Objective To observe the clinical efficacy of the early activity on preventing deep vein thrombosis after joint replacement. Methods A total of 90 patients who undergone skeleton and knee joint replacement from January 2014 to January 2015 were randomly divid-ed into the observation group and the control group (with 45 cases in each group)according to the random number table method.The control group were given routine nursing care to prevent thrombosis,while the observation group were given intervention nursing,namely implementa-tion of early activities.The related symptoms of deep venous thrombosis and D-dimer level of high blood coagulation state of plasma of the two groups were observed and compared before and after treatment.Results The symptoms of deep vein thrombosis of the observation group in the early postoperative period were less than that of the control group,and the difference was significant(P <0.05).The D-dimer level of the observation group was lower than that of the control group 7 days after the operation with a significant difference (P <0.05).Conclusion Systematic nursing intervention of early activities can significantly reduce the related symptoms of forming deep vein thrombosis after joint re-placement.In addition,it has an apparent effect on lowing the high blood coagulation state and preventing deep vein thrombosis.

objective　 To investigate the differences in behaviors between asthmatic and nonasthmatic children , and to evaluate the psychological interventions. Method　 Behaviors were investigated in the 84 children with asthma and 84 healthy children, After psychological interventions of 3～4 months, the effects were evaluated in 18 asthmatic children. Results　 Behavioral problems were more prevalent in asthmatics than nonasthmatics,behavioral problems were different in asthmatic children of different severity and gender,psychological interventions as well as drug therapy have beneficial effects on controling of asthmatic symptoms. Conclusions Asthma contributes to the development of behavioral problems,Psychological intervention in child with asthma has many positive effects on controling the symptom and miniming the bad behaviors.

Objective:To explore differences in beha viors and quality of life between asthmatic and non-asthmatic children . Methods:Be haviors and quality of life were assessed in the 84 children with asthma and healthy children,4-11 years of age .Results :Behavioral problems were more prevalent in asthmatics than non-asthmatics.The major beha vior al problems in children with asthma were recession, physical complaints,anxiety/ de pression,and social intercourse.The children with asthma were less satisfact ory than healthy children with respect to quality of life especially on anxiety,depressi on and somatic feelings.Conclusion:Asthma contribut es to the developmen t of behavioral problem and adversely affects the children's quality of life.

ABSTRACT:Objective To evaluate the clinical therapeutic effect and safety of tumor necrosis factor alpha (TNF-α)blockers in treating moderately to severely active ulcerative colitis (UC)by meta-analysis.Methods Such databases as the Cochrane Central Register of Controlled Trials,PubMed,OVID,Embase,ISI,CBM,CNKI, VIP,and WanFang Data were searched from establishment to June 2013.All randomized clinical trials (RCTs)on tumor necrosis factor alpha blockers in treating UC were collected,and then selected on the basis of the inclusion and exclusion criteria.We assessed the methodological quality,extracted the data from the included articles and performed the meta-analysis with Revman 5.1.Results A total of 13 RCTs involving 3334 patients were analyzed.TNF-αblockers group was superior to the control group in the short-term clinical response (OR =2.5 1, 95% CI 1.73,3.64),short-term clinical remission (OR =2.74,95% CI 1.80,4.1 6),long-term clinical response (OR =2.98,95% CI 1.98,4.47),1ong-term clinical remission (OR =2.64,95% CI 1.89,3.67),and mucosal healing (OR =1.89,95% CI 1.39,2.59)compared with control group.TNF-αblockers could also reduce the rate of colectomy (OR =0.61,95% CI 0.41,0.89)and improve inflammatory bowel disease questionnaire scores (MD=14.74,95% CI 1 1.43,18.06 ).There was no significant difference between the two groups in all reported adverse effects (OR =1.14,95% CI 0.97,1.34)and serious adverse effects (OR=0.78,95% CI 0.56,1.09).Conclusion Compared with conventional therapy or placebo,TNF-αblocking agents can improve the therapeutics effect on UC in clinical response,clinical remission and mucosal healing,and also can reduce the rate of colectomy. In patients with moderately to severely active UC treated with TNF-α blocking agents,it is easier to achieve the improvement of life quality.TNF-αblocking agents treatment is safe for UC.This conclusion should be verified with more large-scale and high-quality RCTs.

Objective To investigate the level of serum angiopoietin-like protein 4 (ANGPTL4) in normal subjects and patients with obesity and newly-diagnosed type 2 diabetes mellitus (T2DM),and to explore the relationship of serum ANGPTL4 with parameters of body fat,glucose-lipid metabolism,and insulin resistance index (HOMA-IR).Methods A total of 160 subjects with normal glucose regulation(NGR) and newly-diagnosed T2DM,were divided into 4 groups:NGR with normal weight group (NGR-NW),NGR with overweight/obese group (NGROW/OB),T2DM with normal weight group (T2DM-NW),and T2DM with overweight/obesity group (T2DM-OW/ OB) according to their body mass index(BMI).ELISA was used to determine the level of serum ANGPTL4.The weight,height,waist circumference,hip circumference,waist hip ratio(WHR),and BMI,fasting insulin(FINS),lipid metabolism parameters,and insulin resistance index (HOMA-IR) were measured.Results Compare with the NGR group,the level of ANGPTL4 was significantly decreased in the T2DM group [(25.75 ±2.85 vs 31.08 ±3.35)ng/ml,P＜0.01],the level of ANGPTL4 in OW/OB group was significantly lower than that in the NW group [(27.27± 3.05 vs 29.04 ± 4.64) ng/ml,P＜0.01].Partial correlation analysis showed that serum ANGPTL4 was negatively correlated with BMI,WHR,FPG,2hPG,HbA1C,FINS,HOMA-IR,AST,ALT,and TG levels(P＜0.01),but positively correlated with the HDL-C(P＜0.01).Multiple stepwise regression analysis showed that HbA1C,FINS,and HDL-C were independent risk factors of serum ANGPTL4 (β =-0.825,-0.119,3.301,P＜0.01).Conclusion Serum ANGPTL4 level in T2DM and OW/OB group was lower than that in NGR and NW group.Serum ANGPTL4 is associated with FINS and lipid metabolism,suggesting that it may play an important role in the pathophysiology of obesity and metabolic syndrome.

Objective:To investigate the speech-evoked brainstem response (speech-ABR) of normal young people under different recording periods,which can provide the experimental evidences for researches on the stability of speech-ABR and promote its applications in clinical researches.Methods:40 healthy young people were randomly divided into two groups,which were tested following the same protocol at different time of two months interval.Latencies and amplitudes of the feature peaks in these groups were compared and the rates of appearance (detection rate) of the feature peaks were analyzed statistically.Results:Speech-ABRs were recorded successfully in two groups.The latencies and amplitudes of feature peaks in these groups were not different statistically,and the detection rates of V,A,C and F peaks were higher than others.Conclusion:The speech-ABRs of the two groups are stable,and the V,A,C and F peaks can be used as important indicators of clinical observation,showing that Speech-ABR is a promising tool in the study of Speech perception mechanism.

Objective:To investigate the effect of Bitongling Granule medicated serum on rabbit articular chondrocytes cultured in vitro.Methods:Bitongling Granule(2ml/kg) was given to New Zealand rabbits for 3 days for preparation of containing serum.Rabbit.chondrocytes were divied into Bitongling Granule groups of different concentrations,blank serum group,experimental control group and anti-bone capsule group.To observe the change of nitric oxide synthase and superoxide dismutase in all groups.Results:Bitongling Granule can reduce the activity of NO and increase the level of SOD in sera.Conclusions:Bitongling Granule can prevent and cure experimental osteoarthritis,which is related to the decrease of NO and activation of SOD.

OBJECTIVE To explore the latency characteristics of speech evoked auditory brainstem response(speech-ABR)from healthy Chinese adults by different stimulation intensities and its significance in neural encoding of speech in the brainstem. METHODS ABRs to speech syllables of 32 subjects were recorded in four stimulus intensities varied from 20 to 80 dB SPL by 20 dB steps, under 11.1/s stimulus rate. A set of featured waves were determined under these intensities, and then the characteristics of their latencies were analyzed. RESULTS A series of featured waves were observed starting from onset response(including V and A waves), transitional C wave, then following frequency-following responses(FFRs), and the offset O wave. As the reduction of stimulus intensity, the latencies of speech-ABR delayed significantly(P

Objective To investigate improvements in the diagnosis and treatment of primary malignant tumor of the duodenum. Methods The clinical data of 54 patients with primary malignant tumor of the duodenum treated during a period of 6 years were analysed retrospectively. Results Tumors located in the first, second, third and fourth parts accounted for 6 cases(11.1%), 44 cases(81.5%), 2 cases(3.7%), and 2 cases(3.7%) respectively; and among them, ampullary tumor accounted for 38 cases(86.4%) of tumor of descending portion of duodenum and 70.4% of the total number of duodenal tumors. The main clinical presentation included jaundice, upper abdominal pain, weight loss, abdominal distention, and gastrointestinal obstruction. Upper abdominal pain, no positive signs and abdominal mass were found in 72.0%, 20.0% and 8.0% respectively on abdominal examination. Preoperative associated cholecystopathy accounted for 37.0%. The accuracy rate of duodenoscopy and ERCP in preoperative diagnosis was 94.4%, and 77.8% respectively. Preoperative diagnostic accuracy rate was 27.8%. Panceaticoduodenectomy was performed in 38 cases, duodenectonmy in 1 case, palliative resection of tumor in 9 cases, and tumor was inoperable in 6 cases. Radical resection rate was 72.2%. The postoperative 3- and 5-year survival rate was 40.6% and 21.9%, respectively. After palliative resection, death occurred from 1month to 24months. Conclusions The tumors in the ampullary region account for the majority of primary malignant tumors of the duodenum and are mainly adenocarcinoma. The symptoms of advanced stage are complicated, and specific signs on abdominal examination are few. Associated cholecystopathy is relatively ferquent and preoperative accurate diagnostic rate is low. The examinations of first choice are duodenoscopy and ERCP, and radical panceaticoduodenectomy can extend survival time.

Objective:To compare the time domain and the frequency domain of speech-evoked auditory brainstem response measured by stimulation of left and right ears, and to explore the difference and possible reasons of neural coding for speech from different ears in auditory brainstem.Method:Speech-ABRs to syllable /da/ of 31 healthy adults were recorded. Statistical analysis was performed on time-domain parameters, such as latencies and amplitudes of featured peaks, and frequency-domain ones, such as amplitudes of the fundamental frequency and the first formant of speech-ABRs ranging from 20-50 ms. A scoring criterion to grade the appearance of featured waves was proposed for waveform evaluation.Result:There were no significant difference for the latencies of binaural featured peaks and amplitudes of feature peaks(except peaks A and O). The waveform scores of right ear were greater than that of left ear. The amplitudes of fundamental frequency of binaural waves were both greater than that of the first formant. There was no significant difference of amplitudes of fundamental frequency and the first formant between two ears.Conclusion:The origins and distributions of speech-ABR are essentially symmetrical in brainstem in contrast with the hemisphere asymmetry of speech.