Objective To explore of laparoscopic abdominal trauma used in the diagnosis and treatment of gastrointestinal tract injury.Methods 180 cases of abdominal trauma and gastrointestinal injury were randomly divided into three groups,A group of 60 cases was given conventional nonoperative treatment,B group of 90 cases was given laparoscopic exploration to surgical treatment,C group of 30 cases was open to probe the surgical treatment.The clinical effect of three groups was observed.Results After treatment,A group of recovered 32 cases,improvement in 16 cases,invalid in 12 cases,the total effective rate 80.0％,length of hospital stay (8 ±4)d,B group healed 58 cases,30 cases improved,invalid in 2 cases,the total effective rate 97.8％,length of hospital stay (8 ± 3) d,C group of 19 cases were healed,better 10 cases,1 case ineffective,the total effective rate 96.7％,length of hospital stay (15 ± 5) d,A,B and C group total effective rate differences were statistically significant (x2 =13.45,4.50,all P ＜0.05).C group hospitalization time was longer than that in A,B group (t =5.24,3.34,all P ＜ 0.05).Conclusion Laparoscopic exploration surgery for abdominal trauma and gastrointestinal injury has better diagnosis and treatment effect,which can reduce the time in hospital to improve the prognosis of patients.

Objective To evaluate the health intervention effect of the health examinees in order to explore their effective on cutting down the incidence of disease and improving people'S lifestyle.Methods Chi-square test were used to analyze the health effective of 49 825 health examinee in the health physical examination center of shandong provincial hospital from the year 2003 to 2005.Results The incidence of handling health knowledge,controlling risk factors,exercising, accepting health education and health examination in regularity increase(P<0.05);abnormal rate of health examinees decreases in the three years.Conclusion Health intervention based on health examination is an effective way to improve lifestyle and to prevent,control chronic disease.

ObjectiveTo measure the changes of eye shape and axial length of the eyeball before and after removing the scleral encircling buckles. MethodsThis is a prospective and controlled study. Twenty eyes (20 patients) with rhegmatogenous retinal detachment and the fellow eyes were enrolled in this study.All patients underwent scleral encircling buckling, and the buckles were removed 2.0 - 3.5 years after the surgery. The eye shape and axial length of both eyes were measured by three-dimensional computed tomography (3D-CT) before and one, three, six months after the removing surgery. The axial length was also measured by intraocular lens (IOL)-Master. Results3D-CT showed that buckled eyeball depressed at the equator, resulting in a gourd-shaped eyeball.One month after removing the encircling buckle the depression disappeared.By 3D-CT scanning, the axial lengths of buckled eyes were (27.65 ± 1.22),(27. 3±1.56), (27. 29 ± 1.46) and (27. 12 ± 1.49) mm before and one, three, six months after the removing surgery respectively.The difference betweenbefore and after removing surgery was not statistically significant(t=2.89, P = 0.723). By IOL-Master, the axial length of operated eyes were (28. 32± 1.94), (28.17± 1.87), (28.21± 1.94), (28.25± 1.93) mm respectively.The difference between before and after removing the encircling band was not statistically significant (t = 3. 304, P =0.93). There was no significant difference in these two measuring modes (t= 3.705, P = 0.847).ConclusionsEncircling buckling can cause eyeball indentation, removing the encircling band can rescue the indentation. There are no changes in the axial length before and after removing the encircling buckles.

Objective To investigate the prevalence of atherosclerotic renal artery stenosis (ARAS) and risk factors in the atherosclerotic patient population. Methods A prospective study was undertaken during Oct 2002 to Nov 2003. Renal angiography was performed to screen the presence of renal artery disease among patients with variety of atherosclerotic disease, including coronary heart disease, cerebrovascular disease and lower-extremity occlusion disease. Before the angiography, clinical data were collected. Clinical features were compared between ARAS patients and non-ARAS ones in order to explore the risk factors. Results Two hundred and eighteen patients with coronary artery disease, cerebrovascular disease or lower-extremity occlusion disease were enrolled in the study. ARAS (≥50% diameter narrowing by angiography) was identified in 53 (24.3%) of all the patients. Insignificant renal artery stenosis (

Objective: To investigate the factors affecting the development of malnutrition among the elderly patients with type 2 diabetes mellitus (T2DM), so as to provide insights into the prevention of malnutrition among the elderly patients with T2DM. Methods: Elderly T2DM patients at ages of 60 years and older admitted to Hangzhou First People's Hospital affiliated to Zhejiang University School of Medicine from June 2022 to June 2023 were recruited. Patients' demographics, number of medicines administered and comorbidities were collected using questionnaire surveys, and glycosylated hemoglobin (HbA1c), serum albumin (ALB) and hemoglobin levels were collected from medical records. The nutrition status was assessed with the new version of the Mini Nutritional Assessment Short Form (MNA-SF). Factors affecting the development of malnutrition were among the elderly T2DM patients identified using a multivariable logistic regression model. Results: A total of 382 elderly T2DM patients were enrolled, including 226 men (59.16%) and 156 women (40.84%) and with a mean age of (70.06±8.41) years. The prevalence of malnutrition was 22.25% among participants. Multivariable logistic regression analysis identified age (70 to 79 years, OR=1.261, 95%CI: 1.007-1.158; 80 years and older, OR=3.285, 95%CI: 1.618-6.662), three and more types of comorbidities (OR=2.790, 95%CI: 1.254-5.191), use of multiple medicines (OR=3.501, 95%CI: 1.841-6.658), sleep disorders (OR=1.613, 95%CI: 1.120-2.322), regular exercises (OR=0.280, 95%CI: 0.115-0.614), serum ALB of 35 g/L and greater (OR=0.272, 95%CI: 0.102-0.560) and HbA1c of 7% and higher (OR=2.914, 95%CI: 1.445-5.881) as factors affecting the development of malnutrition among elderly patients with T2DM. Conclusions The risk of malnutrition is associated with age, types of comorbidities, use of multiple medicines, sleep disorders, regular exercise, HbA1c and ALB among the elderly patients with T2DM. Periodical nutrition screening and intensified health education are recommended for T2DM patients.

Objective To construct the pcDNA3. 1-Brugia malayi (Bm) glyceraldehyde-3-phosphate dehydrogenase (GAPDH) eukaryotic recombinant plasmid and to study its effect on mouse cellular immunity response. Methods Total RNA was prepared from periodic Bm. The target gene fragments were amplified by reverse transcription-polymerase chain reaction (RT-PCR) technique and then were inserted into the cloning vector. pGEM-T Easy, and sub-cloned into pcDNA3. 1. Purified pcDNA 3. 1-BmGAPDH recombinant plasmid and CpG were injected into the anterior tibial muscle of BALB/c mice in order to induce host immunity response. Mice injected with PBS and mice injected with blank plasmid were prepared as controls. The mouse models were immunized for 3 times with an interval of 2 weeks. RT-PCR was utilized to detect target gene expression in the muscle tissue. MTT method was used to measure the immunized mice T lymphocytes stimulation index, while enzyme-linked immunoassay (ELISA) was used to determine the serum interleukin (IL)-4 and interferon (IFN)-γ level. Means were compared using t test with SPSS software. Results The recombinant plasmid pcDNA3. 1-BmGAPDH was constructed sucessfully. The target gene was 1020 bp long and its homology with known gene sequence in database was 99%. BmGAPDH gene in the injected muscle of the immunized mice was detected by PCR. The proliferation of spleen T lymphocytes was higher in pcDNA3-BmGAPDH group than in the 2 control groups which were 1. 398, 1. 006 and 1. 017,respectively (P< 0. 05). The levels of IFN-γ and IL-4 in serums from the immunized mice were significantly higher than those of the PBS control group and blank plasmid control group which were 163.905, 58.589, 51. 317 and 107. 906, 27.111, 34.627, respectively (P<0. 05). Immune adjuvant CpG could accelerate and boost antigen-specific immune responses induced by vaccine, which presented as significant increase of IFN-γ and lymphocyte proliferation at 4 weeks after immunization.Conclusion The recombinant eukaryotic plasmid pcDNA3. 1-BmGAPDH is constructed and could elicit cellular immune responses in immunized mice.

Objective To study the effect of calcium gluconate oral solution combined with psychological intervention on preventing the advertise reaction in blood donation by plateletpheresis.Methods From February 2015 to February 2016, 114 cases were collected in Shaoxing downtown blood bank, and were divided into the control group and the experimental group 57 cases in each group.In the blood collection process, the control group were not given any treatment, the experimental group was given calcium gluconate oral liquid combined with psychological intervention.The total incidence adverse reactions and SAS scores in the two groups was compared.Results Before blood donation, Before blood donation, SAS scores in the two groups has no statistically significance.After blood donation, the SAS scores and the total incidence of adverse reactions in the experimental group were significantly lower than those in the control group, the differences in the two groups were statistically significant.(P<0.05).Conclusion Calcium gluconate oral liquid combined with psychological intervention can prevent the adverse reactions in the process of blood donation by plateletpheresis, which is worthy of promotion in the process of plateletpheresis.

Objective In order to provide information for the health administration and the price authorities to establish the reasonable price,the practical cost of special nursing of the chronic wound be analyzed,and be compared with the present charge,and the deviation be studied.Methods The cost of nursing care for all items was measured,recorded and collected,then calculating the special nursing cost for chronic wound using the method of ladder sharing the project cost.Rusults The true cost on a single special care for chronic wound was (29.42±9.29)yuan,and it reached 2.5 times of present charge ( 12 yuan).Conclusions The present charge on the special care for chronic wound was seriously deviated from the practical cost,and the labor value of special care of nurses could not be embodied.

Objective To discuss the feasibility and applicability in prognosis prediction of t he National Early Warning Score (NEWS) for stroke patients in emergency department through comparing NEWS and modified early warning score(MEWS). Methods 1 195 cases of stroke patients for NEWS and MEWS from May 2013 to June 2015 in emergency centerwere chosen, and were tracked prognosis for 30 days, two score prediction ability were compared. Results When took death as prediction index, the area under the ROC curve of NEWS was AZ=0.906, sensitivity was 84.1%,specificity was 86.1%,best truncated point was 4.5 score; The area under the ROC curve of MEWS was AZ=0.846,sensitivity was 80.5%,specificity was 77.9%,best truncated point was 2.5 score, the difference was statistically significant between them (Z=3.324,P<0.05).It showed that NEWS had higher value than MEWS in prognosis prediction for stroke patients in emergency department. Conclusions NEWS score is a good tool to predict stroke patients in emergency department, which has better value than MEWS.

Objective To investigate the effect of enteral nutrition support on prognosis in patients with severe acute stroke.Methods Ninety-eight cases of severe acute stroke were divided into nutrition supported group(50 cases) and control group(48 cases) randomly.All patients were treated by conventional therapy.Nutrition supported group received high energy nutrition diet and control group received common liquid diet by nasal feeding.The levels of hemoglobin,serum albumin,neurologic impairment score (NIHSS)and the incidence rates of complications were assessed at the 1st,10 th and 21st day after admission.Results Hemoglobin was (122.5 ± 2.4),(106.4 ± 2.8) g/L and serum albumin was (36.5 ± 4.7),(34.2 ± 5.1) g/L at the 21st day after admission in nutrition supported group and control group,and there was significant difference between two groups (P < 0.05).The complication rate in control group was higher than that in nutrition supported group (P< 0.05).NIHSS score was(8.45 ± 3.02) scores in nutrition supported group and (10.24 ± 2.57)scores in control group at the 21st day after admission,and there was significant difference between two groups (P <0.05).Conclusion Early enteral nutrition support can significantly improve nutritional status and decrease the incidence rates of complications in patients with severe acute stroke,and it is helpful for clinical prognosis.