Objective To develop an instrument to measure the quality of life (QOL) suitable for Chinese adult patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and evaluate it. Methods A list of 72 items potentially related to QOL of patients with OSAHS was constructed via discussion with OSAHS related people, as well as referring to some foreign QOL instruments. Twenty patients were asked to identify the most significant items. Then, frequency, importance and impact score, which is the product of frequency and importance, of the items were calculated. Those items with an impact score equal to or greater than 1.5 were retained in the instrument. Fifty-two OSAHS patients were divided into two groups based on their apnea-hypopnea index (AHI) (AHI

Objective To master the rehabilitation in patients with traumatic brain injury in Eastern China, and provide evidence for clinicians to rehabilitate early,correctly and effectively.Methods All sampling of the TBI patients from 80 hospitals in Eastern China were clustered and were analyzed using SPSS 13.0.Results The rate of in -patients in Eastern China with early rehabilitative intervention was 4.68%,and the rate of male was higher than female(male to female ratio was 3.80:1),mean age was (40.10 ±16.33)years old,but there was no difference in gender(χ2 =3.23,P =0.072)and age(t =-0.819,P =0.413)for the early rehabilitative intervention.Local resi-dent patients in early rehabilitative intervention was lower(χ2 =8.28,P <0.05).The average length of stay for the early rehabilitative intervention patients was(39.57 ±34.22)d(t =-17.74,P <0.05),the average cost of hospitali-zation was(42 741.50 ±43 186.69)yuan(t =-18.96,P <0.05).The rate of average length of stay and average cost of hospitalization of the rehabilitative intervention patients were higher and more expensive than the patients who did not obtain early rehabilitative intervention,but did have higher unfavourable prognosis rate(χ2 =85.45,P <0.05). Conclusion We advocate correct and early rehabilitative intervention for traumatic brain injury in patients with different degree,and promote not only the physical and functional rehabilitation,but also comprehensive rehabilitation such as the psychological treatment,family treatment and social regression.

Objective To evaluate the application effect of‘incorrect cases’in medical statis-tics teaching. Methods The junior students (n=307)of clinical medicine were selected as research subjects by random cluster sampling. They were divided into the teaching improving group (n=151) who accepted case teaching and control group (n=156)who accepted traditional teaching. At the end of the term,the teaching effect was surveyed by questionnaires and compared between the two groups. Measurement data was analyzed by t test,enumeration data by χ2 test and ranked data by rank sum test. Results Students' interests of medical statistics and understanding the importance of the course in teaching improving group were significantly higher than that in control group (Z=-2.375,P=0.018;Z=-2.971,P=0.003). The proportion of students with learning difficulties in teaching improving group was obviously lower than that in control group (Z=-2.488,P=0.013). The satisfaction with theory and practical teaching in teaching improving group (84.10% and 88.74%,respectively)was significantly higher that in control group (73.08%and 71.79%,respectively)(χ2=5.530,P=0.013;χ2=13.841,P<0.001). Although no difference was observed in the test score between the two groups (t=1.230,P=0.220),knowledge of parameter estimation,hypothesis testing and science research design in teach-ing improving group was significantly higher than that in control group (χ2=6.829,P=0.009;χ2=5.835, P=0.016). Conclusions Application of ‘incorrect cases’in medical statistics teaching could arouse students' learning interests and improve clinical medical students' comprehensive analy sis ability of medical statistics.

Objective To evaluate the prognostic value of lateral lymphadenectomy for advanced lower rectal cancer. Methods A total of 96 consecutive patients who underwent total mesorectal excision and lateral lymphadenectomy for advanced lower rectal cancer were retrospectively evaluated by using therapeutic index. A product of the frequency of lymph node metastasis and the cancer-related 5-year survival rate. Results The incidences of lymph node metastasis in mesorectal area, superior rectal artery area, inferior mesenteric artery area and lateral area was 21%,13%.10%and 15%respectively.The 5-year survival rate of patients with metastasis to the mesorectal area, superior rectal artery area, inferior mesenteric artery area and lateral area was 35%,25%,20%and 36%respectively.The therapeutic indexes for total mesorectal excision and lateral lymphadenectomy were 7.4 and 5.4,which were much higher than that of lymphadenectomy of the superior rectal artery area(3.3)and inferior mesenteric artery area(2.0).Local recurrence occurred in 19%(18 out of 96 cases)patients with advanced lower rectal cancer. Local recurrence rate of patients with positive lateral lymph node metastasis was 64%(9 of 14 cases),whereas it was 11%(9 of 82 cases)in those without lateral lymph node metastasis. The difference between these two groups was statistically significant(x2=22.308,P=0.000).Kaplan-Meier survival analysis showed significant improvements in median survival(80.9±2.1)m,95%CI:76.7～85.1 m vs(38±6.7)m,(95%CI:24.8～51.2 m)for patients with negative lateral lymph node metastasis over patients with lateral lymph node metastasis(log-rank,P=0.000). Conclusion The current results indicate that lateral pelvic lymphadenectomy could significantly reduce loeal recurrence and effectively improve the survival of patients with advanced lower rectal cancer. Except for total mesorectal excision, lateral pelvic lymphadenectomy should be followed in the surgery of pailents with advanced low rectal cancer.

Background Glial cell line derived neurotrophic factor (GDNF) is determined to have a neurotrophy effect and promoting effect to the growth of axon.GDNF has been applied in ophthalmology.Research showed that artemin,a new member of GDNF family,has a better function in protection of neuron,but seldom relevant document of distruibution of artemin in retina is found so far.Objective The aim of the present study is to investigate the distribution and expression of artemin in normal rat retinal neuron cells and retinal ganglion cells,and imitate diabetic environment to observe the expression of artemin at the condition of high glucose.Methods Retinal tissue was isolated from clean neonatal SD rats and cultured by expand culture method in DMEM/F12 containing 10% fetal bovine serum.40 mmol/L of glucose was added in medium in the seventh day after culture for 12 hours as experimental group.The expression and location of artemin in retina were tested by real-time PCR and cell immunofluorescence assay.Use of experimental animals followed the Management Regulation of experimental animals of Jiangsu Province.Results Cultured cells showed the typical cell body and processes in the seventh day.Cultured retinal ganglion cells (RGCs) presented the red fluorescence for Thy1.1 antibody,and multiple fluorescence label revealed that RGCs exhibited the green fluorescence for artemin antibody and red fluorescence for Thy1.1 antibody,indicating artemin protein was positively expressed in cultured RGCs.The numbers of positive cells for Thy1.1 antibody was (442±9)/high field in normal culture group and (263±7) /high field in 40mmol/L glucose culture group,showing a significant difference between them (P＜0.05).The expression of artemin mRNA in normal culture group and in 40 mmol/L glucose culture group,was showing a considerably difference between them(P＜0.05).Conclusion Artemin can be expressed in cultured retinal neuron cells and RGCs in rats.High glucose environment down-regulate the expression of artemin.This study proved a new idea for protecting RGCs against damage.

OBJECTIVE To provide current tendency of viral transmission by test-negative blood components changing among blood donors and to improve the safety of blood for transfusion.METHODS The test data of 1 608 816 blood donors in Beijing Red Cross Blood Center from 2001 to 2008 were analyzed.RESULTS Before voluntary blood donation,the positive rate of anti-HCV was 0.16%,that of anti-HIV was 0.005% and that of anti-TP was 0.15%.After voluntary blood donation,positive rate of these components increased,there were 0.45%,0.017% and 0.48%,respectively,but the positive rate of HBsAg and ALT was decreased.After voluntary blood donation,the positive rate of HBsAg,anti-HCV,anti-HIV and anti-TP were elevated,that of ALT was decreased in greatly.CONCLUSIONS As the increasing risk of viral transmission disease,it is more important for blood safety to screen volunteer blood donors.

This is a prospective study using first-pass perfusion CT with volume-based technique to investigate perfusion features of gastric cancer. Perfusion CT was performed with 64-section MDCT on 35 patients with gastric cancer; these patients were subdivided into three subgroups according to the location of the tumor; besides, 24 patients with normal stomach served as controls. Four perfusion parameters, including perfusion (PF), peak enhancement (PE), time to peak (TTP), and blood volume (BV), were obtained and compared between the test and control groups, and between the groups with and without lymph-node metastases. ROC analysis was performed to determine the cutoff value for discriminating the microcirculation of gastric cancer from that of the normal stomach. The results showed that blood volume was significantly increased in the test group, compared with the control group. The threshold of 8.6 ml x 100 g(-1) of blood volume was noted to be corresponding to a sensitivity of 88.6% and a specificity of 62.9%. In conclusion, the first-pass perfusion CT with whole tumor acquisition technique could assess tumor vascularity and be useful for the diagnosis of gastric cancer.
Adult ; Aged ; Female ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Perfusion ; methods ; Prospective Studies ; Radiographic Image Interpretation, Computer-Assisted ; methods ; Regional Blood Flow ; Sensitivity and Specificity ; Stomach Neoplasms ; blood supply ; diagnostic imaging ; Tomography, Spiral Computed ; methods

Objective To analyze the molecular biological characteristics of Streptococcus pyogenes (GAS) causing children tonsillitis in Yangfangdian community Haidian district,Beijing between 2011 and 2013.Methods From Apr.2011 to Apr.2013,there were 94 children with tonsillitis treated in outpatient of Beijing Shijitan Hospital Affiliated to Capital Medical University,and 17 strains GAS were isolated from these pediatrician outpatients.Their encoding mature M protein gene (emm gene),7 pairs of alleles housekeeping gene (gki,gtr,murI,mutS,recP,xpt and yqiL),superantigen speA and speC genes,macrolide-resistance genes ermB,mefA and ermRT were amplified by polymerase chain reaction (PCR).The PCR amplified products of emm gene and 7 pairs of alleles housekeeping gene were sequenced.The emm gene sequences were stored in the Centers for Disease Control and Prevention database.The emm types of GAS were identified.The 7 pairs of alleles housekeeping gene sequences of GAS were sent to the multilocus sequence typing (MLST) website for their iso-allelic sequences to identify their sequence types (ST).The PCR amplified products of superantigen gene speA and speC,macrolide-resistance genes ermB,mefA and ermRT were performed with agar gel electrophoresis.The corresponding qualitative results were obtained.Results Five emm-types were discovered:emm12.0 (76.4％),emm1.0 (5.9％),emm89.0 (5.9％),emm75.0 (5.9％) and emm22.0 (5.9％) ;emm12.0 and its subtype strains had the same allelic profiles which belonged to ST36 type; emm1.0 strain belonged to ST28 ; emm89.0 strain belonged to ST101 ; emm75.0 strain belonged to ST49 ; emm22.0 strain belonged to ST46 ; 94.1％ (16/17) strains carried macrolide-resistance gene ermB.None carried macrolide-resistance genes mefA and ermRT.None carried superantigen speA gene.100.0％ (17/17 cases) carried superantigen speC gene.Conclusions emm12.0 (ST36) strain was the most common type of GAS causing the children tonsillitis in Yangfangdian community Haidian District,Beijing between 2011 and 2013.These strains mainly carry macrolide-resistance ermB and superantigen speC gene.

Objective To investigate the influences of psychological rehabilitation nursing on immune function in post stroke depression patients.Methods A total of 80 elderly patients with post stroke depression were recruited from the inpatients in geriatric neurology department at Tianjin Medical University General Hospital.All patients were divided into two groups:the control group received only conventional and auxiliary exercise therapy for 3 months; rehabilitation group received psychological rehabilitation nursing added to the above therapy for 3 months.Barthel indexes,Hamilton Depression Scale (HAMD) scores and immune function were detected at recruit and three months after treatment.Results There were no statistically significant differences in clinical data between the rehabilitation group and control group (all P＞0.05).There were no statistically significant differences in Barthel indexes,Hamilton Depression Scale (HAMD) scores and immune function between rehabilitation group and control group before treatment (all P＞ 0.05).Compared with control group,the rehabilitation group showed that the Barthel Indexes were increased (P=0.000),Hamilton Depression Sale (HAMD) scores were decreased (P=0.000),the levels of T lymphocyte subpopulation (P＜ 0.05) and immunoglobulin (P＜ 0.01) were increased after three months treatment.Conclusions The combination treatment of psychological rehabilitation nursing,auxiliary exercise and drug are helpful to recover immune function and improve the quality of life in patients with post stroke depression.

OBJECTIVETo investigate the effect of augmentative locking compression plate combined with bone graft in treating aseptic femoral shaft nonunion after intramedullary nailing.

METHODSTwenty-one cases with aseptic femoral shaft nonunion after intramedullary nailing from January 2007 to January 2013 were treated,including 18 males and 3 females with a mean age of 37.7 years (ranged from 23 to 64 years). The mean period of nonunion after surgery was 23.9 months (ranged from 9 to 62 months). According to Weber-Cech classification,10 of those 21 cases were hypertrophic nonunion,7 were atrophic, and 4 had oligotrophic fracture nonunion. All patients retained the original intramedullary nail, and applied with augmentation plating of 6 to 8 holes locking compression plate, unicortical fixation with 2 to 3 locking screws in the proximal or distal end, with simultaneous autologous iliac bone grafting. After treatment,all patients were allowed to partial weight-bearing until full weight-bearing according to the radiological results. All patients were followed up and were evaluated with clinical and imaging results.

RESULTSAll patients were followed up from 8 to 24 months, averaged (13.5±3.5) months,which showed clinical union at 4 to 8 months, averaged (6.0±1.0) months and radiological solid union at 7 to 12 months, averaged (9.1±1.5) months. No such complications as infection,hardware loosening or breaking were found.

CONCLUSIONAugmentative locking compression plate(LCP) combined with bone graft for aseptic femoral shaft nonunion after intramedullary nail has a satisfied clinical efficacy. It's an useful and simple method.

Adult ; Bone Nails ; adverse effects ; Bone Plates ; Bone Transplantation ; Female ; Femoral Fractures ; complications ; surgery ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; adverse effects ; Fractures, Ununited ; complications ; surgery ; Humans ; Male ; Middle Aged ; Postoperative Complications ; etiology ; surgery ; Treatment Outcome ; Young Adult