ObjectiveTo investigate the clinical features,early diagnosis and therapeutic methods of primary tumor of the duodenum.MethodsThe clinical data of 130 patients of primary tumor of the duodenum who were hospitalized in Peaking University Third Hospital from 1974 to 2010 were summarized.There were 30 cases of benign tumors and 100 cases of malignancy. ResultsMore than 90％ of primary tumors of the duodenum were located at the duodenal bulb and descendent part.59％ of malignant tumors were located in the area of duodenal papilla. The mean diameter of benign tumors was less than 2 cm compared with more than 3 cm in malignancies. Upper abdominal pain,jaundice,black stool,intestinal obstruction and abdominal mass were among the most common clinical manifestations. Jaudice was most common in papilla tumors,and intestinal obstruction and palpable abdominal mass often indicate advanced stage.Duodenofiberscopy combined with air barium double contrast radiography increase the diagnosis rate.Among the 30 benign cases,11 cases underwent simple tumor resection,14 cases received endoscopic tumor resection and 3 cases underwent pancreaticoduodenectomy.Resection rate and the 5-year survival rate was 100％. Of the 100 malignant cases,56 cases underwent standard pancreaticoduodenectomy,3 cases received pylorus preserving pancreaticoduodenectomy,9 cases underwent simple tumor resection and 12 cases received segmental duodenectomy.Resection rate was 84％.The 5-year survival rate was 46％ in 59 cases receiving Whipple's procedure.ConclusionsPrimary tumor of the duodenum lacks specific clinical features. Simple tumor resection and segmental duodenectomy can be done for benign cases, while pancreaticoduodenectomy is the therapy of choice for malignant cases.

Objective To discuss the non-antibiotic Chinese medicine therapy for the non-gonococcus conjunctivitis in newborns, and reduce the use of antibiotic and the production of bear-medicine-bacterium. Methods 0.9%-sodium chloride was used as the inoculation fluid, Shuanghuanglian (freezing and drying) was uscd as dissolution injection. Dexamethasone sodium phosphate injection 1ml: 5mg was added, mixed-fluid 16ml was matched to spray the eyes after ultrasonic-atomization equipment atomizes. Results 56 examples 103 eyes which had the nongonococcus conjunctivitis in newborns were treated only with the injection with the Shuanghuanglian dexamethasone sodium phosphate injection mixed with the fluided ultrasonic-atomization equipment atomizes and the total effectiveness reached 97.08%. Conclusion The Shuanghuanglian-ultrasonic-atomization way to treat non-gonococcal conjunctivitis in the newborns is safe and effective.

OBJECTIVE:To provide experience and reference for the reform ofintegration of medicine and nursingunder the strategy ofHealth China 2030. METHODS:By literature analysis,the demand characteristics and supply situation ofinte-gration of medicine and nursingservice model in China were analyzed. The development bottleneck ofintegration of medicine and nursingservice model in China was discussed to put forward countermeasures and suggestions. RESULTS&CONCLUSIONS:Integration of medicine and nursingis a new model of the development of pension services in China. Throughout whole country, it is still in the stage of exploration and practice. There are some problems,such as serious inadequate beds,low participation of private pension institutions,pension service quality ofintegration of medicine and nursinghaving to be improved,weak market competition of pension institutions,social forces participation having to be improved,big demand gap of medical and nursing staff,inadequate high-quality medical and nursing talent. A clear positioning ofintegration of medicine and nursingservice model in China should be put forward andintegration of medicine and nursingmonitoring system should be improved. It is suggested to establish service complaint mechanism of pension institutions,encourage the active participation of diverse social forces,broaden the financing channels ofintegration of medicine and nursing,build service information sharing platform ofintegration of medi-cine and nursing,establish electronic health records for the elderly and set up maintenance personnel training mechanism so as to promote the rapid development of the reform ofintegration of medicine and nursing.

Depression is one of the diseases with the highest disability rate in the world. A large number of studies have shown that the intake of unsaturated fatty acids can deal with depression while chronic overconsumption of saturated fatty acids is a risk factor for depression. It was suggested that the mechanism of saturated fatty acids inducing depression is related to the following four aspects: regulating the function which links to depression in whole brain and specific brain regions, including the hippocampus, the hypothalamic-pituitary-adrenal axis, the striatum, and the prefrontal cortex; stimulating the secretion of inflammatory factors; affecting the balance and function of metabolic regulatory hormones, including leptin, adiponectin, glucocorticoid, and insulin; inducing the disturbance of intestinal flora. This article reviews the relationship between dietary fatty acids and depression, and the possible mechanisms by which saturated fatty acids induce depression from the four aspects mentioned above.

Objective To study the attentional bias to threatening faces images of high and low social anxiety subjects in the threatening and non- threatening conditions.Methods 23 high social anxious subjects (HSAs) and 24 low social anxious subjects (LSAs) were chosen from 500 volunteers according to the score and divided randomly into two groups,one group was under the threatening condition (expecting to give a short speech) and the other under the non- threatening condition,and then a dot-probe task was performed and the attentional bias score (ABS) was recorded.Results Under the threatening condition,the ABS of HSAs and LSAs were (-2.63±1.83)ms and (0.42±1.36)ms,the different was significant (t=-4.641,P=0.000);under the non- threatening condition,the ABS of HSAs and LSAs were (-0.41±1.56)ms and (0.47±0.67)ms,the different was not significant (t=-1.732,P=0.106).The ABS of HSAs under the threatening and non- threatening condition were (-2.63±1.83)ms and (-0.41±1.56)ms,the different was significant (t=-3.122,P=0.005);the ABS of LSAs under the threatening and non- threatening condition were (0.42±1.36)ms and (0.47±0.67)ms,the different was not significant(t=-0.124,P=0.903).The effect of the interaction between social anxiety and the experiment condition on ABS was significant (F=6.881,P=0.012).The separately main effect of social anxiety and the experiment condition on ABS was significant (F=20.429,P=0.000) and (F=6.413,P=0.015) too.Conclusion Social anxious individuals attend to avoid the threatening faces images,especially under the threatening condition.

Objective To discuss the necessity and methods of combined reconstruction of the injured posterior cruciate ligament(PCL)and posterolateral complex(PLC)of the knee. Methods From January 2001 to December 2006,28 patients with injury of both PCL(≥Ⅱ°b)and PLC(＞Ⅱ°)of the knee were treated operatively in our department.Eight patients received arthroscopic PCL reconstruction with single bundle of 5-6 strands of hamstring and conservative treatment of PLC during January 2001 to December 2003.Twenty Datients received arthroscopic PCL reconstruction followed by open operative repair of PLC with median 1/3 femoral biceps tendon and gracilis during January 2002 to December 2006. Results All the patients were followed up for 6 to 24 months postoperatively (mean,15 months).By Lysholm scoring,3 cases obtained good results and 5 poor in the first group,while 19 excellent and 1 good in the second group.The mean Lysholm scores were 47.1±8.2 and 86.7±7.2 respectively(P＜0.05).According to IKDC scale,3 patients(37.5%)in the first group and 19 patients (95.0%)in the second group were graded normal or nearlv normal(t=19.277,P＜0.05). Conclusion Arthroseopic PCL reconstruction with single bundle of 5-6 strands of hamstring plus PLC reconstruction with 1/3 femoral biceps tendon and gracilis is more reliable to restore the stability of the knee than PCL reconstruction only.

ObjectiveTo explore the factorial structure of Chinese revision of connor-davidson resilience scale (CD-RISC) in Chinese college students.MethodsA total of 1534 college students were recruited for this study.After item analysis,half of the sample was used for exploratory factor analysis and the other for confirmatory factor analysis.ResultsThe Chinese revision of CD-RISC contained 19 items.Exploratory factor analysis showed that three factors were better:adaptability,tenacity and autonomy.And the results of confirmatory factor analysis ( x2/df =3.83,RMSEA =0.06,GFI =0.92,AGFI =0.90,CFI =0.92,NFI =0.89) indicated that this model provided a reasonable good fit for Chinese college students.ConclusionThis study indicate that the three-factor model of CD-RISC is adaptable to Chinese college students.

[Objective]To study the clinical application value of the measurement of thyroid function during early pregnancy.[Methods] Six hundred and thirteen women in early pregnancy(observation group)accepted thyroid function lest.Patients with abnormal thyroid function received therapeutic intervention.The results were compared with 586 pregnant women(control group)who didn't get thyroid function screening and treatment.[Results]There were 182 cases(29.69％)out of 613 pregnant women with various thyroid diseases.The incidences of fetal distress,premature rupture of membrane,gestational hypertension and neonatal deformity in observation group were significantly lower than those in control group[3.92％(24/613)vs.7.34％(43/596),5.06％(31/613)vs.12.97％(76/586),2.28％(14/613)vs.5.46％(32/586),1.63％(10/613)vs.5.63％(33/586),P＜0.01].[Conclusion] Thyroid function detection and therapeutic intervention during early pregnancy has important clinical value.

OBJECTIVE: Researches on total hip replacements are always the hot spots in recent years. The replacements have obtained satisfactory outcomes in clinic. However, the long-term effect is limited because of the material and technical problems. This paper is to summarize the developmental trend and the prospect of clinical application for total hip replacements in 10 years.DATA SOURCES: A computer-based online search of Medline database was undertaken to identify relevant articles published in English from January 1996 to January 2006 by using the keywords of "total hip replacements, surgical robot, tissue engineering, virtual endoscopy". Meanwhile,Chinese relevant articles published from January 1990 to December 2005 were searched in Wanfang database, the keywords were "total hip replacements, material, virtual endoscopy, surgical robot, tissue engineering" in Chinese.STUDY SELECTION: The articles were primarily checked, and the references in each literature were reviewed. Articles about the study on total hip replacements were involved; Meanwhile, the repetitive studies or Meta analysis were excluded.DATA EXTRACTION: Totally 39 relevant articles were collected, and 22 of them accorded with the. Inclusive criteria, 17 old or repetitive ones were excluded. Of the 22 articles, 5 were about the influence of artificial joint material on prosthetic loosening and its carcinogenesis; 2 about the microinvasion of joint replacement induced by computer-aided surgery navigation; 1 about the introduction of surgical robot; 3 about the development of custom-made and specially made artificial joint; 9 about the possibility for the surface replacement of hip; and 2 about the combination of tissue engineering technique and artificial joint.DATA SYNTHESIS: Modern researches on total hip replacements are exploring wearing tolerant prosthesis to reduce the prosthetic loosening caused by osteolysis and bone resorption. The computer-aided design/made technique is used for special design and manufacture according to the need of disease, so as to solve the fracture around prosthesis and meet the need of limb salvage surgery. The computer-aided surgery navigation realizes the microinvasion of joint replacement and the fast recovery after surgery. The successful rate of total hip replacements is improved by developing localized surgical robot in China. By using the virtual endoscopy, we can accurately know the damaged conditions of intraarticular cartilage and sub-cartilage bone, which are also able to be quantifized, so that more suitable and reliable prosthesis can be selected to increase the accuracy. The tissue engineering technique in repairing defect can increase the synostosis of prosthesis, and perfect the technique of joint replacement.CONCLUSION: In the coming 10 years, total hip replacements will develop towards stability, harmlessness, microinvasion, mechanization, individualization and diversification, so that the total hip replacements will be much stander and safer with higher successful rate.

Objective:To analyze and evaluate the degassing effect of vacuum degassing apparatus through the determination of ox-ygen content in pure water, gas pressure and air volume, and compare with suction filtration, boiling and ultrasonic methods to choose the appropriate degassing method for dissolution medium and guide the daily inspection work. Methods: The water residual oxygen, gas pressure and air volume were determined using a single water quality on-line monitoring instrument and a Carbo QC Anton Pear in-strument. The degassing effect of the vacuum degassing apparatus was detected under the conditions of negative pressure and certain de-gassing time. The degassing effect was also compared with that of suction filter, boiling and ultrasonic methods. Results: Under the conditions of 0. 06 MPa negative pressure, 41℃ medium temperature and 30 min degassing time, the degassing effect of the vacuum degassing apparatus was obvious. The degassing effect of suction filter and boiling methods was similar to that of the vacuum degassing apparatus, while that of ultrasonic method wasn't obvious. Conclusion:The use of vacuum degassing apparatus is simple and efficient with obvious degassing effect, which is suitable for the degassing process of dissolution medium.