Objective To investigate the functioning of outpatients with chronic diseases. Methods 61 outpatients were investigated with the World Health Organization Disability Assessment Schedule 2.0 (WHO-DAS 2.0) Chinese version. Results All the outpatients expressed slight barriers in fields of understanding and communicating, moving and getting around, self-care, interacting with other people, domestic responsibilities, and joining in community activities. The outpatients with musculoskeletal and cutaneous diseases were more difficult in interacting with other people than other patients (P<0.05). Conclusion There are slight barriers in the outpatients with chronic diseases in activities and participations, which may be various with the diseases.

Objective Investigated the clinical features and risk factors of pulmonary metastasis in children with papillary thyroid carcinoma aiming to provide guide for clinical work.Methods Collected the informations of 40 patients with under the age of 14,who underwent surgery in the Thyroid surgery of the First Affiliated Hospital of ZhengZhou University and confirmed for the papillary thyroid carcinoma by the postoperative pathology.At the same time,excluded studies with history of head and neck malignancy or lyphoma or secondary thyroid cancer,papillary thyroid carcinoma with hyperthyroidism and cases of imcomplete informations.The age of the 40 patients was 3 to 14 years old,12 were boy and 28 were girl.The largest tumor diameter was 7.5 cm,and the smallest was 0.3 cm.Tumor lesions were solitary in 22 cases and multiple lesions were in 18 cases.There were 33 cases of cervical lymph node metastases and 7 cases of no cervical lymph nodes.There were 10 cases of pulmonary metastasis and 30 cases of non-pulmonary metastasis.This research adopted chi-square test and Logistic regression statistical analysis of related risk factors and clinical features,including patients' age,gender,tumor diameter,number of lesions,surgical methods,neck lymph node metastasis,and pulmonary metastasis.Results The positive rate of plumonary metastsis in children with papillary thyroid carcinoma was 25％ (10/40),statistical analysis found that the positive rate of children with lung metastasis (x2 =8.620,P =0.003),tumor diameter over 2 cm (x2 =5.763,P =5.763) and the difference was statistically significant higher.Logistic regression analysis showed that the number of risk factors was multifocal papillary thyroid carcinoma in children lung metastasis (OR =13.058,P =0.028).Conclusions Higher lung metastasis is a clinical feature of thyroid papillary carcinoma in children.The risk of lung metastasis was significantly higher for children with thyroid papillary carcinoma who had multiple lessions.

Objective To explore the effect of ankle strategy stability limit training on balance and gait in recovering stroke patients with hemiplegia. Methods Forty recovering stroke patients were randomized into an intervention group and a control group.The patients in the intervention group were given ankle strategy stability limit training using visual feedback on the static long sets of a Smart Equitest Balance Master (SEBM) machine.Those in the control group practiced routine postural balance training using mirror visual feedback in parallel bars.Both groups of patients practiced balance and posture control for 30 minutes,once daily,6 days a week for two weeks. Both groups were also given routine therapy and other rehabilitation.The patients' balance function was evaluated using the Berg Balance Scale (BBS),and their gait was assessed using the walk across technique (WA). Results There was no significant difference between the two groups with regard to general information,BBS scores or WA results before treatment.After 2 weeks of treatment,BBS scores as well as the step length and pace in the WA improved significantly in both groups,but all improved significantly more in the intervention group.There was no significant difference in width of gait. Conclusion Ankle strategy stability limit training can enhance weight-bearing on stroke patients' affected foot as well as their balance and the symmetry of their steps.

Objective To evaluate the safety and feasibility of ketamine-propofol mixture anesthesia for 85 children with congenital heart disease undergoing cardiac catheterization.Methods Eighty-five children with congenital heart disease undergoing cardiac cathete-rization were randomly divided into ketamine group(K group,n=44)and ketamin-propofol group(KP group,n=41).K group:1 mg?kg-1 ketamine was injected intravenously and then infused at 50 ?g?kg-1?min-1 for anesthesia maintenance.KP group:anesthesia was induced with ketamine 1 mg?kg-1 and propofol 1 mg?kg-1 intravenously,and maintained by continuous infusion of ketamine(16.7 ?g?kg-1?min-1)and propofol(33.3 ?g?kg-1?min-1).Electrocardiogram,blood pressure,pluse,respiratory frequency,saturation of blood oxygen were continously monitored.Results Hemodynamic and respiratory function were stable in both 2 groups.Ketamine consumption in K group was significantly more than that in KP group[(52.1?2.8)?g?kg-1?min-1 vs(25.3?7.3)?g?kg-1?min-1],eye opening time and recovery time were also longer in K group than those in KP group [(50.2?16.5)min vs(40.4?18.3)min].Conclusion The ketamine-propofol mixture was a safe,efficacy anesthesia with excellent recovery in children with congenital heart disease undergoing cardiac catheterization.

Objective To evaluate the diagnosis and surgical treatment of primary hyperparathyroidism (PHPT). Methods 53 patients with PHPT who were treated in our hospital from 1997 to 2009 were analyzed retrospectively. Results All patients showed hypercalcemia and elevated parathyroid hormone (PTH). Among them, 43 were diagnosed as parathyroid adenoma, 6 were parathyroid hyperplasia and 4 were parathyroid cancer.The accuracy rate of parathyroid tumor localization was above 94. 3%. All patients presented temporary hypocalcemia after surgery. Conclusions Parathyroidectomy is an effective approach for patients with PHPT. Preoperative localization is essential to the surgery.

Objective To discuss the application value of the capillary electrophoresis in detecting the glycosylation hemoglobin (HbA1c)level.Methods By utilizing the uncoated fused silica capillary column(30 cm in length and 25 μm in diameter)and the specific adsorption peak,the HbA1c levels in the healthy people,patients with diabetes mellitus(DM)and high risk people were de-tected by the photodiode array(PDA)method at the wavelength of 415 nm.During the research process,the precision and accuracy were perfomred the accuracy analysis.Results HbA1c could be effectively separated from non-HbA1c,with a sharp peak.And the relative quantity of HbA1c could be determined.Conclusion The capillary electrophoresis is characterized by specificity,high precision,and high accuracy.Therefore,it should be widely applied in clinic.

Aim To investigate the relationship be-tween the depression-like behaviors of rats induced by chronically unpredictable stress( CUS) and the protein expression of tumor necrosis factor alpha( TNF-α) , in-dole-2 , 3-dioxygenase ( IDO ) and 3-hydroxyl amino acid oxygenase( HAAO) . Methods Thirty male Spra-gue Dawley( SD) rats were randomly divided into con-trol group and model group. CUS plus solitary condi-tion were used to establish the depression model. The open field test ( OFT ) and the force swimming test ( FST ) were used to evaluate the depression-like behaviors of rats ;Western blot was used to determine the protein expressions of TNF-α, IDO and HAAO in the prefrontal cortex and hippocampus of rats. Results Model group rats showed obvious depression-like be-haviors with increasing immobile time in FST ( P <0. 01) and decreasing locomotive activity in OFT( P<0. 01 ) , and up-regulating the protein expression of TNF-α, IDO and HAAO in the prefrontal cortex and hippocampus significantly ( P <0. 05 ) , compared with control group rats. Conclusion The depression-like behaviors of rats induced by CUS may be associated with the activation of IDO-HAAO pathway mediated by TNF-α.

Aim To study the role of histone acetyla-tion and its involvement in the depression-like behav-iors of rats induced by chronic unpredictable stress (CUS ). Methods Thirty male Sprague Dawley (SD ) rats were randomly divided into control group and model group.The method of solitary condition with CUS for consecutive 28 days was used to establish the rat depression model.The open-field test (OFT)and the forced swimming test (FST)were used to evaluate the depressive behaviors of rats;the real time PCR was used to detect the change of HDAC2 mRNA, and Western blot was used to determine the protein expres-sions of H3,H4,acH3 and acH4 in the prefrontal cor-tex and hippocampus of rats.Results Model group showed obvious depression-like behaviors with decrea-sing locomotive activity in OFT (P <0.01 )and in-creasing immobility time in FST (P<0.01),up-regu-lating the mRNA and protein expression of HDAC2 (P<0.0 1 ),and down-regulating the protein expression of acH3 and acH4 (P<0.01)in the prefrontal cortex and hippocampus significantly,compared with control group.Conclusion The mechanism of depressive be-haviors of rats induced by CUS may be associated with down-regulating the level of histone acetylation modifi-cation.

OBJECTIVE To establish a method of polymerase chain reaction(PCR) for detecting staphylococci in positive blood culture bottles.METHODS Genomic DNA in 493 positive blood culture bottles was extracted by guanidine hydrochloride and benzenemethanol,then genes 16S rRNA,ssa and mecA were amplified by PCR to identify staphylococci.Finally,the results of PCR were compared with that of traditional method.RESULTS To compare with traditional method,as the golden standard the sensitivity and specificity of PCR method were 98.6% and 100.0%,respectively,the detection could be finished in four hours.Method of PCR was better than traditional method in detecting meticillin-resistant staphylococci.CONCLUSIONS The PCR-based assay is simple,rapid,sensitive and specific,it can be used to detect staphylococci in positive blood culture bottles.

The papor made a classification and summary on content and pattern of digitizing researches on chinese ancient medical books in mainland China, highlighted the major achievements and put forward a few issues to be solved.