Objective To observe and explore the risk factors of nonalcoholic fatty liver diseas(NAFLD) complicated with hypertension in the enterprise retirees .Methods A total of 209 NAFLD patients diagnosed by ultrasound combined with questionnaire were collected in the enterprise retirees,and they were divided into the NAFLD with hypertension group(100 cases)and NAFLD without hypertension group (109 cases)after combined with physical examination results and past medical history.The relevant data of the two groups were retrospectively analyzed,and the risk factors of NAFLD complicated with hypertension disease were analyzed.Results The levels of age(t =1.69,P <0.05),body mass index(BMI)(t =0.36,P <0.05),waist circumference(t =0.64,P <0.05), total cholesterol(TC)(t =2.31,P <0.05),total bilirubin(TBS)(t =6.83,P <0.05),serum creatinine(Scr)(t =2. 20,P <0.05)in NAFLD complicated with hypertension group were higher than those in NAFLD group,and the differ-ences were statistically significant(P <0.01 or P <0.05).The logistic regression analysis showed that TC(OR =4.2)was the independent influencing factor of NAFLD with hypertension.Conclusion NAFLD is closely associated with hypertension,NAFLD can be incorporated into chronic disease management system with high blood pressure in order to improve the value of the disease in the elderly,and it is conducive to the further study of NAFLD and the management of other chronic disease.

Objective To investigate the application of B -Learning mode in the teaching of department of burns surgery.Methods 234 students were divided into two parts by digital table method randomly.The experimental group was applied by the means of B -learning mode,while the control group was taught by the traditional way.And the results were evaluated.Results The basic theory scores(75.39 ±12.04)points in the students of experimental group were higher than those of the control group(68.27 ±12.38)points.The practice scores(76.42 ±11.89)points in the students of experimental group were higher than those of the control group(65.36 ±12.05)points.Students'professional knowledge scores(79.92 ±12.85)points in the experimental group were higher than those of the control group(71.56 ±13.01)points.Both percentage and score were higher in the experimental group than in the control group in comprehensive ability.Conclusion Blending learning gives students a potential time,environment and recourse to learn.By integrating learning ability and nursing skills improved,B -learning mode plays an important role in improving the quality of burn department internship.

To evaluate the application of intracavitary three-dimensional ultrasonography in the diagnosis of polycystic ovary syndrome ( PCOS). The three-dimensional volumes of ovary were measured by intracavitary ultrasonography in 40 PCOS patients and 40 normal controls. The diagnostic value of parameters derived from three-dimensional ultrasonography was evaluated by using the receiver operating characteristic (ROC) curve. The ovarian volume, stromal volume, and the stromal/total volume ratio in PCOS group were significantly higher than those in control group (both P ＜ 0. 05 ) ; the area under ROC curve ( AUC ) of them were 0. 876, 0. 926, 0. 886 respectively. Among these parameters, stromal volume had the highest diagnostic value for PCOS, the cut-off value of which was 7.52 cm3 with a sensitivity of 88% and a specificity of 90%. Volume parameters of ovary measured by intracavitary three-dimensional ultrasonography can offer quantitative information for the diagnosis of PCOS.

Background Mooren 's ulcer is an immune-related corneal inflammatory disease,and its pathogenesis remains below understood.Previous studies showed that the imbalance of T helper cell type 1 (Th1) and Th2 cell play important roles in the development of some autoimmune diseases.Thereby the influence of Th1/Th2 cells on the pathogenesis of Mooren's ulcer is being concerned.Objective This study was to investigate the change of Th1 and Th2 subsets in periphery blood of patients with active Mooren's ulcer.Methods Eleven consecutive patients with active Mooren's ulcer and 8 age-and gener-matched healthy controls were included in Zhongshan Ophthalmic Center,Sun Yat-sen University from January 2012 to July 2013 under the approval of Ethic Committee of this hospital and informed consent of each subject.The peripheral blood samples of all the subjects were obtained separately and periphery blood mononuclear cells (PBMCs)were isolated.The percentages of Th1 and Th2 in the PBMCs were assayed by flow cytometer.The relative expressions of T-bet mRNA,GATA-3 mRNA and signal transducer and activator of transcription 5 (Stat5) mRNA in the PBMCs were examined and compared by real-time fluorescence quantitative PCR (RT-qPCR) Results The percentage of Th1 cells in CD4+ T cells and Th1/Th2 value was 0.21％ (0.11％,0.31％) and 8.01 (4.49,12.01) respectively in the Mooren's ulcer group,which were significantly lower than 0.35％ (0.22％,0.71％)and 23.90 (22.49,33.49)in the normal control group,respectively (Z =-2.01,P =0.04 ; Z =-3.06,P =0.00).However,no significant difference was found in the percentage of Th2 between the two groups (Z=-1.98,P＞0.05).The relative expressions of T-bet mRNA and GATA-3 mRNA in PBMCs were significantly lower in the Mooren's ulcer group than those in the normal control group (Z =-3.47,-3.06,both at P=0.00) ;While the relative expression of Stat5 mRNA in PBMCs was insignificant changed between the two groups (Z =-1.05,P =0.33).Conclusions Th1 and Th2 cells are unbalanced in the active Mooren's ulcer patients.In addition,the down-expression of relevant transcription factors in peripheral blood also is seen in these patients.It is inferred that Th1 and Th2 cells may participate in the progress of Mooren's ulcer.

Objective To explore the value of strain rate and dobutamine stress echocardiography(DSE) in the diagnosis of coronary heart disease. Methods High-dose DSE was performed in 18 patients with coronary heart disease and 10 healthy persons, proved by selected coronary angiography. Ten patients had single coronary lesion, and the other 8 patients had more. By strain rate technology, systolic peak strain rate(SR_ SYS ) was measured in 12 segments of healthy persons and ischemic segments of patients. Results SR_ SYS of healthy subjects enhanced by the increasement of dose of DSE. In patients with single coronary lesion, SR_ SYS enhanced on the first states of baseline, 10 and 20 ?g?kg -1 ?min -1 ,while SR_ SYS changed non-significantly on 30 ?g?kg -1 ?min -1 , and began to decrease on 40 ?g?kg -1 ?min -1 . However in patients with more than one coronary lesions, SR_ SYS of 10 ?g?kg -1 ?min -1 became larger than that of baseline, while SR_ SYS didn't increase any longer on 20 ?g?kg -1 ?min -1 , and fell significantly on 40 ?g?kg -1 ?min -1 . Conclusions Combining stain rate and DSE to quantify local myocardial motion is valuable to offer many important clinic messages, and improves the diagnosis of coronary heart disease.

Objective To know the epidemiological characteristics of hand-foot-mouth disease in Yangpu District and provide evidence for specific strategies and measures of hand-foot-mouth disease activity prevention and control. Methods Descriptive analysis of the data from hand-foot-mouth disease epidemic situation in Yangpu District from 2005 to 2008 was made. Results 1 348 cases were reported in the whole Yangpu District from 2005 to 2008, and no severe cases, no death. The average morbidity in Yangpu District was 27.48/100 000. The male to female ratio was 1.46∶1. The infection occurred to infants aged from 1 year to 5 years (85.39%). The incidence of the native population children aged 2 to 3 exceeded 10/100 000. The season peak appeared from May to July (70.18%), and outbreaks used to occur at nurseries and kindergartens. The typical clinical presentations mainly included fever and rash. The rash mainly occurred to hands, feet, mouth, buttocks and so on. Conclusions Incidence varied significantly between different sexes, seasons and ages. It can cause large-scale epidemic in a short period of time, the epidemic was very difficult to control, but the leaders attach importance to take the early warning and monitoring, accuratey deal with emergencies, health education promotion and training of comprehensive measures, the epidemic can be effectively controlled.

Objective To evaluate the value of three-dimensional power Doppler imaging(3D-PDI) in the discrimination between benign and malignant endometrium in women with postmenopausal bleeding. Methods Eighty-four women with post menopausal bleeding who examined by 3D-PDI were enrolled. All patients scheduled for pathological examination were divided into benign group (30 cases with endometrial polyps and 34 cases with hyperplasia) and malignant group (20 cases with endometrial carcinoma). Endometrial volume, vascularity index ( VI) , flow index ( FI) and vascularity flow index ( VFI) were measured. The diagnostic value of parameters derived from 3D-PDI was evaluated by using the receiver operating characteristic ( ROC) curve. Results Differences of these parameters (VI, FI and VFI) were considered statistically significant between two groups, the parameters of endometrial volume had no significant differences between two groups; the area under ROC curve(AUC) of the meaningful data were 0.976,0.888 and 0.894 respectively. Among these parameters, VI had the highest diagnostic value for discriminating between benign and malignant endometrium, the cut-off value of which was 2. 97 with a sensitivity of 95% and a specificity of 86%. Conclusions 3D-PDI is a good diagnostic tools in the discriminations between benign and malignant endometrium in women with postmenopausal bleeding.

Acute lung injury/acute respiratory distress syndrome (ALI/ARDS) is a respiratory disorder with high morbidity and mortality caused by various causes. Exosomes can mediate cell communication through paracrine pathways, transfer proteins, lipids, nucleic acids, etc., and interfere with the biological functions of recipient cells. Various cell-derived exosomes have been reported to play an immunomodulatory role in the ALI/ARDS inflammatory model. This article reviews the mechanism of exosomes involved in immune regulation of ALI/ARDS and possible therapeutic approaches.

To explore the diagnostic values of real-time elastosonography quantitative parameters in uterine fibroids and adenomyoma.The clinical data of 175 cases were analyzed retrospectively.Strain ratios (B/A) of lesion and normal adjacent myometrium were measured and mean B/A was calculated.The average B/A of uterine fibroids and adenomyoma was 3.81 ±0.52 and 1.39 ±0.46 respectively.And there was significant statistic difference (t =2.563,P ＜ 0.05).the accuracy rates of real-time elastosonography in the diagnosis of uterine fibroids and adenomyoma were high at 97.4％ (148/152) and 95.3％ (122/128) respectively.Real-time elastosonography has high diagnostic values for uterine fibroids and adenomyoma.

Objective To analyzed imaging features of testicular and epididymal tumors or inflammatory nodes in children and to improve its diagnostic accuracy.Methods 13 cases underwent ultrasonography,of them,plain CT scan in 10 cases,enhanced CT scan in6 cases.Its signs were retrospectively analyzed and compared with surgical and pathological results.Results On ultrasonography,theinhomogenous and different echo could be viewed in 13 cases,color Doppler flow imaging was abundant in 8 masses,3 cases with littler,empty blood flow in 2 cases and retroperitoneal lymphatic metastasis were viewed in 2 cases.On plain CT scan,masses were mixed density in 4 cases,calcification could be seen within tumor in 3 cases,masses were soft tissue or main soft tissue density in 6 cases.Contrast-enhancedCT scan displayed obviously and inhomogenously in 4 cases,lightly enhancment in 1 case and no enhanced in 1 case.By surgical andpathological confirmed,3 were mature treatomaes,1 was immaturity teratoma,4 were yolk sactumor,3 were inflammatory nodes,1 wasrhabdomyosarcoma and 1 was cystic lymphangioma.Conclusion Each kind of testicular tumors in children has its owns CT and UScharacteristics.In combination of CT and US can carry high diagnostic accuracy.