Objective To investigate the changes of waist muscle density and area in the subjects with spiral CT scan examination,and through the quantitative analysis of different age and gender to get the degree of lumbar muscle degeneration.Methods 240 cases of lumbar CT scan reconstruction images (including the patients suffering from low back pain)were collected.According to the age,20 - 29 years old group,30 - 39 years old group,40 -49 years old group,50-59 years old group,60-69 years old group,and 70-79 years old group were set up.The lumbar transverse psoas muscle,lumbar side muscle,erector spinae cross-sectional areas (CSA)and mean CT values were measured at different levels.Scanning equipment:Toshiba Activion 16-slice spiral CT scanners, acquisition range from the waist 1 to S1.Results ①Compared between the measurement results of the same age groups (except 70-79 years old group),the average CSA of the male at the same level waist was higher than the female (P <0.05).②Compared between the same level groups of 20-29 years,30-39 years and 40-49 years, there were no significant differences (P >0.05).Compared between the same level groups of 50-59 years,60-69 years and 70-79 years,there was no significant difference (P >0.05).③Compared the CSA of man’s erector spinae muscle between 40-49 years group and 50-59 years group,there were significant differences (P <0.05).④Compared the same level CSA of female between 20-29 years,30-39 years,40-49 years,50-59 years,60-69 years,70-79 years groups,and the adjacent groups,there were no significant differences (P >0.05).⑤The same level average density of erector spinae muscle was lowest compared with the psoas major muscle and quadratus lumborum muscle,and falling faster,the psoas major muscle was relatively higher.The same level average density of female’s erector spinae muscle was lower than man’s,specially in 70-79 years group.Conclusion Multi-slice spiral CT can be used to diagnose the lumbar degenerative conditions.

Objective To investigate the application of the parenteral nutrition prescriptions for tumor patients in a tertiary hospital .Methods In this cross-sectional study , the parenteral nutrition prescriptions of all tumor inpatients in a tertiary hospital were collected from May to June in 2015 .The general data of patients who had used parenteral nutrition , the types of parenteral nutrition products , as well as the ratio of energy to ni-rogen ( E/N) , glucose/lipid ( G/L) ratio, non-protein energy to nitrogen ratio , and liquid volume were recor-ded and analyzed .Results Parenteral nutrition prescriptions were collected from 528 patients and showed high irrationality.The nutrient insufficiency rate was nearly 58.3%.The E/N (100:1 ~200:1) accounted for 32.3%and the G/L ( 1:1 ~2:1 ) 20.6%.Conclusions The rational application of parenteral nutrition should be a priority in clinical settings .A clinical nutrition supporting team may be established in tertiary hospi-tals to guide the appropriate use of parenteral nutrition .

Objective To explore the formation mechanism of peritumoral brain edema(PTBE)by vascular endothelial growth factor(VEGF).Methods 40 biopsies were obtained from 37 patients.Inmunohistochemical staining and Western blot were performed to detect the expression of VEGF protein.Reverse-transcriptase polymerase chain reaction(RT-PCR)was used to analyze the presence and quantity of VEGF mRNA.The extent of PTBE was estimated as an edema index(EI)based on preoperative magnetic resonance imaging.Results In VEGF-positive cases,a decreasing gradient of VEGF protein expression was observed with increasing distance from tumors(0.38±0.08,0.20±0.03,0.04±0.02).In meningiomas,the protein level and the mRNA level were congruent and the expression of both protein and mRNA had a significant correlation with EI(protein: r =0.892,RNA: r =0.875,P ＜ 0.05).However,in peritumoral areas,protein level were not consistent with the mRNA level.Protein results showed high correlation with EI(r =0.912,P ＜ 0.05),but mRNA almost was almost undetectable(0.06±0.02).Conclusion VEGF is impartant on PTBE.It is concluded that VEGF macromolecules are secreted by tumor tissue and enter peritumoral normal brain tissue to induce edemagenesis in meningiomas.

In order to show the social situation and public opinions for the decision-makers of medical reform, the viewpoints of main media, NPC and PCC members, and Internet users were analyzed according to the real-time monitoring data of public opinions on health-related topics ( new rural cooperative medical system, basic public health service, and rural medical workers) during the NPC and PCC, which showed the public awareness of health reform in grass-roots units of China.

Objective:To investigate the efficacy and the clinical value of magnetic resonance elastography(MRE) in diagnosis of hepatic fibrosis with Meta-analysis, and to provide basis for clinical treatment of hepatic fibrosis.Methods:The studies published before February 2, 2017 about MRE and staging of hepatic fibrosis in Chinese or English were retrived in the databases including PubMed, EMBase, Web of Science, Cochrane Library,CNKI, CBMDisc,VIP, Wanfang data, and supplemented by manual retrieval for relevant literatures.The inclusion and exclusion criterions were used to select and extract the literatures.The literatures qualitie were valuated based on QUADAS-2 tool.The sensitivity(SEN), specificity (SPE), diagnostic odds ratio (DOR), positive likelihood ratio (+LR), negative likelihood ratio (-LR) on the groups of F0 vs F1-F4,F0-F1 vs F2-F4,F0-F2 vs F3-F4, F0-F3 vs F4 and heterogeneity were combined and tested with Stata software respectively.HSROC and AUROC were also implemented.Results:A total of 1 332 studies were searched, and 22 were included.21 of them were in English and 1 in Chinese.The results of Meta analysis showed that the SENp, SPEp, +LRp,-LRp, DOR and AUROC in F0 vs F1-F4 group were 88.8%(85.0-91.7),95.9%(91.5-98.0),21.435(10.215-44.979),0.117(0.086-0.159),183.187(72.533-462.650) and 0.96(0.94-0.98) ,respectively;the SENp, SPEp, +LRp,-LRp, DOR and AUROC in F0-F1 vs F2-F4 group were 93.3%(89.2%-35.9%), 94.1%(90.2%-96.5%),15.839(9.344-26.848),0.072(0.044-0.117),221.224(100.980-484.648) and 0.98(0.96-0.99),respectively;the SENp, SPEp, +LRp, -LRp, DOR and AUROC in F0-F2 vs F3-F4 group were 92.9%(88.9%-95.5%),94.6%(91.2%-96.8%),17.348(10.496-28.671),0.075(0.048-0.119),230.434(111.482-476.317)0.98(0.96-0.99), respectively;the SENp, SPEp, +LRp,-LRp, DOR and AUROC in F0-F3 vs F4 group were 97.7%(93.0%-99.3%),93.2%(90.3%-95.2%),14.337(9.910-20.742),0.025(0.008-0.075),580.405(144.871-2325.307) and 0.98(0.96-0.99),respectively.Conclusion:MRE,as a new and noninvasive imaging method, has high diagnostic value in all stages of hepatic fibrosis, which can provide a reliable reference for clinical precise treatment of hepatic fibrosis.

Objective The study examined the influence on marginal bone levers at implants which implants were assigned to open healing and implant-abutment connection restored according to a platform-switching concept. Methods One implant were placed in the first molar of mandible of 48 patients , randomly assigned to open (OH) or submerge (SH) healing. Standardized radiographs were obtained after implant surgery, when implant transfer and crown mounting, and 6 ,12 and 24 months after implants restoration, then evaluated for implant-bone-lever alterations(ΔIBL). Results After 6 months after implants restoration,ΔIBL were (-0.25 ± 0.08)mm mm(OH)and (-0.26 ± 0.12)mm(SH). After 12 months follow-up, ΔIBL were (-0.29 ± 0.13)mm (OH)and (-0.31 ± 0.14) mm(SH), and after 24 months later, ΔIBLwere (-0.34 ± 0.15)mm(OH)and (-0.33 ± 0.11)mm (SH). Conclusions Platform-switched implants showed very limited peri-implant bone-lever alterations. The healing-mode neither affected the total amount nor the temporal patterns of ΔIBL.

Objective To investigate the relationship between the systemic lupus erythematosus (SLE)and the SOCS-1 gene methylation status of the peripheral blood DNA,to provide the basis for diagnosis and treatment of systemic lupus erythema-tosus.Methods Blood samples of SLE patients (27 cases)and healthy group (19 cases)in January 2015 to April were col-lected and the DNA were extracted.Using polymerase chain reaction combining DNA agarose gel electrophoresis to detect the SOCS-1 gene methylation status.Results In patients with systemic lupus erythematosus SOCS-1 gene complete methyl-ation accounted for 44% (12/27),incomplete methylation accounted for 56% (15/27).In healthy group SOCS-1 gene com-plete methylation accounted for 74% (14/19)and incomplete methylation accounted for 26% (5/19).The rate of complete methylation of SOCS-1 gene of SLE patients was lower than that of healthy group (χ2=3.88,P=0.049).Conclusion SLE patients may have lower SOCS-1 gene methylation status in the peripheral blood DNA,which is worth for further study.

The medical and health reform at grass-root level was monitored during the NPC and CPPCC from 2015-2017 . The public sentiment on medical and health reform at grass-root level in recent years was thus as-sessed according to the text mining and data analysis using the R language and Python method from the aspects ofnow rural cooperative medical care,comprehensive health reform at grass-root level,health service develop-ment at grass-root level and Internet + medical care in order to provide reference for the effective feedback of achievements and development in policies of medical and health reform at grass-root level.

OBJECTIVE:To change the drug management mode in wards,promote drug use for patients timely and rationally. METHODS:Automated dispensing cabinet(ADC)was used to manage the drugs in some wards in our hospital,and introduce its use practice from aspects of drug management mode,pharmacists'management to ADC,related measures when using ADC manag-ing ward drugs,effect evaluation after using ADC(using species of base drugs,average time of dispensing temporary medical or-ders,drug returning times in 5 wards before and after using ADC as indexes),etc. RESULTS:Drug management method was es-tablished in ADC by screening drugs into the cabinet and developing process of taking drugs out. And pharmacists had achieved drug management in wards by establishing drug lists,conducting replenishment and inventory management,developing emergency plan,enhancing supervision and inspection,etc. Compared with before using ADC,average species of base drugs in the 5 wards increased from 65.8 to 157.2;average time of dispensing temporary medical orders dropped from 24.5 min to 5.8 min;and average drug returning times in 3 months decreased from about 200 times to about 20 times(P<0.05 or P<0.01). CONCLUSIONS:Us-ing ADC in wards for drug management has not only improved use convenience of drugs in wards,working efficiency of nurses as well as pharmaceutical care quality of pharmacists,but also has changed drug management mode and promoted rational drug use of patients.

Objective To investigate the influence of the post stroke depression (PSD) on cognitive function in patients with stroke and their correlation, and to evaluate the diagnosis value of P300 cognitive function in patients with PSD. Methods One hundred and seventeen cases of inpatient with acute stroke in neurology medicine were continuously observed and scored using HAMD rating scale at the onset of 2 weeks. And 53 cases of PSD and 64 cases of non-post-stroke depression (NPSD) were scored using MMSE score and P300 determination respectively,and the results were compared. Results The incidence of PSD was 45.29%(53/117) at the 2 weeks after stroke,including 35 cases (29.91%) of mild depression,11 cases (9.40%) of medium degree depression and 7 cases (5.98%) of major depression. Compared with NPSD group, the P300 latency period of PSD group was significantly prolonged ( < 0.01), and the amplitude significantly reduced ( < 0.01) . The MMSE score difference was statistically significant ( <0.05) in the two groups. Conclusion The PSD is given priority to with mild-to-moderate depression, and the cognitive function damage in patients with PSD is more obvious than that in NPSD group. P300 determination can be used as the evaluation indicator of diagnosis cognitive function in patients with PSD.