Objective To study the relationship of Vitamin D and preeclampsia.Methods Four hundred and forty-two pregnant women were enrolled in this study,they were divided into two groups,420women without preeclampsia (control group) and 22 women with preeclampsia (preeclampsia group).Blood serum was collected during the 10th-14th and 24th-28th week of gestation,25-hydroxyvitamin D [25(OH) D]was detected.The level of 25 (OH) D was compared between two groups and Logistic regression analysis was used to investigate the association of 25 (OH) D and preeclampsia.Results The level of 25 (OH) D at 24th-28th week in control group [ (56.3 ± 18.8) nmol/L] was significantly higher than that in preeclampsia group [(46.2 ± 17.4) nmol/L] (P＜0.01).The level of 25 (OH) D had significant relationship with preeclampsia at 24th-28th week (OR =0.67,P =0.01),regression coefficient was -0.3910,Wald was 12.3174.Conclusion The level of 25 (OH) D is associated with preeclampsia at 24th-28th week of gestation.

OBJECTIVE To investigate and analyze the hand hygiene status among clinical medical staff to find the problems and propose improvement measures.METHODS Through the form of a self-designed questionnaire survey according the principles of Ministry of Health of 330 the status quo of hands among medical staff of was investigated.RESULTS The bacterial carriage on the hands among medical staff before handwashing was(161.16?8.93) in average CFU/cm2,but after washing was(15.82?6.91) CFU/cm2,the difference was significant(t=5.27,P

Objective To assess the relationship of ankle brachial index (ABI) with the other traditional risk factors for cardiovascular disease (CVD). Methods A total of 2005 participants with a full data were selected from the survey of risk factors for CVD, carried out in Wuming, Guangxi province, 2004. The relationship of ABI with the other risk factors of CVD was analyzed by multivariate Logistic regression (backward stepwise; probability for stepwise, entry:0.05, removal:0.10). T test used in participants having risk factors vs the normal participants. The risk factors of CVD include age, sex, hypertension, high total cholesterol (HTC), high fasting plasma glucose (high FPG), low high-density lipoprotein cholesterol (low HDL-C), overweight or obesity, cigarette smoking, etc. Results The mean ABI values were significant in the groups having risk factors of overweight or obesity (P=0.02), low HDL-C (P= 0.04) and cigarette smoking (P

Objective To investigate the effect of argatroban on C-reactive protein (CRP) and therapeutic efficacy in patients of malignant tumor complicated by acute lower limbs deep venous thrombosis (DVT).Methods 56 patients of malignant tumor complicated by acute lower limbs DVT were randomly divided into two groups.In observation group (n =28),argatroban was given intravenously as anticoagulation.Urokinase as thrombolysis and warfarin as anticoagulation were used in the control group (n =28).The concentrations of serum CRP were detected before treatment and on the 14th day of post-treatment in observation group and control group.Recanalization and therapeutic effect of DVT were compared.Results Before treatment,there was no significant differences in the serum CRP concentrations between observation group and control group [(46.44±28.82) mg/L vs (45.96±29.40) rmg/L,F =0.004,P =0.951].On the 14th day of post-treatment,the CRP concentrations in observation group and control group were lower than those of pretreatment (F =25.996,P ＜ 0.05,F =4.828,P ＜ 0.05).Compared with the 14th day of post-treatment,the CRP concentration of observation group was lower than that of control group [(16.97±10.22) mg/L vs (31.63± 18.07) mg/L,F =13.965,P ＜ 0.01].Recanalization rate of observation group on the 14th day of post-treatment (96.43 ％,27/28) was higher than that in control group (67.86 ％,19/28) (x2 =8.204,P =0.017).Therapeutic effect rate of observation group on the 14th day of post-treatment (96.43 ％,27/28) was higher than that in control group (75.00 ％,21/28) (x2 =6.205,P =0.045).Conclusion Argatroban can decrease serum level of CRP in patient of malignant tumor complicated by acute lower limbs DVT,which is favorable for improvement of clinical effectiveness.

Objective To discuss the clinical characteristics for central compartment lymph node metastasis in stage cNO papillary thyroid microcarcinoma and significance and feasibility of preventive dissection,aimed to provide reference for clinical treatment.Methods Reviewed the clinical data of 277 patients with stage cNO papillary thyroid microcarcinoma from Jul.2011 to Dec.2015 underwent surgery in the Department of General Surgery of Lianyungang East Hospital.Evaluated the necessity of prophylactic central lymph node dissection.Adopted chi square test and Logistic regression to analyze its relationship with patients' gender,age,tumor number,tumor size,enveloped infiltration,single and bilateral tumor.All 277 patients underwent primary radical resection with ipsilateral central lymph node dissection.The specimen of resection was analyzed by routine pathology.Results The positive rate of thyroid papillary microcarcinoma lymph node metastasis was 36.8 ％ (102/277).The elements of male patients (P =0.023),age ＜ 45 years (P ＜ 0.001) and tumor diameter ＞ 0.5 cm (P =0.019)had high positive rate.The multivariable analysis showed that male patients (OR =2.63,P ＜ 0.001),age ＜ 45 years (OR =2.25,P =0.016),tumor diameter ＞ 0.5 c m (OR =2.13,P =O.009) were independent risk factors for CLN metastasis.Forty-three (15.5％) cases had transient parathyroid function.No Permanent recurrent nerve paralysis and hyperparathyroidism occurred in this group.Conclusions Prophylactic central lymph node dissection is helpful for accurate staging of tumor classification and risk assessment,has important significance,on the follow-up of patients after treatment of choice.For male patients,age ＜ 45,tumor diameter ＞ 0.5 cm,enveloped infiltration,the central compartment lymph node dissection may be necessary.

Objective To improve the quality,efficacy,and efficiency of health checkup by establishing and implementing total quality management system.Methods Routine physical examination data of 5955 individuals (from January 2007 to May 2007,when total quality management system was not implemented) were analyzed and compared with 7520 individuals (from January 2008 to May 2008.when the system was implemented).Results The report quality of routine physical examination was significantly improved,and the qualification rate was increased from 82.6% to 98.2%.The healthcare service procedure was optimized.The examination time for the essential items was shoaened from 51 to 35 minutes.The result report time was reduced from 5 to only 1 day.The customer satisfaction rate Was increased from 86.3% to 98.1%; however,the suing rate Was decreased from 0.05% to 0.01%.The examination efficiency was significantly improved.The growth rate of checkup recipients was increased from 7.22% to 26.38%.There Was statistical significance before and after the implementation of the total quality management system (P

Objective To compare the efficacies of intralesional hyaluronidase(HAase), intralesional dexamethasone(DEX), and intralesional HAase plus intralesional DEX on skin damage caused by vinorelbine extravasation in a rat model. Methods After establishing an animal model with vinorelbine extravasation in each lower extremity of 40 Sprague-Dawley rats, we treated the rats with intralesional HAase,intralesional DEX, intralesional HAase plus intralesional DEX,intralesional saline,or received no treatment as control.The wound area on 1 d, 4 d, 8 d, 12 d, 18 d, 24 d, 30 d and the time of healing were observed and compared.Results The wound area on 1 d, 4 d, 8 d, 12 d, 18 d and 24 d was significantly lower in intralesional HAase group, intralesional DEX group,intralesional HAase plus intralesional DEX group,and intralesional saline group than that in control group (P ＜0.05), and that was significantly lower in intralesional HAase group and intralesional HAase plus intralesional DEX group than that in intralesional DEX group and intralesional saline group (P ＜0.05). The healing time was significantly shorter in 4 therapy groups than that in control group [(25.1±3.1) d, (27.9±2.8) d, (23.0±3.2) d, and (28.4±3.9) d vs.(31.2±3.0) d, P ＜0.05], and that was significantly lower in intralesional HAase group and intralesional HAase plus intralesional DEX group than that in intralesional DEX group and intralesional saline group (P ＜0.05). Conclusion The monotherapy with intralesional HAase or intralesional DEX, with decreasing the extent of skin damage and shortening the healing time, is effective therapy for skin damage caused by vinorelbine extravasation, and the monotherapy with intralesional Haase is more efficacious. The efficacy of intralesional HAase plus intralesional DEX seems better than that of monotherapy.

Objective To further improve the accuracy of bone age identification using the time of secondary ossification center appearance and epiphyseal fusion of 7 joints to estimate the age of living individuals.Methods DR films were taken from 7 parts including sternal end of clavical and the left side of shoulder,elbow,carpal,hip,knee and ankle joints of 1709 individuals who came from eastern China,central China and southern China,whose ages were between 11.0 and 20.0 years.From those 7 joints 24 osteal loci were selected as bone age indexes,which could better reflect age growth of teenagers.The characteristics of secondary ossification center appearance and epiphyseal fusion were observed,and the mean and age range of secondary ossification center appearance and epiphyseal fusion were calculated.Results The fusion time of the 24 epiphyses were advanced at different degrees,the most obvious epiphyses the sternal end of clavicle,scapular acromial end,distal end of the radius,distal end of the ulna,iliac crest,ischial tuberosity,the upper and lower end of tibia and fibula.The appearance time of sternal end of clavicle,scapular acromial end,iliac crest and ischial tuberosity epiphyses were all found to be after the age of 12,and the female's age,approximately 1year ahead of schedule in comparison with the male's.Conclusion The relevant forensic information and data for bone age identification should be updated every 10-15 years so as to provide accurate and objective evidence for court testimony,conviction and sentencing.

Objective To comparatively investigate the adhesive capabilities of sodium alginate and guar gum as bone adhesives.Methods The adhesive capabilities were analysed and discussed by measuring their kinetic viscosities,solidification time and the reaction with calcium ions.Results Guar gum had higher kinetic viscosity and could fit to the supply of both ion calcium and non-ion calcium for the bone cure,but its capability of solidification need to be improved.Sodium alginate had higher solubility and its solidification could be finished in short time,but it had lower viscosity and fit only to the non-ion calcium supply.Conclusion Sodium alginate and guar gum are considered to be the potential natural materials of the bone adhesives.

Objective To realize the autom ated assessm ent of the levels of epiphysis of distal radius and ulna by support vector m achine (SVM). Methods The X-ray film s of the leftwrist jointswere taken from 140 teenagers aged from 11 to 19 years old as training sam ples. The levels of epiphysis of distal radius and ulnawere divided into five developm ental levels. Each level contained 28 sam ples. A nother 35 cas-eswere selected as independent verifying sam ples. SVM classification m odels of the five developm ental levels of epiphysis of distal radius and ulnawere established. The internal cross validationwas m ade by leave one out cross validation (LOOCV ),while the external validationwas m ade by histogram of orient-ed gradient (HOG), and then the accuracy (PA ) of testing resultswas calculated, respectively. Results The PA of SVM, LOOCV and HOG of distal radius epiphyseal levelwere 100%, 78.6%, and 82.8%, respec-tively;whereas the PA of SVM, LOOCV and HOGof distal ulna epiphyseal levelwere 100.0%, 80.0%and 88.6%, respectively. Conclusion The SVM -based autom atic m odels of the growth stage of distal ra-dius and ulna appear to have certain feasibility, and m ay provide a foundation for software developm ent of bone age assessm ent by forensic medicine.