Objective To investigate the clinical features of gastric stump ulcer (GSU)after partial gastrectomy due to gastroduodenal ulcer.Methods From January 1st 2007 to October 31th 2013,272 patients with partial gastrectomy for gastroduodenal ulcer underwent gastroscopy due to upper gastrointestinal symptoms were collected.Among them,there were 237 male patients and 35 female patients with the average age (55 .4 ± 13.0 )years.The lesion location,symptoms and pathological changes of GSU were analyzed.Chi-square test and Fisher exact probability analysis were used for count data comparison.The t test was performed for measurement data comparison.Results There was no significant difference between patients with GSU after Billroth Ⅰ gastrectomy and Billroth Ⅱ gastrectomy in the incidence of dysphagia,nausea and vomiting,retrosternal pain,retrosternal buring sensation,upper abdominal pain, abdominal distention, acid regurgitation and (or) epigastric buring sensation, hematemesis and (or)melena (all P >0.05 ).The proportion of ulcer located in remnant stomach and anastomotic stoma of patients with Billroth Ⅰ gastrectomy (24.7%,18/73 and 72.6%,53/73 )was higher than those of patients with Billroth Ⅱ gastrectomy (10.1 %,20/199 and 58.3%,116/199 )and the difference was statistically significant (OR=2.929 and 1 .896,95 %CI :1 .448 to 5 .927 and 1 .055 to 3.409,χ2 =9.482 and 4.649,P =0.002 and 0.031 ).There was no significant difference between the proportion of afferent loop and efferent loop ulcer in patients with Billroth Ⅱ gastrectomy and the proportion of duodenal ulcer in patients with Billroth Ⅰ gastrectomy (P =0.619).The diameter of GSU of patients with BillrothⅠ((1.1±0.7)cm)was larger than that of ulcer of patients with BillrothⅡ((0.8±0.6)cm) and the difference was statistically significant (t = 3.591 ,P = 0.007 ).The incidence of intestinal metaplasia and atypic hyperplasia of GSU was 8.1 % (22/272),and there was no significant difference in gastric ulcer,stoma ulcer,nek ulcer,afferent loop and efferent loop ulcer (all P >0.05).The incidence of gastric stump cancer of GSU was 4.0% (11/272)and that of gastric ulcer,stoma ulcer,nek ulcer,afferent loop and efferent loop ulcer was 13.2% (5/38 ),2.4% (4/169 ),1.8% (1/55 )and 1/10,respectively.The incidence of gastric stump cancer of gastric ulcer was significantly higher than that of stoma ulcer and nek ulcer, the differences were statistically significant (OR =6.250 and 8.182,95%CI :1.593 to 24.519 and 0.915 to 73.126,χ2 =8.687 and 4.788,P =0.012 and 0.040).There was no statistically significant difference in the incidence of gastric stump cancer of GSU in other gastric parts (all P > 0.05 ).There was no statistically significant difference in the incidence of intestinal metaplasia,atypic hyperplasia and gastric stump cancer between case with BillrothⅠgastrectomy and case with Billroth Ⅱ gastrectomy (P =0.650 and 0.733).Among the 11 gastric stump cancers,the number of cases with the onset time with 20 years,20-30 years and beyond 30 years after gastrectomy were one,three,seven,respectively.Conclusion The incidence of intestinal metaplasia, atypic hyperplasia and gastric stump cancer of patients with GSU was high,and the predilection site of GSU was the remnant stomach.

Objective To investigate the levels of 8 minerals that are related to human health in serum of elderly popu?lation in Tianjin and to provide evidence based guidance for scientifical and rational dietary. Methods Venous blood was collected from 714 elderly people and the levels of 8 minerals were examined by inductively coupled plasma-mass spec?trometry (ICP-MS). Results The percentage of the elderly people who are short of at least one mineral was up to 92.7%. The percentages of deficiency in serum zinc, manganese, magnesium, chrome, iron, calcium, copper, selenium are 79.3%, 73.4%, 58.5%, 42.4%, 39.8%, 23.0%, 1.5%and 0.6%respectively . The level of Ferrum in men’s serum is higher than that in women, while the levels of calcium, chrome and copper in men’s serum are lower than those in women. Conclusion The level of the minerals is generally low in the elderly population from Tianjin and ways were needed in improving dietary.

Objective:To investigate the feasibility of periodontal mechanical therapy for chronic periodontitis and coronary heart disease patients with low dose of aspirin.Methods:Sixty nine chronic periodontitis patients with coronary heart disease were randomly selected as the experimental group (medication group,group A),the control group (withdrawal group,group B) including 20 chronic periodontitis patients with coronary artery disease,stopping the drug for one week and another control group with 50 chronic periodontitis patients (group C).The three groups were examined with pocket probing,and received supragingival scaling,subgingival scaling,and root planning.Local bleeding after operation was observed.In 30 minutes after periodontal mechanical treatment,there was still a need to take some hemostatic measures (containing the oxidized cellulose putting in the periodontal pocket,gauze oppressing,and suturing).Nd:YAG laser was used to stop bleeding 60 minutes after operation.Results:At baseline,there was no significant difference in the three groups,as to the plaque index (PLI),the probing depth (PD),and the attachment loss (AL).The bleeding index (BI)in group A was significantly higher than that in group C (P =0.024),higher than that in group B (P =0.088).The platelet maximum aggregation rate (Aggmax) was detected in some subjects.The average Aggmax value group A was 15.2％,which was much greater than that in group B (60.7％) and group C (62.5 ％).The three groups were all safe in the treatment of periodontal therapy.There were five cases of active bleeding in group A,one case in group B and one case in group C in 30 minutes after operation.In 60 minutes after operation,there was one case of bleeding actively in group A.Nd:YAG laser was used to stop bleeding successfully.Conclusion:The chronic periodontitis and coronary heart disease patients with long-term oral administration of low dose of aspirin can be safely treated with periodontal mechanical treatment,and the effect of local hemostasis is positive without stopping the drug.

Objective To explore the relationship between Stathmin-1 and human papilloma viruse (HPV) persistent infection after conization of uterine cervix, and to show the clinical significance to recurrent of cervical intraepithelial neoplasia (CIN). Methods One hundred and six patients who were treated with conization of uterine cervix for CIN 2-3 grades were enrolled. Thirty-six recurrent patients were enrolled in recurrence group, and the others were enrolled in control group. The expression of Stathmin-1 in primary CIN tissues in two groups was detected by immunohistochemistry. The HPV infection was detected by HPV-DNA test. The relationship of HPV persistent infection and recurrence was analyzed. Results The positive expression rate of HPV persistent infection and HPV persistent infection rate in recurrence group were 88.89%(32/36), 83.33%(30/36), in control group were 34.29%(24/70) and 22.86%(16/70), and there were significant difference (P <0.01). Forty-two patients had HPV persistent infection in 56 patients with stathmin-1 positive expression, and 4 patients had HPV persistent infection in 46 patients Stathmin-1 negative expression. There was positive correlation (r=0.97, P<0.01). The type of HPV persistent infection in two groups was no significant difference (P >0.05). Conclusions Stathmin-1 positive expression is related to HPV persistent infection. The two factors can affect the prognosis of high-grade CIN, and can provide new cues and theory basis for the prevention of recurrence.

Objective:To identify prognosis factors and construct a nomogram for the prediction of cancer-specific survival in surgically resected pediatric melanoma.Methods:A total of 912 patients aged 0-19 years were extracted from the Surveillance, Epidemiology, and SEER database and randomly divided into training cohort (n=640) and validation cohort (n=272) (A ratio of 70:30) . Univariable and multivariable cox analysis were used to determine prognostic factors, and these factors were used to construct a nomogram for predicting cancer-specific survival in patients with resected pediatric melanoma. Model performance was evaluated by Harrell’s concordance index (C-index) ,the area under the time-dependent receiver operating characteristic curve (AUC) and calibration plots.Results:As revealed by the multivariable cox analysis, age, tumor location, ulceration, and lymph node status were all associated with melanoma-specific survival in pediatric patients. On the basis of these factors, a nomogram was constructed. Both the training cohort and the validation cohort had a concordance index of 0.9, which validated the accuracy of our nomogram. The nomogram showed significant discriminative power in both training cohort (3-year AUC: 0.87, 5-year AUC: 0.88, 10-year AUC: 0.85) and validation cohort (3-year AUC: 0.87, 5-year AUC: 0.87, 10-year AUC: 0.89) . Also, the nomogram displayed a good calibration.Conclusions:These results suggest that the new model has superior predictive performance in predicting cancer-specific survival of pediatric melanoma. This individualized prediction model can provide reference for tailoring treatment and clinical counseling of pediatric melanoma.

Objective:To investigate the current situation and influencing factors of humanistic care needs of family members of pregnant women in maternal intensive care unit, and to explore the relationship between humanistic care needs of family members of pregnant women in maternal intensive care unit, relocation stress level and perceived social support ability, so as to provide a basis for clinical nursing staff to implement targeted humanistic care for family members of pregnant women in maternal intensive care unit.Methods:From July to December 2022, 267 family members of pregnant women who were observed in the Maternal Intensive Care Unit of Maternity Hospital Affiliated to Nanjing Medical University/Nanjing Maternal and Child Health Hospital were selected as the research objects by the convenient sampling method. The general information questionnaire, Humanistic Care Needs Scale for Family Members of Pregnant Women in the Obstetric Intensive Care Unit, Family Relocation Stress Scale for Intensive Care Unit Patients and Perceived Social Support Scale were used to carry out a cross sectional investigation.Results:The scores of humanistic care needs, relocation stress scale and perceived social support scale were (175.32 ± 16.04), (35.12 ± 8.11), (57.30 ± 15.43) points, respectively. The length of maternal intensive care unit stay ( B=1.301, P<0.05), the family′s role changed for the first time ( B=2.328, P<0.05), the delivery mode doesn′t match the family′s expectations ( B=-2.407, P<0.05), maternal admission to maternal intensive care unit due to childbirth complications ( B=3.228, P<0.05), relocation stress level of intensive care unit patients′ family members ( B=0.891, P<0.05), and family members′ perceived social support ability ( B=0.461, P<0.05) were the influencing factors of humanistic care needs of maternal family members in maternal intensive care unit factors, which explained 83.2% of the total variation. Conclusions:The humanistic care needs of family members of pregnant women in maternal intensive care unit are at a high level. Medical staff should pay more attention to the family members of pregnant women who stay in maternal intensive care unit for a long time, undergo role change for the first time, have unexpected delivery mode and stay in maternal intensive care unit due to childbirth complications, so as to provide them with more comprehensive humanistic care and establish multiple support system, in order to improve the level of humanistic care for the family members of maternal intensive care unit.

This study was aimed to observe the effects on glucolipid metabolism of aqueous extract of traditional South African herb Sutherlandia. Intraperitoneal injection of streptozotocin (STZ) combined with high fat feed method was used in the establishment of type 2 diabetes rat model. Then, rats were randomly divided into the normal group, model group, pioglitazone group, and the Sutherlandia group. Observation was made on changes of body weight, oral glucose tolerance test (OGTT), blood triglycerides (TG), total cholesterol (TC), low density lipoprotein (LDL-C), high density lipoprotein (HDL-C). Western blot method was used to detect IRS-1 expression of skeletal muscle in rats of each group. The results showed that compared with the normal group, body weight in the model group was decreased, and indicators of OGTT, TG, TC, LDL-C were significantly increased (P< 0.05). Symptoms such as increased drink-ing, eating and urine were obvious; and the IRS-1 expression was obviously decreased (P< 0.05). After treatment, compared with the model group, there was no significant body weight increase in the Sutherlandia group or the pi-oglitazone group. Indicators of blood glucose, TG, TC in the Sutherlandia group and the pioglitazone group were ob-viously decreased with no statistical difference (P< 0.05 or P< 0.01). In the Sutherlandia group and the pioglitazone group, IRS-1 expression of skeletal muscle in rats was obviously increased with no statistical difference (P< 0.05). It was concluded that type 2 diabetes rats induced by intraperitoneal injection of STZ combined with high fat feed method can induce glucolipid metabolism disorders. Traditional South African herb Sutherlandia can obviously reduce the blood sugar level, improve blood lipid metabolism, and improve the level of insulin. Sutherlandia can improve the IRS-1 expression of skeletal muscle in rats, relief the insulin resistance, and lower blood sugar. However, the effect of its exact ways required further in-depth study.

Objective To propose an optimal therapeutic scheme, finite element analysis was used to evaluate the biome?chanical status of femoral head under daily activities. Methods Non?necrotic femoral head volunteers (11 people) and necrotic femoral head patients (7 cases) were included in this study. All these participants were divided into two groups:control group and abnormal group. The DICOM imaging files of each participant were imported into ScanIP software to form a mask showing the prox?imal femurs. Then the finite element models of proximal femurs were progressively reconstructed. The generated models were im?ported into Abaqus, and the forces were added on these models to simulate daily activities, including standing, sitting, upstairs, and squatting etc. The loads and boundary conditions of digital daily activities simulation were collected from Orthoload database. All of the femoral finite element models were progressed in Abaqus under above activity conditions. After the models were pro?cessed, stress concentrating region was defined in each models respectively, which expressed the main bearing structure in each model based on the result of finite element analysis. At last, the elastic modulus (E?modulus) and strain of the stress concentrating region in each femoral model were extracted and calculated. Results There was no significant difference in age, weight, and height between these two groups. In control group, no significant differences of E?modulus (7 125±745 MPa on left, and 7 112±751 MPa on right) and strain (micro?strain:952 on left, and 954 on right)were found between their bilateral proximal femurs;however in abnormal group, the patients' E?modulus (5 798±1036 MPa on normal side, and 6 667±888 MPa on necrotic side) and strain (mi?cro?strain:1 261 on normal side, and 987 on necrotic side) of necrotic side were significantly lower than normal side. As to all the daily activities which were considered in this study, in abnormal group, the E?modulus among each postures of abnormal side were significantly lower than the E?modules of healthy side;the micro?strain in downstairs was also significantly lower than other pos?tures. Conclusion Daily activities with different intensity could generate different mechanical effects on femoral head, espe?cially on necrotic femoral head. The higher intensity of posture, the greater damage would be found in necrotic femoral head.

Objective:To explore the feasibility of using a High-Throughput Chromosome Automatic Scanning System (Metafer 4) to carry out automatic micronucleus detection for radiation workers.Methods:A total of 2 005 radiation workers selected were divided into five groups in terms of diagnostic radiology, radiotherapy, nuclear medicine, interventional radiology and industrial application.The Metafer 4 was used to assay micronuclei in peripheral blood lymphocytes from the subjects, with the factors affecting micronuclei analyzed. A total of 200 micronucleus samples collected by stratified random sampling were manually assayed for comparison of micronuclei frequency and detection efficiency between automatic and manual analysis.Results:The mean micronuclei frequency in 2 005 radiation workers were measured to be (0.92±0.02) ×10 -3. There was significant difference in the frequencies of micronuclei among the five groups ( χ2=11.054, P<0.05), with higher micronuclei frequency in interventional radiology group(1.00±0.03) ×10 -3 than in other groups ( χ2=5.568, 5.334, 7.689, P<0.05). Statistically significant difference could be observed in annual effective dose, length of service and micronuclei frequency among the radiation workers in different medical applications ( F=3.026, χ2=11.582, 8.878, P<0.05). A positive correlation between annual effective dose and micronucleus frequency was shown by Pearson analysis ( r=0.106, P<0.05). Multiple linear regression analysis showed that the automatic assay-based micronuclei frequencies were associated with length of service and work categories( r=9.485×10 -6, 5.660×10 -5, P<0.05), significantly lower when compared with manual analysis ( χ2=169.259, P<0.05). There was a consistency (ICC=0.713, P<0.05) between the two assay methods, but automatic analysis can increase the assayed micronucleus frequency by about 5 folds. Conclusions:The micronucleus frequency tested by automatic detection reflects genetic damage from low-dose chronic radiation exposure, and there may be feasibility of using automatic analysis to assay micronucleus of radiation workers.

The morbidity and mortality of stroke caused by large vessel occlusion are high,and its outcome is closely associated with emergency treatment.In order to receive treatment within the time window,the effective prehospital assessment is very important.The prehospital stroke scale simplifies emergency screening and assessment of such patients.Although the predictive value is good,its role remains controversial.This article reviews some of the prehospital stroke scales used to identify large vessel occlusions and analyzed the characteristics of different scales.