Based on the clinical application of ERA (easy resilient attachment), the construction of two kinds of ERA were introduced including outside-crown-EAR and root-EAR. The clinical operation and attention of EAR application were demonstrated by clinical cases.

Objective To analyze the chromosome abnormalities in the patients with primary and secondary amenorrhea in the infertility clinic, and provide the guidance for their reproduction.Methods Peripheral blood lyphocytes chromoseme samples were prepared and the karyotype was analyzed according to routine method.Results 24 abnormal chromosome karyotypes were detected in 108 cases, the abnormality detection rate was 22.2%, and it was mainly involved in the numerical or structural abnormality of chromosome X. Conclusions Chromosome abnormality is an important cause for primary and secondary amenorrhea, and the X chromosome abnormality is involed mainly.For those patients,chromosome examination should routinely be taken before assistant reproductive technique.

Objective:To explore the effect of dialysis pipeline nursing group mode combined with predictive nursing measures on hemodialysis efficacy of diabetic nephropathy patients with maintenance hemodialysis (MHD).Methods:A total of 96 patients with MHD of diabetic nephropathy admitted to No. 904 Hospital of Joint Logistics Support Force of Chinese People's Liberation Army from January 2015 to December 2019 were selected as the research objects and divided into control group and observation group, 48 cases in each group. Patients in the control group were treated with routine dialysis pipeline and other hemodialysis nursing interventions, while patients in the observation group were treated with predictive nursing measures on this basis. The biochemical indexes, psychological state, compliance, incidence of nosocomial infection and complications and nursing satisfaction of the two groups before and after intervention were compared.Results:After the nursing intervention, the blood urea nitrogen (BUN), creatinine (Cr), and β2 microglobulin (β2-MG) of the two groups of patients were lower than those before the intervention, and the BUN of the observation group after the intervention, Cr and β2-MG were (12.04±1.98) mmol/L, (451.62±82.49) μmol/L, (13.53±2.31) mg/L, respectively, which were lower than those of the control group (15.82±2.31) mmol/L, (591.35±99.21) μmol/L, (18.83±2.92) mg/L, the difference was statistically significant ( t value was 8.608, 7.503, 9.862, P<0.05). After the intervention, the scores of the treatment compliance subscales of the observation group were 29.06±3.58, 23.42±2.99, 20.11±3.01, 14.76±2.94, which were higher than those of the control group (31.91±3.97, 21.53±3.21, 17.03±2.74, 12.36±3.04), the difference was statistically significant ( t value was 2.985-3.932, P<0.05). After the intervention, the SAS and SDS scores of the two groups were lower than those before the intervention, and the SAS and SDS scores of the observation group after intervention were 39.12±4.82 and 36.43±6.03, which were lower than those of the control group 48.25±5.14, 46.75±5.36, the difference was statistically significant ( t value was 8.997, 8.862, P<0.05). The incidence of nosocomial infections and complications in the observation group were 2.08% (1/48) and 4.17% (2/48), which were significantly lower than those in the control group, 14.58% (7/48) and 18.75% (9/48), The difference was statistically significant ( χ2 value was 4.91, 5.26, P<0.05). The nursing satisfaction degree of the observation group was 95.83% (46/48), which was higher than 72.92% (35/48) of the control group, and the difference was statistically significant ( χ2 value was 9.56, P<0.05). Conclusions:The dialysis pipeline combined with predictive nursing can improve the psychological state of patients, reduce the incidence of hospital infection and complications, prolong the service life of vascular access, improve the quality of life of hemodialysis patients, improve the relationship between nurses and patients, and create a harmonious atmosphere, which is worthy of clinical promotion and application.

Bipolar disorder is a common, highly disabling psychiatric disorder characterized by early onset, frequent episodes, high suicide risk, and chronic outcomes, and is associated with severe social dysfunction. The pathogenesis of bipolar disorder is still unclear, and current studies mainly focus on circadian rhythm abnormalities, including rhythm gene mutation, polymorphism, abnormal kinase expression, and rhythm abnormalities in neurotransmitter secretion and transport. It has been found that at any stage of bipolar disorder, whether prodrome, episode, or remission, patients exhibit circadian rhythm disruptions, including disrupted sleep-wake cycles, hormonal phase abnormalities, and irregular social rhythms. Based on this mechanism, the time therapy, such as light therapy, dark therapy, sleep deprivation and behavioral intervention, can rapidly improve the circadian rhythm of patients with bipolar disorder, achieve the goal of rapid relief of symptoms, with fewer side effects, low risk of switching to manic. In this paper, circadian rhythm mechanism, clinical manifestations and chronotherapy of bipolar disorder are reviewed to provide a basis for clinical diagnosis and treatment.

Objective:To explore the mechanism for immunomodulatory activity of Astragalus polysaccharide (APS) with peripheral blood mononuclear cells(PBMC)-derived plasmacytoid dendritic cells (pDCs) from healthy volunteers.Methods:Healthy volunteers-derived pDCs were sorted by flow cytometry,then incubated with APS (0m50,100,200 mg/L ).After 24 hours,the concentration of IFN-?,TNF-?,IL-6 was detected using ELISA.After 5 days,the cultured cells were collected and analyzed by flow cytometry,light microscope and electron microscope scanning.Results:APS-treated pDCs secreted higher level of IFN-?,TNF-?,IL-6.APS could promote differentiation of pDCs to dendritic cells (DCs) which displayed more matured morphology and immunophenotypes compared to the untreated-pDCs.Conclusion:APS could increase the immune function of pDCs,promote differentiation and maturation of pDCs.

In order to definitude the influence caused by the different sampling in voice assessment.Method:We comparing the results acquired by total section and subsection sampling.Result:The results acquired by subsection tended to normal more than those acquired by total section. Conclusion:Subsection sampling voice assessment might conceal the drgree of the disease state of patients

Objective To analyze the correlation of interleukin(IL)-12B gene single nucleotide polymorphism(SNP)rs6887695 with clinical phenotypes(including age at onset,family history,clinical types,gender)of psoriasis vulgaris in Chinese Han population.Methods This study recruited 575 patients with psoriasis vulgaris and 1403 healthy controls.DNA samples were obtained from these subjects.PCR with Taqman fluorescent probe(ABI 7900 system)was performed to analyze the genotype of SNP rs6887695 in IL-12B gene.Statistical analysis was carried out by using the software SPSS 14.0,and Chi-square test was conducted to compare the frequency of the SNP rs6887695 genotypes and alleles between the patients and controls as well as between patients with different clinical phenotypes of psoriasis.Results The frequency of GG,GC and CC genotype of the SNP rs6887695 was 42.61％,45.39％ and 12.0％ respectively in the patients,compared to 34.42％,47.83％ and 17.75％ in the healthy controls(x2 =16.31,P ＜ 0.01);the frequency of G and C allele of the SNP rs6887695 was 65.30％ and 34.70％ respectively in the patients,compared to 58.34％ and 41.66％ respectively in the healthy controls(x2 =16.54,P＜0.01).Significant differences were observed in the distribution of genotypes and alleles of the SNP rs6887695 between patients with chronic plaque psoriasis(n =543)and those with acute guttate psoriasis(n =32,x2 =18.11,12.19,both P ＜ 0.01).Increased frequency of G allele and GG genotype of the SNP rs6887695 were noted in the patients with psoriasis vulgaris compared with the healthy controls,and in the patients with plaque psoriasis compared with those with guttate psoriasis.However,there was no statistical difference in the distribution of SNP rs6887695 genotypes or alleles between 540 patients with adult onset psoriasis and 35 patients with child onset psoriasis,between 102 patients with family history and 440 patients without family history,or between 341 male patients and 234 female patients(all P ＞ 0.05).Conclusions The IL-12B SNP rs6887695 may be associated with the susceptibility to psoriasis vulgaris in Chinese Han population,especially with the susceptibility to plaque psoriasis,but seems unassociated with the age at onset,family history or gender of patients.

Objective To improve the recognition of aggressive natural killer-cell leukemia(ANKL)complicating muhiple organ failure(MOF).Methods A Fare case of ANKL was reported,and the related literatures were reviewed. Results One case of ANKL was diagnosed by bone marrow morphology and immunophenotypes of CD2,CD16,CD56,who developed multiple organ failure involving in liver,kidney,heart,lung,severe metabolic acidosis,tumour lysis syndrome and disseminated intravascular coagulation(DIC)in course of the disease and chemotherapy.VP regimen and symptomatic treatment were performed,and the disease could be stable shortly but died of the failure of lung and heart soon. Conclusion ANKL has a fulminant clinical course and diffuse infihration of tumor cells resulted in multiple organ failure with poor response to treatment and unfavorable prognosis.

Objective　To investigate the effect of breast milk and some other kinds of infant foods on the adhesion of EPEC to Hela cells and intestinal mucosa so as to understand the possible protective mechanism of breast-feeding in the intestine of infants. Methods　The adhesion of EPEC to Hela cells and intestinal mucosa were examined by cell culture, bacterial adherence test, light and electron microscopy in the mediums that contain breast milk, cow's milk and formula milk or contain ecal filtrate of the infants fed by breast milk and formula milk respectively. Results　Adhesive index for EPEC to Hela cells was significantly lower in the medium containing breast milk than in control and so did in the fecal medium containing breast fed infants than artificial feeding infants. Conclusion　Breast milk may inhibit the adhesion of EPEC to infant intestine.

Objective To assess the safety and effectiveness of nasegastric enteral nutrition (NGEN) in patients with severe acute pancreatitis (SAP).Methods A meta-analysis of all the relevant clinical trials was performed.Clinical trials were identified from the following electronic databases:Medline,EMBASE,the Cochrane Controlled Trials Register,and Chinese Bio-medicine Database.The search was undertaken in October 2008.The literature quality was evaluated with Cochrane Handbook 5.0.The statistical analysis was performed by RevMan 4.2 software.Results Four trials involving 157 patients were included.The combined results showed that no significant differences in the safety and tolerance between nasogastric and conventional routes in patients with SAP.Conclusions Currently available data show early NGEN appears to be effective,safe,and tolerable in patients with SAP.However,more large-scale high-quality trials are required to further elucidate this topic.