Abnormal reaction in preventive vaccination is the serious adverse reaction happened in regular vaccination. Department of government and producer of vaccines are liable legislatively. In my opinion, relief fund for abnormal reaction should be established to cover the damage of victims and to decrease the risk of government and enterprises.

Objective To investigate the application effect of flexible management in nursing of general surgery department. Methods 21 nursing staff and 836 patients from January to October, 2007 were selected as research object, and were given flexible management. 21 nursing staff and 797 patients from January to December were selected as the control. The influence of flexible management on nurses and patients and satisfaction degree with nursing work before and after application of flexible management were compared. Results Working and learning enthusiasm greatly improved,educational background and professional titles of nurses increased after application of flexible management. The average hospitalization time was 28 days,the per capita cost was 12 131 yuan,satisfaction degree with nursing was 87.0% before application of flexible management, but the average hospital stay of patients decreased to 20 days, the per capita cost decreased to 8764 yuan and satisfaction degree with nursing increased to 97.0% after application of flexible management. Conclusions Application of flexible management in nursing care of general surgery department showed significant effect,it is suitable for more application in practice.

Optical coherence tomography angiography (OCTA) is an noninvasive, rapid and reproducible technology which can provide high resolution view of the vascular structures and quantifies the vessel densities in retina and choroid. Myopia can be divided into simple myopia and pathologic myopia. The mechanism of myopia is not clear while it is closely related to the vessel density. For simple myopia, OCTA can monitor the course and deepen the understanding of myopia by quantifying the vessel densities in each layers and sectors and the foveal avascular zone. For pathologic myopia, OCTA has an advantage of observing the choroidal neovascularization, chorioretinal atrophy and Zinn-Haller arterial circle which can contribute to the early diagnosis and management and follow-up to estimate the prognosis. However, there are several limitations of OCTA which need to be improved, including in the process of acquiring high-quality images, accurate layering and dynamic observation.

Objective:To develop a questionnaire for compliance with the management standard of nosocomial infection control in hemodialysis rooms (centers), and to evaluate the reliability and validity.Methods:Based on the Knowledge, Attitude/Belief, Practice (KAP) survey model, the initial questionnaire was formed by using literature review, the brainstorming and expert consultation. And the final questionnaire was developed by preliminary investigation and the formal investigation, and the reliability and validity test was carried out.Results:The questionnaire consisted of 3 subscales of knowledge, attitude and practice, totaling 40 items. The S-CVI was 0.953, 0.979, 0.943 respectively and that of each item was above 0.867. In the exploratory factor analysis, 3, 1 and 3 common factors were extracted and the cumulative contribution rate was 47.178%, 68.313% and 62.271% respectively. The Cronbach α coefficient was 0.906 for the total questionnaire and 0.641, 0.958 and 0.864 for 3 subscales. The retest reliability was 0.954 for the total questionnaire and 0.694, 0.893 and 0.708 for 3 subscales.Conclusions:The questionnaire had high reliability and validity, which can be used as an effective evaluation tool for the standard to investigate the compliance of medical staffs in hemodialysis rooms.

Through the different image technologies, peripapillary atrophy can be classified into four types: α zone, β zone, γ zone and δ zone. Each type of them has different imaging and histological features. Peripapillary atrophy is a common structure in peoples' eyes and it is correlated with many factors and diseases such as age, myopia, glaucoma, non-arteritic anterior ischemic optic neuropathy and age-related macular degeneration which bring difficulties to our diagnosis and antidiastole. Classifying and qualifying peripapillary atrophy properly, which can evaluate the changes and degrees, can benefit our studies about their mechanism and offer the clinical biological indictors and research basis.

The application of face recognition technology is gradually expanding to the medical field. It has been initially used in the medical diagnosis of endocrine diseases and genetic syndrome. This technology is expected to be used for the screening of genetic syndrome and endocrine diseases, shortening the delay period of disease diagnosis and helping the staging of endocrine diseases. However, this technology also has some moral risks, such as the risk of personal information security disclosure, the challenge to the future of mankind and the division of moral responsibility. This paper reflected on the dilemma of moral responsibility in the application of face recognition and medical diagnosis, and explored the two basic problems of "who is the subject of moral responsibility" and "the specific division of moral responsibility of different moral subjects" in face recognition and medical diagnosis. Finally, some suggestions on the moral responsibility in face recognition and medical diagnosis are put forward. The first is to determine the role of face recognition and medical diagnosis as an auxiliary category, and doctors are still the main medical subject; the second is to build the responsibility ethics mechanism and laws and regulations, the establishment of the responsibility system of face recognition and medical diagnosis is inseparable from the joint action of law and ethics.

Objective: To construct an evidence-based nursing plan for stroke patients with dysphagia for nursing by searching guidelines and using Delphi method. Methods: The evidence-based nursing plan for stroke patients with dysphagia was constructed by literature review and guideline search. 15 experts from neurology, rehabilitation and nursing were selected to participate in two rounds Delphi consultation. Results: The two-round response rates were 15/15. The expert authority coefficient was 0.877. The coordination coefficients were 0.180, 0.132 and 0.185 (P<0.05). The final plan included 4 first-grade indicators, 14 second-grade indicators and 20 third-grade indicators. Conclusion The evidence-based nursing intervention plan for stroke patients with dysphagia based on Delphi method is reliable, which can provide reference for the rehabilitation nursing of stroke patients with dysphagia.

To examine associations of 25?hydroxyvitamin D [25(OH)D] concentrations with sex hormone levels and cardiovascular risk factors. Methods A total of 697 male subjects were obtained from the thyroid disorders, lodine status and diabetes: a national epidemiological survey?2014 (TIDE) research??Henan sub?center survey through multistage stratified cluster random sampling from December 2015 to March 2016. The associations between 25(OH)D and sex hormones or cardiovascular risk factors were analyzed by linear regression analyses. Results The age of the subjects was (46.6 ± 15.9) years (19?85 years). Proportions of vitamin D deficient, vitamin D intermediate and vitamin D optimal were 9.3%, 13.1% and 77.6%, respectively. More subjects with vitamin D deficient were in urban area than in rural area (13.3% vs. 5.7%, P=0.001). After fully adjusting for age, residence area, economic status, education, body mass index, waist circumference, homeostasis model assessment of insulin resistance (HOMA?IR), hypertension, diabetes, triglyceride, high?density lipoproteincholesterol, total cholesterol, low?density lipoprotein cholesterol and uric acid, linear regression analyses showed that every 25 nmol/L increase in 25(OH)D levels increased lg FT(FT=free testosterone) by 0.013ng/L (β=0.013, P=0.036), lg DHT (DHT=dihydrotestosterone) by 0.030 ng/L (β=0.030, P=0.019), and lg AD (AD=androstenedione) by 0.019 μg/L (β=0.019, P=0.008). After fully adjusting for age, residence area, economic status and education, every 25 nmol/L increase in 25(OH)D levels lowered glycosylated hemoglobin A1c (HbA1c) by 0.051% (β=-0.051, P=0.027). Conclusions Higher 25(OH)D concentrations in men were associated with higher FT, DHT, AD and lower HbA1c levels.

Objective To observe the choroidal blood flow and morphological changes in patients with severe stenosis of internal carotid artery stenosis (ICAS).Methods A retrospective case-control study. Forty-six patients (46 eyes) with ICAS were enrolled in this study. There was severe stenosis in one side (the eyes in this side were set as case group) and mild or no stenosis in other side (the eyes in this side were set as control group). Color doppler ultrasound (CDI) was used to observe the changes of hemodynamic parameters of the ophthalmic artery (OA) and posterior ciliary artery (PCA),the main parameters of ultrasound Doppler imaging are peak systolic velocity (PSV), end diastolic velocity (EDV), resistance indices (RI) and the calculation of the pulsation indices (PI) through the use of a formula. Enhanced binarization of deep imaging coherence tomography (EDI-OCT) was used to measure the subfoveal choroidal thickness (SFCT). The total subfoveal choroidal area (TCA), luminal (LA), stromal (SA) and choroidal vascularity index (CVI) were obtained by modified image binarization technique.Results In the case group, the PSV in the OA and PCA was significantly lower than that of the control group (t=?2.200, ?2.612;P=0.030, 0.011). There were no significant differences in EDV, RI, PI of OA (t=0.337, ?1.810, ?1.848;P=0.737, 0.074, 0.068) and PCA (t=?1.160, 1.400, 0.815;P=0.249, 0.165, 0.417). The SFCT (t=?3.711,P<0.001), TCA (t=?2.736,P=0.007), LA (t=?3.188, P=0.002) and CVI (t=?2.096,P=0.039) of the case group was significantly lower than that of the control group. There were no significant differences in SA (t=?1.262,P=0.210) and LA/SA (t=?1.696,P=0.093).Conclusion In severe stenosis ICAS eyes, the PSV in the PCA and SFCT, TCA, LA, CVI are decreased.

Objective:To investigate the effect of miR-425-5p on glucagon-like peptide-1(GLP-1) secretion in intestinal L cells induced by lipopolysaccharide(LPS), and to explore its mechanism.Methods:GLUTag cells of intestinal L cell line were incubated with LPS to determine the levels of miR-425-5p and GLP-1. Cell viability was determined by MTT assay, and cell apoptosis was detected by flow cytometry. Quantitative real time-PCR and western blot were performed to determine the expressions of miR-425-5p, phosphatase and tensin homology(PTEN), proglucagon, and GLP-1. Activity of Wnt/β-catenin signaling pathway was determined by detecting TOP/FOP ratio. Interaction among miR-425-5p, PTEN, and β-catenin was analyzed using luciferase activity assay and chromatin immunoprecipitation(ChIP)assay.Results:In GLUTag cells, with the elevation of LPS concentration, the expression of miR-425-5p and the apoptosis rate were increased, while the level of active GLP-1 and the cell viability were decreased. MiR-425-5p was involved in the regulation of LPS on GLP-1 secretion and intestinal L cell viability. Inhibition of miR-425-5p reduced the mRNA expression of proglucagon and the TOP/FOP ratio, increased PTEN protein level, and inhibited cell viability. In LPS-treated GLUTag cells, miR-425-5p increased the level of β-catenin by targeting PTEN, and β-catenin acted as a cis-acting element to induce the transcription of proglucagon and promote the secretion of GLP-1.Conclusion:In LPS-induced intestinal L cells, miR-425-5p promotes the expression of GLP-1 by targeting PTEN to modulate β-catenin.