Objective To investigate the expression of forkhead box C2 (FOXC2),Vimentin and E-cadherin protein in colorectal adenocarcinoma and the relationship of FOXC2,Vimentin and E-cadherin with the clinicopathological parameters,and the role of epithelial-mesenchymal transition (EMT) in colorec tal adenocarcinoma and the correlation between FOXC2 and EMT.Methods The expressions of FOXC2,Vimentin and E-cadherin in 102 cases of colorectal adenocarcinoma tissues and 30 cases of adjacent noncancerous tissues were detected by immunohistochemical method,and the correlation between FOXC2 and EMT and the clinicopathological parameters of colorectal adenocarcinoma were analyzed.Results The positive rates of FOXC2,Vimentin and E-cadherin in colorectal adenocarcinoma tissues were 53.9％,40.2％ and 26.5％,respectively.The positive rates of FOXC2,Vimentin and E-cadherin in adjacent noncancerous tissues were 6.7％,0 and 63.3％.Compared to paracancerous tissue,the expression of FOXC2 and Vimentin in colorectal adenocarcinoma was significantly increased,while the expression of E-cadherin was significantly decreased.The positive rates of FOXC2 and Vimentin in lymph node metastasis group were 79.1％ and 67.4％,respectively,which were significantly higher than those without lymph node metastasis (35.6％,P ＜0.01;20.3％,P ＜0.01).The positive rate of E-cadherin in lymph node metastasis group was 16.3％,which was significantly lower than that without lymph node metastasis (33.9％,P ＜ 0.01).The positive rates of FOXC2 and Vimentin in T1 +T2 phase were 41.7％ and 25.0％,respectively,which were significantly lower than those in T3 + T4 stage (83.3％,P ＜0.01;76.7％,P ＜0.01).The positive rate of Ecadherin in T1 + T2 stage group was 33.3％,which was significantly higher than that in T3 + T4 stage (10.0％,P ＜ 0.01).There was a positive correlation between FOXC2 and Vimentin in colorectal adenocarcinoma (P ＜0.01),and negatively correlated with E-cadherin expression (P ＜ 0.01).Conclusions EMT may promote the development and metastasis of colorectal adenocarcinoma,FOXC2 may be involved in colorectal cancer EMT and through the EMT to promote the malignant process of colorectal adenocarcinoma.

Objective To explore the correlation between miR-221/222 expression and the pathological features of thyroid carcinomas.Methods A total of thyroid tissue specimens was collected in thyroid surgery from Mar 2013 to Feb 2014.The expression levels of miR-221/222 were tested with quantitative real-time polymerase chain reaction (RT-PCR).The expression levels of miR-221/222 were analyzed in different thyroid carcinoma tissues.Results The expression levels of miR-221/222 were significantly over-expressed in thyroid carcinoma tissues compared to non-thyroid carcinoma tissues (F =9.358,P =0.0014).No significant difference was found among different groups of non-thyroid carcinoma tissues (F =1.367,P =0.839).The expression levels of miR-221/222 were significantly different in thyroid carcinoma specimens with different pathological features (P ＜ 0.05).Conclusions The expression levels of miR-221/222 were significantly over-expressed in thyroid carcinoma tissues.Both expression levels of miR221/222 were associated with extrathyroidal invasion,regional lymph nodes,and tumor staging.The expression levels of miR-221/222 might guide diagnosis,treatment,and prognosis of thyroid carcinomas.

Objective To investigate whether the incidence and severity of retinopathy of prematurity (ROP) differs between infants conceived naturally and those who were in vitro fertilization (IVF),and to analyze ROP-related factors,with a comparative case series.Methods This was a study on premature infants who required screening and treatment of ROP in the Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University,carried out between January 2008 and April 2012.One thousand and one hundred eighty three infants met the study criteria and were divided into two groups:natural conception (group Ⅰ,1058 infants) and IVF (group Ⅱ,125 infants).Multiple variables were recorded,including birth weight (BW),gestational age (GA),number of births (NOB,singleton/twins/triplets),type of conception (natural conception/IVF),neonatal respiratory distress syndrome (NRDS),patent ductus arteriosus (PDA),neonatal asphyxia,neonatal hyperbilirubinemia (NHB),intracranial hemorrhage (IH),congenital heart disease (CHD),neonatal anemia,neonatal sepsis,and bronchopulmonary dysplasia (BPD).The results of ophthalmological examinations were also recorded.The incidence of ROP between groups was compared with the Pearson Chi-square test.We applied Spearman correlation analysis to identify the variables that were most significantly associated with ROP.Results There were 138 infants of ROP in group Ⅰ (total 1058,13.0％),and 17 in group Ⅱ (total 125,13.6％),without significant difference in the presence of ROP between two groups (P ＞ 0.05).No significant difference was found in the presence of ROP affected by BW,GA,NOB,NRDS and other diseases between two groups (P ＞ 0.05).A significantly inverse association was found between ROP and BW (P ＜ 0.05),and between ROP and GA (P ＜ 0.05).No association was found between ROP and NOB (P ＞ 0.05).There was no significant difference in the presence of diseases between infants conceived naturally and those by IVF in group ROP (P ＞ 0.05).A significant association was found between ROP and NRDS (P ＜ 0.05).No association was found between ROP and diseases (PDA,neonatal asphyxia,NHB,IH,CHD,neonatal anemia,neonatal sepsis,and BPD).Conclusions Our study shows that IVF was not a risk factor for ROP.

Objective To investigate the clinical effects of fast track surgery ( FTS ) in perioperative nursing care of laparoscopic cholecystectomy . Methods A total of 200 cases of laparoscopic cholecystectomy between January and December 2012 were randomly divided into two groups , with 100 cases of each group , receiving either FTS or conventional treatment .Comparison of the two groups in patients rehabilitation and complications were observed . Results The postoperative anal flatus time was significantly shorter in the FTS group (12.0 ±4.4) h than that in the control group (24.9 ±5.4) h (t=-18.519, P=0.000).The postoperative hospital stay was significantly shorter in the FTS group (3.2 ±1.3) d than that in the control group (4.2 ±2.1) d (t=-4.049, P=0.000).The patients’ weight loss at the 5 postoperative day was significantly less in the FTS group (3.2 ±0.3) kg than that in the control group (5.2 ±0.6) kg (t=-29.814, P=0.000). Conclusion FTS measures applied in laparoscopic cholecystectomy can significantly accelerate postoperative rehabilitation .

Objective To investigate incidence and severity of retinopathy of prematurity (ROP)screened by RetcamⅢ and the related factors.Comparative case series were designed.Methods A study was performed among infants who required screening by RetcamⅢ in the second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University,and carried out between May 2012 and April 2013.A total of 1097 infants met the study criteria,and were divided into group Ⅰ (n =333 from outpatient screening) and group Ⅱ (n =764 from inpatient screening).Variables were recorded,including birth weight (BW),gestational age (GA),number of births (NOB,singleton/twins/triplets),gender,neonatal respiratory distress syndrome (NRDS),patent ductus arteriosus (PDA),neonatal asphyxia,neonatal hyperbilirubinemia,intracranial hemorrhage,congenital heart disease,neonatal anemia,neonatal sepsis,necrotizing enterocolitis (NEC),and bronchopulmonary dysplasia (BPD).The results of ophthalmological examinations by RetcamⅢ were also recorded.Spearman correlation analysis was used to identify the variables most significantly associated with ROP.Results There were 98 infants of ROP in group Ⅱ (total 764,12.8％).There was a significant association of ROP with variables (P ＜0.05),including BW,GA,and NOB.There was a significant association of ROP with diseases (P ＜ 0.05),including NRDS,neonatal asphyxia,intracranial hemorrhage,neonatal anemia,neonatal sepsis,NEC,and BPD.However,there was no association of ROP with diseases (P ＞ 0.05),including PDA,neonatal hyperbilirubinemia,and congenital heart disease.Conclusions RetcamⅢ can be used to screen retina of infants.ROP is still the most common eye disease in preterm infants.The incidence of ROP was 12.83％ in Wenzhou.Variables,including BW,GA,NOB,NRDS,neonatal asphyxia,intracranial hemorrhage,neonatal anemia,neonatal sepsis,NEC,and BPD,were the most significant factors associated with ROP.

Objective:To understand the relationship between pain, negative emotions (anxiety and depression), insomnia and fatigue in patients with rheumatoid arthritis, and explore the multiple mediating effects of negative emotions and insomnia on pain and fatigue.Methods:A total of 240 patients with rheumatoid arthritis were selected from Northern Theater General Hospital from October 2018 to January 2019. The general questionnaire, Bristol Rheumatoid Arthritis Fatigue Multi-Dimensional Questionnaire,Visual Analogue Scale,The Hospital Anxiety and Depression Scale and the Asens Insomnia Scale were used to investigate the demographic data, fatigue, pain, anxiety, depression, and insomnia, respectively. SPSS 20.0 was used for correlation analysis, and Mplus 7.0 was used for mediation analysis.Results:The fatigue score of patients with rheumatoid arthritis was (28.88±14.89), which was moderate. The score of Visual Analogue Scale was 4(2-7), the score of insomnia was 7(3-11), the score of anxiety was 5(3-8), the score of depression was 7(4-11). There was a positive correlation between fatigue and pain, negative emotion and insomnia ( r values were 0.432-0.950, P<0.01). Negative emotions and insomnia had a partial mediating effect between pain and fatigue, with mediating effects accounting for 56.44% of the total effect. Conclusions:The fatigue of patients with rheumatoid arthritis is moderate; fatigue is associated with pain, negative emotions, and insomnia; negative emotions and insomnia have multiple mediating effects between pain and fatigue.

Objective:To analyze the clinical characteristics and laboratory examinations of hospitalized children with influenza, and improve medical personal awareness of severe influenza.Methods:Data of inpatients with influenza from November 2018 to February 2019 at Shenzhen Children′s Hospital was collected, and the clinical characteristics and laboratory examinations were statistical analyzed.Results:Of the 702 cases, 464(66.1%) cases were mild influenza, and 238 cases(33.9%)were severe influenza; the median age was 3.8 years, and 457(65.1%) cases were 0 to 5 years old.The number of patients with basic diseases and wheezing symptoms in the severe group was more than those in the mild group, with statistically significant differences(all P<0.05). The white blood cell count, percentage of neutrophils, neutrophils to lymphocytes ratio(NLR), C-reactive protein and procalcitonin in the severe group were higher than those in the mild group, while the percentage of lymphocytes was lower than that in the mild group(all P<0.05). Logistic multivariate regression analysis showed that underlying diseases, wheezing and NLR were risk factors for severe influenza.The area under the curve of NLR for severe influenza was 0.574, whose best cutoff value was 1.43. Conclusion:Influenza virus infection among children is mainly influenza A, and mostly affected children are under 5 years old.The blood routine of children with severe influenza mostly showes increased white blood cell, mainly neutrophils increased significantly, and increased C-reactive protein and procalcitonin.Children with underlying diseases, wheezing symptoms during the course of the disease, and elevated NLR are more likely to progress to severe cases, and NLR cannot be used as a independent predictor of severe influenza.

Assistive Technology Act of the USA is a very important law for the persons with disability in USA. The background of the Assistive Technology Act of the USA was reviewed and the guarantee of laws for the disabilities was discussed in the paper. From which, some theory and practice for special education of China can be obtained, and some experience and enlightenment for setting up related laws in China also can be worked out.

OBJECTIVE: To review the established tele-pharmacy service system,service pattern and standard based on modern telecommunications and information technologies and provide references for exploration and implementation of tele-pharmacy in China to deliver pharmaceutical care to patients at a distance. METHODS: Literatures about tele-pharmacy practice in domestic and at abroad were retrieved. The development,service pattern,advantages and disadvantages and related application studies of tele-pharmacy were summarized and analyzed. RESULTS: Tele-pharmacy is used to deal with how to obtain equivalent pharmaceutical care as traditional service pattern to underserved populations in the status of lacking pharmacists and poor access to pharmaceutical care. More and more countries have approved and conducted this pattern,and the impact and patient satisfaction have been confirmed. But limitations such as laws and technologies still exist. CONCLUSION: Tele-pharmacy service could play an important role in balancing pharmacist resources and promoting rational drug use.

Objective To understand the epidemiological characteristics of metabolic syndrome (MS ) among adults in Wanzhou District of Chongqing City in order to provide reference for carrying out the prevention and treatment of MS in this re‐gion .Methods The multi‐stage random sampling method was adopted to perform the questionnaire survey ,body measurements and laboratory detection in the adult residents aged 18 years old and over extracted from 26 villages ,towns and urban streets .The MS prevalence rate was calculated and MS component distribution situation was analyzed .Results A total of 2 587 people were effec‐tively surveyed .The MS total prevalence rate was 13 .8% ,which was risen along with the age increase .The prevalence rates of ab‐dominal obesity ,hypertriglyceridemia ,low HDL‐C level ,hypertension and hyperglycemia were 16 .5% ,23 .5% ,23 .3% ,35 .5% and 27 .2% respectively .The proportions of people possessing at least 1 ,2 ,3 ,4 components and 5 components of MS were 71 .6% , 36 .2% ,13 .8% ,3 .9% and 0 .5% respectively .Conclusion The prevalence rate of MS reaches a certain level in this region ,it is necessary to carry out the health education of MS ,change the adverse lifestyle ,control the corresponding factors ,which could reduce the MS risk and promotes its reversion .