ObjectiveTo investigate the current status of hope in maintenance hemodialysis patients and analyze its influential factor,in order to provide reference for effective intervention.MethodsA total of 182 maintenance hemodialysis patients were recruited from 3 dialysis centers in Guangzhou and were investigated with the self-designed questionnaire,dialysis symptom Index,the Herth hope scale,simplified coping scale and social support scale.The data were analyzed by single-factor and multiple-factor analysis.ResultsThe average score of hope in maintenance hemodialysis patients was 31.83 ±3.69,and 87.91％ of patients got a moderate hope level.The average scores of present of symptom distress,degree of distress,active coping style,passive coping style and social support were 13.44 ± 5.63,35.27 ± 18.51,2.15 ± 0.28,1.56 ± 0.33 and 42.24 ± 4.09 respectively.Multiple linear regression indicated that symptoms presence,the symptoms distress degree,the passive coping style were the risk factors of hope level and the standard regression coefficient were - 0.098,- 0.424,- 0.104,P =0.047 ～ 0.000.The social support and the active coping style were the protective factors of hope level and the standard regression coefficient were 0.183,0.226,P=0.000.And they explained 96.2％ of the variance.ConclusionThe level of hope in maintenance hemodialysis patients is moderate.Symptom distress,the coping style and social support are factors influencing hope level of patients.

Objective To develop a method for the determination of aflatoxins B1,B2,G1 and G2 in Chinese herbal medicine.Methods The herbal medicine samples were cleaned up on immunoaffinity columns and analyzed by high performance liquid chromatography(HPLC) with fluorescence detection.For chromatographic separation,a Zorbax SB C18(4.6 mm?150 mm,5 ?m) column was employed.The separation was carried out as the mobile phase of methanol-0.01 mol/L KH2PO(44+6)with a flow rate of 0.5 ml/min at column temperature of 35 ℃.The reaction tube temperature of postcolumn derivatization system was 70 ℃.The detection was observed by fluorescence with excitation at 360 nm and emission wavelength at 425 nm.Results The calibration curve showed good linearity in the range of 12.00-300.00 ?g/L for aflatoxin B1,and 24.00-600.00 ?g/L for aflatoxin B2,G1 and G2.The lowest limits of detection for aflatoxins in Chinese herbal medicine were 0.025 ?g/L for AFB1,0.085 ?g/L for AFB2,0.060 ?g/L for AFG1,and 0.055 ?g/L for AFG2,and the correlation coefficients were ≥0.996.Recoveries were 81.7%-101.2% for aflatoxin B1,B2,G1 and G2 spiked to Fructus amomi,Radix angelicae sinensis,Rhizoma polygonati,Rhizoma atractylodis macrocephalae and Rhizoma dioscoreae at the level of 5 ?g/L,and the relative standard deviations were 0.7%-4.9% in all instances.Conclusion The method has good stability,high sensitivity and high selectivity,and it is applicable to the determination of aflatoxins in Chinese herbal medicine.

BACKGROUND: The pathological change of femoral head was observed after treating necrosis with core decompression and autogenous iliac bone implantation, expected to obtain a better understanding of the prognosis of autogenous iliac bone implantation method.OBJECTIVE: To explore the curative effect of the ischemic necrosis of femoral head filling the hole of the core decompression with autogenous iliac bone implantation in animal models. DESIGN, TIME AND SETTING: Animal trial observation. The experiment was performed at the Central Laboratory of the Guilin Medical University from April 2006 to September 2007.MATERIALS: Nine hybrid adult dogs were prepared for necrosis of femoral head models.METHODS: The ischemic necrosis of femur head was made with the liquid nitrogen in dogs. The rod-shape autogenous cancellous bone that comes from the posterior superior iliac spine was driven into the full depth of the core r decompression tunnel to the subchondral bone. The dogs were divided into 3 groups, 3 dogs in each groups were sacrificed respectively at 3, 6, 12 weeks after operation. Radiograph and histological examination were used to evaluate the results.MAIN OUTCOME MEASURES: Histological changes of the femoral head necrosis and bone graft at the weeks 3, 6 and 12.RESULTS: No collapse of femoral head was observed at the 3 weeks after operation. The graft as well as perivascular tissues showed necrosis with empty lacune. Fiber granulation tissues could be seen ingrowth of capillaries and perivascular tissues into the bone graft. At 6 weeks after operation, basophilia blue area and new born osteoblast, cartilage, as well as chondroblasts zone could be found at the surface of bone trabecula. After 12 weeks of operation, new bone formation, representing typical process of "creeping substitution". And the cancellous bone of necrotic femoral head was rebuilt gradually. CONCLUSION: Core decompression combined with implantation of autogenous iliac bone implantation can accelerate femoral head repairing, delay or prevent femoral head from necrosis.

A new urine analysis core module based on high performance 32-bit microprocessor and high precision color sensor was presented. A novel optical structure and a specific circuit were applied to improve measurement precision and temperature was used to compensate for results in this core module. The information of urine test peice, such as all original data and color RGB value, reflectivity, semi-quantitative level, etc. can be output. The results showed that the measuring precision was about 95% or above with ideal stability and reliability using this presented core module, which can be conveniently applied in various urine analyzers, and can greatly decrease the cost of urine analyzers in development and production.
Color ; Equipment Design ; Microcomputers ; Reproducibility of Results ; Temperature ; Urinalysis ; instrumentation ; methods

Objective: To discuss whether T_2 breast cancer patients with 1-3 positive axillary lymph nodes after radical mastectomy need radiotherapy, and to determine the corresponding target region. Methods: We retrospectively analyzed 103 breast cancer patients treated in our hospital between 1997 and 1998. All pa-tients underwent radical mastectomy. Of these patients, 44 did not receive irradiation, 59 received irradiation to the internal mammary chain and supraclavicular area. All patients had no intumescent axillary lymph nodes or distant metastasis before radical mastectomy. T-test was used to analyze quantitative data, and ANOVA was used to analyze numerical data. Kaplan-Meier method and Log rank test were employed to calculate and compare the survival rate. Results: The 10-year survival rate was 56.8% in the non-irradiation group and 72.9% in the irradiation group (X~2=2.805, P=0.094). The 10-year disease free survival rate was 50.0% in the non-irradiation group and 64.4% in the irradiation group (X~2=4.063, P=0.044). The 10-year local recurrence rate was 27.3% in the non-irradiation and 10.2% in the irradiation group (X~2=5.112, P=0.035). The 10-year met-astatic rate was 43.2% in the non-irradiation group and 22.0% in the irradiation group (X~2=5.263, P=0.031).The 10-year chest wall recurrence rate in all patients was 7.8%. No patients had recurrence in the internal mammary chain area. Irradiation in the internal mammary chain area was useless and could not increase sur-vival rate and disease free survival rate. Irradiation in the internal mammary chain area was not helpful for re-ducing local recurrence rate or distant metastatic rate. Conclusion: Radiation therapy can reduce local recur-rence rate and metastatic rate in T_2 breast cancer patients with one to three positive axillary lymph nodes, and can increase survival rate and disease free survival rate. Recurrence in the internal mammary chain area is rare. Therefore, it is not necessary to irradiate the internal mammary chain area. We suggest that T_2 breast cancer patients with 1-3 positive axillary lymph nodes after radical mastectomy should have irradiation to the chest wall and supraclavicular area.

Objective We reported the rehabilitative nursing points of patients with pectoralis minor muscle transplantation for recovery of thumb oppositional function. Methods We selected 10 patients who underwent pectoralis minor muscle transplantation for recovery of thumb oppositional function and gave them perfect preoperative examination and psychological nursing. We also implemented rigorous monitoring postoperation and auxiliary electric stimulation and functional exercises. The emphasis was put on the exercise of thumb oppositional function. Results The thumb oppositional function of all the ten patients recovered. The myodynamia reached level 4 and the shape of thenar was satisfying after 6 to 12 months of follow-up visit. Conclusions Sufficient preoperative psychological nursing and effective postoperative rehabilitative treatment had pivotal significance for the success of operation and the recovery of thumb oppositional function.

OBJECTIVE:To analyze the risk factors of adverse reaction in children induced by Azithromycin for injection. METHODS:Data and medication of 428 children used Azithromycin for injection were retrospectively collected,and logistic re-gression method was used to analyze the risk factors of adverse reactions that likely to occur. RESULTS:In the 428 children,98 re-ported adverse reactions with incidence of 22.9%,among which,53 showed gastrointestinal adverse reactions (12.4%),22 showed pain in injection site(5.1%),12 showed phlebitis(2.8%),4 showed pruritus(0.9%),2 showed rash(0.5%),3 showed liver function abnormalities(0.7%),1 showed thrombocytopenia(0.2%)and 1 showed drowsiness(0.2%). According to adverse reactions diagnostic criteria,24 were sure,23 were very likely and 51 were possible. Logistic regression analysis showed younger age [OR=0.811,95% CI(0.754,0.842),P=0.000] and long duration [OR=0.1.357,95% CI(1.212,1.519),P=0.000] might the rick factors that caused adverse reactions. CONCLUSIONS:Younger age and long duration are the possible rick factors that caused adverse reactions in children after intravenous administration of azithromycin,close observation and controlling duration should be noticed to reduce the incidence of adverse reactions in children medication.

Objective To evaluate the long-term clinical efficacy and toxicities of combined intracavitary hyperthermia and radiotherapy fur locally advanced uterine cervical cancer. Methods 310 patients with locally advanced uterine cervical cancer were assigned into intracavitary hyperthermia + radiotherapy group(TRT, 181 patients) and external-beam radiotherapy + traditional intracavitary radiation group (RT,129 patients). The external-beam radiotherapy were given with 60Co γ-my or 6-8 MV X-ray in traditional fractionation. In TRT group,radiotherapy was 40 Gy using the anterior-posterior pelvic fields and additional 20-25 Gy using the lateral fields. Hyperthermia was delivered by the 915 MHz microwave hyperthermia device within 15-60 min after external radiotherapy for 10-12 times(40 min each time,1-2 times per week). The temperature of tumor surface was 46-47℃. In the RT group, the external-beam radiotherapy of 40 Gy was delivered using the anterior-posterior pelvic fields. The intracavity radiotherapy of radium was delivered before 1989 ,with 50 mg radium in the vagina and 30 mg in uterine cavity for 24 hours ,weekly for 3 times to a total dose of 7200 mg·h. After 1989,intraeavity radiotherapy of 192Ir was delivered to a total dose of 30-36 Gy to point A in 5-6 Gy fractions,2 fractions per week. Results The 5-year survival of patients in TRT group and RT group was 67.4% versus 52.1% for stage Ⅱ disease (χ2=7.55,P=0.006), and 60.0% vemus32.3% forstage Ⅲ (χ2=7.06,P=0.007) . The 10-year survival was46.5% versus42.6% for stage Ⅱ (χ2=3.90,P=0.058), and 43.7% versus 20.6% for stage Ⅲ(χ2=17.28,P=0.000). Cox regression analysis showed that the tumor stage(P=0.023) and intracavitary hyperthermia( P=0.019) were prognostic factors. According to the RTOG criteria, the rate of mild to moderate late side effects of rectum and bladder in TRT and RT group was 17.7% and 33.1%, respectively (χ2=9.18, P=0.002). Rectovaginal fistula was developed in5 patients(3.9% ) in RT group and I patient (0.6%) in TRT group(χ2= 4.38,P=0.036). Conclusions The long-term survival of patients with stage Ⅲ uterine cervical cancer is better of TRT group than RT group. The TRT is well tolerated and the late toxicity rate is obviously low. It is necessary to carry out large randomized clinical trials to confirm these outcomes.

BACKGROUND: Vitamin D receptor (VDR) gene shows restriction fragment length polymorphism with incision enzyme Bsm Ⅰ ,Apa Ⅰ ,Taq Ⅰ ,which is related to bone mineral density (BMD).However, it is unclear that the relationship between VDR gene (Bsm Ⅰ ) polymorphisms and BMD,osteoporosis.OBJECTIVE: To analyze the distribution regularity of vitamin D receptor gene polymorphism related to BMD in postmenopausal women of Han,Uygur, Kazak and Mongoloid nationality in China. DESIGN: controlled observation.SETTING: Institute of Gerontology,General Hospital of Chinese PLA.PARTICIPANTS: Totally 179 women of Han,who were taking physical examination in General Hospital of Chinese PLA from January 2002 to December 2003, at the average age of (59±3) years,were selected. A total number of 122 women of Uygur with average age of 56.49 years; 63 women of Kazak with average age of (55±3) years; and 112 women of Mongoloid with average age of (57±3) years,who were all taking physical examination in department of geriatrics, Urumqi General Hospital of Lanzhou Military Area Command of Chinese PLA from January 2001 to December 2003.All of them were informed consent.METHODS: VDR genotypes(Bsm Ⅰ ) were defined with polymerase chain reaction-restriction fragment length polymorphism,so as to analyze distribution of Vitamin-D receptor gene (Bsm Ⅰ )polymorphisms of postmenopausal women in Han,Uygur, Kazak,Mongoloid nationality,and compared with the data of USA,Australia,France,Japan,Korea. Enumeration data were compared with Chi-square test.MAIN OUTCOME MEASURES: VDR (Bsm Ⅰ ) polymorphisms in healthy postmenopausal women from Han, Uygur, Kazak, Mongoloid populations in China, which were compared with the data of USA, Australia,France, Japan, Korea.RESULTS: For women of Han, Uygur, Kazak and Mongoloid nationality,the BB genotypes accounted for 0, 4.1%, 6.35% and 4.46%, the bb genotypes accounted for 90.5%, 69.67%, 38.1% and 50% respectively. There was a significant difference between women of Han, Uygur, Kazak, and Mongoloid nationality(P ＜ 0.01). There was insignificant difference in comparation of distribtuion of VDR genotype between Kazak nationality and the west races, but it was significantly different to that in Japan,Korea races.CONCLUSION:VDR genotype polymorphisms is characterized by obvious racial diversify in postmenopausal women of Han,Uygur, Kazak,Mongoloid populations in China;Distribution of VDR gene frequency of Kazak population is similar with the west race ,but is different to Japanese and Korea's race.

To study the effect of titanium alloy cage on the treatment of the ischemic necrosis of femoral head in dog, the model of the ischemic necrosis of femoral head was made with the liquid nitrogon in 15 hybrid adult dogs. The titanium alloy cage made of a hollow cylinder was driven into the subchondral bone of necrotic femoral head via central channel. The dogs were divided into 3 groups, each group was sacrificed 3, 6, 12 weeks after the operation respectively. No collapse of femoral head was observed after the operation. The position of the cages was good on radiograph. Microscopically, the cancellous bone of necrotic femoral head rebuilt gradually and grew into cage. After 12 weeks of creeping substitution, the cancellous bone filled up the hollow cavity and holes of the cages. It is concluded that the titanium alloy cage can provide structural support for the subchondral bone and prevent collapse and can be used for the treatment of the ischemic necrosis of femoral head.