Objective To evaluate the efficacy and safety of helmet delivered continuous positive airway pressure (Helmet-CPAP)for hypoxemia in airway extubated patients after cardiac surgery.Methods 120 adult patients in ICU from March 2014 to July 2015,who were after cardiac surgery,were enrolled.These patients who suffered hypoxemia within 48 hours after extubation,defined as that PaO2/FiO2 with oxygen mask could not reach 200,were divided into two groups.In the control group high concentration oxygen therapy with mask was delivered,while helmet-CPAP was delivered in the experimental group.Treatment duration was 6 hours.Results Helmet-CPAP significantly improved PaO2/FiO2 (144.35 ± 24.43 vs.201.35 ± 52.97,P ＜ 0.05) and left ventricular ejection fractions(0.5383 ± 0.0844 vs.0.5540 ± 0.0844,P ＜ 0.05).Breathing rate (22.60±5.08 vs.18.53 ±4.13,P＜0.05),heart rate(102.72±17.9 vs.95.15 ±13.79,P＜0.05)and shock index (0.85 ± 0.35 vs.0.75 ± 0.15,P ＜ 0.05) were significantly lower.The rate of using mechanical ventilation (6.67％ vs.28.33％,P ＜ 0.05) and length of ICU stay[41.0(25.0,67.5) hours vs.49.5 (32.5,90.8) hours,P ＜ 0.05] was significantly less than control group.Conclusion Helmet delivered continuous positive airway pressure is an effective and safe treatment for hypoxemia in airway extubated patients after cardiac surgery.

Objective To understand HIV/AIDS related knowledge and attitude among different population groups in Rizhao.Method Self-designed questionnaires were used to investigate HIV/AIDS related knowledge and attitude among rural and urban residents,hotel attendants and government officers.Results The rates of right answers on HIV/AIDS related questions among the government officers,the urban residents,the hotel attendants and the rural residents were 83.38%,72.45%,72.33% and 66.36%,respectively.Conclusion Although different population groups in Rizhao city have relatively high awareness of HIV/AIDS,there still exist some deficiencies,and consequently education and publicity in this respect should be further strengthened.

Objective To analyze the significant impact factors of postoperative hemorrhage after pancreaticoduodenectomy.Method The clinical data of 154 patients who underwent pancreatieoduodeneetomy from Jan.2009 to Jun.2012 were retrospectively analyzed.Results The incidence of postoperative hemorrhage was 10.4％ (16/154).The mortality caused by this complication was 12.5％ (2/16).Among these patients,intra-abdominal hemorrhage occurred in seven patients,and gastrointestinal hemorrhage occurred in nine patients.One patient suffered from both these complications.There were five and two patients presenting with early or delayed intra-abdominal hemorrhage,respectively.Early and delayed gastrointestinal hemorrhage occurred in three and six patients,respec tively.Statistical analysis showed that infection (P=0.002,P＜ 0.01) and pancreatic fistula (P=0.048,P＜0.05) are significantly associated with postoperative hemorrhage.Conclusions Postoperative hemorrhage after pancreaticoduodenectomy is a severe complication.Adequate hemostasis and prevention of pancreatic fistula and infection are the key points in reducing postoperative hemorrhage.Proper treatments should be used according to the site,type of onset and severity of hemorrhage.

Objective To explore the clinical therapeutic effects in arterial interventional therapy in early osteosarcoma patients.Methods Thirty-eight early osteosarcoma patients received arterial chemoembolization therapies and performed operations.94.7% patients received limb salvage surgeries.Levels of alkaline phosphatase were tested in preoperative and postoperative phases.Results Levels of postoperativealkaline phosphatase[average(191.7±107.0)U/L]were significantly decreased compared with that before interventional therapy[average(1129.1±572.3)U/J.The survival rate in follow-up at 1,3 and 5 years Was97%,79%,50% respectively.The rate of recurrence and metastasis WAg 24%.Conclusions Arterialchemoembolization therapies in patients with early osteosarcoma could improve clinical symptoms effectively,enhance survival rate,relieve recurrence and metastasis,remain affected extremity.The clinical thempeutic effects of iodinated oil were the best among the three embolism materials.

Objective By studying the prescriptions and medicines for treating rheumatoid arthritis (RA) prescribed by modem doctors, we tried to provide new ideas for developing the new medicines for treating rheumatoid arthritis. Methods 340 prescriptions on treating rheumatoid arthritis were collected from core medical periodicals and books published in the recent 20 years. Make a statistical analysis to the medicines in these prescriptions according to TCM etiological and pharmaceutical theories and modern researching foundlings. Results Among all 254 Chinese medicines used for treating RA, 32 medicines belong to worm and vine medicines, being used for 806 times. Conclusion The worm and vine medicines are frequently used in treating RA with good therapeutic effects combined with other kinds of medicines.

ObjectiveTo survey the status of Helicobacter pylori (HP)infection in cholangiocarcinoma,and its relation to clinical and pathological parameters and prognosis. MethodsHP infection in 80 cholangiocarcinoma samples and 30 controls was detected by PCR,in those with positive results the expression of Cag A and its subtypes of Vac A sla,m1 and m2 was further tested by PCR.ResultsChi-square test showed that the detection rate of in HP ( + ) in cholangiocarcinoma group is 71％,higher than 20％ in control group.The positive cases of CagA and VacA sla,m1,m2 in cholangiocarcinoma group was respectively 30,40,5 and 43 cases.HP infection in cholangiocarcinoma was correlated with the location of the tumor(x2 =27.580,P ＜ 0.05 ). MultivariateLogisticanalysisshowedthat cholangiocarcinoma is over 10 times more likely in HP ( + ) patients than HP ( - ) ( OR =10.531 ).Cox regression analyses showed that the infection of HP(HR =8.105,P =0.032),the staging of TNM( Ⅱ/ⅢHR=9.141,P=0.040,Ⅳ HR =29.071,P=0.040) and surgery (HR=9.531,P =0.015) are all independent prognostic factors of cholangiocarcinoma. Life table analyses showed HP infection negatively affects the survival time of cholangiocarcinoma after a surgery ( u =10.074,P =0.002),and the median survival time is 7.25 months shorter than HP( - ) patients. ConclusionsIt is common that HP infection complicating cholangiocarcinoma,usually with the genotype of VacA sla/m2,HP infection is a risk factor for cholangiocarcinoma,and negatively affects oatients survival after surgery.

Objective To detect the expression and significance of serum miRNA-183 and TK1 in patients with colorectal cancer, and the mechanism thereof. Methods Fifty-two serum samples of colorectal cancer patients and paired health serum samples were collected. The expression of miRNA-183 was detected by real-time quantitative PCR, and TK1 was detected by Western blot enhanced chemiluminescence assay. The correlation between miRNA-183 and TK1 and their relations with the clinicpathologic characteristics were analyzed. Results The serum miRNA-183 expression was significantly higher in colorectal cancer group than that in normal control group (P<0.01). The expression of serum miRNA-183 was significantly higher in stage Ⅲ-Ⅳ group than that in stage Ⅰ-Ⅱ group (P < 0.01). There was more significant increase in serum miRNA-183 in lymphatic metastasis group than that without lymphatic metastasis group (P < 0.01). Receiver operating characteristic (ROC) curve showed that of there was a diagnostic value for serum miRNA-183 in colorectal cancer, with an optimal value of 1.15. The diagnostic sensitivity and specificity were 78.8%and 67.3%, and the positive predictive value and negative predictive value were 78.9%and 70.2%. The serum TK1 expression was also higher in colorectal cancer group compared with that of normal control group (P<0.01). And the TK1 expression was also higher in stageⅢ-Ⅳgroup than that in stageⅠ-Ⅱgroup (P<0.01). Furthermore, miRNA-183 expression was positively correlated with TK1 expression (rs=0.692, P<0.01). Conclusion The serum expression levels of miR-183 and TK1 may act as tumor markers for early colorectal cancer diagnosis, and also can be used to predict the malignant degree and prognosis of colorectal cancer.

Objective To explore the effects of mental practice on upper extremity function after stroke. Methods Thirty sub-acute stroke patients were randomly divided into a treatment group ( n=15 ) and a control group (n=15). The patients in the control group were treated with conventional therapy. The patients in the treat-ment group were treated with motor imagery therapy in addition. All patients were assessed using the Fugl-Meyer mo-tor assessment (FMA) and the motor assessment scale (bIAS) before treatment and after 2, 4 and 8 weeks of treat-ment. Results After 2 weeks of treatment, average MAS scores in the treatment group improved significantly com-pared with before treatment, but there was no significant difference between the two groups. After 4 weeks, FMA and MAS scores in the two groups had improved, and the FMA scores in the treatment group were significantly higher than those of the control group. After 8 weeks, the FMA and MAS scores of both groups had further improved significant-ly, but the average FMA and MAS scores in the treatment group were now significantly higher than those in the control group. Conclusions Mental practice can improve the functional performance of the upper extremities of stroke pa-tients.

Objective Medical system requirements of a large naval ship are presented in this paper to provide refer -ence for ship design and construction .Methods The relations between health service missions of a large naval ship and naval strategic needs were analyzed .According to the naval strategies in the new era , the health service mission of the ship was given.Results The medical system configuration scheme and ship design requirement related to the medical system were proposed .Conclusion The medical system design requirements and configuraion scheme can effectively improve the patient-treating capability in defensive combat on high seas and in diverse missions .They are also of great significance for maintaining troop strength and promoting a country′s ability to provide humanitarian aid .

Objective To detect the antibodies against recombinant chlamydial plasmid-encoded protein 3(rPgp3),chlamydial protease-like activity factor(rCPAF),Ct143 encoded protein(rCT143), Ct101 encoded protein(rCT101),Ct694 encoded protein(rCT694),Ct813 encoded protein(rCT813), Chlamydia membrane protein A(rIncA),Ct875 encoded protein(rCT875),major outer membrane protein (rMOMP)and heat shock protein 60( rHsp60)in serum samples collected form patients with urogenital Chlamydia trachomatis(Ct)infection and to evaluate the antigenicity of those proteins. Methods The re-combinant plasmids expressing the 10 proteins and a blank plasmid were transformed into E. coli BL21 strains,respectively. The transformed E. coli BL21 strains were induced by isopropyl β-D-1-thiogalactopyr-anoside(IPTG)to express recombinant proteins. The glutathione pre-coated 96-well ELISA plates were coa-ted with lysates. Serum samples were collected from 50 patients with Ct infection and 10 patients without Ct infection. ELISA was performed to detect the antibodies against 10 recombinant proteins. Results The anti-bodies against rPgp3,rCPAF,rCT143,rCT101,rCT694,rCT875,rCT813,rMOMP,rIncA and rHsp60 proteins were respectively detected in 44 cases(88% ),38 cases(76% ),37 cases(74% ),36 cases (72% ),33 cases(66% ),31 cases(62% ),30 cases(60% ),26 cases(52% ),24 cases(48% )and 17 cases(34% )out of 50 serum samples. No antibodies against 10 recombinant proteins were detected in the serum samples collected from patients without Ct infection. Conclusion The rPgp3 protein showed the strongest antigenicity among all of the studied proteins,followed by rCPAF and rCT143 proteins. The rHsp60 protein showed the lowest antigenicity.