Objective To draw up the Chinese Words Reading Test and try to use it as way of premorbid intelligence. Methods 373 health middle-elderly people as study subjects, from five communities in Shanghai city, are between age 55 and 85, and their edueational background is junior high school or above, and their MMSE scores are more than 24 points. 34 of the cases have finished CWRT and Weehsler Adult Intelligence Scale (WAIS) Chinese Revised edition. The main analysis indicators of CWRT: CWRT-Ⅰ for number of right reading 50 characters and CWRT-Ⅱ for 50 words. Results Both CWRT-Ⅰ and CWRT-Ⅱ are relative to education level( r = 0.462,0.489, and P < 0.01), while the correlation with age is not signifieant. Performance of the male participants are better than that of the female. The coefficient of correlation between scores of CWRT-Ⅰ and full IQ of WAIS is 0.79. The mean and standard deviation of scores of CWRT-Ⅰ and CWRT-Ⅱ for the normal elder people with different education levels and gender are provided. Conclusion CWRT is not very diffieuh or easy, and is highly relative to score of WAIS. So it can be used as an evaluating tool for premorbid intelligence.

Objective To evaluate the effect of remifentanil on mean arterial pressure (MAP), heart rate (HR) and QTc interval during tracheal intubation of general anesthesia patients. Methods Seventy-five ASA Ⅰ -Ⅱ grade patients were selected and allocated to receive either saline (group C), remifentanil 0.50 μg/kg (group R1) or remifentanil 0.75 μg/kg(group R2) by random digits table with 25 cases in each, they were administrated as a bolus intravenous, followed by a continuous infusion at 0.10 μg/ (kg·min), 1 min before laryngoscopy. All patients received fentanyl 3 μg/kg,propofol 1.0 - 1.5 mg/kg and vecuronium 0.1 mg/kg. The ECG.MAP and HR were recorded prior to induction of anesthesia (T0), 2 min following the start of drug intravenous of fentanyl and propofol with vecuronium (T1), 1 min following remifentanil or saline (T2), before laryngoscopy(T3), 30 s (T4), 2 min (T5) and 4 min (T6) after intubation. Results The QTc interval was significantly prolonged immediately following intubation in group C and group R1, but it remained stable in group R2, compared with the QTc interval just before laryngoscopy. In group R2, QTc interval was significantly shorter at T4-T6 compared to group C(P＜ 0.05 or ＜ 0.01). QTc interval significantly increased from baseline at T4 in group R1 and T4-T6 in group C (P＜ 0.05 or ＜ 0.01). The number of patients with QTc interval ＞ 440 ms were significantly greater immediately following tracheal intubation in group C than that in group R2 [44% (11/25) vs. 12% (3/25)] (P ＜ 0.05). Conclusions QTc interval increases following tracheal intubation during induction of anesthesia using fentanyl and propofol. Intravenous of remifentanil attenuates the QTc interval prolongation associated with tracheal intubation. In addition, remifentanil decreases the hemodynamic responses to tracheal intubation.

Objective To evaluate the effectiveness of epidural saline washout on regression of sensory and motor block after epidural anesthesia in elderly patients.Methods A total of 70 males with ASA Ⅰ or Ⅱ who were subjected lumbar epidural anesthesia with 10 ml of 1.73% bicarbonate-lidocaine and fentanyl 50 μg (1 ml).At the end of transurethral surgery,the washout group (35 cases) received an epidural bolus of 20 ml saline while the control group(35 cases) did not,extracted the epidural catheter after 10 minutes.Results Mean times of 3-dermatomal sensory regression for pinpric, 1-grade of motor block, and the rate of 1 h motor block were significantly shorter in the washout group than those in the control group [(24.6 ± 15.9) min vs(32.8 ± 16.7) min, (32.7 ± 13.4) min vs(47.9 ± 22.6) min,5 cases (14.3%) vs 14 cases (40.0%)](P < 0.05 or < 0.01 ).There was no difference in pain-killer utilization, postoperative pain scores no more than 3 scores and side effects between the two groups (P > 0.05).Conclusion It suggests that epidural washout facihtates regression of both sensory and motor block following epidural anesthesia without reducing the postoperative analgesic benefit.

Objective To evaluate the effect of oxytocin on Tp-e and QTc interval during caesarean section under spinal anesthesia in healthy puerperas. Methods Forty ASA Ⅰ puerperas were selected and allocated to receive oxytocin intravenous bolus group (group-IB) or oxytocin continuous infusion group (group-CI) with 20 puerperas in each by random digits table. An intravenous bolus of 5% glucose 5 ml and 5 U oxytocin was administered after delivery a 55-60 s period. A continuous infusion of 5% glucose 5 ml and 5U oxytocin was administered after delivery a 10 min period. Measured the QTc interval,Tp-e interval,mean arterial pressure (MAP) and beart rate ( HR ) pre-operatively, then 1,3 and 5 ain after spinal anesthesia, and at least 1,3,5 and 10 min after oxytocin injection. Results In group-IB:HR was fast 1 min after oxytocin injection compared with pre-operatively [(89 ± 13) beats/min vs. (73 ± 12) beats/min] ,MAP was decreased [(69 ± 12 ) mm Hg ( 1 mm Hg= 0. 133 kPa ) vs. ( 82 ± 13 ) mm Hg] and QTc interval was prolonged [(426 ±21 ) ms vs. (405 ± 18 ) ms] (P ＜ 0.01 ); but Tp-e interval was prolonged 1,3,5 min after oxytocin injection compared with pre-operatively (P ＜ 0.01 or ＜ 0.05 ). Conclusions Single large dose of oxytocin intravenous bolus (5 U) can prolong QTc interval and Tp-e interval in healthy puerperas, and Tp-e interval can exact predict the occurrence of ventricular arrhythmias. The risk-benefit balance of oxytocin bolus during caesarean delivery should be discussed with women with a history of long QT syndrome.

Objective To investigate the conversion rate of subtypes of amnestic mild cognitive impairment (aMCI) to Alzheimer' s disease (AD) and assess the contribution of neuropsychological disturbance in progression from MCI to AD over 2 years. Method Subjects from memory clinic of Huashan hospital including 130 of who met the operational criteria for Mayo Clinic defined aMCI by neuropsychological tests covering global cognitive function, executive function, memory function, language function and visual spatial skills. They underwent multidimensional assessment and a neuropsychological battery at baseline and at follow-up, after about 2 years. Diagnosis for dementia was based on National Institute of Neurological and Communicative Disorders and Stroke; Alzheimer' s Disease and Related Disorders Association (NINCDS-ADRDA) criteria. Results Forty-four cases of 130 (33. 8% ) elder people with aMCI converted to probable AD with 17 aMCI-s and 27 aMCI-m subjects within an average 23.8 (6. 8 ) months. There was significant difference between the reversion rate of aMCI-s and aMCI-m (26. 2% vs 42. 9%, x2 = 3.957,P = 0. 047). Moreover, as the disease progressing,the two groups declined similarly in memory and executive function while in the aMCI-s group, the function of spatial structure relatively reserved in aMCI-s but function of language and attention diminished faster, and in the aMCI-m group, the ability of spatial structure declined even more significantly. Conclusion The aMCI-m is more likely to progress to AD than aMCI-s and it' s necessary to divide aMCI into aMCI-s and aMCI-m to help determine prognosis.

Objective To develop an one-off multifunctional instrument for blood collection and transfusion.Methods Blood collection pipe,blood sample pipe and blood transfusion pipe were united by means of three-way pipe.Different venipuncture needles could be selected by means of different connectors.Plastic clips and connectors were used to cut off and connect pipes.It was also equipped with pipe warming apparatus,manual pipe seal apparatus and newest venipuncture needles.Results The one-off multifunctional instrument for blood collection and transfusion possessed advanced technology,convenience and good application value.Conclusion The one-off multifunctional instrument for blood collection and transfusion can be applied into blood medical service,all kinds of surgical operations,emergency care,abrupt affairs,and it meets the requirements of war-readiness and medical service for troops in different periods.

Objective To summarize the experience on diagnosis and treatment of splenic neoplasm. Methods Clinical data of 40 patients with primary splenic space occupying lesion treated in our hospital were retrospectively analyzed. Results Thirty four out of the 40 cases were diagnosed as primary splenic neoplasm preoperatively. The detectable rate of B-US was 94%, and that of CT was 96%. The discrimination rate of benignancy and malignancy by CT was 84%. Serum AKP and ?-GT were significanfiy increased in most of the malignancies. Seventeen among 22 cases with benignancy were treated by splenectomy, and the others underwent partial splenectomy or tumor resection. Sixteen of 18 patients with malignancy underwent splenectomy, and two did biopsy. Pathology revealed cysts in 13, angiocavernoma in 4, inflammatory pseudotumor in 3, caverous lymphangioma in 1, and cystic degeneration of liomyoma in 1; malignant lymphoma and lymphsarcoma in 9, hemangiosarcoma in 3, and fibrosarcoma, liomyosarcoma, malignant fibrous histiocytoma in 1 each. Three cases with malignancy have survived more than 5 years. Conclusions Splenic neoplasm is diagnosed mainly according to clinical manifestation and image examination. The discrimination of benignancy and malignancy depends on CT, angiography, and serous AKP and ?-GT level. Radical operation and complex treatment could improve the prognosis of splenic malignant tumor.

Objective To translate the English version of Northwick Park Dependency Score (NPDS) and to investigate the reliability and validity of the Chinese version of NPDS as a nursing dependency instrument for stroke patients. Methods The NPDS was Chinesized according to the Brislin's translation model. The expert evaluation method and the pilot investigation were implemented for cross-cultural research. The reliability and validity of the Chinese version of NPDS were tested in a cohort of 259 stroke patients. SPSS 17.0 was used to analyze the data. Results The Chinese version of NPDS consisted of 17 items, and 4 factors were extracted by exploratory factor analysis, which could explain 64.598% of the total variance. The content validity index (CVI) was 0.926. The criterion-related validity of NPDS with nursing hours per patient day and activity of daily life were 0.541,0.624 respectively (P<0.001). The Cronbach's coefficient was 0.852, and the inter-rater reliability was 0.975. Conclusions The Chinese version of NPDS has high reliability and validity, and is a valuable nursing dependency instrument for Chinese stroke patients.

Objective:To investigate the factors that affect the therapeutic effects of endoscopic radiofrequency ablation (Stretta procedure) on gastroesophageal reflux disease (GERD).Methods:Seventy patients with gastroesophageal reflux disease who received endoscopic radiofrequency ablation (Stretta procedure) treatment in Jinhua Hospital of Traditional Chinese Medicine from January 2016 to January 2019 were included in this study. They were divided into good prognosis group ( n = 57) and poor prognosis group ( n = 13) according to prognostic effects. The clinical data of all patients were collected, including gender, age, body mass index (BMI), course of disease, complications (hypertension, coronary heart disease, diabetes), smoking, drinking, Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) scores. Unconditional stepwise logistic regression was performed to analyze the factors that affect the therapeutic effects of Stretta procedure on GERD. Results:Univariate analysis results revealed that the proportion of patients aged ≥ 60 years with BMI ≥ 25 kg/m 2, alcohol abuse, HAMD score ≥ 8, HAMD score ≥ 7 was significantly higher in the poor prognosis group than in the good prognosis group ( χ2 = 9.574, 10.821, 22.575, 8.653, 10.586, 4.070, 8.653, all P < 0.05). Logistic regression analysis confirmed that female gender, age ≥ 60 years, BMI ≥ 25 kg/m 2, course of disease ≥ 5 years, alcohol abuse, HAMD score ≥ 8 and HAMA score ≥ 7 were the risk factors for poor prognosis of gastroesophageal reflux disease ( χ2 = 11.174, 6.023, 8.698, 5.972, 5.821, 7.485, 5.443, all P < 0.05). Consistency analysis revealed that gender, age, BMI, course of disease, alcohol abuse, HAMD score and HAMA score could be used to predict the therapeutic effects of endoscopic radiofrequency ablation (Stretta procedure) on GERD. Combined application of gender, age, BMI, course of disease, alcohol abuse, HAMD score and HAMA score exhibited higher consistency than a single application, 0.827 > 0.577, 0.533, 0.795, 0.547, 0.606, 0.434 and 0.547. Conclusion:There are many factors that affect the therapeutic effects of endoscopic radiofrequency ablation (Stretta procedure) on GERD, including gender, age, BMI, course of disease, alcohol abuse, HAMD score and HAMA score. This is of certain reference value for clinical treatment of GERD, and combined application of these influential factors has a high accuracy in the prediction of the therapeutic effects of Stretta procedure on GERD.

Objective:To conduct a scoping review of the application of mobile health applications (MHA) in the care of patients with colorectal cancer, summarizing the development process, the functions achieved, as well as the evaluation metrics, to provide references for MHA practice and related research.Methods:Following the scoping review framework, a comprehensive search was conducted across both domestic and international databases, including the China Biomedical Literature Database, Wanfang Database, China National Knowledge Infrastructure (CNKI), VIP Database, Cochrane Library, PubMed, Embase, CINAHL, Web of Science, and Scopus. The search period was from the database inception to February, 2024.Results:A total of 16 studies were included. The development of MHA involved multiple methods including literature reviews, qualitative interviews, consultations with multidisciplinary teams, and guidance from theoretical models. The functions of MHA include health education, peer support, guided feedback, monitoring, and reminder features. Evaluation metrics for MHA comprise usability, adherence, and effectiveness.Conclusions:MHA has demonstrated positive effects in enhancing patients' knowledge and alleviating symptoms such as fatigue and vomiting in colorectal cancer patients. However, it is still in its early stages, and further high-quality studies are needed to scientifically develop MHA that meets patients' needs.