Objective To investigate the significance of clinical nursing pathway in perioperative period of children with hypospadia.Methods 63 cases of hypospadia children patients were randomly divided into the control group (30 cases)and the experimental group (33 cases).The traditional nursing method was used in the control group,while the clinical nursing pathway was used in the experimental group.Results The hospital stay,hospital charges and complications of the experimental group were less than the control group.The satisfaction degree of the experimental group was higher than the control group.There was significant difference.Conclusions Clinical nursing pathway is a safe and effective nursing model.It can shorten hospital stay,reduce hospital charges,decrease complications,and improve patients' satisfaction degree.

More studies have shown that dietary calcium intake can decrease the incidence of metabolic syndrome. Milk consumption in childhood and the habit of milk drinking are positively correlated with bone mineral density in adult-hood. This article summarizes the relationship between dietary calcium and bone mineral density and obesity-related metabolic disorder in children.

OBJECTIVE:To explore the role of clinical evidence-based pharmacy in anticoagulant treatment strategies during continuous renal replacement therapy (CRRT). METHODS:Taking a thrombocytopenia patient of anticoagulant treatment during CRRT for instance,clinical pharmacists analyzed the evidence of taken argatroban anticoagulant therapy during CRRT for high risk blooding and thrombocytopenia patients based on evidence-based pharmacy combined with clinical data,monitored the efficacy and safety and evaluated the treatment process. RESULTS:Totally five literature about anticoagulant treatment strategies during CRRT for high risk blooding and thrombocytopenia patients were obtained,including one systematic review,one RCT and three cohort studies. Based on the above evidences,good results were achieved in the clinical practice of this patient,no thrombotic or hemor-rhagic complications occurred in this patient,platelet count and coagulation indicators of patients also improved. CONCLUSIONS:Evidence-based pharmacy plays an important role in anticoagulant treatment strategies during CRRT.

Objective To investigate clinical effects differences of ropivacaine combined with two doses of sufentanil on labor analgesia.Methods300 lying-in women with painless childbirth in the period from January 2016 to December 2016 in department of obstetrics in Deqing hospital of traditional Chinese medicine were chosen and randomly divided into two groups including A group (150 cases) with ropivacaine combined with conventional doses of sufentanil for 7.5μg and B group (150 cases) with ropivacaine combined with low doses of sufentanil for 2.5μg;the block onset time of sensory and motor, arrival time at the maximum block level, modified Bromage score, Apgar score, VAS score at different time points and adverse reaction rate of both groups were compared.ResultsTwo groups of maternal sensory and motor block work time and reach the highest block plane comparative differences had no statistical significance.The modified Bromage score of B group were significant better than A group(P<0.05).The adverse reaction rate of B group were significant lower than A group(P<0.05).ConclusionCompared with conventional dosage sufentanil, luo pp paid in combination with low dose used in epidural sufentanil analgesia can obviously reduce the working time, improve the quality of anesthesia and reduce the incidence of adverse reactions, is suitable for clinicians to choose application.

Objective To study the relationship between Xsp Ⅰ restriction fregment length polymorphism (RFLP) in exon 4 of low-density lipoprotein receptor (LDLR) gene and hypercholesterolemia. Methods PCR-RFLP method was applied to determine the polymorphism of LDLR gene in 446 cases of hypercholesterolemia, 284 of borderline hypercholesterolemia and 187 normal control subjects. Results Three genotypes, X+X+, X+X- and X-X-, were found in the population. (1) The frequencies of the X+X+ genotype and X+ allele in the group with hypercholesterolemia were higher than those of the other 2 groups (P<0.05). (2) From X-X- to X+X+ genotype, cholesterol and low-density lipoprotein-cholesterol increased gradually, while high-density lipoprotein-cholesterol decreased (all P < 0.05). (3) With logistic regression analysis, LDLR genotype was associated with hypercholesterolemia. Conclusion Polymorphism in Xsp I restriction site at the exon 4 of LDLR (X+ X+ genotype and X+ allele) may be a risk factor of hypercholesterolemia in Chinese population.

Objective To compare and analyse four references for assessment of obesity in Chinese children. Methods The height and weight of 2347 children(1175 boys and 1172 girls) aged 7 to 8 years in Shanghai were measured,and their body mass indexes (BMI) were calculated.The prevalences of overweight and obesity were evaluated and compared among reference of Weight for Height 1985(WFH 1985 reference),BMI reference of Working Group on Obesity in China (WGOC reference),BMI reference of Europe International Obesity Task Force(IOTF reference) and BMI reference of Centers for Disease Control and Prevention of American 2000 (CDC reference). Results The prevalence of overweiight in boys evaluated by IOTF reference was significantly higher than those by the other three references(P<0.05),and the prevalence of overweight in girls evaluated by IOTF reference was significantly higher than those by WGOC and CDC references (P<0.05).The prevalence of obesity in boys evaluated by IOTF reference was significantly lower than those by the other three references (P<0.01),and the prevalence of obesity in girls evaluated by IOTF reference was significantly lower than those by WGOC and WFH 1985 references(P<0.01).There was no significant difference in the evaluation findings of obesity and overweight between WFH 1985 and WGOC references(P>0.05). Conclusion WFH 1985 and WGOC references are more suitable than IOTF and CDC references for assessment of overweight and obesity in Chinese children.

With more and more non-affiliated hospitals of universities joining the clinical teaching of infectious diseases,there have been some dilemmas on clinical teaching,such as the shortage of staff,teaching experience,poor lecture art and teaching enthusiasm,textbook lag,the shortage of case teaching abd students'fear of infectious disease etc. Countermeasures such as perfecting the organizational structure,formulating preferential policy,clearing historical mission,increasing students' interest in learning,adding new academic progress,enriching teaching methods,setting up experts'supervision will ensure the effective teaching quality.

The significance for specialized hospital's resident physicians participating in the standardized clinical resident training in general hospital is expounded and its existing prob-lems are pointed out.It is suggested that the administration division should give full play to subjective initiative,coordinate problem solving and improve training quality,and meanwhile speciality hospitals should make an active effort in the application for national subspeciality physician training base.

Objective To survey the nutritional status and nutritional knowledge,attitude and practice (KAP) of primary and middle school teachers in Shanghai,and to study the possible correlation of nutritional KAP with overweight/obesity and obesity-related complications.Method Using stratified cluster random sampling,a questionnaire survey was conducted among 544 hygiene teachers and 150 non-hygiene teachers selected from all primary and middle schools in all districts in Shanghai,investigating the nutritional status and nutritional KAP in this population.Results The prevalence of overweight/obesity and obesity-related complications were significantly lower in hygiene teachers than in non-hygiene teachers (19.81％ vs.38.15％,t =22.303,P=0.000; 18.6％ vs.26.39％,t =4.156,P=0.047).The attitude score was the highest among the 3 surveyed parts,significantly higher than the lowest,which was practice score (hygiece teachers:91.76 ±13.66 vs.74.42±11.61,t=14.595,P=0.000; non-hygiene teachers:85.67 ±18.77 vs.69.88 ±13.30,t =25.400,P =0.000).Hygiene teachers scored significantly higher than non-hygiene teachers in all the 3 parts of KAP (knowledge:84.43 ± 11.98 vs.75.73 ± 16.82,t =5.822,P =0.000; attitude:91.76 ± 13.66 vs.85.67±18.77,t =3.640,P=0.000; practice:74.42 ±11.61 vs.69.88 ±13.30,t =4.030,P=0.000).There was no correlation between the teachers' body mass index and KAP scores,nor between obesityrelated complications and knowledge or attitude scores,while obesity-related complications was found correlated with practice score and KAP score (t =-0.146,P =0.005 ; t =-0.105,P =0.043).Conclusions The nutritional status of teachers in Shanghai primary and middle schools is associated with their nutritional KAP.There is a correlation between obesity-related complications and practice score.Hygiene teachers have better nutritional KAP compared with non-hygiene teachers.

Objective To investigate the association between activity energy expenditure ( AEE ) and body composition in school-age children.Methods A total of 62 students ( Grades 3 and 4, aged 8 -10 years) from a primary school in Shanghai were enrolled in this study .AEE was estimated with a metabolic cart (energy metabolism determination system ).Body composition (body mass, body mass index, fat percentage, fat mass, fat-free mass, fat mass index, fat-free mass index, obesity degree) was evaluated by bioelectrical im-pedance analysis .The above indicators were compared between obese and non-obese students .Results There were no statistically significant differences in exercise time , total AEE and relative AEE between obese and non-obese boys [ (9.70 ±1.91) min vs.(10.00 ±1.97) min, t=0.336, P=0.739; (198.74 ±53.33) kJ vs.(171.54 ±41.75) kJ, t =-1.422, P =0.165; (0.46 ±0.09) kJ/(min· kg) vs.(0.51 ± 0.04) kJ/(min· kg), t=2.043, P=0.051], while obese boys had higher absolute AEE than non-obese boys [(20.06 ±3.14) kJ/min vs.(16.93 ±1.85) kJ/min, t=-2.910, P=0.007].Obese girls had shor-ter exercise time and lower relative AEE than non-obese girls [ (7.35 ±3.05) min vs.(9.98 ±1.82) min, t=2.509, P=0.027;(0.41 ±0.09) kJ/(min· kg) vs.(0.51 ±0.07) kJ/(min· kg), t=3.244, P=0.003 ] , whereas there were no statistically significant differences in total AEE and absolute AEE between obese and non-obese girls [ (129.29 ±71.13) kJ vs.(161.50 ±35.38) kJ, t =1.351, P =0.203; (16.82 ± 3.26) kJ/min vs.(16.17 ±2.00) kJ/min, t=-0.676, P=0.504].After controlling for age and gender, absolute AEE was significantly positively correlated with body mass index ( P=0.015 ) , obesity degree ( P=0.010), fat mass (P=0.047), fat-free mass (P=0.010), and fat-free mass index (P=0.003) in boys, but not in girls.Relative AEE was significantly negatively correlated with body mass index ( boys: P =0.000, girls: P=0.000), obesity degree (boys: P=0.002, girls: P=0.000), fat percentage (boys:P=0.000, girls:P=0.001), fat mass (boys:P=0.000, girls:P=0.000), fat-free mass (boys: P=0.002 , girls: P=0.022 ) , and fat mass index ( boys: P=0.000 , girls: P =0.000 ) in both boys and girls.Conclusions In obese children, AEE is correlated with body composition, with relative AEE reducing as obesity degree increasing.There may be complex relationships among body size , body composition, and energy metabolism in children.