Objective To assess the risk of malnutrition in elder home-care patients through mini nutritional assessment (MNA) and study the correlations between total MNA score and 18 individual questions in this patient group.Methods In May 2011,62 elder home-care patients from our center answered the MNA questionnaire.And the results were used to analyze the correlations between total MNA score and individual questions and the correlations among MNA classifications and body mass index(BMI),mid-arm muscle circumference (MAMC) and calf circunference (CC).Results According to MNA,18％ were malnourished ( 11/62 ),47％ at risk of malnutrition ( 29/62 ) and 35％ well-nourished ( 22/62 ) ; BMI,independence,mobility,neuropsychological problems,ingesting method,MAMC,CC and selfperceived nutritional status,self-perceived health status showed strong correlations with total MNA score (0.601,0.600,0.666,0.611,0.627,0.618,0.726,0.612,0.672,P ＜0.05).And weight loss within a month,number of daily meals and intake of drinks showed weak correlations with total MNA score (0.35,0.319,0.288,P ＜ 0.05 ).Positive correlations existed among MNA classifications and BMI,MAMC,CC (15.45,19.85,31.89,P＜0.05).Conclusions The elder home-care patients have a high risk for malnutrition.Half of 18 individual questions are strongly correlated with total MNA score in this patient group.

ObjectiveTo analyze the dead reasons in treatment of acute myocardial infarction (AMI) by emergent percutaneous coronary intervention (EPCI) during perioperation. Methods The clinical characteristics of the dead patients,results of EPCI and reasons of death were retrospectively analyzed in 473 patients with AMI who received EPCI treatment during March 2004 to March 2011. ResultsAmong the 18 cases(3.8％)dead patients,there were 8 case with three-vessel lesions,5 cases with two-vessel lesions, 2 cases with single vessel lesion and 3 cases with left main lesion. Nine patients were accompanied with hypertensions,5 cases with diabetes mellitus, 1 case with old myocardial infarction, 2 cases with old cerebral infarction, 1 case with chronic obstructive pulmonary disease complicated by severe pneumonia, and 1 case with chronic renal insufficiency. Nine patients died of cardiogenic shocks , 4 cases (22. 2％) of heart ruptures, 2 cases (11.1％) of noreflow,1 case (5.6％) of massive hemorrhage of the upper alimentary tract, 1 case (5.6％) of respiratory failure and 1 cases (5.6％) of refractory ventricular fibrillation.ConclusionsPrimary reasons for perioperative death were cardiac shock and heart rupture in treatment of acute myocardial infarction by EPCI. Multi-vessel lesion, complications with hypertensions and diabetes mellitus may serve as succumbed factors of death.

Objective:To identify differentially expressed proteins related with malignant transformation of esophageal squamous cell carcinoma (ESCC) using proteomic analysis. Methods:Two-dimensional gel electrophoresis (2-DE) and matrix-assisted laser desorption/ionization timE-of flight mass spectrometry (MALDI-TOF-MS) in combination with protein database searching were used to determine and identify differentially expressed proteins in esophageal cancer cell lines (EC1, EC18, and EC109) and immortal cell line (NECA-E6E7-hTERT). Western blotting and immunocytochemistry were used to verify the differential expression of annexin 2 in esophageal cancer cell lines and immortal cell line (NECA-E6E7-hTERT). Real-time fluorogentic quantitative PCR(RFQ-PCR) was performed to analyze the expression level of annexin A2 mRNA.Results: A total of 15 differentially expressed proteins were identified with more than 5 folds difference. Among them three proteins were down-regulated and 12 proteins were up-regulated. Western blotting and immunocytochemical analysis verified the down-regulation of annexin A2 protein in ESCC cell lines. However, differential expression pattern of annexin A2 mRNA was not consistant with its protein expression in ESCC cell lines and immortal cell line (NECA-E6E7-hTERT). Conclusion:The findings provide important clues for identifying the candidate biomarkers for high-risk population screening and early diagnosis of ESCC. Post-translative regulation/modification contributes to the down-regulation of annexin A2 protein.

To enhance primary and secondary stroke prevention, the Stroke Prevention and Control Project committee of the National Health Commission launched since October 2017 a nationwide training program for cerebrocardiac health advisors in the country. The authors introduced the standardized training system for such advisors, and the health management plan for stroke patients, in an effort to provide full-course health management scheme for stroke patients, and explore a stroke management model led by cerebrocardiac health advisors. Such efforts were designed to promote effective implementation of integrated prevention and control strategies for stroke, and provide a reference for the clinical practice of cerebrocardiac health advisors in a comprehensive and in-depth manner.

Stroke is one of the main causes of mortality, long-term physical and cognitive impairment in China. In order to meet the challenge, Stroke Prevention and Treatment Project of the National Health Commission(SPTPC) was established in April 2011 in the Ministry of Health. In 2016, SPTPC issued a work plan of stroke center hospital. In order to shorten the time of pre-hospital, the SPTPC established the stroke center network, stroke map and stroke green channel to create "the three 1-hour gold rescue circle" to form a hierarchical stroke diagnosis and treatment system. The current construction of the Chinese Stroke Center is divided into two levels and four layers. As of December 31, 2018, SPTPC has certified a total of 310 advanced stroke centers, including 30 demonstration advanced stroke centers and 280 advanced stroke centers, and 127 stroke prevention centers, including 85 demonstration stroke prevention centers and 42 stroke prevention centers. The median time from admission to intravenous thrombolysis (DNT) at the advanced stroke center was decreased by 13.2% (53 min vs. 46 min) in the fourth quarter of 2018 as compared with that in the first quarter of 2017.The national thrombolytic rate of acute ischemic stroke was increased 3.24 times (1.78% vs. 0.42%) in 2017 compared that in 2010. In the next step, SPTPC will vigorously promote the construction of stroke centers and graded diagnosis and treatment mechanisms, consolidate quality control and standardization, increase the scope of influence of mobile stroke and remote diagnosis and treatment, and further improve the construction of stroke center systems with Chinese characteristics.

Objective To explore the situation as well as influence factors of life quality situation of soldiers of the field operations and to provide evidence for its improvement .Methods Cluster random sampling was taken .A total of 616 soldiers from North China , Central China and Southern part of China were investigated by WHOQOL-BREF(Chinese version) and Perceived Social Support Scale (PSSS).Database was established on Epidata 3.0 and was analyzed using SPSS 20.0.Results Informants got an average score of ( 57.99 ± 8.62) points in life quality, with the scores in psychology and social relationship field exceeding and in environmental field being inferior to those of the national norm (t=8.609,7.609,12.898;P<0.01).Difference of investigators with different education background and from family of different income were significant ( t=2.501, 3.373;P<0.01).Soldiers social support had an average score of (63.14 ±11.40)points;each domain of quality of life and dimensions of social support were positively correlated (r>0.3,P<0.01).Conclusions The general life quality of soldiers of the field operations is satisfactory .Education background , family income , and social support are crucial influence factors on life quality of soldiers .Quality of life is closely associated with social support .To advance social support , especially support from others is the key action to improve their life quality .

Objective? To explore the effects of nursing project management on reducing the incidence of red buttock in neonates. Methods? The data of 289 neonates hospitalized in Peking University Third Hospital between February and April 2018 were collected as the control group by convenient sampling. The causes of red buttock were identified, and targeted measured were developed for continuous quality improvement. Another 333 neonates hospitalized from June to August 2018 were selected as the treatment group, who received nursing care using the nursing project. The incidence rate of red buttock was compared between the two groups. Results? After the nursing project was implemented, the incidence rate of red buttock was reduced from 13.15%(38/289) in the control group to 4.50% (15/333) in the treatment group, and there was statistically significant difference between the two groups (P＜0.01). There was no III red buttock in the treatment group. Conclusions? The nursing project enables the nurses to have a better command of the knowledge about red buttock in neonates, empowers them to pay attention to and prevent red buttock in neonates, improves their standardized operations and level of expertise, enhances the neonates' comfort, and promotes the quality of nursing service in neonatal wards.

Objective:To investigate the factors affecting willingness of pregnant and parturient women for epidural labor analgesia and to provide the basis for further promoting epidural labor analgesia.Methods:Using the convenient sampling method, a total of 225 parturient women who underwent vaginal delivery in Department of Obstetrics in Peking University Third Hospital from March to May 2019 as the research objects. General information questionnaire, Questionnaires on Information Sources of Epidural Labor Analgesia and Suggestions of Medical Staff, Relatives and Friends for Epidural Labor Analgesia and Epidural Labor Analgesia Brief Scale were used to investigate them. A total of 225 questionnaires were distributed and 214 valid questionnaires were returned.Results:Among the 214 parturient women, 106 pregnant women (49.53%) had willingness for epidural labor analgesia. The results of binary Logistic regression analysis showed that gravidity, whether or not epidural labor analgesia was used and belief of epidural labor analgesia were the influencing factors of willingness of pregnant and parturient women for epidural labor analgesia ( P<0.05) . Conclusions:In the future, it is necessary to strengthen the education of medical staff on the professional knowledge of epidural labor analgesia for pregnant women and improve the belief of epidural labor analgesia for pregnant women, so as to further promote epidural labor analgesia.

Objective:To explore the risk factors of postpartum hemorrhage in parturients undergoing vaginal delivery with a second child and establish a risk prediction model.Methods:Using the convenient sampling method, a total of 2 500 parturients undergoing vaginal delivery with a second child who underwent regular prenatal examinations at Peking University Third Hospital from July 2019 to March 2023 were selected as the research objects. According to the amount of blood loss, parturients with blood loss greater than or equal to 500 ml within 24 hours after delivery were selected as the case group ( n=278), while parturients with blood loss less than 500 ml within 24 hours after delivery in the same period were selected as the control group ( n=2 222). Univariate analysis and binomial Logistic regression were used to analyze the influencing factors of postpartum hemorrhage in parturients with vaginal delivery with a second child. Based on the selected risk factors, a nomogram prediction model was established using R software, and the consistency of the model was tested. Results:The incidence of postpartum hemorrhage in 2 500 parturients undergoing vaginal delivery with a second child was 11.12% (278/2 500). Binomial Logistic regression analysis showed that in in vitro fertilization-embryo transfer, pre-delivery body mass index, lateral perineal incision, neonatal weight, placenta previa, placenta implantation and manual extraction of placenta were the influencing factors for postpartum hemorrhage in parturients undergoing vaginal delivery with a second child ( P<0.05). According to the influencing factors, a nomogram model was established to predict the probability of postpartum hemorrhage in women who gave birth to a second child. The C- index of the prediction model was 0.706, the area under the receiver operating characteristic curve was 0.706, and the χ 2 value of the Hosmer-Lemeshow goodness-of-fit test was 7.720 ( P=0.461) . Conclusions:In vitro fertilization embryo transfer, pre-delivery body mass index, perineal lateral resection, neonatal weight, placenta previa, placental implantation and manual extraction of placenta are risk factors for postpartum hemorrhage in parturients undergoing vaginal delivery for a second child. The prediction model constructed based on risk factors has certain accuracy and clinical value for predicting postpartum hemorrhage in parturients with vaginal delivery of a second child.

Objective: To summarize the treatment options for congenital maxillary lateral incisor agenesis (MLIA). Methods : Review the literature, summarize the current treatment options and advantages and disadvantages of various methods of MLIA, and analyze cases. Results : When a patient′s occlusion and other conditions are suitable for space closure and canine substitution, closure of the gap is the recommended method, as it has good aesthetic results and leads to good periodontal health. However, when closure cannot be performed, a dental implant has a strong advantage compared with other restoration methods. When planning implants for MLIA patients, doctors should carefully select the correct surgery time and take care with the implant position to obtain good results. Conclusion In the choice of a treatment plan for MLIA, we need to use the concept of multidisciplinary combined treatment to obtain a more satisfactory treatment effect with regard to aesthetics and function.