Objective To explore the effect of health education path on care and household rehabilitation in children with cerebral palsy (CP). Methods 100 CP children from June to December, 2012 were divided into experimental group (n=50) and control group (n=50). The control group was given conventional health education, while the experimental group along with the health education path. Mastery rates of disease knowledge and family rehabilitation methods, cooperation rate, and care satisfaction rate of parents was assessed before discharge.Results Mastery rates of disease knowledge, family rehabilitation methods, cooperation rate, and care satisfaction rate of parents were higher in the experimental group than in the control group (P<0.05). Conclusion Application of health education path can rule the health education of nurses, and improve the CP patient's satisfaction and compliance.

Objective To evaluate the value of ultrasonic diagnosis of congenital prepyloric diaphragm. Methods Twelve cases were collected for the analysis of the characteristics of ultrasonography in diagnosis of congenital prepyloric diaphragm. Results Of the 12 cases of congenital prepyloric diaphragm, valvula in pyloric antrum could be observed in 5 cases, inclusive of 2 cases of complicating pachyntic stenosis of pyloric muscular layer. Other valvula in pyloric canal could not be found with ultrasonography. No pyloric muscular layer pachynsis was observed, but signs of pyloric obstruction such as gastric retention, slow or difficult transfer of gastric contents, gastro-esophageal reflux were found. Prepyloric diaphragm was confirmed surgically in all cases. Conclusion Ultrasonic diagnosis of congenital prepyloric diaphragm is of practical value in clinical practice and can provide reliable imaging data for the option of preoperative approaches.

Objective To study retrospectively the efficacy and complications of different surgery approaches used to treat primary spinal tumors and to discuss the surgical strategy in treating them. Methods 135 patients with primary spinal tumors had been treated between July 1998 and July 2005. The following diagnoses were made based on histopathological findings: multiple myeloma in 25 patients, giant cell tumor in 17, neurofibroma or neurilemmoma in 23, chondrosarcoma in 7, osteoblastoma in 6, aneurysmal bone cyst in 4, lymphoma in 9, eosinophilic granuloma in 6, hemangioma in 15, osteosarcoma in 3, Ewing sarcoma in 5, and other different tumors in 15. Anterior approach and posterior approach was used in 73 cases and 31 cases respectively. Posterolateral approach was used in 13 cases and combination of anterior and posterior approach was used in 18 cases. Results Pain relief was obtained in 126 of the 135 patients(93.3%). Improved neurological function was seen in 86 of 92 patients who had suffered from impaired neurological function. No severe complications were found in the follow-up period. Cerebrospinal fluid leakage was observed in 11 patients, and which was successfully treated using antibiotics therapy and raising the foot of the bed. 3 patients suffered from stress ulcer after operation, but they recovered soon after blood transfusion and anti-acid treatment. Other complications included subcutaneous emphysema (in 3 patients), superficial wound infection (in 3 patients),nerve root injury (in 2 patients), implant loosening (in 2 patients), and neurological morbidity due to surgery (in 1 patient). Conclusion When single or two adjacent vertebrae are involved by spinal tumors such as giant cell tumor and chondrosarcoma, tumor resection should be performed through combination of anterior and posterior approach. Aggressive resection based on the Tomita or WBB staging system is the treatment most likely to achieve long-term local control.

Objective To explore the feeling of nurses after needle stick injuries and analyze the cause and impact of needle stick injuries,so as to explore protection measures.Methods The phenomenological methodology was used in the study to analyze the main causes of needle stick injuries,handling method and report reasons.Results The main causes of needle stick injuries were violation of the operation sequence and the weakness of protection awareness.The main reactions of nurses to needle stick injuries were fear and worry.The report circuit was complex.Conclusions It is suggested to pay attention to the analysis and discussion of needle stick injuries and make standardized the operation sequence,improve self-protection awareness,and perfect the support system after needle stick injuries,then bring it into the routine management work.

Objective To investigate the expression of glioma-associated oncogene 2 (Gli2) in giant cell tumor of bone, and analyze the differential expression in the different classification of imaging and pathology and the recurrent diseases, to discuss its role and significance in the pathogenesis and prognosis of giant cell tumor of bone. Methods 46 cases of giant cell tumor of bone who received the primary treatment in Peking University Peopleˊs Hospital during Jan 2009 and Dec 2012 and had the full data of treatment and could be follow-up were collected. Among which there were 40 benign cases and 6 malignant cases. The expression of Gli2 in the different cases of giant cell tumor of bone were detected by immunohistochemistry and real-time PCR, and its effect on the prognosis of giant cell tumor of bone was analyzed. Results Immunohistochemistry revealed positive expression of Gli2 in giant cell tumor of bone. The positive rate of Gli2 in malignant cases was significantly higher than that in benign cases [100.0 % (6/6) vs 55.0 % (22/40), P=0.035], and only found increasing trend but no significant difference among recurrent cases (P=0.204). Results of real-time PCR indicated that Gli2 highly expressed in giant cell tumor of bone, and the increasing trend of expression in different pathological types, different image classifications and recurrent cases, but no statistical different were found (all P>0.05). The expression correlation analysis showed that the expression of Gli2 and PTHrP, and the expression of RANKL and OPG either had a significant correlation (both P< 0.05). Additionally the expression of PTHrP and RANKL had a moderate correlation (P<0.05). Conclusions The expression level of Gli2 is high in giant cell tumor of bone, and Gli2 may be involved in recurrence,metastasis and malignant transformation. Gli2 may effect the osteolytic process of giant cell tumor of bone by the regulation mechanism of Gli2-PTHrP-RANKL pathway.

Fasting plasma preptin level was assayed by RIA in the patients with different glucose tolerances. Regarding fasting plasma preptin levels, it was higher in females than in males. Fasting plasma preptin level was increased in patients with type 2 diabetes as compared with subjects of impaired glucose tolerance and normal controls, and there were positive correlations with diastolic blood pressure, blood triglyceride, total cholesterol, high-density lipoprotein-cholesterol, free fatty acids, 2 h plasma glucose after glucose load, HbA1C and HOMA-IR, suggesting a potential link between preptin and glucose-lipid metabolism and insulin resistance.

Objective:To label monoclonal anti-GPⅢa antibody (SZ21) with 99 Tcm and evaluate the value of 99 Tcm-SZ-21 for detecting thrombi in vivo.Methods:SZ-21 was modified with 2-iminotholane and labeled with 99 Tcm-GH and radiochemical purity was determined by ITLC-SG.99Tcm-SZ-21 was injected via ear edge vein in 5 rabbits in which thrombi were induced in the right femoral arteries.As control,99 Tcm-GH was administered in 1 rabbit.Static images were acquired and irregularly shaped ROIs were drawn on the images to calculate the ratios of T/M and T/B.Vein blood was drawn at 2 min,5 min,10 min,30 min and 1 h-3 h after injection in 2 rabbits so as to observe the blood clearance of 99 Tcm-SZ-21.Rabbits were sacrificed after 3 h of imaging.The vessels including clots were harvested and imaged.Cardiac muscle,liver,spleen,lung,kidney,etc.were excised and weighed.Radioactivity counts were measured to calculate % ID/g.Results:The radiochemical purity of 99 Tcm-SZ21 was beyond 90% and stable in vitro.Thrombi could be visualized at 30 min after injection,and at 2 h image of thrombi was clearly visualized,T/M (2.55?0.72) and T/B (1.94?0.51) ratios were high.In vitro imaging showed that T/B was 4.43?1.5.Conclusion:99Tcm-SZ-21 could be a potential agent for imaging diagnosis of thrombotic disease.

Objective: To observe the effect of vitamin A and iron supplementation on iron status during pregnancy. Methods: 167 pregnant women aged 21～33 years in the second trimester were recruited and randomly allocated to four groups: placebo; vitamin A (1.1 mg/d); iron(60 mg elemental iron); vitamin A and iron, for 10 weeks. Results:The incidences of vitamin A deficiency, anemia and iron depletion were 0.6%,7.8% and 6.2% in the second trimester respectively. Serum VA level was not changed in three supplemented groups but decreased in placebo group. Hemoglobin in all groups before and after supplementation was in normal range, with no significant differences. The improvement in serum ferritin, free erythrocyte proporphyrin and transferrin saturation was better in the group supplemented with VA+Fe than VA or Fe alone. Conclusion: The simultaneous supplementation of vitamin A and iron is better in improvement of iron status than supplementation of vitamin A or iron alone during pregnancy. Improvement of iron status by simultaneous supplementation of pregnant women with vitamin A and iron was better than supplementation with iron or vitamin A alone.

Objective To review the long-term oncologic and functional outcomes of surgical treatment for pelvic chondrosarcoma at a single institution to further delineate surgical strategy of resection and function reconstruction.Methods All of 165 patients with pelvic chondrosarcoma that had been surgically treated between July 2000 and Dec 2013 were reviewed retrospectively.There were 102 male and 63 female patients who had a mean age of 43.5 (range,13 to 75) years.The resection type included Type T 16,type Ⅱ 18,type Ⅲ 11,type Ⅰ+Ⅱ 19,type Ⅱ+Ⅲ 63,type Ⅰ+Ⅳ 15,type Ⅰ+Ⅱ+Ⅲ 10 and type Ⅰ+Ⅱ+Ⅳ 13 cases.The pathology diagnosis was grade Ⅰ in 15,grade Ⅱ in 88,grade Ⅲ in 20,dedifferentiated in 28,mesenchymal in 12 and clear cell chondrosarcoma in 2 patients.Nine cases were secondary lesion following multiple exostoses.114 patients received no previous treatment while others were referred due to recurrent tumor.En bloc resection was achieved in 142 patients and intralesional resection in 23 cases.Twelve patients had a hemipelvectomy to achieve local tumor control,whereas 153 patients underwent a limb-salvage procedure.Spinal screw-rod system was used to reconstruct anterior pelvic ring after ilium resection.Modular hemipelvic endoprosthesis was utilized to reconstruct periacetabular defect after tumor resection while no reconstruction was performed after ischium and pubis resection.Results The median duration of follow-up was 54.1 (range,l0 to 159) months.147 (89.1％) patients were alive at the final follow-up,seven of which were alive with tumor.The estimated 5-year survival was 81.5％.Thirty-three patients (20％) had local recurrence,and twenty (12.1％) had lung metastasis.Recurrent case,sacroiliac joint involvement and intralesional resction were three risk factors for postoperative recurrence.Patients who received type Ⅱ+Ⅲ resection and reconstruction had a mean functional score of 23 according to MSTS 93.The mean MSTS 93 for patients with type Ⅰ+Ⅱ and type Ⅰ+Ⅱ+Ⅳ resection and reconstruction was 18.The wound complication rate was 15.8％.Two aseptic loosening and 2 pubic connection plate breakage were observed in hemipelvic endoprosthesis reconstruction.Conclusion Tumor grade correlates with overall or disease-free survival.For low-grade chondrosarcoma,adequate surgical margin can provide long-term local control while for high-grade cases,distant metastasis is the main case of treatment failure.Adequate surgical margin can be achieved in cases with acetabulum involved.However,aggressive surgical resection of pelvic chondrosarcoma still remains as a challenge for orthopaedic oncologists when the tumor invades the iliosacral joint,which necessitates careful preoperative plan and skilled surgical techniques.

Objective:To assess the efficacy and safety of oncoplastic breast-conserving surgery (OBCS) in the treatment of early breast cancer. Methods:The clinicopathological data of breast cancer patients who were treated with OBCS (67 cases) and standard breast-conserving surgery (SBCS;117 cases) in Affiliated Cancer Hospital of Guangxi Medical University were retrospectively analyzed. Postop-erative complication, specimen weight, margins, and surgery re-excision rate between the two groups were compared. Results:Sero-ma (14.9%versus 48.7%, P<0.001), hematoma (4.5%versus 14.5%, P=0.035), and poor wound healing (3.0%versus 11.9%, P=0.036) were more common in the SBCS group than in the OBCS group. The patient satisfaction in the OBCS group was statistically higher than in the SBCS group (P<0.05). Compared with standard surgery, oncoplastic techniques can be employed for significantly larger tumors (25.04 mm versus 21.14 mm, P<0.001). OBCS resulted in higher mean specimen weights (92.24 g versus 57.44 g, P<0.001), wider clear nearest margins (12.04 mm versus 9.58 mm, P<0.001), and wider furthest margins (24.16 mm versus 15.24 mm, P<0.001). No statisti-cal increase was observed in further surgery re-excision of margins. Conclusion:OBCS is more successful than standard wide local exci-sion in treating larger tumors and obtaining wider radial margins. Oncoplastic approach showed no increase in postoperative complica-tion rate. The postoperative complication was excellent. OBCS is a safe and effective procedure for early breast cancer.