Venous thromboembolism is a serious complication of the patients undergoing orthopaedic surgery.Effective diagno-sis and assessment are important methods to predict venous thromboembolismand decrease the incidence of venous thromboenbolism . This paper summaries the advantages and disadvantages of subjective and objective assessment tools to help doctors and nurses find the patients with high risk in the early stage,take individual prevention,and decrease the incidence of venous thromboembolism.

Objective To explore advantages of laparoscopic sphincter preserving surgery for ultra low rectal cancer . Methods From April 2006 to January 2015, we performed laparoscopic sphincter preserving surgery in 108 cases of ultra-low rectal cancer.After laparoscopic mesorectal resection and lymph node dissection were completed , transection of the rectum was performed with the Endo-GIA at 2 cm from the lower margin of the tumor .The right lower abdomen main operation port was expanded to remove the lesion and introduce the stapler base .The proximal colon was returned and the pneumoperitoneum was re-established .A colorectal end-to-end anastomosis was conducted through the anus by using a carliber 29 circular stapler . Results Laparoscopic operation was successfully accomplished in all the 108 cases.No conversion to open surgery was required .No operative mortality was encountered . The operation time was 68 -145 min ( mean, 104 min ) , the intraoperative blood loss was 10 -100 ml ( mean, 40 ml ) , the postoperative flatus time was 1-3.5 d (mean, 2.3 d), and the number of removed lymph nodes was 8-37 (mean, 12.5).There were 98 patients followed up for 6-62 months (mean, 24.6 months).No tumor metastasis or recurrence was found . Conclusion Laparoscopic total mesorectal excision of ultra low sphincter preserving operation is feasible .

Objective To examine the status of and factors influencing medical students' mental health.Methods The China undergraduates' mental health scale and an information questionnaire developed by the authors were administered on 1 205 students selected from Grade 1-3 in chnical medicine,anesthesia,and medical diagnostic programs using cluster sampling.Results The level of medical students' somatization,a~nxiety,depression,social withdrawal,irritabihty,and obsession was higher as compared to the norms for general undergraduates in China.Female medical students showed higher scores than males on 4 aspects:somatization,anxiety,depression,and obsession.Additionally,those belonging to minority nationalities showed higher scores on social withdrawal,irritability,and impulse as compared to those with the Han nationality.Further,students with low professional identity had higher scores on somatization,anxiety,depression,inferiority,irritability,and social withdrawal as compared to those with high professional identity.Conclusion Medical students' mental health is not optimal;therefore,it needs to be addressed by educational departments and educational works.Thus,mental health education,professional counseling,and appropriate interventions need to be conducted for medical students.

Objective Early identification of deep vein thrombosis(DVT) risk in patients with joint arthroplasty helps to reduce the incidence of DVT.The study aimed to investigate the effectiveness of Autar risk assessment model in assessing DVT risk in patients with joint arthroplasty.Methods 72 patients with DVT from 10 hospitals from November 2014 to February 2016 were selected as the case group, and 144 non-DVP patients who hospitalized during the same period served as the control group.The medical history, laboratory tests and other related clinical data of the patients were collected, and Autar risk assessment scale was used to evaluate the patients.Multiple logistic regression was applied to analyze the relationship between the risk scale of DVT and the risk of DVT formation.Results 216 patients were included in the research.The Autar score of DVT patients (17.09±2.83) in case group was higher than that of control group (14.25±2.46) and the difference is of statistical significance(P<0.05).The area under the ROC curve of Autar scale in case group was 0.789 (95％CI: 0.719, 0.858,P<0.05).When the ROC curve cutoff point was 15, the sensitivity and the specificity of Autar scale were 88.57％ and 57.90％ respectively.In Autar scale, the main risk factors of DVT incidence were age≥70 years old, BMI≥30, strict bed rest, varicose veins, lower limb injuries and orthopedic surgery.The result of logistic regression analysis showed the difference of Autar risk rating between these two groups was of statistical significance(P<0.05).In comparison with low risk group, the DVT risk of patients with joint arthroplasty at medium risk was of no significant difference (OR=1.178, 95％ CI: 0.733-1.490, P=0.053) while that of patients with joint arthroplasty at high risk was of significant difference (OR=5.536, 95％ CI:3.577-7.132, P<0.001).Conclusion Autar DVT risk assessment scale assessed patients with joint arthroplasty at high risk are high risk group of DVT.The risk of DVT increases with the risk rating in patients with joint arthroplasty.Therefore, Autar risk assessment scale can be applied in the assessment of DVT risk in patients with joint arthroplasty.

Objective To find out the changes of voice in different noisy background by computer acoustic analysis.Methods 25 young people with normal hearing and normal vocal cords were selected.Sustained /a/ and /i/ were recorded in three different background:quiet, white band noise and speech noise. The software of Multi Speech and Doctor Speech were used. Testing parameters included: Fo, mean amplitudes, standard deviations of amplitudes,F 1, F 2.Results Fundamental frequencies of noisy groups were significantly higher in male-/a/, female-/a/ and female-/i/.F 1 of noisy groups were significantly higher in male-/a/, male-/i/ and female-/i/.Conclusion Fo and F 1 of normal people can be changed by noise of backgroud.

ObjectiveTo evaluate the reliability and validity of Chinese version of Postoperative Pain Assessment Nursing Practice Questionnaire (PPA-NPQ).MethodsA forward-backward translation procedure was followed to develop the Chinese version of PPA-NPQ.A total of 258 surgical nurses were investigated by the revised Chinese version dimensions of PPA-NPQ,then the results were tested on reliability and validity by SPSS17.0.ResultsThe cronbach's α of the Chinese version of PPA-NPQ was 0.889.The split- half coefficient and testretest reliability of PPA-NPQ were 0.729,0.875 respectively ; the Cronbach's a,split- half coefficient and test-retest reliability of each sub-scale were ranged from 0.820-0.857,0.797-0.862,0.846-0.902 respectively.The correlation between each sub-scale and total scale were ranged from 0.704-0.818 (P ＜ 0.01 ).ConclusionThe revised Chinese PPA-NPQ is reliable and valid,and can be used to test the level of postoperative pain assessment practice by surgical nurse.

Objective To find the frequencies of FcγRIIIA polymorphisms in Chinese people and the potential role of these polymorphisms(SNPs) in systemic lupus erythermatosus(SLE) and lupus nephritis(LN).Methods The investigation covers 324 unrelated Chinese SLE patients and 319 controls.FcγRIIIA F158V polymorphism was genotyped by specific primer-polymerase chain reaction(PCR).Results The frequency of F allele of FcγRIIIA polymorphism is 60.8% in Chinese people.FcγRIIIA polymorphism revealed a significant difference of both genotype and allele distribution in SLE patients and controls.LN patients have a significant increase in carrier frequency of the FF genotype, while the VV genotype reveals a significant decreased risk of early onset of LN.ConclusionsFcγRIIIA polymorphisms is potentially related with SLE in Chinese people.The homozygous FF genotype of FcγRIIIA might be the risk factor for LN, while the homozygous VV genotype might be the protective factor for late onset lupus nephritis.

Objective To evaluate the status of the morbidity of serum lipids in Beijing through the detection of serum lipids in health checking adults.Methods The serum total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C)and triglyceride (TG)were detected by chemistry test in 13 336 adults,and age-adjusted prevalence of dyslipidemia and its distribution in different sexes and age groups were statistically analyzed.Results The prevalence of total dyslipidemia is 59.9%,71.6 % in male and 47.2% in female.The prevalence of the four components of serum lipids raised with age in both sex(P

BACKGROUND:Compliance of mechanical device reduced in the prevention of deep venous thrombosis.
OBJECTIVE:To evaluate the compliance on mechanical prevention measures in the prevention of deep venous thrombosis, and to analyze the reason for compliance reduction.
METHODS:We searched Cochrane Library, PubMed, Embase, and Medline for articles on compliance of inpatients on mechanical device for prevention of deep vein thrombosis published from inception to December 2015. At the same time, the“snowbal”method was used to screen the references. After the literatures were screened, using the Newcastle Ottawa Scale tools and Agency for Healthcare Research and Quality standard, two researchers evaluated the quality of the literatures independently and strictly. Data were extracted if meet the discharge standard. The software of Meta-analyst Beta3.13 was used for heterogeneity analysis and publication bias test in the extracted data. According to the heterogeneity analysis results and literature types, a reasonable statistical analysis method was selected to col ate, summarize and discuss.
RESULTS AND CONCLUSION:Final y, 12 papers were included, 9 of which were cross-sectional studies, 2 cohort studies, and 1 case-control study. The odds ratio about compliance rate of inpatients with mechanical devices was 53.2%(95%CI:38.7-67.2). Subgroup analysis showed that the odds ratio about compliance rate of pneumatic compression devices was 54.9%(95%CI:34.9-73.4). The odds ratio about compliance rate on elastic stockings was 47.9%(95%CI:34.3-61.8). The detection of mechanical device of surgical patients showed that odds ratio about compliance rate was 66.8%(95%CI:47.4-81.7). Our results confirm that the compliance rate of the use of mechanical devices for the prevention of deep venous thrombosis in clinical inpatients requests to be improved. The reason for reduced compliance rate should be further investigated to improve the compliance rate.