Objective To investigate the depression and its influential factors in the elderly with hypertension in communities,so as to provide the theoretical evidence for practicing intervention for community health workers.Methods According to uniform inclusion and exclusion criteria,350 elderly people aged 60 years and over in Changxing Community and Town God's Temple Community in Changzhi city included hypertensive patients and healthy persons who were extracted by stratified random sampling method.The face-to-face survey method was taken,and the questionnaire included general information and Geriatric Depression Scale (GDS).All data were through statistical analysis by SPSS 13.0.Results The incidence of depression was higher in elderly hypertensive patients (scores:11.70±6.67,56.4%) than in normal elderly persons [scores:(6.49+5.97,21.3)%,t=-7.314,x2=41.489,P<0.01].The results of multiple stepwise regression analysis showed the influencing factors of depression were subjective symptoms,complicating disease,knowledge of hypertension,co-living family and economic burden.Conclusions The incidence of depression is higher in elderly hypertensive patients than in normal elderly people.If community health workers do something to intervene the influencing factors of the depression in elderly hypertensive patients,the incidence may be reduced.

Hyperlipidemic pancreatitis (HLP) has an increasing incidence.Primary HLP is common in patients with familial difficiency of lipoprotion lipase or apo-C Ⅱ.While for secondary HLP,the common reasons are excessive drinking,diabetes,obesity,fat-rich diet and special medications.Lipidlowering drugs,plasma exchange (PE) or continuous veno-venous hemofiltration (CVVH),low molecular heparin as well as insulin,have been widely used for the treatment of HLP.Changing of diet and lifestyle,in addition to controlling risk factors are the keys to preventing HLP.This article summarizes the latest perspectives and research progress of HLP.

Objective To explore the role and mechanism of keratin 19 (KRT19) in breast cancer.Methods Quantitative real-time polymerase chain reaction (qRT-PCR) assay was used to determine KRT19 levles in 35 cases of breast cancer tissues and normal tissues.The correlation between KRT19 levels and clinical property of breast cancer was analyzed.Meanwhile,the expression levels of KRT19 in several breast cancer cells and mammary epithelial cell Michigan cancer foundation (MCF)-10A were evaluated by qRT-PCR assay.Over-expressed and knocked-down KRT19 in breast cancer ceils,3-(4,5-dimenthylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium (MTS) assay was performed to detect the proliferation and chemosensitivity of these cells.The ability of forming colon of these breast cancer cells with treated KRT19 was studied via colony-forming unit assays.Western blot assay was performed to determine expression levels of ceil cycler related proteins.Results KRT19 was upregulated in breast cancer tissues comparing to normal tissues.KRT19 was positively related to tumor node metastasis (TNM) stage and distant metastasis of breast cancer.Similarly,KRT19 was highly expressed in breast cancer cells compared to mammary epithelial cell MCF-10A.The proliferation and colony-forming ability was significantly enhanced in MCF-7 cell with o,verexpressed KRT19.MTS assay showed that chemosensitivity of MCF-7 cells with overexpression of KRT19 was much more remarkably reduced than the control group.However,knocking down KRT19 in breast cancer cells MDA-MB-231 got the opposite results.Western blot assay suggested that KRT19 could obviously upregulated cyclin-dependent kinase 1 (CDK1) but not p27 expression levels.Conclusions KRT19 was upregulated in breast cancer tissues and was positively related to TNM stage and distant metastasis of breast cancer.KRT19 can significantly enhance proliferation and chemoresistance of breast cancer cells via upregulating CDK1.

SUMMARY Intravesical bacillus Calmette-Guérin ( BCG) was a common treatment for non-muscle inva-sive urothelial carcinoma of the bladder. The complication of prostatic abscess was rare. We reported a case of tuberculous prostatic abscess after BCG therapy. A 65-year-old man was diagnosed as bladder cancer and accepted transurethral resection of bladder tumor ( TURBT) treatment. He received a 6-week induction course without any infection complication. Following the second BCG maintenance instillation, he complained of fever and dysuria. Transrectal ultrasound ( TRUS) demonstrated a well-defined complex mass in the right lobe of his prostate. The diagnosis of tuberculous prostatic abscess was considered after excluding other bacterial infection. The patient was treated with an anti-tuberculous regimen of isoniazid, rifampicin, and ethambutol. The symptoms were relieved after 4 weeks of anti-tuberculous therapy. Be-cause of the good response to the medicine, no further aspiration or drainage of prostatic abscess was car-ried out. The anti-tuberculous therapy had to be stopped for serious drug induced liver injury after 6 weeks of anti-tuberculous therapy. Eight weeks later of stopping anti-tuberculous therapy, the follow-up TRUS showed the disappearance of the prostatic abscess and the test of his liver function was normal. Considering the virulence of BCG is weaker than that of common tuberclebacillus, the shorter course of anti-tuberculous therapy maybe an alternative choice, and surgical drainage is not always necessary.

Objective: To investigate the position and the size of ureteral stone in patients before treated with ureteroscopic lithotripsy or percutaneous nephrolithotomy (PCNL), as well as the dilatation of ureter caused by stone, which may be helpful for better understanding of pathogenesis of ureteral stone and improvement of the diagnosis and treatment in clinic.Methods: A total of 129 cases with ureteral stone for endourologic lithotripsy in Peking University People''s Hospital from Aug.2016 to Mar.2017 were included for the retrospective review.The CT data of the ureteral stones and the ureteral dilatation were collected, including the position of stone, the transverse and longitudinal diameter of stone, and the transverse diameter of dilated upper ureter and ureteropelvic junction (UPJ).The distribution of ureteral stones and dilatation in different parts of ureter were compared and analyzed.Results: All of the 129 cases of ureteral stone, stones were located at UPJ in 9 cases (7.0%), proximal ureter in 75 (58.0%), ureter crossing external iliac vessel (UEIV) in 6 (4.7%), distal ureter in 26 (20.2%), and ure-terovesical junction (UVJ) in 13 (10.1%).The mean transverse diameter of proximal ureteral stones was greater than that of distal ureteral stones [(8.47±2.36) mm vs.(6.74±1.99) mm, P<0.001], as the same as the mean longitudinal diameter [(11.00±4.41) mm vs.(7.50±4.28) mm, P<0.001].In 114 cases of dilated ureter for stone, the UPJ had a greater transverse diameter compared with the upper ureter [(14.39±6.09) mm vs.(11.45±3.85) mm, P<0.001].Conclusion: The most common location of stone is the proximal ureter in patients for endourologic lithotripsy, as the location in UEIV is rare.Both transverse and longitudinal diameters of stone in proximal ureter are greater than those in distal ureter.For dilated ureter, it is more severe in UPJ than in upper ureter.Traditionally, it is accepted that the stones lodge at 3 sites of natural narrowing in ureter, which may be questioned.

OBJECTIVE:To screen and analyze the ?-lactamases-resistant genes in imipenem-resistant pseudomonas aeruginosa (IMPRPa). METHODS: ?-lactamases-resistant genes including IMP,VIM and OprD2 in 60 clinically isolated IMPRPa strains were detected by polymerase chain reaction (PCR),and sequence analysis was performed on the PCR amplified products of some of IMP and VIM genes. RESULTS: Of the 60 IMPRPa strains,?-lactamases-resistant positive genes were as follows: IMP gene was positive in 7 strains,VIM gene was positive in 18 strains,and both IMP and VIM genes were positive in 3 strains. Sequencing of the PCR products of IMP and VIM genes were IMP-1 and VIM-2 types,and OprD2 gene deletion was noted in 29 strains. CONCLUSION: OprD2 protein channel deletion and metal-producing ?-lactamases are the chief mechanisms for the resistance of IMPRPa to imipenem.

Objective To investigate the diagnosis value of serum procalcitonin(PCT)detection combined with antibody de-tection of respiratory pathogens in children with pneumonia.Methods 1 256 cases of pneumonia in children were collected in the hospital from 2013 July to 2014 January were analyzed,detection PCT by chemiluminescence,using enzyme linked immu-nosorbent assay for detection of Mycoplasma pneumoniae ,Chlamydia pneumoniae and common respiratory virus.Results The positive rates of PCT was 30.7%,and MP IgM,CP IgM,RSV IgM,ADV IgM and FLUA IgM were 21.4%,16.8%, 11.8%,8.4%,and 10.9%.PCT in children with different gender in the largest number of positive cases,respectively,male 227 cases and female 158 cases,but the PCT and respiratory pathogen antibody positive in different gender did not exist sta-tistical difference (P >0.05).In different age groups,procalcitonin positive cases in 1 years in the group most,Mycoplasma pneumoniae and Chlamydia pneumoniae IgM positive cases in 1~3 years old were the largest number,the number of respir-atory virus positive patients with different maximum performance in different age groups.PCT and respiratory pathogen an-tibody positive in different age there was no statistical difference (P >0.05).Conclusion The PCT combined with respira-tory pathogen detection of antibodies help the clinic to determine the type of pneumonia in children,to provide help for the diagnosis and treatment of pneumonia in children.

Objective To summarize the effect of laparoscopic repair of acute gastric perforation. Methods Patients with acute gastric perforation underwent laparoscopic repair and abdominal drainage under intravenous- inhalation general anesthesia after a histological biopsy. Results Forty-six patients with acute gastric perforation were successfully operated.Of which, 6 patients with pylonic perforation, 37 patients with perforation in the front wall of gastric antrum, 3 patients with perforation in stomach body. Thirty-three cases were received frozen section biopsy, only 1 case showed a cancer in the lesser curve of stomach body. There was no complications occurred and no operative mortality in this series. Of the 45 benign ulcers patients,31 patients were discharged 7 days after the operation, 14 patients were discharged 2 weeks after medication treatment.Three months after operation the symptoms of the 45 patients disappeared totally,they had normal diet,and got body weight 1-3kg. Pathological examination showed that no malignant cell was found in 45 benign ulcer patients. The cancer patient was discharged 9 days after operation and refusing to further treatment. Conclusions Laparoscopic repair is a safe mini-invasive method, and it isn′t breach the surgical principles,it allows the patients recover quickly and with less complications. The intraoperative biopsy can prevent misdiagnosis of cancer. It is an effective treatment for acute gastric perforation and worthy to be widely used.

OBJECTIVETo observe the short-term clinical effectiveness of bone ring graft technique and to summarize the key points of related surgical operation to provide comprehensive clinical guidelines.

METHODSFifteen patients with severe alveolar bone absorption were selected to receive bone ring grafting and immediate dental implant. Final fixed prostheses were cemented five months after initial implantation. Cone beam CT scans were conducted on all subjects before the procedure, as well as four months post-operation to evaluate alveolar bone height and level of bone height and absorption around the implants. Four to six months after prosthesis installation, each implant's Jemt classification, gingiva attachment, and probing depth (PD) were analyzed. The difference of PD between implants and adjacent teeth, as well as the difference of the bone absorption between labial and lingual sides, was compared. The survival rate of the bone ring and the retention rate of implants were calculated. Complications and patient satisfaction were also investigated.

RESULTSBone graft survival rate was 94.4% and dental implantation retention rate was 100% four months post-operation. Average bone level increase was (6.06 +/- 1.06) mm, average bone absorption was (1.33 +/- 0.84) mm, and average bone thickness at the neck of the dental implant body was (6.94 +/- 0.73) mm. Approximately 4 to 6 months after crown restoration, average bone level increase was (5.62 +/- 1.03) mm, average bone absorption was (1.51 +/- 1.02) mm, and average bone thickness at the neck of the dental implant body was (6.77 +/- 0.72) mm. The PD around the implant body and the adjacent teeth was statistically insignificant. No major post-operative complication was observed, restorations were successful, and patient satisfaction level was high.

CONCLUSIONBone ring graft technique and immediate dental implantation are relatively simple to perform, and these techniques facilitate reduction in required treatment time. Short-term effect is reliable and satisfactory, whereas long-term outcomes require further follow up and study.

ObjectiveTo explore and analyze the effect of simulation-based learning combined with debriefing in neonatal resuscitation training.MethodsA total of 114 clinical medical staffs attended the neonatal resuscitation training course hold by Department of Neonatology, Quzhou Maternal and Child Health Hospital from November 2014 to May 2015, and were randomly assigned to observation (n=60) and control group (n=84) by coin tossing. Staffs in the observation group adopted to training skills with simulation-based learning combined with debriefing,while those in the control group were educated with traditional method. The examinations on theoretical knowledge were taken before and after the training. Operational exam and self-confident questionnaire for all staffs on each procedure taught in the course were taken at last. Scores of the exams and self-confident questionnaire were compared between the two groups witht-test and Mann-WhitneyU test.ResultsThe mean score of theoretical test rose up significantly after the training in both observation and control group (25.19±2.62 vs 20.17±3.71,t=7.725,P<0.01; 25.44±2.64 vs 18.90±4.27,t=11.170,P<0.01), but no difference was found in this score after the training between the two groups (t=0.492,P=0.624). The practical operation examination score in the observation group was higher than that in the control (34.05±1.34 vs 31.32±4.10,t=4.183,P<0.01). All questionnaires sent to the staffs were retrieved (100%), and the total values after the training in the observation group were higher than in the control (mean rank: 92.81 vs 57.99; rank sum:5 569 vs 4 872,Z=-4.96,P<0.01).ConclusionsSimulation-based learning combined with debriefing is a much more effective teaching methods for neonatal resuscitation training, which might quickly improve the resuscitation skills of clinical staffs.