Aesthetic ability is the best fundamental psychological quality of medical and nursing staff.The article elaborated the intentions of clinical aesthetic ability and its inherent factors and the external expressions.It also pointed out the means and methods of medical and nursing workers' aesthetic ability training.

Objective To analyze the related knowledge-attitude-practice(KAP)and the influencing factors of human papilloma virus(HPV)vaccine among 16 — 45 year old resident women in Pudong New Area.Methods Six of the 36streets(towns)in Pudong New Area were randomly selected as the survey site,the resident women aged 16 — 45 years were randomly selected excluding those with reading or comprehension disabilities and those with mental disorders,and a total of 1 022 valid questionnaires were collected through self-filling questionnaires to understand the KAP status of the HPV vaccine among the resident women in Pudong New Area. The relationship among KAP of HPV vaccine and its influencing factors were analyzed by univariate analysis and structural equation model.Results The overall awareness rate of HPV vaccine among 16-45 year old resident women in Pudong area was higher. Univariate analysis showed that marital status,educational level,employment status and household annual income were related to the awareness level of HPV vaccine（χ~2=12. 832,17. 636,16. 770 and 20. 030,respectively,each P < 0. 05）;Age,marital status,employment status and children′s status were correlated with HPV vaccination level（χ~2= 12. 382,25. 777,8. 830 and 20. 138,respectively,each P <0. 05）;HPV vaccine health education,HPV and HPV vaccine knowledge scores affected HPV vaccination status（χ~2=97. 561 and 68. 969,respectively,P < 0. 001）;Subjects' knowledge of cervical cancer was positively affected by knowledge of HPV infection(γ_(11)= 0. 756,P < 0. 001). Knowledge of cervical cancer not only positively affected subjects′ attitudes towards the efficacy of HPV vaccine(β_(21)= 0. 557,P < 0. 001),also had a direct effect on the HPV vaccination behavior of the subjects,showing a promoting effect(β_(31)= 0. 274,P = 0. 004). Subjects′ approval of the efficacy of HPV vaccine had a positive effect on their actual vaccination behavior(β_(32)= 0. 175,P = 0. 016).Conclusion The willingness of the 16 — 45 year old resident women in Pudong New Area to inoculate HPV vaccine was positive,but the actual vaccination rate was low. It is suggested to strengthen the HPV vaccine publicity while strengthening the education of cervical cancer and HPV infection,and consider the necessity of including the suitable age males in the scope of human vaccination.

Objective: To study the morphologic and functional changes of the valve after tricuspid valve prosthesis. Methods: Sixty five patiens whose ages averaged (44.6?10.6) years underwent valve replacement and tricuspid value reconstruction. Color Doppler echocardiography were performed before and after operation. Results: Follow up averaged 12 months after operation, the morphology of tricuspid valve was normal. The diameter of the annulus decreased to (2.2?0.2) cm ( P

Objective: To evaluate the surgical results of aortic valve replacement with autologous pericardial valve. Methods: Nine patients underwent aortic valve replacement with autologous pericardial valve were studied by color Dopplor echocardiography (HP 1000 type). The mobility, thickness, opening amplitude, valve orifice areas, regurgitant stroke volume and transorifice pressure gradient of the autologous pericardial valves were measured and analysed intraoperatively and postoperatively. Results: 10 days postoperation, there was no significant difference in above mentioned indices between patients and normal group. Two years after operation, the mobility, thickness, opening amplitude, valve orifice areas, regurgitant stroke volume and transorifice pressure gradient of the autologous pericardial valves showed no significant changes, the EDV and LVEDD significant reduced as compared with 10 days postoperatively. Conclusion: Two years after operation, the structure and function of the autologous pericardial valve may maintain good condition.

Hypotha is the center of energy homeostasis in the organism.The central step of its endocrinology regulation network is that it can receive the leptin signal provided by peripheral adipose tissues,and subsequently modulate the expression of Agouti-related protein(AgRP) and proopiomelanocortin(POMC),maintaining energy homeostasis by regulating energy intake and consumption.Transcription factors FoxO1 and STAT3(signal transducer and activator of transcription 3) are key molecules in leptin-mediated transcriptional regulation of AgRP;they directly participate in the regulation of energy homeostasis.FoxO1 can enhance AgRP expression and activated STAT3 can inhibit AgRP expression.Leptin can modulate AgRP and energy homeostasis through inhibiting FoxO1 activity and activating STAT3.The article reviews the regulatory mechanism of leptin upon AgRP.

A large metaanalysis showed that immediate anticoagulation of patients with acute ischemic stroke was not associated with a significant reduction in death or dependency.The heparin data from the International Stroke Trial(IST) suggest that the use of early unmonitored subcutaneous heparin will reduce early stroke recurrence risks,but these benefits can be eliminated by increased hemorrhagic complications.The use of lower doses of heparin may provide more benefits rather than hemorrhagic side effects.We recommend early anticoagulation for various specific stroke subgroups including cardioembolic stroke,progressing stroke,stroke due to large-artery atherosclerotic stenosis,documented intra-luminal thrombus,and deep venous thrombosis prophylaxis.

Objective To discuss the ultrasound diagnosis on the apophysis lesions of the gallbladder. Methods A retrospective analysis was made in 51 cases of polypoid lesions of gallbladder ultrasound char-acteristics of cases, clinical symptoms and pathological types. Results There were 43 cases of benign le-sious (39 cases of cholesterol polyp, 3 cases of adenomyosis, 1 case of inflammatory polyps), 8 cases of tumor lesions (5 cases of adenomatous polyp, 3 cases of malignant tumors). Among those patients with out clinical symptoms (n = 32) were for cholesterol polyps (P < 0. 05) while in, with symptomatic patients (21 cases), 8 were complicated with stone, 4 with ulcerative disease. Three cases (100%) with adenomyosis and 4 cases (80%) with adenomatous polyposis shouwed symptoms (P < 0. 05). Patients with multiple pol-ypoid lesions (22 cases), were benign lesions, and 95.5% were pathologlicdly cholesterol polyp. Seven ca-ses of ultrasound diagnosis of gallbladder polyps were pathologically diagnosed having polyp diameter smaller than 0.3 cm. Ultrasound showed gallbladder wall thickening in 6 cases, 3 with adenomyosis (wall thickness 0. 5 - 1.8 cm), 3 with malignant lesions in gallbladder (wall thickness 0. 5 - 1.2 cm). Conclusions For those patients ultrasound showed asymptomatic or multiple polyps of the gallbladder, cholesterol polyps are the most common type of lesion. Ultrasound is not sensitive to polypoid lesions of the gallbladder with diame-ter less than 0. 3 cm. Those with limited ultrasonic gallbladder wall thickening (>0. 5 cm) should pay more attention to the possibility of having malignant tumors and adenomyosis.

Pharmacogenomics aims to identify the effects of genomie variants on drug efficacy and safety. This article summarized the progress of pharmacogenomic study on anti-diabetic drugs.

Objective To evaluate the effect of esmolol on refractory veatricular fibrillation just after aortic declamp during cardiopulmonary bypass.Methods 40 patients undergoing valve replacement occurring refractory ventricular fibrillation after release of aortic cross-clamp was randomly given esmolol (prepared to 10 mg/ml) 1 mg/kg(group esmolol,n =20),or Lidocaine (prepared to 10 mg/ml) 1 mg/kg(group control,n=20),the endocardial electric defibrillation was continued after 2min.If the fibrillation still can not be reversed after another two times defribrillation,the routine clinical method would beused.The time of aortic cross-clamp,rectal temperature,MAP,and the value of serum Lactic acid,potassium,and PH were recorded.After intervention,the times of defibrillation,heart rate and rhythm 5 min after reversal were recorded.At the end of CPB,the CPB time and the dosage of positive inotropic drugs were also recorded.Results The success rate of defibrillation was higer in group esmolol than control group(P ＜0.05).Heart rate after reversal in group esmolol were slower than that in control group(P ＜ 0.05).The CPB time of control group was longer than group esmolol (P ＜ 0.05),and the dosage of positiveinotropic drugs was significantly higher in control group(P ＜ 0.01).Conclusion When occurring refractory ventricular fibrillation just after aortic declamp during CPB,Using esomolol by way of intravenous infusion can apparently reduce the frequency of defibrillation,and improve the rate of rewersal.It can also be favorable to cardiac function,and decrease the dependency of positive inotropic drugs,and shorten the time of CPB.

Objective To investigate the effect of nutritional therapy for an infant with short bowel syndrome (SBS) who had jejuno-colostomy. Methods An individualized nutritional support before and after the closure of jejunum colostomy was provided to a 3-month-old girl with SBS who had jejuno-colostomy so as to find out its influence on prognosis. Results Paren-teral nutrition is a life-saving therapy for infants with SBS. The proper enteral nutrition can improve intestinal tolerance and re-duce the incidence of postoperative complications, and improve outcomes of SBS infants. Conclusions Appropriate nutrition therapy is important to reduce the complications and improve the prognosis of SBS infants.