Objective To understand the effect of environmental risk factors exposed in the first trimester of pregnancy on congenital heart disease, then provide scientific evidence for congenital heart disease prevention. Methods A hospital-based 1:1 matched case-control study was conducted. The risk factors were obtained by field investigation with standardized questionnaires. The data was dealt with single factor analysis and conditional Logistic regression using SPSS version 11.5. Results Folic acid(OR=0.340, 95%CI: 0.178-0.649), milk(OR=0.660, 95%CI: 0.460-0.947), meat(OR=0.771, 95%CI: 0.583-0.867) and nausea and vomiting of pregnancy(OR=0.457, 95%CI: 0.271-0.770)were significantly associated with congenital heart disease. Maternal infection(OR=2.736, 95%CI: 1.462-5.121), taking medicine(OR=2.735, 95%CI: 1.483-5.044), poisonous chemicals(OR=2.764, 95%CI: 1.065-7.177) and mental stress(OR=2.211, 95%CI: 1.022-4.782) were risk factors of congenital heart disease. Conclusion To prevent congenital heart diseases, pregnant women should take more nutriment, keep healthy state and avoid infecting, taking medicine and exposing chemical toxicants in the first trimester of pregnancy.

Objective To investigate the clinical manifestations,laboratory tests,and image modalities on rheumatoid arthritis (RA) accompanied with atlanto-axial joint involvement.Methods Sixty-four cases of RA accompanied with cervical vertebra involvement were divided into 2groups by lesion location.Twenty-two cases were RA accompanied with atlanto-axial joint involvement,while 42 cases were RA with cervical vertebra other than atlanto-axial joint involvement.The age,course,clinical manifestations and the lab results were compared between the two groups by t test,Chi-square test and Fisher's exact probability.The X-ray,CT and magnetic resonance imaging (MRI) for cervical vertebra were analyzed in RA with atlanto-axial joint involvement.Results Compared with non-atlantoaxial cervical group,the disease course [(15±10) years vs (8±9) years,t=3.030,P=0.004],upper cervical vertebra pain (73％ vs 7％,x2=29.75,P＜0.01),lower cervical vertebra pain (9％ vs 40％,x2=6.813,P=0.009),cervical activity limitation (68％ vs 14％,x2=19.023,P＜0.01),upper cervical vertebra pressing pain (100％ vs 7％,22=52.297,P＜0.01),lower cervical vertebra pressing pain (9％ vs 60％,x 2=15.056,P＜0.01) and erythrocyte sedimentation rate (ESR) [(73±34) mm/1 h vs (53±37) am/1 h,t=2.039,P=0.046)] were significantly different in atlantoaxial joint lesions group.CT combined with MRI exams had high diagnostic..value in RA with atlanto-axial joint involvement.CT scan had the conformed diagnostic value.Sixteen cases were positive (73％) by MRI scan,while 3 cases (14％) by X-ray.Conclusion Timely CT scan and/or MRI scan for RA patients with neck pain in upper cervical vertebra,long disease course,cervical activity limitation and high ESR are helpful for early diagnosis of atlanto-axial joint involvement.

Objective:To sort out the situation of disaster related projects in national social science projects in recent 10 years and discuss hot spots and front direction of disaster nursing research.Methods:relevant fund information of disaster research in the national social science foundation and the humanities and social science research foundation of the ministry of education from 2009 to 2019 was analyzed by keyword clustering.Results:A total of 648 fund information was retrieved. Four research hots pots in recent 10 years were obtained: disaster risk prediction mechanism, multi-organization disaster response management, logistics optimization model, disaster public opinion and information dissemination.Conclusion:The development of nursing is inseparable from technology and information. Nursing should cooperate with other disciplines and organizations to form a nursing emergency system.

To review the state of research on medullary thyroid carcinoma (MTC) over the past two decades, so as to offer a quick reference for understanding the current state and future trends in this field.

OBJECTIVE: To assess the effectiveness of a novel minimally invasive Achilles tendon suture instrument in the treatment of fresh closed Achilles tendon rupture. METHODS: A retrospective study was conducted on 150 patients who underwent surgical intervention for fresh closed Achilles tendon rupture. Eighty patients were treated with the novel minimally invasive Achilles tendon suture instrument (minimally invasive group) and 70 patients with traditional open surgery (traditional group). The two groups were comparable in terms of gender, age, injured side, cause of injury, the interval between injury and operation, and the distance from the fracture end to the calcaneal tuberosity ( P>0.05). The operation time, intraoperative blood loss, incision length, hospital stays, hospitalization expenses, and complications were recorded and compared. At 1 year after operation, the ankle joint function was evaluated by the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score. RESULTS: The minimally invasive group demonstrated significantly shorter operation time, smaller incision length, and lower intraoperative blood loss when compared with the traditional group ( P<0.05). However, there was no significant difference in terms of hospital stays and hospitalization expenses between the two groups ( P>0.05). All patients were followed up 12-24 months after operation (mean, 15.5 months). In the traditional group, 6 cases of incision necrosis and 7 cases of Achilles tendon adhesion occurred, while in the minimally invasive group, all incisions healed at first intention and no Achilles tendon adhesion occurred. The differences in the incidences of the two complications between the two groups were significant ( P<0.05). At 1 year after operation, the AOFAS ankle-hindfoot score in the minimally invasive group was superior to that of the traditional group ( P<0.05). CONCLUSION In comparison with traditional open surgery, the use of self-designed novel minimally invasive Achilles tendon suture instrument proves to be an ideal technique for treating fresh closed Achilles tendon ruptures. This approach offers the benefits of smaller incisions, fewer complications, and better postoperative functional recovery, without increasing hospital costs.
Humans ; Blood Loss, Surgical ; Retrospective Studies ; Neurosurgical Procedures ; Achilles Tendon/surgery* ; Tendon Injuries/surgery* ; Ankle Injuries ; Surgical Wound ; Sutures