Objective To explore the impact of iodine nutrition on 8-10 years old children after adjusting the iodine content in iodized salt in Hangzhou.Methods Twelve counties (areas,cities) were divided into urban,suburban and rural areas in Hangzhou.By population proportion survey (PPS),every county(area,city) was divided into east,west,south,north and middle districts; one school was selected in each district; forty children (half male and half female) aged 8-10 years old in each school were selected; family salt and urine samples of each student were collected.The levels of salt and urinary iodine were measured by picric sodium thiosulfate titrimetric (GB 13025.7-2012) and spectrophotometer method (WS/T 107-2006),respectively.Results Two thousand seven hundred and twenty-five household salt samples were collected.The median of salt iodine,the iodized salt coverage rate,the qualification rate of iodized salt and the consumption rate of qualified iodized salt were 24.00 mg/kg,4.35％(2 571/2 725),91.02％(2 340/2 571) and 85.87％(2 340/2 725),respectively.The medians of salt iodine in urban,suburb and rural areas were 24.10,22.12,24.30 mg/kg,respectively.A total of 2 664 children urine samples were collected.The median of urinary iodine (MUI) of the children was 177.24 μg/L.The MUIs in urban,suburb and rural areas were 175.00,178.55,178.00 μg/L,respectively; in male was 183.00 μg/L and female was 170.50 μg/L.When non-iodized and unqualified iodized salt were taken,the differences of urinary iodine within groups were statistically significant in urban,suburb and rural areas(x2 =18.652,14.686,all P ＜ 0.05).In rural area,the difference of urinary iodine of 8-10 years old children who ingested different types of iodized salt was statistically significant(x2 =39.07,P ＜ 0.05).Conclusion After adjusting the iodine content of salt in Hangzhou,the iodine-nutritional status of 8-10 years old students is at a appropriatelevel.

Objective To investigate traditional Chinese medical emotional intervention on the cognition function of senile patients after abdominal surgery. Methods Seventy senile patients having elective abdominal operation were randomized into intervention group and control group, 35 cases in each group. The control group received routine peri-operative nursing, and the intervention group was given routine peri-operative nursing and emotional intervention based on the theory of traditional Chinese medicine. The cognition function was evaluated with mini-mental state examination (MMSE) on preoperative day 1, postoperative day 3 and 7, and serum S100βprotein level was detected before operation and on postoperative day 7. Results (1)Time for recovery from general anesthesia in the intervention group was much shortened as compared with that of the control group(P<0.05). (2)On postoperative day 3, the incidence of postoperative cognitive dysfunction(POCD) was much lower than that of the control group(P<0 . 0 5), and on postoperative day 7 , the difference of POCD incidence was insignificant between the two groups(P>0.05). (3) On postoperative day 7, serum S-100β protein level in the two groups was increased as compared with that before treatment(P<0.05), but the difference between the two groups was insignificant(P>0.05). Conclusion Traditional Chinese medical emotional intervention has an effect on shortening time for recovery from general anesthesia and decreasing POCD incidence, but has no effect on POCD incidence and serum S100βprotein level on postoperative day 7.

Purpose:To study the expression of COX 2,P53 and PCNA in esophageal carcinomas and its significance. Methods:Immunohistochemical method was used to examine the sections from 82 esophageal squamous cell carcinomas, 20 esophagitis and 16 normal esophageal mucosa tissues. Results:The positive ratios of COX 2,p53 and PCNA were 87.8%(72/82),82.9%(68/82)and 95.1%(78/82) in 82 esophageal carcinomas, respectively. But there was no expression in adjacent noncancerous tissues and normal esophageal mucosa tissues. The positive ratio of COX 2 protein was significantly higher in the well differentiated and moderately differentiated esophageal carcinomas than in the poorly differentiated esophageal carcinomas( P

Objective To explore the impact of iodine nutrition on pregnant women before and after adjusting the iodine content in iodine salt.Methods Twelve counties (areas,cities) in Hangzhou were divided into urban,suburban and rural areas before and after adjusting the iodine content of salt.One survey spot was selected in each district and one hundred pregnant women were selected;family salt and urinary samples of each pregnant woman were collected.The levels of salt and urinary iodine were measured by the methods of picric sodium thiosulfate titrimetric (GB 13025.7-2012) and spectrophotometer (WS/T 107-2006),respectively.Results One thousand two hundred and thirty-nine and one thousand two hundred and thirty-three household salt samples were collected before and after adjusting the iodine content in iodine salt.The median of salt iodine of pregnant women (23.30 mg/kg) before adjusting the iodine content in iodine salt was lower than that after adjusting the iodine content in iodine salt (30.09 mg/kg,x2 =-4.71,P ＜ 0.01).The iodine salt coverage rate and the consumption rate of qualified iodized salt after adjusting the iodine content in iodine salt [93.92％ (1 158/1 233),93.84％ (1 157/1 233)] were higher than those before adjusting the iodine content in iodine salt [91.85％ (1 138/1 239),91.37％ (1 132/1 239),x2 =4.01,5.51,all P ＜ 0.05].The iodine salt coverage rate and the consumption rate of qualified iodized salt in urban and suburb areas after adjusting the iodine content in iodine salt [99.42％ (510/513),100.00％ (203/203),97.86％ (5021513),100.00％ (203/203)] were higher than those before adjusting the iodine content in iodine salt [86.71％ (450/519),98.00％ (196/200),77.26％ (401/519),85.00％ (170/200)],but the iodine salt coverage rate and the consumption rate of qualified iodized salt in rural area before adjusting the iodine content in iodine salt [94.62％ (492/520),86.92％ (452/520)] were higher than those after adjusting the iodine content in iodine salt [85.69％(443/517),76.98％ (398/517),x2=64.22,2.32,100.02,32.90,23.31,17.33,all P ＜ 0.05].One thousand two hundred and thirty-four and one thousand two hundred and thirty-one household urine samples were collected before and after adjusting the iodine content in iodine salt.The median of urinary iodine (MUI,114.80 μg/L) of pregnant women after adjusting the iodine content in iodine salt was lower than that before adjusting the iodine content in iodine salt (168.60 μg/L,x2 =36.92,P ＜ 0.01).The MUIs of pregnant women in urban,suburban,and rural areas (171.30,170.20 and 162.40 μg/L) before adjusting the iodine content in iodine salt were higher than those after adjusting the iodine content in iodine salt (101.00,149.48 and 119.90 μg/L,x2 =-7.78,-2.63,-6.28,all P ＜ 0.01).The differences of urinary iodine between groups were statistically significant in urban,suburban and rural areas after adjusting the iodine content in iodine salt (x2 =32.86,P ＜ 0.01),the MUI of pregnant women in urban areas was lower than those in the suburban and rural areas (x2 =6.70,8.13,all P ＜ 0.05).Conclusions After adjusting the iodine content of salt in Hangzhou,the iodine-nutrition level of pregnant women is decreased.But the consumption rates of qualified iodized salt and the MUIs in urban,suburb,rural areas are different,so the coverage of iodized salt at household level needs to be enhanced and the health education should be highlighted.

Objective: To quantify the effect of motor-developmental Tuina therapy on 61children with cerebral palsy. Methods: All the children received the motor-developmental Tuina therapy for 20 min each time, 3 to 6 times per week. The gross motor functions of the children were evaluated by GMFM 66. The baseline period evaluations in 15 children and follow-up period evaluations in 26 children were performed. Results: GMFM 66 score significantly increased at the end of treatment period (P<0.001). The GMFM 66 score changes per month in treatment period was significantly greater than those of both baseline period and follow-up period (P<0.001). Conclusion: The effect of motor-developmental Tuina therapy was notable on children with cerebral palsy. Continuous progress of the gross motor functions in these children may be obtained by continuous therapy.

Objective To explore the impact of iodine nutrition on children in areas with different iodized-salt covering rate after adjusting the iodine content in iodized salt in Hangzhou.Methods After adjusting the iodine content of salt,every county (area,city) of Hangzhou was divided into east,west,south,north and middle districts;one school was selected in each district,40 children aged 8-10 years old in each school were selected.The goiter rates of 8-10 years old students were examined (WS 276-2007).The family salt and urine samples of each student were collected.The levels of salt and urinary iodine were measured by picric sodium thiosulfate titrimetric (GB 13025.7-2012) and spectrophotometer method (WS/T 107-2006),respectively.Areas were classified according to the coverage rate of iodized salt ＜95％ and ≥95％,and their urinary iodine levels were compared.Results A total of 2 395 samples were collected with a median salt iodine concentration of 23.50 mg/kg and a urinary iodine level of 167.45 μg/L.The goiter rate of children 8-10 years old was 1.75％ (42/2 395).The total iodized-salt covering rate was 93.15％ (2 231/2 395) and the difference was statistically significant between different districts and towns (x2 =153.13,P ＜0.01),but the level was less than 95％ in 6 areas.The urinary median iodine was 151.00 μg/L in the areas where the iodized-salt covering rate was less than 95％,lower than 173.50 μg/L in the areas where the iodized-salt covering rate was more than or equal to 95％ (x2 =-5.28,P ＜0.01).Conclusions After adjusting the iodine content of salt in Hangzhou,the iodine-nutrition status of 8 to 10 years old students is optimal.But the urinary iodine levels are different in areas with different iodized-salt covering rates,so the coverage of iodized salt at household level need to be enhanced and the health education should be strengthen.

Objective To investigate the status of social adjustment in undergraduate nursing students, and to explore the influence of interpersonal relations and social support on social adjustment. Methods A total of 485 undergraduate nursing students in the School of Nursing of University of South China were investigated by using the Comprehensive Diagnostic Scale for Interpersonal Relations, Social Support Rating Scale and Chinese College Students' Adaptability Scale with stratified cluster sampling method. Results The total scores of social adjustment of undergraduate nursing students were (195.37 ± 26.63) points. The total scores of interpersonal relations were (9.18 ± 5.81) points. The total scores of social support were (36.72 ± 5.39) points. Social support and social adjustment were positively correlated (r=0.274, P<0.01), but interpersonal relations and social adjustment were negatively correlated (r=-0.490, P<0.01). The main influencing factors of social adjustment in a descending order included interpersonal dating(β=-0.390, P=0.000), interpersonal conversation(β=-0.146, P =0.024) and subjective support(β=0.133, P =0.005). Conclusions The scores of the social adjustment, social support and interpersonal relations of undergraduate nursing students are all in the middle level. The main influencing factors of social adjustment include interpersonal dating, interpersonal conversation and subjective support, particulally interpersonal dating. Educators can improve their social adjustment through improving interpersonal dating, interpersonal conversation and subjective support .

Objective To introduce inhaled inactivated-mycobacterium phlei on prevention and treatment of moderate bronchial asthma to observe the clinical effect. Method This study was a prospective and controlled study. The patients diagnosed with asthma in our out-patient from March 2009 to December 2010 were collected, who met the following conditions were included in the study: age≥ 14 years; met the criteria of moderate chronic persistent bronchial asthma in Global Initiative for Asthma (GINA) in 2008; suspended receiving systemic corticosteroids, Montelukast, ketotifen and other anti-inflammatory and anti-allergic drugs in one month; no significant respiratory tract infections; and other serious illnesses or abnormalities known.A total of 100 patients with asthma were selected, including 37 males and 63 females, age (32.11 ± 12.95 )years. The patients were randomly(random number) divided into two groups: A group(treatment group; 16males and 34 females, age 33.56 ± 14.23 years) and B group (control group; 21 males and 29 females,age 30.66 ± 11.50 years); 50 in each group. No significant difference was noted between the two groups on age and gender composition. The patients in A group were treated with inhaled inactivated-mycobacterium phlei F. U. 36 Injection 1.72 μg/mL × 2 that adding 3 mL normal saline, once a day for 5 days. The patients in B group were treated with salmeterol xinafoate and fluticasone propionate powder for inhalation (50/100 μg), twice daily for sustainable use. The patients in the two groups were observed for one month. During this course, the patients in the two groups could inhale the salbutamol sulphate aerosol as need to relieve symptoms. And the number of using was recorded. Pulmonary function test and asthma provocative test were carried out on the Day O, 6 and 31. ACT scores were measured before and after the treatment. Results On Day 6 and 31 after treatment, the negative conversion rates of asthma provocative test of the patients in A group were 82% and 78% respectively, B group were 84% and 90% respectively. Provocative test of the patients in the two groups were negative conversion significantly before and after treatment. There was no significant difference between the two groups by chi-square test (P ＞ 0. 05 ). Completely random designed data was analyzed by analysis of variance. The analysis showed that the accumulated doses of methacholine of the patients in the two group increased significantly ( P ＜ 0. 05 ), but no difference between the two groups.There was a improvement trend on forced expiratory volume in one second( FEV1 )of the patients in A group after treatment, but no difference. FEV1 of the patients in B group increased significantly higher ( P ＜0.05), which was significantly higher than A group on the 31th day (P ＜0. 05); Peak expiratory flow (PEF) of the patients in the two group increased significantly on Day 6 and 31 after treatment (P ＜0.05 ).On Day 31, B group was significantly higher than A group ( P ＜ 0. 05 ); Scores of asthma control test (ACT)of the patients in the two group were significantly increased, and the number of using of salbutamol sulfate aerosol was significantly reduced (P ＜0.01 ). B group was obvious than group A (P ＜0.05 ). During treatment, there were only two adverse reaction cases of transient low fever; most obvious was on the third day.Conclusions Inhaled inactivated-mycobacterium phlei would inhibit the airway hyperresponsiveness of the patients with moderate bronchial asthma in short time, improve the symptoms, reduce the acute exacerbation, and reduce the use of rescue medication, which has the roles of prevention and treatment of moderate asthma in a certain period of time.

Objective: To explore the correlation of monocyte to HDL-C ratio (MHR) and post-operative slow lfow or no relfow in patients with ST-segment elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI). Methods: A total of 216 STEMI patients treated in our hospital from 2014-10 to 2016-05 were enrolled. The patients were divided into 2 groups: Slow lfow or no relfow group, the patients with TIMI grade≤2,n=43 and Normal lfow group, n=173. Receiver operating characteristic (ROC) curve was performed to assess the best cut-off value for MHR predicting slow lfow or no relfow with its sensitivity and speciifcity; Logistic regression analysis was conducted to studied weather MHR could be used as an independent risk factor for coronary slow lfow or no relfow in STEMI patients after PCI. Results: Compared with Normal lfow group, Slow lfow or no relfow group had the higher MHR (18.6±9.8) vs (10.9±5.5), P<0.001. Univariate Regression analysis indicated that MHR was a risk factor of slow lfow or no relfow occurrence (OR=2.22, 95% CI 1.58-3.28); multivariate regression analysis presented that MHR was an independent risk factor of slow lfow or no relfow occurrence (OR=1.55, 95% CI 1.01-2.38). ROC curve showed that the best cut-off value for MHR predicting slow lfow or no relfow occurrence was 13.37 with the sensitivity and speciifcity at 67.4% and 70.5% respectively, the area under curve (AUC) was 0.734, 95% CI 0.646-0.822. Conclusion: MHR was an independent risk factor for slow lfow or no relfow occurrence in STEMI patients after PCI.

Based on the teaching concept of constructivism, this study aims to promote independent inquiry-based learning and clinical thinking among students and establish the guiding ideology of "full participation, process control, in-depth discussion, and expansion of thinking". A blending learning model was adopted with offline inquiry-based group learning and in-class defense and comment, as well as online teacher-student interaction and supervision to promote learning. Case-problem-based learning (CPBL) of pathophysiology was carried out among the medical students in the class of 2017, and process management was strengthened to effectively manage the two key links of data retrieval and group discussion. The analysis of 176 teaching evaluations collected at the end of the semester show that in terms of the overall evaluation of CPBL teaching, 162 students (92.05%) had high evaluation on teaching objectives, organization, cases, and personal gains and held a very or relatively favorable attitude. There were more negative feedbacks on "appropriate time allocation"; 21 students (11.93%) held a relatively or very disapproving attitude, and 149 students (84.66%) "felt very tired". In terms of teaching effect evaluation, 150 students (85.23%) strongly or relatively agreed that CPBL teaching may help to understand professional knowledge, stimulate learning enthusiasm and initiative, improve problem solving ability, emphasize clinical practice to cultivate clinical thinking, supervise and promote learning, and enhance team cooperation and teacher-student communication. In terms of the evaluation of teachers, 167 students (94.89%) thought that teachers were rigorous, responsible, and enthusiastic in teaching, attached importance to process management, and did well in effective guidance and thinking inspiration (strongly or relatively agree). The above results suggest that the CPBL teaching reform of pathophysiology based on process management can effectively promote in-depth inquiry-based independent learning and the cultivation of clinical thinking and improve teaching effectiveness, but further improvement is needed for teaching arrangement and time allocation.