SUMMARY Mercury intoxication is a rare cause of severe hypertension. A case of mercury intoxication presented with severe hypertension and erythromelalgia was reported. A 10-year-and-5-month-old girl presented with recurrent rash and painful hands for 2 months, with seizure attack and episodic loss of consciousness for one hand half months. The girl was found to have red painful hands, a blood pressure 170/120 mm Hg(1 mm Hg=0.133 kPa), tachycardia and hypokalemia (2.83-3.25 mmol/L, reference value 3.5-5.5 mmol/L). An extensive investigation ensued. Elevated renin-angiotensin and aldosterone were demonstrated in plasma. Cranial MRI T2 weighed images showed widespread white matter signal abnormalities, which particularly involved parietal, occipital and frontal lobes. With hypertension controlled, white matter signal abnormalities weakened. Other symptoms included insomnia, nausea and paroxysmal abdominal pain. The girl was found to have a raised concentration of mercury in urine (0.171 mg/L, reference value

Objective To explore the value of hysteroscopy in diagnostic curettage, the incidence of complications and preventive measures in senile women. Methods One hundred and thirteen senile patients who underwent hysteroscopy from January 2002 to December 2007 were recruited in the study, and one hundred and fifty-seven non senile patients were selected as control group. All the patients were operated with diagnostic curettage and hysteroseopy. The success rate of hysteroscopy operation, the incidence of complications and control effect were recorded and compared between two groups. Results The success rate of hysteroscopy operation was 88. 5% (100/113) in the senile group and 100% (157/157) in the non senile group, and there was significant differenee(P <0. 01). The incidence of complications was higher in the senile women group than that in the non senile women group (P< 0. 01). In senile group, the accuracy of diagnostic curettage and hysteroscopy was higher than diagnostic curettage alone, and the success rate was 95.5% (64/67)in estrogen group and 69.6%(32/46) in blank control group (P<0. 01) ,which indicated that estrogen was positively related with the success rate of operation. Compared with misoprostol, estradiol-pretreatment operation was safer and had higher success rate. Conclusions It is safe and feasible to perform hysteroscopy and diagnostic curettage for older women, though it has higher incidence of complications and lower success rate compared with non senile women. Hysteroscopy and diagnostic curettage are more accurate than diagnostic curettage alone, and it is a good choice to apply estradiol before operation.

Objective To investigate the relationship between tumor subclassifieation and the clinicopathologic features and prognosis of patients with gastrointestinal diffuse large B-cell lymphoma (DLBCL). Method From June 2000 to June 2007, 63 gastrointestinal DLBCL cases were enrolled. Immunohistochemical staining was performed to detect CDIO, Bcl-6 and MUM1 expression. Tumors were subclassified according to CDIO, Bcl-6 and MUM1 expression. Results CD10 expression was positive in 13 cases. Bcl-6 expression was positive in 53 cases. MUM1 expression was positive in 52 cases. According to the expression of CD10, Bcl-6 and MUM1, 17 cases(27%) were of germinal center B cell-like (GCB) DLBCL and 46 cases (73%) were of non-GCB. There was a significant difference in local lymph node metastasis between GCB group and non-GCB group, but there was no significant difference in terms of tumor size and infiltrate depth between the two subgroups. The survival time of patients in GCB group(76 months) was significantly longer than that of non-GCB group (28 months). Among cases receiving postoperative chemotherapy (CHOP), the survival of GCB group (76 months) was longer than non-GCB group (24 months). All 4 GCB cases and 4 non-GCB cases under R-CHOP chemotherapy are alive (22 ～ 47 months). Conclusion Gastrointestinal DLBCL subclassification is closely correlated with local lymph node metastasis, and this in combination with the expression of CD10 could be used to predict the prognosis of patients with gastrointestinal DLBCL.

The theoretical basis, significance and feasibility of tutor system for undergraduates in medical informa-tion education were studied.It was considered that the tutor system for undergraduates is an effective means for training medical information talents as it can help the undergraduates to know what role they will play in itheir future po-sition and the professional knowledge they should master, ncrease their study interests and stimulate their study motives by providing the professional skill education service in an order form.The management model of tutor system for under-graduates was put forward according to the significant features of undergraduate course education and cross subjects, the various requirements of professional skills, and the low study motives in domestic medical information education.The problems to which attention should be paid in implementing the tutor system for undergraduates were elaborated .

Objective To study the main pathogenic bacteria and drug sensitivity in patients with chronic sup-purative otitis media and patients with middle ear cholesteatoma in Xinjiang ,and to provide evidence for reasonable u-sing antibiotics for the two diseases .Methods We performed a retrospective analysis of the middle ear secretion bac-terial culture results of 409 patients with chronic suppurative otitis media and middle ear cholesteatoma at our hospi-tal from January 2008 to December 2013 .Results ①There were 361 strains of microbes isolated from 409 patients , and 16 of them were fungi ,and 245 were bacteria .There was a statistical significance of the pathogen detection rate about G+ and G- bacteria between chronic suppurative otitis media and middle ear cholesteatoma (χ2 =12 .216 ,P=0 .000) .②Staphylococcus aureus(in 78 of 254 ears ,30 .7% ) ,pseudomonas aeruginosa(in 46 of 254 ears ,18 .1% ) , coagulase-negative staphylococcus(in 42 of 254 ears ,16 .5% ) ,and proteus mirabilis(in 20 of 254 ears ,7 .87% ) were the most frequently insolated pathogens in chronic suppurative otitis media ,while staphylococcus aureus(in 26 of 107 ears ,24 .30% ) ,pseudomonas aeruginosa(in 17 of 107 ears ,15 .9% ) ,coagulase-negative staphylococcus (in 16 of 107 ears ,15 .0% ) ,and proteus mirabilis(in 14 of 107 ears ,13 .1% ) were the most frequently insolated patho-gens in middle ear cholesteatoma .③Staphylococcus aureus and coagulase -negative staphylococcus were all sensi-tive to quinoline nupu ting /dalfopristin ,teicoplanin ,vancomycin ,and moxifloxacin .The sensitivity of coagulase -negative staphylococcus to gentamicin ,trimethoprim -sulfamethoxazole ,and erythromycin in the middle ear chol-esteatoma were higher than those of in chronic suppurative otitis media .The sensitivity of pseudomonas aeruginosa to ceftazidime ,and imipenem were lower in the middle ear cholesteatoma .The drug sensitivity of pseudomonas aeruginosa ,proteus to trimethoprim/sulfamethoxazole and cefazolin was higher in middle ear cholesteatoma .Conclu-sion There are differences between chronic suppurative otitis media (active) and middle ear cholesteatoma about G+ ,G- bacteria detection rate .Staphylococcus aureus ,coagulase-negative staphylococcus ,pseudomonas aerugi-nosa ,and proteus mirabilis are the main pathogenic bacteria in these two chronic otitis media .There is a difference of some commonly used antimicrobial sensitivity in these two kinds of otitis media ,which is more obvious in pseudo-monas aeruginosa and proteus mirabilis .

After the current situation in medical information construction and the training of health information management undergraduates in Anhui Province were analyzed, suggestions were put forward, such as further strengthening the training of health information management professionals and establishing their positions in medical information construction, in terms of new student enrolment, offered curriculum, and graduate employment.

After the feasibility to reform the blended teaching model for health information management and its im-plementation were described , the reform of blended teaching model for health information management and its prob-lems were analyzed in terms of its model establishment , process implementation and effect assessment according to the target of professional training in Bengbu Medical College .

Objective To analyze the clinico-pathological characteristics and prognostic factors of patients with gastric neuroendocrine carcinoma(G-NEC).Methods Clinical data of 40 cases of G-NEC form January 2003 to August 2013 at Ren Ji Hospital of Shanghai Jiaotong University were analyzed.Tumors were classified into different grades and stages according to the 2010 WHO classification and the 2006 European neuroendocrine tumor society (ENETS).Follow-up was conducted by telephone.The survival curves were drawn using Kaplan-Meier method.Univariate analysis was performed by the Log-rank test and multivariate analysis was performed by the COX proportional hazards model.Results Among the 40 G-NECs patients,29 were male(72％) and 11 were female(28％),with an median age of 61 years.Tumors located in the gastric cardia in 20 cases,in the gastric antrum in 11 cases and in the gastric body in 9 cases.Tumor ranged from 1 cm-20 cm.All patients were G-NEC (G3).Follow-up rate was 100％ (40/40).The median overall survival rate was 12 months,and one-year survival rate was 82％.Immunohistochemically G-NEC cells were positive for CgA and Syn in 11 cases.Gender (x2 =5.673,P ＜ 0.05),Ki-67 index (x2 =8.612,P ＜ 0.05),and lymphnode involvement (x2 =0.559,P ＜ 0.05) were prognostic factors of G-NEC patients.Conclusions The symptoms of G-NEC are nonspecific.Its diagnosis relies on pathological examination and immunohistochemistry.Syn and CgA are the most important markers.Female gender,lower Ki-67 index and lower lymph node metastasis predict a survival advantage.

Objective To establish and apply the systemic caring and nursing model,the five-heart nursing service model. Methods The five-heart nursing service content was designed,the five-heart nursing service organization was perfected,the five-heart nursing service manual books were compiled and the satisfaction questionnaires for five-heart nursing service were designed.Three tryout departments were selected and the nursing staff was trained by human theory and five-heart nursing service amenity and flow according to the five-heart nursing service requirement. Results The patients satisfaction degree, medical entanglemant complaint and praise after the application of five-heart nursing service were greatly improved compared with those of before its application (P ＜ 0.05). Conclusion The application of five-heart nursing service supplied systemic caring and nursing for patients and it proved effective to improve patients satisfaction degree.

Objective To study the changes of biochemical markers of bone turnover and bone mineral density (BMD) in mid- and old-aged women.Methods A total of 408 female volunteers aged 40 to 86 years were enrolled.Serum bone alkaline phosphatase (BAP),osteoealtin and urine type I collagen N-telopeptide(uN'TX) were measured using ELISA,and BM D at anteroposterior lumbar spine 1-4(L1-4)and femoral neck (FN) was detected by dual energy X-ray absorptiometry (QDR4500A).Results (1) Serum BAP,osteocaltin and uNTX levels were positively correlated with age,parity,number of births and duration of menopause (all P