Objective To investigate the red blood cell in urine after kidney puncture and know the best detection method.Methods Collected three urines of 31 patients after kidney puncture and detected the red blood cell by UF-100 and the hemoglobin by urine dipstick test.At the same time,detect the conductivity of the urine by UF-100.Results Both the UF-100 and urine dipstick test could reflect the decrease of red blood cell after kidney puncture.But both of them had some limits.Sometimes the results of the two method were not relative(κ=0.148).The agreement of two methods was 0.538.Neither of them could reflect the bleeding of the kidney accuracy.Conclusion By the best,we should use both the UF-100 and the urine dipstick test to detect the red blood cell in urine after kidney puncture,at the same time we should consider the conductivity of the UF-100.

Objective To assess the effect of anti- Helicobacter pylori (Hp) treatment on patients with chronic idiopathic thrombocytopenic purpura (cITP). Methods Fifty-nine patients with cITP and positive-Hp were divided into two groups by random digits table:Hp eradication group (30 cases,given a standard anti-Hp treatment) and placebo controlled group (29 cases,received a placebo). The platelet response of two groups was compared after three months' follow-up. Result The platelet response in Hp eradication group (63.3%, 19/30) was significantly higher than that in placebo controlled group (27.6%,8/29 )(χ2 = 7.59, P ＜ 0.05 ), and the increasing level of platelet count in Hp eradication group [ (33.5 ± 21.6)× 109/L] was higher than that in placebo controlled group [(12.6 ± 19.5) × 109/L] (t = 5.52,P ＜0.05).Conclusion Hp eradication treatment can promote the platelet recovery in mild and moderate cITP patients with positive-Hp.

Objective:To investigate the effects of Jianpijiedutang combined with Kangfuxin Liquid in the treatment of recurrent oral ulcer(ROU).Methods:80 patients with ROU were divided into 2 groups(n=40).The patients in control group were treated with Kangfuxin Liquid local spray,those in the test group were treated with Jianpijiedutang combined with Kangfuxin Liquid spray.The patients were followed up for 24 weeks.The effects were evaluated according to the trial standard of Chinese Stomatological Association.Results:The interval of ROU increased and ulcer number decreased in the 2 groups during the observation period,the test group showed more effective outcome than the control group(P<0.05).In the treatment group ROU interval increased more than in the control group(P<0.01),and ROU ulcer number decreased more(P<0.01).Conclusion:The Jianpijiedutang combined with Kangfuxin Liquid spray is more effective than the latter used only.

OBJECTIVE:To evaluate the feasibility and effectiveness of Hazard analysis and critical control point (HACCP) system in the process of production of Loratadine tablets. METHODS:Taking wet granulation and tableting technology of Lorata-dine tablets as an example,and through the introduction of the concept of HACCP,the basic theory and method of HACCP were applied for hazard analysis on each production link to find critical control points and set critical limits for production quality man-agement. RESULTS:By HACCP analysis,three links namely drying,granules fitting and mixing,internal and external packaging were finally determined as the critical control points in the process of production of Loratadine tablets,thereby critical control lim-its were set for monitoring. After effective control over the risks in the process was ensured,HACCP work plan was made and veri-fied,and the results showed that HACCP system could effectively control and reduce the risks in the process of production and en-sure quality safety. CONCLUSIONS:Application of HACCP system to wet granulation and tableting technology of Loratadine tab-lets can fully embody its feasibility and effectiveness.

Objective : To understand the prevalence of overweight and obesity, and the influencing factors among students aged 7-22 years in Zhejiang Province. Methods : Stratified random cluster sampling was used to randomly select students aged 7-22 years in 11 prefectures of Zhejiang Province in 2019. Height and weight were measured. The general information, dietary habits and living habits of students were collected using the Student Health Status and Influencing Factors Questionnaire. The multivariate logistic regression model was used to analyze the influencing factors of overweight and obesity. Results : A total of 33 800 respondents were included, 7 685 (22.74%) were overweight/obese, 4 729 ( 13.99% ) were overweight, and 2 956 ( 8.75% ) were obese. The multivariate logistic regression analysis suggested that boys ( OR=2.059, 95%CI：1.949-2.175), not living on campus( OR=1.306, 95%CI: 1.214-1.405), history of alcohol consumption ( OR=1.158, 95%CI：1.083-1.238 ), average daily consumption of sugar-sweetened beverages in the past week ( less than once, OR=1.214, 95%CI: 1.103-1.336; once and more, OR=1.431, 95%CI: 1.259-1.626 ), average daily consumption of fries in the past week ( less than once, OR=1.171, 95%CI: 1.065-1.288; once and more, OR=1.266, 95%CI: 1.102-1.454 ), and average daily consumption of sweets in the past week (less than once, OR=0.727, 95%CI: 0.658-0.802; once and more, OR=0.504, 95%CI: 0.444-0.572) were associated with overweight and obesity in students. Conclusion The prevalence rates of overweight and obesity among students aged 7-22 years in Zhejiang Province are 13.99% and 8.75%, respectively, which are associated with boys, not living on campus, and consumption of sugar-sweetened beverages, fries, sweets and alcohol.

Objective To explore the effect of general intervention in improving the psychological condition of healthy pregnant women. Methods Totally 96 pregnant women who made prenatal visits in our obstetrics and outpatient department were divided into the control and the intervention group stochasti-cally. The intervention group started from first prenatal visit. The general intervention measures included cognitive intervention, the behavioral intervention, family coping intervention and psychological intervention with self-designed relaxation exercises. While conventional prenatal visit, propaganda and nursing were im-plemented to the control group.Self-made general questionnaire and symptom checklist 90 (SCL-90)were used to survey and analyze the results. Results Post-natal depression and anxiety of the control group was obviously higher than that of the prenatal. The Post-natal obsessive-compulsive symptom, interpersonal sensitivity, depression, hostility, terror and bigotry in the intervention group were greatly alleviated. Com-pared with the control group, obsessive-compulsive symptom, interpersonal sensitivity, depression, hostility and terror of the intervention group were significantly different (P<0.05). The depression improved while the difference was not evidently differenL Conclusions Delivery had great influence on the psychological status of women,especially anxiety and depression. General intervention measures like psychological relax-ation exercises can improve the psychological condition of healthy pregnant women obviously,especially de-pression.

Objective To investigate the dynamic changes of regulatory T cells (Treg ) and the surface expression of programmed death (PD)‐1 and the level of transforming growth factor (TGF )‐βduring antiviral treatment in patients with chronic hepatitis C (CHC) .Methods Eighty‐six CHC patients referred to the First Affiliated Hospital of Zhengzhou University from October 2012 to October 2013 were included ,and all of them were administered with pegylated interferon α‐2a and ribavirin .Thirty healthy controls were enrolled .The percentage of Treg cells ,PD‐1 expression and TGF‐β level were analyzed by flow cytometry at baseline and at time of achieving rapid virological response (RVR ) , early viral virological (EVR ) , end‐of‐treatment virological response (ETVR ) and sustained virological response (SVR) ,or not achieving SVR .Comparison between two groups was analyzed by t test .Results Among 86 CHC patients ,the proportions of RVR ,EVR ,ETVR ,and SVR at week 24 of follow‐up were 29 cases ,67 cases ,79 cases and 67 cases ,respectively .Percentage of Treg cells in CHC patients was much higher than that in healthy controls (10 .31 ± 5 .61 vs 2 .18 ± 0 .65 ,t = 2 .28 , P< 0 .05) .During antiviral therapy ,percentages of Treg cells declined ,not only in CHC patients with HCV genotype 1b (at baseline , RVR ,EVR ,and ETVR :14 .44 ± 3 .78 ,11 .01 ± 1 .79 ,8 .24 ± 2 .98 ,and 5 .36 ± 1 .47 ,respectively ) ,but also in those infected with HCV genotype 2a (at baseline ,RVR ,EVR ,and ETVR :12 .34 ± 2 .82 ,8 .99 ± 1 .68 ,7 .53 ± 2 .96 ,and 4 .79 ± 1 .23 ,respectively ) .Expressions of PD‐1 and TGF‐β also decreased .At baseline ,the expressions of PD‐1 in patients with SVR and without SVR were 29 .11 ± 14 .65 and 37 .73 ± 11 .65 ,respectively (t = 2 .15 , P = 0 .04) ,and the levels of TGF‐β were 41 .20 ± 18 .96 and 56 .75 ± 14 .42 ,respectively (t= 2 .66 ,P< 0 .01) .At week 24 ,the expressions of PD‐1 in patients with SVR and without SVR were 10 .36 ± 4 .81 and 36 .46 ± 10 .52 ,respectively (t= 13 .95 ,P< 0 .01) ,and the levels of TGF‐β were 10 .06 ± 4 .64 and 45 .23 ± 17 .85 , respectively ( t = 11 .85 , P < 0 .01 ) . Conclusions Percentages of Treg cells and expressions of PD‐1 and TGF‐β decrease during antiviral treatment in CHC patients .Thus ,it could be of assist to predict the treatment response by monitoring these parameters .

Objective To evaluate the feasibility and efficiency of transthoracic echocardiography(TTE) combined with real-time three dimensional echocardiography(RT-3DE)in guiding transcatheter closure of atrial septal defect(TCASD)without X-ray.Methods Eleven patients with atrial septal defects(ASD)underwent the procedure of TCASD guided by TTE combined with RT-3DE.The position of the catheter and transporting sheath,the location and deploying of ASD occluder(ASO)were monitored by muhisection echoscan.especially in RT-3DE.The results were compared with those guided by conventional method(TTE and X-ray).Results All the operations were held successfully.The complications of cardiac tamponade,shedding of occluder,residual shunt,atrioventricular valve regurgitation,embolism and arrhythmia were not observed.Compared with the conventional procedure of the control group,the operation time was significantly prolonged[(65.76±14.15)min versus(45.50±20.88)min,P＜0.000)].Conclusions TCASD was tested to be safe and efficient guided by TTE combined RT-3DE without X-ray,especially for children and pregnant women.It may be expected used widely in the future independently from X-ray.

Objective To evaluate the efficacy and side effects of arsenic trioxide (ATO) combined with thalidomide in the treatment of relapsed/refractory multiple myeloma (MM). Methods 35 patients with relapsed/refractory MM were treated with ATO (10 mg/d) and Vit C (2 g/d) for 14 days,28 days per cycle.Meanwhile they were orally administered thalidomide 50 mg/d,and then one week later orally thalidomide was added to 100-150 mg/d. After 3 cycles of treatment, response and the side effects were evaluated. Patients responsed to the regimen were continued the treatment of thalidomide and were followed up to estimate the PFS. Responses were assessed according to the criteria of the EBMT.Adverse events were graded according to the criteria of the WHO.Results The overall response Was 71.43 ％ (25/35),CR 5.71％ (2/35),PR 34.29 ％ (12/35),MR 31.43 ％ (11/35).After a median follow-up of 11 months,the median PFS was 9 months.The major adverse reactions were digestive tract reaction,leukocytopenia,liver function damage,peripheral neuropathy.They were mild,and could be tolerated.Conclusions The combination of ATO and thalidomide is a feasible and active regimen in treatment of relapsed/refractory MM with better compliance in general.

Objective To explore the feasibility and effectiveness of the revised OSCE stations.Methods 106 sstudents of grade 2008 and 2009 from Xinhua clinical medical school of Shanghai Jiaotong University School of Medicine were involved,32 of whom (experimental group) tool modified OSCE examination and 74 of whom (control group) tool traditional OSCE examination.The revised OSCE exam was the one which on the basis of original OSCE test station setup,improved the operating part of the test stand,adopted clinical cases as stem,asked the students to make possible diagnosis,and perform the corresponding operation.We evaluated the students based on the OSCE scores from the school exam and the overall performances in the national clinical skills competition.Comparison between the two groups was performed by using t test.Results All students who have received the new training methods agreed that it stood closer to the clinical setting.Revised-OSCE trained group of students test scores than traditional OSCE trained group of students,though it didn't have statistical significance.Students from the revised-OSCE group had the score of (80.50 ± 15.45),while the traditional group had the score of (78.30 ± 17.68).By taking the revised-OSCE trainings,all the students have improved their clinical skills and two years in a row to win the Shanghai Jiaotong University School of Medicine Clinical Skills Competition.Conclusions Case-based OSCE stations are well accepted.The new OSCE stations are much closer to clinical teaching and can make better objective assessment of students,so it plays a good role in improving medical students' overall performances.