Objective To investigate the relationship between plasma low-density lipoprotein (LDL) levels and hematoma enlargement of early intracerebral hemorrhage,outcome at 3 months and death.Methods A total of 316 patients with primary intracerebral hemorrhage were included in the study.Their general information was documented.The patients underwent CT scans at 6 and 24 hours after onset.The lipids,blood glucose,blood pressure,and the National Institutes of Health Stroke Scale (NIHSS) scores were detected at the same time.The patients were followed up for 3 months and their modified Rankin scale (mRS) scores and the number of death were recorded.Results The decreased plasma LDL level (odds ratio [OR] 0.323,95％ confidence interval [CI] 0.128 - 0.819; P =0.017) and the increased systolic pressure (OR 1.015,95％ CI 1.000 -1.029; P =0.043) were independently associated with the early hematoma enlargement.The decreased plasma LDL level (OR 0.253,95％ CI 0.102-0.629; P=0.003) and the increased blood glucose (OR 1.458,95％ CI 1.257 - 1.693; P ＜ 0.001 ) were the independent risk factors for poor outcome at 3 months after onset.The decreased plasma LDL level (OR 0.211,95％ CI 0.075 - 0.597; P =0.003),the increased bloot glucose level (OR 1.406,95％ CI 1.212 - 1.632; P =0.001) and the increased blood glucose level (OR 1.026,95％ CI 1.009 - 1.043; P =0.002) were the independent risk factors for death within 3 months.Receiver operating characteristic curves showed that the LDL level ＜ 2.58 mmol/L was an independent predictor for hematoma enlargement (sensitivity 71.79％,specificity 64.71％,positive predictive value 40.00％,and negative predictive value 87.50％ ).Conclusion The decreased plasma LDL level was the independent predictor for early hematoma enlargement,poor outcome and death at 3 months in patients with primary intracerebral hemorrhage.

Abstract: Objective　To analyze the vaccination status of SARS-CoV-2 in children, and explore the relationship between SARS-CoV-2 vaccination and COVID-19 in children. Methods　A retrospective study was conducted to analyze the clinical data of 335 cases of SARS-CoV-2 Omicron variant infection from February 15, 2022 to March 18, 2022 in Shenzhen Third People's Hospital. Results　Among 335 children with SARS-CoV-2 infection, 174(51.9%) cases were vaccinated with the SARS-CoV-2 vaccine; 33(31.4%) cases were vaccinated in the 3-<6 years old group; 141(61.3%) cases were vaccinated in the 6-<14 years old group. There was a statistically significant difference in the proportion of SARS-CoV-2 vaccination between the 6-<14 years old group and the 3-<6 years old group (χ2=26.1, P<0.05). In the study cohort, 3-<6 years old group and 6-<14 years old group, there was no significant difference in the incidence of COVID-19 in the vaccinated group compared with the unvaccinated group (P>0.05). In the study cohort, the proportion of confirmed cases of 1 dose of SARS-CoV-2 vaccine and 2 doses or more of SARS-CoV-2 vaccine was 89.5% (68 cases) and 77.6% (76 cases), respectively; in the 6~<14 years old group, the proportion of confirmed cases of 1 dose of SARS-CoV-2 vaccine and 2 doses or more of SARS-CoV-2 vaccine was 90.0% (54 cases) and 76.5% (62 cases), respectively; the differences were statistically significant (χ2=4.264, P<0.05; χ2=4.279，P<0.05). The IgG levels of 18.28 (6.61, 55.2) AU/mL and 58.3 (25.85, 131.41) AU/mL in the study cohort who were vaccinated for 1 dose, 2 doses and more, respectively; the IgG levels of 20.13 (8.33, 44.33) AU/mL and 56.57 (25.85, 150.07) AU/mL in the 6~<14 years old group who were vaccinated for 1 dose, 2 doses and more, respectively; and the differences were statistically significant (Z=-4.37, P<0.05; Z=-3.96, P<0.05). Conclusions　Children who received 2 doses of SARS-CoV-2 vaccine have a lower incidence of COVID-19 and higher levels of SARS-CoV-2 antibodies compared with who received 1 dose . It is recommended that children are advised to be vaccinated against the COVID-19.

Objective To evaluate the effect of intravenous lidocaine on postoperative pain and acute rehabilitation after laparoscopic hysterectomy.Methods Ninety-six patients scheduled for lapa-roscopic hysterectomy under general anesthesia were randomized into 2 groups (n = 48 ).In test group,lidocaine 1.5 mg/kg was administered at induction,then with a continously infusing rate of 2 mg·kg-1 ·h-1 until the end of surgery.In control group,saline was instead.Record the resting and coughing pain scores at 6,12,24 and 48 h after surgery,morphine consumption during the first 48 h, time to first flatus,6 min walk test (6MWT)result,and side effects such as dizzy,nausea and vomi-ting.Results Resting VAS scores at 6,12 and 24 h postoperatively were lower in test group than in control group (P <0.05).Coughing VAS scores in test group were lower than in control group at all time points (P <0.05).The morphine consumption was lower in test group than in control group (P<0.05).Time to first flatus was earlier in test group than in control group (P <0.05 ).6MWT at day 4 and 5 were significantly enhanced in test group (P <0.05 ).Conclusion Intravenous lidocaine can reduce postoperative pain scores and morphine consumption,as well as improve early rehabilita-tion after laparoscopic hysterectomy.

Objective To investigate the influence of antiepileptic drugs (AEDs) on levels of serum homocysteine (Hcy),folate,vitamin B12 and B6 in patients with post-stroke epilepsy (PSE).Methods The serum levels of Hcy,folate,vitamin B12 and B6 of 194 PSE patients with AEDs treatment for more than 1 year (AEDs treatment group) and 40 newly diagnosed PSE patients without AEDs therapy (control group) were detected.The effects of AEDs on above indexes were analyzed.Results Compared with control group,the serum level of serum Hcy was significantly increased,and the serum levels of folate,B12 were significantly decreased in AEDs treatment group (all P<0.05).The difference of the serum levels of vitamin B6 among the groups was not significant.Compared with monothetapy subgroup,the serum levels of Hcy was significantly increased in the combination therapy subgroup (P<0.05).Compared with control group,the serum levels of Hcy were significantly increased in patients with Valproate (VPA),Carbamazepine (CBZ) and Oxcarbazepine (OXC) monotherapy,the serum levels of folate were significantly decreased in patients with VPA and CBZ monotherapy,and the serum level of B12 was significantly decreased in patients with VPA monotherapy (all P<0.05).Compared with control group,the serum levels of Hcy were significantly increased in patients with 2 kinds of AEDs combination treatment [VPA+CBZ,VPA+Levetiracetam (LEV),VPA+OXC,CBZ+LEV] or ≥3 kinds of AEDs combination treatment,the serum levels of folate was significantly decreased in patients with 2 kinds of AEDs combination treatment (VPA+LEV,VPA+OXC,CBZ+LEV) or ≥3 kinds of AEDs combination treatment,the serum levels of B12 were siginificantly decreased in patients with 2 kinds of AEDs combination treatment (VPA+CBZ,VPA+OXC,CBZ+LEV) or ≥3 kinds of AEDs combination treatment (all P<0.05).The incidence of hyperhomocysteinemia (HHcy) in AEDs treatment group (36.6%) was significantly higher than that in control group (20.0%) (χ2=4.085,P=0.043).And the difference of HHcy incidence between the combination therapy subgroup (47.6%) and the control group was statistical significant (χ2=6.950,P=0.008).The difference of HHcy incidence between the monotherapy subgroup (33.6%) and the control group was not significant.The HHcy incidence of patients with VPA and CBZ monotherapy (40.5%;43.8%) were significantly higer than those in the control group (χ2=3.871,P=0.049;χ2=4.726,P=0.030).The differences of HHcy incidence between patients with OXC,LEV monotherapy (29.2%;22.9%) and the control group were not significant.Conclusions AEDs therapy has little influence on the serum levels of vitamin B6,while has great influence on the serum levels of Hcy,folate and vitamin B12.Combination treatment of AEDs and monotherapy of VPA,CBZ may increase the incidence of HHcy in PSE patients.

Objective To investigate the influence of vitamin B supplementation on the plasma total homocysteine (Hcy), serum folate, serum vitamin B12, serum vitamin B6, and clinical state of senile epilepsy.Methods A total of 132 senile epilepsy patients with hyperhomocysteinemia, who visited the Second Affiliated Hospital of Soochow University from January 2013 to July 2015, were enrolled into this study.Eighty-three patients who accepted the therapy of vitamin B supplementation (folate 2.5 mg/d, vitamin B6 10.0 mg/d, vitamin B12 1.5 mg/d) were selected as treatment group, and 49 patients with no vitamin B supplementation were selected as control group.All patients were followed-up for one year.The differences of serum Hcy, folate, vitamin B12, vitamin B6 and seizure frequency, MMSE scores, Hamilton Depression Rating Scale (HDMA) scores between the treatment and the control groups were compared.According to the concentration of serum Hcy, 132 patients were divided into two groups: 75 patients (46 patients in the treatment group and 29 patients in the control group) with mild hyperhomocysteinemia (Hcy: 15.0-29.9 μmol/L), 57 patients (37 patients in the treatment group and 20 patients in the control group) with moderate-severe hyperhomocysteinemia (Hcy≥30.0 μmol/L).The differences of serum Hcy, folate, vitamin B12, vitamin B6 and seizure frequency, MMSE scores, HDMA scores between the treatment and the control group in the mild hyperhomocysteinemia group and in the moderate-severe hyperhomocysteinemia group were compared.And the influence factors of Hcy were analyzed.Results Correlation analysis revealed that Hcy was positively correlated with age (r=0.269, P=0.002), and negatively correlated with folate (r=-0.222, P=0.010).Hcy was associated with smoking (χ2=7.363,P=0.007), hypertension (χ2=6.187,P=0.013), and two or more antiepileptic drugs polytherapy (χ2=4.708,P=0.030).After vitamin B supplementation in the group of moderate-severe hyperhomocysteinemia, serum Hcy concentration ((15.68±4.85) μmol/L in the treatment group vs (31.14±11.18) μmol/L in the control group, t=5.890, P<0.01), seizure frequency (4.85±2.78 vs 6.15±1.95, t=2.028, P=0.047) and HDMA scores (15.22±7.55 vs 17.70±4.90, t=2.862, P=0.005) decreased, whereas serum folate ((9.08±3.33) ng/ml vs (5.87±2.91) ng/ml, t=3.618, P=0.001), vitamin B12 ((556.39±276.76) pg/ml vs (419.71±164.53) pg/ml, t=2.336, P=0.023), vitamin B6 ((22.94±5.59) μmol/L vs (21.09±4.87) μmol/L, t=2.029, P=0.047) and MMSE scores (26.89±1.94 vs 25.75±2.20, t=2.024,P=0.048) increased in the treatment group compared with the control group.While in the group of mild hyperhomocysteinemia, the differences of seizure frequency, HDMA and MMSE scores were not statistically significant between the treatment group and the control group (all P>0.05).Conclusions It is necessary to monitor serum Hcy for senile epilepsy.Vitamin B supplementation is a safe and inexpensive way to reduce the concentration of Hcy, assist to control seizures and improve the clinical symptom of depression and cognitive impairment for senile epilepsy with moderate-severe hyperhomocysteinemia.

Based on JCI standard,conduct nursing practice area activities themed as the Warmness,Safe and Painless in the emergency department and outpatient department,deepen the connotation of nursing service.Use PDCA to achieve improvement simultaneously.In all these ways,we improved nursing quality,decreased sentinel event and increased satisfactory rate of the patients,enhance the nursing staff ＇s overall image,promote harmonious relations between nurses and patients.

By studying the developmental strategy of the revonal medical science and technology and implementation condition from 2001 to 2004 as well as systematically studying the national policy of the scientific and technical field,we proposed the developmental strategy of medical science and technology in Shanghai that the priority for the introduction,the application and the popularization of new or suitable technology should be given,also continuous advancement in technology should be kept.As a result,it is possible to provide the people a safer,more effective,convenient and moderately priced public health and basic medical service.During the past 5 years.we made an experimental work in selected Pudong in Shanghai.It Was proved that the strategy tallies with the actual situation of Pudong and is effectual in practice.

Anemia, Iron-Deficiency ; blood ; diagnosis ; Biomarkers ; blood ; Child ; Child, Preschool ; China ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Infant ; Male ; Receptors, Transferrin ; blood

Objective To find out whether Shanghai residents have mastered the knowledge related to iodine deficiency disorders (IDD),and how they choose different kind of salt.Methods Residents were selected by stratified random sampling from all 18 districts(counties) of Shanghai in 2010.Simple random sampling was used at the first level; random function was used at the second level to produce the last 4 numbers of a phone number.People who own the number were selected to be called.Results Totally 219 people completed the investigation.49.3％ (108/219) of the residents only selected iodized salt,and 25.6％(56/219) choose non-iodized salt; 6.8％ (15/219) selected both,and 18.3％ (40/219) don't care.About the reason of choosing iodized salt,25.9％ (28/108) thought it can prevent IDD,6.5％ (7/108) thought it's good to children's intelligence.About the reason of choosing non-iodized salt,35.7％ (20/56) thought they were not iodine deficiency,17.9％ (10/56) thought Shanghai was not an IDD epidemic region.Among the 126 people who had heard of iodine deficiency disorders,7.1％ (9/126) believed that iodine deficiency disorders can lead to varying degrees of mental impairment,65.1％ (82/126) thought it can lead to endemic goiter; 45.2％(57/126) thought eating iodized salt and 33.3％ (42/126) thought eating kelp and laver can prevent IDD.58％(127/219) had no idea of IDD and/or its hazards.Conclusions The resident's knowledge on iodine deficiency disorders is not satisfactory.We should make more effort in health education and help people to choose salt reasonably.

Objective:To study the radiation dose rate around patients underwent renal dynamic imaging of SPECT with 99Tcm-DTPA, so as to provide the basis for ensuring the radiation safety of the surrounding environment and the general public.Methods: 109 patients who underwent renal dynamic imaging were enrolled in this study, and the radiation dose rates of different time and different distance after 99Tcm-DTPA was injected patients were measured. And then, the changes of dose rate following time and distance were analyzed. Results: At the 0.5h, 1h, 2h, 3h, 6h, and 7h after radiopharmaceuticals were injected patients underwent renal dynamic imaging, the radiation dose rates were 0.76-8.86 μSv/h, 0.68-7.27 μSv/h, 0.57-4.52 μSv/h, 0.56-3.90 μSv/h, 0.23-2.07 μSv/h and 0.21-1.05 μSv/h, respectively, between 0.5 m and 4 m away from patients. At 24h after radiopharmaceuticals were injected, all of radiation dose rates at different distances around patients were same with background values.Conclusion: The radiation dose rates around patients underwent renal dynamic imaging will rapidly decrease with the increasing of time and distance. At 24h after radiopharmaceuticals were injected, all of radiation dose rates at different distances away from patients were same with background values.