Objective To investigate the clinical characteristics of digestive system cancer during pregnancy and its influence on mother and fetus.Methods Clinical data of 12 pregnant women accompanied with digestive system cancer obtained from the follow-up record of cancer patients between July 2007 and January 2016 in Daqiao Community Health Service Center of Yangpu District,Shanghai,were retrospectively analyzed.Results Delayed treatment,missed diagnosis and misdiagnosis were found in ten of the 12 cases.Eleven cases underwent B-type ultrasound as an early imaging screening method.Eleven patients had advanced cancer,but only two of them were eligible for radical surgery.Five patients could be treated with anti-tumor therapy.Eleven of the 12 patients died within two years after diagnosis,and only one survived over five years.Eight of the twelve embryos or fetuses died and four neonates survived.Conclusions Digestive system cancer during pregnancy has an insidious onset,and the rates of missed diagnosis and misdiagnosis are high,with advanced disease stage at diagnosis and poor prognosis.Knowledge of the digestive system cancer during pregnancy and early diagnosis and treatment capacity should be enhanced so as to reduce the damage to both the pregnant woman and fetus.

Objective To discuss influence of early rehabilitation nursing on rehabilitation effect of patients after heart valve replacement.Methods 60 patients with heart valve replacement were divided into the rehabilitation group and the control group with 30 patients in each group.The control group was given normal nursing and self-exercise ad libitum.Based upon the above,the rehabilitation group was given systemic and normative rehabilitation nursing according to programs established for each individual.The incidence of complications,guardianship time and hospitalization time were compared between the two groups.Results The incidence of complications of the patients in the rehabilitation group was much lower than the patients in the control group.And the time of the patients in the rehabilitation group in ICU and hospitalization time was shorter than the patients in the control group.Conclusions Early rehabilitation care can effectively reduce the incidence of complications after cardiac surgery,promote recovery of cardiac function,also can improve the quality of life of patients.

Objective To observe the effect of Aitongping on c-fos gene expression and substance P(SP) content in spinal dorsal horn of rats with formalin-induced pain.Methods Fifty SD rats were randomized into 5 groups: blank control group,model group,tramadol group(0.06g/kg),high-and low-dose Aitongping groups(36 and 18g/kg respectively).Rats model of pain was induced by subcutaneous injection of formalin into the plantar surface of the left hind paw of rats.The fos gene expression and SP content were observed in superficial lamella of spinal dorsal horn of spinal section from the lumbar vertebrae L3 to L5 by immunohistochemical method.Results The number of neurons with fos gene expression positive and the optical density(D value) of reactants with SP expression positive were increased in the model group(P

Objective To study the characteristics of immune function,Epstein-Barr virus(EBV) antibodies and EBV-DNA in children with different clinical types of EBV infection,which provide basis for prevention and treatment of EBV infection.Methods Clinical data of 103 patients suffering from EBV infection were retrospectively analyzed in Xijing Hospital of the Fourth Military Medical University.A total of 103 children were divided into infectious mononualeosis(IM) group(n=68),chronic active Epstein-Barr virus infection(CAEBV) group(n=13) and Epstein-Barr virus-related hemophagocytic lymphohistiocytosis(EBV-HLH) group(n=22).The changes of EBV antibodies,EBV-DNA,immunoglobulin levels,lymphocyte subpopulation and complement series were detected and compared among the three groups.A total of 26 healthy children at the same stage were enrolled as a control group,immunoglobulin levels,lymphocyte subpopulation and complement series were detected in control group,then compared with the rest of the three groups.Results The levels of C3 and C4 in CAEBV group and EBV-HLH group were significantly decreased than those in the control group(P<0.05).The levels of IgA,IgG and IgE in EBV-HLH group,CAEBV group,IM group and control group gradually increased(P<0.05,respectively).The levels of IgA,IgG and IgE in EBV-HLH group and CAEBV group significantly decreased than those in control group(P<0.05,respectively).The levels of IgA,IgG and IgE in IM group decreased than those in control group,while there were no statistically significant differences(P>0.05).CD8+T cells in IM group significantly increased than those in the rest of the three groups(P<0.05,respectively).T cells,CD8+T cells,CD4+ T cells,CD4+/CD8+ ratios,NK cells,B cells of EBV-HLH group significantly decreased than those in the rest of the three groups(P<0.05).The positive rates of EBV antibodies in CAEBV group and IM group were significantly higher than those in EBV-HLH group(P<0.05).EBV-DNA in EBV-HLH group were significantly higher than those of CAEBV group and IM group(P<0.05).Conclusion EBV-DNA levels in the serum are positively correlated with disease types and severity,the pathogenesis of IM,CAEBV and EBV-HLH induced by EBV infection are associated with immune dysfunction.Dynamic monitoring of EBV load and cell immune function can reflect disease status and progress risk.

Objective To evaluate the techniques and efficacy of artery embolization in the treatment of benign prostatic hyperplasia(BHP).Methods This study included 12 patients(age range,61-82 years) who were diagnosed to have BHP by clinical manifestations,CT and B-ultrasound,with the disease course of 2-16 years.The relevant parameters were as follows:mean residual urine(RU) of 138 ml,Qmax of 9.6 ml/s,mean IPSS of 24.2 and QOL of 4.8.In these patients,the prostate blood-supply arteries were confirmed by super-selective arteriography,and were embolized by injection of PVA and Gelfoam via artery catheters.The pre-and post-operative IPSS,QOL,Qmax and RU were compared.Meanwhile the changes of prostate volume and blood supply were evaluated by CT and B-ultrasound.In addition,the change of urethral diameter was evaluated by urethrography.Results In the 12 patients,21 prostate blood-supply arteries were embolized,including 5 branches of internal iliac artery,9 branches of inferior vesical artery,5 branches of internal pudendal artery,2 branches of obturator artery.The arteries were embolized bilaterally in 9 patients and embolized unilaterally in 3 patients.Postoperatively,the mean IPSS was 4.8;QOL,1.3;Qmax,18.9 ml/s;RU,0-3 ml,which indicated that the urethral obstruction was obviously improved after operation.CT and B-ultrasound showed that the prostate volume was obviously decreased from 127 ml to 90 ml on average with a reduction rate of 71%,and the urethral stricture disappeared on X-ray examination.Color Doppler imaging showed that the blood supply inside the prostate was reduced.Conclusions The artery embolization for the treatment of BHP is a new method with several virtues of less trauma, marked effect,better safety and fewer complications.

PurposeAdult intussusception is rare, and clinical symptoms are atypical and tend to be misdiagnosed. This study aims to explore the imaging features of intussusception on multi-slice CT (MSCT) and to improve the diagnosis of this disease. Materials and Methods Sixty cases with intussusception conifrmed by pathology were recruited and imaging ifndings including sleeve head lesions, set sheath canal, exhumation of intestine, involved mesenteric fat, and blood vessels were retrospectively analyzed. Results The direct sings included 60 cases with target signs, 44 of them with single target signs and 16 of them with double target signs; the shape was kidney like in 39 cases and irregular in 21 cases; 22 cases showed double intestinal signs, 15 cases showed comet tail signs, and 25 cases showed mountain like with different direction. The indirect signs included 60 cases with thickened intestinal wall and 45 cases with mesenterium fat and vessel in enteric cavity, 12 cases with adjacent mesenteric mass and enlarged retroperitoneal lymph nodes, 15 cases with ascites, 7 cases with metastatic tumors, including 4 cases of liver metastasis, 2 of pelvic ossiifcation metastasis, and 1 of multiple organ metastasis, 1 case combined with renal calculus and 3 case with ureteral caluli. Conclusion There are some special CT manifestations of adult intussusception. Mountain like sign with different direction at the tail is one of the characteristics. CT plays an important role in clinical procedure.

This study was to evaluate the effect of individualized health education on blood glucose control in type 2 diabetic(T2D)Patients.Two hundred and thirty-eight T2D patients were randomly received individualized diabetes education(intervention group)or general education(control group).At 48 week,change of blood glucose control from baseline was observed.The blood glucose level and HbA1c in the intervention group were lower than those in the control group[(7.1±0.8)vs (9.3±6.5)mmol/L,(7.0 ±1.3)%vs(8.0%±1.0)%;P＜0.05].Thus,individualized diabetes education might be helpful for blood glucose control in T2D patients.

Objective To study the clinical characteristics of chronic active Epstein-Barr virus (EBV) infection (CAEBV) in children and to provide a basis for the diagnosis and treatment of CAEBV.Methods Clinical data,laboratory serology,pathological examination,treatment and follow-up results of 10 cases with CAEBV infection who were treated in Xijing Hospital of the Fourth Military Medical University from January 2008 to January 2016 were analyzed retrospectively.Results CAEBV major manifestations were continuous or intermittent fever,hepatomegaly,splenomegaly and lymphadenopathy,and others,including general fatigue,cough,hematemesis,diarrhea,skin rash,jaundice,sore throat,muscle joint pain,and so on.And with liver dysfunction,hematologic abnormality,and so on.All patients in anti-EB virus capsid antigen IgG (EBVCA-IgG)antibodies and EBEA-IgG antibodies had positive,while all patients in EBVCA-IgM antibodies had negative.The median load of EBV-DNA detected by real-time polymerase chain reaction(PCR) in the peripheral blood was 7.15× 105 copies/ml.Six of 10 cases CAEBV patients presented a poor clinical course,1 case died from intracranial hemorrhage,2 cases from respiratory failure,1 case from gastrointestinal bleeding,1 case from liver failure,1 case from severe multiple pathogens infection,rest 3 cases showed an improvement and 1 cases had a recurrence.Conclusion CAEBV infection has varieties of clinical features,with poor prognosis and high mortality.If the patients had unexplained fever,hepatomegaly,splenomegaly and lymphadenectasis,we should be timely detect virology and histopathological to diagnosis as early as possible.

Potassium metabolism in young adult men exercising in the heat for six consecutive days and the effect of potassium deficiency in mice and rats induced by low potassium diet during heat exposure were observed. Increased potassium loss in sweat and lower potassium intake resulted in negative potassium balance. Individuals with a negative potassium balance had lower se- rum potassium levels and higher body temperature after exercise. Potassium deficient mice accomplished less work done (2.372 vs 4.253 Kg.M) but exih-ibited a markedly greater rate of heat gain (1.36 vs 0.87℃/Kg.M) as compared to the controls. The survival rate and cellular energy metabolism also decreasedThese observations suggest that prevention from potassium deficiency must be emphasized during prolonged physical activity under hot environments. According to the linear regression equations between potassium intake and balance, it is proposed that the potassium requirements in mild and medium physical activity in the heat are 40 and 60 mEq/day respectively, and the allowance of potassium in the latter may be 70-80 mEq/day.

Objective:To develop and evaluate the improved Chinese hearing questionnaire for school children(CHQS)for mass epidemiology study on hearing impairment in China.Method:Using the probability proportion to size(PPS) method, 8 412 residents were investigated in 40 clusters in Jiangsu province with the WHO ear diseases and hearing disorders survey protocol.87.9% of the residents aged 7 years and over answered the questionnaire and accepted the pure tone audiometry.Result:The prevalence of hearing impairment was 12.9% by the questionnaire. Compared with golden standard(pure tone audiometry), Sen=58.5%, Spe=96.7%, PV+=78.9%, PV-=91.7%, overall accuracy=90.0% . The sensitivity for women was higher than men.Conclusion:The questionnaire produced high efficiency and specificity values.It could be used in mass hearing screening, particularly in remote and rural area, although the sensitivity was as low as most questionnaires.