After a description of the demand for medical information in grass-root PLA health units, the experiences of Medical Library of Chinese PLA in providing medical information service for grass-root PLA health units were summarized, and suggestions were proposed for medical library and information institutions to provide information service for them.

Objective To investigate the safty and proper concentration of using the sufentanil combined with ropivacaine in patient-controlled epidural analgesia (PCEA) under lower limb surgery in elderly. Methods Eighty patients scheduled for lower limb surgery were divided into 4 groups by random digits table with 20 cases in each. The concentration of the sufentanil were 0.1,0.2,0.3 and 0.4 μ g/ml in group A, B, C, D respectively. The concentration of the ropivacaine were 0.125% in each group for the PCEA.R-VAS, C-VAS , Bromage score, Ramsay score, press times ,dosage and side effects were monitored and recorded at 4,10,24 and 48 h after operation. Results Compared with those in group C, D, C-VAS,dosage of the analgesia,press times of PCEA were higher in group A,B (P＜0.01 or ＜ 0.05),the efficacy of press was lower in group A, B(P＜0.05), but there was no significant difference between group C and group D(P＞0.05 ).The Ramsay score 10,24 h after operation in group D[(4.5 ± 0.5 ), (4.6 ± 0.6) scores] was higher than that in group A,B,C [(2.7 ±0.8), (2.7 ±0.8) scores vs.(2.9 ± 0.9), (2.7 ± 0.9) scores vs. (3.0 ±0.7), (2.9 ±0.5) scores] (P ＜0.05). There were no case with hypotension and respiratory depression.Conclusion PCEA of four methods are safe and effective in elderly which 0.3 μ g/ml sufentanil combined with 0.125% ropivacaine have good analgesic effect and less side effect.

Objective To systematically analyze and assess the overall value of transrectal shear wave elastograpy in diagnosis of prostate cancer (PCa) using Meta-analysis.Methods Relevant Chinese and foreign papers diagnosing PCa with transrectal shear wave elastograpy published before December 2016 were searched.The references were evaluated and screened according to the criteria of diagnostic research.The selected references were analyzed by Meta-Disc 1.4 and Stata 12.0 statistical software.Results Eight articles were included in the present Meta-analysis.Five of these literatures were about transrectal shear wave elastograpy in diagnosis of PCa,the summarized sensitivity (SEN) and summarized specificity (SPE) in diagnosis of PCa were 0.80 (95％CI [0.75,0.84]) and 0.75 (95％CI [0.71,0.79]),respectively;the positive likelihood ratios (PLR) and negative likelihood ratios (NLR) were 3.60 (95 ％ CI [2.57,5.05]) and 0.17 (95 ％ CI[0.08,0.37]),respectively;the area under SROC curves was 0.895.Five of these literatures were about transrectal shear wave elastograpy supplemental prostatic biopsy in diagnosis of PCa,the summarized SEN and SPE were 0.86 (95％ CI [0.83,0.88]) and 0.84 (95％CI [0.82,0.85]) respectively;the PLR and NLR were 5.81 (95％CI [3.07,10.99]) and 0.14 (95％CI [0.04,0.49]) respectively;the area under SROC curves were 0.924.Conclusion Transrectal shear wave elastograpy has better clinical value in detection of PCa and can be used to supplemental prostatic biopsy.

Objective To investigate the influence of Let-7f regulation on MMP-11 in migration and in-vasion of pancreatic cancer. Methods RT-qPCR was performed to assay the expression of Let7 and MMP-11 ex-pression in pancreatic cancer cells and normal pancreatic cells. Let-7f mimic and inhibitor were transfected to PANC-1 and Bx-PC3, respectively. The influence of Let-7f expression on migration and invasion of pancreatic cancer cells was analyzed by transwell. The influence of Let-7f intervention on MMP-11 expression was observed by RT-qPCR. Results Let-7f expression decreased in PANC-1 and Bx-PC3, compared to HPDE6c7, while MMP-11 expression up-regulated in PANC-1 and Bx-PC3 , compared to HPDE6c7 cells. Let-7f overexpression in-hibited the expression of MMP-11. Up-regulated Let-7f could significantly inhibit migration and invasion of PANC-1 and Bx-PC3 and Let-7f inhibitor enhanced MMP-11 expression. However , down-expression of Let-7f could not significantly promote migration and invasion abilities of PANC-1 and Bx-PC3cells. Conclusions Let-7f may affect migration and invasion by regulating MMP-11 expression in pancreatic cancer , suggesting that Let-7f might be a potential target for gene therapy in human pancreatic cancer.

Objective To analyze factors of volume maintenance percentage after autologous fat grafting breast augmentation.Methods From March 2011 to December 2014,39 patients were included.Age,BMI,donor site,breast preoperative volume,whether or not application of Brava and water-jet-assisted liposuction were collected as variables.We performed multivariate regression and univariate regression analyses in a general linear regression model and multilevel linear regression model to identify significant factors.Results The mean percentage of volume maintenance was (34± 12) ％.In univariate regression analysis,rate of volume maintenace was decreased 3.3％ as increase of age per 5 years;Brava application increased volume maintenace,compared with donor sites of the back and abdomen 8.4％ (40.7％ vs 32.3％,P＜0.05),application of leg fat increased by 9.6％ of volume maintenace (39.1％ vs 29.5％,P＜0.05).In the multivariate regression analysis,Brava use increased volume maintenance of 6.2％ (P＜0.05);use of leg fat increased by 6.0 ％ of volume maintenace as compared with donor sites of the back and abdomen (P＜0.05).Conclusions The age,Brava,and donor site are significant impact factors to percentage volume maintenance in autologous fat graft breast augmentation.

This paper uses the data collected from 138,477 patient discharge records of 37 Shanghai tertiary public hospitals in December 2013 and classifies all the records into different groups by using a localized diagnosis re-lated group tool.The coefficient of variation index ( CV) of each group was used to analyze the dispersion of average hospital cost per inpatient day for each group, in order to evaluate the suitability of diagnosis related group systems and to set the coefficients of difficulty ( relative weights) for each disease.The study has found that severity-based di-agnosis related group systems are more suitable and consistent.However, future studies should collect more detailed information on health costs in order to reflect the value of health professionals and technologies and therefore further improve diagnosis related classification and develop new systems that can be adapted to local conditions by applying the weights of different groups.

Objective:To explore the relationship between frailty and nutritional status of the elderly in communities.Method:Using the convenience sampling method, 458 elderly people in the community were investigated with the general data questionnaire, frailty phenotype, Mini-Nutritional Assessment, Mini-Mental State Examination, Self-Rating Depression Scale and Instrumental Activity of Daily Living.Results:The prevalence of frailty, pre-frailty and non-frailty in the elderly of the community was 9.2%, 60.0%, and 30.8% respectively, and 10.5% were malnourished or at risk of malnutrition. Logistic analysis showed that malnutrition increased the risk of frailty in the elderly ( OR=9.534, P=0.001). Conclusion:Malnutrition is a risk factor of frailty in the elderly in communities. Improving the nutritional status of the elderly in communities can help delay the development of frailty.

Objective To explore the gender differences in disgust processing in patients with ob-sessive-compulsive disorder ( OCD). Methods A total of 74 patients with obsessive-compulsive disorder (39 males and 35 females) and 65 normal healthy controls (35 males and 30 females) were assessed with Padua inventory-Washington State University revision (PI-WSUR),Yale-Brown obsessive-compulsive scale (Y-BOCS) and were tested the lexical decision task,in order to evaluate their OCD symptoms and severity. The results of reaction time,accuracy and rating intensity of core disgust words,moral disgust words and neu-tral words were recorded,and the gender differences in disgust processing in patients with obsessive-compul-sive disorder and normal healthy controls were analyzed. Results The reaction time of core disgust words ((753.6±84.1) vs (711.8±83.8)ms),the reaction time of moral disgust words((813.5±89.0) vs (749.4± 81.4)ms) and neutral words((775.3±91.8) vs (725.9±104.2)ms) showed significant differences between males and females in pateints with OCD,but there were no differences in accuracy and rating intensity(P＜0.05 or P＜0.01). In normal healthy controls,there were only differences between males and females in reac-tion time of neutral words,females were also showed shorter reaction time than males (P＜0.01). Pearson cor-relation analysis showed that both male and female patients had a negative correlation between the reaction time of core disgust words and total PI-WSUR scores (P＜0.05). There was a gender difference in the relative variables of PI-WSUR,Y-BOCS and disgust processing in OCD patients. Conclusion There were gender differences in disgust cognitive processing in patients with obsessive-compulsive disorder,females with ob-sessive-compulsive disorder have higher core disgust and moral disgust than males. Females with OCD have a special high sense of moral disgust.

ObjectiveTo investigate the association between baseline blood ammonia (BLA) and 90-day prognosis in patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure (HBV-ACLF). MethodsA retrospective analysis was performed for the clinical data of 789 patients with HBV-ACLF who were admitted to The Fifth Medical Center of Chinese PLA General Hospital from January 2013 to December 2016, and the association between baseline BLA and 90-day prognosis was analyzed. The Cox regression risk model was used for multivariate analysis. The Kaplan-Meier survival curve was used to analyze the 90-day survival rate of patients with different levels of baseline BLA, and the log-rank test was used for comparison. ResultsThe Cox multivariate regression analysis showed that BLA was independently and positively correlated with the risk of 90-day death in HBV-ACLF patients (Model 2: hazard ratio = 1.007, 95% confidence interval: 1.005-1.010, P＜0.00001). The log-rank test indicated that in the patients without hepatic encephalopathy (HE), the BLAhigh group had the highest 90-day cumulative mortality rate, followed by the BLAmid group and the BLAlow group (P=0002 3); among the patients with HE, the BLAhigh group had a significantly higher 90-day cumulative mortality rate than the other two groups (P=0.012), while there was no significant difference in 90-day cumulative mortality rate between these two groups (P=0.18). ConclusionBaseline BLA is independently and positively correlated with the risk of 90-day death in HBV-ACLF patients, and it may have a certain clinical value in treatment and prognostic evaluation.

OBJECTIVETo evaluate the accuracy of the time interval between the onset of early transmitral flow velocity (E) and that of early diastolic mitral annular velocity (e') (TE-e') measured by dual Doppler echocardiography in the diagnosis of diastolic dysfunction.

METHODSSeventy-seven coronary heart disease patients with preserved systolic function underwent a echocardiographic study. Early transmitral flow velocity E and early diastolic mitral annular velocity e' were simultaneously recorded by dual Doppler echocardiography. The E/e' and TE-e' were calculated and compared with the left ventricular end diastolic pressure (LVEDP), which was measured invasively. The validity of TE-e', E/e' and their combination was analyzed in estimating left ventricular dysfunction (LVEDP ≥12 mmHg).

RESULTSThe single-beat E/e' and TE-e' were correlated with the LVEDP (r=0.79 and 0.42, respectively, P<0.001). Receiver-operating characteristic analysis showed that the optimal cut-off for TE-e' was 38 ms (sensitivity 54%, specificity 79%, AUC 0.71) and that for E/e' was 9.2 (sensitivity 74%, specificity 81%, AUC 0.87) for diagnosis of left ventricular diastolic dysfunction. The combined cut-offs of TE-e'≥38 ms and E/e'≥9.2 had a sensitivity of 100% and a specificity of 62% in diagnosing left ventricular diastolic dysfunction with an AUC of 0.96.

CONCLUSIONIn patients with coronary heart disease, the simultaneous recording of TE-e' by dual Doppler echocardiography can accurately estimate diastolic dysfunction, and its combination with E/e' can further improve the diagnostic accuracy.

Aged ; Coronary Disease ; diagnostic imaging ; physiopathology ; Echocardiography, Doppler, Pulsed ; Female ; Humans ; Male ; Middle Aged ; Ventricular Dysfunction, Left ; diagnostic imaging ; physiopathology