[Objective]To study the role and the effect of establishing the plan of meeting emergency in the rehabilitation and reestablishment of high-octane body hurt.[Method]Eighty six patients of high-octane body hurt were collected from Shi He Zi people's hospital during 1998 to 2007.According to Gustilo-Anderson categorize of open fracture and mark of ISS,high-octane body hurt can be divided into three parts.Meanwhile,different part can be taken different methods to rehabilitate and reestablish.Therefore,we can analyze pertinence between cure principle and curative effect.[Result]Eighty three patients were observed during the period of fifteen and thirty-three months,the average were nineteen months.Five of them contracted double floating knee injury,and their knee joint appeared anchylosis,abnormality and function failure afterfracture healed up.We did one-off knee joint release while extracting internal fixation,and used CPM machine to assist exercise.Fortunately,the function of knee joint could be renewed.Another five patients' fracture did not heal up very well.However,after experiencing the apply of oneself bone autograft,fracture could be healed up perfectly.The time of allograft bone union ranged from five to sixteen months,the average time were 7.5 months.There are three patients contract paraplegia,and three patients dead.By autopsy,some of them belongs to multiple fracture and multiple viscera burst.Mortality was 3.48%.[Conclusion]By establishing the plan of meeting emergency of high-octane body hurt,using the Gustilo-Anderson categorize of open fracture and mark of ISS,we can systemic classify damage degree,and make scientific treatment by stages,therefore,attaining our goal of early diagnoses,early treatment,and decreasing mortality and decreasing the proportion of disabled.After all,the plan of meeting emergency plays an essential role in traumatie surgery.

Objective To investigate the correlation between social factors and postpartum depression.Methods A total of 182 parturients were investigated with Edinburgh Postnatal Depression Scale (EPDS)and self-designed questionnaire.The social factors and postpartum depression of parturients were analyzed using univariate and multivariable logistic regression analysis.Results Family income,relation of family,relation of couples,sex of newborns and negative life events were associated with the risk of postpartum depression.Conclusions Low family income,bad relation of family,bad relation of couples,female newborns,and negative life events during pregnancy may increase the risk of postpartum depression.

Objective To evaluate X-ray and MRI features of limbs in childhood acute leukemia.Methods Thirteen children with acute leukemia in our pediatric hematology ward were recruited.Allpatients were pathologically diagnosed by bone marrow aspiration and complained of bone or joint pain in the first visit.ConventionaI X-ray and MRI examinations of algesic sites were performed before clinical treatment and after complete remission.MR images were obtained with SE-T1WI,SE-T2WI and T2WI-fat suppressed sequences and symmetria bilateralis was requested while scanning.X-ray and MRI manifestations were evaluated and compared.Resuits All 13 patients had received X-ray examinations.Among them,6 had normal X-ray findings,whereas the other 7(14 sites)showed various abnormalities including radiolucent metaphyseal bands(5 sites),periosteal reaction(3 sites),osteapenia(2 sites),mixed lesions(lysissclerosis,1 site),and permeative pattern(3 sites).The number of patients for MRI examinations was 8(11 sites).Among them,6(9 sites)showed bone marrow infiluration and bone marrow necrosis accompanied by normal X-ray findings,another 2(2 sites)showed bone marrow infiltration associated with radiographic abnormalities of periosteal reaction and radiolucent metaphyseal bands.Four cases were followed up within 1 week when reached complete remission by chemotherapy.MR images features included reduced sizes of bone marrow infiltration lesions associated with increased signal intensity on T1WI,and disappearance of double-line sign on bone marrow necrosis accompanied by signal homogenization.However,the radiograph before and after treatment in the same cases did not differ significantly.Conclusions MRI was earlier and more comprehensive in showing limbs bone marrow abnormality than radiogram in acute leukemia children with chief complaint of osteoarticular pains.MRI might be one of indicators in following up therapeutic effect for AL children with osteoarticular disorder.

Objective To investigate the incidence of surgical site infection (SSI)in patients undergoing orthopedic surgery,analyze the risk factors,and provide basis for the prevention and control of SSI.Methods All hospitalized orthopedic patients undergoing surgery in a hospital from January 2010 to December 2014 were retrospectively sur-veyed,questionnaires were designed,patients’medical records were reviewed,incidence of SSI was analyzed,risk factors for SSI were analyzed with univariate and logistic regression methods.Results A total of 14 300 orthopedic patients undergoing surgery were investigated,576 (4.03%)patients had SSI,predominantly were superficial inci-sion infection (n=429,74.48%),615 strains of pathogenic bacteria were isolated from 576 patients,mainly were Staphylococcus aureus (n=137,22.28%),Escherichia coli (n=84,13.66%),and Enterobacter cloacae (n=73, 11 .87%).The incidence of SSI decreased year by year in patients undergoing orthopedics surgery(χ2 =24.706,P <0.001);the incidence of SSI in patients with amputation was the highest (22.67%),followed by patients with de-bridement (7.16%);multivariate logistic regression analysis indicated that long duration of operation,long length of hospital stay,underlying diseases,use of implants,contaminated incision,more intraoperative blood loss,irra-tional perioperative use of antimicrobial agents,and without using negative pressure drainage were independent risk factors for SSI in patients undergoing orthopedic surgery.Conclusion The incidence of SSI is high in orthopedic pa-tients undergoing surgery,effective preventive measures should be actively taken according to the related risk factors of SSI,so as to reduce the occurrence of SSI.

Objective To report the clinical and neuroimaging features in three cases of neurosyphilis with mesiotemporal lobe lesions; and to discuss possible pathogenesis and differential diagnosis.Methods The clinical manifestations,laboratory examinations,neuroimaging features,differential diagnosis and curative effect of 3 cases of neurosyphilis with mesiotemporal lobe lesions were analyzed retrospectively.The possible pathogenesis was discussed.Results All of 3 cases had positive and high titer index of syphilis in both serum and cerebrospinal fluid.The onset symptom was abnormal cognitive functions with acute aggravation or rapid progression.Cerebrospinal fluid analysis implied lymphocyte predominant inflammatory reaction with increased protein.Electroencephalography showed localized slow waves as to the lesions.On brain magnetic resonance imaging,unilateral or asymmetrical bilateral mesiotemporal lobe was affected with long T2 signal.Herpes simplex virus encephalitis and paraneoplastic limbic encephalitis should beconsidered in differential diagnosis.The symptoms and laboratory indexes improved significantly after anti-syphilis treatment.Conclusions Neurosyphilis should be evaluatedin a patient with onset of abnormal cognitive functions and having mesiotemporal lobe lesions on magnetic resonance imaging.Promptly diagnosis and early treatment could achieve good prognosis.

Objective: To investigate cardiovascular disease (CVD) prevention status among residents with intra-urban migration in Central China, so as to provide insights into targeted prevention and control of CVD. Methods: Basic data of residents aged 35 to 75 years who participated in Early Screening and Comprehensive Intervention Project for CVD high-risk populations in Central China from September 2015 to August 2020 were collected. According to birth place, type of registered residence and current residence, residents were divided into four groups: local residents in old urban area, local residents in new urban area, other urban migrants and other rural migrants. The status of CVD primary and secondary prevention, were analysed by using a robust Poisson regression model. Results: A total of 76 513 residents were recruited, including 29 420 males (38.45%) and 47 093 females (61.55%), and had a mean age of (56.36±9.84) years. There were 45 087 (58.93%) local residents in old urban area, 23 868 (31.19%) local residents in new urban area, 5 668 (7.41%) other urban migrants and 1 890 (2.47%) other rural migrants. After adjusting for variables such as age, gender and educational level, the results of robust Poisson regression analysis showed that compared with local residents in old urban area, local residents in new urban area had lower compliance rates of non- or moderate-drinking (RR=0.987, 95%CI: 0.975-1.000) and healthy diet (RR=0.535, 95%CI: 0.365-0.782), lower proportion of using aspirin as primary prevention in CVD high-risk population (RR=0.616, 95%CI: 0.511-0.741), lower awareness (RR=0.873, 95%CI: 0.782-0.974) and control rates (RR=0.730, 95%CI: 0.627-0.849) of hypertension; other urban migrants had higher compliance rate of non-smoking (RR=1.045, 95%CI: 1.017-1.075); other rural migrants had lower proportion of using aspirin as primary prevention in CVD high-risk population (RR=0.826, 95%CI: 0.707-0.966). Conclusion The CVD primaryprevention among local residents in new urban area is relatively poor among four groups of residents in Central China, and key interventions are needed.

Objective To explore the effects of the health education model based on the theory of planned behavior (TPB) on the quality of life and sexual life in patients with cervical cancer six months after the surgery.Methods Totally 60 patients with cervical cancer who were treated and received surgery in the First Maternity and Infant Hospital Affiliated to Tongji University from March 2016 to April 2017 were selected by convenient sampling, and equally divided into a control group and a treatment group according to the random number table. Patients in the control group received routine health education after the surgery, while patients in the treatment group received the health education based on TPB. The Functional Assessment of Cancer Therapy-Cervix (FACT-Cx) and the Female Sexual Function Index (FSFI) were used to observe the difference in the quality of life and sexual life between the patients in the two groups six months after the surgery.Results The total scores in all dimensions of FACT-Cx of the patients in the treatment group six months after the surgery was higher than that of the patients in the control group(P<0.05). In FSFI, the scores in dyspareunia and sexual satisfaction of the patients in the treatment group were higher than those of the patients in the control group (P<0.05).Conclusions The health education model based on TPB can effectively improve the quality of life and sexual life in patients with cervical cancer six months after the surgery, thus worthy of clinical application.

Objective:To explore the nursing knowledge of extracorporeal membrane oxygenation (ECMO) in cardiac surgery nurses and analyze its influencing factors, in order to provide a reference for improving the nursing ability of clinical cardiac surgery nurses.Methods:Totally 104 nurses were selected from the Department of Cardiac Surgery, the First Affiliated Hospital of Zhengzhou University from January 2017 to January 2018, and investigated with the self-designed questionnaire of ECMO-related nursing knowledge and attitude. The status quo and influencing factors of ECMO nursing knowledge in cardiac surgery nurses were analyzed.Results:For the content of ECMO-related nursing knowledge, the percentages of nurses giving the 100% correct answers to "bleeding, anticoagulation problems and nursing measures", "nursing measures of the circulatory system", and "management of the catheter" were higher, being 92.31%, 88.46%, and 84.61% respectively, while the dimension to which the percentage of nurses giving 100% correct answers was the lowest was "prevention and control of related nosocomial infections", which was only 65.38%. The total proportion of nurses who gave 100% correct answers was 79.81%. There was no statistically significant difference in ECMO-related nursing knowledge scores between nurses at different ages ( P>0.05) . The difference in ECMO-related nursing knowledge and attitude scores between nurses with different working years, positions, and educational backgrounds was statistically significant ( F/t=96.834, 12.014, 44.726; P<0.05) . Multiple linear regression analysis showed that 1-3 years of working and educational backgrounds were the influencing factors to the difference in ECMO nursing knowledge scores between cardiac surgery nurses ( P<0.05) , and two variables could account for 65.7% of the variance of ECMO-related nursing knowledge scores in cardiac surgery nurses ( R2=0.657, P<0.01) . Conclusions:Cardiac surgery nurses have a good grasp of ECMO-related nursing knowledge, and 1-3 years of working and educational backgrounds were the influencing factors its scores. Cardiac surgery nurses still need to strengthen learning and training in terms of aseptic technical operation practices and related prevention measures for hospital infection.

Objective:To analyze the advantages of human epididymis protein 4 (HE4) compared with traditional tumor markers in the diagnosis and treatment of lung cancer.Methods:From February 2021 to June 2022, 230 lung cancer patients (138 males, 92 females; age (61.1±12.3) years), 96 benign lung disease patients (62 males, 34 females; age (60.2±14.8) years; including 43 cases of lung benign placeholder and 53 cases of pulmonary infection), and 60 healthy volunteers (40 males, 20 females; age (62.8±11.4) years) from the Second Affiliated Hospital of Soochow University were prospectively collected. Serum HE4, carcinoembryonic antigen (CEA), neuron-specific enolase (NSE), cytokeratin 19 fragment (CYFRA21-1), pro-gastrin-releasing peptide (ProGRP) and carbohydrate antigen (CA)125 were detected by electrochemical analysis. The expression of HE4 in tumor tissues of 55 patients with lung cancer was detected by immunohistochemical method. χ2 test, Mann-Whitney U test, Kruskal-Wallis rank sum test and Bonferroni correction method were used to analyze data. The diagnostic efficiencies of HE4 and other tumor markers were evaluated by ROC curve analysis and the difference of AUCs was analyzed by Delong test. Results:The positive expression rate of HE4 in adenocarcinoma tissue was significantly higher than that in non-adenocarcinoma tissue (93.1%(27/29) vs 23.1% (6/26); χ2=28.01, P<0.001). The level of serum HE4 in the lung cancer group (70.70(51.93, 109.05) pmol/L) was significantly higher than that in the pulmonary benign placeholder group (59.80(48.20, 73.50) pmol/L) and the healthy control group (55.25(44.60, 74.25) pmol/L), and that in the pulmonary infection group (97.90(76.62, 155.00) pmol/L) was higher than that in the lung cancer group ( H=46.19, all P<0.008 (Bonferroni correction method)). The levels of serum HE4 were significantly different in age, sex, smoking, disease stage and pathological types in early stage ( z values: from -5.07 to 9.83, all P<0.05). The ROC curve analysis indicated that the optimal cut-off value of serum HE4 for diagnosing lung cancer was 79.22 pmol/L, with the sensitivity and specificity of 41.30%(95/230) and 83.33%(50/60). Compared with other traditional tumor markers, serum HE4 and CA125 showed the higher diagnostic value (AUC CA125 (0.695)>AUC HE4(0.656)>AUC CEA(0.614)>AUC CYFRA21-1(0.599)>AUC ProGRP (0.501)>AUC NSE (0.470)). The combination of HE4 with other traditional tumor markers significantly improved the diagnostic efficacy (AUC=0.750; z=2.75, P=0.006). Conclusions:HE4 is highly expressed in lung adenocarcinoma by immunohistochemistry. Serum HE4 exhibits a great application value in the differential diagnosis between benign and malignant pulmonary nodules, and plays an important role in assessment of patients′ conditions.

OBJECTIVETo disclose the molecular genetic mechanism of type 2 diabetes mellitus and to determine chromosomal location of type 2 diabetes mellitus gene.

METHODSGenome-wide screening and genotyping were conducted in a family of type 2 diabetes mellitus, and linkage analysis by LINKAGE and GENEHUNTER package was used to determine the potential chromosomal location of the family of type 2 diabetes mellitus gene.

RESULTSEvidence of linkage was found at the long arm of chromosome 2. The maximum Lod score is 1.80 and non-parameter Lod score is 5.06.

CONCLUSIONThe type 2 diabetes mellitus gene of the family is located at 2q.

Adult ; Age of Onset ; Aged ; Aged, 80 and over ; Chromosome Mapping ; Chromosomes, Human, Pair 2 ; genetics ; Diabetes Mellitus, Type 2 ; genetics ; Family Health ; Female ; Genetic Linkage ; Genetic Predisposition to Disease ; genetics ; Genome, Human ; Humans ; Lod Score ; Male ; Microsatellite Repeats ; Middle Aged ; Pedigree