Objective To analyze the clinical features of rheumatic diseases patients with Glucocorticoid (GC) induced osteoporotic fractures.Methods Fourteen patients with GC induced osteoporotic fractures in Beijing Children's Hospital from January 2005 to December 2012 were retrospectively analyzed.The clinical features,spine radiographs/CT,dose of GC were analyzed.Results In various rheumatic diseases,systemic lupus erythematosus (SLE) and systemic onset juvenile idiopathic arthritis (SoJIA) were the most common related diseases.All children had no obvious causes of fracture.Eleven patients had back pain or limitation of activity.Fourteen patients had vertebral fractures.Seven cases had thoracic vertebral fracture,3 cases had fractures of lumbar vertebra.Four cases had multiple painful vertebral fractures.The time of fracture occurrence in patients received glucocorticoid therapy were between 5 months and 6.5 years.Daily minimum dose of glucocorticoid was 0.25-1.12 mg/kg and mean dose was 0.47-2.62 mg/kg.Conclusion GC induced osteo-porotic fractures is a serious complication of long-term use of glucocorticoid.Physicians taking care of children who have received long-term glucocorticoid therapy should be alert of the manifestation of osteo-porosis,such as back pain.

Objective To study the effects of individualized nursing on the anxiety, depression mood, quality of life of patients with hemoptysis. Methods Sixty patients with hemoptysis were randomized into the intervention group and the control group with 25 cases in each. The control group received single conventional therapy while the intervention group was given individualized nursing intervention besides the conventional therapy. Using SDS, SAS and SF-36 Life Quality Measuring Scale to evaluate the effects of the patients in both groups on admission and prior to discharge. Results The scores of anxiety and depression among the intervention group were lower than those of the control group after intervention.The dimensions of quality of life besides the physical function and bodily pain in the intervention group were significantly different after intervention. Conclusions The individualized nursing intervention can improve quality of care, the state of anxiety, depression and the quality of life of patients with hemoptysis.

Objective To explore if strand breaks of DNA in human early chorionic villus cells in uterus were induced by diagnostic ultrasound and to evaluate the method used for detection of single-stranded breaks and doublestranded breaks in human DNA. Methods 60 normal pregnant women aged 20-30, who underwent artificial abortion during 6-8 weeks of gestation, were randomly divided into 2 experimental groups: All 30 cases were exposed to diagnostic ultrasound in uterus for 10 minutes, and 24 hours later chorionic villi were extracted; the other 30 cases were taken as the control group. Single-stranded DNA and double-stranded DNA in villus cells in all cases were isolated by the alkaline unwinding combined with hydroxylapatite chromatography, and were quantitatively detected using32 P-labeled Alu probe for dot-blotting hybridization. Results There was no significant difference in quantity and percentage in single-stranded DNA and double-stranded DNA between 2 groups (P＞0.05). 32 P-Alu probe could only hybridize with human DNA, and could detect DNA isolated from as few as 2.5 × 103 chorionic villus cells and 0.45 ng DNA in human leukocytes. Conclusion The results suggested that there were no DNA strand damages in human chorionic villus cells when the uterus was exposed to diagnostic ultrasound for 10 minutes. The method, 32P-Alu probe for dot-blotting hybridization, was even more specific, sensitive and accurate than conventional approaches.

Objective: To probe into distribution on characteristics of TCM syndromes and syndromes elements of menopausal syndrome.Methods:The literature about menopausal syndrome in past 20 years were collected.The principle of evidence-based medicine was used to establish the databank with EpiData2.0,and the literature meeting the enrolled criteria were recorded and checked.SPSS12.0 software was adopted to analyze frequency-times of syndromes and syndromes elements.Results:The top three syndromes are yin-deficiency of both liver and kidney,yin-deficiency of kidney,yang-deficiency of kidney;The kidney,liver,and heart are the top three locations of syndromes elements;And yin-deficiency,yang-deficiency and fire are the top three pathogenesis types of syndromes elements.Conclusion: Distribution of TCM syndrome types of menopausal syndrome is scattered.It lead to clinical syndrome differentiation is complicated.Compared with it,syndrome elements can reflect the substance of disease more concise and active.

ObjectiveTo explore the cause of early death (death within 3-12 months after hemodialysis) and the related influencing factors patients undergoing maintenance hemodialysis (MHD) as to provide a scientific basis for the prevention of early death.Methods A retrospective matched controlled study was conducted. Fifty-one patients who underwent MHD from January 2004 to April 2014 and died within 3-12 months after hemodialysis in hemodialysis center of the 174th Chinese People's Liberation Army Hospital were included in the case group by retrospective analysis method. According to 1∶2 matched controls, 102 patients underwent hemodialysis in the same period (±2 months) and survived over 12 months were selected as control group. All patients received regular hemodialysis (dialysis 2-3 times per week), with conventional limitation of water and sodium intake, routine treatments such as control of blood pressure, treatment of anemia and disorders of calcium and phosphorus contents. Causes of short-term death were analyzed. Clinical and biochemical parameters of two groups were collected when dialysis was started, and the single factor and multiple factors logistic regression was used to analyze the related risk factors when dialysis was started. Receiver operating characteristic curve (ROC) was plotted to evaluate the value of above parameters in predicting the early death in patents with MHD.Results The main causes of early death of 51 patients with MHD were mainly cardiovascular and cerebrovascular diseases (27 cases, 52.9%), and infections (15 cases, 29.4%). It was shown by single factor analysis that the age [odds ratio (OR) = 6.625, 95% confidence interval (95%CI) = 3.232-13.580,P = 0.000], diabetes (OR = 3.875, 95%CI = 0.654 - 10.622,P = 0.031), specialist intervention time before dialysis (OR = 0.349, 95%CI =0.287 - 0.572,P = 0.004), the emergence of cardiovascular and cerebrovascular events before dialysis (OR = 9.667, 95%CI = 4.632 - 20.174,P = 0.000), the first dialysis for emergency dialysis (OR = 3.875, 95%CI = 1.713 - 8.765, P = 0.005), blood albumin level (OR = 0.294, 95%CI = 0.068 - 0.550,P = 0.008), leukocyte count (OR = 6.286, 95%CI = 1.648 - 23.982,P = 0.026), neutrophil count (OR = 2.833, 95%CI = 1.630 - 4.923,P = 0.001) might be the factors correlating with early death. Eight independent factors were statistically significant, and their effect on the MHD patients was analyzed by logistic regression analysis inα = 0.05 level. The results showed that patients with old age (OR = 1.054, 95%CI = 1.019-1.090,P = 0.002), and the emergence of cardio-cerebrovascular events (OR = 7.469, 95%CI = 2.474 - 22.545,P = 0.000)were early death risk factors of MHD patients, and early specialist intervention before dialysis was a protective factor (OR = 0.286, 95%CI = 0.113-0.722,P = 0.008). ROC curve showed that age had moderate diagnostic value for early death of MHD [area under ROC curve (AUC) = 0.756], the cut-off value was 59.0 years old, the sensitivity was 66.7%, and the specificity was 77.5%. The diagnostic value of early specialist intervention before dialysis was relatively low (AUC = 0.367), the cut-off value was 0.875 years, the sensitivity was 39.2%, and the specificity was 33.3%.Conclusion Old age, the emergency of cardiovascular and cerebrovascular events before dialysis is associated with early death, and specialist intervention ahead of dialysis can reduce the risk of early death.

Objective To explore the effect of flushing uterine cavity with metronidazole solution at different temperatures on postpartums with high risk of infections during cesarean section.Methods One hundred and two puerperas with high risks of infections undergoing caesarean section were randomized according to random sampling into three groups equally.Groups A,B and C were treated with uterine cavity flushing with metronidazole solution at three temperatures of 22~24℃,39~40℃and 37.5~37.8℃respectively.Comparisons were done between the three groups in terms of vaginal bleeding 2h after operation,heart rates 15 min before operation and 15 min after operation and the temperatures.Results The differences in temperature and heart rate 15 min after operation were significantly different arnong the groups(P<0.05).The temperature and heart rates of group A were higher and faster than the other two groups(both P<0.05)but no differences between group B and group C(P>0.05).In group A,the temperature and heart rate after operation were significantly lower and faster than those before operation(P<0.05),while there were no differences within group B and C respectively (P>0.05).The vaginal bleeding volume 2 h after operation in groups A and B was significantly more than group C(P<0.05)and that of group B was significantly smaller than group A(P<0.05).Conclusion Uterine cavity flushing using metronidazole at the temperature of 37.5~37.8℃after cesarean section can reduce postpartum hemorrhage and relieve patient’s discomfort.

Objective To investigate the relationship between family cohesion and adaptation and the anxiety and depression level of parents of children with congenital heart disease after surgery.Methods 302 parents of children with congenital heart disease and 330 parents in child health care clinic were conveniently selected and investigated with Hospital Anxiety and Depression Scale (HADS).And Family Cohesion and Adaptation Questionnaire (FACES Ⅱ-CV) was applied to investigate the former.Results The mean score of the anxiety and depression level of parents of children with congenital heart disease was higher than that of the parents in child health care clinic.The difference was significant.The score of anxiety and depression of parents of children with congenital heart disease was significantly correlated with dissatisfaction of family coherence and adaptation; while negatively correlated with real family cohesion and adaptation.Multiple linear regression showed that real family adaptation,dissatisfaction of family adaptation were influential important factors of parents' anxiety.Dissatisfaction of family adaptation was also the influential important factors of the parents' depression.Conclusions The anxiety and depression of parents was above the average level,we must pay more attention to improve it,make full use of the function of families,and to improve their anxiety and depression condition.

Objective To observe the protective effect of bioimpedance spectroscopy guided ultrahltration on residual renal function in new hemodialysis patients.Methods Patients with end-stage renal disease recruited from January 2015 to June 2016,were randomly divided into experimental group and control group.And all the patients were followed up for 3 months.The ultrafiltration was guided by the bioimpedance spectroscopy analysis in the experimental group,while the ultrafiltration was based on the edema,blood pressure,symptoms of low blood pressure and the increase of weight during the hemodialysis interphase in the control group.The difference of residual renal function,24 hours urine volume and the incidence rate of adverse events between the two groups were collected.Results Compared with the control group,the urine volume(932.58 ± 230.16 ml vs 584.45 ± 137.76 ml,t =7.226,P ＜ 0.001) and residual renal function (RRF) (4.55 ± 0.90 ml/min vs 3.08 ±0.68 ml/min,t =7.300,P ＜0.001)in the experimental group were higher.The drop of RRF(3.14 ±2.05 ml/min vs 4.40 ±2.09 ml/min,t =-2.384,P =0.020) and urinary volume (452.58 ±456.96 ml vs 877.45 ± 452.45 ml,t =-3.679,P =0.001) were lower in the experimental group.While there was no significant difference in the incidence of adverse events between the two groups (t =2.081,P =0.084).Conclusions It is helpful for slowing down the decline of residual renal function by using the bioimpedance spectroscopy guided ultrafiltration.

To investigate the etiology and differential diagnoses of patients with systemic lupus erythematosus (SLE) and fever of unknown origin (FUO).From January 2012 to December 2014,a total of 928 SLE patients were admitted to Peking Union Medical College Hospital.Only 50 patients were combined with FUO (5.4％).The most common reason of fever was caused by infections (33 cases,66.0％),including bacterial infection in 17 cases with 5 tuberculosis,viral infection in 11 cases,and fungal infection in 5 cases.The second reason offever was due to poor disease control or recurrence in 17 patients (34.0％).No fever was caused by malignant tumor.When clinical data was compared between 17 non-infected patients versus 33 infected patients,C reactive protein and procalcitonin in the infected group were significantly higher than those in the non-infected group.In SLE patients combined with FUO,infection is the most common etiology which is necessary to be paid attention to.