 0.016,P>0.05). Carotid atherosclerosis was more common in carotid bifurcation and carotid artery siphon.Conclusion DSCTA can demonstrate the location and characteristics of carotid atherosclerosis in ischemic stroke patients with diabetes mellitus. Diabetes is a risk factor for the formation of carotid atherosclerosis, especially vulnerable plaques.

Objective To investigate the diagnostic value of dual-source CT angiography (DSCTA) for vertebrobasilar atherosclerosis in patients with transient ischemia attack (TIA).Methods 80 TIA patients underwent DSCTA.Common data were collected.Vertebrobasilar plaques and stenosis degree were analyzed by using CT reconstruction.Results 152 plaques were found in 69 patients(86.2％,69/80),59 plaques(38.9％,59/152)in unilateral vertebral artery in 31 patients,83 plaques (54.6％,83/152) inbilateral vertebral artery in 28 cases,10 plaques (6.6％,10/152) in basilar artery in 10 patients,among which 51(33.6％,51/152)plaques were hard,69(45.3％,69/ 152)plaques were soft,32(21.1％,32/152)plaques were mixed.There were 31 cases (44.9％,31/ 69) with mild stenosis,27 cases (39.1％,27/69) with moderate stenosis,7 cases (10.1％,7/69) with severe stenosis,and 4 cases (5.8％,4/69) had vascular occlusion.Conclusions Vertebrobasilar atherosclerosis is a common cause of TIA.DSCTA can be used to analyze the vertebrobasilar plaques and stenosis degree.Soft plaques and severe stenosis promote TIA.

目的观察心理康复对焦虑、抑郁症状的疗效。方法对212例具有失眠、慢性头痛、头晕或多系统症状而不能用某一种疾病解释的患者,进行焦虑抑郁量表检测,并随机分为康复组(88例)和对照组(124例)。前者给予心理康复治疗,后者给予药物治疗,比较两者的疗效。结果康复组总有效率90.91%,高于对照组(74.19%)(P<0.05)。结论对综合医院中具有失眠、头痛、头晕或多系统症状而不能用某一种疾病解释的患者,应进行焦虑抑郁量表检测并给予心理康复治疗。

Objective Retrospectively analyze of urate crystal deposition using dual-source CT in asymptomatic hyperuricaemia and symptomatic gout patients.Methods Sixty patients with asymptomatic hyperuricemia (uric acid ≥540 μmol/L) and 48 patients with gout (without any change in the appearance of the limbs and obvious gout nodules) were selected.All patients underwent dual-energy CT imaging.The location number and size were analyzed using CT gout software.Results Eighteen patients with asymptomatic hyperuricemia with urate crystal deposition in limb joints (13 in foot and ankle, 7 in the hand and wrist, 2 in knee), the average size of crystal was (0.12±0.04) cm3.Forty-eight gout patients (28 cases of early gout and 20 cases of late gout and 20 gout cases) had urate crystal deposition (48 in foot and ankle, 39 in hand and wrist, 27 in knee), the average size of crystal was (1.7±0.7) cm3.The number and size of urate crystals deposited in the joints, tendons and ligaments was higher in patients with gout than asymptomatic hyperuricemia (x2=52.076, P＜0.001;t=44.834, P＜0.001).There was no difference between the early gout and late gout in the size of urate crystals (t=0.163, P＞0.05).Conclusion Urate crystals can deposite in asymptomatic hyperuricemia.However, more and larger urate crystals appear in gout patients, there is no difference in size and number of urate crystals between the course duration of gout.

Objective:To report a rare case of renal injury secondary to Strongyloides stercoralis infection, and investigate common pathological subtypes, pathogenesis and differential diagnosis of Strongyloides stercoralis infection-associated renal injury combined with literature. Methods:The pathological features of renal biopsy were analyzed by immunofloruscence, light microscope and electronic microscope. The pathological changes of digestive tract and pathogen morphology were observed through endoscope and digestive tract biopsy. The correlation between clinical-pathological features and pathological changes of kidney and digestive tract was analized.Results:The 26-year-old male patient presented with nephrotic syndrome. The pathological changes of renal biopsy were consistent with minimal change disease with interstitial focal eosinophil infiltration. Laboratory examination showed that the patient had unexplained eosinophilia and increased IgE level. Hence the patient was treated with glucocorticoid. After 2 months of therapy, proteinuria decreased and turned to negative while the patient developed progressive headache, gastrointestinal bleeding and progressive decrease of hemoglobin. Emergency gastroscopy showed extensive congestion and erosion of the stomach and duodenum. Gastric mucosal biopsy showed a large number of slender "s" shape larvae in the mucosa. The patient also had bilateral lung infection, positive Escherichia coli in cerebrospinal fluid and purplish skin rash around the umbilicus. A serious infection of Strongyloides stercoralis was diagnosed. After antibiotics and anthelmintic treatment, gastrointestinal symptoms and headache disappeared, and no parasite was found in endoscopy. No recurrence of nephrotic syndrome was found during 2 years of follow-up. Conclusions:Strongyloides stercoralis infection might first present with nephrotic syndrome with handful hints of digestive tract combined with eosinophilia and increased IgE levels. Therefore, in epidemic areas or patients with suspicious exposure history, it is necessary to exclude Strongyloides stercoralis infection before immunosuppressive therapy to avoid fatal complications.

Objective: Non-suicidal self-injury (NSSI) in adolescents appeared prevalent and multifactorial. This study was to examine the associations between exposure to suicidal behaviors and NSSI in the Chinese adolescents. Methods: Participants included for analyses were 5 154 adolescent students who participated in the baseline survey in 2015 and the first follow-up survey in 2016 of the Shandong Adolescent Behavior and Health Cohort, but with no history of NSSI at the baseline survey. A self-administered structured questionnaire was used to collect data on demographics, behavioral and emotional problems, lifetime and last-year NSSI. Data on the history of exposure to suicide attempt or death of a family member, friend, or close acquaintance were also collected. Multivariate logistic regression methods were used to examine the associations between exposure to suicidal behaviors and NSSI. Results: In the baseline survey, mean age of the 5 154 participants was (14.49±1.48) years, with 48.5% of the participants as girls. Of the participants, 9.0% reported having been exposed to suicidal behaviors, including 6.0% reported to suicide attempt, 4.9% to suicide death, 7.3% to suicidal behaviors of friends/close acquaintances, and 3.1% to suicidal behaviors of relatives. The prevalence rates of NSSI in the last year were significantly higher in adolescents who had been exposed to suicidal behaviors than those who had not (P<0.05). Results from the multivariate logistic regressions showed that exposure to suicide death (OR=1.91, 95%CI: 1.22-3.01) or to suicidal behaviors of relatives (OR=1.79, 95%CI: 1.02-3.12) were both significantly associated with the increased risk of NSSI. Conclusions Experiences related to exposure to suicide-death or suicidal behaviors of relatives were associated with increased risk of NSSI in adolescents. After the suicide events, psychological counseling and health education programs set for high-risk groups were helpful in promoting physical and mental health and preventing the attempt of self-injury in teenagers.

Objective To evaluate the clinical application value of multi-slice helical CT volumetric (VH) scanning in lumber spine. Methods One thousand of patients with back and leg pain who underwent CT examinations were selected as subjects. We simulated the traditional protocol of single-slice(SS) discrete scanning for L3/4, L4/5, and LS/S1 intervertebral discs. The VH scanning mode was performed with 120 kV, 210 mAs,pitch of 1.5 and coverage of 97. 5 mm. The simulated SS scanning mode was performed with 120 kV, 240 mAs and coverage of 45.0 mm. The diagnostic outcomes and the radiation doses were compared between the two scanning modes. Two groups doctors observed ten terms, including the osseous spinal stenosis,narrowed intervertebral space and so on in two scanning modes respectively. Then consistency analysis of the data was carried out. Results The VH scanning mode showed far more features than the SS mode. The detection rates of the VH mode in the osseous spinal stenosis, narrowed intervertebral space,herniated nucleus pulposus, narrowed lateral recess, vertebral lesion, hypertrophy of L5 transverse process,abnormal direction of facet, facet degeneration, lumbar spondyloschisis, and paraspinal soft tissue were 11.8% (n =118), 38. 5% (n =385), 9. 3% (n =93), 46. 8% (n =468), 31.4% (n =314), 5.7% (n =57), 25.4% (n = 254), 49. 7% (n = 497), 9.9% (n = 99), and 0. 6% (n = 6) respectively, while the detection rates of the SS mode in ten terms were 5.6% (n = 56), 0, 0. 6% (n = 6), 27. 9% (n = 279),22.4% (n =224), 1.2% (n = 12), 16.7% (n = 167), 37.2% (n =372), 0.5% (n =5), and 0.2%(n = 2) respectively. The difference between the two groups had statistically significance (average P <0.05), except the paraspinal soft tissue abnormal (P > 0.05). The detection rates of the VH mode were higher than the SS mode in the osseous spinal stenosis, narrowed intervertebral space, herniated nucleus pulposus, lumbar spondyloschisis, being 6.2% (n = 62) , 38. 5% (n = 385) , 8.7% (n = 87), and 9.4%(n =94), respectively. In addition, VH mode only partially showed the articular facets, narrowed lateral recess, hypertrophy of L.5 transverse process, and paraspinal soft tissue. We could not acquire the imaging slices paralleling to intervertebral discs in SS mode in 467 patients (46.7%) with lumbosacral angle greater than 35°. The radiation dose of VH mode (164.9 mGy/em) was slightly higher than SS mode (147.0 mGy/cm) Conclusion MSCT VH scanning mode can significantly improve the diagnostic rate of lumbar spine diseases compared with SS mode, and was not restricted by the lumbosacral angle with slightly increasing radiation dosage.

From December 2016 to February 2018,5 patients with type Ⅲ or mass type cesarean scar pregnancy (CSP) were treated in Zhejiang Taizhou Hospital.The clinical features,imaging findings and disease outcome were retrospectively analyzed.There were 3 cases of type Ⅲ and 2 cases of mass type,which were diagnosed by transvaginal ultrasound.The CSPs were resected with combination of laparoscopy and hysteroscopy,the average intraoperative blood loss was 80 ml (50-100 ml) and there were not postoperative complications.The average length of hospital stay was 9.4 days (8-12 d).Postoperative serum β-hCG returned to normal in average 22 days (14-30 d),and the menstruation recovered in 22-39 days after operation.The data indicates that resection of type Ⅲ or mass type caesarean scar pregnancy with a combination of laparoscopy and hysteroscopy is an effective treatment.