Objective Investigating the relationship between the incidence of Primary Acute Cerebral Infarction (PACI) and seasonal variation to employ measures to prevent PACI with climate change. Methods A retrospective analysis of patients diagnosed with PACI between 2009 and 2013 in the department of Neurology of Second hospital of Tian Jin Medi-cal University (n=1 198 patients) was carried out. Combined with the general clinical data, we analyzed seasonal, monthly and weekly variation among PACI incidents. Results The incidence of PACI increases over years between 2009 to 2013 (P ＜ 0.01). Significant difference of incidents of PACI was observed between each season (P=0.047). Incidence of PACI peaked in winter(30.33 ± 9.63/month), while bottomed in spring(21.83 ± 5.36/month). Significant difference of incidents of PACI was also observed between each months(P=0.010). The monthly incidence was highest in January and February (33.25 ± 9.62/month)and lowest in March and April(20.75 ± 4.89/month). The seasonal variation was only found in the pa-tients who are complicated with pulmonary infection (P＜0.01) regardless of the presence or absence of other risk factors, such as smoking, drinking ,hypertension, coronary heart disease, and diabetes mellitus. The weekly variation of PACI was on-ly significant in patients younger than 65 years old(P=0.043). The peak incidence among a week was Monday(17.86%),and incidence bottomed on Friday (13.36%). Conclusion Our study revealed that the incidence of PACI increase over year be-tween 2009 to 2013 and it shew a characteristic variation with respect to season, month and week. Based on these results, we can formulate prevention measures accordingly.

Objective To study the sensitivity and reliability of rat skin anaphylactoid test method, detect and evaluate the anaphylactoid reaction of traditional Chinese medecine injection. Methods The condition of rat skin anaphylactoid test was optimized by studying the influencing factors of sensitivity and reliability of test with C48/80 as a tool drug, Tween80, endotoxin, China cobra toxin, trichosanthin injection, Tanreqing injection and Xuesaitong injection were investigated. Results The best conditions of rat skin anaphylactoid test was as follows:intrademal inject the drug with insulin syringe, 50-100μL per point, immediately inject 0.5%Evans blue dye 1 mL though caudal vein, 15 min later, kill the rat by carotid artery bleeding, clip dorsal skin to do the test. With this method, Tween80, endotoxin, China cobra toxin and trichosanthin injection all can induce blue stain in rat skin. Tanreqing injection showed no blue stain at the clinical dose. Xuesaitong injection although can induce blue stain in rat skin at the clinical dose, but the results cannot exclude the interference of its pharmacological function. Conclusion The method is simple with short test cycle, less dose of test drug, high detection sensitivity and good reproducibility, but some drug can show false positive result due to its own property.

Objective To understand the influencing factors of professional adaptability for college nursing students and the mechanism. Methods A group of 1 105 college students from grades 2010 and 2011 were surveyed with questionnaire for professional adaptability. The data were analyzed with SPSS 16.0. Measurement data were expressed as x±s while enumeration data were expressed as percentage. t test and variance analysis were used to compare the differces among groups of different grades and genders. Results The professional adaptability mean score of college nursing students was (102.66 ± 14.93) and significant differences in professional adaptability were observed between different grades and genders (P=0.004 3, P=0.001 5). The possible influencing factors professional adaptability were different sources of students, family location, family income, etc. There were statis-tic differences in professional promise between arts and science students and between rural an urban students (P=0.029 8, P=0.007 0). Conclusion Grade and genders are the main influencing factors for professional adaptability of college nursing students while other factors exert little effect on it.

Objective To analyze the central visual fields and the ocular fundus changes of both eyes of patients with pituitary adenoma. Methods A total of 70 cases of pituitary adenoma received the examination of static central visual fields of all liminal values by Humphrey instruments 750 cycloscope and the fundus exams by Topcon TRC 50X fundus photography before operations. Results There were 64.3% patients with decreased visual acuities, 80.7% with the defect of visual field, and 46.4% with fundus changes. The decrease of the visual acuity was the first diagnostic symptom in 45.7% patients, among whom 28.6% were misdiagnosed as ocular diseases. Conclusions The misdiagnosed cause is that the first diagnostic symptom is the decrease of visual acuity without defect of visual field accompanied by ocular diseases. To avoid the misdiagnosis and the omitter of pituitary adenoma, general examination of visual field should be carried out in the patients with decreased visual acuity and optic atrophy with unknown reason in the clinical diagnosis of ophthalmology.

Objective:To study the relationship between gingival thickness(GT)and the underlying alveolar bone thickness(BT)in maxillary anterior region and the distance from cemento-enamel junction(CEJ)to alveolar crest.Methods:30 young volunteers with healthy gingiva were included.GT was measured at 2mm below the CEJ,buccal BT were measured at 3 locations:2,4 and 6 mm below the alveolar crest respectively,the distance from CEJ to alveolar crest were measured by CBCT and clinical direct measure respectively. Results:The correlation coefficient (r)values between GT and BT at 2,4 and 6 mm below alveolar crest were 0.493,0.383 and 0.342 (P <0.001 )respectively,the r value between GT and the distance from CEJ to alveolar crest was -0.21 3(P <0.01 ).No statistically significant difference was observed between CBCT and clinical measurements(t =-0.521 ,P =0.603).Conclusion:There is positive correlation between GT and BT at 2,4 and 6 mm below alveolar crest and negative relation between GT and the distance from CEJ to alveolar crest.

Objective To describe the current situation of oncology nurses' mastery of cancer pain-related knowledge and explore the correlation between the mastery of knowledge and nursing activities.Methods By convenient sampling,323 oncology nurses in four hospitals were recruited in the questionnaire study.Results Among the 40 pain-related knowledge questions assessed,the mean number of correctly answered questions was (19.33±3.96),with a range of 9 to 33,the correct answer rate for entire questionnaire was between 22.5％ to 81.5％,and the pass rate of the questionnaire was 0.62 ％; the score of the questionnaire had a positive correlation with pain assessment dimension and therapeutic communication and health education dimension;the self-rated score of pain-related knowledge had a positive correlation with the four dimensions; the times of nurses participating in cancer pain control study and the times of the department's cancer pain control study had a positive correlation with pain assessment dimension.Conclusions Oncology nurses did not grasp cancer pain-related knowledge well,and showed discrepancy in mastery of knowledge and nursing activities.Nursing management can strengthen nurses training in cancer pain management or increase the times of cancer pain control study to promote the implementation of cancer pain nursing activities,and to advance the quality of cancer pain nursing.

Objective To analyze the changes of thyroid function of healthy primipara before 20 weeks of gestation to establish normal gestational age-specific reference interval of thyroid hormones,and to investigate the prevalence of maternal thyroid disorders during the first half of pregnancy.Methods A total of 1605 healthy primipara without risk factors of thyroid diseases before 20 gestational weeks and 200 non-pregnant healthy women who accepted pre-conception care in Beijing Friendship Hospital from September 2010 to June 2011 were tested for serum thyroid stimulating hormone (TSH),free thyroxine (FT4) and thyroid peroxidase antihody (TPOAb) by chemiluminometric immunoanalysis.One thousand two hundred and fourty-three pregnant women among them with negative thyroid antibooly and without previons thyroid diseases were selected as the standard population for normal interval.Gestational age-specific percentile categories for TSH and FT4 were calculated.The prevalence of maternal thyroid disorders was examined by gestational agespecific intervals.Results (1) Compared with non-pregnant women,the median value of serum TSH in pregnant women decreased by 29.56％ to the value of 0.91 mU/L; while that of FT4 rose by 7.79％ to the value of 11.33 pmol/L before 12 weeks; and TSH increased while FT4 decreased during 13 to 20 weeks.(2) The median values and reference intervals (2.5th percentile,97.5th percentile) for TSH were 1.59 mU/L (0.15 mU/L,5.19 mU/L) in no-pregnant women,1.12 mU/L (0.03 mU/L,3.67 mU/L) at 8-12+6 gestational weeks,1.21 mU/L (0.05 mU/L,3.74 mU/L) at 13-16+6 gestational weeks,1.50 mU/L (0.31 mU/L,4.33 mU/L) at 17-19+6 gestational weeks; and the median values and reference intervals (2.5th percentile,97.5th percentile) for FT4 were 9.91 pmol/L (6.69 pmol/L,14.03 pmol/L),10.68 pmol/L (7.98 pmol/L,18.66 pmol/L),10.04 pmol/L (6.18 pmol/L,16.22 pmol/L),9.40 pmol/L (6.44 pmol/L,13.51 pmol/L) respectively.(3) According to gestational age-specific reference intervals,the general prevalence of maternal thyroid disorders,including hyperthyroidism,hypothyroidism,subclinical hypothyroidism and hypothyroinemia,was 3.55％ (57/1606).At 8-12+6 gestational weeks,13-16+6 gestational weeks and 17 19+6 gestational weeks,the occurrence of hyperthyroidism was 0.00％,0.13％ and 0.00％;that of hypothyroidism was 0.00％,0.13％ and 0.00％; the incidence of subclinical hypothyroidism was 3.60％,2.76％ and 3.00％; the occurrence of hypothyroxinemia was 0.16％,0.26％ and 0.86％,respectively.The positive rate of TPOAb at 8-12+6,13-16+6 and 17-19+6 gestational weeks were 22.91％ (140/611),16.56％ (126/761) and 15.45％(36/233),and the total positive rate of TPOAb was 18.82％ (302/1605).The median level of TPOAb was 38.90,41.87 and 39.10 mU/L,respectively.Conclusions Before 20 gestational weeks,specific changes occur in maternal thyroid function.TSH level decreases during 8 to 12 gestational weeks,and then increases gradually; while FT4 level increases during 8 to 12 weeks,and then decreases gradually.Thyroid dysfunction during pregnancy is common and subclinical hypothyroidisum is the leading problem in thyroid disorders.Screening for thyroid function during early pregnancy is suggested.

Objective To evaluate the influence of inappropriate position deviation on radioactive iodine uptake (RAIU),effective half-life (Teff) and the corresponding dose variances in patients suffering from Graves hyperthyroidism.Methods RAIU was examined in 20 patients with Graves hyperthyroidism (7 males,13 females,average age (46.60 ±9.55) years) 2,4,6,and 24 h after intake of the radioiodine capsule.A scintillation probe was positioned at the center of the inferior edge of the thyroid cartilage 25 cm away for 2 min,which was defined as the standard manipulation (test 1).Then,the probe was moved either 5 cm backward (test 2) or 5 cm higher (test 3) compared with test 1.Variants of RAIU,Teff as well as dose calculations were acquired by different combinations (CⅠ-Ⅸ) of 4 h and 24 h-RAIU,according to the above 3 manipulations (C Ⅰ-Ⅲ:test 1 for RAIU4 h,test 1,2,3 for RAIU24 h respectively ; C Ⅳ-Ⅵ:test 2 for RAIU4h,test 1,2,3 for RAIU24h respectively; CⅦ-Ⅸ:test 3 for RAIU4h,test 1,2,3 for RAIU24h respectively).Paired t test was used to compare the statistical differences between C H-Ⅸ to C Ⅰ.Results RAIU24 h of test 2 (68.08％ ± 7.88％) and test 3 (62.18％ ± 7.45％) were significantly lower than that of test 1 (78.05％ ± 8.31％ ;t =12.15,14.37,respectively,both P ＜ 0.01).Teffs of C Ⅱ (4.42 ± 0.73) d,CⅢ(3.76 ±0.53) d,CⅤ(5.59 ±0.46) d,CⅥ(4.47 ±0.44) d,CⅧ(5.94 ±0.54) d and CⅨ (5.45 ±0.66) d were significantly different from that of C Ⅰ (5.04 ±0.56) d which was defined as standard (t:3.86-13.64,all P ＜0.01).Among the 180 131I dose values calculated by different Teff and RAIU values induced from C Ⅰ-Ⅸ combinations,74.4％ (119/160) were over-calculated while 9.4％ (15/160) were under-calculated.Taking one patient as an example,the changes of RAIU24 h (decreased up to 26.0％) and the percentage of Teff deviation(66.9％,ranged from-47.5％ to 19.4％)led to an over-calculated 131 I dosage by as high as 129.8％ compared with CⅠ.Conclusions Incorrect positioning in RAIU detection could result in various false RAIU,Teff and 131I dose calculations.Such deviations could possibly exert an impact on the patients' therapeutic outcomes,thus influencing the efficacy of the iodine therapy.Optimization of RAIU positioning is essential for clinical practice to guarantee radioiodine dose management.

Objective:To evaluate 131I adjuvant therapy in B-Raf proto-oncogene, serine/threonine kinase (BRAF) V600E mutant patients with non-distant metastatic papillary thyroid cancer (PTC). Methods:From January 2008 to January 2019, a total of 181 PTC patients (65 males, 116 females, age: (38.9±11.8) years) with non-distant metastases from Peking Union Medical College Hospital were retrospectively enrolled. All patients received only one time 131I therapy with complete clinicopathological information, data of follow-up (median time: 63 months) and assessment of response to therapy. Patients were divided into mutant and wild type group in terms of BRAF V600E status or ablation group (1.1 GBq) and adjuvant therapy group (3.7-5.5 GBq) in terms of different 131I dosage. Clinicopathological features and the response to therapy were compared between different groups by using independent-sample t test, Mann-Whitney U test and χ2 test. Results:The levels of preablative stimulated thyroglobulin (ps-Tg) in the BRAF V600E mutant type group ( n=150) was significantly higher than that in the wild type group ( n=31; 6.32(0.90, 8.70) vs 3.92(0.40, 4.40) μg/L; z=-2.413, P=0.016), however, there were no significant differences in other clinicopathological characteristics (including age, sex, tumor size, multifocality, capsule invasion and N staging) between the two groups ( t=-0.663, z=-1.151, χ2 values: 0.003-1.491, all P>0.05) and the therapeutic response was also not different between the two groups( χ2=1.094, P=0.778). Of 81 patients who received 131I adjuvant therapy, the ps-Tg level of BRAF V600E mutant type group ( n=69) was higher than that of the wild type group( n=12; 8.70(1.30, 11.80) vs 3.40(0.30, 4.50) μg/L; z=-2.194, P=0.028), while the therapeutic response was not different between the two groups ( χ2=1.792, P=0.617). Compared with BRAF V600E mutant patients received 131I ablation ( n=81), BRAF V600E mutant patients received 131I adjuvant therapy ( n=69) had larger tumors (1.52(0.95, 2.00) vs 1.21(0.60, 1.50) cm; z=-2.728, P=0.006), more advanced N staging ( χ2=11.460, P=0.003) and higher ps-Tg level (8.70(1.30, 11.80) vs 4.34(0.50, 5.30) μg/L; z=-3.314, P=0.001), but the therapeutic response was not different between the two groups ( χ2=6.478, P=0.091). Conclusion:131I adjuvant therapy may improve the longer-term response to therapy in BRAF V600E mutant PTC patients with lager tumors, more advanced N staging and higher ps-Tg level.

Objective To investigate the mechanical prosperity and degradation rate of the scaffolds with compounding collagen and the nano sol-gel derived bioactive glass were studied,and provide the theoretical basis for the further application of collagen based scaffolds.Method The scaffold with compounding collagen and the nano sol-gel derived bioactive glass(58S)were prepared using the freeze-drying techniques with the bioactive glass as phase addition.By affecting the aggregation state of the collagen fibers with adjusting the supplementation of bioactive glass to change the microstructures of the compound scaffolds and finatly the compound scaffolds with different mechanical properties were prepared.Results (1)As the aggregation state of the collagen fibers changes,the scaffolds with the coarser collagen fibers is prepared with the diameters 400-600 nm approximately.The coarser collagen fibers will play an important role in improving the mechanical property and slowing down the degradation rate of the collagen based scaffolds.(2)The interactions between bioactive glass and collagen are studied by FTIR and Raman technologies.When the quality of content of collagen in the compound scaffolds is lower than 20%,the secondary structure of collagen is damaged severely.Conclusion The composite scaffolds with the mass ratio of collagen to bioactive glass 40:60 has the best performance in mechanical property and degradation,which will be helpful for further applications.