Objective To study the clinical value of neoadjuvant radiotherapy (NRT),neoadjuvant chemoradiotherapy (NCRT) or surgery alone (S) in treatment of middle and low rectal cancer.Methods 139 cases were divided into 3 groups:47 cases were given NRT (50 Gy/25 f/5 w) as group NRT,46 cases were given NCRT (Capox+ radiotherapy) as group NCRT,and the remaining 46 cases were treated with surgery alone as group S.Patients in 3 groups were followed-up for 3 years for the observation of the rates of anuspreserving and 3-year survival rates.Results Compared with the patients in group S,the rates of anuspreserving in group NRT and NCRT were significant improvement [74.47 ％ (35/47) and 73.91％ (34/46) vs 54.35 ％ (25/46)],(x2 =4.111,3.827; P=0.043,0.050).The 1,2,3-year survival rates of the 3 groups had no significantly different (P ＞0.05).However,the 1-year survival rates might be lower in group NRT and group NCRT than that in group S [87.23 ％ (41/47) and 88.89 ％ (40/45) vs 97.83 ％ (45/46)] (x2 =4.611,P =0.100).Conclusion NRT and NCRT can improve the rate of anus-preserving,but might not improve the 1,2,3-year survival rate,instead,the death rate may increase in the first year.

Objective To investigate the security characteristics of rural young boarding pupils and its influencing factors.Methods 210 boarding and 265 non-boarding rural young pupils of Huojia in Henan were tested by questionnaires,including of a self-developed questionnaire,security questionnaire and adolescent mental resilience scale.Results ①The scores of the interpersonal security (25.99 ± 5.53),the determine control sense factor (24.63 ±6.17) and the total security(50.62 ± 10.37) in the boarding pupils were statistically lower than non-boarding pupils (27.36 ± 6.38,26.00 ± 6.55,53.36 ± 11.77,P ＜0.05).②There were statistically significant difference in the scores of the interpersonal security,the determine control sense factor and the total security among the different grades(P＜0.05),but there were no statistically sex difference in the scores(P ＞ 0.05).③Group regression analysis showed that,no family factors in the young boarding pupils had influence on the score of the security sense factors and the total (P＞0.05),and marital relationship of parents,only child,father' s and mother(')s education background of non-boarding pupils had certain influence on the score of the interpersonal security,the determine control sense factor and the total security (β =-0.43-0.27,P＜ 0.05).④The group regression analysis showed that,the problem solving and self-efficacy,parents'high expectations in mental toughness respectively had some effect on the interpersonal security of boarding and non-boarding pupils(β =-0.15,β =0.25,P＜0.05),and social ability and family care,schools resilience respectively had influence on the determine control sense in boarding and non-boarding pupils (β =-2.91-2.87,P＜0.05),and social ability,parents'high expectations respectively had influence on the total security in boarding and non-boarding pupils (β =-0.17,β=0.22,P＜0.05).Conclusion The security-sense in boarding young pupils are lower than the non-boarding young pupils,and family factors and mental toughness have different effects on security-sense of two kinds pupils.

Objective:To improve the TLC identification method in the quality standard for Yangyin Qingfei granules by identifying paeoniflorin and radix scrophulariae on the same condition plate. Methods:The preparation method for paeoniflorin sample solution in the original standard of TLC identification was improved, the extraction method was water-saturated n-butanol extraction, and the reference crude herb solution of radix scrophulariae was prepared. Simultaneous TLC identification of paeoniflorin and radix scrophular-iae was carried out according to the method described in the original standard. Results:The improved TLC method could be used in the simultaneous identification of paeoniflorin and radix scrophulariae, the spots were clear, and the separation and reproducibility were promising without interference. Conclusion:The improved method is more useful in the quality control of the product with simplified operation.

AIM: To investigate lipoprotein lipase gene HindⅢ polymorphism and its relationship with serum lipids and apolipoprotein, serum HDL subclasses in patients with hyperlipoidemia. METHODS: Lipoprotein lipase gene HindⅢ polymorphism was assayed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). The subclasses of serum HDL in 152 hyperlipoidemia patients and 128 healthy subjects were determined by two-dimensional gel electrophoresis conjunction with immunodetection method. RESULTS: H+H+ genotype and allele H+ in hyperlipoidemia and control groups were both the highest. In hyperlipidemia group, H+H+ genotypes tended to be higher than that in control group, while H+H- and H-H- genotypes were significantly lower (P

Objective To investigate the risk factors for clopidogrel resistance (CR) in patients with ischemic stroke.Methods Turbidimatry was used to measure the platelet aggregation rate changes after the patients with acute ischemic stroke taking 75 mg of clopidogrel per day for 10-14 days.The patients were divided into either a CR or a clopidogrel sensitivity (CS) group according to the platelet aggregation rate changes.The demographic and clinical data of both groups were compared.Multivariate logistic regression analysis was used to identify the independent risk factors for CR.Results A total of 147 patients with acute ischemic stroke were included,42 of them (28.57％ ) were in the RC group and 105 (71.43％) were in the CS group.The proportion of patients in diabetes (54.76％ vs.11.43％ ;x2 =31.054,P =0.000),the history of transient ischemic attack (TIA) (80.95％ vs.26.67％ ;x2 =36.251,P=0.000) or percutaneous coronary intervention (PCI) (26.19％ vs.3.81％;x2 =16.400,P=0.000),taking calcium channel blocker (CCB) (83.33％ vs.54.29％ ;x2 =10.810,P =0.001 ),angiotensin converting enzyme inhibitor (ACEI)/angiotensin receptor blocker (ARB) (66.67％ vs.42.86％;x2 =6.803,P=0.009),and proton pump inhibitor (47.62％ vs. 14.29％;x2 =18.375,P =0.000) in the CR group,as well as the levels of plasma total cholesterol (TC),glucose,and glycated hemoglobin were significantly higher than those in the CS group.Multivariate logistic regression analysis showed that diabetes (odds ratio [ OR] 13.711,95％ confidence interval [ CI] 1.667 - 112.784; P =0.015),increased TC level (OR 2.828,95％CI 1.574 - 5.080; P =0.001),previous history of TIA (OR16.627,95％ CI 4.691 - 58.934; P =0.000),and long-term taking CCB (OR 4.147,95％ CI 1.053 - 16.332;P =0.042),and ACEI/ARB (OR 4.841,95％ CI 1.539 - 15.231; P =0.007) were the independent risk factors for CR.Conclusions CR in patients with ischemic stroke is associated with a variety of factors,in which diabetes,increased TC,as well as long-term taking CCB and ACEI/ARB are the independent risk factors for CR.

Objective To explore the mental education and continuing education among non-psychiatric medical workers of the general hospitals in Guangzhou city.Methods A cross-sectional study was carried out in 17 general hospitals of Guangzhou city including 2617 participants from December 2012 to April 2013.Results Among 2617 participants,41.6％ of them hadn't taken part in psychiatric course study,66.9％ hadn't received psychiatric rotation,and 66.7％ hadn't received psychiatry and related training;93.8％ of the medical staff had interest in mental specialized training courses,of which 72.0％ medical staff stood for training classes/participation,72.3％ medical staff most satisfied with 4-5 days of a training course,strengthen training every 6 months (2 days) and a psychiatrist to connect.Conclusion Non-psychiatric medical workers of the general hospitals in Guangzhou city lack the knowledge of mental health,and mental health care training are urgently needed.

Objective:To determine the content of self-manufactured and imported lurasidone hydrochloride tablets in order to e-valuate their internal qualities. Methods:The determination of lurasidone hydrochloride tablets was performed by HPLC. The HPLC system consisted of a Waters C8 column (250 mm × 4. 6 mm, 3. 5 μm) and the mobile phase of 0. 05 mol·L-1 phosphate buffer solu-tion (pH 3. 0)-acetonitrile(60∶40), the detection wavelength was 230 nm, the flow rate was 1. 2 ml·min-1 and the column tempera-ture was 40℃, and the injection volume was 20μl. Results:The linear range of lurasidone hydrochloride was 0. 100 8-0. 806 4 mg· ml-1(r=0. 999 5). The average recovery was 99. 95% with RSD of 0. 31%(n=9). Conclusion:The method is simple, rapid, ac-curate, and reliable. The method can determine lurasidone hydrochloride tablets satisfactorily. According to the results, there are few differences among the self-manufactured and imported lurasidone hydrochloride tablets.

OBJECTIVETo explore the epidemiological characteristics of inhalation injury and to summarize the clinical application experience of diagnostic standard of burn of larynx.

METHODSMedical records of 443 patients with inhalation injury admitted to our burn unit from January 1999 to June 2013 were analyzed, including gender, age, severity of inhalation injury, complications and diseases before injury; total area and that of full-thickness burn injury, admission time after burn, and burn condition of larynx of patients with different degrees of inhalation injury; treatment and outcome including rate, time, and complication of tracheotomy, mortality, and cause of death. Data were processed with nonparametric Kruskal-Wallis test and chi-square test. The relationship between severity of inhalation injury and total burn area, degree of burn of larynx, tracheotomy rate, and mortality was assessed by Spearman correlation analysis.

RESULTS(1) Among the patients, there were 353 (79.7% ) male and 90 (20.3% ) female, with the ratio of male to female 4:1. There were 64 (14.4%) patients younger than or equal to 20 years, 203 (45.8%) patients older than 20 years and younger than or equal to 40 years, 144 (32.5%) patients older than 40 years and younger than or equal to 60 years, and 32 (7.2%) patients older than 60 years. The numbers of patients with mild, moderate, and severe inhalation injury were respectively 297, 108, and 38. Seven patients suffered from complications, and 21 patients had diseases before injury. There were statistically significant differences among the patients with different degree of inhalation injury in regard to total burn area and full-thickness burn area (with H values respectively 73.752 and 142.830, P values below 0.01), while no statistically significant difference was observed in admission time after burn ( H = 1.528, P > 0.05). Correlation analysis showed that severity of inhalation injury was positively correlated with total burn area (r = 0.399, P < 0.001). Among the patients with mild inhalation injury, incidences of patients with mild, moderate, and severe burn of larynx were respectively 68.0% (202/297), 32.0% (95/297), and 0, and those among the patients with moderate inhalation injury were respectively 0,53.7% (58/108), and 46.3% (50/108). There were statistically significant differences in degree of burn of larynx of patients with different degree of inhalation injury (χ2 = 336.703, P < 0.001). Correlation analysis showed that severity of burn of larynx was positively correlated with severity of inhalation injury (r = 0.700, P < 0.001). (2) The rate of tracheotomy was 37.02% (164/443). The rates of tracheotomy in patients with mild, moderate, and severe inhalation injury were respectively 10.44% (31/297), 87.96% (95/108), and 100.00% (38/38), χ2 = 271.654, P < 0.001. Correlation analysis showed that the rate of tracheotomy was positively correlated with severity of inhalation injury (r = 0.784, P < 0.001). Tracheotomy was done mainly within 6 h post burn (63.4%, 104/164). The incidence rate of complication of tracheotomy was 5.5% (9/164). (3) Thirty-one patients died, with a mortality rate of 7.00%. The mortality rates of patients with mild, moderate, and severe inhalation injury were respectively 1.01% (3/297), 12.96% (14/108), and 36.84% (14/38), H = 74.273, P < 0.001. It was found that the mortality was positively correlated with severity of inhalation injury (r = 0.371, P < 0.001). The causes of death of the patients were respectively sepsis (14, 45.2%), respiratory failure (7, 22.6%), airway obstruction (2, 6.5%), airway hemorrhage (2, 6.5%), cerebral hemorrhage (2, 6.5%), cardiac accident (2, 6.5%), and diabetes insipidus (1, 3.2%), and 1 (3.2%) patient quit treatment and discharged from hospital for economic reason.

CONCLUSIONSAmong the patients with inhalation injury, male is dominated in number, and the young adults formed the highest constituent ratio. The severity of inhalation injury was correlated with total burn area, severity of burn of larynx, tracheotomy rate, and mortality. With the guidance of diagnostic criteria of burn of larynx and indication of tracheotomy, the risk of laryngeal obstruction can be eliminated. The early preventive tracheotomy can decrease the difficulty and risk of the operation.

Adolescent ; Adult ; Age Distribution ; Aged ; Airway Obstruction ; etiology ; surgery ; Burn Units ; Burns ; Burns, Inhalation ; complications ; mortality ; surgery ; China ; epidemiology ; Female ; Humans ; Incidence ; Injury Severity Score ; Male ; Middle Aged ; Postoperative Complications ; epidemiology ; Sepsis ; epidemiology ; Severity of Illness Index ; Sex Distribution ; Tracheotomy ; methods ; Young Adult

Objective:To investigate the influencing factors of nursing interns' satisfaction with having internship in third-grade class-A hospitals in Luzhou City.Methods:Using self-compiled satisfaction questionnaire and mentor's behavior scale (MBS), the internship situation of nursing interns in third-grade class-A hospitals in Luzhou City were investigated. The collected data were described by SPSS 22.0 and analyzed by binary logistic regression to understand the influencing factors of nurses' satisfaction.Results:A total of 729 questionnaires were distributed and 567 valid questionnaires were recovered, with an effective recovery rate of 77.78%. The MBS scores of 567 nursing interns were (3.54±0.72) and 81.1% (460/567) were satisfied with the clinical internship. The teaching mode ( OR=3.570) and the behavior of mentors ( OR=1.056) were the influencing factors of students' internship satisfaction. Conclusion:During the internship, one-to-one clinical teaching mode should be adopted in the process of internship, for improving students' internship experience. Meanwhile, teachers' behavior should be standardized to improve students' learning satisfaction and clinical teaching quality.

Objective To study the application of refined nursing intervention in prevention of postoperative urethral stricture in patients with hypospadias.Methods A total of 144 patients who underwent hypospadias surgery in our hospital were selected as study subjects,and were divided into control group and observation group by random number table method,with 72 cases per group.Both groups were treated with targeted surgery according to severity and different sites of hypospadias.The patients in the control group performed routine nursing intervention during the perioperative period,while the patients in the observation group were given refined nursing intervention on the basis of the control group.The response rate,incidence rates of postoperative complications and hypospadias were evaluated.Results The total response rate in the observation group was higher than that in the control group (P ＜ 0.05).After nursing,the incidence rate of postoperative complications such as bleeding,urinary fistula,infection,and urine extravasation was lower in the observation group than that in the control group[6.94％ (5/72) vs.(18.06％) (13/72),P ＜0.05).After nursing,the total incidence rate of mild and severe urethral stricture in the observation group was lower than that in the control group [(2.78％ (2/72) vs.12.50％ (9/72),P＜0.05).Conclusion Refined nursing intervention for patients with hypospadias can effectively enhance treatment efficacy,reduce postoperative complications,and prevent urethral stricture,thereby to improve the prognosis of the disease.