Objective To explore an assessment questionnaire for assessing caregiving knowledge of primary caregivers in children with nephrotic syndrome. Methods Delphi method was used to review the literature. Ten primary caregivers of children with nephrotic syndrome were interviewed and five medical, nursing experts were pre-surveyed to form an expert consultation questionnaire. Sixteen experts from some provinces were selected to carry out two rounds expert consultation. To screen the dimensions, factors, entries of the questionnaire and to analyze the reliability and validity of the questionnaire. Results The positive coefficient was 100%, the expert authority coefficient was 0.95 and the expert co-ordination coefficient W test was P<0.05 of the two rounds expert consultation. The questionnaire data included 6 dimensions, 26 factors, 106 items. The basic knowledge of disease, diet knowledge, medication knowledge, personal hygiene and infection prevention, activity and rest, home care constitute the dimensions. The Cronbach α coefficient was 0.872, the test-retest reliability was 0.823, the split-half reliability was 0.855, and the average overall validity index of the questionnaire was 0.948. Six common factors were extracted for exploratory factor analysis and the cumulative variance contribution> 65.633%. Conclusions The questionnaire of caregiving knowledge of primary caregivers of children with nephrotic syndrome developed by Delphi method has high reliability. The questionnaire is of practical significance for evaluating the care of primary caregivers of children with nephrotic syndrome.

Objective To analyze the factors affecting quality of life (QOL) in patients with stroke. Methods Eight hundred and six stroke patients were recruited by using the stratification and random sampling method, and QOL questionnaire was applied. Results It was shown that QOL was worse comparatively in stroke patients with poorer education, divorce or lose of spouse, non-free medical service, unemployment, serious deficit of nervous function, while it was indicated by the results of multiple factor analysis that QOL was influenced mainly by such factors as education background, marriage and neurological function. Conclusion In order to improve QOL of patients, we should pay more attention to the health of elders, social security system, education and medical technology.

Objective To investigate the correlation between the incidence of thyroid carcinoma and TSH, and to provide evidence for clinical application.MethodsSelect 450 cases of patients with thyroid from August 2014 to August 2016 in our hospital as the object of study in this group, the analysis of gender and age of patients, lymph nodes, tumor, laboratory examination results, to explore the relationship between TSH levels and thyroid cancer.ResultsThyroid patients with TSH was significantly higher than that in benign tumor group (P<0.05);the level of TSH and patients with lesion diameter, tumor stage, lymph node metastasis and capsule invasion was significantly correlated (P<0.05), but the level of TSH and age, gender, tumor number, vascular invasion and no significant correlation;TSH the level of thyroid cancer patients were significantly increased (P<0.05).ConclusionThe level of TSH in serum is closely related to the occurrence and development of thyroid cancer, and is closely related to lymph node metastasis and tumor stage, and the higher TSH level can increase the risk of thyroid cancer.

Objective To evaluate the operative technique and the short-term clinical results of ce-mentless total hip arthroplasty (THA) for developmental dysplasia of the hip (DDH) in adults with high level dislocation. Methods Nine patients (11 hips) with DDH of Hartofilakidis type Ⅲ, who underwent cement-less THA between 1997 and 2002, were analyzed. Of 9 patients, 8 were females, and 1 male with an average age of 29.4 years (range, 17 to 56 years). There were unilateral DDH in 7, and bilateral in 2. The patients had no previous surgery. The preoperative average length difference between the two legs was 4.1 cm (range, 0 to 7 cm). The femoral head was dislocated upward from the normal position by 4.8 cm on average (range, 3.2 to 7.0 cm). The Zweym?ller cup was placed on the original acetabulum in all patients with more than 80% bony coverage on the cup, and no bone graft needed. In 4 hips with more than 5 cm of displacement, the reduction of prosthesis was achieved by shortening osteotomy below lesser trochanter. The preoperative average Harris score was 40.2. Results All of 9 patients were obtained follow-up of X-ray films and clinical evaluation. The follow-up ranged from 6 to 32 months with a mean of 18.2 months, the osteotomy of 4 hips were bony healed at 3 months postoperatively showed by X-ray films. The postoperative average difference of the two leg length reduced to an average 1.1 cm (range, 0 to 3 cm), and the postoperative average Harris score increased to 90. Femoral nerve impairment occurred in 1 case, and recovered 4 months later. There were no loosening, dislocation and infection at follow-up. Conclusion Based on the short-term results of the cementless total hip arthroplasty for the developmental dislocation of the hip in adults with high level dislocation, it is proven to be a good technique, and the satisfied clinical results would be obtained.

BACKGROUND: Functional injury of brain and limb induced by hemorrhage of cerebral arteriovenous malformation could be restored by rehabilitative treatment OBJECTIVE: To investigate the curative effect of rehabilitation on restoration of the functional injury of the brain and limbs induced by bleeding of hemorrhage cerebral arteriovenous malformation (AVM) after embolization.DESIGN: Case analysis.SETTING: Department of Interventional Medicine of General Hospital of Chinese PLA.PARTICIPANTS: From January 1996 to December 2001, a total 56 patients who were diagaosed as cerebral hemorrhage or intraventricle hemorrhage by CT or MRI scanning was selected from General Hospital of Chinese PLA.METHODS: All 56 patients with cerebral arteriovenous malformation were diagnosed by DSA. Rehabilitative treatment was performed with α-butyl cyanoac-rylate or radian surgery. Rehabilitative therapy were as follow: [1] Electric stimulate: S J-Ⅱ type nerve-muscle therapy instrument was used to stimulate the muscles (flexor and extensor) of limbs in the involved side, intensity of which is from weak to strong and frequency of which was from 2 to 3 or 4 per day; [2] Acupuncture: The selected points are:Fengchi, Fengfu, Yintang, Shangxing, Baihui, Quchi, Waiguan, Hegu,Huantiao, Zusanli, Yanglingquan, Sanyinjiao, Taichong, et al. In those who suffered aphasia, lianquan, Jinjin, Yuye were selected. Once a day and a period of treatment was 2 weeks; [3] physical training: the passive movement on the joint in the involved limbs were performed in grade 0 to 1 of muscle strength, the balance training of sitting on bed or standing beside the bed in grade 1 to 2, walking training in grade 2 to 3. The training intensity should be from weak to strong gradually. The items of observation were the improvement in speaking, sense and activity in limbs in the involved side. Evaluation of myodynamia was referenced to 6 grading method of Lovett.MAIN OUTCOME MEASURES: [1] the degree of embolism; [2] the degree of speaking fluency, the sense of limbs and the strength of the muscles of the limbs.RESULTS: Totally 56 cases entered the final analysis without any loss. [1]Degree of embolism: Among 56 cases, 100% focus was eliminated for 77% in 43 cases, 90% was eliminated for 12% in 7 cases and 60%-80% was eliminated for 11% in 6 cases. [2] Fluency of language: Before the treatment of rehabilitation, they suffered different degree impediment of speaking in 14 cases, improvement in 14 cases and obvious improvement in 11 cases. [3] Sense of limb:The sense of limbs was improved in 23 cases and 18 of them improved obviously. [4] Strength of muscles: The strength of muscles in 0 to 1 grade in 3 cases, 1 to 2 grade in 11 cases, 2 to 3 grade in 15 cases. But after the treatment of rehabilitation, speaking ability was improved in 14 cases, and 11 of them improved obviously. The strength of muscles was. resumed to 2 or 3 grade from 0or 1 grade in 2 cases, and to 4 grade in 21 cases and 5 grade in 6 cases.CONCLUSION: Endovascular embolization is a minimal traumatic, the rehabilitative therapy which is secure and effective method for treatment of high risk cerebral AVM, can promote motion function, language function and ability of activity of daily living, and quality of life of patients with cerebral arteriovenous malformation after embolism.

Objective To evaluate left atrial systolic function and synchronization by two dimensional speckle tracking imaging(2D-STI) measuring the strain in healthy subjects.Methods Thirty-two healthy subjects were studied.The peak velocity(Vmax),the peak amplitude of longitudinal and radial strain (Am-LS and Am-RS),the peak time of both longitudinal and radial strain(T-LS and T-RS) were acquired in each left atrial wall(anterior,inferior,posterior,lateral and septal) at three levels (basal,middle and apical)during left atrial active contraction by 2D-STI.Results ① No significant differences were found at theVmax,Am-LS,Am-RS,T-LS and T-RS among all left atrial walls in the same level ( P ＞ 0.05).②The Vmax,Am-LS and Am-RS were decreased progressively from basal to apical,and there were significant differences( P ＜0.05) except the Am-RS at anterior,posterior and septal( P =0.218,0.258 and 0.238,separately).③Compared all levels in each left atrial wall,the T-LS and T-RS showed no significant differences( P ＞0.05),except the T-LS at posterior( P =0.002) and the T-RS at lateral( P =0.026).④The standard deviation of the T-LS,T-RS and T-globe were 37.38 ms,48.25 ms and 43.85 ms,respectively.There were no significant correlation between T-LS and T-RS in the same segment with r =0.014 and P =0.885.Conclusions There were some regularity during left atrial active contraction.On the whole,the peak velocity and the peak amplitude were decreased progressively from basal to apical in each atrial wall,and the peak time of strain showed no significant difference in the same level of each left atrial wall.The 2D-STI may paly important roles in the evaluation of left atrial systolic function and synchronization.

Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) is a breakthrough in the field of hepatobiliary surgery.The remnant liver regeneration was stimulated during the first stage of the operation,and the radical resection of the tumor could be successfully carried out during the second stage of the operation.ALPPS is a new approach for patients with tumor which is previously considered unresectable during one hospital stay.In April 2014,a patient with hepatocellular carcinoma (HCC) in the right liver and liver cirrhosis was admitted to the Southwest Hospital.Preoperative examination confirmed that the ratio of the remnant liver volume to the standard liver volume was 26.9％,which indicated that the patient was inappropriate to receive radical resection of HCC.Therefore,totally laparoscopic ALPPS was applied.In the first stage of the operation,the portal vein ligation associated with liver hanging tape placement and in situ splitting of liver were carried out after hanging the Glisson's pedicle under the laparoscope.Thirteen days after the first stage of the operation,the ratio of the remnant liver volume to the standard liver volume was 40.6％.The second stage of the operation was carried out 14 days after the first stage of the operation.The right hepatic pedicle and right hepatic vein were transected with a stapler.The tumor was removed after full mobilization of the right liver.The distance between the resection margin to the tumor was 1.5 cm.No complications were detected after the first stage of the operation,while the patient was complicated with pleural effusion after the second stage of the operation and was cured by pleural puncture and drainage.The patient was discharged at postoperative day 9 and followed up at postoperative month 1.The results of follow-up confirmed that the hepatic function was normal,and no mass occupying lesions and pleural effusion were detected.Totally laparoscopic ALPPS is safe and feasible with satisfactory short-term efficacy.

Objective To investigate the relationship between gene expression of endothelin-3(ET-3) and inflammation of acute pancreatitis(AP) in rats.Methods Fifty-four rats were divided randomly into 4 groups:sham operation group,AP group,arterial injection group and vein injection group.AP was induced by reverse intra-bile duct infusion 4.5% sodium taurocholate,treated with low dose dopamine 〔5 ?g/(kg?min)〕 by injecting arterial or tail vein.Rats were sacrificed at 1,6 and 24 h after the induction of AP.The mRNA expression of ET-3 was evaluated by semi-quantitative reverse transcription-polymerase chain reaction(RT-PCR) and pathological changes was observed in rats.Results Expression of ET-3 mRNA could be detected from 1 up to 24 h after the induction of pancreatitis.Expression of ET-3 mRNA of sham operation group was decreased significantly compared with other three groups.Expression of ET-3 mRNA showed a significant decrease by arterial injection dopamine than that by tail vein(P

AlM: To observe the clinic effect of oral mucosa transplantation in the treatment of severe contracted conjunctival sac after ocular prosthesis implantation .
METHODS: Thirty-three cases ( 33 eyes ) with globe disorders and severe contracted conjunctval sac were operated ocular prosthesis implantation firstly, and conjunctival sac plasty using oral mucosa after 6mo.
RESULTS: Thirty - one cases were successful, no complications appeared. One case had primary ptosis and 1 case had recurrent conjunctival sac contracture.
CONCLUSlON:lt is recognised that the methods of oral mucosa transplantation in severe contracted conjunctival sac after ocular prosthesis implantation are effective on those cases.

Anemia, Dyserythropoietic, Congenital ; pathology ; Child ; Humans ; Male ; Siblings