Objective To explore pressure ulcer risk factors among hospitalized elderly patients.Methods 271 patients were selected from departments of high pressure ulcer incidence of a srade three A hospital.Multiple factors were assessed prospectively and the occurrence of pressure ulcer monitored.Logistic regression was applied to analyze the correlation between the factors and the occurrence of pressure ulcer.Results Correlated factors included medical and nursing interventions,surgery,impaired activity and impaired tissue tolerance.Similar results were found for two kinds of dependent variables,namely suge I and stage Ⅱ pressure ulcers.Conclusions Medical and nursing interventions,surgery,impaired activity and impaired tissue tolerance are considered risk factors of pressure ulcers for hospitalized elderly patients.Relative prevention and interventions should be integrated in clinical nursing care.

Objective To compare and evaluate the reliability and validity of the application of three pressure ulcer risk assessment scales in hospitalized elderly patients by Norton,Braden and Waterlow pressure ulcer risk assessment scales. Methods We selected 271 elderly patiehts from a certain thirdclass and first-grade hospital and assessed their pressure ulcer risks by 3 assessment scales.The reliability and validity of these Scales were evaluated and compared by the following methods such as Cronbaeh's α coefficient,content validity index,factor analysis and ROC curve. Results The Cronbach's α coefficient of these 3 scales were 0.71,0.79 and 0.32 respectively.The content validity indices of them were 0.85,0.91and 0.87.The cumulative variance explained were 71.73%,70.34%and 65.76%respectively.The sensitivity and specificity upon cut-off points were(0.75,0.62),(0.74,0.59)and(0.86,0.59).Conclusion The Waterlow scale showed insufficient internal consistency but good predictive ability.The Braden scale showed moderate reliability and validity but with a lower predictive ability compared with the Norton and Waterlow scales.

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 double-stranded 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). 32P-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 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.

Cardiac neurosis is a syndrome caused by dysfunction of CNS,which influences autonomic function and then disordered cardiac-vascular function.The author sums up a set of firm-soft differentiation treatment to the disease under his years of clinical experience,which has marked clinical cure effect.

Objective: To select the common syndrome factors of menopausal syndrome through questionnaire investigation among experts. Methods: Firstly, a questionnaire was constructed on the basis of our previous research, and then investigation of the experts by the questionnaire was carried out. The experts came from twelve tertiary hospitals (6 cities) in China, and engaged in clinical practice of gynecology of traditional Chinese medicine (TCM) or integrated traditional Chinese and Western medicine. The common TCM syndrome factors of menopausal syndrome were selected based on consent degree of the experts in mean value, full marks ratio, rank sum and variation coefficient. Results: One hundred sets of the questionnaires were sent out and ninety-eight sets were returned back. The callback rate was 98%. In accordance with cumulative percentage of expert agreement and complete agreement more than 50% and the coefficient variation less than 0.25, we confirmed the common TCM syndrome factors of menopause syndrome. The syndrome factors related to disease location were kidney, liver, heart, and spleen, and those related to the nature of disease were yin deficiency, deficiency of essence, yang deficiency, hyperactivity of yang, qi deficiency, qi stagnation, blood deficiency, and blood stasis. Conclusion: Expert consultation questionnaire can collect consensus opinions of experts and is effective for identifying common TCM syndrome factors of a disease. The TCM syndrome factors acquired through the study may provide the evidence for establishment of TCM syndrome diagnosis criteria for the disease in future.

Objective To investigate the impact of calcification on differential diagnosis of thyroid nodule using shear wave elastography (SWE). Methods One hundred and forty-six patients with thyroid nodules were prospectively enrolled in the study. Ultrasound observations included nodule size, boundary, shape, envelope, internal echotexture, posterior acoustic enhancement, and the relationship with surrounding tissue. According to the presence of internal calciifcation, patients were divided into calciifcation group (groupⅠ) and no calciifcation group (groupⅡ). Real-time shear wave elastography (young′s modulus value) were taken in both groups. Taking surgical pathologic results as the gold standard, receiver operating characteristic (ROC) curve of SWE in diagnosis of benign and malignant thyroid nodule were drawn for two groups respectively. Results In groupⅠ, 25 cases were benign and 38 cases were malignant. The malignant incidence was 60%. Among them the rate of malignant nodules in microcalcification group was 92%(24/26). The incidence of malignant nodules in coarse calcification group was 38%(14/37). The area under the curve (AUC) of SWE in groupⅠwas 0.564. In groupⅡ, 67 cases were benign and malignant had 16 cases. Using 30.43 kPa as the diagnostic point of young′s modulus value, the sensitivity, speciifcity, accuracy and AUC were 93.2%, 81.2%, 84.8%and 0.824. Conclusion In no calciifcation group, SWE is more meaningful in the differential diagnosis of benign and malignant thyroid nodules.

BACKGROUND: Through exercise and/or hypoxia to increase the body's stress level and timing of hypoxia, so as to improve the body's adaptation level to exercise and/or hypoxia. However, little was known concerning the effects of acute exercise and/or hypoxia on vascular endothelial cell growth factor (VEGF) expression in skeletal muscles.OBJECTIVE: To study the effects of acute exercise and/or hypoxia on VEGF expression in rats' gastrocnemius muscles. DESIGN, TIME AND SETTING: The randomized controlled animal experiment was performed at the Clinical Laboratory, People's Hospital of Jiangsu Province, between September 2005 and September 2006.MATERIALS: Totally 108 health male SD rats were randomly divided into 6 groups, namely, normoxia quiet, normoxia high intensity, normoxia moderate intensity, hypoxia quiet, living high-training low high intensity and living high-training low high intensity moderated intensity groups, with 12 animals in each group.METHODS: In acute normoxia exercise models, rats were performed adaptive activity at 48 hours prior to experiment. The high intensity exercise was comprised of 50 m/minx1.5 min training with 2 minutes rest. The moderate intensity exercise was 30 m/min×30 min. Hypoxia environment was produced by using low oxygen instrument to simulate hypoxia training, with hypoxia for 3 days, 22 h/d, 12.8% altitude, with 22 ℃ temperature and 55% humidity. In acute training low-living high models, rats were placed in above hypoxia environment after high intensity Or moderate intensity exercise. Four rats were sacrificed at hours 0, 2 and 4 after training, and the gastrocnemius muscles were obtained.MAIN OUTCOME MEASURES: The expression of VEGF in rats' gastrocnemius muscles was detected by using western-blot.RESULTS: Hypoxia and acute normoxia exercise enhanced the expression of VEGF, hypoxia after exercise weakened exercise-induced VEGF expression, and the exercise with long time and common intensity induced the higher level VEGF expression. The expression of VEGF was the most at the time points of instantaneousness and 2 hour after exercise, the sorting of the recovery speed of VEGF changes from fast to slow was: hypoxia or training low-living high and normoxic exercise. CONCLUSION: The expressions of VEGF in rats' skeletal muscles induced by acute exercise and/or hypoxia belong to the effect of immediate-early, with existing intensity-threshold, which recovery speed is inversely proportional to the expression amplitude;"training low-living high" may be able to enhance the adaptation of skeletal muscles to sports.

Objective: To compare the influence of nickel-chromium alloy and gold-platinum alloy porcelain-fused-to-metal ( PFM ) on ultramicrostructure of canine gingival tissues, to survey the biological effects after PFM full crown restoration, and to provide data for selection of PFM materials. Methods; The nickel-chromium alloy and gold-platinum alloy PFM full crowns were used to repair canines in 3 healthy dogs. The microstructure of canine gingival tissue was observed through light microscope and transmission electron microscope. Apoptosis of canine gingival cells was detected by TUNEL method. Results; Under light microscope, inflammatory cell infiltration and partial bleeding were seen in the nickel-chromium alloy PFM full crown repaired canine gingival tissues. Under transmission electron microscope, large amount of cell apoptosis and neuclear condensation were observed in these tissues,and apoptotic index was 58.63% ±11. 12%. While under light microscope, inflammatory cell infiltration and partial bleeding were not seen in the gold-platinum metal PFM full crown repaired canine gingival tissues. Under transmission electron microscope, only small amount of cell apoptosis was detected in these tissues,and apoptotic index was 26. 90% ± 17. 35%. Statistical significance was found in both nickel-chromium alloy group and gold-platinum metal group compared to control group. There was also statistical significance between nickel-chromium alloy group and gold-platinum metal group in cell apoptosis numbers (P <0. 05). Cell apoptosis number in nickel-chromium alloy group was much higher than that in gold-platinum metal group. Conclusion; The negtive effects on ultramicrostructure of gingival tissue using nickel-chromium alloy PFM are more evident than using gold-platinum metal. When select PFM to repair defect teeth, it is better to select the inactive gold-platinum metal PFM as base crown.

Objective To evaluate and compare the predictive validity of the Braden Q and Braden pressure ulcer risk assessment scales in the acute pediatric patients, and explore the cutoff score of the scales. Methods We adopted the prospective cohort study design.The settings included three PICU of three different children's hospitals. Two nurses were appointed as the data collectors, and they were in charge of both the scoring and the skin assessment separately. Results We collected 145 samples. There were 9 patients who developed the pressure ulcers, and the incidence rate was 6.2%. The cutoff score of Braden Q and Braden scale was 17 and 14. The AUC of the ROC curve of the two scales was 0.481 and 0.398. Conclusions The Braden Q scale is more suitable for the pediatric patients. Further study is neededed to improve the scale.