Objective To get the information about the infection condition of blood in voluntary donors in Fuling District from 2001 to 2007, so as to take measures to improve blood quality and ensure blood safety.Methods Serum ALT was detected with Reitman-Frankel assay, and HBsAg, anti-HCV, anti-HIV and anti-TP were detected with ELISA.Results A total of 72 868 serum samples from blood donors were detected, in which 5 512 (7.56%) were positive. The positive rates of HBsAg, anti-HCV, anti-HIV and anti-TP were 3.09%, 0.48%, 0.07% and 1.27% respectively, and the abnormality rate of ALT was 2.73%. There was statistical difference of positive rate among various years (from 2001 to 2007).Conclusion The positive rate of blood in voluntary donors decreases year by year. HBsAg was the highest (1.16%), followed by ALT (2.73%), anti-TP (1.27%), anti-HCV and anti-HIV. It suggests that blood quality monitoring should be strengthed to assure blood safety.

Thirty assistant general practitioners (GPs) of Jiading District Shanghai were trained for clinical skills and communication skills by using standardized patients (SP) in outpatient department from January to April 2014.The scores of clinical skills and communication skills were evaluated and compared before and two months after training.The results showed that the score of clinical skills [(72 ± 5) vs (56 ± 7), t=7.871, P＜0.05] and communication skills [(71 ±4) vs (45 ±5), t =9.573, P＜0.05] were significantly improved after training.After training, the scores of medical history taking [(36 ±5) vs (28 ± 6), t =4.352], clinical thinking [(17 ± 2) vs (14 ± 3), t =3.974], health education [(3 ± 1) vs (2 ± 1), t =3.090] and medical record v,riting [(13 ± 1) vs (8 ±2), t =5.317] were significantly higher than those before training (all P ＜ 0.05).But there was no difference in reception time management [(4 ± 0) vs (4 ± 0), t =1.025] before and after training (P ＞ 0.05).After training, the scores and the proportions of the trainees qualified for building physician-patient relationship [(20 ± 3) vs (15 ± 4), t =4.056],collecting information and providing feedback [(22 ±4) vs (13 ±3), t =4.682], understanding complaints from patients' perspective [(5 ± 2) vs (3 ± 2), t =3.107], sharing information and obtaining informed consent [(19 ± 4) vs (11 ± 5), t =4.322] and closing consultation [(6 ± 2) vs (3 ± 1), t =2.987] were higher than before training (all P ＜ 0.05).The results indicate that training by using SP can effectively improve the clinical skills and communication skills of assistant GPs.

Objective: To establish the method for determining matrine in Sophora subprostrala Chun et T.Chen. by HPLC. Methods: A CLC-phenyl column was selected as separation column at 30 ?C . Matrine was isocratically eluted by methanol-water-triethylamine (50∶50∶0.05,v/v) at flow rate of 1.0ml?min -1 . The peak of matrine was monitored at UV 219nm. Results: The detection limit was 2ng?ml -1 . The recovery of the added sample was above 95%. RSD of intra-day and inter-day was less than 2% and 4%, respectively. The linear range was 1.0～1000?g?ml -1 . Conclusion: The method was simple, rapid and producible.

OBJECTIVETo observe the clinical efficacy and safety of sildenafil in the treatment of high altitude heart disease associated with severe pulmonary arterial hypertension (PAH) in children.

METHODSFifty children (aged 2 months to 2 years) with high altitude heart disease associated with severe PAH, who were continuously transferred to the Intensive Care Unit between January 2011 and October 2013, were randomly assigned to observation and control groups. The control group was given conventional treatment, while the observation group received oral sildenafil [1 mg/(kg . d)] three times daily for 7-10 days in addition to the conventional treatment. Before and after treatment, hemodynamics, blood gas, routine blood parameters, and blood biochemical parameters were recorded.

RESULTSAfter treatment, the observation group had a significantly higher decrease in mean pulmonary artery pressure and significantly higher increases in arterial partial pressure of oxygen, cardiac output, cardiac index, and oxygenation index compared with the control group (P<0.05). In the observation group, there were no significant changes in mean arterial pressure, routine blood parameters and blood biochemical parameters (P>0.05), and no obvious adverse reactions were found.

CONCLUSIONSFor children with high altitude heart disease associated with severe PAH, sildenafil can effectively reduce pulmonary artery pressure and improve cardiac function and does not cause adverse reactions. This therapy has good safety according to the preliminary evaluation.

Altitude ; Familial Primary Pulmonary Hypertension ; Female ; Heart Diseases ; drug therapy ; Humans ; Hypertension, Pulmonary ; complications ; physiopathology ; Infant ; Male ; Piperazines ; adverse effects ; therapeutic use ; Purines ; adverse effects ; therapeutic use ; Sildenafil Citrate ; Sulfones ; adverse effects ; therapeutic use ; Vasodilator Agents ; adverse effects ; therapeutic use

Objective To explore changes of procedural memory in patients with primary insomnia(PI) and its characteristics.Methods Thirty-six PI patients and 36 controls were enrolled.The procedural memory was respectively detected with category exemplar generation and motor sequence tasks,and the declarative memory was assessed by free recall task.Results Compared with the controls,PI patients showed few correct numbers in the category exemplar generation (7.0 (6.0,8.8) vs 9.0 (9.0,11.0),Z=5.537,P＜0.01) and motor sequence task (8.0±3.3 vs 11.5 (8.6,13.8),Z=4.152,P＜ 0.01)and the phases of immediate recall (3.0 (2.3,4.0) vs 6.0 (5.0,7.0),Z =6.479,P ＜ 0.01),delayed recall (9.0 ± 2.2 vs 11.0 (10.0,12.0),Z =4.747,P ＜ 0.01) and delayed recognition (15.0 (13.0,15.0) vs 15.0 (15.0,15.0),Z=4.637,P＜0.01) of the free recall task.Furthermore,the early morning awakening group had significantly lower correct numbers in the motor sequence task,the delayed recall and recognition phases of the free recall task than the difficulty initiating and maintaining sleep groups.Conclusion The procedural and declarative memories are impaired in the PI patients,especially the early morning awakening insomniacs.

OBJECTIVE: To study the clinical and pathological features of pilomatricoma. METHOD: The authors retrospectively investigated the clinical and pathological materials of 399 patients with pilomatricoma. RESULT: Single lesion occurred in most patients (99%) and 56.39% of them were younger than 30 years. The male-female ratio was 1:1.33. The lesions which sizes average 1.22 cm were commonly emerged in the head, neck, and upper extremity. CONCLUSION Pilomatricoma is a slowly developed benign cutaneous tumour, but it can aggravate sometimes. It's manifestation is diversed and easily misdiagnosed. Early complete excision is recommended for hard or tenacious nodules on head, neck and upper extremity.
Adult ; Extremities ; Female ; Hair Diseases ; pathology ; surgery ; Head and Neck Neoplasms ; pathology ; surgery ; Humans ; Male ; Middle Aged ; Pilomatrixoma ; pathology ; surgery ; Retrospective Studies ; Skin Neoplasms ; pathology ; surgery ; Tumor Burden

Objective To evaluate the effectiveness of biofeedback for anxiety patients by carrying out a Meta-analysis.Methods We searched CNKI,VIP,CBM(1989 to 2013) to identify relevant randomized-control trials applying biofeedback for anxiety patients.We used Review Management (RevMan) 5.0 software (provided by the Cochrane collaboration) to conduct Meta-analysis.Results We included 11 studies.Meta-analysis for the biofeedback group vs.the control group showed that biofeedback was significantly superior to control (SMD=-3.00,95％CI:-4.40～-1.61); Meta-analysis for the biofeedback plus drug group vs.drug group showed that biofeedback plus drug was significantly superior to drug (SMD=-1.33,95％CI:-1.82～-0.85).Conclusions We found evidence that biofeedback (applying alone or combined with drugs) is effective in improving anxiety symptom.But all the studies had methodological limitations,our conclusion needs further studies with strict design,high quality and consistent assessment tools to be expounded and proven.

Objective To analyze the curative effect of traditional Chinese medicine(TCM)combined with early enteral nutrition(EN)for treatment of patients with severe acute pancreatitis(SAP). Methods 70 SAP patients were randomly divided into TCM plus EN group(36 cases)and conventional therapy group(34 cases). Both groups received routine treatment. Additionally,TCM+EN group received early EN and TCM decoction treatment〔the ingredients of decoction including radix bupleuri,radix paeoniae alba,radix scutellariae,fructus aurantii immaturus, magnolia bark,raw rhubarb(rhubarb was added at last during cooking the decoction)and natrii sulfas exsiccatus (dissolved in water to be administered)each 10 g,the decoction was concentrated to 150 mL and then administered via a stomach tube to the patient,afterwards the tube was clipped for 2.5-3 hours,twice a day,4-7 days constituting a therapeutic course〕. After treatment,the time for patients' symptoms improvement,the situation of intestinal recovery, the length of stay in hospital,the total medical cost,serum C-reactive protein(CRP),aspartate aminotransferase (AST), lactate dehydrogenase (LDH), amylase (AMY), acute physiology and chronic health evaluationⅡ(APACHEⅡ)score and complications,intensive care unit(ICU)transfer rate and case fatality rate in two groups were observed. Results The time for symptoms improvement of abdominal tenderness(day:1.68±1.01 vs. 3.89±1.07), abdominal distension(day:2.17±1.48 vs. 4.24±3.23),abdominal pain(day:3.12±1.14 vs. 4.94±3.21)and the intestinal recovery of exhaust defecation time(day:3.48±0.92 vs. 5.32±3.30)of SAP patients after treatment in the TCM+EN group were faster significantly than those in the conventional therapy group(all P<0.05). The length of stay in hospital(day:15.50±1.75 vs. 19.35±1.69)and total cost(wan yuan:1.812±0.424 vs. 3.292±1.081) of TCM+EN group were less than those of conventional therapy group(P<0.05 or P<0.01). After treatment,the levels of serum CRP,AST,LDH,AMY,APACHEⅡscore in TCM+EN group and conventional therapy group were all lower than those before treatment,and on day 10,the degree of descent was more prominent in TCM+EN group〔CRP(mg/L):98.972±43.384 vs. 122.392±71.621,AST(U/L):75.952±55.668 vs. 126.391±47.431, LDH (μmol?s-1?L-1):1.48±0.21 vs. 2.61±1.46,AMY(U/L):146.362±58.792 vs. 226.392±37.692,APACHE Ⅱscores:6.978±3.352 vs. 13.652±7.621,P<0.05 or P<0.01〕. There was no death in TCM+EN group,while in the conventional therapy group,there was 1 case dead. ICU transfer rate in TCM+EN group was less than that in the conventional therapy group(2.78% vs. 11.76%),but there was no statistical significant difference between the two groups(χ2=0.99,P>0.05). Among the 70 patients with SAP,the cause of the disease due to gallstone accounted for 55.72%,hyperlipidemia for 37.14%,alcoholic for 4.28%and other 2.86%. Conclusion The use of TCM combined with early EN for treatment of patients with SAP can enhance the curative effect of SAP,reduce the hospitalization time and the total cost of patients,and decrease complications and mortality,that is conducive to the faster recovery of patients.

Objective To investigate the localization,zone and activation intensity of olfactory center in young versus elderly healthy volunteers by functional magnetic resonance imaging (BOLD-fMRI),so as to elucidate the effect of age on olfactory center in healthy population.Methods Thirteen right-handed healthy adult volunteers were recruited and divided into two groups:young group (5 males and 3 females,mean aged 23 years) and elderly group (2 males and 3 females,mean aged 69.2 years).The olfactory stimulus was r-undecalactone,and it was given according to a block design.The fMRI detection was performed on Philips Achieva 3.0 T MR scanner,and data of BOLE-fMRI was processed and analyzed to get cerebration image by using SPM2.Results In groupaveraged maps,both young and elderly group showed significant olfactory activation in right parahippocampal gyrus,left hippocampal sulcus,right and left superior temporal gyrus,etc,subcortical activation in right thalamus,dorsal pons,and cerebellum activation in cerebellar vermis.Activations in right inferior frontal gyrus,right middle frontal gyrus,right medial occipito-temporal gyrus and right fimbria of hippocampus were observed only in young group,while activation in bilateral middle temporal gyrus was observed only in elderly group.Activation area was apparently smaller and activation degree was lower in elderly group than in young group.Activation intensity in right superior parietal lobule and bilateral superior temporal gyri was higher in male group than in female group (t=13.7,6.08,5.36,respectively,all P＜0.001).Conclusions The intensity of activation in olfactory center is lower in the elderly than in the young,and absence of part of the active regions is found in the elderly,which demonstrates the regression of olfactory center in the elderly.The olfactory center shows right-predominant activation,and olfactory activation intensity in some cortical regions is higher in males than in females.

This article summarized perioperative nursing experience of 6 patients underwent percutaneous microwave or radiofrequency ablation liver partition and portal vein embolization for planned hepatectomy(PALPP).The key points of nursing included:psychological counseling applied throughout the perioperative treatment;personalized preoperative biliary drainage;nursing intervention targeting at Enhanced Recovery After Surgery(ERAS);complication-directed prevention and nursing after microwave or radiofrequency ablation,portal vein embolization,and radical hepatectomy.All 6 patients were recovered and discharged successfully.