ObjectiveTo discuss effective measures to improve postoperative sexual life quality of patients with cervical intraepithelial neoplasia (CIN).MethodsOne hundred and twenty patients with CIN were randomly assigned to the blue-ribbon club group, the friendship-support group and the control group. The blue-ribbon club patients were regarded as club members and received special education every two months. The friendship-support group patients received education one by one in the hospital setting and the control group patients received the same education as before participated into the trial. Female sexual function index (FSFI)was used to evaluate sexual function before and 6 months after intervention.ResultsExcept sexual pain, the total score of FSFI and the score of sub-domain in the blueribbon club were significantly higher than that in the control group. The total score of FSFI and score of sub-domain were significantly higher than that in the control group. There were no significant differences between both intervention groups.ConclusionsBoth education intervention modes of the blue-ribbon club group and the friendship- support group could effectively improve sexual function for post-operation patients with CIN.

Objective To evaluate clinical application of VCS technology in diagnosis for acute leukemia and its subtypes by LH750 automated hematology analyzer. Methods A total of 178 leukemia patients (105 acute granilocytic leukemia, 42 acute lymphocytic leukemia, 31 acute monecytic leukemia)and 151 non-leukemia patients (86 granulocytic abnormal cases, 35 lymphocytic abnormal cases,30 monocytic abnormal cases) were enrolled into this study. Peripheral blood samples were analyzed by both Coulter LH750 automated hematology analyzer and manual microscopic examination. Microscopic examination was used as reference to evaluate the diagnosis value of VCS technology in blast detecting. VCS parameters were compared for AGL subsets. The clinical value of VCS technology in diagnosis for different acute leukemia was also evaluated by combining VCS scattergram and suspect flags provided by LH750. Results Compared with manual examination, a sensitivity of 95.5% (170/178) and specificity of 95.4% (144/151) were achieved by VCS technology in detecting blasts in acute leukemia and nonleukemia patients. In patients with AGL, the MNV, MNV-SD, MNC and MNC-SD (224.40 ± 23.37,37.40 ±12. 31,145. 80 ±7. 93,24. 79 ±5. 18) were higher than granulocytic abnormal patients( 169.96 ±11.50,29.21 ± 5.27,133.30 ± 5.50, 10.62 ± 4.09) and the differences were statistically significant ( t values were 16. 832, 5. 148, 5. 735, 19. 953 respectively, P < 0. 01 ). On the contrary, MNS ( 122. 90 ±6. 35) in AGL patients was significantly lower than granulocytic abnormal patients( 131.00 ± 5. 69, t =-7.64, P<0.01). In patients with ALL, the MLV, MLV-SD, MLC, MLS, MLS-SD (97.60 ± 13.40,22. 35 ± 7.94,110. 00 ± 4. 60,77. 60 ± 19.00,20. 61 ± 3.30 ) were higher than lymphocytic abnormal patients(82. 10 ± 3.00, 14.41 ±2.35, 100.60 ±2.70, 48. 10 ±3.50, 17.60 ± 1.60). The data also showed a statistical significance (t values were 7.576, 6. 118, 4. 041, 9. 353, 2. 988 respectively, P <0.05). In patients with AMOL, the MMV, MMV-SD, MMC, MMC-SD, MMS(197. 30 ±20.50,30.47 ±6.58,123.20 ± 10. 10,6.57 ± 1.57,98.00 ± 5.60) were significantly higher than monocytic abnormal patients( 167.80 ± 15.77,21.90 ± 9. 64,113.60 ± 6. 73,5.20 ± 3. 21,84. 20 ± 14. 35 ) and the differences were statistically significant (t values were 6. 332, 4. 033, 4. 650, 2. 993, 6. 273 respectively , P <0. 01 ).The differences of MNV, MNV-SD, MNC, MNC-SD, MNS-SD for different AGL subtypes were statistically significant ( F values were 21.2, 169. 5, 13.6, 3. 6 and 98.6 respectively, P <0. 01 ). For AGL, ALL and AMOL, the ratios of normal blast distribution in scattergram were 81% (85/105), 74% (31/42) ,and 74% (23/31). Conclusions The VCS parameters can reflect the changes of peripheral white blood cell morphology sensitively. VCS technology can diagnose acute leukemia and its subtypes efficieutly.

Objective To assess the therapeutic effect of high-frequency repetitive transcranial magnetic stimulation (rTMS) combined with neuromuscular electrical stimulation (NMES) on poststroke dysphagia.Methods A total of 90 patients with poststroke dysphagia were enrolled.They were randomly divided into either a NMES + rTMS group or a NMES + sham rTMS group (n =45 in each group).The Kuhota water drinking test and Standardized Swallowing Assessment (SSA) were used to assess the swallowing function.Results The scores of Kuhota water drinking test (F=82.001,P＜0.001) and the SSA (F =33.743,P ＜0.001) before treatment,treatment of one course,treatment of two courses,and at 3 months after treatment in the NMES + rTMS group had significant differences.Compared with before treatment,they were improved significantly for treatment of one course (P ＜0.01 and P ＜0.05,respectively),two courses (all P＜0.01),and at 3 months (all P＜0.01) after treatment.The scores of Kuhota water drinking test (F =53.647,P＜0.001) and the SSA (F=19.178,P＜0.001) in the NMES + sham rTMS group also had significant difference.Compared with before treatment,they had significant improvement for treatment of one course (all P ＜0.05),two courses (P ＜0.05 and P ＜0.01,respectively) and at 3 months (all P＜0.01)after treatment.The scores of Kuhota water drinking test for treatment of one course,two courses,and at 3 months after treatment (treatment of one course:t=2.217,P=0.02;treatment of two courses:t =2.406,P =0.019;at 3 months after treatment:t =2.128,P =0.037) and the SSA (treatment of one course:t =2.196,P =0.030,treatment of two courses:t =2.425,P =0.016;at 3 months after treatment:t =2.512,P=0.013) in the NMES + rTMS group were significantly better than those in the NMES + sham rTMS group.Conclusions High-frequency rTMS combined with NMES may significantly improve the swallowing function in patients with stroke.Its efficacy is superior to NMES.

Objective To develop a real-time fluorescence quantitative PCR method for detection of Legionella pneumophila as a tool for environmental and clinical examination. Methods A pair of degen-erated primers and one TaqMan-MGB probe were designed to test the conserved region at the macrophage in-fective potentiation (mip) gene of Legionella pneumophila. TaqMan MGB real-time quantitative PCR assay was developed with pMD-19T plasmid including mip gene of Legionella pneumophila as standard sample. The sensitivity and specificity of the real-time quantitative PCR was evaluated using the standard sample and dif-ferent strains. Results The detection limit of 0.71 copy/μl was obtained for the standard sample in a reac-tion system of 0.6μl of sense and antisense primers (20μmol/L), respectively, 0.4μl of probe (20μmol/L) and 6.0μl of DNA temple. Conditions for the PCR reactions were as follows. After an initial de-naturation at 95℃ for 20s, 40 amplification cycles were performed. Each cycle consisted of denaturation at 95℃ for 10 s, primer annealing at 50℃ for45s. The PCR Ct value of a standard strain and 12 isolates was in a scale of 13.23 and 16.04. However, the Ct values of the strains of Staphylococcus aureus, Salmonella typhimurium, Vibrio parahaemolyticus, Escherichia coli, Pseudomonas aeruginosa and Shigella sonnei were greater than 30. Conclusion The real-time quantitative PCR method has good sensitivity and specificity and the result has potentiality of applying for detecting Legionella pneumophila.

Objective To investigate the intensity of HBsAg and HBcAg expression in liver tissue of patients with chronic hepatitis B virus (HBV) infection and its clinical significance.Methods A total of 994 HBV infected patients underwent liver biopsy and histopathological examination.The expression of HBsAg and HBcAg in liver tissue was detected by histoimmunochemistry.Patients were divided into HBeAg (+)/HBVDNA(+), HBeAg(-)/HBV DNA(+) and HBeAg(-)/HBV DNA(-) groups according to HBeAg and HBV DNA levels;patients were divided into ＜2 × normal (ULN) group, 2-＜5 × ULN groupand ≥5 × ULN group according to the alanine aminotransferase (ALT) levels.The histologic activity (A), fibrosis (F), the expression of HBsAg and HBcAg in liver tissue and their correlations with clinical features were analyzed.Logistic regression analysis was used to study the factors affecting the expression of HBsAg and HBcAg in liver tissue.Results Among 994 HBV infected patients, 941 cases (94.67％) were intrahepatic HBsAg positive and 553 cases (55.63％) were intrahepatic HBcAg positive;403 cases (40.85％) were ≥A2 in histologic activity and 371 cases (36.09％) were ≥F2 in fibrosis.The degree of A and F was the highest in HBeAg (-) / HBV DNA (+) group, followed by HBeAg (-) / HBV DNA (-) group, and was the lowest in HBeAg (+) / HBV DNA (+) group.The intensity of intrahepatic HBsAg expression was significantly different among three groups (x2 =6.299, r =-0.760, P ＜ 0.05), however, the difference was not showed in pairwise comparisons.The difference of intrahepatic HBcAg intensity among three groups was statistically significant (x2 =282.995, r =-0.645, P ＜ 0.01), the intensity was the highest in HBeAg (+) / HBV DNA (+) group and the lowest in HBeAg (-) / HBV DNA (-) group.The constituent ratio of HBeAg positive and HBV DNA level were higher and the average age was lower in intrahepatic HBsAg positive group than those in HBsAg negative group.The constituent ratio of positive HBeAg, the levels of ALT, AST, PLT and HBV DNA were higher and the average age, the average FIB-4 level were lower in intrahepatic HBcAg positive group than those in HBcAg negative group.The HBV DNA level was an independent risk factor for intrahepatic HBsAg intensity, and the HBeAg positive and HBV DNA level were independent risk factors for intrahepatic HBcAg intensity.There were no significant differences in A and F among different groups of intrahepatic HBsAg intensity (x2 =1.943 and 2.630, both P ＞ 0.05).There was significant difference in F among different groups of intrahepatic HBcAg intensity (x2 =12.352, P ＜ 0.01), but not in A.The degree of F was the highest in intrahepatic HBcAg negative group.There was significant difference in intrahepatic HBcAg intensity among different groups of ALT level (x2 =16.349, P ＜ 0.01), but not in intrahepatic HBsAg intensity.The intrahepatic HBcAg intensity in ALT ＜ 2 × ULN group was lower than that in other two groups.Conclusions Most of patients with chronic HBV infection are intrahepatic HBsAg positive and more than half of them are intrahepatic HBcAg positive.The intrahepatic HBsAg intensity is not associated with A and F, but correlates with HBV DNA level.The intrahepatic HBcAg intensity is not associated with A, but it is negatively correlated with F and positively correlated with positive HBeAg expression, HBV DNA level and ALT level.

Objective: To investigate the daily learning time status of elementary school students and understand the implementation of Health Requirements of Daily Learning Time for Secondary and Elementary School Students (GB/T 17223-2012) in schools, so as to provide a reference for strengthening and improving school health and health education in the new era. Methods: A stratified cluster random sampling method was used to select 7 776 primary school students in Shandong Province, and a survey questionnaire was designed based on the Health Requirements for Dayily Learning Time for Secondary and Elementary School Students(GB/T 17223-2012) standard to investigate their daily learning arrangements, sleep and physical activities, and breaks between classes. Comparison of intergroup differences were used by Chi square test and Kruskal-Wallis H test. Results: About 55.88 % of primary school students for daily learning time met the standard. There was a statistically significant difference in the daily learning time achievement rate among primary school students in three grades for first and second grade, third and fourth grade and fifth and sixth grade ( Z=1 629.47, P <0.01), and the fifth and sixth grade had the highest proportion of achieving the standard (85.92%). Specifically, the proportions of students whose class hours, class numbers and morning reading time meeting the standards were 30.07%, 10.20% and 42.19%, respectively. The sleep deficiency rate of primary school studnets was 58.69%, and the physical activity deficiency rate was 65.78%; and there was a statistically significant difference in the rate of insufficient sleep time and physical activity time among primary school students of different grades ( χ 2=56.39, 95.95, P <0.01), with sixth grade students showing the highest rates for both sleep and physical activity deficiencies (64.35%, 73.37%). Additionally, 49.78% of students had recess time below the standard requirements. Conclusion The health status of daily learning time among primary school students in Shandong Province is poor, with insufficient implementation of school standards, and the implementation of standards needs to be further strengthened.

Objective To comparative analyze the influence factors of short-term (6 months) and long-term (10 years) prognosis in patients with HBV-related acute-on-chronic liver failure (ACLF),and to provide some reference values on clinic therapy and follow-up management.Methods The data of 524 hospitalized patients with ACLF from January 2001 to December 2009 were analyzed retrospectively.The follow-up termination time was December 2013.Patients were all given internal medical therapy,and were given antiviral therapy with nucleoside and nucleotide analogs (NAs) (yes/no) and plasma exchange in artificial liver support system (yes/no) according to the patient's informed choice.The method of Cox regression analysis was used to analyze the short-term prognostic factors and long-term prognosis factors of ACLF.Results The short-term prognosis factors in patients with ACLF were MELD scores,ages,percentage of neutrophils,hepatic encephalopathy,whether to apply NAs or not,HBV DNA levels,times of plasma exchange in artificial liver support system,cholinesterase levels and total bilirubin levels in turn (P ＜0.05).The long-term prognosis factors were ages,whether to apply NAs or not,MELD scores,cholinesterase levels,concomitant infection,white blood cell counts,gender and hepatic encephalopathy in turn (P ＜ 0.05),and antiviral therapy with NAs was a time-dependent independent prognostic factor.Conclusions There are some differences between the short-term prognosis factors and the long-term prognosis factors in patients with ACLF.We should give antiviral therapy with NAs,measures to improve liver function,preventions and treatments of infection and hepatic encephalopathy and other complications from early-stage to long-term follow-up managements.And in early-stage of ACLF we should also give the treatment with artificial liver support system.

Objective To practice the distance nursing and healthcare through mobile care clinic, and to provide a higher quality of specialist care to colostomy patients. Methods 76 colostomy patients who were operated during August 2015 to January 2016 were investigated and randomly divided into the intervention group ( n=40) and the control group ( n=36 ) . Based on the conventional nursing care, the intervention group received additional continuing care including the subsequent visit and telephone follow-up with the help of mobile care clinic. After one month of intervention, patients′satisfaction level and their awareness of health knowledge were surveyed using an autonomous questionnaire. Results The intervention group had much higher level of satisfaction compared to the control group [ ( 98. 4 ± 1. 6 ) vs ( 91. 3 ± 1. 7 ); t=18. 75, P<0. 05 ] . They also performed better wound care and knowledge awareness compared to the control group ( 92. 5% vs 69. 4%;82. 50% vs 58.33%; χ2=6.70, 5.38; P<0.05). Furthermore, the intervention group had significantly fewer cases of fecal dermatitis than the control group (2 vs 11; χ2=8.73,P<0.05).Conclusions With the help of home health care platform and mobile care clinic, more professional nursing guidelines can be provided in time. It can also improve the nursing satisfaction and reduce related compliances.

Objective:To study the risk factors of adverse pregnancy outcomes for induced abortion of cesarean scar pregnancy in midtrimester.Methods:A national multicenter retrospective study was conducted. A total of 154 singletons pregnant women with cesarean scar pregnancy during the second trimester induced abortion by various reasons in 12 tertiary A hospitals were selected, their pregnant outcomes were observed and the risk factors of serious adverse outcomes were analyzed with univariate and multivariate logstic regression; the role of ultrasound and MRI in predicting placenta accreta and severe adverse outcomes was evaluated, the effectiveness of uterine artery embolization (UAE) in preventing hemorrhage in pregnant women with and without placenta accreta was compared.Results:Among 154 subjects, the rate of placenta accreta was 42.2% (65/154), the rate of postpartum hemorrhage≥1 000 ml was 39.0% (60/154), the rate of hysterectomy was 14.9% (23/154), the rate of uterine rupture was 0.6% (1/154). The risk factor of postpartum hemorrhage≥1 000 ml and hysterectomy was placenta accreta ( P<0.01). For each increase in the number of parity, the risk of placenta accreta increased 2.385 times (95% CI: 1.046-5.439; P=0.039); and the risk of placenta accreta decreased with increasing ultrasound measurement of scar myometrium thickness ( OR=0.033, 95% CI: 0.001-0.762; P=0.033). The amount of postpartum hemorrhage and hysterectomy rate in the group with placenta accreta diagnosed by ultrasound combined with MRI were not significantly different from those in the group with placenta accreta diagnosed by ultrasound only or MRI only (all P>0.05). For pregnant women with placenta accreta, there were no significant difference in the amount of bleeding and hysterectomy rate between the UAE group [median: 1 300 ml; 34% (16/47)] and the non-embolization group (all P>0.05); in pregnant women without placenta accreta, the amount of bleeding in the UAE group was lower than that in the non-embolization group (median: 100 vs 600 ml; P<0.01), but there was no significant difference in hysterectomy rate [2% (1/56) vs 9% (3/33); P>0.05]. Conclusions:(1) Placenta accreta is the only risk factor of postpartum hemorrhage≥1 000 ml with hysterectomy for induced abortion of cesarean scar pregnancy in midtrimester; multi-parity and ultrasound measurement of scar myometrium thickness are risk factors for placenta accreta. (2) The technique of using ultrasound and MRI in predicting placenta accreta of cesarean scar pregnancy needs to be improved. (3) It is necessary to discuss of UAE in preventing postpartum hemorrhage for induced abortion of cesarean scar pregnancy in midtrimester.