Cancer can induce venous thromboembolism by many ways. It influences tumor patients life quality and prophylaxis. Venous thromboembolism can also indicate carcinogenesis, so the association between cancer and thrombosis is paid more and more attention. Proper treatment to prevent thrombus can not only reduce compilation, but improve patients prognosis.

Objective:To explore the communication problems among nursing students in early clinical prac-tice, and to provide reference for clinical nursing education .Methods:Introspecting diary of the clinical communi-cation in nursing students were classified and analyzed by using qualitative research method .Results:5 themes were extracted as following: barriers for communication between nurses and patients , reflection on patient , nurse occupation , clinical teaching and critical reflection on public opinion .Conclusion:Introspecting diary is important to help teachers in teaching , to guide and cultivate nursing students to develop their interpersonal communication competence .

Objective To analyze the safety of blood transfusion in hospitalized senile patients,and to prevent or reduce adverse transfusion reactions. Methods The blood transfusion information of patients over the age of 60 years in our hospital from January 2009 to December 2011 were retrospective analyzed. The data of pre-storage type of autologous blood transfusion for elective surgery were also discussed. Results Among 3549 cases of elderly patients,there were totally 23877 times of allogeneic transfusion and 84 cases with blood transfusion adverse reactions of heating or allergic reactions.The adverse reaction rates occured most in the infusion of fresh frozen plasma (0.55％).There was no hemolytic reaction,and transfusion adverse reactions occarred during stored blood autotransfusion. Conclusions Medical institutions should set the scientific and rational principle of blood use and select the appropriate blood components to reduce transfusion adverse events in the elderly patients. The autologous blood transfusion in the elderly patients should be actively pursued.

OBJECTIVE To analyze the effect of advanced glycation end products(AGEs) on apoptosis of cultured mouse spiral ganglion cells(SGCs) and expression of receptor of AGEs(RAGE). To explore the pathway of AGEs in promoting apoptosis of SGCs. And to explore the possible mechanism of neural presbycusis. METHODS The effect of AGEs on apoptosis of SGCs was studied by Tunel technique and fluorescence microscope. The expression of RAGE mRNA was assayed by Real time RT-PCR. RESULTS AGEs induced apoptosis of cultured SGCs. The effects were dose-dependent and time-dependent. Meanwhile RAGE mRNA expression was enhanced in apoptosis cells. CONCLUSION AGEs induced apoptosis in SGCs,which may be mediated by RAGE. And this may be one of the mechanisms of neural presbycusis.

Objective:To determine the residual formaldehyde fumigation on the surface of pharmaceutical equipments by AHMT method. Methods:The reaction time of AHMT was controlled in 20 min, the solution with sodium periodate was then shaken for 30 seconds and stood for 30 seconds, and then the absorbance at 550 nm was measured. Results: The linear range of formaldehyde was 0. 250~2. 495 μg·ml-1. The recovery of formaldehyde on glass plate, color steel plate and stainless steel plate was (83. 42 ± 1. 48)%(n=3), (83. 63 ± 1. 94)%(n=3)and (83. 94 ± 2. 28)%(n=3), respectively. Conclusion:The method is proved to be convenient and accurate, and is suitable for the determination of formaldehyde on the surface of pharmaceutical equipments.

Objective To investigate the blood transfusion paths in elderly patients in order to ensure the blood transfusion safety in the elderly.Methods Clinical data of elderly patients (aged 60 and over) receiving blood transfusion were selected from January 2008 to December 2013.Data of blood transfusion in different clinical department were analyzed.Results From 2008 to 2013,the number of elderly patients receiving blood transfusion and transfusion volume showed the rising trends.Patients in Department of Cardiothoracic Surgery had the most blood transfusion volume among all surgical departments (9.3U/person),and plasma transfusion accounted for the most with plasma and red blood cells in a 3 ∶ 1 ratio.Patients in Department of Internal Medicine had the most blood transfusion volume among all non surgical departments (15.9U/person),and platelets transfusion accounted for the most with platelets and red blood cells in a 3 ∶ 1 ratio.The oldest patients on average receiving blood transfusion in the top 10 was from Department of Emergency (aged 77 years),and the most common cause was gastrointestinal hemorrhage.The youngest patients receiving blood transfusion in the top 10 was from Department of Cardiothoracic Surgery and Department of Gynecology (aged 69 years),and the most common cause was huge pleural mass and ovarian cancer.Conclusions Blood transfusion for elderly patients should be restrict the indications for transfusion strictly,choose the reasonable transfusion time,blood components and volume.Physiological and functional changes and clinical features of elderly patients should be paid attention to at the same time in order to reduce unnecessary transfusions,particularly the dependence on plasma transfusion and unnecessary collocated blood transfusion,to avoid the overload and adverse transfusion reactions.

Objective:To evaluate the radiologic and clinical outcomes of supramalleolar dome osteotomy in the treatment of varus-type ankle arthritis.Methods:From June 2018 to December 2019, 13 patients with varus-type ankle arthritis underwent supramalleolar dome osteotomy at Department of Foot and Ankle Surgery, Beijing Jishuitan Hospital. Of them, 13 (5 males and 8 females) were included in the study. Their average age at surgery was 47.2 years (range, from 16 to 65 years). By the modified Takakura staging for arthritis, 3 cases were stage 2, 4 cases stage 3a and 6 cases stage 3b. Comparisons were made between preoperation and the last follow-up in ankle-hindfoot score of American Orthopedic Foot and Ankle Society (AOFAS), foot function index (FFI), visual analogue scale (VAS), Takakura staging, dorsal extension, plantar flexion, range of motion (ROM), tibial anterior surface angle (TAS), tibial lateral surface angle (TLS), and talar tilt (TT).Results:This cohort were followed up for 12 to 29 months (average, 17.2 months). At the last follow-up, AOFAS score (86.5±8.0), FFI (14.5±1.6), VAS score (1.5±1.0), Takakura staging (2.7±1.3), ROM (39.4°±8.0°), TAS (92.4°±6.0°), TT (3.7°±4.4°) were significantly improved than the preoperative values (68.3±14.4, 43.7±3.0, 4.2±1.4, 3.2±0.8, 43.3°±7.6°, 78.2°±8.3° and 7.0°±5.1°), and dorsal extension (10.9°±4.4°) was significantly smaller than the preoperative value (13.6°±5.1°) (all P<0.05). There were no significant differences between preoperation and the last follow-up in plantar flexion (29.7°±4.6° versus 28.5°±5.2°) or TLS (77.8°±4.5° versus 78.1°±5.3°) ( P>0.05). Conclusions:Supramalleolar dome osteotomy has shown promising short-term clinical efficacy in the treatment of varus-type ankle arthritis. It can significantly relieve pain, improve function, substantially correct deformity and retard progression of arthritis, but it may affect dorsal extension.

Objective Present study aimed to characterize the alteration of cortical thickness in first-episode, never-medicated, adult patients with major depressive disorder (MDD), and explore whether such deficits were related with their disease duration and clinical symptom severity. Methods Thirty-seven adult MDD patients were recruited from March 2013 to August 2015 as patient group, and 41 healthy volunteers were as control group. All the patients underwent three-dimensional spoiled gradient recalled (3D-SPGR) sequences, and the images were acquired. Constructions of the cortical surface were developed from 3D-SPGR images using FreeSurfer software, and the thickness of the entire cortex was measured according to the automated surface reconstruction, transformation, and high-resolution inter-subject alignment procedures. Finally, cortical thickness was compared between the two groups, and the relativity between clinical symptom severity, disease progression and clinical scores were analyzed using the General Linear Model (GLM). Results Our results revealed a significant increase in cortical thickness(P<0.05, false discovery rate corrected) in the left anterior and middle cingulate cortex, bilateral precentral cortex, left paracentral cortex, bilateral superior parietal cortex, left temporal pole, and right lateral occipital cortex (cortical thickness 1.89-2.87 mm, cortical volume 34-384 mm2, P<0.05) in MDD patients compared to healthy controls, while no reversed alternation was found. In addition, clinical symptom severity and disease progression showed no correlation with the cortical thickness abnormalities in MDD group(P>0.05). Conclusion Excluding the impact of treatment, our study showed that the cortical thickness change was mainly located in the prefrontal-limbic system in the in early course of MDD.

[Summary] The high-risk subjects of type 2 diabetes mellitus ( T2DM) in normal glucose tolerance ( NGT) were screened. The subjects with NGT at baseline were divided into high-risk and low-risk groups according to the diagnostic threshold of insulin area under the curve ( AUCINS ) 108. 43 mU/L. The incidence of prediabetes and/or T2DM was significantly increased in high risk group in comparison with low risk group ( 29. 41 vs 2. 21%, P<0. 01). The result suggests that the diagnosis threshold for AUCINS≥108. 43 mU/L can be used to screen the high-risk subjects of T2DM in NGT.

With the development of laparoscopic technique, single port laparoscopic technique application is more and more common, further achieving the ideal effect without abdominal scar. Efficacy of colectomy by transumbilical single port laparoscopic surgery in treating patients with chronic intractable constipation was satisfactory in our hospital during the past two years. This paper mainly introduces the role and development of single port laparoscopic surgery in the treatment of chronic intractable constipation. In order to form the operation triangle as possible, and avoid the "apparatus fighting" between devices, incision protection device and rubber glove were used to make the multi-channel single incision puncture device. Advantages of this device can provide the surgeon with greater space to operate and more convenient operation, but owing to the poor fixation of rubber gloves and the absence of incumbent pivot in this devices, the proficiency of the camera holder is required in order to ensure a clear and stable vision. In the future, with the development of economy and equipment, single port laparoscopic surgery in the treatment of chronic intractable constipation will be used more widely.