Objective: To investigate the quality of life (QOL) and its influence factors in the scattered elderly in Shanghai, and to evaluate the effect of nutrition status on the QOL. Methods: Ninty-five randomly-selected elderly were investigated with QOL questionnaire, food frequency questionnaire and 24 h dietary recalls, their nutrition status were awarded by nutrient intake and medical examinations. Results: The percentage of poor, moderate and good QOL were 1.05%, 61.05% and 37.89%. The significant influence factors of QOL were health status, nutrition status, livelihood satisfaction, mentality health, family harmony, medical examination and income. The main nutrition intake of the 95 cases were sufficient, such as energy, protein, but the intake of diet fat and salt were overtaken. The rate of overweight and obesity were 26.3% and 40.0%. Conclusion: Nutrition status is the main influence factor of QOL in the elderly. To improve the QOL of the elderly, health education and balance nutrition guidance should be strengthened.

Objective:To study the expression of IFN-γ,IL-4 and IL-17 in peripheral blood of patients with oral lichen planus(OLP). Methods:The level of IFN-γ,IL-4 and IL-17 in peripheral blood were detected by ELISA in 60 OLP patients(including 30 erosive ca-ses and 30 non-erosive cases)and 25 healthy volunteers(controls).Data were statistically analyzed by SPSS 13.0.Results:(1 )The level of IFN-γin serum of patients with non-erosive OLP and erosive OLP were significantly lower than that in the controls(P<0.01);while the level of IL-4 in the patients were significantly higher than that in the controls(P<0.01),and the IFN-γ/IL-4 ratio in non-ero-sive OLP and erosive groups were significantly lower than that in the control group(P<0.01);(2)The level of IL-17 in erosive OLP pa-tients was significantly higher than that in the controls(P<0.05),while no statistical difference was seen between non-erosive OLP group and the control group(P>0.05).Conclusion:The down-regulated level of IFN-γand up-regulated level of IL-4,which result in the decrease of IFN-γ/IL-4 ratio,might be one of the immune etiological factors of OLP,while the up-regulated level of IL-17 protein in OLP may be mainly related with the inflammatory processes of OLP.

Objective To investigate the risk factors for deep vein thrombosis (DVT) of lower limbs after laparoscopic surgery.Methods A total of 230 patients underwent laparoscopic surgery were selected in Huanggang Central Hospital from January 2014 to August 2016.The patients were divided into DVT group and non-DVT group according to DVT of the lower limbs,and the related risk factors for DVT of lower limbs after laparoscopic surgery were analyzed.Results In the 230 patients,there were 10 patients with DVT of lower limbs and 220 patients without DVT of lower limbs,the incidence of DVT of lower limbs was 4.35％ (10/230).Logistic regression analysis showed that age ≥40 years old,operation time ≥120 min,postoperative ambulation time ≥ 30 h,the intraoperative position of high-head and low-foot,plasma D-Dimer level ≥0.5 mg · L-1 were the independent risk factors for DVT of lower limbs after laparoscopic surgery (P ＜ 0.05).Conclusion There is a certain incidence of DVT of the lower limbs after laparoscopic surgery.The effective prevention measures should be taken to reduce the incidence of DVT after laparoscopic surgery according to the related factors of DVT.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Catheter Ablation ; methods ; Endoscopy ; Epistaxis ; surgery ; Female ; Humans ; Male ; Middle Aged ; Young Adult

Objective To study the synthesis and degradation of collagen at the transcription level during liver fibrosis in rabbits with schistosomiasis japonica. Methods New Zealand rabbits infected with Schistosoma japonicum cercariae were served as animal models of liver fibrosis. The liver specimens were collected through operations at 4, 6, 8, 10, 12, 16, 20, 24 and 28 weeks after infection. TypeⅠcollagen, type Ⅲ collagen, type Ⅳ collagen, MMP\|1 and MMP\|9 mRNA levels of liver tissue were detected by RT\|PCR plus dot blotting, and the size of egg granulomas and the degree of liver fibrosis were measured by histopathological examinations. Results TypeⅠcollagen, type Ⅲ collagen, type Ⅳ collagen, MMP\|1 and MMP\|9 mRNA levels increased simultaneously in the early stage after the infection, mostly reaching their peaks at 10 weeks after infection. Compared with normal controls, type Ⅰ collagen, type Ⅲ collagen, type Ⅳ collagen, MMP\|1 and MMP\|9 mRNA levels increased by 12\^0 , 11\^0 , 6\^6 , 10\^0 and 11\^0\|fold, respectively, coinciding with the changes of egg granulomas. Thereafter, both collagen and collagenase mRNA levels decreased. TypesⅠ, Ⅲ and Ⅳ collagen mRNA levels declined to 2\|fold to 3\|fold compared with normal controls ( P 0\^05) at 28 weeks. This study showed that the synthesis and degradation of collagen remained dynamic balance in the early stage of schistosomiasis, while in the later stage the metabolism of collagen synthesis was higher than that of collagen degradation. Conclusion It was confirmed at the transcription level that when the metabolism of collagen synthesis was higher than that of collagen degradation in rabbits with schistosomiasis japonica, liver fibrosis might be produced.

Humans ; Occupational Diseases ; prevention & control ; Occupational Health Services ; organization & administration ; Trichloroethylene ; adverse effects

Objective To investigate the relationship between acute biliary pancreatitis (ABP) and anomalous pancreaticobiliary duetal union (APBDU). Methods 131 patients with ABP were enrolled to test the serum total bilirubin (TB), alanine amintransferase (ALT), aspartate amintransferase (AST), alkaline phosphates (ALP), γ-glutamyl transferase (γ-GT). All the patients received medical treatment, and then these tests were performed again. Thereafter, all the patients underwent selective surgery and intra-operative cholangiography was performed to observe the pancreaticobiliary duetal union. Results 27 patients (20.6%) with APBDU were found in 131 patients. Among them, 8 cases (29.6%) was B-P subtype (TypeⅠ), 16 cases (59.3%) was P-B subtype (TypeⅡ) , and the remaining 3 cases was mixed subtype (TypeⅢ). A significant decrease of ALT, AST, ALP, γ-GT after non-surgical treatment in both group of APBDU and NAPBDU was noted (P＜0.05). The serum levels of ALT, AST,γ-GT in APBDU patients were (71.81± 23.19) U/L, (47.85±27.87) U/L, (52.86±31.49) U/L, respectively; and in NAPBDU patients were (51.96±15.40) U/L, (40.77±16.58) U/L, (34.86±26.47) U/L. The difference was statistically significant (P＜0.05). Condusions APBDU is an important etiology of ABP.

Objective To develop experimental animal model of the brain stem myoclonus,which more closely replicate clinic features of mechanism, behavior, neuroelectrophysiology and pharmacodynamics.Methods L-5-HTP (the precursor of L-5-HT)was microinjected into the dorsal pons of young guinea pig to induce myoclonus (electromyogram burst of myoclonus≤400 ms by synchronous recording).Some animals were pretreated with anticonvulsant VPA,CZP or CBZ at effective dose 50 (EC_(50)).Myoclonus was induced when the drug level was within their effective anticonvulsion concentration.The neuroelectrophysiological characteristics of myoclonus including latency,time of reaching its peak,duration of seizure peak,the maximum seizure frequency and total duration were detected.EMG and ictal electroencephalogram(EEG)were recorded synchronously.The origin of myoclonus and its correlation with epileptic discharges were further confirmed by jerk-locked back averaging(JLA).Results (1)L-5-HTP induced pure myoclonus from the dorsal pons of guinea pig permanently(8/every site,the rate of producing myoclonus is 100%).(2)The myoclonus presented bilaterally or as general myoclonus,which was sensitive to tactile and sound sensation.(3)The EMG duration of the myoclonus wag longer((208.75 ± 81.42)ms),and ictal EEG showed scattered and irregular spikes and sharp waves without time-locked correlation with EMG activities.(4)The synchronous ictal EEG of the myoclonus showed spike and sharp waves,but there was no time-locked EEG activity in JLA.(5)In the animals treated with anticonvulsant at EC_(50) concentrations:VPA and CZP decreased the maximum seizure frequency(there are 28.13±3.79 per minutes in VPA group and 37.17±4.67 perminutes in CZP group)and shortened the duration of peak time ((55.00±14.14)minutes in VPA group and(50.00±11.73)minutes in CZP group respectively)and total time(VPA group was(124.17±40.04)minutes and CZP group was(156.88±30.71)minutes)of myoclonus(F value were between 23.41 and 35.44,P＜0.01 or P＜0.05).CBZ increased duration of peak time((98.75±13.86)minutes)and total time((257.50±14.79)minutes)of myoclonus(P＜0.05 and 0.01).Conclusions The new model generates pure myoclonus originating from brain stem and also has a shorter duration of muscle construction(≤400 ms)and more sensitivity to tactile and sound sensation.Therefore,the model presents characteristics closer to the brain stem myoclonus in the clinic phenotype in respect of seizure behavior,pharmacodynamics and neuroelectrophysiology.

Objective To analyze clinical outcome of anterior atlantoaxial transarticular screw fixation in treatment of atlantoaxial instability.Methods Thirty-two patients with atlantoaxial instability treated between March 2004 and June 2009 were enrolled in the study.The patients consisted of 21 males and 11 females,at age of 22-64 years (mean 49 years).Atlantoaxial instability was attributed to old odontoid fracture in 10 patients,free odontoid malformation in 16,transverse ligament rupture in two,and rheumatoid arthritis in four.Anterior atlantoaxial transarticular screw fixation under monitoring of cortical somatosensory evoked potential (CSEP) was performed for all patients.Operation time,intraoperative blood loss,and complications were recorded.Japanese Orthopedic Association (JOA) scoring system was used to evaluate neurologic function preoperatively and at one year postoperatively.Results Operation lasted for average 98 minutes and intraoperative blood loss averaged 110 ml.Injuries on esophagus,nerve and vertebral arteries as well as leakage of cerebrospinal fluid were not observed in operation.All patients received a follow-up of 12-31 months.JOA score was increased from preoperative 9.8 points to 15.8 points at one year postoperatively,with improvement rate of 83％.Bone fusion and satisfactory internal fgxation were achieved in all patients.Hypoglossal nerve injury symptom was found in two patients postoperatively and was recovered two months later.Conclusion Anterior atlantoaxial transarticular screw fixation is an effective treatment for atlantoaxial instability.

Objective To investigate the epidemiological features of out-of-hospital cardiac arrest (OHCA) in Zhejiang and to analysis factors associated with outcomes for providing evidence on improving the success rate of cardiopulmonary resuscitation (CPR). Methods Clinical data of 493 patients with OHCA collected from the emergency department (ED) of Zhejiang Provincial People's Hospital, Ningbo Emergency Medical Service Center and Shaoxing Emergency Medical Service Center from January 2012 to August 2016 were analyzed retrospectively. All the data were recorded following the Utstein style included causes of arrest, location of arrest, first arrest rhythm, witnessed by bystanders, bystander CPR, pre-hospital defibrillation, pre-hospital intubation, pre-hospital epinephrine administration, emergency medical services (EMS) response time, return of spontaneous circulation (ROSC) at scene/enroute, ROSC at ED, admission to hospital, survival to hospital discharge and neurological outcomes at discharge. Factors associated with 30 days survival rate of patients with OHCA were analyzed. Results 493 patients were enrolled, of whom 342 were male and 151 were female. The average age was (58.8±21.4) years. The causes of arrests consisted of cardiac etiology (219 cases), trauma (155 cases), respiratory disease (22 cases), drowning (19 cases), electrocution (8 cases) and others (70 cases). Most of the events occurred at home (65.1%) and public places (22.7%). 55.2% patients were witnessed by bystanders while bystander CPR was performed in only 2.6% cases. Asystole was the predominant rhythm (78.7%) observed by the ambulance crew at the arrest site while only 5.5% first arrest rhythms were ventricular fibrillation/ventricular tachycardia (VF/VT). Only 6.9% patients underwent pre-hospital defibrillation. Pre-hospital intubations were attempted in 16.4% patients. Epinephrine was administered in 56.4% patients at scene or in ambulances. EMS response time was (13.6±8.0) minutes. 4.5% patients had ROSC at scene/enroute and 7.7% had ROSC at ED. Only 9.7% patients were admitted to hospital and 1.2% discharged alive. 0.8% patients were still in hospital on 30th day. The 30-day survival rate was 2.0% (10/493) and only 0.8% patients had neurologically favorable survivals [with the cerebral performance category (CPC) score of 1 or 2]. Witnessed by bystanders (3.31% vs. 0.45%), VF/VT as the first arrest rhythm (7.41% vs. 1.72%), bystander CPR (15.38% vs. 1.67%), pre-hospital defibrillation (8.82% vs. 1.53%) and EMS response time < 10 minutes (3.57% vs. 0.74%) could improve 30-day survival rate of OHCA significantly (all P < 0.05). Conclusion Resuscitation survival of OHCA in Zhejiang province was unsatisfactory. Improvements are required in series aspects of OHCA survival chain.