Adult ; Facial Nerve Diseases ; complications ; Female ; Humans ; Mastoiditis ; complications ; Neurofibroma ; complications

Objective To explore the experience of nursing patients with Crohn’s disease.Method The nursing histories of 80 patients with Crohn’s disease were retrospectively reviewed to analyze and summarize the measures for nursing them.Result After active treatment and effective nursing,all the patients were improved and discharged.Conclusion Effective nursing is of positive significance to improve the curative effect of Crohn's disease.

Objective To explore the inner feelings of gestational diabetes at their primary use of the real-time blood glucose monitoring. Method Using the qualitative method, 10 gestational diabetic patients monitored their blood glucose using the real-time blood glucose monitoring for the first time and then were interviewed, the acquired results treated with phenomenological analysis. Result The inner feelings of the 10 patients were summarized including 5 themes:worry about the safety of the fetus, fear on alarming at monitoring, different views on four times input of finger blood glucose values, worry about inaccuracy in blood glucose monitoring data, changes in mental conditions and diets. Conclusion Health care workers should provide the gestational diabetic patients with targeted care strategies based on presence of psychological status and knowledge needs so as to improve their compliance, reduce the psychological burden of patients and control their blood glucose level.

Objective To investigate the prevalence of endemic fluorosis in Guide county of Qinghai province, in order to provide appropriate measures to monitor and control the disease. Methods Damo, Wenquan, Baoning villages(water source has been changed) and Taiping village(water source has not been changed) in Guide county were involved in the study in 2008. One tap water sample was collected in dry and rainy seasons, respectively. Water fluoride was tested in accordance with the "Standard Test Methods for Drinking Water" (GB/T 5750.5-2006); of all the children aged 8 to 12, dental fluorosis was diagnosed using Dean criteria; 6 copies of urine samples were collected in each age group, urinary fluoride was measured using fluoride ion-selective electrode (WS/T 89-1996). According to the "Clinical Diagnostic Criteria of Endemic Skeletal Fluorosis "(WS 192-2008), clinical skeletal fluorosis was determined in adults over the age of 16 by X-ray examination for 10 people in each selected village. Results The mean water fluoride was 0.58,0.38,2.28,0.37 mg/L in Damo, Wenquan, Taiping, and Baoning villages, respectively, and that of Taiping village exceeded the national standard(1.0 mg/L). One hundred and ninety-three children aged 8-12 were checked, the detection rate of dental fluorosis was 49.74% (96/193); urine samples of 116 children were tested, median urinary fluoride was 1.49 mg/L A total of 1503 adults over the age of 16 were examined, the clinical detection of skeletal fluorosis was 51.63%(776/1503); a total of 82 people were X-rayed, X-ray detection of skeletal fluorosis was 20.73%(17/82). The characteristic of X-rays were degeneration and ossification of interosseous membrane. Conclusions Prevalence of dental fluorosis of children and adult clinical skeletal fluorosis are higher. The endemic fluorosis is still comparatively serious. Prevention efforts need to be further strengthened.

Objective To analyze the risk of smoking on early diabetic foot patients.Methods One hundred and four early diabetic foot patients were involved in the study.According to cigarette smoking,patients were divided into the smoking group(n=45) and the no-smoking group(n=59).FBG,PBG2h,HbA_1c,TC,TG,HDL,LDL, BUN,Cr,CRP,ABI(ankle-branchial index)were examined.T-test and chi-square test were used to assess the risk of smoking on early diabetic foot patients.Results Compared with the no-smoking group,the smoking group were as- sociated with HDL and CRP.Chi-square-test demonstrated a statistically significant difference between the groups with smoking and no smoking on peripheral vascular disease in early diabetic foot patients.Conclusion Smoking re- mains significantly an independent risk of early diabetic foot patients.

BACKGROUND: The proximal tibia is the second common site for primary bony sarcomas,which lacks adequate soft tissue coverage.Resection and reconstruction by any technique leave the reconstructed area in a subcutaneous position.This has been a major source of necrosis of skin and infections.OBJECTIVE: To observe the effect of gastrocnemius muscle transfer to obtain soft-tissue coverage and extensor mechanism reconstruction for limb-sparing resection of the proximal tibia with endoprosthetic reconstruction.METHODS: From January 2001 to June 2008,27 patients with osteosarcoma of the proximal tibia confirmed by biopsy were selected.All the tumours were assigned to stage IIB based on Enneking's classical staging system.Neoadjuvant chemotherapy(Bacci,IOR/OS-N4)was utilized for the patients.All the patients adopted limb-sparing surgery,i.e.resection of proximal tibia with endoprosthetic reconstruction.A gastrocnemius flap was utilized to improve implant coverage and enhance the patellar tendon repair.MSTS was used to measure the functional status of patients with a sarcoma in the leg.RESULTS AND CONCLUSION: The follow-up was averagely 53.1 months.Of 27 patients,2 cases(7%)died of lung metastasis within 2 years,1(4%)suffered from amputation due to infection and underwent amputation.The others developed no complications or recurrence.The MSTS score was averagely 25.1 points.Results show that resection with endoprosthetic reconstruction utilizing a gastrocnemius muscle flap for osteosarcoma of the proximal tibia is reliable and predictable in combination with neoadjuvant chemotherapy.

Objective Assessment of right ventricular function in patients with atrial septal defect (ASD) is difficult. The Doppler myocardial performance index (MPI) may provide a method of assessing function in these patients. The purposes of this study were to evaluate the right ventricular function and its changes in patients with ASD after transcatheter closure of ASD. Methods MPI, defined as the sum of isovolumic relaxation time and isovolumic contraction time derived by ejection time, was measured from tricuspid inflow and right ventricular outflow; Doppler velocity profiles recorded during routine echocardiography. Twenty nine patients ( 13 men, 16 women;mean age 25.28 ± 12.69, range 6 to 57 years) were diagnosed to secundum ASD [the stretched diameters of ASD were from 9 To 36 (24.91 ±7.98) mm], and had a successfully placed Amplatzer septal occluder (ASO) (the sizes of ASO were from 11 to 40 mm ); there were 81 sex-matched, age-matched healthy people (control group 41men, 40 women; mean age 29.02 ± 14.22, range 4 to 45 years).MPI was measured again on 3 days and 1 month after closure of ASD. Change in the study group was assessed and compared to the control subjects with structurally normal hearts. A complete 2- dimensional and Doppler echocardiographic examination was performed in all study groups. Results 1) The isovolumic relaxation and isovolumic contraction times [respectively(77.59 ± 14.39)ms vs (60.93 ± 12.94)ms, P＜0.0001; (28.28 ± 10.88)ms vs (23.64 ± 9.01)ms, P=0.027] were prolonged, and ejection time [(260.65 ± 21.86 )ms vs (271.85 ± 21.92)ms, P=0.033] was shortened in patients with ASD compared with that in control subjects, resulting in a marked increase in the MPI(0.40 ± 0.07 vs 0.31 ± 0.05, P＜0.0001) from normal values; 2) by Pearson's correlations, the MPI had no correlation with heart rate and blood pressure in control subjects and patients with ASD, but it correlated positively with age in patients with ASD; 3) by Pearson's correlations, the MPI correlated positively with the diameter of ASD and pulmonary artery pressure; 4) after transcatheter closure of ASD, the MPI decreased markedly. Conclusions 1) MPI is a conceptually new, simple, and reproducible Doppler index in patients with ASD; 2) MPI is free from the effect of age, heart rate and blood pressure; (3) MPI appears to be relatively dependent on changes in the diameter of ASD and pulmonary artery pressure; 4) the right ventricular function was improved after transcatheter closure of ASD.

Objective To study the AmpC beta-lactarnase and its genotype mediated by plasmid in Escherichia coli.Methods AmpC beta-lactamase was detected based on that AmpC beta-laetamase can be inhibited by 3-aminophenylboronic acid(APB).MIC was ehecked by agar dilution method.Conjugation test was used to check the transfer of ampC gene.Gene chip and PCR were used to detect ampC gene.The amplified ampC gene were sequenced and analyzed by EMBOSS software.The molecular epidemiology of clinical isolates was investigated by Enterbacterial repetitive intergenic consensus(ERIC)typing method.Results In 74 strains of Escherichia coli insusceptible to cefoxtin,AmpC beta-lactamase was positive in 33 strains.8 strains possessed AmpC beta-lactamase of CIT group by gene chip and 8 transconjugants were obtained by conjugation test.CMY type ampC gene could be further amplified by specific CMY gene primers from both 8 clinical isolates of E.coli and plasmids extracted from 8 transconjugants.CMY-2 type ampC gene was found by sequencing(accession number DQ823449).The most transconjugants displayed similar MIC value(intermediate or resistant).ERIC genotyping showed 6 out of 8 isolates with CMY-2 ampC gene derived from different resource.Conclusion CMY-2 AmpC beta- lactamase mediated by plasmid could be detected in E.coli isolates from patients in the General Hospital of People Liberation Army,Beijing.The plasmid carried ampC gene could mediate multi-drug resistance.

To promote the construction of first-class disciplines of "Double First-Class" universities in China, the construction of a comprehensive evaluation system was explored, so as to provide suggestions for the development of these disciplines.Essential Science Indicators (ESI), InCites and Derwent Innovation Index databases, together with range transformation method and entropy weight method, were employed to analyze the data in the field of pharmacology and toxicology from some universities; the construction approaches and index performance of the system were studied. The score performances of the sample universities in the index system are different from their ESI rankings, suggesting that the system has certain practical value.ESI rankings cannot fully reflect the development levels of disciplines, while the multi-dimensional index evaluation system can overcome this shortcoming to a certain extent.This paper establishes an evaluation system with published papers and granted patents as the main evaluation objects, covering as many multi-angle indicators of scientific research output as possible, and trying to overcome the disadvantages due to lack of information in a single or few index systems.It is suggested that universities should formulate their discipline development plans from the perspectives of publishing high-quality original research results, leading or widely participating in scientific research cooperation, strengthening university-enterprise cooperation, promoting the application of research results, promoting open science and encouraging open access.

BACKGROUNDPolypharmacy and potentially inappropriate medications (PIMs) are prominent prescribing issues in elderly patients. This study was to investigate the different prevalence of PIM use in elderly inpatients between 65-79 years of age and 80 years or older, who were discharged from Geriatric Department in West China Hospital.

METHODSA large-scale cohort of 1796 inpatients aged 65 years or over was recruited. Respectively, 618 patients were 65-79 years and 1178 patients were 80 years or older. Updated 2012 Beers Criteria by the American Geriatric Society was applied to assess the use of PIM among the investigated samples.

RESULTSA review of the prescribed medications identified 686 patients aged 80 years or older consumed at least one PIM giving a rate of 58.2%. Conversely, 268 (43.4%) patients aged 65-79 years consumed at least one PIM (χ2 = 40.18, P < 0.001). Patients aged 80 years or older had higher hospitalization expenses, length of stay, co-morbidities, medical prescription, and mortality than patients aged 65-79 years (all with P < 0.001). Patients aged 80 years or older were prescribed with more benzodiazepines, drugs with strong anticholinergic properties, megestrol, antipsychotics, theophylline, and aspirin. In multiple regression analysis, PIM use was significantly associated with female gender, age, number of diagnostic disease, and number of prescribed medication.

CONCLUSIONSThe finding from this study revealed that inpatients aged 80 years or older encountered more PIM use than those aged 65-79 years. Anticholinergic properties, megestrol, antipsychotics, theophylline, and aspirin are medications that often prescribed to inpatients aged 80 years or older. Doctors should carefully choose drugs for the elderly, especially the elderly aged 80 years or older.