Objective To investigate the relationship between vitamin D level in plasma and concomitant symptoms in children over 4 years of age. Methods Radioimmunoassay was employed to detect the vitamin D level in plasma of 98 children over 4 years of age suffering from monoarticular joint-pain, debility, dizziness and hyperhidrosis. Results Among the 98 cases, 15 cases (rickets) were found to have a vitamin D level of 0-10ng/ml, 26 cases (subclinic rickets) with a level of 10.1-15ng/ml, 55 cases with a level of 15.1-60ng/ml, and the remaining 2 were found to have a level of 61-86ng/ml. A significant positive correlation existed between the low vitamin D level in plasma and the symptoms of joint-pain, debility, dizziness, and hyperhidrosis. Conclusion It is of a diagnostic significance to determine the 25-hydroxyvitanmin D_3 level in plasma to confirm the diagnosis of delayed vitamin D deficiency rickets in children.

Objective To study the antioxidant activities of different parts of Forsythia suspensa and two components isolated from it. Methods The antioxidant activities were assayed through scavenging effects to DPPH radical. The content of forsythiaside and forsythin of Forsythia suspensa was determined by HPLC- PDA. Results Both different parts of Forsythia suspensa and two components isolated from it had antioxidant activity. Conclution Forsythiaside showed much higher antioxidant activity than forsythin. It is an effective natural free radical scavenger.

Objective To study the content of forsythiaside and forsythin from fruits of Forsythia suspensa and Forsythia viridissima Lindl collected in different periods. Methods Samples were dealt by HPLC-PDA with Diamonsil-C18 (4.6 mm?250 mm,5 ?m) column. The mobile phase consisted of methanol-water,gradient elution,the flow rate was 1.0 mL/min. The UV detection was set at 270 nm. Results The content of forsythiaside from fruits of Forsythia suspensa was much higher than that from fruits of Forsythia viridissima Lindl. And there was no forsythin from fruits of Forsythia viridissima Lindl. Conclusion There was much difference in content of forsythiaside and forsythin from the two kinds of fruits above. Forsythia viridissima Lindl should not be used as Forsythia suspensa.

Objective To explore the experiences of internship in nursing homes among college students of elderly service and management major. Methods Descriptive phenomenological methodology was adopted in this study, a semi-structured interview was conducted with 10 college students of elderly service and management major. Data were analyzed based on Colaizzi' s phenomenological research method. Results Six themes were extracted including: sense of worthlessness;heavy burden of work;respond actively and continuous learning;sense of satisfaction and achievement;the future is mixed;eager to pursue further study. Conclusions College students of elderly service and management major have heavy burden of work and feel worthlessness, they worry about the future, so educators in colleges, managers of nursing homes and national policy-makers should take targeted measures to stable talent team of old-age service.

OBJECTIVE To investigate the protective effect of total alkaloids of Rhizoma Corydalis (TARC) on experimental gastric mucosal lesions in rats. METHODS Gastric mucosal lesions were induced in rats by injecting acetic acid under gastric mucosal. From the 2nd day post the preparation of the rat model, cimetidine 400 mg · kg-1 or TARC 20, 40 and 80 mg · kg-1 was ig delivered for 15 d in different groups. Two days after the last delivery, gastric juice volume and total acidity were measured. Histopathology of stomach tissues was observed by HE staining. The area of gastric ulcer area was measured and the ulcer index and ulcer inhibitory rate were calculated. The expression of epidermal growth factor (EGF) and EGF receptor (EGFR) was detected by immunohistochemical staining. RESULTS Comparing with shame group, the eare of gastric ulcer and ulcer index were increased signifi?cantly in the model group(P<0.01), suggesting that the model rats were prepared properly. Compared with the model group, the ulcer area in rats of cimetidine and TARC 80 mg·kg-1 groups was decreased by 39.9%and 23.7%,respectively. The ulcer index was decreased by 52.3%and 30.5%,respectively. There was no significant difference between the cimetidine group and TARC 80 mg · kg-1 group, in the ulcer area or index. Compared with model group, EGF protein expression of cimetidine and TARC 40 and 80 mg · kg-1 groups was increased by 81.8%,24.2%and 57.6%,respectively while EGFR protein expression was increased by 45.9%,16.2%and 29.7%,respectively(P<0.05,P<0.01). Deciduous and necrotic gastric mucosal and a large amount of inflmmatory cells infiltration were observed in model group, and gastric mucosal lesions were improved in cimetidine and TARC 40 and 80 mg · kg-1 groups. CONCLUSION TARC has protective effect on gastric mucosal lesions in rats. The mechanism may be related to the increase of EGF and EGFR protein expression.

Objective:To observe the safety of intravitreal injection of triamcinolone acetonide (TA) combined with partial anterior pars plana vitrectomy (PPV) for cataract with severe vitreous hemorrhage.Methods:A retrospective case-control study. A total of 60 patients (60 eyes) with cataract and severe vitreous hemorrhage were included from June 2017 to June 2019 in Xi’an People’s Hospital (Xi’an Fourth Hospital). There were 32 males (32 eyes) and 28 females (28 eyes), with a mean age of 64.8 years. The eyes were randomly divided into intravitreal injection TA group (TA group) and non-TA injection group (control group), with 30 eyes in each group. Before phacoemulsification, 0.05-0.10 ml TA was injected into the vitreous cavity in the TA group and the vitreous besides the vitrectomy channel was removed. The eyes of the control group underwent conventional cataract phacoemulsification combined with PPV. The follow-up time after surgery was ≥6 months. The rate of success continuous circular capsulorhexis, posterior capsule rupture, and intraocular lens (IOL) implantation in the capsular bag were compared between the two groups. The statistical data were compared with χ2 test. Results:For all eyes in the TA group, after intravitreal injection of TA combined with partial anterior PPV, the white reflection of the fundus can clearly show the anterior and posterior capsule of the lens. Continuous circular capsulorhexis was completed, the posterior capsule was not broken, and the IOL was successfully implanted inside the capsular bag. Among the 30 eyes of the control group, 4 eyes did not complete continuous circular capsulorhexis. Radial tear occurred during capsulorhexis, and capsulorhexis was used to complete capsulorhexis. In 5 eyes with posterior capsule rupture, the posterior capsule occurred in 3 eyes during phacoemulsification, and injecting the lens cortex caused posterior capsule repture in 2 eyes; the IOL was implanted in the ciliary sulcus and the capsular bag in 4 and 1 eyes, respectively. Whether the consecutive capsulorhexis was successful ( χ2=4.286), whether the posterior capsule was ruptured ( χ2=5.455), whether the IOL was implanted in the capsular bag ( χ2=4.286), the differences in the number of eyes between the two groups were statistically significant ( P= 0.038, 0.020, 0.038). At the last follow-up, no special complications occurred. Conclusions:Intravitreal injection of TA combined with partial anterior PPV can improve the visibility of the anterior and posterior lens capsule and lens nucleus during phacoemulsification in patients with cataract and severe vitreous hemorrhage. The surgical success rate is high, the complications are few, and the safety is good.

A derivatization method for the determination of oligosaccharides with high sensitivity by matrix-assisted laser desorption/ionization-time of flight-mass spectrometry(MALDI-TOF-MS) based on a labeling regent 1-(4-Cyanophenyl)-4-piperidinecarbohydrazide(CPH) was proposed. The hydrazones were generated by the reaction of the reducing ends of oligosaccharides and the hydrazide of CPH. The derivatives were directly analyzed by MALDI-TOF-MS. Reaction conditions such as reaction temperature, concentration of acetic acid and excess ratio of CPH regent were optimized. When the oligosaccharides reacted with 100 time excess of CPH at 100 ℃ and in 0.125% acetic acid (V/V), the yield was highest. The results showed the derivatization with CPH increased the sensitivity of MS detection and this method was suitable for the analysis of oligosaccharides′ compositions.

Objective To explore the value of CT spectral imaging in the demonstration of pancreatic ductal adenocarcinoma (PDAC).Methods 113 patients were scanned by CT spectral,and gemstone spectral imaging (GSI) was performed in late arterial phase (AP) and portal venous phase (PP).All diagnosis were pathologically confirmed.The ROIs were placed on the lesion and on the pancreatic parenchyma.The ROI files including the CTmono values and the normalized CTmono values (normalized to pancreatic parenchyma) were saved.The works were performed three times repeatedly.CNR values ranged from 40 keV to 140 keV and the optimal keV in AP and PP were calculated.The differences of CTmono values, normalized CTmono values,and CNR were compared between the optimal keV and 70 keV(equivalent to conventional 120 kVp energy level).Paired t-test and Wilcoxon signed rank test were performed.P<0.05 was considered statistically significant.Results The optimal monochromatic energy of PDAC were 40 keV in both AP and PP.The optimal CNR values(mean±standard) were 2.31±1.02 and 2.38±1.02 in AP and PP,while the corresponding values of 70 keV were 2.08±0.98 and 2.12±0.96.The CNR of 40 keV was higher than that of 70 keV in both AP and PP.The CTmono values of PDAC were (58±13) HU and (71±19) HU at 70 keV and were (111±44) HU and (155±57) HU at 40 keV in AP and PP.The CTmono value in PP was higher than in AP.The median of normalized CTmono values of PDAC at 40 keV were 47.0% and 53.9% in AP and PP, and were lower than those of 70 keV,which were 57.7% and 61.8%.The differences of normalized CTmono values between 40 keV and 70 keV were significant.Conclusion CT spectral imaging manifests that PDAC is hypovascular both in AP and PP and is progressively enhanced form AP to PP.There is maximal conspicuity of tumor in AP, and the optimal monochromatic imaging can improve the conspicuity of PDAC lesion.

Objective To investigate the construction of PICC catheterization nurses in Shandong province. Methods A total of 235 hospitals were investigated from PICC maintenance network in Shandong province with self-designed questionnaire through internet survey. Results 179 hospitals established intravenous (IV) nurse team(76.17%). 86.92%(93/107) of the tertiary hospitals established Ⅳ nurse team, which was higher than 67.19% (86/128) of the secondary hospitals, the difference was statistically significant(χ2=12.50,P<0.01). There were 1335 trained and certificated nurses while 1382 nurses engaging in PICC catheterization, and there were more PICC catheterization nurses in tertiary hospitals than secondary hospitals, the difference was statistically significant(t=7.23,P<0.01). 22.98%(54/235) of the hospitals had more PICC catheterization nurses than trained and certificated nurses, 11.49%(27/235) of the hospitals had more trained and certificated nurses than PICC catheterization nurses. 7.81%(108/1382) of the PICC catheterization nurses worked full-time and 31.91%(441/1382) had a manager position. 51.06% (120/235) of the hospitals had set up clear selection criteria for PICC catheterization nurses, mainly focusing on education background, professional tittle and (or) work experience. Organization in PICC training was diversified, giving priority to nursing association in provinceand nursing association in city. PICC catheterization nurses in only 20.43% (48/235) of the hospitals would accept training annually, 31.49%(74/235) of the hospitals would re-certificate PICC nurses. Conclusion PICC nurse team has been preliminarily established in Shandong province, but nursing staff deployment was unevenness, and primary hospitals should be further reinforced. The position role of PICC nurses should be further clarified. The selection criteria of PICC nurses should be further standardized. And the training space of PICC nurses should be further promoted.

Objective To assess the value of computed tomography (CT) and magnetic resonance imaging (MRI) in the diagnosis of pancreatic neuroendocrine neoplasms (PNEN) and to analyze the factors influencing thepreoperative imaging diagnosis of PNEN.Methods From January 2016 to November 2016, patients with PNEN diagnosed by surgery and biopsy were collected. CT and MRI data of them were analyzed. The CT values or signal intensity of the lesions and the pancreatic parenchyma were measured and the contrast-to-noise ratio (CNR) of the lesion was calculated. Detecting sensitivity and diagnosis accuracy of CT and MRI were compared. Detecting sensitivity of different MRI sequences was also analyzed. Diagnosis accuracy of non-functional PNEN and functional PNEN was compared and analyzed. Lesion CNR was compared between arterial phase and portal venous phase of the contrast enhanced CT. The sensitivity, accuracy and constituent ratio were compared by nonparametric analysis. Independent sample t test and one-way analysis of variancewere performed for the quantitative parameters comparison. Results A total of 54 patients with 56 lesions of PNEN were included for two of whom had two lesions each. CT and MRI were both performed in 44 patients (46 lesions).Detecting sensitivity and diagnosis accuracy of CT were 97.8% (45/46) and87.0% (40/46), respectively. Detecting sensitivity of MRI were 97.8% (45/46) and89.1% (41/46), respectively. There was no significant difference in detecting sensitivity and diagnosis accuracy between CT and MRI (both P>0.05). The CNR of lesion in arterial phase was higher than that of portal venous phase(4.7±3.8 vs 3.4±2.5), and the difference was statistically significant (t=2.949, P<0.05). Detecting rates of T1 weighted imaging with fat suppression (T1WI-FS) image, T2 weighted imaging with fat suppression (T2WI-FS) image, diffusion weighted imagingand dynamic contrast enhanced T1WI-FS image were 90.0% (45/50), 88.0%(44/50), 86.0%(43/50), and 91.7% (44/48), respectively. There was no significant difference in detecting rate among these images sequences (Q=2.526, P=0.510). Tumor diameter in non-functional PNEN was significantly larger than that in functional PNEN ((2.9±1.6) cm vs (1.7±0.7) cm)(t=3.479,P<0.05). The overall diagnosis rate of non-functional PNEN with CT and MRI before operation was 70.8% (17/24), which was significantly lower than that of functional PNEN (100.0%, 31/31) (χ2=10.360，P=0.002).Conclusions CT and MRI are both sensitive in detectingPNEN, and they were two complementary modalities. CT image in arterial phase delineated the lesion better than that in portal venous phase. MRI images with different sequences can becomplementary and there is no significant difference in detecting sensitivity for PNEN among different sequences. CT and MRI play an equal rolein the diagnosis of PNEN before operation. Because of atypical CT and MRI findings, the diagnosis of non-functional PNEN is more difficult thanfunctional PNEN.