Objective To evaluate the impact of masticatory function on malnutrition and gastrointestinal symptoms in senile patients.Methods Dental status and denture quality in 120 senile patients were investigated with questionnaires,and thecorrelation of masticatory ability with nutritional status and gastrointestinal symptoms were evaluated.Results The nutritional status of elderly patients was correlated with the condition of the denture,but not correlated with the number of denture and chewing ability.Gastrointestinal disconffort had correlation with masticatory function,chewing problems,difficulty in chewing and food limit,but chewing function was highly correlated with taking gastrointestinal drugs.Conclusions The chewing ability and nutritional status is not relevant,but since elderly patients with weakened chewing ability avoid certain foods,thus gastrointestinal discomfort and symptoms of gastrointestinal disorders such as medication increased.

TWO average expense control(TAEC) is the method that the hospital want to control the increasing breadth of medicine expense by limiting the total expense which include both clinic expense and hospitalize expense.TAEC will fake great help to improve the relationship of docfor and patient and to promote the hospital work.But the method of TAEC will also to be optimize further.

Objective To establish an evaluation system about animals infected with hantavirus,an observation of the BALB/c mice infected with hantavirus was made.Methods BALB/c mice were infected with hantavirus by intramuscular injection with stock solution.The specific antigen from BALB/c mice tissues after 3 days was detected with enzyme-linked immunosorbent assay (ELISA) and viral RNA with real-time polymerase chain reaction (RT-PCR).Results Within a short term,the specific antigen and viral RNA were detected from the brain and liver at day 3 after infection,but not be detected from the heart,spleen,lung,and kidney samples.Conclusions The results provided ones with some information on animals infected with hantavirus.

Objective It is necessary for nursing staff members to assign priorities in health education to hospitalized patients to ensure curative effect .The purose of the study was to explore the effect of process management application in health education path -way to patients with rheumatoid arthritis ( RA) . Methods A total of 70 patients with rheumatoid arthritis were randomly divided into observation group and control group , 35 patients in each group .Traditional health education was done in control group , while health education pathway was performed in observation in observation group according to process management .A study of patients′satisfaction with hospitalization , compliance of medication and knowledge of health education was undertaken . Results Observation group had priority to control group in satisfaction with hospitalization and medication compliance (77.1% vs 42.9%,P <0.05; 80.0% vs 57.1%,P<0.05).As to knowledge of health education , observation group was prior to control group in dietary restrictions , functional training methods and return visit conditions (71.4% vs 40.0%;37.1% vs 14.3%;45.7% vs 17.1%).Howerver, no significant difference was found in congintion of drugs among the two groups (P>0.05). Conclusion Compared with traditional health educa-tion, the process management application of RA health education pathway helps to improve patients ′health konwledge and medical compliance , which is an effective adjuvant treatment .

Objective To analyse the routes and MRI characteristics of disseminated intracranial gliomas after operation. Methods 10 patients of intracranial gliomas confirmed by pathology and intracranial dissemination after operation underwent MRI examina-tions including T_1 WI, FSE T_2 WI, FLAIR and fat-suppressed T_1 WI after intravenous injection of Gd-DTPA. In addition, 4 cases were also examinated with DWI, 1 case with SWI and DTI. Results In 10 cases,there were glioblastoma in 7 cases,grade Ⅱ astro-cytoma in 2 and grade Ⅲ astrocytoma in one. The disseminated tumors were found by MRI in 4 to 56 months after operation. The le-sions in all patients were confirmed with the comparison of contrast-enhanced MRI positive signs between preoperation and post-operation. Plain MR scanning showed line-like thicking with isointensity in 1/7 case/time (C/T)and multiple noduli in 5/7 (C/T) on T_1 WI respectively;shallowed cortical sulci and cistern in 2/7(C/T) and nodular in 5/7(C/T) on T_2 WI;shaUowed cortical aulci and cistern in 2/7 (C/T) and nodular in 6/7(C/T) on FLAIR. The signal intensity of noduli of disseminated tumors in 7 cases were in complete consistency with that of primary neoplasm , however, in 3 cases, it was inconsistent. Enhanced scanning showed 7 ca-ses with the signs of line-like thicking, 7 cases with noduli , 6 cases with :cast-like shape" sign and 6 cases with different extent of hydrocephalus. Conclusion Enhanced MRI can be used as a most useful and reliable monitoring tools for detecting dissemination of brain glioma.

Objective To investigate the adjuvant effect of dimo-thylidioctyl ammonium bromide (DDA) and/or DDA-BCG polysaccharide nucleic acid( BCG-PSN), which was combined with a Mycobacterium tuberculosis fusion protein AMM ( Ag 8 5 B - MPT64190-198 - Mtb8.4 ) to boost BCG primed immunization. Methods DDA with or without BCG PSN was mixed with the fusion protein AMM to construct the boosting vaccine. Mice were immunized with BCG and then boosted twice with AMM formulated with the adjuvant DDA with or without BCG-PSN. PBS or BCG vaccination without boosting was used as control. The humoral and cell-mediated immune responses were analyzed by ELISA and ELISPOT. Moreover, the protective efficacy of BCG prime-AMM subunit vaccine boosting against Mycobacterium tuberculosis infection was analyzed. Results With in vitro stimulation of Ag85B and PPD( purified protein derivative) antigen, the number of IFN-γ secreting cells from the mice boosted twice by AMM/DDA/BCG-PSN and AMM/DDA were higher than BCG and PBS group (P <0.05). The CFU in lungs of mice boosted with AMM/DDA/BCG-PSN was less than that of PBS group(P <0.05), while the CFU of AMM/DDA-boosted mice was less than that of BCG and PBS group(P < 0.05).However, fewer lesions were seen in lungs of mice immunized with BCG alone or BCG-prime-AMM/DDA/BCG-PSN boosting than the other groups. Conclusion DDA is an idea adjuvant for tuberculosis subunit vaccine;BCG-PSN might play a role in alleviating the immunity-mediated pathology.

Objective To investigate the safety and clinical efficacy of uterime artery chemoembolization in postpartum hemorrhage (PPH) caused by abnormal placental implantation.Methods Between December 2006 and September 2009, there were 23 cases of abnormal placental implantation with PPH in our hospital, among which 9 presented with continuous small amount of vaginal bleeding and 14 with acute excessive bleeding.The average bleeding time was (8±6) d and the mean blood loss was (980±660) ml.Abnormal placental implantation was confirmed by color Doppler ultrasound (CD-US) in all cases, the internal lilac artery angiography was performed to identify the uterine artery and bilateral uterine artery chemoembolization (UACE) with methotrexate (MTX) and gelfoam particles to the distal end of uterine artery was conducted after.CD-US rechecked all patients within 48 h after UACE and those patients with blurred margins between placenta and uterus and abnormal blood flow (> 1 cm×1 cm) received ultrasonic-guided per vagina MTX multipoint injections.All cases were followed up for 3-26 months (average 12 months) to observe vaginal bleeding, placenta tissue discharge, serum human chorionic gonadotropin (hCG), uterine involution, menses, and side-effects or complications.Results (1) Curative effect: These 23 cases underwent 24 procedures of UACE successfully and vaginal bleeding ceased at an average of (3.5±1.3) min after UACE.Reduced blood flow in the placental implantation area was detected under CD-US after UACE.Among the 23 patients, wterine curettage was required in 16 cases due to retained placenta tissues with the mean blood loss of (40 ± 28) ml during the operation, 2 underwent subtotal hysterectomy and confirmed to be placenta percreta by pathology examination, and placenta tissues were spontaneously discharged completely in 5 cases.Totally, 91% of the patients (21/23) reserved their uterus.(2) Follow-up: the serum hCG reduced to normal within 1-13 d after the placenta tissue were evacuated.Regular menstruation returned within 2-3 months in those patients who reserved uterus and normal size uterus was found under sonography at 3 months.No severe complication was reported except for some post embolization syndrome, such as pelvic pain or fever.Conclusions UACE, combined with ultrasonic-guided transvaginal MTX injection, is a safe, minimal invasive and quick hemostatic procedure in treatment of abnormal placental implantation with PPH, and allows the preservation of uterus possible.CD-US is helpful in evaluation of the blood flow changes before and after UACE in abnormal placental implantation patients.

Objective To study the effects of rehabilitation training on learning and memory ability and the expression of growth-associated protein-43(GAP-43)in rats with vascular dementia.Methods Forty-four female Sprague-Dawley rats were randomly assigned to a rehabilitation group(n=20),an immobilization group(n=20),and a sham-operation group(n=4).The rats in the former 2 groups were operated on to establish the experimental vascular dementia model by repeatedly ischemia/reperfusion injury of brain induced by ligation of bilateral common carotid arteries and lowering of blood pressure induced by intraabdominal injection of sodium nitroprusside.The rats in rehabilitation group were administered with rotating bar and rolling cage exercises for 1 hour once daily,while those in the immobilization group were immobilized and without any exercise:the rats in sham-operation group could move freely in cage.Learning and memory tests were preformed by using step-down avoidance test at the 27th and 28th days after operation.Immunohistochemical staining was used to detect GAP-43 expression in hippocampus CA1 area at different time points after operation. Results The rats in rehabilitation group demonstrated better learning and memory ability than those in immobilization group(P<0.01),and more GAP-43 expression in hippocampus CA1 ar-ea than those in immobilization group and sham-operation(P<0.01).Conclusion Rehabilitation training can im-prove the learning and memory ability of rats with experimental vascular dementia,and the mechanism is probably re-lated to the increase of GAP-43 in hippocampus CA1 area.

Objective To investigate the effect of rehabilitation training on learning and memory ability and the expression of neural cell adhesion molecule(NCAM)in rats modeling vascular dementia.Methods Foay-five female Sprague-Dawley rats were randomly assigned to a rehabilitation group(20 rats),an immobilization group(20 rats),or a sham-operation group(5 rats).The experimental vascular dementia model was established by repeatedly clipping the common carotid artery to induce repetitive isehemia-reperfusion,and by reducing blood pressure with intra-abdominal injection of sodium nitroprusside.The rats' learning and memory were tested on the 27th and 28th days after the operation using a water-maze step-down avoidance test.A RT-PCR technique was used to detect NCAM expression around the hippocampal area at different times after the operation.Results The rehabilitation group rats showed significantly better learning and memory ability than those in the immobilization group.NCAM was also more strongly expressed in their hippocampi than in those of the immobilization group and sham-operation group.Conclusion Rehabilitation can accelerate recovery of learning and memory ability in rats,and the mechanism possibly is related to the increase of NCAM expression in the hippocampus.

Objective To investigate the mechanism of recurrent laryngeal nerve injury during total thyroidectomy.Methods The clinical data of 36 patients suffering from recurrent laryngeal nerve injury in total thyroidectomy from 2003 to 2014 was analyzed retrospectively.Results 21 cases had temporary recurrent laryngeal nerve injury while 16 cases had permanent injury.The cases of injury included giant thyroid goitre,with variation of recurrent laryngeal nerve,undergoing secondary surgery,with tumor invasion and complicating thyroiditis.During the first surgery,the incidence of temporary recurrent laryngeal nerve injury was 0.43％,and the incidence of permanent damage was 0.27％.The temporary and permanent injury incidence of secondary surgery after initial subtotal thyroidectomy was 4.59％ and 4.59％,respectively.For patients with grade 3 thyroid gland,that was 1.81％ and 0.30％,respectively and 0.51％,0.72％ respectively in malignant cases.In cases complicating thyroiditis temporary recurrent laryngeal nerve injury occurred in 1.01％.Conclusions There is increased risk of recurrent laryngeal nerve injury in giant goiter cases undergoing secondary operations.Hence it is suggested that initial surgical procedure be hemithyroidectomy or total thyroidectomy