Objective Toexploretheclinicaldiagnosisvalueofthehighfrequencycolordopplerultrasound(HFCDU)character-istiesofwristdamageinpatientswithrheumatoidarthritis(RA).Methods 78patientswithRA(RAgroup)werecollectedfrom June 2012 to December 2012 in the Affiliated Hospital of Inner Mongolia Medical University ,sonogram anatomy changes and syno-vial thickness of bilateral wrist were measured using colorul trasound ,meanwhile the respective data obtained from 50 healthy peo-ple undergoing physical examination(healthy control group);using color doppler flow imaging and color doppler energy ,synovial blood flow of artery resistance index (RI) and pulse index(PI) in synovial were measured and detected according to semi-quantitative method of alder ,and explord the correlations between RI and PI .Results (1)Among the 78 cases(156 joints) with RA ,join thy-drops(65 cases ,122 joints) ,inflammatory exudation(34 cases ,70 joints) ,synovium proliferation(78 cases ,153 joints) ,pannus(37 cases ,69 joints) and bony erosion(29 cases ,58 joints) were found.The thickness of synovial membrane of wrist in RA group was (3 .50 ± 1 .37)mm ,that in healthy control group was(1 .46 ± 0 .32)mm ,the different was statistically significant(P<0 .05) .(2) 64 cases among the 78 patients with RA were detected blood flow signals ,RI progressively reduced with blood flow grade the increas-ion which there was a negative correlation (r= -0 .79 ,P<0 .05);there was no significant correlation between PI and blood flow grade .(3) Ultrasound examination was more sensitive than rheumatoid factor (RF) and X-ray in detection rate of RA (P<0 .05) . Conclusion Ultrasound examination could detecte the pathological changes of wrist in patients with RA which is more sensitive than RF and X-ray ,and it could improve the detection rate of RA which contribute to early diagnosis and reasonable treatment for RA .

Objective To observe the effect of rational-emotive therapy(RET)on rehabilitation of patients with depression after stroke.Methods 62 hemiplegic patients with depression after stroke were randomly divided into the RET group and control group with 31 cases in each group.All patients were evaluated with Hamilton Rating Scale for Depresstion(HAMD)and Barthel Index(BI)before and after treatment.Results After treatment,the scores of HAMD and BI of the patients in the RET group was superior to those in the control group(P<0.01).Conclusion The rational-emotive therapy is effective to improve not only depressive symptoms but also the quality of living.

Objective Analysis of the genetic structure stability of Brandt ’ s vole ( lasiopodomys brandtii ) in closed colony using microsatellite marker technology.Methods Genomic DNA was extracted from tail tip using high-concentration-salt precipitation methods.Marked with fluorescent tags( Fam) , 7 microsatellite primers were filtered out by PCR, and the DNA structure of three consecutive generations of Brandt’ s vole was analyzed by microsatellite marker. Results By the analysis of the average heterozygosity and polymorphism information content, Brandt’ s vole populations maintaineda closed group of qualified genetic structure.Conclusions The present results show that the closed group of Brandt’ s vole species in our laboratory maintain a stable genetic structure.

Objective To systematically evaluate the risk factors for hospital-acquired pneumonia(HAP) in patients in departments of neurosurgery.Methods Literatures about the risk factors for HAP in patients in departments of neurosurgery published at home and abroad between 2001 and 2016 were retrieved, the standard clinical data were selected for Meta analysis, the combined OR value for each factor was calculated.Results A total of 7 literatures (3 250 studied objects) were included in the study.Publication bias was excluded, a total of 8 factors were statistically significant, which including age (OR, 1.68 [95% CI, 1.16-2.11]), endotracheal intubation or tracheotomy(OR, 11.31 [95% CI, 9.14-13.63]), disturbance of consciousness(OR, 12.74 [95% CI, 10.63-15.91]), length of hospital stay(OR, 2.36 [95% CI, 1.42-4.81]), underlying diseases(OR, 3.17 [95% CI, 2.18-5.24]), use of ventilator(OR, 2.38 [95% CI, 1.56-4.32]), nutritional status(OR, 4.92 [95% CI, 2.69-6.47]), and invasive procedure(OR, 2.13 [95%CI, 1.34-3.86]).Conclusion Risk factors for HAP in patients in departments of neurosurgery are age, endotracheal intubation or tracheotomy, disturbance of consciousness, length of hospital stay, underlying diseases, use of ventilator, nutritional status, and invasive procedure.While smoking, gender, and types of surgery are not identified as risk factors for HAP in patients in departments of neurosurgery.

Objective To investigate hospital acquired infections in patients with liver cirrhosis caused by relevant factors.Methods From July 2008 to June 2013,the clinical data of 470 cases of hospital acquired infections patients with chronic hepatitis B virus (HBV) infection were retrospectively analyzed by case-control study for the effective factors.Results Hospital acquired rate was 29.1％ (137/470).By logistic regression analysis,the effective factors were length of stay (OR =27.824,95％ CI 7.187-98.386),invasive operation (OR =17.201,95％ CI 4.245-71.303),a complication (OR =2.138,95％ CI 1.030-4.377),preventive use of antibiotics(OR =2.741,95％CI 1.816-4.010),drinking history(OR=34.248,95％CI 13.045-82.328),serum albumin(OR =17.258,95％ CI 6.242-53.162),quantitative PCR-HBVDNA (OR =4.859,95％ CI 3.214 -7.625),white blood cell (OR =4.271,95 ％ CI 1.520-12.157),c holinesterase (OR =2.761,95 ％ CI 1.523 -3.787) and anti virus medicine(OR=0.128,95％CI 0.041-0.375) (P＜0.05).Conclusion This study shows that length of stay,invasive operation history,complications,low white blood cell,low serum protein,low cholinesterase,the prophylactic use of antibiotics,hormone,high PCR-HBVDNA quantitative and drinking are the important risk of hospital acquired infections infection factors of patients of impact chronic HBV infection.Applications of antiviral drugs are effective in the prevention of chronic HBV infection protection factors of hospital acquired infections infection patients.

Objective To evaluate the effects on pregnancy outcome of freezing time from oocyte retrieval and thawing method for metaphase Ⅱ human oocytes vitrification. Methods From Mar 2007 to Mar 2009, the clinical outcome of 30 infertile women undergoing vitrified-thawing oocytes of in vitro fertilizationembryo transfer(IVF-ET) in the Reproductive Medical Center of the First Affiliated Hospital of Zhengzhou University was studied retrospectively, including 21 women with double fallopian tube obstruction and 9 women's husband azoospermia. All infertile women were divided into three groups, including 5 cases in group A (freezing between 4 and 5 hours from oocyte retrieval and conventional thawing method), 9 cases in group B (freezing within 2 hours from retrieval and conventional thawing method) and 16 cases in group C (freezing within 2 hours from retrieval and improved thawing method). The vitrified oocytes were preserved for 2 months to I year and thawed for Intracytoplasmic sperm injection (ICSI) and embryo transfer. The outcome of IVF and pregnancy were recorded. Results (1) The rates of oocyte survival was (65±33) % in group B and (72±23)% in group C and the rate of transfer cycle was 9/9 in group B and 16/16 in group C, which were all significantly higher than (16±17) % of oocyte survival and 1/5 of transfer cycle in group A (P = 0. 001,0. 021). However, the rate of oocyte survival and transfer cycle between group B and group C did not reach statistical difference (P > 0. 05). The rate of implantation and clinical pregnancy of (33±38) % and 9/16 in group C were significantly higher (4±11)% and 1/9 in group B (P =0. 033,0. 040).(2)The mean age of women in group C were (28.6±2.1) in oneself oocyte, (28.0±4.6) in donor oocyte and (28.1±3.4) in donor sperm. The rate of oocyte survival was (73±25) %, (88±10) % and (66±25) %. The rate of fertilization rate was (84. 6±0. 9) %, (79. 3±2. 0) % and (82. 8±15.0) %. The rate of implantation was (20. 0±44. 7) %, (33. 0±0. 1) % , (41.6±41.7) %. The rate of clinical pregnancy was 1/5 in oneself cycles,3/3 in donor oocyte cycles, 5/8 banked donor sperm cycles in group C. All above clinical parameters were not statistically different (P >0. 05). (3) In group A, one women underwent IVFET and no clinical pregnancy was observed. One women pregnancy was terminated at two months in group B.The clinical pregnancies rate of group C was 9/16, late abortion occurred in 1 woman, the other 8 women underwent term pregnancy, including 5 male infants and 4 female infants. All of infants showed normal Karyotype. Live-birth rates per warmed oocyte was 5.9% (8/135). The mean gestational weeks and birth weight of the infants were (39. 4±0. 9) weeks and (3574±569) g, respectively. Conclusions Embryo quality and clinical outcome of thawing cycles could be significantly improved when oocyte vitrification was performed within 2 hours from oocyte retrieval and improved thawing method.

ObjectiveTo develop a simple scoring system to identify individuals with higher risk of type 2 diabetes mellitus ( T2DM ).Methods Major risk factors of T2DM were fixed after literature review.Logistic regression was used to select risk factors of T2DM.Target populations were randomly assigned to 2 groups,and group A was used for the development of risk factor scoring method and group B for the confirmation of this new method.Results The threshold for T2DM risk was 65.0 for men and 65.5 for women ( sensitivity 90.6％ and 83.3％,respectively; specificity 89.4％ and 97.7％,respectively ; positive predictive value 58.8％and 80.0％,respectively;negative predictive value 98.3％and 98.2％,respectively ; area under the curve 0.955 and 0.899,respectively).There was significant difference of T2DM detection between screening and risk scoring system ( P =0.000 ).Conclusion Our T2DM risk scoring system may provide an effective tool to identify individuals with a higher risk of developing T2DM.

Objective To explore the association between epidermal growth factor receptor (EGFR) mutation subtypes and the prognosis of brain metastasis in patients with lung adenocarcinoma.Methods A retrospective analysis was performed on the clinical data of 256 patients who were admitted to our hospital and confirmed with brain metastases of lung adenocarcinoma by EGFR mutation detection from 2010 to 2015.The prognostic factors for brain metastases were analyzed.The survival rate was calculated by the Kaplan-Meier method and analyzed by the log-rank test.The univariate and multivariate prognostic analyses were performed by the log-rank test and the Cox proportional hazards model.Results The median survival time was 10.13 months in all patients.The univariate analysis showed that sex,EGFR mutation status,exon 19 deletion,the Karnofsky Performance Status (KPS) score of brain metastases,and targeted therapy were prognostic predictors (P=0.006,0.001,0.010,0.000,0.003).The multivariate analysis showed that the KPS score and exon 19 deletion were prognostic factors for brain metastases (P=O.000,0.045).When grouped into the recursive partitioning analysis classes,all the patients were split into three subgroups with significantly different prognosis (P =0.000).Conclusions Exon 19 deletion is a prognostic predictor of brain metastases in patieuts with lung adenocarcinoma,which can be integrated into the prognosis scoring system for brain metastases of lung adenocarcinoma.EGFR tyrosine kinase inhibitors improve the survival in patients with brain metastases of lung adenocarcinoma and EGFR mutation,particularly,in those with exon 19 deletion.

Objective To explore the correlations between work engagement and transformational leadership among PICC specialized nurses.Method A total of 176 PICC specialized nurses recruited from Shandong Province by convenience sampling method were involved in the study by the Utrecht work engagement scale (UWES-9) and transformational leadership scale.Results The average scores of work engagement and transformational leadership were (39.21±11.56) and (89.68±23.52).Work engagement dedication and absorption were positively correlated to transformational lendership (P＜0.05).Conclusion Hospital administrators should plan a clear direction for the development of the PICC specialized nurses to enhance their work engagement.

Aim To investigate the effect of the total flavonoids of Epimedium (TFE)on MAPK/NF-κB sig-naling pathway and the inflammatory reaction in the hippocampus of natural aging male rats.Methods The morphological changes of the hippocampus com-posed of three areas (CA1 ,CA3 and DG)were ob-served using haematoxylin-eoin (HE ) staining.The protein expression levels of senescence-associated pro-tein p21,apoptosis-related proteins Bax and Bcl-2, nuclear transcription factor-κB p65 (NF-κB p65 )and its downstream inflammatory factors TNF-α,IL-1βand COX-2,and MAPK signaling pathway-related proteins (ERK1/2,p-ERK1/2,JNK,p-JNK,p38MAPK,p-p38MAPK)in hippocampal were detected by Western blot.Results Compared with natural aging group, TFE obviously improved the morphology and structure of hippocampal neurons,and the nerve cells arranged neatly and closely. Furthermore, TFE significantly downregulated the protein expression levels of p2 1 and Bax,upregulated the protein expression levels of Bcl-2 and the ratio of Bcl-2/Bax,and reduced the expression of NF-κB p65 and of its downstream inflammatory fac-tors TNF-α, IL-1β, COX-2, and MAPK signaling pathway-related proteins (p-ERK1/2,p-JNK and p-p38 MAPK ) in hippocampus of natural aging rats. Conclusions TFE effectively protects against inflam-matory reaction in brain aging of SD male rats.The mechanism is related with inhibition of NF-κB nuclear translocation and reduction of its downstream inflamma-tory cytokines expression by inhibiting MAPK signaling pathway activation.