Objective To investigate effect of the transtheoretical model and stages of change (TTM) on self-management paradigm,serum calcium and phosphorus levels in patients undergoing maintenance hemodialysis (MHD).Methods Total 140 MHD patients were separated into two groups as the intervention group (65 of 70 cases completed with TTM) and the control group (63 of 70 cases completed with routine nursing care) by random number table.Data obtained by using hyperphosphatemia related knowledge questionnaires and Self-management Rating Scale before and after intervention.The levels of serum calcium and phosphorus between the above groups were compared.Results The scores of self-management behavior were higher in control group after 3 months intervention,the differences was statistically significant (P ＜ 0.05),in which the scores of problem solving (2.97 ± 0.28),self care activities (2.99±0.28),relationships (3.13±0.35) and emotional treatment (2.80 ± 0.32) in experimental group was apparently higher than control group at the same time,the scores were (2.63±0.32),(2.67±0.38),(2.76±0.42),(2.44±0.36) respectively in conrtol group,t values were-0.907,-7.68,-6.03 and-8.43,respectively.And also,there was statistically significant difference between the two groups in serum phosphorus level [(1.81±0.49) mmol/L vs.(2.56±0.69) mmol/L],the product of calcium and phosphorus [(55.33±14.45) mg2/dl2 vs.(72.35±20.94) mg2/dl2],serum parathyroid hormone [238.00 (130.35,413.85) ng/L vs.297.75 (155.02,760.37) ng/L] (t=11.01,8.43,Z=-2.09,P＜0.05).Conclusions TTM is conducive to promote behavior change,improve self-management conduct,and also reduce serum phosphorus level in MHD patients.

Objective To discuss the expansion model of the eyeball and investigate the morphologic characteristics of high-my- opic eyeball through the dimensional measurement in high-myopia and emmetropia by MRI. Design Case controll study. Participants Thirty-two emmetropes (60 eyes) and 33 high myopes (60 eyes) were enrolled, without eye diseases and history of ocular surgery or in- jury. Methods 60 high-myopic eyes and 60 emmetropic eyes were measured with MRI (I.5T,PHILIPS) to get the data of three inner ocular dimensions, intraocular volume and the volume of different parts. Main Outcome Measures Three dimensions and volumes of eyeballs. Results The average value of axial (28.16?2.80 mm), horizontal (22.87+1.23 mm) and vertical length (23.40?0.99 ram) of high-myopic eyes were much bigger than those of emmetropic eyes(P=0.000), especially the axial length( with difference of 5.38 mm); The axial length was correlated with refractive error (0.36 mm/D,r~2=0.88, P=0.000). The average value of the whole ocular volume (7. 46?0.89 ml) and vitreous volume(6.90?0.8 ml) of the high myopic eyes were bigger than those of emmetropic eyes(P=0.000), while ante- rior segment volume and lens volume were about the same as that of emmetropic eyes (P=0.220, P=0.630). Conclusions The three di- mensions of high-myopic eyes were significantly longer than that of emmetropic eyes. In high myopes, the increased vitreous volume lead to the increase of the whole ocular volume. There may be two models in the ocular expansion of high myopia: global expansion and axial elongation expansion. More serious refractive error cause more obvious expansion in axial elongation.

Objective To investigate the value of functional MRI in the diagnosis and differential diagnosis of breast diseases.Methods Sixty-five patients with 68 lesions were enrolled in this study. Conventional T_1 WI and T_2 WI scan,dynamic contrast enhanced MRI,diffusion weighted imaging and ~1H single voxel MR spectroscopy were performed consequently.All lesions were verified by pathology,including 4 cases of breast adenosis,22 fibroadenomas,2 chronic inflammations,3 cysts,33 infitrating ductal carcinomas,1 intraductal carcinoma and 3 cystosarcoma phyllodes tumors.Morphological features,maximum enhancement ratio,time-intensity curve,apparent diffusion coefficient and Choline peak were analyzed. Results The detection rates of T_1 WI and T_2 WI were 14.7%(n=10)and 51.5%(n=35).The sensitivity,specificity,accuracy of dynamic contrast.enhanced MRI for the malignant tumor were 94.6%, 71.4% and 76.5% respectively.Retrospective study showed that diffusion weighted imaging,with the b value from 800 s/mm~2 to 1000 s/mm~2,could be used to differentiate various types of breast lesions.~1H signal voxel spectroscopy had a sensitivity of 51.4%,specificity of 82.6%,and accuracy of 67.6% for the malignent.The sensitivity,specificity and accuracy could reach 97.3%,90.0% and 92.6% respectively by combining conventional scan,dynamic contrast enhanced MRI and MR spectroscopy.Conclusion Functional MRI,with high sensitivity,specificity and accuracy,can be used widely in the diagnosis of malignant breast lesions.

Anti-Bacterial Agents ; adverse effects ; therapeutic use ; Humans ; Liver Diseases ; drug therapy

OBJECTIVETo provide scientific evidence of making measures for prevention of pesticide poisoning, the investigation on the condition of pesticide poisoning was carried out in Quzhou.

METHODSRegistration data of pesticide poisoning from 2008 to 2010 in Quzhou were collected and statistically analyzed by SPSS 12.0.

RESULTSDuring the three years, there were 1222 cases reported for pesticide poisoning. Among them, the number of occupational poisoning was 225 (1 case died), with fatality rate of 0.44%. The number of non-occupational poisoning was 997 (77 cases died), and its fatality rate was 7.72% . The incidence of occupational poisoning and non-occupational poisoning accounted for 18.4% and 81.6% respectively. Male patients were in the majority in occupational pesticides poisoning (accounting for 76.4%), female patients in non-occupational poisoning (accounting for 52.1%). The pesticide poisoning mainly occurred from July to September. Occupational poisoning and non-occupational poisoning cases mainly concentrated in over 65 age group, accounting for 36.0% (81 cases) and 26.3% (262 cases) respectively. Insecticide ranks the first in the terms of total poisoning cases caused by pesticide, and organophosphate poisoning ranks the first in all insecticides.

CONCLUSIONPesticides poisoning has badly threatened the public health in Quzhou, attention should be paid to non-occupational poisoning. The pesticides poisoning was mainly caused by organophosphate insecticides.

Adolescent ; Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Agricultural Workers' Diseases ; epidemiology ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Incidence ; Infant ; Male ; Middle Aged ; Organophosphate Poisoning ; epidemiology ; Pesticides ; poisoning ; Young Adult

OBJECTIVETo investigate the placement of a long tube into the small intestine under fluoroscopic guidance and to evaluate its decompression effect on early postoperative small bowel obstruction (EPSBO).

METHODSFifty-four patients with EPSBO requiring decompression between April 2010 and July 2014 were enrolled in the study. Insertion of a long tube was guided by fluoroscopy. We first used the guide wire to pass the pylorus and then used the 10 Fr feeding tube as an exchangeable tube to put the superstiff wire into the duodenum. Finally the long tube could be passed over the guide wire through the pylorus into the intestine. The total procedure time, the radiation exposure time, and the incidence of complications were evaluated.

RESULTSThe long tubes passed into the jejunum on initial insertion for all patients, so the success rate of this technique was 100%. The long tube was inserted into ileum in 18 patients. The mean total procedure time was 34.4 ± 8.6 minutes, and the mean radiation exposure time 18.9 ± 6.8 minutes. A total of 47 patients (87%) experienced full recovery following long-tube decompression and without the need for surgical intervention.

CONCLUSIONSUsing the wire-exchange technique, it is easy to place a long tube into the small bowel under fluoroscopic guidance. This decompression method is safe and effective for management of EPSBO.

Adult ; Aged ; Decompression, Surgical ; methods ; Female ; Fluoroscopy ; Humans ; Intestinal Obstruction ; surgery ; Male ; Middle Aged ; Postoperative Complications ; surgery ; Retrospective Studies

DNA Replication ; Epigenesis, Genetic ; Hepatitis B virus ; genetics ; physiology ; Virus Replication

Objective To investigate the differences of apparent diffusion coefficient(ADC)value in normal breasts and to evaluate the correlation between ADC value and corresponding histology.Methods Sixty-two normal breasts including 42 normal breasts of 42 patients with unilateral lesions and 20 normal breasts of 10 volunteers were studied.The ADC value of all 62 normal breasts were calculated when b value was given from 1000 to 0 s/mm~2,1000 to 500 s/mm~2and 500 to 0 s/mm~2.The MRI features of 60 normal breasts were classified into 3 types(dense,lobular-speckled,degenerative types)according to Wolf's classification and histology.Results DWI and ADC images were different in 3 types of normal breasts because of different histologic structures.The mean ADC value of the dense type breasts was(1.70? 0.37)?10~(-3)mm~2/s,the lobular-speckled type was(1.93?0.46)?10~(-3)mm~2/s and the degenerative type was(1.18?0.65)?10~(-3)mm~2/s(F=12.998,P=0.000).There were no significant differences between the dense type and the lobular-speckled type(F=2.167,P=0.147),but significant differences between the dense type and the degenerative type,the lobular-speckled type and the degenerate type(F=5.593 and 19.128;P=0.029 and 0.000).When b value decreased,the ADC value of the dense type and the lobular- speckled type increased correspondingly,but the degenerative type didn't increase apparently.Conclusion ADC value was influenced by histologic structures in normal breasts and also was influenced by b value in the dense type and lobular-speckled type breasts.

Background The quantitative analysis of the relationship between the vitreous volume with diopter and axial length in high myopic eye can offer a valuable basis for relevant clinical research. However, how to measure the ocular volume in vivo is a problem. Objective This study was to measure the eyeball volumes with magnetic resonance imaging ( MRI) and compare the difference of ocular volume between emmetropic and high-myopic eyes in order to explore the influent factors of changes of eyeball volumes. Methods The volumes of ocular anterior segment,lens and vitreous were measured using MRI( 1.5-T) in 60 emmetropic eyes and 60 high-myopic eyes. The ocular axial lengths of the subjects were measured by A-scan ultrasonography. The alterations of vitreous volumes with the changes of axial lengths and diopters were evaluated by linear regression analysis. Written informed consent was obtained from each patient before any medical examination. Results The mean diopters of high myopic eyes was ( - 15. 62 ± 8. 27 ) D and the mean axial lengths were ( 28. 68 ± 2. 68 ) mm, showing a significantly positive correlation between them(R2=0. 830,P = 0. 000). The mean total ocular volumes were(7.46±0. 89)ml3 and those of vitreous were ( 6. 90 ± 0. 8 ) ml3 in the high-myopic eyes with a significant increase in comparison with emmetropic eyes [ ( 6. 00 ± 0. 35 ) ml3 and ( 5. 41 ±0. 32 ) ml3 ] ( t = - 11. 846, P = 0. 000; t = - 12. 1, P = 0. 000 ). However,no significant differences were found in the anterior segment volumes and lens volumes between high myopic eyes and emmetropic eyes (t = 1. 23, P = 0. 220; t = -0. 483 , P = 0. 630 ). The vitreous volumes of high myopic eyes were significantly correlated with the diopters and the axial lengths (R2 =0. 75 ,P = 0. 000 ;R2 =0. 85 ,P = 0. 000) ,and so were the total ocular volumes (R2 = 0. 7543, P = 0. 000; R2 = 0. 8413, P = 0. 000). Conclusion The alteration of vitreous volumes is a mainly cause of difference of total ocular volume in ammetropic eyes. In high myopic eye, vitreous volume has a good linear correlation with refractive error and axial length, which may offer valuable information for vitrectomy.

Objective: To analyze the research hotspots of transitional care in patients with heart failure, and to provide reference for the development of related research in China. Methods: Based on the literature on transitional care for heart failure patients included in the Web of Science database, Use CiteSpace software to visualize research institutions, core journals, cited documents, and high-frequency keywords. Results: The current research in the field of transitional care for patients with international heart failure is mainly concentrated in colleges and universities in the United States. The core publications include Journals of The American Geriatrics Society and Bmc Health Services Research. Through keyword co-occurrence cluster analysis, the international hot topics of transitional care and discharge plan, readmission risk, quality improvement and quality of life in patients with heart failure were explored. Conclusion Hong Kong's transitional care research in patients with heart failure is more in-depth. Although the academic research of mainland China has increased, it has not yet reached the international frontier and needs further development and improvement.