Objective To study the effect of the toothpaste containing FE enzyme on oral care to for critically ill patients with stroke. Methods Sixty cases of critically ill stroke patients were randomly divided into the experiment group and the control group with 30 cases in each group.The toothpaste containing FE enzyme was used in experiment group for oral care,and the routine oral care was used in the control group.The two groups were compared in terms of the oral cleaning effect,dental plaque and costs for the oral care.Results The incidences of bad breath,oral uncleanness and oral infection were significantly lower than those of the control group(P<0.01 or P<0.05). The dental plaque index after oral care was significantly lower in the experiment group than that in the control group(P<0.001).The cost in the experiment group was significantly lower than that in the control group(P<0.01).Conclusion Oral care using toothpaste containing FE enzymecan not only achieve an effective oral cleaning purpose,but also reduce the cost of oral care.

Objective:To analyze the influence of clinicopathological features on the prognosis of anorectal malignant melanoma (AMM), and to establish a more accurate prognosis prediction model.Methods:From January 1, 2006 to December 31, 2018, at Fudan University Shanghai Cancer Center, the data of 89 patients diagnosed with AMM and underwent operation were retrospectively analyzed. The Cox proportional hazard regression model was used to analyze factors affecting the prognosis. Backward elimination was used to select variables, Nomogram prognosis prediction model was established and verified internally, and the consistency index was calculated.Results:Among 89 AMM patients, 65 (73.0%) were female, 78(87.6%) were <70 years old, and the most common tumor location was the rectum (48.3%, n=43), followed by the anal canal (31.5%, n=28) and the anorectal canal (20.2%, n=18). Thirty-eight (42.7%) patients directly received abdominal-perineal resection (APR), 37 patients (41.6%) received interferon-based immunotherapy, and 11 patients (12.4%) received both systemic chemotherapy and immunotherapy. The 3-year disease-specific survival (DSS) rate was 41.6%(37/89), and the 5-year DSS rate was 31.5%(28/89). The results of multivariate Cox analysis showed that age ≥70 years old and T2 stage were risk factors of the prognosis of AMM patients (hazard ratio ( HR)=11.29, 4.83; 95% confidence interval ( CI) 2.89 to 44.13, 1.66 to 14.11; both P<0.01), while neurovascular invasion, immunotherapy treatment, systemic chemotherapy combined with immunotherapy, APR after extensive local resection, directly APR and APR combined with inguinal lymphadenectomy were protective factors of the prognosis ( HR=0.09, 0.23, 0.10, 0.13, 0.26, 0.02; 95% CI 0.02 to 0.34, 0.10 to 0.57, 0.02 to 0.49, 0.03 to 0.52, 0.08 to 0.90, 0.00 to 0.27; all P<0.05). The Nomogram model was further established with age, gender, tumor location, T stage, distant metastasis, medication chemotherapy and surgical treatment. The results of the Nomogram model internal verification indicated that the accuracy of the model in predicting 1-year, 3-year and 5-year DSS was good, and the consistency index was 0.749, which was significantly higher than the consistency index of traditional TNM stage (0.607). Conclusions:Most AMM patients are <70 years old, and the majority of them are female. The common location of AMM is rectum, and many patients receive immunotherapy. Age ≥70 years old and T2 stage are risk factors affecting the prognosis of AMM patients. Neurovascalar invasion, immunotherapy based comprehensive treatment, APR after extensive local resection, directly APR and APR combined with inguinal lymphadenectomy are protective factors of the prognosis. Nomogram prognosis prediction model established based on the clinicopathological features and treatment of AMM patients has higher accuracy and clinical reference value than the traditional TNM stage system.

Objective To set up a method of three-dimensional breast volume measurement, to observe the effect of the artificial influencing factors on the final data, which are used for 3-D reconstruction of breast volume. Methods The CT data were used to reconstruct a digital prototype of the breast implant and the chest. The 3-D models were established firstly, and then the model was reasonablly cut to get single breast volume, breast implant volume, differences of the both sides of chest and breast volume. These methods were put up by the repeated test when the reference frame and the ranges were fixed. And the analysis of the artificial influencing factors was performed on 10 women whose breasts were unsym-metrical. The effects of the artificial influencing factors were analyzed by moving the coordinate axis, revolving the chest around the coordinate axis and changing the selected area. Results The repeatable test showed that the error was less than 4. 08 ml. The average volume differences between both sides of the breast before and after the given influencing factors were set, were 10. 339 ml and 7. 73 ml, as moved ± 4mm along the axis X; as revolving ±2° along the axis Z, that were 8. 654 ml and 7. 971 ml; as increasing or decreasing of the selected diameter of ± 4 mm, that were 6. 764 ml and 4. 267 ml, respectively. Conclusion Using the 3-D reconstruction technique for breast volume measurement is more simple, accurate and repeatable.

OBJECTIVE:To establish a method of determining the plasma concentration of capecitabine/polyethylene glycol 1000/montmorillonite (CAP/PEG1000/MMT) in rats’plasma for the study on pharmacokinetics of CAP compound in rats in vivo. METHODS:HPLC was adopted. The determination was performed on Kromasil C18 with mobile phase consisted of 0.1% glacial acetic acid-acetonitrile(73∶27),at the flow rate of 1.0 ml/min. The detection wavelength was 250 nm and column temperature was 40 ℃. The sample size was 10 μl. 18 Wistar rats were randomly divided into CAP group,CAP/MMT group(MMT as carrier)and CAP/PEG1000/MMT group(PEG1000/MMT as carrier)and ig given corresponding drugs,that equal to 200 mg/kg of CAP. Blood sample was respectively taken 15,30,60,90,120,180,240,300 and 360 min after the administration of drugs,and plasma was isolated and added with internal standard ferulic acid. The concentration of the drug in the plasma was determined by HPLC fol-lowing protein precipitation with methanol,based on which the pharmacokinetic parameters were calculated by 3p97 software. RE-SULTS:The linear range of CAP was 0.054 9-4.390 0 μg/ml (r=0.998 2) with the method recovery of 98.2%-102.1%(RSD=1.50%-3.29%, n=5) and absolute recovery of 76.2%-78.9%(RSD=2.29%-2.99%, n=5). In the above-mentioned three groups,t1/2 were(1.11±0.32),(1.57±0.32)and(1.62±0.10)h;cmax were(2.91±0.36),(0.91±0.23)and(0.91±0.14)μg/ml;AUC0-6 h were (8.70 ± 1.79),(3.76 ± 0.27) and (3.73 ± 0.25)μg·h/ml;and tmax were (0.97 ± 0.20),(1.55 ± 0.47) and (1.50 ± 0.07) h,respectively. There was no significant difference in the pharmacokinetic parameters between the CAP/MMT group and CAP/PEG1000/MMT group(P>0.05). CONCLUSIONS:The method is reliable and simple,and can be used for pharmacokinetic study of CAP/PEG1000/MMT in rats. MMT and PEG1000/MMT compound can prolong CAP acting time in the body.

Objective To explore the pathological and imaging characteristics of focal nodular hyperplasia(FNH) of liver.Methods 17 cases of FNH proven pathologically underwent triphase spiral CT scan,of them,10 cases underwent fast MR imaging.The pathological andimaging features were comparatively analysed.Results All lesions were a solitary globular or lobulated mass,the majority of cases wasapproximately 2~5 cm in diameter.On plain CT and MRI,FNH was classically seen as a solitary,homogeneous and slightly hypoattenuating or isoattenuating area in comparison with normal liver,slightly hyper-or isointense on T_2WI,intense homogeneous enhancement during the arterial phase of enhanced imaging,and hyperattenuating in 12 cases,hypoattenuating or isoattenuating in 6 cases in comparison with normal liver during venous and delayed phase.The central scar was showed in 11 cases during delayed phase and 8 cases showed delayed enhancement,4 cases had pseudocapsular like enhancement in delayed images.In histology,17 cases of FNH were well limited but nonencapsulated,the hyperplastic parenchyma of the liver was subdivided into small nodules surrounded by the fibrous septa,there was a central scar composedof fibrous connective tissue and malformed vessels of various caliber.Conclusion The typical FNH can be easily diagnosed,while theatypical cases should be differentiated from hepatocelluar adenoma,hepatocellular carcinoma and hemangiomas.

Objective:To investigate the ethical practices in individual supervision of counseling in China.Method:Forty-one graduate students and 38 participants of the China American Psychoanalytic Alliance (CAPA) were included in this study.The Ethical Practices in Supervision Scale (EPSS) was used for the investigation.The scale included two parts.The first part was to investigate supervisors'ethical practices,and the second part focused on supervisees'impact from unethical supervisors.Results:The findings showed that 7 out of 28 items in the scale were significantly different between two groups.CAPA participants' supervisors performed better than graduate students' supervisors (P ＜ 0.05) in supervision scheduling,ethics discussion,and counselor/therapist role.Graduate students' supervisors performed better than CAPA participants' supervisors (P ＜ 0.05) in live supervision,audio/video review,informing clients of supervisee's status as trainee,and supervision contract.If individuals experience their supervisors being unethical or unprofessional,more than 55 percent of the individuals responded to negatively affect their thoughts toward their supervisor and the supervisory alliance,and almost 50 percent of the individuals responded to negatively impact their emotion and quality of their counseling for clients.Conclusion:Both graduate students and CAPA participants respond that their supervisors perform well in both monitoring supervisees' performance and maintaining appropriate boundaries.However,both of them should work more on reviewing video or audiotapes of supervisees' sessions regularly.

Objective To explore the distribution and antimicrobial resistance of pathogens causing healthcare-associated infection(HAI) in a hospital,and provide theoretical basis for rational use of antimicrobial agents and control of HAL Methods HAI occurred in patients in this hospital between 2011 and 2015 were chosen,distribution of major pathogens causing HAI and antimicrobial resistance were analyzed.Results A total of 852 pathogenic strains were isolated,including 458 (53.75 ％) strains of gram-negative bacteria,259 (30.40 ％) fungi,and 135 (15.85 ％) gram-positive bacteria,the top 4 pathogens were Klebsiella pneumoniae (n =159,18.66 ％),Candida albicans (n =119,13.97％),Acinetobacter baumannii (n =81,9.51％),and Escherichia coli (n =74,8.69 ％).Isolation rate of gram-negative bacteria increased from 47.41 ％ in 2012 to 61.57％ in 2015,fungi increased from 24.78％ in 2011 to 34.45％ in 2014 (2015 was 27.95％),gram-positive bacteria decreased from 26.55％ in 2011 to 10.48％ in 2015.Resistance rates of Escherichia coli and Klebsiella pneumoniae to imipenem and meropenem were 8.11％-12.58％;Acinetobacter baumannii had the lowest resistance rate to cefoperazone/sulbactam(23.46％),resistance rate of Candida albicans to fluconazole was up to 59.66％,vancomycin-resistant gram-positive bacteria was not found.Conclusion The major pathogens causing HAI are opportunistic pathogens,antimicrobial resistance is serious,the species and distribution varies with different years,it is necessary to enhance specimen detection rate,strengthen the monitoring on pathogen resistance,and use antimicrobial agents rationally.

Objective To detect and analyse the levels of nitrite in marketed milk powder.Methods 6 brands of maketed milk powder were selected in this study.Interferents,such as protein,were removed from milk powder preliminarily by using potassium ferrocynide and zinc acetate.The levels of nitrite were detected by using fluorospectrophotometry method,and compared with na-tional standard(2 mg/kg).Results The levels of nitrite in the 6 brands of maketed milk powder were lower than the national stand-ard limit,had statistically significant differences(P <0.05).Conclusion The levels of nitrite of 6 brands of milk powders do not ex-ceed the national standard.

Objective To explore prevention of cyclosporine A (CsA) combined with Cobalt protoporphyrin (CoPP) against murine graft versus-host disease (GVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods C57BL/6 (H-2Kb) mice were used as donors and BALB/c (H-2Kd) mice as recipients,which were randomly divided into 4 groups.The mice in total body irradiation group (TBI group) were lethally irradiated and injected intravenously with PBS; The mice in Allo-HSCT group (BS group) were lethally irradiated and injected intravenously with bone marrow cells and spleen cells; The mice in CsA intervention group (CsA group) were injected with CsA intraperitoneally after allo-HSCT; The mice in CsA combine with CoPP intervention group (combination group) received both CsA and CoPP intraperitoneally after alloHSCT.Recipients were monitored for condition,survival rate and weight.The liver,small intestine and skin in the recipients were gained and pathological changes of GVHD were assessed.The kidney was stained with Masson staining dye to observe the tissue fibrosis.The expression levels of renal HO-1 mRNA in the recipients were detected.Results In contrast to BS and CsA groups,GVHD degree in combination group was mild,with less reduction and quick recovery of weight.On the day 30 after HSCT,survival rate in BS group was 36.8％,and that in combination group and CsA group was 69.6％ and 53.5％ respectively (P＜0.05).In comparison with BS and CsA groups,pathological changes in combination group were mild,cellular edema and degeneration degree of the liver,small intestine and skin were slight,and few necrosis and infiltrated inflammatory cells were observed.Tubulointerstitial fibrosis hardly occurred in combination group,but it occurred in CsA group abundantly.As compared with BS group,the expression levels of HO-1 mRNA was increased in combination group,while decreased in CsA group (P＜0.05).Conclusion CsA combined with CoPP enhanced the protective effect of CsA against GVHD,moreover,CoPP could alleviate the side effects of CsA,which might be related with up-regulation of the expression levels of HO-1.

AIM:To explore the association between single nucleotide polymorphism in exon 33 (E33SNP) of thyroglobulin gene and Graves ’ disease ( GD) relapse after antithyroid drug ( ATD) withdrawal .METHODS:The healthy controls (232 cases) and GD patients with discontinued treatment (243 cases) were selected.According to the time of re-lapse, the GD patients were divided into A, B and C subgroups.The A group contained 77 cases of relapse within 1 year, B group contained 86 cases of relapse 1~2 years after treatment and C group contained 80 cases without recurrence within 2 years.The genotypes of E33SNP were identified by RT-PCR.The genotype ratio of thyroglobulin between control group and observation group was comparatively analyzed , and the levels of thyroid-stimulating hormone ( TSH) , free triiodothyro-nine (FT3), free thyroxine (FT4) and thyrotropin receptor antibody (TRAb), ophthalmopathy and goiter size in A , B and C subgroups in different genotype GD patients were investigated .Moreover , cumulative efficiency for patients with different genotypes in the observation group after ATD treatment within 2 years were analyzed .RESULTS:The genotype of E33SNP between observation group and control group had no significant difference , but a significant difference between A , B and C subgroups was observed (P<0.05).The levels of TSH, FT3 and FT4, and goiter size of the patients with different geno-types had no significant difference , while the TRAb levels and ophthalmopathy presented a significant difference ( P <0.05).In addition, the cumulative efficiency within 2 years for GD patients with E33SNP T/T, E33SNP T/C and E33SNP C/C genotypes was 61.8%, 42.6% and 21.3%, respectively, all with significant differences (P<0.05).CONCLU-SION:The GD patients with E33SNP C/C genotype have significantly higher TRAb level and ophthalmopathy rate than those in the patients with E33SNP C/T and E33SNP C/C genotypes, and are more likely to relapse after ATD treatment . The GD patients with E33SNP T/T genotype show a lower recurrence rate .Therefore, combination treatment or other treat-ment modalities may be more reasonable for the GD patients with E 33SNP C/C genotype.