Objective To explore the reporting process of our health risk warning system and its long-term effectiveness.Methods A total of 1 168 individuals who were identified as higher risk populations from July 2011 to June 2012 in our Health Mangement Center were served as the control group,and another 973 adults who were identified as higher risk individuals from July 2012 to May 2013 were assigned to the study group.Diagnosis and treatment were based on our health risk reporting process and follow-up system.Paired t test and paired contingency table x2 test were used for data analysis.Results The rate of follow-up (97％ vs 100％,x2=30.503,P＜0.05),consultation (83.48％ vs 93.63％,x2=52.142,P＜ 0.05),mean treatment time ((3.0±0.5) vs (1.5±0.5) d,t=69.12,P＜0.05) and patient satisfaction (87.84％ vs 96.20％,x2=48.361,P＜0.05) were significantly different between the two groups,although no statistically significant difference of incidence of adverse events was found (0.26％ vs 0.10％,x2 =0.102,P＞0.05).Conclusion Our health risk warning system may reduce the time for physical examination and improve disease diagnosis level and patients' satisfaction.Moreover,our health manatement system and health service quality should further be improved in practice.

Objective To investigate the influence of individual psychological intervention on quality of life of HIV infection / AIDS patients.Methods 50 cases diagnosed as HIV infection / AIDS were selected,randomly divided into the control group and the observation group with 25 cases in each group.The control group received routine treatment and care,while for the observation group,the psychological health and quality of life were measured with SCL-90,SF-36 scales,then personalized psychological intervention was implemented after analyzing the influencing factors.Three months after discharge,the assessment test was carried out using SCL-90 and SF-36 scales,then compared the quality of mental health and life situation of the two groups.Results Mental health and quality of life between the observation group and the control group before intervention was not statistically significant.After intervention,the comparison is statistically significant Conclusions Individualized psychological intervention can improve patients quality of life.

OBJECTIVE To explore the clinical features for pulmonary cryptococcosis due to Cryptococcus neoformans,and to improve diagnosis and treatment of the disease.METHODS The clinical features of inpatients with pulmonary cryptococcosis were studied retrospectively.RESULTS There were nine cases of pulmonary cryptococcosis from 1999 to 2006 of all inpatients in our hospital.Mals 5(56%),females 4(44%),and 3 cases(33%) were more than 60 years old.Three cases(33%) were immunocompromised hosts,6 cases(67%) had clinical symptoms.Chest X-ray and computed tomography were various included single or poly patching or nodule shadows,some had cavity(33%) and some had pleural effusions(22%).Six cases had positive results with serum cryptococcal antigen test.All nine patients were treated with fluconazole and improved or cured.CONCLUSIONS Pulmonary cryptococcosis is seldom seen in clinic,it can be observed in humans with normal immune responses or immunocompromised hosts and has no significant clinic manifestations,serum cryptococcal antigen test is helpful,definitive diagnosis needs early lung biopsy.The therapeutic effect is well.

To explore the clinical manifestation of lymphomatoid granulomatosis (LG) and the early diagnosis. Retrospective analyses of the clinical features of LG and pathology features by open lung bio-psies were conducted. The patient was a 42-year-old female with irregular fever,and her chest X-ray and computed tomography showed nodules with cavity and pleural effusion. Open lung biopsy proved LG. LG is seldom seen in clinic. Open lung biopsy is very important for pathology diagnosis. Early diagnosis and treatment are the key to improving survival in these patients. The therapeutic effect is good.

Objective To investigate the effect of iuvenile rheumatoid arthritis(JRA) serum (leukotriene B4,LTB4) LTB4-BLT2 on mice DCs.Methods Bone marrow(BM)-derived DCs from healthy mouse were purified.and induced by cytokine IL-4 and GM-CSF to immature DCs and then differentiated to mature DCs under the stimulation of LPS in vitro.DCs were evaluated by light microscope and flow cvtometry.The concentrations of LTB4 in DCs supernatant,normal serum,active JRA,and that of the co-cuItured with BLT2 antagonist LY255283 were detected by ELISA.The expression of BLT2 protein and mRNA in DCs was examined by immunocytochemistry,immunofluorescence and RT-PCR.Meanwhile,the expression of BLT2 in DCs after 18 h co-cultured with normal serum,in serum of active JRA and that of BLT2 antagonist (LY255283)group was assayed by flow cytometry respectively.Results LTB4-BLT2 was expressed by DCs.Not only BLT2 mRNA but also its protein was expressed in DCs.The concentration of LTB4 Was(17±3)pg/ml,(82±20)pg/ml,(82±20)pg/ml and(24±6)pg/ml,(115±20)pg/ml,(91±11)pg/ml in normal serum group,active JRA group and LY255283 group before and after 1 8 h,respectively.The expression Was higher in serum of active JRA group than that of normal sertlm group(P<0.01)and there was a tendency to be higher when compared with LY255283 group(P<0.05).The DC BLT2 expression was 27.7±2.9,46.3±8.7 and 30.3±5.5 in normal serum group,serum of active JRA group and LY255283 grbup after 1 8h respectively.The expression was stronger in active JRA group than other groups(P<0.05).Conclusion DC can develop a LTB4-BLT2 signal pathway by BLT2 with autocrine and/or extrinsic LTB4.The overexpression of this pathway may be involved in the initiating and activation of JRA.

[ ABSTRACT] AIM:To observe the change of skin histology in diabetic rats and to investigate the possible me-chanism of c-Jun N-terminal kinase (JNK) protein in the dorsal root ganglion (DRG) during the process.METHODS:Diabetic animal model was established in the male SD rats by intraperitoneal injection of streptozotocin.Plantar skin speci-mens of the rats were collected from control group, DM 2-week group (DM2), DM 4-week group (DM4), and DM 8-week group ( DM8) .Immunohistochemical staining and HE staining were used to observe the change of PGP 9.5 immunoreactive nerve terminals and the structures of the skin tissues.The protein expression of PGP 9.5 in the plantar skin tissues, and JNK and p-JNK protein in the DRG within lumbar 5, 6 (L5, 6), and sacral 1 (S1) spinal cord segments were detected by Western blotting.RESULTS:PGP 9.5 immunoreactive nerve terminals of the plantar skin of the rats mainly distributed in the basal layer of the epidermis and papillary dermis.Compared with control group, PGP 9.5 positive nerve terminals in DM4 group showed reduced density and sparse distribution.PGP 9.5 positive nerve terminals in DM8 group showed signifi-cantly reduced distribution, thinner nerve diameter, shorter length and distorted shape.Histological changes of the thinner epidermal tissue, reduced epidermal cell layers, uneven cell distribution and arrangement in DM4 group, and significantly reduced epidermal cell layers, swollen and blurred cells, increasing cell gap, lack of stratified epidermis arrangement for part of epidermis, atropal and degenerated dermal collagen fiber, significantly decreased subcutaneous fat in DM8 group were observed.The results of Western blotting showed that the protein expression of PGP 9.5 in the plantar skin tissue of DM rats was progressively decreased along with the disease, while the protein level of p-JNK in L5, 6-DRG or S1-DRG showed a gradual increasing trend.PGP 9.5 immunoreactive positive nerve terminal density of plantar skin in DM rats had a negative correlation with the protein level of p-JNK in L5, 6-DRG and S1-DRG (P<0.01), but showed a significant positive correlation with the plantar skin thickness (P<0.01).CONCLUSION:The protein level of p-JNK within L5, 6-DRG or S1-DRG in DM rats shows a progressive enhancement.At the same time, there is a significant change in the skin tissue density and structure.The changes of skin tissue and nerve morphology in DM rat may be related to the activation of JNK/SAPK pathway in L5, 6-DRG or S1-DRG cells.Blocking or inhibiting JNK/SAPK pathway may delay the diabetic pe-ripheral neuropathy and reduce the risk of skin lesions.

BACKGROUND: Peri-intraventricular hemorrhage (PIVH) in preterm infants is one of the most important reasons for mortality and disability. Moreover, investigative exponents may bring supported data for incidence rate of PIVH and high-risk factors of preterm infants with PIVH.OBJECTIVE: To explore the incidence rate and analyze the high-risk factors of PIVH in preterm infants.DESIGN: Survey and analysis.SETTING: Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology; Beijing Obstetrics & Gynecology Hospital, Capital Medical Universit; Qinhuangdao Maternity and Infants' Hospital of Hebei Province.PARTICIPANTS: A total of 1 122 preterm infants of 26.3-36.8 gestational age were selected from Beijing Obstetrics & Gynecology Hospital, Qinhuangdao Maternity and Infants' Hospital from January 2002 to August 2005. All infants received ultrasonic examination on skull within 1 week. There were 594 boys and 528 girls, and the birth weight was 850-4 500 g.METHODS: All infants received ultrasonic examination on skull within 1 week. New Philips 5500 and GE Healthcare Logiq 400 ultrasonic diagnosis devices were provided by Philip Company, Dutch and GE Company, respectively.MAIN OUTCOME MEASURES: The incidence rate and related high-risk factors of PIVH.RESULTS: All 1 122 preterm infants were involved in the final analysis. Among 1 122 preterm infants, 619 cases (55.2%) had PIVH; especially, 110 had severe PIVH with the degree more than Ⅲ, which was accounted for 17.8%.High-risk factors were mainly low gestational age, low birth weight, mechanical ventilation, hypoglycemia, hypercapnia,hyperlactic acidemia, acidosis, hypoxia, abnormal blood coagulation, and so on. Antenatal corticosteroid could reduce the incidence rate of PIVH. However, there was no obvious effect on preterm infants of old gestational age.CONCLUSION: Routine intracranial ultrasonic examination is useful for the diagnosis of PIVH in preterm infants.

All sorts of medical imaging is filtered by image processing toolbox so as to wipe off all sorts of signal noise jamming and increase the SNR,which offers simple and convenient methods for the imperceptibility observing and analyzing.

Objective Dieulafoy's lesion is a rare cause of upper gastrointestinal bleeding. The purpose of this study was to recognize the clinical characteristics of gastric Dieulafoy and to identify possible predictive factors of rebleeding. Methods Retrospective study of patients with gastrointestinal bleeding secondary to Dieulafoy's lesion from January 2009 to June 2016. We analyzed the clinical data and endoscopic findings and the correlated with rebleeding risk factors with Dieulafoy's lesion. Results 111 patients were included in the study, 97 (87.4%) patients were male; the most common location of the bleeding lesions were Proximal stomach of 53 cases (47.7%); According to the Forrest type, 46.8% of the cases were arterial (spurting), 52.3% of the cases were arterial (oozing), there were 101 (91.0%) patients treated by endoscopic combined drug therapy. The success rate of Endoscopic hemostatic treatment was 84.2%, endoscopic hemostatic treatment success rate was as follows: single endoscopic, 85.0%; two endoscopic, 84.8%; three endoscopic, 75.0%. The hemostatic treatment success rate of 101 patients with endoscopic combined drug was as follows: Proximal stomach, 83.7%; mid-stomach, 82.1%; and distal stomach, 88.9%. Age (P = 0.002) and blood transfusion (P = 0.004) were risk factors for rebleeding in the study. Blood transfusion was associated with a higher recurrence rate for bleeding (P = 0.018, OR=37.77, 95% CI = 1.86~766.47) for 101 patients with endoscopic in combination with drug. Conclusion Endoscopic therapy is effective for treating Dieulafoy's lesion. The blood transfusion was associated with a high rate of bleeding recurrence. There were no significant differences between the rebleeding and non-rebleeding groups with respect to bleeding location or hemostatic methods.

Objective: To explore the effect of modified cold therapy instrument on postoperative pain and swelling of patients with tibiofibular fracture. Methods: Eighty patients with tibia and fibula fracture who underwent surgery in Changzhou Cancer Hospital from June 2016 to June 2017 were selected and divided into control group and experimental group according to random number table method, 40 cases in each group. Patients in the control group were treated with conventional ice care, and the experimental group was treated with a modified cold therapy device. The Numerical Rating Scale (NRS) scores, tension blisters and skin dermatoglyphics, swelling and complications were observed before and after treatment. Results: Before the intervention, the difference in pain score and swelling degree between the two groups was not statistically significant (P>0.05). After nursing intervention, the pain scores of the two groups decreased, but the score of the experimental group was 2.2 ± 0.3, which was significantly lower than that of the control group (3.6 ± 0.5) (t= 15.185, P < 0.05); the incidence of tension blisters, the incidence of dermatoglyph and moderate swelling in the experimental group were 10% (4/40), 77.5% (31/40), 10% (4/40), which were lower than 30% (12/40), higher than 50% (20/20), less than 27.5% (11/40) of the control group (χ²= 5.000, 6.545, 4.021, P<0.05); no complications such as deep vein thrombosis and compartment syndrome were found in both groups. Conclusion The improved cold therapy device cold compress is better than the conventional ice dressing treatment, and can reduce the swelling and pain degree of the patients with tibiofibular fracture, which is beneficial to the rehabilitation of the patient and is worthy of clinical application.