Background and purpose: Metastatic carcinoma and lymphoma are usually the causes of cervical malignant lymph nodes. This paper was aimed to investigate the different appearances of cervical malignant lymph nodes by 2 dimension and color doppler flow imaging (CDFI) and discuss the role of ultrasenography in diagnosing cervical malignant lymph nodes. Methods: Ninety-nine patients and 40 healthy people were selected as our subjects, among which 54 cases were diagnased as metastatic tumor and 45 cases as lymphoma according to pathology examination. With high frequency transducers, ultrasonography was used to document the shape of cervical lymph nodes, the ratio of long/short axis (L/S), types of echo and hilus of lymph node. CDFI features were also recorded and measured in order to analyze the parameters. Results: Compared with image of normal lymph nodes, the image of cervical malignant lymph nodes showed that the shape tended to be round and the ratio of L/S decreased. In addition, the majority of echo types of malignant lymph nodes was a low level echo and easily became fused. Meanwhile, the image of hilus of lymph node tended to disappear or shift. The lymph node of cases with metastatic tumor was shown to be either calcified or liquefied. The rate of blood flow in the artery was observed to be of high velocity and high resistive index (RI). Between metastatic tumor and lymphoma tumor case, there was significant difference in terms of ultrasonographic and CDFI features. All the above results showed that the features of malignant lymph nodes were significantly different from the normal ones. Conclusion: Ultrasonography could be regarded as one method of evaluating cervical malignant lymph nodes.

Objective To investigate the status of knowledge,attitude and behavior of schistosomiasis control of rural resi-dents in Wanjiang River region after a flood,so as to provide the reference for targeted health education. Methods The multi-stage sampling was applied to select the respondents in rural residents in Wanjiang River region,and the self-designed question-naire was used to investigate the current situation of knowledge,attitude and behavior of schistosomiasis prevention and control of the rural residents. Results The total awareness rate of knowledge about the prevention and control of schistosomiasis was 47.92%. The age,education,family income,relatives and friends with medical background,and health education significantly influenced the awareness rate(χ2=12.76,89.19,18.19,50.83 and 92.60 respectively,all P<0.05). The accuracy rates of at-titude and behavior in schistosomiasis control were 62.89%and 52.37%respectively. Conclusion The awareness rate of knowl-edge about the prevention and control of schistosomiasis,and the accuracy rates of attitude and behavior in schistosomiasis con-trol of the rural residents in Wanjiang River region are all inefficient,and therefore,the targeted health education should be strengthened to decrease the risk of schistosomiasis transmission.

Objective To explore the rehabilitation effect of group education intervention in self-control on schizophrenic patients. Methods 112 schizophrenic patients were divided into study group (56 cases) and control group (56 cases). Two groups were treated with antipsychotics. The control group was subjected to general healthy education, while the study group received education intervention of self-control. All patients of two groups were assessed by Self-care Behavior Questionnaire(SCBQ), Brief Psychiatric Rating Scale(BPRS) and Social Disability Screening Schedule(SDSS) before and affter intervention, and drug-compliance was also assessed.Results After one year, the total score of SCBQ was significantly higher in the study group than in the control group, while the total scores of BPRS and SDSS were significantly lower in the study group than in the control group (P<0.01); Drug-compliance was significantly more in the study group than in the control group(P<0.01).Conclusion Group education intervention of self-control can improve distinctly the ability of self-control disease, have positive effect on remission psychical symptom, and improve the social function and retention psychosomatic healthy.

A method was developed for the determination of four sulfa antibiotics in groundwater, soil and excreta using solid phase micro extraction disks coupled with high performance liquid chromatography. The influence of eluent, different solid phase micro extraction membranes on the recovery of sulfa antibiotics in groundwater was investigated and it was found that when using the mixture of methyl alcohol and 1 . 0% formic acid as eluent, HLB ( divinyl benzene-N-vinyl pyrrolidone polymer ) as extraction membranes, an optimal enrichment effect was obtained. Different pretreatment methods for the 3 kinds of samples abovementioned were also examined. It was found that the signal response values obtained by using mixture of methyl alcohol and 1 . 0% formic acid as base solution of standard or sample solution was higher 8-10 times than that by using methyl alcohol only. Under the optimal conditions, good linear relationships were obtained in the sulfa antibiotics concentrations of 0 . 005-10 . 0 mg/L with the correlation coefficients>0 . 9999;The detection limits of sulfathiazole ( ST ) , sulfadiazine ( SM ) , sulfamethazine ( SM2 ) , sulfamethoxazole ( SMX ) were 1 . 08 , 3. 56, 4. 63 and 1. 84 ng/L(S/N=3), respectively. The enrichment factors for four sulfa antibiotics were 4000 times with solid phase micro extraction disks. The RSD of matrix spiked samples were 0. 1%-0. 4%(n=7). The proposed method was applied to the determination of the four sulfa antibiotics in groundwater, soil and excreta with spiked recoveries of the four sulfa antibiotics in the range of 69 . 80%-117 . 60%.

Objective To explore the correlation of the throid function and malnutrition in maintenance hemodialysis(MHD) patients.Methods Fifty-four MHD patients and 16 normal controls were enrolled as our subjects and named as MHD group and control group.Serum concentrations of total triiodothyronine (TT3),total thyroxine (TT4),free thyroine (FT4),free triiodothyronine (FT3),and thyroid-stimulating hormone (TSH) were measured by enhanced chemiluminescence immunoassay.Their anthropometry,biochemical assays,malnutrition-inflammation score (MlS) and micro-inflammation parameters such as high sensitivity C-reactiveprotein(hs-CRP) were also measured.Results Serum T3,FT3,T4,FT4 concentration in MHD patients were (1.18 ±0.31) nmol/L,(2.61 ±0.62) pmol/L,(100.00 ± 19.96) nmol/L,(8.56 ±0.85) pmol/L respectively,lower than that of control group ((2.95 ± 0.27) nmol/L,(7.12 ± 0.94) pmol/L,(136.25 ± 19.68) nmol/L,(8.89 ± 0.56) pmol/L respectively,P ＜ 0.01).while there was no significant change on TSH (P =0.058).According to albumin nutrient grading standard:the morbidity of malnutrition was 75％ (39/54).The morbidity of malnutrition was 100％ based on the criteria of MIS.Of which,mild malnutrition rate was 29.63％ (16/54),moderate rate for 37.04％ (20/54) and sever rate for 33％ (18/54).The levels of serum creatinine,hemoglobin,serum iron,upper arm circumference,body mass index(BMI),deltoid skinfold,hs-CRP,T3,FT3,T4,FT4,TSH in MHD patients with mild,moderate and serve rate MIS were significant different(P ＜ 0.01).Of 54 MHD patients,32 cases were with micro inflammatory state,accounting for 59.26％ (32/54).There was a positive correlation between FT3 and albumin (P ＜0.01).T3 was related to serum creatinine(P ＜ 0.05).Thyroid function parameters showed a negative correlation with hs-CRP,MIS(P ＜ 0.01).And a negative correlation was seen between nutrition indices and hs-CRP and MIS (P ＜ 0.01).Conclusion Thyroid function can reflect the nutrition status of MHD patients to some degree,and both relate with miro-inflammation.Furthermore,MIS is a useful index for the estimation of malnutrition inflammation status.

Objective To investigate the relationship between clinical presentation and pathological characteristics in HBeAg negative chronic hepatitis B(CHB) patients with steatosis, and to find out the predictors of hepatic inflammation and fibrosis. Methods HgeAg negative CHB patients with (n=56) or without (n=60) steatosis confirmed clinically and pathologically were enrolled in the study. All patients were examined for fasting blood glucose(FBG), fasting insulin (FINS), triglyceride (TG), cholesterol (TC), alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyhransferase (GGT), alkaline phosphatase (ALP) albumin (Alb), globulin(Glb), homeostatic model assessment of insulin resistance (HOMA-IR), HBV-DNA and body mass index(BMI). The association of above parameters with hepatic inflammation, fibrosis and fatty deposition were analyzed statistically. Results It was demonstrated that BMI, FBG, FINS, TG, TC, GGT, ALP , Glb and HOMA-IR were significantly higher in HBeAg negative CHB patients with steatosis than those without steatosis (P<0.05). Whereas the levels of HBV-DNA, Alb, ALT and AST were significantly lower in HBeAg negative CHB patients with steatosis compared with those without steatosis (P<0.05). The hepatic inflammation and fibrosis were aggravated in patients with steatosis. It was implicated that BMI,FBG, FINS, TG, TC, GGT and HOMA-IR(all P values 0.05) were significant predictors for hepatic steatosis, while ALT, AST, Glb and HBV-DNA(all P values <0.05) were significant predictors for hepatic inflammation. And the predictors for hepatic fibrosis were ALT, AST, Alb, Glb and HBV-DNA(all P values <0.05). Conclusions Hepatic steatosis is common in HBeAg negative CHB patients which is positively associated with parameters including BMI, FBG, FINS, TG, TC, GGT, ALP and HOMA-IR. Besides steatosis, the hepatic inflammation and fibrosis are also aggravated in these patients.

Objective To explore the effect of pain management by pain resource nurse (PRN) attending pain nursing group, and to know the patient′s satisfaction. Methods Advanced practice nurse as the lead of the group. The selection of PRN members in the group was made on merit which all have definite responsibility and like pain nursing, established pain management quality control system in group and training,standardized pain management processes and the regulations, educated knowledge and skills of pain management for PRN. Results Patient satisfaction with pain management increased significantly from 82.0%(496/605) to 97.1%(572/589)(P<0.05). Moderate and serious pain rate of patients decreased significantly from 60.0%to 20.0%(P<0.01). The qualified rate of pain assessment increased from 84.9%(514/605) to 95.1%(560/589)(P<0.05). Conclusions The establishment of pain nursing group can not only improve pain management quality and patients satisfaction, but also improve of PRN′s professional behaviors and development of clinical pain nursing .

Objective To explore the clinical manifestations of hypermastigote detected from bronchoalveolar lavage fluid in children with mycoplasma pneumoniae pneumonia (MPP).Methods The clinical data from 18 cases (7 male cases,11 female cases;the age raged from 5 months to 13 years;13 case lived in rural cottage,5 cases lived in town building;the course ranged from 2 to 60 days) of MPP coinfected with hypermastigote were retrospectively analyzed,including the symptomatic and physical examination data, laboratory test, chest imaging features, bronchoscopic manifestation imaging,treatment and prognosis.The clinical characteristics and treatment of MPP coinfected with hypermastigote were analyzed.Results Clinical symptoms showed that 18 cases had cough, 14 cases had fever and 4 cases had asthma;laboratory blood routine test detected that 13 cases had increased leukocytes,5 cases with increased eosinophils;11 cases with increased C reactive protein and 8 cases with increased erythrocyte sedimentation rate.Eleven of 18 cases received immunological examination,which showed that 3 cases had increased IgG,2 cases with increased IgM,5 cases with increased IgA,and 11 cases with decreased ratio of CD4 and CD8;bronchoalveolar lavage fluid test showed that 1 case had increased eosinophils and hypermastigote were detected in 18 cases.High density spotty shadow were seen in chest imaging.Mucosal congestion, attached with white sputamentum, longitudinal folds, floc floating and sputum bolt obstructing within the lumen were seen under the bronchoscopy.The macrolides antibiotics combined with metronidazole (5 cases received metronidazole lung lavage) were effective.Conclusions Hypermastigote is a new type pathogen isolated from the lower respiratory tract in Liaocheng.For patients with MPP who have unsatisfactory response, hypermastigote should be taken into account and combined with metronidazole in therapy for better effect.

Objective:To explore the expression of caveolin-1 (Cav-1) and Chitinase-40 (YKL-40) in acute cerebral infarction and the value of combined detection in prognosis evaluation.Methods:118 patients with acute cerebral infarction admitted to the First Affiliated Hospital of Hebei Northern University from January 2016 to June 2019 were selected as the research objects. According to the cerebral infarction volume, the patients were divided into small infarction group (<5 cm 3), middle infarction group (5-10 cm 3) and large infarction group (>10 cm 3). 108 healthy people were selected as the healthy control group. The serum levels of Cav-1 and YKL-40 were compared in the 3 groups, and the correlation between the degree of cerebral infarction and serum levels of Cav-1 and YKL-40 was analyzed. Receiver operating characteristic curve (ROC) was used to analyze the diagnostic value of the expression levels of Cav-1 and YKL-40 in patients with acute cerebral infarction; the patients were followed up for one year and the prognosis was evaluated by modified Rankin Scale (mRS); the correlation between serum Cav-1 and YKL-40 and prognosis was analyzed. Results:The expression levels of serum Cav-1 and YKL-40 in patients with acute cerebral infarction were significantly higher than those in healthy group ( P<0.001). The serum levels of Cav-1 and YKL-40 were positively correlated with the infarct volume of acute cerebral infarction ( r=0.854, P=0.004; r=0.867, P=0.002). ROC curve analysis showed that the sensitivity, Youden index and area under ROC curve of Cav-1 (21.78 μg/L) combined with YKL-40 (158.69 ng/ml) in the diagnosis of acute cerebral infarction were 85.59%, 0.532 and 0.896 (95% CI: 0.741-0.932), respectively, which were significantly higher than those of single index ( P<0.05). At 8 and 12 months of follow-up, the proportion of death and mRS score in the positive group were significantly higher than those in the negative group ( P<0.05). Conclusions:The serum Cav-1 and YKL-40 levels are significantly higher in patients with acute cerebral infarction. The combined examination of Cav-1 and YKL-40 can improve the diagnostic efficiency and has potential application value for early diagnosis and prognosis prediction of patients.

Objective To investigate the expression of transforming growth factor β1,transforming growth factor beta receptor(TBR)Ⅰ,TβR Ⅱ,Smad4 and C-Jun in rats with nonalcoholic fatty liver disease(NAFLD)and to find out the mechanisms of liver fibrosis in patients with NAFLD.Methods A total of 18 male SD rats were randomly divided into normal control group(n=9)and model group(n=9).The rats in control group were fed with normal diet,and those in model group were fed with fat-rich diet(consisted of 10%lard oil+2%cholesterol).An rats were sacrificed at the 20th week.The levels of TGFβ1,TβR Ⅰ and TβR Ⅱ mRNA were examined by RT-PCR.The expressions of TGFβ1 and Smad4 in liver tissue were detected by immunohistochemistry.The expression of C-Jun protein was detected by Western blotting.Results The NAFLD model was successfully established.The immunohistochemistry examination revealed that TGFβ1 and Smad4 were expressed weekly in control group,but strongly expressed in model group.RT-PCR showed that A values of TGFβ1,TβR Ⅰ and TβR Ⅱ mRNA were 0.46±0.12,5.z4±2.70 and 3.35±1.95,respectively,in model group,which were higher than those in control group(0.21±0.09,1.36±0.77 and 0.52±0.19,all P values＜0.01).The Western blotting results demonstrated that the expression of C-Jun protein in model group(0.93±0.41)was higher than that in control group (0.32±0.25,P=0.001).Conclusion TGFβ1/Smad4 signal pathway might be involved in the development of hepatic fibrosis in NAFLD.Blocking TGFβ1/Smad4 signal pathway will be helpful in treatment of NAFLD.