One hundred and sixteen patients with lower limb fracture were screened by Doppler ultrasound for deep vein thrombosis(DVT) of bilateral lower extremities within the first 72 h, d7 and d21 after fracture. Results showed that DVT was detected in 31 (26. 7% ) out of 116 cases within 72 h; at d7 and d21 DVT was detected in 3 and 1 patient respectively with a cumulated DVT rate of 30. 2% in 3 weeks.Serial Doppler ultrasonography is of value in screening for DVT of the lower extremities in patients with lower limb fracture at early stage.

Objective:To explore the correlation among risk factors of hypertension and waist-to-height ratio (WHtR) in officers of regiment and above in troops stationed in Zhejiang .Methods :A total of 2641 officers of regi-ment and above from troops stationed in Zhejiang ,who participated in annual physical examination in our hospital from 2012 to 2013 ,were selected .Correlation among body mass index (BMI) ,waist circumference (WC) ,WHtR , waist/hip ratio (WHR) and blood pressure were analyzed ;receiver operator characteristic curve (ROC) was used to compare and analyze the predictive value of above four indexes on hypertension and judge the optimal cut-off point . Results :(1) Pearson correlation analysis indicated that WHtR was positively correlated with WC ,BMI ,WHR ,sys-tolic and diastolic blood pressure (r=0.25~0.94 ,P<0.005~ <0.001);(2) Among above four indexes ,WHtR had the largest area under the ROC curve 0.697 (95% CI 0.676~0.718) and the optimal cut-off point was 0.51 ;and it's 0.651 (95% CI 0.639~0.662) for BMI ,0.689 (95% CI 0.664~0.751) for WC and 0.685 (95% CI 0.672~0.698) for WHR ;for morbidity risk of hypertension ,compared with BMI ,WC and WHR ,WHtR possessed the most balanced sensitivity (60.68% ) and specificity (70.74% ) ,and the largest OR 4.12 (3.71~4.59) .Conclusion:(1) Among officers of regiment and above in troops stationed in Zhejiang ,anthropometric indexes are closely relat-ed to blood pressure ,which can be regarded as simple indexes for predicting and assessing morbidity risk of the popu-lation ;(2) Waist-to-height ratio may be the best anthropometric index evaluating risk of hypertension in these popu-lation and its optimal cuf-off point is 0.51 for predicting hypertension .

Objective:To learn the effect of personality in the course of cognitive decline.Methods:106 aged people from two districts were selected randomly.Arithmetic,digit span,picture filling,block patterns,digit symbol,visual attention span,spatial reasoning were used to learn the cognitive ability,“Kartaier's 16 personality factors test”were used to explore the personality of aged people.Results:16 personality factors test shows that old people are more deferential and self-assured.The relation between reasoning and arithmetic,rule-consciousness and arithmetic,abstractedness and digit span,reasoning and block design,dominance and digit symbol,sensitivity and special reasoning,apprehension and visual attention span,openness to change and visual attention span reach the statistical significance.Conclusion:Age is the most important reason to the cognitive impairment in aged people, education can prevent the cognitive impairment in a large degree.Personality can affect the cognitive ability although different personality factor affect different cognitive fields.

Objective To investigate the effects and mechanisms of immunosuppressants on in- duction of apoptosis of peripheral T lymphocytes.Methods T lymphocytes were derived from healthy donors and activated by super antigen SEB.The rest or activated T lymphocytes were incubated with immunosuppressants such as myophenolate mofetil (MMF),cyclosporine A (CsA),FK506,azathio- prine (Aza),sirolimus (SRL),prednisone (Pred),and daclizumab (Dac,anti-CD25mAb),alone or combined,for 3 days.The incidence of apoptosis was determined by the methods of confocal microsco- py,flow cytometer,DNA-ladder fragmentation electrophoresis,and reverse transcription-polymerase chain reaction (RT-PCR) gene amplification profiles.The quantitive assay of IL-2 and Fas in the cul- ture medium was also performed using the enzyme linked immunosorbent assay kit.Results Apoptosis in rest T lymphocytes was just induced by Pred among various immunosuppressants.MMF,Aza,and Pred promoted apoptosis in activated T lymphocytes (P＜0.05,P＜0.01),but it was blocked by CsA,FK506,SRL,and Dac (P＜0.01).After adding two or three kinds of immunosuppressants, the incidence of apoptosis in activated T lymphocytes was apparently lower than in control group (P＜0.01).The expression of Fas and IL-2 by activated T lymphocytes was inhibited by FK506 and CsA (P＜0.05).Conclusion MMF,Aza,and Pred may induce apoptosis of activated T lymphocytes via the signal pathway of Fas/Fasl.CsA and FK506 could inhibit the apoptosis of activated T lymphocytes by blocking the production of IL-2.Also,SRL and Dac can block the apoptosis of activated T lympho- cyte by interfering with the effect of IL-2 on T lymphocytes activation process.

Objective To investigate the incidence of needle stick injuries of nursing students in different stages of clinical practice and occupational protective education to provide evidence for developing education strategies. Methods One hundred and forty-one nursing students were surveyed retrospectively by a self-designed questionnaire. Results A total of 75.9%(107/141) nursing students had been injured in clinical practice. The incidence of needle stick injuries varied in different stages of clinical practice. Compared with the middle and late stage of clinical practice, the incidence of needle stick injuries was highest in the early stage of clinical practice:53.9%(76/141) vs. 38.3%(54/141),7.8%(11/141),and there was significant difference, χ2=216.14, P<0.05.About 64.2%(88/141)-78.0%(110/141) nursing students had not received protective education on the needle stick injuries. Only 48.9%(69/141)-55.3%(78/141) of nursing students were given protective training on needle stick injuries in their practice hospitals. Before clinical practice, 63.1%(89/141) nursing students had not been vaccinated to prevent infective diseases. Conclusions To reduce the incidence of needle stick injuries and related potential risks of infection caused by injuries, it is necessary to strengthen pre-practice education on occupational protection among nursing students. Perfect supervision system should also be established in practice hospitals and clinic wards.

Objective To elucidate the effect of Deduhonghua-7 powder and its main components on liver fibrosis induced by carbon tetrachloride(CCl4)by regulating chemokine receptor 1(CCR1)and DNA methyltransferase 1(DNMT1).Methods C57BL/6 mice were randomly divided into blank group,model group,Deduhonghua-7 powder group(0.75 g·kg-1 Deduhonghua-7 powder),Scabiosa Atropurea group(0.75 g·kg-1 Scabiosa Atropurea)and Luteolin-L,-H groups(0.02 and 0.04 g·kg-1 Luteolin,respectively).Except the blank group,the other groups were intrabitoneally injected with 10％CC14 olive oil solution to establish liver fibrosis model,and all groups were given 0.5％CMC-Na dissolved intragastric drug once a day for 4 weeks,and blood and liver tissues were collected after the last administration.The serum CCR1,DNMT1,α-smooth muscle actin(α-smA)and precollagen Ⅲ contents were detected by enzyme linked immunosorbent assay;the CCR1,DNMT1,α-smA,Collagen Ⅰprotein expression were detected by Western blot.Result The contents of serum DNMT1 in blank group,model group,Deduhonghua-7 powder group,Luteotin-L,-H groups and Scabiosa Atropurea group were(4.56±0.69),(6.09±0.59),(5.21±0.33),(4.99±0.68),(5.03±0.45)and(5.17±0.61)pg·mL-1;the contents of CCR1 were(13.38±0.47),(11.20±0.73),(12.97±0.80),(12.89±0.75)(12.88±0.95)and(12.92±0.58)pg·mL-1;the contents of α-smA were(181.80±24.50),(281.30±26.60),(220.90±22.30),(193.70±16.10),(199.30±17.70)and(205.80±14.70)pg·mL-1;the contents of procollagen Ⅲ were(49.29±8.26),(77.56±8.61),(67.56±5.63),(55.47±7.07),(64.93±8.66)and(59.66±8.51)pg·mL-1;the relative expression levels of DNMT1 protein in liver tissues were 0.08±0.03,0.26±0.08,0.13±0.01,0.12±0.05,0.13±0.05 and 0.15±0.03;the CCR1 protein relative expression levels were 0.18±0.03,0.13±0.02,0.21±0.06,0.22±0.07,0.17±0.07 and 0.18±0.06;the α-smA protein relative expression levels were 0.03±0.01,0.27±0.11,0.09±0.05,0.12±0.08,0.09±0.07 and 0.11±0.07;the expression of Colagen Ⅰ protein were 0.09±0.04,0.65±0.22,0.28±0.12,0.26±0.19,0.30±0.22 and 0.25±0.12.The differences of above indicators between the model group and the blank group,between the Deduhonghua-7 powder group,Luteotin-L,-H groups,Scabiosa Atropurea group and the model group were statistically significant(all P＜0.05).Conclusion Luteotein is one of the pharmacodynamic substance bases of Deduhonghua-7 powder to alleviate liver fibrosis induced by CC14.It can inhibit or delay the formation of liver fibrosis through CCR1,DNMT1,α-smA and Collagen Ⅰ proteins.

OBJECTIVETo compare the clinical curative effect of thoracolumbar burst fracture treated by the posterior unilateral approach corpectomy fusion screw-rod fixation and anterior corpectomy bone fusion screw plate fixation.

METHODSFrom January 2008 to May 2014,36 cases of thoracolumbar burst fracture underwent operation of decompression, fusion, and internal fixation was retrospective analyzed. Among them, 16 patients were treated through posterior approach as posterior group, including 13 males and 3 females aged from 37 to 62 years old; 9 cases caused by falling injury, 3 cases by traffic accident injury,4 cases by heavy aboved;the injury segment was on T₁₂ in 2 cases, L₁ in 5 cases, L₂ in 7 cases, L₃ in 2 cases; according ASIA grade, 3 cases were grade A, 2 cases were grade B, 2 cases were grade C, 5 cases were grade D, 4 cases were grade E; the time between injury and operation ranged from 5 to 15 days. Other 20 patients were treated through anterior-lateral approach as anterior-lateral group, including 15 males and 5 females with age from 27 to 62 years old; 12 cases caused by falling injury, 4 cases by traffic accident injury, 4 cases by heavy aboved; the injury segment was on T₁₂ in 2 cases, L₁, in 7 cases, L₂ in 9 cases, L₃ in 2 cases; for ASIA grade: 4 cases were grade A, 2 cases were grade B, 4 cases were grade C, 6 cases were grade D, 4 cases were grade E; the time between injury and operation ranged from 4 to 12 days. The operation time, bleeding during operation and postoperative drainage volume were observed in two groups,and the changes of nerve function of ASIA grade, clinical efficacy,improved degree of thoracic and lumbar lordosis,and bony fusion were compared between two groups.

RESULTSAll patients were followed up from 12 to 24 months with an average of (15.8 ± 3.3) months. The operation time, bleeding during operation, and postoperative drainage volume had no significant different between two groups (P > 0.05). As compared with preoperative, ASIA grade of two groups at last follow-up had statistically significantly different (P < 0.01), the neural function of two groups after operation was recovered for different extent. The JOA score of two groups was compared between last follow-up and preoperative, the difference had statistically significant (P < 0.01), the two groups showed good clinical effect. The clinical results of ASIA grade, JOA score and RIS had no significant differences between two groups. All patients of two groups were obtained fusion. Thoracic and lumbar lordosis angle improvement degree had no significant difference between two groups ,it bad significant difference had statistical significance compared with preoperative, the two approaches could effectively restore the spinal sequence.

CONCLUSIONFor patients with thoracolumbar burst fracture just treated by anterior decompression and reconstruction of anterior column, according to the degree of operation performer' skill proficiency and the patient' condition to choose, but for patients must performed the spinal canal decompression anterior and posterior, the three column-reconstruction to required anterior-posterior approach, the posterior unilateral approach corpectomy fusion screw-rod fixation obviously shorten operation time, reduce the operation wound, it is worth the clinical promotion.

Adult ; Decompression, Surgical ; methods ; Female ; Humans ; Lumbar Vertebrae ; injuries ; surgery ; Male ; Middle Aged ; Pedicle Screws ; Reconstructive Surgical Procedures ; Retrospective Studies ; Spinal Fractures ; surgery ; Spinal Fusion ; methods ; Thoracic Vertebrae ; injuries ; surgery

ObjectiveTo analyse the clinical characteristics of pancreatic intraductal papillary mucinous neoplasm (IPMN) which coexists with extrapancreatic malignancy (EPM),with an aim to provide strategies for clinical diagnosis and treatment.MethodsThe PubMed was used to search for the pancreatic IPMN related articles with positive pathologic results.A pooled analysis was then performed.The ratio ofpancreatic IPMNs coexisting with EPMs and the locations (or the type) of EPMs were analyzed.ResultsAfter a strict process of screening,18 articles met the pre-determined standardsand were accepted.Of the 1327 patients,363 had coexisting EPMs (27.35％).There were 392 EPMs in these 363 patients.The EPMs occurred in almost all the systems of the body,especially in the digestive tract and its related organs,which accounted for 63.06％ of the EPMs. Conclusions There is a tendency for patients with pancreatic IPMN to have coexisting EPM. More than half of these EPMs are malignant tumors in the digestive system. When pancreatic IPMN is diagnosed,the clinician should be aware of the possible coexistence of an EPM and should look for the possibility of a new EPM developing in a patient after treatment of pancreatic IPMN.

Objective To detect the level of plasma miR-155 in patients with pancreatic cancer and evaluate its diagnostic value for pancreatic cancer. Methods Sixty-two cases of pancreatic cancer patients, 61 patients of chronic pancreatitis and 36 normal controls were included in the study. miR-155 in the total RNA extracted from the plasma was measured using real time PCR. The diagnostic parameters and relationship of the miR-155 with clinical characteristics in pancreatic cancer patients were analyzed. Results The relative abundance of plasma miR-155 in pancreatic cancer, chronic pancreatitis and normal controls were 5.41 ±3.14,2.59 ±2.49 and 0.77 ± 1.17, and the value was significantly higher in pancreatic cancer group compared with those of chronic pancreatitis and normal group (P ＜ 0. 01 ). No significant correlation between the level of plasma miR-155 and age, sex, tumor size in pancreatic cancer patients was found. But there was a negative correlation between the level of plasma miR-155 and TNM staging (r = -0. 323, P = 0.01 ). For discriminating pancreatic cancer from normal control, the AUC ROC of miR-155 was 0. 943 (95% CI 0.902-0.985), and the sensitivity and specificity were 87.1% and 83.3%, respectively. For discriminating pancreatic cancer from chronic pancreatitis, the AUC ROC of miR-155 was 0.762 (95% CI0. 678-0. 846),and the sensitivity and specificity were 64.5% and 73.8%, respectively. For discriminating pancreatic cancer from chronic pancreatitis and normal, the AUC-ROC of miR-155 was 0. 829(95% CI0. 767-0.892), and the sensitivity and specificity were 62.9% and 84.5%, respectively. Conclusions Plasma miR-155 was significantly increased in patients with pancreatic cancer, and can be used for diagnosis of pancreatic cancer.

Objective To study the clinical characteristics which are related to malignancy in pancreatic intraductal papillary mucinous neoplasm (IPMN) with an aim to provide evidence for clinical practice.Methods Using PubMed,all pancreatic IPMN related articles with positive pathologic results before July 30th,2011 were studied.A pooled analysis was carried out on the morphological features of the disease.The analysis included gender,diameter of main pancreatic duct,diameter of cystic lesion,mural nodules and histological types (benign/malignant) of the neoplasm.Results 98 articles (including 1902 cases) were collected and analyzed.1025 cases were benign (53.89％) and 877 cases (46.11 ％) were malignant.Morphologically,there were a correlation between main pancreatic duct dilatation (≥5 mm),cystic lesion of large size (≥30 mm),presence of mural nodules and malignancy.The OR (95％ CI) were 5.591 (3.657-8.548),3.633 (2.626-5.027) and 4.983 (3.872-6.412) respectively.Conclusions A main pancreatic duct dilatation (≥5 mm),cystic lesions of large size (≥30 mm) and presence of mural nodules prompt the tumor to be malignant.In clinical work,the management of pancreatic IPMN should be made prudently based on comprehensive analysis of clinical features and the patient's status and intent.