Objective To investigate the incidence of anxiety and depression in hospitalized patients with chronic obstructive pulmonary disease( COPD) ,and to analyze the related factors that affect the occurrence of anxiety and depression in patients with chronic obstructive pulmonary disease.Methods In the observation group and control group,the anxiety and depression were assessed,and the influencing factors of the patients with depression were ana-lyzed.Results In the observation group,the patients with anxiety and depression (38.03%) were significantly more than the control group (23.08%),and the difference was statistically significant (χ2 =4.28,P<0.05).The multi-variate logistic regression analysis showed that sex,course of disease,degree of culture,social support and self rated health status of five variables on COPD depression effects were statistically significant ( OR=0.413,1.534,2.651, 1.673,2.442,all P <0.05).Conclusion There is higher incidence of anxiety and depression in patients with COPD.Gender,COPD duration,education,social support and self rated health status are the important factors influen-cing the anxiety and depression of the patients.

Objective To probe into the remodeling and maturity process along with extension of time in anterior cruciate ligament (ACL) reconstruction with hamstring autograft in order to confirm the date of maturity postoperatively. Methods Thirty-three patients after arthroscopic ACL reconstruction with hamstring autograft, were undergone second-look arthroscopical surgery. Meantime, biopsy specimens were obtained from the mid-zone of the hamstring graft. As a control group, specimens of normal ACL were obtained from total knee replacement of four cases, and specimens of semitendinous tendons obtained from ACL reconstruction of the four cases. The interval from initial reconstruction to second-look arthroscopy ranged from 2 to 36 months(mean 11.9 months). Patients were divided into different groups by postoperative time such as 1-, 4-, 7-, 10-, 13-, 18- and 25- month group. Thirty-three specimens were ordinarily sliced up into longitudinal sections. The sections were stained with hematoxylin and eosin so that cell and collagen fibrils were observed under light microscope, then compared the results with those of control group. Results Under microscopical observation, it was showed that tissue of hamstring graft was remodeled from more blood vessels and cellular amount to normal one, and from an irregular orientated crimp pattern of collagen to regular orientated crimp pattern of collagen in a time-dependent manner. Decreasing cellular amount, changing cell type, and a regular orientated crimp pattern of collagen of the hamstring graft were observed in 7- month group primarily, comparing with the original ACL. However, there existed a slower process in the other groups that are older than that of 7- month. Conclusion There are well histological features in the process of remodeling and maturation of the hamstring autograft after operation following extension of time, such as better survival of early period, and remodel of vessels and collagen. The process of remodeling and maturation in the hamstring autograft is similar to BPB autograft. The maturation period of the hamstring autograft after ACL reconstruction in human patients appears between 7 month and 9 month postoperatively.

Objective:This study aims to investigate the effect of addition and subtraction treatment to Renshen Maidongsan on metabolism of glucose， lipid and pregnancy outcome when used to gestational diabetes mellitus （GDM） with deficiency of both Qi and Yin. Method:In this study， 108 patients with GDM were randomly divided into observation group with 54 cases and control group with 54 cases. Patients in control group took Yuquan wan orally， 6 g/time， 4 times/day ， and patients in observation group were prescribed addition and subtraction treatment to Renshen Maidongsan， 1 dose/day. The course of treatment for both groups was 4 weeks. Oral glucose tolerance test （OGTT） was performed before and after treatment. Fasting blood glucose （FBG） ， 1 h our plasma glucose （1 h PG）， 2 h our plasma glucose （2 h PG）， glycosylated hemoglobin （HbA1c） and other indicators were detected to record the pregnancy outcome. Also， the levels of total cholesterol （TC）， triglyceride （TG）， high density lipoprotein cholesterol （HDL-C）， low density lipoprotein cholesterol （LDL-C）， adiponectin， serum amyloid A （SAA）， tumor necrosis factor-α （TNF-α）， resistin， interleukin-1β （IL-1β） and interleukin-6 （IL-6） were detected before and after treatment. Then the safety evalution was carried out. Result:The levels of insulin resistance index （HOMA-IR）， FBG， 1 h PG， 2 h PG， HbA1c， TC， LDL-C， TG， IL-6， IL-1β， TNF-α， SAA， leptin and resistin in observation group were lower than the data checked in control group （P<0.01）， and the levels of HOMA-β， insulin sensitivity index （InISI） and adiponectin were higher than the standards of from control group （P<0.01）. Then the incidence of medical cesarean section， pregnancy induced hypertension， polyhydramnios， premature rupture of membranes， premature delivery and adverse pregnancy outcomes were lower than those in control group （P<0.01）. Conclusion:Addition and subtraction treatment to Renshen Maidongsan can improve insulin sensitivity and islet β-cell function， regulate inflammatory factors and adipokines， improve insulin resistance （IR）， effectively regulate glucose and lipid metabolism， improve maternal and infant adverse pregnancy outcomes when used on patients with GDM and deficiency of Qi and Yin， and it was safe to use in clinic.

Objective To investigate the level of uncertainty of illness and social support state in patients with prediabetes,and to discuss the correlation between the two.Methods 243 cases with prediabetes were analyzed by Uncertainty in Illness Scale and Social Support Rating Scale.Results There was a middle uncertainty in the elderly patients with prediabetes.The objective support,sabjective support,social support utilization degree and social support score were negatively related to the complexity of uncertainty(r--0.419,-0.433,-0.390 and-0.421,respectively,all P＜ 0.05).Conclusions Medical staff should evaluate the uncertainty in illness in elderly patients with prediabetes and conduct nursing intervention accordingly,in order to reduce the uncertainty,increase social support,and ultimately improve the quality of life.

Objective To explore the clinical manifestation,imaging features,histopathological classifications and treatment of primary orbital tumors.Methods Twenty-six cases with primary orbital tumors were retrospectively studied.Results All of 26 primary orbital tumor cases received surgical treatment.Sixteen primary orbital tumors cases were male and 10 cases were female.The mean age was 46 years (ranged from 15 to 72).The mean hospital stay was 13 d (ranged from 9 to 21).Among 26 primary orbital tumors cases,21 cases were benign tumors which included 11 cases of cavernous hemangioma,5 cases of inflammatory pseudotumor,3 cases of dermoid cyst,2 cases of venous angioma.Five cases were malignant tumors which included 4 cases of adenoid cystic carcinoma and 1 case of rhabdomyosarcoma.After operation,visual acuity improved in 9 cases,unchanged in 11 cases,decreased in 6 cases.The patients were followed up for 18-48 months (mean,25 months).There were 4 cases of malignant tumors recurrence after operation and received radical operation.While 2 patients were lost,the other 24 patients survived with tumor-free.Conclusions Surgical excision is the main and effective treatment for primary orbital tumors.To be very familiar with the imaging characteristics and local anatomy is the key for operation.Individualized treatment plan should be chosen based on clinical manifestation,imaging features and histopathological classifications.

OBJECTIVE To monitor hospital infection continuously in five years in order to learn the rule of dynamic movements and its characters.METHODS To analyze the documents by prospective monitoring and retrospective(investigation).RESULTS The number of discharged inpatients increased year by year while the infection rate(developed) smoothly.Its average rate was 6.88%.CONCLUSIONS The aim to take hospital infection under control has(accomplished).

It is known that extracorporeal shock wave (SW) may promote healing of fracture. A previous study reported that SW promoted human bone marrow stromal cells (hMSCs) towards osteoblasts in vitro. To study the osteogenesis ability of hMSCs treated by shock wave in porous hydroxyapatite (HA) in vivo, primary hMSCs of SW group and control group were cultured in the porous HA for 2 weeks and then implanted into subcutaneous sites of nude mouse. These implants were harvested and prepared for the biochemical analysis of alkaline phosphatase activity by AKP kit, histological analysis of decalcified and undecalcified sections and morphology by scan electric microscope (SEM), as well as osteocalcin mRNA expression by RT- PCR 4 weeks and 8 weeks after implantation. It showed that cells of SW and control group almost covered the rough surface of HA before implantation and the extracelluar matrix of SW group was abundant by SEM photomicrograph . The histological analysis and SEM photomicrograph showed active bone formation 4 weeks and 8 weeks after implantation, as well as tetracycline labeling under fluoroscopy analysis in SW group. Alkaline phosphatase in supernatants of the implants detected 4 weeks and 8 weeks after implantation in SW group was higher than in control group (P

Objective To study the clinical characteristics,pathological type,diagnosis,treatment and follow-up result of the primary tumors of the sacrum.Methods The cases of 18 patients with primary tumors of the sacrum were treated by operation(12 cases with chordoma,1 case with osteosarcoma,5 cases with giant cell tumor of bone),patients with chordoma performed by radiotherapy after operation,and all patients had been followed up for 4～8 years.Results 15 patients were cured and 3 patients were recurred after operation.Conclusions Chordoma is the most frequent tumor in primary sacrum tumor.This kind of tumor should be treated by surgical and other assist methods.

BACKGROUND: At present, titanium and its alloy materials are mostly used in prosthesis and bone implants. These materials have superior mechanical properties and excellent corrosion resistance, but their bioactivity is insufficient, so it is difficult to form a good chemical bond with bone tissue. OBJECTIVE: To prepare titanium dioxide nanotube coating containing silicon on the surface of pure titanium screw and observe its osteogenic properties in vivo. METHODS: Titanium dioxide nanotube layers were prepared on the surface of pure titanium screws by anodic oxidation method (positive control group). Silicon ions were deposited on the surface of titanium nanotube layers by plasma immersion ion implantation and deposition (experimental group). Pure titanium screws were used as negative control group. The morphology of each group was observed by scanning electron microscope. The three kinds of screws were implanted into the femur of SD rats. The femoral specimens were taken out at 2, 4 and 6 weeks after implantation for biomechanical test, and immunofluorescence analysis was performed at 6 weeks after implantation. The animal experiment was approved by the Ethics Committee of Experimental Animal Management and Animal Welfare of Jiangnan University. RESULTS AND CONCLUSION: (1) Scanning electron microscopy showed that uniform double-layer nanotube arrays were observed in the experimental group and the positive control group, and there was no significant difference between the two groups. (2) At 2 and 4 weeks after screw implantation, the average peak pullout force of the experimental group was significantly higher than that of the positive control group and the negative control group (P < 0.05), and the positive control group was significantly higher than the negative control group (P < 0.05). At the sixth week, there was no significant difference in pullout force among the three groups (P > 0.05). (3) Immunofluorescence showed that at 6 weeks after implantation, there was almost no new bone attachment around the screw in the negative control group, and extensive new bone attachment was observed around the screw thread in the experimental group and the positive control group, among which the new bone formation was the most in the experimental group. (4) The results showed that the silicon dioxide titanium nanotube layer could significantly promote the formation of new bone around the pure titanium screw and increase the pullout force of screws.

Objective To evaluate the promotional effectiveness of different TCM appropriate technology packages; To provide a scientific basis for improving the technology package. Methods 8 assessment indexes, including input costs, the number of experts, the number of people with senior professional post, the number of grassroots people under the guidance of experts, the number of training hours, the number of people receiving training, evaluating rate and the number of users were selected. TOPSIS method was used to evaluate the promotional effectiveness of five kinds of TCM packages in grassroots. Results The Ci values for appropriate technology packages were 0.76 for pains in neck, shoulder, waist and lower extremities, 0.49 for gynecological diseases, 0.44 for infantile diarrhea, 0.66 for chronic gastropathy, and 0.00 for tumors. Conclusion The effectiveness of promotion of TCM appropriate technology packages from high to low is pains in neck, shoulder, waist and lower extremities package, chronic gastropathy package, gynecological diseases package, infantile diarrhea package, tumors package.