Objective To study the course of development of aneurysm of abdominal aorta (AAA) with nonsurgical treatment in senile patients. Methods 37 subjects were included in the study, and they were divided into 3 groups according to the size of aneurysm observed at the first visit. The diameter of aneurysm was measured, and the measurement was repeated at periodic follow up. The yearly increase of the diameter was calculated and analyzed. Results For the 37 patients, the AAA mean diameter was 4.68cm at the first visit. The period of follow-up was 0.5 to 11 years, with a mean of 6.1 years. The average yearly increase in tumor diameter was 0.47cm/year. 14 patients with aneurysm diameter of 6.0cm had an average increase of 0.67cm/year. 5 patients died during the follow-up period, 2 of them died of rupture of the aneurysm, the diameter of which was 8.35cm and 8.91cm, respectively. Endoaneurysmorrhaphy with stent was performed in 7 patients. Conclusion The size of AAA in the senile patients increased slowly if the aneurysm diameter is 6.0 cm, the tumor size might increase quickly, and active intervention is recommended.

Objective To investigate the relationships between of 2-dimensional (2D) and color Doppler ultrasonographic features and the expressions of both estrogen receptor (ER) and progesterone receptor (PR) in postmenopausal women with infiltrating ductal carcinoma (IDC) in breast, and to evaluate the feasibility of predicting the expressions of ER and PR in IDC by means of ultrasonographic features. Methods The clinical data of 96 patients with breast infiltrating ductal carcinoma diagnosed by pathology during Jun. 2002 to Jun. 2007 were retrospectively analyzed. The correlation between ultrasonographic features and both ER and PR expressions in the mastectomy specimens determined by immunohistochemical technique was statistically analyzed. Results Of the 96 cases, the positive expression rates of ER and PR were 54.17% and 50%, respectively, the bi-positive and bi-negative expression rates of ER and PR were 41.67% and 37.5%, respectively. Among the breast carcinoma, the positive expression rate of ER was higher in tumor with ultrasonographic spicule sign (P

Objective To study the epidemiological characteristics of measles in Fuyong Street in order to predict its occurrence and reduce its incidence by establishing preventive and control measures.Methods Epidemiological data in Fuyong Street between 2003 and 2007 were analyzed.Results The result showed that 393 measles cases were reported in the whole street during 2003 and 2007,329 were confirmed by laboratory,and 60 were local cases.The measles annual average incidence was 18.29/100 000.The high incidence period was from March to August and the most measles cases were young adults and infants.30.79% cases had no immunization history and 24.68% cases had immunization history.Conclusions The incidence of measles is kept at a high level.It will go on possibly for half a year or a year.A comprehensive control measures should be thaken to strengthen vaccination program especially for foreign people and to reinforce the surveillance and analysis of epidemic situation in order to avoid the outbreak of the disease.

To study the chemical constituents of K. oblongifolia, silica gel column chromatography, MCI and Sephadex LH-20 were used to separate the 70% acetone extract of the stems of K. oblongifolia. The structures of the isolated compounds have been established on the basis of physicochemical and NMR spectroscopic evidence as well as ESI-MS in some cases. Twenty compounds were obtained and identified as heteroclitalignan A (1), kadsulignan F (2), kadoblongifolin C (3), schizanrin F (4), heteroclitalignan C (5), kadsurarin (6), kadsulignan O (7), eburicol (8), meso-dihydroguaiaretic acid (9), kadsufolin A (10), tiegusanin M (11), heteroclitin B (12), (7'S)-parabenzlactone (13), angeloylbinankadsurin B (14), propinquain H (15), quercetin (16), kadsulignan P (17), schizanrin G (18), micrandilactone C (19) and (-)-shikimic acid (20). Compouds 1, 5, 8, 11-15, 18 and 20 were isolated from this plant for the first time. Toxicity of compounds 1-10 were evaluated with zebrafish model to observe the effect on its embryonic development and heart function. The results showed that compounds 7, 9 and 10 caused edema of zebrafish embryo and decreased the heart rate of zebrafish, which exhibited interference effect on heart development of zebrafish.

Objective To survey the cognitive attitude and participation intention for stakeholders of public hospitals,in order to provide basis for public hospitals social evaluation.Methods 621 stakeholders of public hospitals were subject to the questionnaire survey.Results 76.7%(475/619) stakeholders held it as necessary to independently launch the public hospitals social evaluation,and held that the evaluation subjects selection should be professional(83.8%),independent(67.7%),authoritative (55.6%),and proactive(46.1%).The survey also recommended that social evaluation of public hospitals should have such indexes as government investment (80.2%),social supervision (76.0%),and information disclosure system(7 1.1%).The overall willingness rate of stakeholders to participate in the public hospital social evaluation was 7 1.6%.Conclusions Development of the social evaluation index system of public hospitals and diversified evaluation subj ects are key to developing the theory and practice system of public hospitals social evaluation.

Aim To study the effect of rhein on renal damage induced by aristolochic acid. Methods Ze-brafish model of aristolochic acid nephropathy, genera-ted by treating zebrafish larvae with aristolochic acid for 24 h, was treated with rhein simultaneously . Mor-pholigical changes were observed and the creatinine level in larvae tissue was measured. And mRNA ex-pression levels of inflammatory factor cox2 a and fibrosis factor TGF-β1 in larvae tissue were detected using qPCR. Results Some larvae show periocular edema and circulation system defection e. g. weak heart beat, narrow cardiac vesicle, decreased blood flow and even blockage , with a dose-response relationship after expo-sure to aristolochic acid for 24 h. The creatinine level in larvae tissue of the treated group was significantly higher than that of the control larvae. And the expres-sion levels of cox2 a and TGF-β1 in larvae tissue of the treated group were also significantly increased. Per-centage of abnormal larvae and creatinine level in lar-vae tissue were decreased when treated with rhein sim-ultaneously. And the expression levels of cox2a was down-regulated by rhein compared with the aristolochic acid treated group. But rhein had no effect on TGF-β1 expression. Conclusion To some extent rhein can protect renal from damage induced by aristolochic acid.

Objective To review the clinical characteristics and risk factors of Pseudomonas aeruginosa bloodstream infections. Methods The clinical data of P. aeruginosa bloodstream infections in the First Affiliated Hospital of Soochow University from January 2007 to December 2016 were analyzed retrospectively. Results Of the 251 patients identified, APACHE Ⅱ score on admission was 11.5±5.2. Majority (98.4％, 247/251) of the patients had fever. Leukopenia was found in 125 patients, leukocytosis in 87 patients, neutropenia in 122 patients, agranulocytosis in 113 patients, anemia in 193 patients, and hypoalbuminemia in 120 patients. Overall, 219 patients had at least one underlying disease, primarily hematological malignancy, or malignant solid tumor. Most (229) patients received invasive procedures such as deep venous catheter, urinary catheter, mechanical ventilation before blood sampling. P. aeruginosa was isolated from 108 of the 173 deep venous catheters. In addition, 130 patients received radiation or chemotherapy. Immunosuppressive agents were used in 124 patients. Among the 251 strains of P. aeruginosa, 87.3％ were susceptible to amikacin, followed by ciprofloxacin (85.7％) and cefepime (81.6％). Multidrug-resistant P. aeruginosa was isolated from 36 (14.3％) patients, and extensively drug resistant strain was isolated from 7 patients. All the 251 patients were treated withantimicrobial agents, mainly β-lactam/β-lactamase inhibitor combinations, carbapenems or fluoroquinolones. Overall, 20 (8.0％) of the 251 patients died, 37 (14.7％) refused further therapy due to worsening condition, and 194 (77.3％) improved. Binary logistic regression analysis showed that high APACHE Ⅱ score on admission, anemia and hypoalbuminemia were risk factors for poor outcome of bloodstream infectionscaused by P. aeruginosa. Conclusions P. aeruginosa bloodstream infection occurs more readily in immunocompromised patients. High APACHE Ⅱ score on admission, anemia and hypoalbuminemia are associated with poor prognosis. Appropriate empiric antimicrobial treatment as early as possible can improve the prognosis of P. aeruginosa bloodstream infection.

Objective:To investigate the risk factors and predictive value of early neurological deterioration (END) in patients with minor stroke caused by middle cerebral artery occlusion.Methods:Consecutive patients with minor stroke caused by middle cerebral artery occlusion admitted to Zhangjiagang Hospital Affiliated to Soochow University from October 2021 to May 2023 were retrospectively included. Minor stroke was defined as the National Institutes of Health Stroke Scale (NIHSS) score ≤5 at admission, and END was defined as an increase of ≥4 from baseline in the NIHSS score within 24 h of admission (excluding intracranial hemorrhage). Multivariate logistic regression analysis was used to determine independent risk factors for END. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of various risk factors on END. Results:A total of 130 patients with minor stroke caused by middle cerebral artery occlusion were included, of which 33 (25.4%) had END and 97 (74.6%) did not. Univariate analysis showed that there were statistically significant differences in NIHSS scores, volume with cerebral blood flow <30%, CT perfusion mismatch volume, baseline blood glucose, and baseline white blood cell count between the END and non-END groups (all P<0.05). Multivariate logistic regression analysis showed that CT perfusion mismatch volume (odds ratio [ OR] 1.010, 95% confidence interval [ CI] 1.003-1.017; P=0.007) and baseline white blood cell count ( OR 1.582, 95% CI 1.200-2.085; P=0.001) were the independent risk factors for END. ROC curve analysis showed that the area under the curves of CT perfusion mismatch volume and baseline white blood cell count for predicting END were 0.748 (95% CI 0.660-0.835; P<0.001) and 0.757 (95% CI 0.659-0.854; P<0.001), respectively. The area under the curve of combined predicting END was 0.821 (95% CI 0.738-0.905; P<0.001). Conclusions:CT perfusion mismatch volume and baseline white blood cell count are independent risk factors for the occurrence of END patients with minor stroke caused by middle cerebral artery occlusion, and the combination of the two has good predictive value for END.

Objective:To search, evaluate and summarize the best research evidence of perioperative intestinal management in patients with cervical spinal cord injury, so as to provide evidence-based basis for clinical nursing practice.Methods:Literature on perioperative intestinal management of cervical spinal cord injury were systematically searched in databases, domestic and foreign relevant guidlines network and professional associations, such as UpToDate, Cochrane Library, PubMed, China National Knowledge Infrastructure, Wanfang Database, etc. The search period was from the establishment of the databases to October 1, 2023. The quality of the included literature was evaluated and the evidence was extracted and summarized.Results:Finally, 9 articles were included, including 2 guidelines, 2 expert consensuses, 1 randomized controlled trials, and 4 observational studies. Twenty-five pieces of evidence were summarized across six aspects: assessment, diet management, physical activity, physical therapy, drug therapy, prevention and management of intestinal complications.Conclusions:The best evidence of perioperative intestinal management in patients with cervical spinal cord injury summarized in this study can provide reference for clinical nursing practice.

his article reviews the research status of functional exercise in patients with catheterization by peripherally inserted central catheters (PICC). This study describes the functional exercise method, exercise start time, exercise frequency and duration, exercise intensity and intervention effect, and provides references for guiding health education, discharge guidance and nursing intervention for patients with catheterization.