Objective:Primary gastric choriocarcinoma (PGC) is a rare tumor. This study aimed to analyze cases reported in Chi-nese and two cases in our hospital. This study was also conducted to investigate the clinical characteristics and treatment of PGC. Meth-ods:The Chinese Medical Current Contents and China Biology Medicine database was retrieved with the following terms:primary gas-tric choriocarcinoma, stomach choriocarcinoma, and ectopic choriocarcinoma. The clinical data in published literature were retrospec-tively analyzed. Two cases from our hospital were also retrospectively analyzed. Results:A total of 16 patients with PGC (14 case stud-ies and 2 cases from our hospital) were included in this study. The average age of the patients was 57.69 years (ranging from 42 years to 79 years). Among the 16 patients, 4 were females and 12 were males. The main clinical manifestation was abdominal discomfort (12/16). Laboratory and imaging tests were non-specific, but HCG-βin all of the patients increased (11/11). Organ or lymph node metasta-sis was found in 13 patients, including 6 cases in which two or more organs showed metastasis. These organs were primarily the liver, the stomach lymph nodes, the lungs, the brain, and the abdominal cavity. Pathological examination results showed that 12 of the 16 cas-es displayed ulcers with necrosis and hemorrhage. The four remaining cases manifested lesions. Lesions may occur in the stomach less-er curvature (5 cases), stomach sinus (6 cases), cardiac (2 cases), and gastric body (3 cases). The histological components of PGC co-ex-isted with other factors, such as adenocarcinoma (7 cases), adenocarcinoma and squamous (2 cases), adenocarcinoma and a signet ring cell (1 case), or pure choriocarcinoma (6 cases). Surgery combined with chemotherapy was the main treatment. A total of 14 patients un-derwent surgical operations. Among these patients seven underwent chemotherapy after surgery and one underwent chemotherapy. Among the 10 patients who were followed up, 8 died within six months after diagnosis. Conclusion:PGC is a rare stomach cancer with poor prognosis and primarily affects older men. No characteristic clinical manifestations were observed, but HCG-βas a specific serum tumor biomarker increased in all of the affected patients. Histological components co-existed with other stomach cancers. Surgical exci-sion combined with chemotherapy was the preferred treatment in early stages, and systemic chemotherapy was the recommended treat-ment in advanced stages.

Objective To explore the path of subjective well-being, perceived social support and professional commitment among undergraduate nursing students. Methods A total of 207 undergraduate nursing students in a medical university in Anhui were recruited by cross-sectional survey method. Nursing students were investigated using General Information Questionnaire, Index of Well-being, Perceived Social Support Scale, Professional Commitment Scale during October to November 2016. SPSS 16.0 was used for statistical analysis, the data were analyzed by t test or variance analysis;Multivariate analysis was performed by multiple linear regression, and AMOS 17.0 was used for mediation analysis. Results The professional commitment score for nursing students was (88.01 ±10.94); perceived social support and subjective well-being were positively correlated with professional commitment (r=0.349-0.413, P=0.000); nursing role, pro-fessional interest, perceived social support, subjective well-being can positively predict professional commit-ment (β=0.157, 0.324, 0.210, 0.220), motivation can negatively predict professional commitment;path analysis showed that perceived social support played a partial mediating role between subjective well-being and pro-fessional commitment. Conclusion The professional commitment were related to subjective well-being and perceived social support, and perceived social support plays a partial mediating role between subjective well-being and professional commitment among nursing students. Nursing educators can understand social support and subjective well-being as the breakthrough point, which actively formulate intervention strategies to enhance the professional commitment, stabilize the development of nursing team, and improve the quality of nursing.

Objective: To learn the results of MNA ( mini nutritional assessment ） nutrition screening and influencing factors in the elderly living at home, so as to provide basis for improving the nutritional status of the elderly living at home. Methods: The elderly people at home were recruited from Yinzhou District, Yiwu City and Changshan County in Zhejiang Province by the multi-stage random sampling method. Their demographic information, living habits and nutritional status were collected by the MNA scale and the questionnaire for nutrition and health status surveillance. The multivariate linear regression model was used to analyze influencing factors for the nutritional status. Results: Of 374 study subjects, 186 ( 49.73% ) were males and 188 ( 50.27% ) were females. The age was ( 69.63±6.68 ) years ( range, 60-90 years ). The average score of MNA scale was 25.26±2.81. The prevalence of malnutrition risk in the elderly living at home was 20.59%. Age ( β'=-0.140), marital status ( β'=0.110 ), annual income ( β'=0.155 ), active physical exercise ( β'= 0.104 ), eating health products/nutritional supplements ( β'= 0.110 ) and satiety ( full diet β'=0.196 ) were influencing factors for MNA scores ( P<0.05 ）. Conclusion The prevalence of malnutrition risk among the elderly living at home is 20.59%. The prevalence increases with age. Having a spouse, doing active physical exercise, eating health products/nutritional supplements, having healthy eating habits are conducive to maintaining the nutritional health of the elderly.

Tilianin was separated and authenticated from the seeds of Dracocephalum moldavia, a Uygur medicine, by chromatographic technique and spectroscopic method. The purity of tilianin is more than 98% determined by HPLC area normalization method. Thin layer chromatography (TLC) method was used to separate tilianin from D. moldavia by mixture of chloroform-methanol (5: 1) as a developing solvent on high performance silicagel precoated plate (SGF254) and using aluminium trichloride as a chromogenic agent for qualitative identification of D. moldavia. To establish a HPLC method for quantitative analysis of D. moldavia, tilianin was used as a Quantitative marker and separated on a C18 (4.6 mm x 250 mm, 5 μm) column with acetonitrile-01% formic acid (25: 75) as the mobile phase and detected at 330 nm. The calibration curve of tilianin displayed ideal linearity over the range of 0.617 2-123.44 μg x mL(-1) with a regression equation of Y = 33.773X - 0.824 8 (r = 1). The average recovery of tilianin was 101.0% with RSD of 3.7%. The RSD values of intra-day and inter-day precision were less than 2%. The content of tilianin in 4 batches of the authenticated semen of D. Moldavia was between 0.016 and 0.187 mg x g(-1). The qualitative and quantitative method established is suitable for the quality evaluation and assessment of semen of D. Moldavia.
Chromatography, High Pressure Liquid ; Chromatography, Thin Layer ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; standards ; Flavonoids ; chemistry ; isolation & purification ; standards ; Glycosides ; chemistry ; isolation & purification ; standards ; Lamiaceae ; chemistry ; Magnetic Resonance Spectroscopy ; Quality Control

Objective:To explore the relationship among psychological distress,adult attachment,and social support in primary caregivers of cancer patients.Methods:A total of 208 primary caregivers of cancer patients in one third grade hospital in Anhui Province were recruited.The 10-item Kessler Psychological Distress Scale(K10),Experiences in Close Relationships Inventory(ECR) and Social Support Questionnaire(SSQ) were used to explore psychological distress,adult attachment,and social support status.Results:The average K10 score was (21.5 ± 7.5).Multiple linear regression analysis indicated that caregiver gender,pressure on patient care,and attachment anxiety had positive prediction on psychological distress (β =2.30,3.02,0.13),while residence had negative prediction on psychological distress (β =-3.22).Conclusion:It suggests that the psychological distress is related to attachment anxiety and social support among the primary caregivers.

In recent years, the concept of "augmented renal clearance" (ARC) has been proposed in the field of critical illness and is defined as enhanced renal clearance of drugs. ARC is considered when the creatinine clearance rate exceeds 130 mL/(min·1.73 m). An increasing number of evidence has shown that ARC is commonly seen in critically ill adults and children. In critically ill children, low drug concentration due to ARC may lead to treatment failure. Unfortunately, ARC is often neglected due to the lack of reliable tools to assess renal function in critically ill children. Therefore, with reference to the articles on ARC in critically ill children, this article reviews the concept of ARC, the pathogenesis of ARC, the influencing factors for ARC, the identification tools for ARC, and the influence of ARC on pharmacokinetics/pharmacodynamics of antibacterial agents and clinical outcome, in order to provide a reference for clinical medication.
Anti-Bacterial Agents ; Child ; Creatinine ; Critical Illness ; Humans ; Kidney Function Tests ; Risk Factors

Objective To investigate the prevalence and influencing factors related to abuse and negligence against the elderly in the rural areas. Methods 975 elderly over 60 years from 41counties in Anhui province were included. All participants completed an anonymous questionnaire including items as: educational background, marital condition, income, child-discipline, rude action to parents, daily activities, physical functions, having chronic illness, abuse and negligence against the elderly, etc. Results In the last year, rates of common physical abuse, serious physical abuse,emotional abuse, financial exploitation, negligence, overall abuse and negligence against the elderly were 4.5%, 1.5%, 26.9%, 4.9%, 7.2%, 29.9% respectively. Among the 281 victims, 80.4% reported that they were suffered more than 3 times of abuse and neglect episodes, and 34.9% reported that they were suffered more than 2 forms of abuse and negligence. The primary sadism was carried out by the daughter-in-law or son-in-law (43.2%) of the elderly. Low activity on daily life and having chronic illness were the risk factors causing common physical abuse while better education was the protective factor to it, Low ability in managing daily activity of living was the risk factor causing serions physical abuse. Less active on daily life and having rude action to parents were the risk factors to emotional abuse, but being strict with their children was the protective factor to emotional abuse. Less active on daily life, often beating their children and having rude action to parents were the risk factors related to financial exploitation. Less active on daily life, having rude action to parents and having bad physical functions were the risk factors causing negligence. Less active on daily life and having rude manner to parents were the risk factors of overall elderly abuse and negligence, but being strict with their children was protective factor to the abuse and negligence against the elderly. Conclusion High prevalence on abuse and negligence against the elderly was seen in the rural areas of China. Different forms on elderly abuse and negligence were affected by different factors that called for more attention to be paid to those elderly with lower ability in managing their daily life.

Objective To investigate the prevalence of hypertension with diabetes and the cardiovascular disease risk among adults in Zhejiang Province. Methods Based on a population-based cross-sectional survey in Zhejiang Province in 2010, data of total 17437 adults aged 18 years and older were analyzed. Results The overall prevalence of hypertension with diabetes was 5.36％, which was significantly higher in females (5.71％) than in males (4.96％) (P<0.05) . With age increased, the prevalence of hypertension with diabetes significantly increased (P<0.01) . And 98.29％ of hypertension with diabetes patients had three or more cardiovascular disease risk factors. The exposure rate of clustering was higher in males (99.26％) than in females (97.54％)(P<0.05), and which increased significantly along with age (P<0.05) . Conclusion Hypertension with diabetes patients had higher cardiovascular disease risk in Zhejiang, and elder and male patients appeared to be the targeted population.

OBJECTIVETo study the socio-demographic characteristics, acquired immune deficiency syndrome (AIDS) related behaviors of male clients of female sex workers and their determinants.

METHODSContacting subjects through 5 ways including volunteers of female sex workers (FSWs), sexually transmitted disease (STD) clinics, long-distance bus stations, long-distance cargo station while adopting methods as snowballing, employing an anonymous questionnaire. Data was analyzed by logistic regression analysis.

RESULTS(1) The majority of clients were 25-45 years old, married and of junior high school or above educational levels; (2) Among male clients of FSWs, numbers of having had commercial sexual intercourse was between 1 to 240, averaged 24 in the previous year. It significantly related to their occupation and the experience of their friends or colleagues who ever visited female sex workers; (3) 27.98% of them used condom every time during commercial sexual intercourse, which significantly related to the score of knowledge on AIDS, concourse of sex intercourse and inhabitation; (4) 28.36% of them had ever contracted STD, which significantly related to the frequency of commercial sexual intercourse in the previous year, risk awareness of being infected with human immunodeficiency virus, and frequency of condom use during commercial sexual intercourse.

CONCLUSIONThe proportion of always using condom was low among male clients of FSWs, and had had STDs. And it's necessary for active and specific intervention programs to them.

Acquired Immunodeficiency Syndrome ; prevention & control ; Adult ; China ; Condoms ; Humans ; Male ; Middle Aged ; Risk-Taking ; Sex Work ; Sexual Behavior ; Unsafe Sex ; statistics & numerical data

OBJECTIVETo access the prevalence rates of pre-hypertensive patients at different stages and its associated risk factors among adults of Zhejiang province.

METHODSStudy subjects were selected among local residents aged ≥ 18 years from 15 counties by multi stage stratified cluster random sampling method, from July to November, 2010. Each participant was required to complete questionnaire, physical examination and testing for overnight fasting blood specimen.

RESULTS17 437 residents were surveyed including 8169 males and 9268 females. The overall prevalence of prehypertension was 34.39%. The prevalence of pre-hypertension appeared to be higher in males (38.57%) than in females (30.70%) (χ(2) = 119.36, P < 0.0001). The prevalence of pre-hypertension decreased with the increase of age in males who were above 25 year olds (χ(2) = 76.94, P < 0.0001) and in females who were above 45 year olds (χ(2) = 114.66, P < 0.0001). The prevalence of pre-hypertension appeared to be higher in the rural (35.60%) than in the urban (32.39%) areas (χ(2) = 18.69, P < 0.0001). Data from multivariable logistic regression showed that factors as being male, aged older than 35 years of age, with waist circumference as ≥ 85 cm for men and ≥ 80 cm for women, body mass index ≥ 25.0 kg/m(2) and triglyceride ≥ 1.7 mmol/L were risk factors of pre-hypertension while having had higher education was a protective factor.

CONCLUSIONPre-hypertension was prevalent among adults residents in Zhejiang province. Factors as overweight, obesity, dyslipidemia appeared to be major risk factors for pre-hypertension.

Adolescent ; Adult ; Aged ; China ; epidemiology ; Cross-Sectional Studies ; Female ; Humans ; Male ; Middle Aged ; Prehypertension ; epidemiology ; Prevalence ; Risk Factors