Objective: To investigate the causes of the recurrent nasal polyps in patients with rhinosinusitis after endoscopic surgery and the problems of operative technique, classification and the management of postoperative were discussed. Methods: The clinical data of 38 patients with rhinosinusitis who had recurrent nasal polyps after endoscopic surgery were retrospected. Results: The causes of recurrent nasal polyps were incomplete remove of the upper nasal cavity in 13, adhesion of the middle turbinat in 12, obstruction of the maxillary sinus in 4, incomplete section of the polyps in maxillary sinus in 3, the deviation of the upper nasal septum in 3 and unknown in 3. Conclusion: Good knowledge of the functional anatomy of the endoscopic surgery, good endoscopic surgery skills, proper polyps section for the high site, extensive postoperative care and patients follow\|up are the important factors to prevent or reduce the recurrence of the nasal polyps.

Objective To investigate the occurrence of intraoperative occupational exposure to blood among sur-geons in a hospital,so as to make effective precaution measures.Methods Combined with questionnaires,the mo-nitoring data of occupational exposure to blood among surgeons from June 2011 to June 2013 were analyzed statisti-cally.Results A total of 49 surgeons sustained 115 times of occupational exposure to blood,including 42 times (36.52%)in general surgery surgeons,36 (31 .30%)in orthopedic surgeons,31 (26.96%)in obstetrics and gyne-cology surgeons,and 6(5.22%)in urinary surgery surgeons.The main occupational exposure were sharp injuries (n=71 ,61 .74%),blood and body fluid splashing were 44 times (38.26%);the top two exposed sites were hands (49.57%)and faces (17.39%).88.70% of exposed cases were given emergent treatment,and 55.65% of exposed cases were reported.The follow-up found no surgeons were infected after the prompt and correct treatment. Conclusion Surgeons are at high risk of occupational exposure.Occupational precaution should be strengthened, occupational awareness and ability of HCWs should be enhanced,and post-exposure treatment should be improved.

Objective To evaluate the effects of compositive cognitive training on reasoning ability for healthy community elderly.Method All the participants were selected from one district in Shanghai by every 50 samples.151 community healthy elderly who accorded with the standard were collected at last.They were divided into cognitive intervention group ( n =90) and control group ( n =61 ) by sequence.The interventions ( includes reasoning,memory training,et al) were conducted in 24 sessions over 12 weeks.All individuals were assessed by Neuropsychological Test Battery for Elderly (NTBE) at baseline,follow-up,half a year follow-up and one year follow-up phase,and Raven' s Standard Progressive Matrices on reasoning classes.Results The scores of Raven' s Standard Progressive Matrices were significantly higher after reasoning training in intervention group( (15.54 ±5.70),(10.35 ± 5.10),t =3.595,P ＜ 0.01 ).Compared with baseline,the reasoning test scores of NTBE were significantly higher after cognitive intervention in treatment group at follow-up phase,and were also significantly higher than control group (P ＜ 0.05 or P ＜ 0.01 ).Conclusion Results support the effectiveness of compositive cognitive training in improving reasoning ability are positive,and can last for one year.

Objective To evaluate the middle and short-term effects of integrative cognitive training on mild cognitive impairments(MCI).Methods All the participants with MCI aged over 70 years were selected from one sub-district of Putuo District,Shanghai and divided into cognitive intervention group (n=46) and control group (n=35).The integrative cognitive training was conducted in 24 sessions for 12 weeks.All subjects were assessed by Neuropsychological Test Battery for Elderly (NTBE) and by a questionnaire of Shanghai Health Survey for the Elderly (VER2006)at baseline,follow-up and one-year follow up phases.Results At baseline phase,semantic relations test in NTBE was better (t=2.13,P=0.037),verbal fluency test (vegetables) in NTBE was worse(t =-2.25,P=0.038) in intervention group than in control group,while there were no significant differences in scores of other neuropsychological tests between intervention group and control group(all P＞0.05).At follow up phase,16 subscales in reasoning test of NTBE were improved (t=-2.70,P=0.010)and 2 subscales were declined in cognitive intervention group(all P＜0.05).9 subscales in semantic relations test of NTBE (t=-2.27,P=0.013) were improved and 5 subscales were declined in control group (all P＜ 0.05).Comparison between groups at one year follow-up showed that 5 subscales in reasoning test of NTBE (F=16.80,P=0.000) were better in intervention group than in control group(all P＜0.05).General linear model (GLM) with repeated measures at three time points showed that 4 subscales in reasoning test of NTBE had a time-by group interaction (F=5.16,P=0.01).Conclusions Integrative cognitive training can improve cognitive function in patients with mild cognitive impairments,and the validity of reasoning ability can sustain one year.

Objective To explore the status and economic burden of falls in elderly people living in an urban community and tO provide evidence for prevention of falls in the elderly. Methods A cross-section study was conducted in a community in Beijing.A total of 1512 persons aged 60 years and over were selected with stratified cluster sampling,and the data about falls within the past 12months,the consequences and the direct economic burden were collected by face-to-face interview.Results The overall incidence of falls was 18.0%within 1 year among 1512 interviewees.Of the participants,8.7%(131 cases)suffered from injuries of falls(143 times)and 77.6%(111 times)adopted the corresponding treatments.Direct economic burden caused by falls totaled 741.82 yuan per fall,including direct medical cost 650.77 yuan per fall,and 244.76 yuan per fall should be paid by the elderly themselves.In 143 times of falls,74.8%recovered and a few(5 cases)had complications and disability accordingly. Conclusions The incidence of fall in an urban elderly community of Beijing is high and will cause huge economic burden.

Objective To compare the prevalence and genotype distribution of human papillomavirus (HPV) between human immunodeficiency virus (HIV)-positive and-negative populations.Methods Patients with condyloma acuminatum or persons who recently had sexual contact with patients with condyloma acuminatum were enrolled into this study,and classified into HIV-positive group (n =62) and HIV-negative group (n =2 716).GeneChip analysis was performed to detect HPV and determine HPV genotypes in mucocutaneous samples collected from the external genitalia of these subjects.Statistical analysis was carried out by chi-square test using the SPSS software version 19.0.Results The prevalence rates of HPV infection,high-risk HPV types and low-risk HPV types were significantly higher in HIV-positive persons than in HIV-negative persons (74.19％ (46/62) vs.42.30％ (1 149/2 716),67.74％ (42/62) vs.29.57％ (803/2 716),58.06％ (36/62) vs.24.71％ (671/2 716),respectively,all P＜ 0.01).The detection rate of HPV was also increased in HIV-positive men compared with HIV-negative men (92.11％ (35/38) vs.37.38％ (382/1 022),x2 =45.98,P ＜ 0.01).Although the top three genotypes of low-risk HPV were types 6,43 and 11 in both HIV-positive and-negative groups,the prevalence rate of HPV 6 was 37.10％ (23/62) in HIV-positive group,but only 11.12％ (302/2 716) in HIV-negative group.The top five genotypes of high-risk HPV were types 16 (22.58％,14/62),52,66,58 and 18 in HIV-positive group,and types 16 (7.77％,211/2716),58,56,66 and 52 in HIV-negative group.Coinfections with multiple HPV subtypes were common in both groups,and the number of concurrent HPV genotypes was as high as 8 in HIV-positive group,and 9 in HIV-negative group.The prevalence rate of coinfections with three or more HPV genotypes in HIV-positive group was significantly higher than that in HIV-negative group (65.21％ (30/46) vs.16.71％ (192/1 149)).Conclusions Compared with HIV-negative populations,HIV-positive populations show elevated prevalence of HPV infection,high-risk HPV genotypes and low-risk HPV genotypes.Moreover,the prevalence of HPV is higher in HIV-positive men than in HIV-negative men.These findings are worthy of further attention in clinic.

Objective To assess the evaluation of SRT (Stereotactic radiotherapy ) and 3D-CRT (Three-dimensional conformal ra-diotherapy)on treatment of brain metastasis from lung cancer .Methods From June 2009 to June 2011 ,74 patients with multiple brain metastasis(brain metastasis ≤3 ,tumor mass ≤3 cm) from lung cancer were analyzed retrospectively ,37 patients received 3D-CRT alone were retrospectively compared with 37 patients who received SRT alone .the results was evaluated by median survival time(MS) ,local control(LC) and toxicity effect .Results The median survival time(MS) was 9 .3 ,which 8 .6 months after 3D-CRT ,and 10 .6 months after SRT .the local control rate was 73 .5% for 3D-CRT ,and 79 .6% for SRT after 3 months .there was no difference between two groups on toxicity effect from stastic .Conclusion The SRT was a efficacious methods for the treatment of brain metastasis from lung cancer ,which could improve the local control rate ,but there was no more toxiticy .

ObjectiveTo explore the treatment and economic burden of urine incontinence (UI) in the rural elderly,and provide evidences for preventive intervention.MethodsA cluster sampling was carried out in 743 people (aged 60 years and over) from 5 villages dominated by Yanliu and Dafengshang health centers,Jixian County,Tianjin from 2007 to 2008.The information about general state of health,treatment and economic burden of disease were analyzed. Results The prevalence of UI was 33.4％ (248 cases) among the 743 elderly people.Only 12 patients (4.8％) with UI ever visited community health-care service centers or hospitals for diagnosis and treatment,among whom only 1 case visited hospital within 1 year,8 cases during 1 to 5 years,and 3 cases over 5 years.And the method of treatment was all drug therapy.Among 248 cases with UI,there were 227 cases (91.5％) without any treatment,9 cases (3.6％) buying medicines by themselves.The direct cost for treatment of UI was 80-12000 yuan RMB,including 2 cases below 100 yuan RMB,2 cases 100-1000 yuan RMB,7 cases 1001-5000 yuan RMB and 1 case over 10000 yuan RMB. Conclusions Prevalence of UI is high while hospital-visiting rate is very low,and the financial burden of disease is serious,thus intervention measures for UI should be taken for the elderly people in rural areas of Jixian County,Tianjin.

Intraoperative cell salvage ( IOCS) was conducted during cesarean delivery from May 2011 to April 2016 in our hospital: when the volume of autologous blood collected from the surgical field≥800 ml during surgery and the parturients′hemoglobin≤100 g∕L after hemorrhage, the autologous blood was centrifuged, concentrated, washed and then filtered using a leucocyte depletion filter before reinfusion. IOCS was carried out in 1 085 cases during cesarean delivery within 5 yr. For the parturients who underwent IOCS, the percentage of patients who did not require transfusion of allogeneic red blood cells was 82.95%(900 cases), the percentage of patients who required plasma transfusion was 41.66% (452 cases), the percentage of patients who required platelet transfusion was 3.32% (36 cases), and no autologous blood transfusion?related adverse reactions were found during surgery and hospital stay. In conclusion, IOCS could be safely and effectively used for blood?saving effect in cesarean delivery.

AIM: To investigate alteration of inward re ctifier potassium current (I K1) in atrial myocytes and mRNA expression of gene Kir2.1 encoding I K1 in atrial myocardial tissue in patients with chronic atrial fibrillation (AF) compared to that with sinus rhythm (SR).METHODS: Single myocytes were isolated by enzymatic dissociation with the chunk method an d the ionic current was recorded using whole cell patch clamp technique. The sem i-quantitative reverse transcriptase-polymerase chain reaction (RT-PCR) was used to measure the mRNA expression of Kir2.1 in atrial myocardial tissue, and the g ene GAPDH was used as an internal control.RESULTS: (1) The I K1 density was increased in AF group at hyperpolarizing pot entials, at -120 mV the current densities was (-5.71?0.65) pA/pF in AF group (n=28 cells from 7 patients) and (-4.26?1.22) pA/pF in SR group (n=35 cells from 9 patients) (P0.05).CONCLUSIONS: The increase in I K1 at hyperpolarizing potentials may be related to th e atrial electrophysiological remodeling in chronic human AF. The increased I K1 density in atrial myocytes in AF group without alteration of Kir2.1 mRNA expression in atrial tissue suggests that I K1 may be mediated at post-transcriptional levels.