Objective To evaluate the prevalence of low back pain in Chinese nurses.Methods We searched PubMed,Springer,OVID,CNKI,Wanfang,and VIP databases for relevant studies.Pooled estimates were summarized by meta-analysis.Results The pooled low back pain prevalence for all studies was 72％(65％～79％).We also obtained the estimates according to different study characteristics,such as working department,seniority,study published year and study quality.Conclusions The incidence of low back pain of Chinese nurses is high.The problem is more serious among nurses working in ICU,the longer the working years,the higher incidence of low back pain.

Objective To evaluate the effectiveness of occupation-safety education for prevention of sharp object injury among Chinese student nurses.Methods We searched PubMed,Springer,OVID,CNKI,Wanfang,and VIP databases for studies comparing the effect of education versus non-education for nursing students to prevent sharp object injury.Results 13 eligible studies were included in this metaanalysis.The pooled data revealed that sharp object injury was statistically significantly reduced in the education group.Furthermore,a significant more proportion of students in the education group dealt with the injury correctly.Conclusions Occupation-safety education is effective for student nurses to prevent sharp object injury.

ObjectiveTo investigate the endoscopic and clinical characteristics of gastrointestinal Behcet's disease (BD). MethodsWe analyzed the clinical and follow-up data of 27 patients with gastrointestinal BD retrospectively.Results Most common locations involved were esophagus and ileocecum,74. 1％ (20/27) and 59. 3％ (16/27), respectively. The most common parenteral symptoms were oral ulcers (85.2％), genital ulcers (25.9％), ophthalmitis (7. 4％ ) and skin damage (7. 4％ ). The most common gastrointestinal symptom was chest pain (48. 1％, 13/27). Ulcer was the basic endoscopic feature,most of which were with uneven bottom and peripheral inflammatory response. There was no difference in endoscopic features between typical BD and atypical BD. Pathology showed typical small vasculitis (44. 4％,12/27). ConclusionClinical manifestations of intestinal BD vary. Symptoms are not necessarily consistent with the involved locations. A small number of patients with BD present with gastrointestinal symptoms as the first and only symptom, with serious complications in some patients. Physicians need to be fully aware of the disease.

Objective To investigate the relationship between the clinical onset of cerebral infarction in anterior cycle and properties of carotid atheromatous plaque.Methods A retrospective analysis was carried out on clinical data of 624 cases of cerebral infarction in anterior cycle from December 2010 to December 2013 in our hospital.The carotid artery plaque Crouse score,index,and intima-media thickness (IMT) were used to evaluate carotid atherosclerosis and plaque lesions.The National Institute of Health stroke scale (NIHSS) questionnaire was used to evaluate neural function defect.Results Compared to the non-lesion side,the lesion side carotid artery plaque Crouse score was decreased and IMT was increased (P ＜ 0.05) ; the lesion carotid artery plaque Crouse was lower,the higher NIHSS scores (r =-0.546,P =0.004) ; IMT score was higher,higher NIHSS score; carotid artery atheromatous plaque Crouse was negatively related to NIHSS score; IMT score was positively related to NIHSS score (r =0.672,P =0.003).Conclusions The clinical onset of cerebral infarction in anterior cycle was correlated with the carotid sclerosis degree.The Crouse score and IMT of the lesion have certain significance in predicting prognosis of cerebral infarction in anterior cycle.

Background Local medical treatment of refractory immunologic keratitis is unsuccessful,and systemic steroids and immunosuppressive agents could cause severe side-effects.Tacrolimus is a potent immunosuppressive drug,it has been proved that topical application of tacrolimus could reduce immunologic inflammation.The safety and efficacy of 0.05％ tacrolimus eye drops for refractory immunologic keratitis has not been described.Objective This study was to evaluate efficacy and safety of 0.05％ tacrolimus eye drops for refractory ulcerative keratitis.Methods A retrospective study was performed.Twenty-one eyes of 17 patients with refractory immunologic keratitis,which had uncontrolled inflammation despite initially treatment including topical steroids and 1％ cyclosporine A,were enrolled,including 11 males and 6 females,with the mean ages of 52 years.Infectious ulcer was excluded by laboratory tests.No systemic disease was found in 11 patients,and Wegener's granulomatosis,rheumatoid arthritis and ulcerative colitis were seen in 1 patient,4 patients and 1 patient respectively before presentation and they were all in remission under conventional systemic therapy.Four patients got binocularly involved and thirteen patients were monocularly involved.Of the 21 eyes,2 eyes with ulcer were ≥ 3 quarters of the limbus,and 19 eyes with ulcer were ≤ 2 quarters.All patients were treated with 0.05％ tacrolimus eyedrops after discontinuing cyclosporine A.The dosage was adjusted according to the severity of inflammation and was gradually tapered when improvement occurred.The corneal lesions were examined under the slit lamp microscope and Heidelberg HRT3 Rostock Cornea Module regularly,and inflammatory cell infiltrations were analyzed with Cell Count(R) software (Heidelberg Engineering GmbH).The safety variables were monitored regularly,including adverse response of eye,tacrolimus blood concentrations measured by chemiluminescent microparticle immunoassay (CMIA) and laboratory examinations of blood routine,blood glucose level,liver and kidney function.Results The patients were treated and followed-up for a mean duration of 18.1 months (range,8-24 months).Corneal ulcer area was obviously reduced 1 month after treatment in 19 eyes,and 2 eyes of 2 cases received anterior lamellar keratoplasty due to progressive corneal destruction despite of tacrolimus therapy.Corneal ulcer was cured 3 months after treatment,and stromal edema and infiltration disappeared 6 months after treatment under the slit lamp microscope.The inflammatory cell densities at lesion zone were (958±329),(858±339),(459±261),(192±124),(98±52),(44±24) and (3±2)/mm2 before treatment and 1 week,1 month as well as 3,6,12,24 months following treatment,respectively,showing a gradually decline as time lapse (F =125.439,P =0.000),and the inflammatory cells were significantly decreased in 1,3,6,12 and 24 months following the administration of 0.05％ tacrolimus eye drops in comparison with that before treatment (all at P =0.000).The therapy duration was 12 months in 9 eyes and 24 months in 12 eyes.Transient irritation sensation occurred in 4 eyes during the treating period.Blood concentrations of tacrolimus were below 1.0 ng/ml in all of the patients.No abnormality was found in laboratory tests.Conclusions The use of 0.05％ tacrolimus eye drops is a safe and effective approach to refractory immunologic keratitis.

Background Xenotransplantation is arousing more attention of researchers because of the lack of corneal donors.Biological corneal scaffolds constructed by porcine corneal acellular stroma appears to have an acceptable biocompatibility.However,its clinical effects and the histomorphological features in the corneal tissue of receipts' are still unclear.Objective This study was to evaluate the viability of bioengineered corneas as a new material of human lamellar keratoplasty and observe the in viva biological features after human keratoplasty under the laser confocal microscope.Methods A prospective serial cases observational study was carried out.Fifteen eyes of 15 patients with infectious keratitis were enrolled in Henan Eye Hospital from February to August 2014 under the approval of Ethic Committee of Henan Eye Hospital and informed consent of each patient, including 4 eyes of fungal keratitis,1 eye of bacterial keratitis, 9 eyes of mixed infectious keratitis and 1 eye of leucoma.Corneal lamellar transplantation was performed on the eyes with the bioengineered corneas as grafts and the follow-up time was one year.The survival of grafts was assessed and scored, and the indices including corneal transparency,neovascularization, graft lysis or inflammatory recurrence and visual acuity (logMAR) were evaluated.The morphology and density of corneal epithelial cells and endothelial cells, corneal stroma and subepithelial neural fibers were examined by laser confocal microscope 3,6,9 and 12 months after surgery.Results Postoperative inflammatory response was seen 3 days and disappeared 7 days after surgery.The grafts were clear 1 month after surgery, and no corneal dissolution was found during the follow-up duration.Glaucoma occurred in 1 eye at 6 months and graft rejection occurred in another eye 12 months after surgery.The logMAR, corneal transparency scores and corneal neovascularization scores improved after surgery in comparison with before surgery,with a significant difference among various time points (x2 =92.63,59.37,10.50 ,all at P＜0.05).Complete epithelization of grafts was seen.Compared with the contralateral eyes,the morphology of epithelial cells was similar and endothelial cells were enlarged in the operated eyes.In addition,no stromal cell structure was seen in the corneal stroma in the operative eyes.Subepithelial nerve fibers appeared in 8 eyes at 6 months, but the fiber density was lower in the operated eyes than that in the contralateral eyes.Significant difference was found in epithelial cell density among different time points (F=1.48, P =0.22).The endothelial cell densities were (2 542 ± 119), (1 895 ± 129), (1 869 ± 135), (1 854 ± 101) and (1 844 ± 103)/mm2 before surgery and 3, 6, 9 and 12 months after surgery, showing significant differences between preoperation and postoperative time points (all at P＜0.05).The subepithelial nerve fibers densities were (1.26± 0.13),(3.62±0.81) and (5.98±0.44) mm/mm2 at 6,9 and 12 months after surgery,with significant differences between adjacent two time points (t'=-8.16 ,-7.24;both at P=0.00).Conclusions Bioengineered corneal grafts survive well in human eye after lamellar transplantation,which can reconstruct ocular surface and improve the visual acuity.Biological cornea can replace human corneal materials.

Objective To evaluate the clinical significance of intercellular space diameters (ISD)of squamous epithelium by light microscopy (LM) in lower esophagus of erosive reflux esophagitis (ERD),non-erosive reflux disease ( NERD), Barrett esophagus (BE) and healthy controls. Methods A total of 21 ERD and 21 NERD patients with reflux symptoms and confirmed with 24-hour esophageal pH monitoring, 13 BE patients diagnosed by gastroscopy and biopsy, and 20 other healthy controls were enrolled in the study.Samples of ERD, NERD and control group were collected at 2 cm above dentate line, and made HE slides in the conventional way. Images for measurement of ICS were acquired with oil lens ( × 1000). ICS of squamous epithelium was quantitatively measured by computer-assisted morphometry. Ten cells were taken for each sample, 10 consecutive ISD for each cell, i.e. 100 ISD for each subject. Mean ISD was calculated.Results Mean ISDs by LM in control, BE, ERD, and NERD groups were 0. 59, 0. 99, 1.29 and 1.06 μm, respectively. The mean ISDs in BE, ERD, and NERD group were much greater than that in control (P＜0. 05). The mean, maximal and minimal ISDs of group ERD were greater than those of NERD and BE (P = 0. 000). However, the ISDs of NERD and BE are of no significant difference ( P ＞ 0. 05 ). The cut-off value of mean ISD for diagnosis of gastro-esophageal reflux disease (GERD) was 0. 85 μm. Diagnostic sensitivity and specificity for ERD, NERD and BE were 89. 1% and 100. 0%, with reference to clinical symptoms, endoscopy and ISDs above the cut-off value. Conclusion Larger ISDs in lower esophagus by using LM will be found in all subgroups of GERD, including ERD, NERD and BE. Increased ISDs may be one of the markers for diagnosis of ERD, NERD and BE.

Objective To analyze the epidemiological characteristics, clinical manifestations, diagnosis and treatment effect of brucella in=nfection, and to provide practical foundation and valuable experience for clinical treatment and prevention of brucellosis.Methods One hundred and nineteen patients with brucella infection hospitalized at the First Hospital of Lanzhou University from January 1st 2011 to July 30th 2011 were enrolled.Clinical data including gender, age, contact history with bovine and clinical manifestations such as fever, sweating and joint and muscle pain were extracted.Diagnosis and treatment effect of these patients were all recorded.The epidemiological characteristics and clinical manifestations were analyzed.Results The majority of patients were middle-aged male, and the number of male cases were 2.5 times of female cases.The brucella infections were observed all seasons in Lanzhou, while most cases were observed between May and July.A total of 78 cases had clear animal contact history.Among them, 53 cases (44.54%) had contact history with bovine.Main clinical manifestations included fever (n=84, 70.59%), muscle and joint pain (n=93, 78.15%), sweating (n=52, 43.70%), fatigue (n=29, 24.37%), and the most common clinical symptoms was joint and muscle pain.Blood routine test showed neutropenia (n=25, 21.01%), increase in blood sedimentation (n=34, 28.57%) and blood coagulation dysfunction (n=30, 25.21%).Liver function examination showed increase in ALT (n=37, 31.09%) and AST (n=43, 36.13%).Other examination showed that splenomegaly (n=28, 23.52%) was the most common finding, and liver diffuse lesions (n=22, 18.49%) ranked second.The most common drugs were doxycycline (n=79, 66.39%), rifampin (n=60, 50.42%) and cephalosporins (n=50, 42.02%).Among them, 45 cases (37.82%) were treated with combination therapy of rifampin and doxycycline, and 31 cases were treated with combination therapy of doxycycline and rifapentine or cephalosporins.Totally 112 cases (94.12%) recovered.Conclusions The majority of patients with brucellosis are male.The clinical manifestations of brucellosis are varied.Clinicians should pay attention to identify and prevent misdiagnosis.The timely and effective treatment should be provided according to patients' conditions.The relevant departments should also strengthen supervision and education of brucellosis.

Objective To investigate the correlation between seminal plasma hepatitis B virus (HBV) DNA copy and semen parameters and sperm DNA fragmentation (SDF).Methods The seminal plasma HBV-DNA was detected by the real-time PCR in 148 infertility males,and those with serum HBV-DNA above (positive) or below (negative) 5.0 × 102U/ml were analyzed respectively by semen parameters,sperm morphology and sperm DNA fragmentation (SDF).Results Of 148 male,60 (40.5％) were seminal plasma HBV-DNA positive,and of 60 positive patients,56 (93.3％) were serum hepatitis B e antigen(HBeAg) positive,which was higher than those of seminal plasma HBV-DNA negative males (31cases,35.2％).Serum HBeAg and HBV-DNA in seminal plasma HBV-DNA positive patients were 845.7(0.2 ～ 1455.0) S/CO and (1.7 ± 1.1) × 108U/ml,which were higher than those of HBV-DNA negative patients [HBeAg:0.1 (0.1 ～ 1374.0) S/CO;HBV-DNA:(2.3 ± 1.1) × 107 U/ml,P ＜ 0.01].Seminal plasma HBV-DNA positive patients exhibited lower semen volume,sperm concentration,the percentage of forward moving sperm and less normal morphology compared to HBV-DNA negative patients [(2.44±1.2)mlvs.(3.07±1.3)ml,(66.8±49.1) ×106/mlvs.(87.1 ±65.4) ×106/ml,(54.3± 16.1)％ vs.(59.1 ±15.3)％,(3.77 ±2.8)％ vs.(6.15 ±4.2)％,P＜0.05].The number of patients with teratozoospermia was significantly higher in seminal plasma HBV-DNA positive patients (56.7％ versus 34.1％,(P ＜ 0.01).The SDF in seminal plasma HBV-DNA positive patients was(18.1 ± 12.3)％,while it was(14.4 ± 8.4)％ in negative patients,and the difference of SDF in these two groups was significantly (t =2.197,P ＜ 0.05).Conclusion Seminal plasma HBV-DNA positive could affect the semen parameters,sperm morphology and SDF.

Objective: To investigate the effect of the acid inhibitor-Lansoprazole on the distribution of Helicobacter pylori (H.pylori) in stomach. Methods: Biopsy specimens were taken from the duodenal ulcer patients who underwent gastroscopy before and after the treatment of Lansoprazole. The biopsy specimens were taken from the lesser curvature of the antrum and the greater curvature of the corpus respectively. H&E and Warthin-Starry staining were used for detecting the changing of active gastritis and the positive rate of H.pylori. Results: (1)The positive rates of H.pylori before treatment, 4 weeks after treatment and 3 months after treatment, in the lesser curvature of the antrum were 93.02%, 58.14%, and 86.05%, respectively. The positive rate and density of H.pylori 4 weeks after treatment were greatly decreased compared with those before treatment (P