Objective To identify high?risk groups of Charcot foot( CN) in the people with diabetic foot neuropathic ulcerations( NU) . Methods Twenty cases patients with CN who were diagnosed in General Hospital of the Chinese People Air Force from June 2008 to June 2013 and 58 patients with diabetic neuropathic ulcer who were hospitalized from January 2010 to December 2011 and followed up until June 2014 without foot deform?ity were retrospectively analyzed. All patient's general condition, examination and laboratory results, diabetic chronic complications,complication,diabetes distribution of foot ulcers,and plain features. Results There were no statistically significant differences in terms of patients' average age, sex ratio, proportion of smokers, BMI, HbA1c,blood lipid,dorsalis pedis artery diameter and diabetic nephropathy (Ⅲ?Ⅳperiod) ,chronic kidney dis?ease stage 3 above,proliferation diabetic retinal pathological changes,the prevalence of coronary heart disease between the two groups(P>0. 05). Compared with NU group,patients with single high proportion(40. 00%(8/20) vs. 10. 34%(6/58)),Short duration of diabetes((12. 37±5. 64) years vs. (14. 27±8. 04) years),Feet long numbness(6(5,9) years vs. 4(2,20) years),low rate of hardening of the arteries narrow(ABI<0. 9)( 0 ( 0/20) vs. 39. 66%( 13/58) ) ,high recurrent diabetic foot ulcer prevalence( 70. 00%( 14/20) vs. 25. 86%( 15/58)),more patients with diabetes mellitus autonomic neuropathy(75. 00%(15/20) vs. 39. 66%(23/58)),less combined with hypertension ( 25. 00%( 5/20 ) vs. 58. 62%( 34/58 ) ) , the differences were significant ( t orχ2=6. 981,2. 259,4. 068,3. 887,12. 405,7. 436,6. 724;P<0. 05) . Diabetic foot wound distribution on mesopodi?um of CN group and NU group was 36. 84%(7/19),6. 90%(4/58) respectively,the difference was significant (χ2=11. 443,P=0. 003) . Diabetic foot amputation rate( Wanger 4,5 grade) of CN group and NU group was 44. 44%(4/9),6. 90%(2/29) respectively,the difference was significant(χ2=4. 732,P=0. 020). Conclusion The characteristics of high?risk groups of diabetics Charcot foot in the people with diabetic foot neuropathic ulcerations are middle aged,no foot of ischemia,combine the diabetic autonomic neuropathy and the feet always with recurrent ulcers.

Objective To study the status quo of the caring character of baccalaureate nursing students and its related factors.Methods A total of baccalaureate nursing students were recruited from two and three levels of baccalaureate in Nantong district by convenience sampling method and cluster sampling method.The students were investigated with a nurse caring character questionnaire which was developed in the previous study and then an analysis was conducted.Results The caring characters of the nursing baccalaureate students were at the medium level.The caring characters of baccalaureate nursing students were affected by various factors.The linear regression revealed that choosing nursing willingly or not,relationship with familyand sex,among other things had the greatest influence on their caring characters.Conclusions Therefore,importance should be attached to the caring character of baccalaureate students and corresponding guidance and education directed at the various grades should be offered so as to increase their caring characters.

Objective To summarize the clinical experiences in microsurgical treatment of severe children hand injuries caused by firecrackers. Methods 26 cases of children hand injuries caused by a firecracker blast were treated with microsurgical procedures. An emergency operation was done for 23 cases, and a delayed repair was done for 3 cases. Operative procedures differed from case to case, according to the injury type. Results All flaps and reconstructed thumbs survived completely by first intention. Of the 9 cases with 11 fingers replanted, 7cases with 9 fingers survived. The follow up for over two years showed that satisfactory restoration of hand function and shape was achieved and the replanted fingers also showed satisfactory restoration of holding and finger to palm and finger to finger functions. Conclusion Severe children hand injuries caused by a firecracker blast must be treated as soon as possible with microsurgical procedures. Preoperative planning of a proper repair or reconstruction approach is also of great importance.

Objective To investigate the correlation of rCBV with vascular endothelial growth factor (VEGF) protein expression and microvessel density (MVD) in gliomas Methods MR examinations were performed preoperatively in 46 patients with suspected supratentorial gliomas All the 46 cases were proved by operation and pathology Immunohistochemical stain methods were used to demonstrate the situation of VEGF protein expression and quantitatively measure the MVD in gliomas The procedures of MR examinations included plain MR scan, PWI and routine contrast enhanced MR scan The pulse sequence of PWI was single shot GRE EPI T  2WI The CBV maps were calculated from the original data of perfusion images and the maximum rCBV of gliomas was acquired from CBV maps through measurement on the region of interest (ROI) According to the situation of VEGF protein expression, all the 46 cases were divided into two groupsincluding positive VEGF protein expression group and negative VEGF protein expression group Mann Whitney U test was used for comparing the difference between the two groups Spearman′s rho correlation analysis was used for observing the correlation between maximum rCBV and MVD in gliomas Results Of the 46 cases; 12 cases were astrocytomas, 3 were oligodendrogliomas, 1 was mixed glioma, 14 were anaplastic astrocytomas, and 16 were glioblastomas multiforme The maximum rCBV value in VEGF(-) group ( n =14) and VEGF(+) group ( n =32) ranged from 0 33～6 63 and 1 03～10 68, with median of 3 08 and 5 95, respectively The difference in maximum rCBV between the two groups was statistically significant ( Mann Whitney U test | z| =2 638, P

Objective To evaluate the application effects of mind map in community health education of rheumatoid arthritis patients. Methods 65 rheumatoid arthritis patients from Shunqing district of Nanchong City, Sichuan Province were randomly divided into an observation group (n=33) and a control group(n=32). Both groups received six-month health education. Health educators utilized mind map for the observation group and traditional health education for the control group. Before and after implementation, the two groups' mastery of disease knowledge was compared. During the period of 1, 3, 6 months, two groups received compliance evaluation respectively. During the study period, a questionnaire was given to the observation group to collect their attitude towards the mind map health education and their evaluation about it. Measurement data was represented by x ± s, using group t-test design information and single-sample t-test. χ2test was used in the count data for compar-ison between groups with test levelα=0.05. Results The scores of disease knowledge were as follows. Before implementation there was no statistically significant difference between two groups (P=0.921);After implementation, the score of observation group was(19.97±3.03), while the score of control group was(17.59±3.11), the difference was statistically significant(t=3.122,P=0.003). The difference of 1,3,6-month compliance scores was statistically significant(t=2.173,P=0.034;t=2.371,P=0.021;t=2.615,P=0.011) with the observation group's scores(18.24±3.44),(18.94±3.25),(19.64±3.06) respectively,and the control group's scores(16.47±3.13),(16.97±3.45),(17.44±3.70). Observation group's attitude questionnaire scores of each project are > 3, and there was significant difference be-tween two groups (P=0.000). Conclusion Mind mapping method can be used in community health education for rheumatoid arthritis patients to help patients master the knowledge of the disease and improve the compliance. Its effect is better than traditional methods.

Objective To investigate the effect of midazolam on cardiopulmonary function during colonoscopy.Methods From June 2014 to June 2015,214 patients underwent colonoscopy were randomly divided into two groups:109 patients in the midazolam group and 105 patients in the non-sedated group(control group).systolic blood pressure(SBP),diastolic blood pressure (DBP),heart rate (HR) and peripheral blood oxygen partial pressure (SpO2) in the two groups before and after colonoscopy were compared.Results In the midazolam group,SBP and DBP decreased more during colonoscopy than in the control group.However,the frequency with a significant change in SBP was similar in both groups.During colonoscopy,HR andSpO2 decreased more in the midazolam group compared to those in the control group.SpO2 levels returned to normal after the procedure in two groups.Conclusion Midazolam has a tolerable effect on cardiopulmonary function and may be safely used during colonoscopy.

Objective To investigate the effect of exogenous hydrogen sulfide (H 2 S) on H2 S concentration and cystathionine β-synthase (CBS) expression in hippocampus in a rat model of vascular dementia (VaD). Methods A rat model of VaD was induced by using the modified four -vessel occlusion. The rats were divided into sham operation, model, low -dose and high-dose NaHS groups using the random number table method. They were further redivided into one day, seven -day, and 30-day subgroups according to the time after modeling. After modeling respectively, NaHS 30 μmol/kg and 100 μmol/kg were injected intraperitoneally every day in the low -dose and high-dose NaHS groups. The normal saline was injected intraperitoneally every day in the sham operation group and the VaD model group. Morris water maze test was used to evaluate the learning and memory ability of the rats. The expression of CBS in hippocampus was detected by real-time fluorescent polymerase chain reaction. Western Blotting was used to detect expression of CBS protein in hippocampus. Results Morris water maze test showed that the escape latencies of the model group, low -dose and high-dose NaHS groups were prolonged significantly compared with the sham operation group (P <0.05); the times of crossing the platform were decreased significantly compared with the model group (P <0.05); and the escape latencies were shortened significantly in the low -dose and high-dose NaHS groups compared with the model group ( P <0.05). The H2 S content in hippocampus was decreased significantly in the model group, low -dose and high-dose NaHS groups compared with the sham operation group, but the low -dose and high-dose NaHS group was significantly higher than that in the model group (all P <0.05). The expression of CBS mRNA and protein in the model, low -dose and high-dose NaHS groups was significantly lower than that of the sham operation group (all P < 0.05), and there was no significant difference between the low -dose and high-dose NaHS groups and the model group. Conclusions Exogenous H2 S may improve the learning and memory ability of the VaD rats. It may be associated with the increased H2 S content in hippocampus. However, it has no effect on CBS expression.

Objective To investigate the relationship of the serum bilirubin level with acute ischemic stroke (AIS), and Chinese isch-emic stroke subclassification (CISS), stroke severity and short-term outcome of AIS patients. Methods 616 patients with AIS as well as 664 patients without stroke matched with gender and age were compared and analyzed with the non-conditional Logistic regression. The AIS pa-tients were divided based on the CISS, and their bilirubin levels were compared. The AIS patients were divided into high bilirubin group and normal bilirubin group, their scores of the National Institute of Health Stroke Scale (NIHSS) as admission and discharge, and neural func-tion improvement rate were compared. Results The levels of total bilirubin (TBIL), direct bilirubin (DBIL) and indirect bilirubin (IBIL) were higher in the AIS group than in the control group (P<0.01), and the TBIL was the independent risk factors of AIS (OR=1.026, 95%CI 1.012-1.041, P<0.001). There was no significant difference of the levels of TBIL, DBIL and IBIL among the patients of CISS (P>0.05). The NIHSS score was higher in the high bilirubin group than in the normal bilirubin group as admission (P<0.05), but it was not significant as discharge (P>0.05), nor the rate of neural function improvement (P>0.05). Conclusion The serum bilirubin level elevated and correlated with the severity in the AIS patients, which might be the risk of pathogenesis and AIS. The bilirubin was not various with the CISS, and might be less involved in the short-term outcome of AIS.

Objective The aim of this study was to investigate the effects of hesperidin ( HDN) on antioxidant ac-tivity in mice.Methods HDN scavenging free radicals was detected by spectrophotometry, inhibition of mitochondrial swelling was detected by pyrogallol autoxidation, and erythrocyte hemolysis was detected by Fe2+phenanthroline.The mice were fed with HDN at different concentrations (0, 80, 160, 320 mg/kg) by gastric gavage for 12 days.ELISA and spec-trophotometric methods were used to assay the amount of MDA in mouse liver and kidney tissues and the activity of antioxi-dant enzymes ( SOD, CAT, GSH-PX) , and the antioxidant enzyme gene mRNA expression was analyzed by RT-PCR.Re-sults Compared with the control group, the radical (· OH, O2 -· , DPPH· ) clearance rate was significantly increased in the HDN groups.There was a significant decrease of oxidative hemolysis of erythrocytes and mitochondrial swelling in vitro. MDA content in the mouse liver and kidney tissues and serum showed a decrease, and the activity of antioxidant enzymes ( SOD, CAT, GSH-PX) in the HDN group was significantly higher than that in the control group.There was an up-regula-tion of mRNA expression of antioxidant enzyme in mouse liver and kidney tissues.Conclusions The results showed that HDN can eliminate free radicals, reduce cell oxidative damage caused by free radicals, inhibit superoxide production, up-regulate antioxidant enzyme gene expression and enhance their enzyme activity, thus showing a good antioxidant effect.