Objective To research the nutritive condition and establish prediction model of chlorophyll-a(Chla) in a surface water source of Zhengzhou, China. Methods The water temperature(WT), Secchi-depth(SD), chemical oxygen demand(CODMn), total nitrogen(TN), total phosphorus(TP), Chla were determined in two sampling sites of the water source by standardized methods from Mar, 2004 to Oct, 2004. Nutritive condition of the water source was analyzed by trophic level index(?)[TLI(?)]. The influence of some environmental factors on Chla was analyzed by correlation analysis and stepwise multiple regression. Chla was predicted by establishing a stepwise multiple regression equation. Results In the spring, summer and autumn, nutritive condition of the water source was from the maximum of mesotropher, the maximum of light eutropher to the minimum of middle eutropher. A positive correlations were found between the standardized Chla and WT, CODMn, TP. A negative correlation was found between the standardized Chla and SD. The equation was ln(CChla+1)=-0.114+0.083 48 WT+6.874 TP+0.193 CODMn(R2=0.900, F=62.674, P

Objective: To determine the relationship among perceived stigma, mental health and unsafe sexual behaviors of people living with HIV/AIDS. Methods: Cross-sectional research was used to interview people living with HIV/AIDS (PLWHA) from April 2012 to March 2013 in Changsha, China. The questionnaires included General Questionnaire, Sexual Behavior Questionnaire, Patient Health Questionnaire Depression Scale (PHQ-9), General Anxiety Disorder Scale (GAD-7) and Psychometric Assessment of the HIV Stigma Scale. hTe results were statistically analyzed with SPSS18.0. Results: hTe total score of perceived stigma and its 4 dimensions were positively correlated with anxiety and depression. The total score of perceived stigma and its dimensions were associated with disclosure, but no signiifcantly correlated with other sexual behaviors. Hierarchical regression showed perceived stigma had an effect on anxiety. Conclusion: hTe stigma perceived by PLWHA is above the average level. Perceived stigma has an effect on mental health, especially anxiety, but no effect on unsafe sexual behaviors.

Modern information technology was used to establish the simulating interview question bank which includes the parts of medical history,physical examination,primary diagnosis,lab test, treatment,confirmed diagnosis and the final case abstract according to the clinical management process. Results of the application in gynecology and obstetrics teaching assessment among the medical probation showed that the simulating interview question bank had some advantages in assessing the student's ability of the knowledge comprehensive evaluation,self-thinking and synthetic analyzing. It could also make au-tomatic analysis after the examination and provide teaching feedback. This novel teaching assessment could be optimized and applied extensively.

The establishment of medical morality and behavior appraisal system and research on its application developed in comprehensive hospitals were clarified.Several aspects related to the medical morality and behavior appraisal,such as index,standard,approach,method,record and the result,were investigated and practiced,and the establishment of a scientific and reasonable medical morality and behavior appraisal system was investigated in the aspects of consummating the organization management of medical morality appraisal,subdividing the medical morality appraisal system,quantifying the medical morality appraisal standard,operating and performing the medical morality appraisal and establishing the electronic archives of medical morality appraisal to construct an efficient incentive and restraint mechanism,and moreover,to promote the establishment of hospital convention and the enhancement of the overall management level.

Objective To explore the effect of probucol on the inflammatory response in rabbits with arteriosclerosis obliterans.Methods SPF male new zealand white rabbits were subjected to incomplete right femoral artery ligation model of arteriosclerosis obliterans.The model rabbits were divided into experimental group and control group.The rabbits in experimental group were treated by probucol.After treatment for 4 weeks,HE staining was used to evaluate the injury severity of right femoral artery in rabbits;ELISA was used to measure the levels of IL-1,IL-6,TNF-α and CRP;Realtime PCR was used to detect the expressions of IL-1,TNF-α in right femoral artery;Western blot was used to measured the nucleus accumulations of NF-κB,and the phosphorylation of IκB.Results Compared with control group,the degree of pathological injury of right femoral artery was significantly atteunated,the levels of IL-1 、IL-6 、TNF-α and CRP in plasma,the mRNA expressions of IL-1 、TNF-α and the nucleus accumulations of NF-κB,and the phosphorylation of IκB in right femoral artery decreased significantly.Conclusion Probucol attenuates the inflammatory response in rabbits with arteriosclerosis obliterans significantly.

Objective:To evaluate the seven existing vaginal birth after cesarean (VBAC)screening tools and to identify additional factors that may predict VBAC or failed trial of labor in China.Methods:In the study,53 patients with 1 previous cesarean delivery who then delivered between January 1,2007 and Novenber 31,2014 were recruited.The average age of the patients was (32.1 ±3.5 )years,the average gestational age was (38.0 ±2.3)weeks.There was no significant difference of the successful group and the failed group in the maternal /neonatal mortality and morbidity,also in the incidence of the postpartum hemorrhage and the postpartum infection.The probability of VBAC was calculated for each participant using 7 prediction models created by Weinstein,Flamm,Grobman,Gonen,Troyer,Smith and Torri.The data were analyzed using t test,rank-sum test,and receiver operating curve analysis. Results:44 trial of labor patients had a vaginal birth after cesarean delivery,and the successful rate was 83%.The scores between the successful group and the failed group had significant difference when eva-luated by Weinstein and Grobman scoring models only.After recalculating the successful rate of VBAC in different score levels according to the references,there was significant difference between the rates of dif-ferent score levels when evaluated by the Weinstein model.The successful rates of different score levels were higher compared to the references (<50%)when evaluated by the Troyer (70%),Gonen (60%),Torri (85.7%)models.The area under the receiver operating characteristic curve of Weinstein prediction model (0.746)and Flamm prediction model (0.723)were more than 0.7,and there was no significant difference between the seven models.Conclusion:Among the seven scoring models,the Weinstein model is more applicable to the population of our country,but a new model more applying to Chinese women still needs to be created.

Objective To explore the developmental tendency of eco-migrant children's extroversive behavior and the relationship between extroversive behavior and personality and family environment.Methods 856 eco-migrant children(aged 6-16)participated in the present longitudinal study.At first time the Child behavior checklist(CBCL),Eysenck personality questionnaire (EPQ) and Family environment scale (FES) were used to assess their behavioral problems,personality and family environment.Participants' parents subsequently completed measures assessing behavioral problems every nine months for 27 months.Data were analyzed using hierarchical linear modeling analyses.Results The scores of extroversive behavior in eco-migrant children were(10.09±7.11) at first time,(7.66±7.56) at the second wave,(8.54±7.49)at the third wave and(8.11±7.33) at the last time.During the longitudinal period,the descending trend of eco-migrant children's extroversive behavior was significant (β=-0.51,P＜0.05).The scores of psychoticism,neuroticism,family conflict,organization,cohesion and cultural factors were differently correlated with children's extroversive behavior (β=-0.67-0.32,P＜0.05).Family conflict predicted the developmental trend of children's externalizing (β=-0.46,P＜0.05).Conclusion During the longitudinal period,the level of eco-migrant children's extroversive behavior decreased,and personality and family environment have significant influences on it.

Objective To discuss the influence of bath frequency on neonatal skin condition and body temperature. Methods 108 newborns from obstetrics of People′s Hospital of Peking University during November 2015 to December 2015 were selected, and were randomly distributed t into two groups by lottery. The control group took bath every day, whereas the experimental group did every three days. The newborns were followed up for 4 weeks on their skin condition and body temperature. Then the data were systemized and performed statistical analysis. Results During the first 4 weeks after babies were born, the control group and experimental group showed no significant difference on their skin condition (P>0.05). When compared at the time of first 3 days, 1 week and 2 weeks after the babies were born, body temperature of the experimental group were (36.693±0.182), (36.738±0.174), (36.772±0.185)℃, while the control group were (36.591 ± 0.160), (36.671 ± 0.158), (36.684 ± 0.155)℃,which tended to be significantly lower than the experimental group (t values were -2.697,-2.087,-2.669, P <0.01 or 0.05), but still within the normal range. However, this difference of body temperature disappeared after the first 2 weeks (P>0.05). Conclusions Reducing the bath frequency form once a day to every third day showed no influence on neonatal skin condition. Meanwhile, it did avoid significant reduce of body temperature after bath. This may help improve healthy skin care of newborns, promote their growth, and at the same time, redistribute the clinical nursing work efficiently.

Objective To compare the differences and similarities between the diagnostic criteria of obstetrics and internal medicine in China with that of Hibbard for peripartum cardiomyopathy (PPCM).Methods From March 1995 to September 2009, a total of 49 patients were diagnosed as PPCM at the Peking University People's Hospital and the Fu Wai Hospital in Beijing, China. Obstetric diagnostic criteria was:PPCM was one of dilated cardiomyopathy,occurred during the third trimester of pregnancy through the 6th month postpartum,and without cardiovascular diseases before. Internal medicine diagnostic criteria was:PPCM was unexplained cardiomegaly and heart failure, occurred during the last month of pregnancy through the 5th month postpartum, and meet the echocardiographic criteria of dialated cardiomyopathy as follows:left ventricular end-diastolic dimension (LVEDd) greater than 5.0 cm; left ventricular ejection fraction (LVEF)less than 45% , and(or) left ventricular fractional shortening (LVFS) less than 30% ; or LVEDd greater than 2. 7 cm/body surface area (m2) ; or LVEDd > 117% of age and body surface area predictive value. Hibbard diagnostic criteria was: All four of the following: (1) heart failure within last month of pregnancy and 5 months postpartum; (2) absence of prior heart disease; (3) no determinable cause; (4) strict echocardiographic indication of left ventricular dysfunction; LVEF less than 45% , and/or LVFS less than 30% , and LVEDd greater than 2. 7 cm/m2. The compliance between obstetric and internal criteria with Hibbard criteria, and the reasons of incompliance between Chinese and international criteria were analyzed. Results Eight patients were diagnosed of PPCM by obstetricians according to Chinese obstetric criteria. Among them, 6 patients (6/8) did not meet Hibbard criteria. 2 of the six did not reach the time regulated in the criteria. All of the six had other determinable causes for heart failure, and their echocardiographic results did not meet the diagnostic standard either. The other 41 patients were diagnosed of PPCM by physicians according to Chinese internal medicine criteria. Among them, 7 patients (17%) did not meet Hibbard criteria, 3 of the seven did not reach the time regulated in the criteria, and had other determinable causes for heart failure either. 4 of the seven did not meet the echocardiographic standard part in the criteria. The Chinese internal medicine diagnostic criteria has a significant higher coincidence rate with Hibbard criteria, compared to Chinese obstetric criteria (83% vs. 25% ; P <0. 01). Among all 13 patients whose PPCM diagnosis did not meet Hibbard criteria, 5 cases did not reach the time regulated in the criteria, 9 cases had other determinable causes for heart failure, and 10 cases did not meet the echocardiographic standard part in the criteria. Preeclampsia was the most common determinable causes for heart failure, accounted for 7 cases. Conclusion There is obvious difference between Chinese and Hibbard diagnostic criteria for PPCM, especially Chinese obstetric criteria.

Objective To investigate de-escalation of empiric broad-spectrum antibiotics treatment for patients in intensive care unit (ICU).Methods Data of the patients discharged from ICU in the Second Affiliated Hospital of Zhejiang University from July 1 to December 31 of 2012 and from July 1 to December 31 of 2013 were retrospectively reviewed.Patients with initial use of empirical broad-spectrum antibiotics within 3 d after ICU admission were included in the study.Clinical data including status of infection,the initial empiric antimicrobial therapy,pathogens culture and adjustment of antibiotics in 5 days were analyzed.Results A total of 841 patients were discharged from ICU during the study periods and antibiotics were used in 786 (93.5％) patients.Among 786 patients,389 (49.5％) were treated empirically with broad-spectrum antibiotics,but only 269 (69.2％) had evidences of bacterial infections.Of the 389 patients with empiric antibiotics use,de-escalation of antibiotics was applied only in 6 (1.54％) patients within 5 days after the initiation of treatment.In 269 patients with evidence of infection,specimen sampling and culture were performed in 248 (92.2％) patients within 3 days,among which 165 samples were positive,and the clinical isolates were mainly multi-drug resistant gram negative bacilli and colonized bacteria in oropharyngeal cavity.De-escalation was applied only in 4 (1.49％,4/269) patients with evidences of bacterial infections.Conclusion Broad-spectrum antibiotics as initial empiric therapy is common for patients in ICU,however de-escalation of empiric therapy is rarely applied even in patients with positive results in pathogen isolation and culture.