Objective To explore the levels of urine iodine in mothers and urine iodine and blood thyroid-stimulating hormone (TSH) in their neonates, and the correlations. Methods A total of 695 pairs of mothers and their neonates were included. Urine sample of both mothers and newborns were collected and the levels of urine iodine were detected. Heel blood sample of newborns were collected and the levels of TSH were detected. Results The median urine iodine level in 695 mothers was 212 . 9μg/L, among whom 163 case ( 34 . 39%) were iodine deifcient (?5 mIU/L in neonates whose mother were iodine deifcient or excessive were higher than those in neonates whose mother were iodine adequate or more than adequate, and the difference was statistically signiifcant (P

Objective To study the characteristics and its risk fastors of brain development of the preterm infant early after birth in amplitude-integrated electroencephalography(aEEG). Methods The 153 preterm infants who had seen a doctor in Peking University First Hospital from April 2009 to August 2013 accepted the aEEG check at term of corrected gestational age ( ≥ 38 weeks but < 42 weeks of corrected gestational age). The risk factors of brain development, such as gestational age ( < 30, 30 ≤ - ≤ 33+6 and 34≤-≤36+6 weeks), clinical informations [relatively stable group including 104 cases without any serious complications or brain injury, the group only suffering from a serious brain injury (19 cases), and the group only suffering from severe systemic disease (30 cases)] and nutrition (good or malnutrition), were analyzed. Also the relationship between the aEEG and the cranial ultrasound detected at the same time and the Gesell Developmental Scale at six months of corrected gestational age. Theχ2 test, two independent samples t-test and Logistic regression analysis were used for statistical analysis. Results The aEEG of 52%(79/153) cases reached the level of normal full-term newborn at term of corrected gestational age, only 48% (74/153) were abnormal. The abnormal rate of aEEG results in relatively stable preterm infants decreased from 3/6 (<30 weeks) to 35%(13/37) at 34 ≤ - ≤ 36+6 weeks, but the difference was not statistically significant (χ2=1.998, P=0.353). The abnormal rate of aEEG results in the group suffering from a serious brain injury was higher than the relatively stable preterm infants [14/19 vs 44%(46/104) ,χ2=5.578, P=0.024]. In relatively stable preterm infants, there was no difference of the abnormal rate of the aEEG results between intrauterine malnutrition group and good nutrition group [46%(19/41) vs 43%(27/63),χ2=0.122, P=0.727]. Neither was between extrauterine malnutrition group and good nutrition group [52%(13/25) vs 42%(33/79),χ2=0.805, P=0.369]. Serious brain injury was independent risk factor of abnormal aEEG (OR=3.453, 95%CI: 1.177-10.132, P=0.024). The coincidence rate of aEEG and the cranial ultrasound examination or the scores of Gesell Developmental Scale was 57%(56/98) and 50%(10/20), respectively. Conclusions The brain catch-up development may appears early after birth in preterm infants, which are impaired by lower gestational age and the severe brain injury. It is more effective of aEEG for evaluating the brain development of preterm infants when combines with other methods.

Objective To explore the effect of sinomenine on the expression of tumor necrosis factor-α (TNF-α),cathepsin G (Cat-G) and cathepsin S (Cat-S) in rats with collagen induced arthritis (CIA).Methods The 60 SPF male Wistar rats were randomly divided into normal group,model group,high dose group,medium dose group,low dose group,and dexamethasone group (with 1 0 in each group).In the normal control group,the rats were given ordinary feed.For the other five groups,the rats were used to build a CIA model and give pharmacologic intervention in the following 20 days.After 20 days of inflammation,sinomenine would be divided into three different dose groups,with 120 mg/kg,90 mg/kg and 60 mg/kg,respectively,and each group was given a gavage daily.For the dexamethasone group,7.5 mg/kg dexamethasone was given for gavage once a day.In terms of the model group and normal group,the rats were perfused with the same volume of saline once daily.Then,taken the pictures of foot paw X-ray and foot paw pictures of rats in each group,measured the content of TNF-α,Cat-G,Cat-S in blood serum,observed the pathological changes in the synovial tissue of rats in each group by tissue section,measured the content of TNF-α,Cat-G,Cat-S in in spleen of rats by Immunohistochemical staining.Results The results of X-ray showed that there were obvious soft tissue swelling,joint deformity and osteolysis in the paws of the model group,and the above symptoms were alleviated in different degrees in each treatment group compared with the model group.Compared with the model group,the expression of TNF-α (376.48 ± 22.21 pg/ml,369.45 ± 82.68 pg/ml,425.17 ± 153.51 pg/ml vs.457.63 ± 152.67 pg/ml),Cat-G (1 398.05 ± 167.32 pg/ml,1 337.65 ± 209.34 pg/ml,1 412.78 ± 67.65 pg/ml vs.2 283.03 ± 185.21 pg/ml),and Cat-S (662.18 ± 169.66 pg/ml,406.80 ± 41.93 pg/ml,452.76 ± 50.49 pg/ml vs.838.11 ± 141.86 pg/ml) in blood serum of sinomenine high dose group,medium dose group and low dose group significantly decreased (P＜0.05).The expression of TNF-α (0.28 ± 0.05,0.21 ± 0.03,0.34 ± 0.04 vs.0.50 ± 0.04),Cat-G (0.28 ± 0.02,0.18 ± 0.06,0.27 ± 0.02 vs.0.37 ± 0.03),and Cat-S (0.22 ± 0.02,0.18 ± 0.03,0.27 ± 0.02 vs.0.35 ± 0.03) in spleen tissue significantly decreased (P＜0.05).The results of HE staining showed that the synovial tissue of normal rats was normal,the synovial tissue cells of model rats were damaged,the expression of inflammatory cells was significantly increased,and pannus hyperplasia was observed.Inflammatory cell infiltration and pannus hyperplasia were decreased in each group after administration.Conclusions Sinomenine has a sound and comprehensive intervention effect on rheumatoid arthritis,and the mechanism may be related to the inhibition of the expression ofTNF-α,Cat-G and Cat-S.

Objective To investigate the effect of sensitive indicators of nursing quality in the management of elderly inpatients in neurology department. Methods A total of 160 inpatients in the department of neurology who were admitted between January 2016 and December 2017 were selected as study subjects. The patients were divided into pre-implementation (January to December 2016) and post-implementation (2017 Month-December) with 80 cases each. Traditional nursing Quality Management mode was adopted before implementation, and the management mode of nursing quality sensitive index was adopted after implementation. These two with priority improvement indicators, adverse events in nursing care, patient satisfaction and so on were compared. Results After the implementation, the correct rate of risk assessment, the implementation rate of nursing specifications, the correct rate of drug delivery, the rate of graded care execution, and the rate of individualized rehabilitation training were significantly higher than before implementation.The difference was statistically significant (χ2=4.103-5.769, P<0.05). The incidence rate of adverse events such as stress injury was 3.75% (3/80), which was significantly lower than that before implementation 20.0% (16/80). The difference was statistically significant (χ2=7.206, P<0.05). The patient satisfaction rate was 96.25%(77/80), which was significantly higher than 87.50% (70/80) before implementation.The difference was statistically significant (χ2=4.103, P<0.05). Conclusion The implementation of the sensitive index of nursing quality can improve the nursing quality of elderly inpatients in the department of neurology, reduce the occurrence of nursing adverse events and improve the satisfaction of patients.

Objective To survey the prevalence of stress urinary incontinence(SUI)and related knowledge among postpartum women in Shanghai Melong district.Methods A questionnaire survey on the knowledge of stress urinary incontinence was conducted among 317 postpartum women who were home visited by Meilong Community Health Service Center between March 2017 and June 2017.The self-designed questionnaire included the general situation(age, height, weight, occupation, menstrual history), pregnancy and childbirth, and knowledge of SUI; the International Consultation on Incontinence Questionnaire Short form(ICIQ-SF)was also used.Total 317 questionnaires were distributed and 313 valid ones were retrieved(98.73%).Results The prevalence of SUI in the participants was 26.84%(84/313).Multivariate logistic regression showed that BMI≥24 kg/m2(OR=6.24, 95% CI: 3.41 -11.41), complicated metabolic syndrome(OR=9.84, 95% CI: 2.77 -34.96)and birth weight of previous child ≥4 kg(OR=0.09,95%CI:0.04-0.19)is independent risk factors for the development of SUI.The average SUI knowledge score was(10.39 +8.65)points, only 26.20%(82/313)of the participants knew Kegel training(score 5.99 ±1.60).The SUI knowledge level of postpartum women was associated with educational level(F=12.41),occupation(F=9.06), income(F=4.05), reproductive history(F=10.98)and presence of urinary incontinence symptom(F=22.31)(all P<0.05). Conclusion The knowledge level of maternal stress urinary incontinence in Meilong district is relatively low,and the publicity of SUI and pelvic floor rehabilitation knowledge should be enhanced for the pregnant women.

Objective To observe the restraint strap with auxiliary lower limbs braking effect on sleep status of patients after global cerebral angiography. Methods A total of 400 patients, who performed with global cerebral angiography admitted at Department of Neurology, Chinese PLA General Hospital from January to August 2014, were randomly divided into observation group and control group, each with 200 cases. The patients in the control group maintained operative limb braking straight for 12 hours and then kept prostration for 24 hours, but the rest of body could move freely. The patients of observation group received the auxiliary brake application with lower limbs extremity restraint strap based on the care of the control group. Sleep status of the two groups were observed and compared. Results The patients in two groups suffered decreased quality of sleep, but the patient of observation group acquired (1. 07 ± 0. 58), (1. 02 ± 0. 89), (0. 93 ± 0. 75), (0. 90 ± 0. 96), (1. 23 ± 0. 67) and (7. 73 ± 2. 82) in the PSQI scores of each factor including sleep quality, bedtime, hour of sleep, sleep efficiency, dysssomnia and total PSQI score lower (1. 43 ± 0. 97), (1. 73 ± 0. 75), (1. 40 ± 0. 89), (1. 43 ± 0. 89), (1. 53 ± 0. 68) and (9. 13 ± 4. 13) in the control group (t = 4. 505, 8. 627, 6. 440, 5. 726, 4. 444, 3. 959,respectively;P < 0. 05). Conclusions The usage of restraint strap after global cerebral angiography can decrease the incidence rate of sleep disorder, further promote the rehabilitation of patients, so widely clinical application should be taken into consideration.

Objective To investigate the clinical significance of restrictive foramen ovale ( RFO ) monitored by fetal echocardiography during the middle to late stage of pregnancy . Methods The detection rate ,echocardiographic features and outcome in fetuses with RFO without cardiac malformations from 7319 pregnant women received prenatal echocardiography were retrospectively reviewed and analyzed . Results RFO was found in 40 of 7319 (0 .55％ ) fetuses . The inclusion criteria including a narrow right to left shunt of less than 2 .5 mm in diameter across atrial septum , enlarged right atrium , increased right-to-left ventricular size ratio ,and increased size ratio of main pulmonary artery to aorta were present in 40 fetuses . The direct ultrasound characters of RFO included limited opening of oval valve ( 70％ ) and foramen ovale diameter less than 2 .5 mm (30％ ) . And atrial septal aneurysm ( 62 .5％ ) ,redundant primum atrial septum (57 .5％ ) ,abnormal ductus arteriosus ( 57 .5％ ) might also be present commonly in RFO . As the gestational weeks increased , the size ratio of right-to-left atrium , right-to-left ventricle and the main pulmonary artery to aorta also increased significantly( P =0 .004 , P <0 .001 , P <0 .001) . Among the 40 fetuses with RFO ,21 cases ( 52 .5％ ) gave birth in full term ,8 cases ( 20％ ) which were detected severe tricuspid regurgitation gave birth in early cesarean section ,5 cases ( 12 .5％ ) had induced labor and 6 cases (15％ ) were lost in the follow-up . Of the 29 newborns ,only 1 case died of heart failure ,and the other 28 subjects recovered both from heart structure or cardiac function within four months . Conclusions RFOwithout cardiac malformations presents echocardiographic features characterized by a narrow right to left shunt of less than 2 .5 mm in diameter across atrial septum . Fetal echocardiography can monitor the dynamic change of fetal heart structure and function based on the increase of right heart load and decrease of left heart volume ,which has important clinical significance for assessing fetal intrauterine condition and prognosis .

Huacao Community Health Service Center has established an integrated chronic kidney disease (CKD) management system since 2015,which greatly improved CKD management in the community.From September 2016 to August 2017,4084 residents were screened by the family doctor team,975 were suspected to have CKD (23.87％),among whom 202 (20.72％) were referred to district CKD treatment center,and 197 (97.52％) were confirmed as CKD.The detection rate of suspected CKD among patients with hypertension and diabetes mellitus was the highest,which was much higher than that among outpatients and those with routine health check up.It is suggested that the integrated management of CKD should be widely implemented to cope with the prevalence of CKD,particularly for those with hypertension and diabetes.

Objective:To investigate the prevalence of hyperuricemia (HUA), patients′ awareness of HUA, and related factors among elderly in community.Methods:The health check-up data of 6 897 residents aged over 65 years in Gumei Community of Shanghai were collected from January 2019 to January 2020. There were 1 156 subject with increased serum uric acid levels (HUA group) and 5 741 with normal uric acid levels (non-HUA group). The differences of clinical indicators between HUA group and non-HUA group were analyzed and the risk factors of HUA was determined by multivariate logistic stepwise regression. A questionnaire survey on the knowledge of HUA and the adoption of relevant health behaviors was conducted among HUA patients.Results:The overall prevalence was 16.8% (1 156/6 897) in this population. The prevalence in males was significantly higher than that in females[26.4%(842/3 195) vs. 8.5%(314/3 702), P<0.001); and the prevalence in females increased with age (χ 2=7.56, P=0.023). Body mass index(BMI), waist circumference(WC), total cholesterol(TC), triglyceride(TG), serum creatinine, alanine aminotransferase(ALT) and albumin/urine creatinine ratio(UACR) in the HUA group were significantly higher than those in the non-HUA group, while estimated glomerular filtration rate(eGFR) and high-density lipoprotein(HDL) were lower than those in the non-HUA group (all P<0.01). The prevalence of hypertension, decreased renal function, overweight or obesity, abdominal obesity, fatty liver and renal cyst in HUA group was significantly higher than that in non-HUA group (all P<0.01). High values of TG, low-density lipoprotein(LDL), WC, hypertension and fatty liver were risk factors for HUA( OR=1.14, 1.20, 1.03, 1.43, 2.19; P<0.01); while female gender, eGFR, HDL and glycosylated hemoglobin A1c(HbA1c) were protective factors for HUA( OR=0.32, 0.94, 0.65, 0.78; P<0.01). The questionnaire survey was conducted among 1 090 HUA patients, and the results showed that 73.2% (798 cases) were aware of the disease after the health check-up results released; only 30.9% (337 cases) knew the diagnostic criteria of HUA, 21.1% (230 cases) knew that HUA needed life-long follow-up care, 56.3% (614 cases), 49.2% (536 cases) and 47.9% (522 cases) thought that HUA should eat less seafood, broth and soya bean products, 17.0%(185 cases) were atcohol drinker and the awareness rates of above questions in patients with gout were higher than those in patients without gout ( P<0.05). Conclusion:The study shows that the prevalence of HUA among the elderly in Gumei community of Shanghai is high, and the HUA related knowledge levels and health behavior performance are not ideal, especially for HUA patients without gout, therefore health education should be strengthened for elderly residents in the community.

Objective:To explore the association of urinary phenol concentration and blood biochemical indices in coke oven workers.Methods:From April to may 2019, we investigated 771 employing coke oven workers from a coke plant in Taiyuan city, and categorized into benzene-exposed group ( n=402) and control group ( n=369) based on their benzene exposures in workplace and urophenol concentrations. All subjects were interviewed face-to-face using a questionnaire including name, age (year) , gender, smoking and drinking habits, personal vocational history, working length (year) , and occupational protection, etc. Post-shift urine samples detected using a gas chromatography-hydrogen flame ionization detector. Fasting venous blood was drawn in the morning and centrifuged, the separated serum were detected the following items using an automatic blood biochemistry analyzer. Covariance and multiple linear regression were used to test the association of urinary phenol concentration and the levels of all the blood biochemical indices. Results:The subjects were predominantly males ( n=719, 93.3%) , with an average age of (42.3±8.2) years and an average working length of (20.6±8.2) years. Compared with the control group, the benzene-exposed group were significantly different in age, working length of years, gender, smoking and drinking habits ( P<0.05) . The median (interquartile interval) concentration of urinary phenol was 6.00 (0.00-33.00) μg/ml in the benzene-exposed group, which was significantly higher than that in the control group ( P<0.05) . Covariance analysis indicated that the fasting blood glucose, total cholesterol and high density cholesterol in the benzene-exposed group were significantly reduced compared with the control group, yet the serum creatinine, serum uric acid and triglyceride were significantly increased ( P<0.05) . Multiple linear regression showed that, an increase of each natural logarithm (Ln) transformed urinary phenol concentration was significantly associated with increases in serum uric acid level [9.82 (95% CI: 2.18-17.47) μmol/L] and cholesterol level[0.10 (95% CI:0.00-0.20) mmol/L]. An increase of each Ln-transformed accumulated benzene exposure levels was significantly associated with an increase in total cholesterol level[0.09 (95% CI: 0.01-0.17) mmol/L]. Conclusion:Occupational benzene exposure is possibly related to the variation of purine and total cholesterol metabolism in coke oven workers.