Objective To evaluate the application effect of continuity care model for hospitalized infertile patients after discharging from hospital. Methods Select 108 cases of infertility patients were randomly divided into trial group and control group, each group of 54 cases, control group given routine nursing intervention, intervention group in conventional nursing care and treatment on the basis of implementing continuity nursing intervention, intervention 6 months after the evaluation of two groups of patients with anxiety, depression, quality of life, and pregnancies. Results The scores of SAS and SDS were (48.32 ± 11.28), (50.62 ± 11.20) points before in the intervention group, and after the intervention (34.63 ± 8.95), (37.68 ± 9.72) points, and there were significant difference(t=-5.478, P<0.05;t=-4.840, P<0.05);before in the intervention , the scores of SAS and SDS were (49.76±13.08), (48.64±12.23) points in the control group, and after the intervention (41.18 ± 12.84), (40.31 ± 10.12) points, and there were significant difference (t=-7.361, P<0.05;t=-4.840, P<0.05), and there were significant differences in two group after intervention (t=6.682, P<0.05;t=7.341, P<0.05). The scores of quality of life were significant differences after intervention in two group, and six months after the intervention, the experimental group intrauterine pregnancy rate is higher than the control group (χ2=46.790, P < 0.05). Conclusions Applying continuity care model e for hospitalized infertile patients can improve the psychological state, reduce depression and anxiety, increase the quality of life and rate of pregnancy.

Objective To investigate the perioperative health care to patients with perineal endometriosis (PME) involving anal sphincter.Method The clinical data of 17 patients diagnosed with PEM involving anal sphincter at the Peking Union Medical College Hospital from January 2009 to June 2013 were analyzed retrospectively.Results The perineal incisions in all cases were satisfactorily healed,without any fatal incontinence or other complications.There was only one case of recurrence,accounting for 5.9%.Conclusion Preoperative psychological nursing,postoperative close observation on the incisions,diet instructions,management of defecation and targeted health education can all contribute to patients’ recovery.

Radiotherapy plays a crucial role in cervical cancer.Intensity modulated radiation therapy is widely used gradually,which allows the photon beam within each field to be modulated and therefore improves the dose distribution by maximizing target coverage and minimizing the damage to normal tissue.Concurrent radiochemotherapy plus brachytherapy are standard therapeutic methods for local advanced cervical cancer.

Objective To evaluate the blood-saving effect of acute hypervolemic hemodilution (AHH) with 6％ hydroxyethyl starch 130/0.4 (HES 130/0.4) in preschool children.Methods Forty ASA Ⅰ patients,aged 3-6 yr,weighing 11.5-22.5 kg,with body height of 78-120 cm,scheduled for orthopedic or general surgeries,were divided into 2 groups by drawing lots:group AHH (n =20) and group control (n =20).6％HES 130/0.4 10 ml/kg was infused over 30 min at a rate of 0.3 ml·kg-1 · min-1 through the internal jugular vein before surgery in group AHH.The fluid balance,blood loss,urine output and blood transfusion during operation were recorded.The blood routine,liver and kidney function and coagulation function (prothrombin time (PT),activated partial thromboplastin time (APTT),fibrinogen (Fib)) were measured before AHH (T0) and at 0,4 and 24 h after AHH (T1-3).Hypokalemia,hypocalcemia and prolongation of PT and APTT during surgery,and pulmonary edema,heart failure and abnormal bleeding from the site in the wound during the perioperative period were recorded.Results The two groups were comparable with regard to the volume of multiple electrolyte solution consumed,blood loss,parameters of liver and kidney function,platelet count and incidences of hypokalemia and hypocalcemia (P ＞ 0.05).The urine output was significantly increased,Hct at T1 and Fib at T1,2 were significantly decreased,PT and APTT were prolonged,and the percentage of patients without allogeneic blood transfusion and incidences of prolongation of PT and APTT were significantly increased in group AHH as compared with group C (P ＜ 0.05).No pulmonary edema,heart failure and abnormal bleeding were found during the perioperative period.Conclusion AHH with 6％ HES 130/0.4 10 ml/kg provides better blood-saving effect in preschool children,has little effect on the internal environment,but prolongs the coagulation time and exerts effect on coagulation function to some extent.

Objective The study was conducted to investigate the acute phase of convulsion related problem on the clinical manifestations,imaging and electroencephalograph (EEG) examination of purulent meningitis.Methods Cluster sampling method was employed to select children in our hospital,a total of 301 cases with purulent meningitis was analyzed retrospectively.Among them,62 cases had convulsion.The incidence of convulsion in the acute phase of the purulent meningitis,risk factors,and prognosis were analyzed.Results The convulsion incidence rate of acute purulent meningitis was 20.60％.The partial seizure was eight cases (12.90％).The secondarily generalized seizure following partial seizure was 15 cases (24.19％).The generalized seizure was 32 cases (51.61％).The convulsive status was 7 cases (11.29％).The EEG abnormality was significantly different between the convulsion group and the no convulsion group (P ＜ 0.05).The incidence of brain organic damage was significantly different between two groups (P ＜0.05).The multivariate unconditional logistic regression analysis showed,cause of disease,first symptom,disturbance of consciousness,obvious signs,and cerebrospinal fluid culture with convulsion were the relevant factors (P ＜ 0.01).Conclusions The most common seizure of purulent meningitis was the generalized seizure.Brain organic damage easily resulted in convulsion of purulent meningitis.The days of hospitalization,cause of disease,first symptom,disturbance of consciousness,obvious signs,and cerebrospinal fluid culture with convulsion were the positively relevant factors.Those positively relevant factors in combination of the clinical manifestations,imaging,and EEG examination in children would play an important role in diagnosis,treatment,and prognosis evaluation of convulsion derived from purulent meningitis.Moreover,convulsion affects the disease recovery in children with purulent meningitis.

Objective To explore the clinical and pathological characters of Xp1 1.2 translocation renal cell carcinoma.Method We screened patients of renal cell carcinoma of PUMCH between Jan.2011 and Dec.2015,6 patients with Xp11.2 translocation renal cell carcinoma were found.There were 2 males and 4 females,with average age of 39 (ranging from 16 to 73 years old).Diameter of tumor ranged from 1.9cm to 19.0cm,and 9.6cra in average.Among which,3 cases were detected by routine physical examination,1 by severe anemia (Hb 66g/L),1 by gross hematuria,and 1 by flank discomfort.Before treatment,2 cases had local metastasis (local lymph node,renal pelvis invasion),1 had distant metastasis (pulmonary metastasis).CT examination showed that the tumors had soft tissue density / low density,with significant enhancment or uneven enhancement in enhanced scanning,and were all considered malignancy.6 patients were all treated with surgeries,of which 5 patients received radical nephrectomy,1 patient received nephron sparing surgery.Result Pathologically,most clear cells arranged in a papillary,nest like structure,with psaamoma bodies in them.Immunohistochemical examination showed that all patients were positive for TFE3.AE1/AE3,RCC,Vimentin,CD10,EMA,P504 were positive in different degree.According to pathological result,all 6 patients were proved to be Xp1 1.2 translocation renal cell carcinoma.After surgery,2 patients received immunotherapy,2 received targeted drug therapy,and 1 received local radiotherapy.The follow-up duration ranged from 9 to 56 months (average 37 months).Among which,1 patient died from tumor recurrence and multiple metastasis 22 months after surgery,1 had pulmonary metastasis 12 months after surgery,and the tumor had no significant progress after receiving targeted drug therapy.All the other patients survive without tumor recurrence.Conclusions Xp1 1.2 translocation renal cell carcinoma predominantly occurs in children and adults younger than 40 years.Arterial phase enhancement is slightly lower for Xp1 1.2 translocation renal cell carcinoma in CT scan than that of renal clear cell carcinoma.Histological features and immunohistochemical staining of TFE3 positive expression are important means of diagnosis of this disease.If necessary,gene detection could be done to make better diagnose.Surgery is preferred treatment option.Metastatic leads to poor prognosis,and need to be supplemented by targeted drug therapy.

Objective To analyze the potential etiologies and risk factors of childhood stroke. Methods This study retrospectively reviewed the clinical data of 159 children who were admitted from Jan.2006 to Jan.2014. Results The 159 children were composed of 100 boys and 59 girls , with median onset age of 1.8 years (ranged from 1 day to 12 years old) and median peak age of 0.9 years (ranged from 3 months to 2.8 years old). Their initial symptoms included limb hemiplegia,language dififculties and convulsion. The common causes included infections found in 46 cases (central nervous system infection in 32 cases, respiratory and gastrointestinal tract infection in 14 case), head injury in 42 cases, vitamin K deifciency in 29 cases, Moyamoya disease in 8 cases, heart diseases in 11 cases, spontaneous hemorrhage in 11 cases and 12 cases of unknown reason. Infectious diseases were the most common cause of children acute ischemic stroke in toddler period;and vitamin K1 deifciency were the most common cause of children hemorrhage stroke in infancy. The most common region of infarction is basal ganglia and middle cerebral artery in neuronal imaging. The median age at the time of diagnosis was 1.4 days. The median time of inhospital was 28 days. The median apex time was 4.3 days. Conclusions Among 159 cases, acute ischemic stroke is much more common than hemorrhagic stroke in children stroke, and the major risk factors are infections and head injury;Vitamin K1 deifciency is a major risk factor in infants with hemorrhagic stroke.

Objective To investigate and evaluate the polymorphism distribution of arsenic(+3 oxidation state)methyhransferase(AS3MT)5'-UTR VNTR in Chinese populations.Methods Genomic DNA was extracted from peripheral blood anti-coagulated with ACD of 1440 individuals in a standard phenol-chloroform protocol.The phenotypes of AS3MT 5'-UTR VNTR were determined by polymerase chain reaction(PCR)associated with agarose gel electrophoresis.Results Of the 1440 individuals,771(53.5%),426(29.6%),211(14.7%),16(1.1%)and 16(1.1%)were carriers of the V2/V3(AB/A2B),V3/V3(A2B/A2B),V2/V2(AB/AB),V2/V4(AB/A3B)and V3/V4(A2B/A3B)genotype,respectively.The AB(V2),A2B(V3)and A3B(V4)allele frequency was 41.9%,57.0%,1.1%respectively.The differences of AB(V2)and A2B(V3)allele frequency were all significant between the northern and southern populations respectively(χ2=23.39,χ2=33.28,P＜0.007).Conclusions In different regions the AB(V2)and A2B(V3)allele frequency is different,the AS3MT 5'-UTR VNTR polymorphism can be used to evaluate the susceptivity of arsenieosis.

Background Econazole nitrate is not effective as an antifungal eyedrop because of its poor intraocular permeability,therefore changing the formulation of econazole nitrate to improve its intraocular permeability become a critical point in the treatment of intraocular fungal infection. Objective The present study was to observe the penetration of 0.5％ econazole nitrate nanoparticles in the corneas and aqueous humors following its topicaladministration. Methods Econazole nitrate nanoparticles were prepared by quasi-emulsion solvent diffusion.Characteristics and size of nanoparticles were examined with transmission electron microscope and laser scatteringmethod,respectively.Econazole nitrate nanoparticles drops (0.5％ )was topically administered in 27 New Zealandwhite rabbits bilaterally,and aqueous humor and corneas were obtained after the application of the eye drops for 5,15,30,45,60,90,120,180,240 minutes respectively to detect the concentration of econazole nitrate with highperformance liquid chromatography (HPLC). The pharmacokinetic parameters were calculated with 3 p97pharmacokinetic computer software.The use of the animals followed the Regulation for the Administration of AffairsConcerning Experimental Animals by State Science and Technology Commission. Results The diameter of thenanoparticles was 50 nm with the round shape and encapsulation efficiency was 96.0％.Econazole nitrate nanoparticlesat the concentration of 0.5％ could be rapidly separated with other elements by HPLC with a lowest quantitativeconcentration of 0.1 mg/L.The mean recovery rates of econazole nitrate nanoparticles were 98.09％ in cornea and 99.66％ in aqueous humor,respectively after topical administration.The peak levels of econazole nitrate nanoparticles in cornea and aqueous humor were achieved at 5 minutes after application ( cornea:40.620 μg/g± 7.756 μg/g;aqueous humor:0.504 mg/L±0.153 mg/L),and its half-life( t1/2 )in cornea and aqueous humor was 23.5 minutes and 18.6 minutes,respectively. Conclusions Econazole nitrate nanoparticles at 0.5％ concentration can remain a feasible bioavailability in ocular tissue and therapeutic level in cornea and aqueous humor.

Aggressive Periodontitis ; therapy ; Humans ; Periodontics ; methods