Neurogenic bowel is a syndrome that resulted from the denervation after spinal cord injury (SCI), and may influence the quality of life of SCI patients for the constipation and incontinence. It might be benefit of multidimensional bowel management including nu-trition, medicine and liquid, as well as stimulation, clyster etc. Surgery could be considered if necessary.

[ Objective ] To screen the duck model with congenital infection of duck hepatitis B virus (DHBV) by polymerase chain reaction (PCR) method. [Methods] Serum DHBV-DNA level in one-day-old ducklings was detected by PCR method and was compared with that by Dot-blot method. Ducklings with serum DHBV-DNA being negative confirmed by PCR method were inoculated DHBV-DNA positive serum to establish acquired infection models. Pathological features of liver tissues in the congenital infec tion model and the acquired infection model were also observed. [Results] Sensitivity and specificity of PCR detecting serum DHBV-DNA were superior to those of Dot-blot method. In the congenital infection model, viremia maintained long time, the titer of serum DHBV-DNA was high and the inflammatory af fection in liver tissues was slight as compared with those in the acquired infection model. [Conclusion] The duck model with congenital infection of DHBV screened by PCR method is more suitable for the phar macological and pharmacodynamic research of drugs for chronic hepatitis B.

BACKGROUND: Hydroxyapatite/β-tricalcium phosphate biphasic ceramic bone has good cel compatibility, but its mechanical properties are poor. OBJECTIVE: To construct chitosan/ or calcium alginate/biphasic ceramic bone scaffolds and to detect their mechanical properties and cytocompatibility. METHODS: Different concentrations of chitosan (2%, 4%, 7%, 10%) or calcium alginate (3%, 4%, 5%, 7%) were mixed with biphasic ceramic bone to prepare chitosan/biphasic ceramic bone scaffold and calcium alginate/biphasic ceramic bone scaffold. Their morphology and structure, coagulation time, anti-dissolution properties, shear force, compressive strength and cel compatibility were detected. RESULTS AND CONCLUSION: (1) Coagulation time: with the concentration increase, the initial and final setting time of these two kinds of composite scaffolds were prolonged to some extent. (2) Scanning electron microscopy: these two kinds of composite scaffolds showed porous microstructures with different pore sizes. (3) Anti-dissolution properties: the calcium alginate/biphasic ceramic bone scaffold (3%, 4%, 5%, 7%) and chitosan/biphasic ceramic bone scaffold (7%, 10%) had good anti-dissolution properties in the liquid. (4) Mechanical strength: with the concentration increase, the shear force and compressive strength of the calcium alginate/biphasic ceramic bone scaffold were reduced. (5) Cel compatibility: the cytotoxicity of chitosan/ or calcium alginate/biphasic ceramic bone scaffolds was graded as 0-1 or 2-3, respectively. These results show that the chitosan/biphasic ceramic bone scaffold has better mechanical properties and cel compatibility than the calcium alginate/biphasic ceramic bone scaffold.

Objectives:This paper at measuring the inequity and its influencing factors of medical care utiliza-tion of elderly aged above 60 ( inclusive) . Methods:data comes from 2013 China Health and Retirement Longitudinal Study ( CHARLS) where the population aged 60 and above was selected as the research object. Concentration index ( CI) and its decomposition or centralized curve was used to measure the inequity of medical care services utilization of the elderly, and then the influencing factors of inequity were analyzed by means of the centralized index. Results:The concentration index for outpatient and inpatient service utilization for the elderly was 0 . 0619 and 0 . 1050 , re-spectively, and the concentration curves were below the absolute fair line. The top 2 factors that showed positive con-tribution to the outpatient service utilization included annual per capita consumption expenditure and the pension a-mount. The top 2 factors that showed negative contribution and larger contribution rate to the outpatient service utiliza-tion included New Rural Cooperative Medical Insurance (NRCMI), and Physical Ability in Daily Life (PADL). The top 2 factors that positively and highly contributed to the inpatient service utilization included the household per capita consumption expenditure and the Urban Employees' Basic Medical Insurance (UEBMI). The top 2 factors that nega-tively contributed to the inpatient service utilization included the New Rural Cooperative Medical Insurance ( NRCMI) and the Physical Ability in Daily Life ( PADL) . The horizontal inequity of outpatient and inpatient service utilization was 0. 0739 and 0. 1339, respectively, indicating that there was unfairness in the use of outpatient and inpatient services among elderly. Conclusion:There is inequity of medical care service utilization among the elderly in China. The economic status contributes the largest part of inequity, meaning that it is unfair to the first contribution factor;while the Needs-based fac-tors and New Rural Cooperative Medical Insurance (NRCMI) showed an inequity, narrowing the unfair gap.

Objective:To construct a esophageal cancer module with Chinese characteristics based on MD Anderson Symptom Inventory (MDASI) public scale, develop the Perioperative Esophageal Cancer Symptoms Assessment Scale combining above two parts.Methods:The original item pool was formulated through literature review, clinical interviews, and reference of existing symptoms assessment tools. After two rounds of expert evaluation and pilot survey, the preliminary Perioperative Esophageal Cancer Symptoms Assessmment Scale was developed combining Chinese MDASI (MDASI-C). A total of 150 perioperative esophageal cancer patients was assessed using the new scale, the included items were analyzed one by one, the reliability, validity and sensitivity of scale were checked.Results:Feasibility: the scale recovery was 100%, the completion rate of scale was 93.75%, the average completion time was 10 min. Reliability: the value of Cronbach α of the esophageal cancer module, MDASI-C, the combined scale were 0.747, 0.894, 0.883, respectively. Validity: the range of content validity index of items was 0.83-1.00, the scale-level content validity index average value was 0.93. Two common factors, which explained for 67.994% of variance, were extracted by exploratory factor analysis, the validity of criterion had statistical significance ( P<0.05). Sensitivity: the scores of the esophageal cancer module were significantly different among perioperative esophageal cancer patients with different Eastern Cooperative Oncology Group performance status ( H value was 9.264, P<0.05). Conclusions:The Perioperative Esophageal Cancer Symptoms Assessment Scale has good feasibility, reliability, validity and sensitivity, it is suitable for symptoms assessment of Chinese perioperative esophageal cancer patients.

Objective　To evaluate the effect of phacoemulsification and intraocular lens implantation with topical anesthesia in out-patients department.Methods　Phacoemulsification and intraocular lens implantation were performed successively in 132 patients(157 eyes) with topical anesthesia.Results　Phacoemulsification and intraocular lens implantation were successfully performed in 152 eyes(96.8%)with topical anesthesia and 5 eyes(3.2%)need retrobulbar anesthesia additionally.The visual acuity and complications after operation in the topical anesthesia were the same as that performed previously under retrobular anesthesia.Conclusions　Phacoemulsification and intraocular lens implantation may be performed with topical anesthesia through scleral tunnel incision.It is convenient for us to perform the operations on the out-patient patients with cataract.

Objective:Anti-synthase syndrome (ASS) is a rare autoimmune disease. To increase the understanding of the disease and reduce the rate of miss diagnosis.Methods:The clinical data of 8 patients with positive anti-synthase antibody afterprimary Sj?gren's syndrome (pSS) were retrospectively analyzed and descriptive statistical analysis was carried out.Results:The diagnosis of Sjogren's syndrome (SS) was in accordance with the revised European criteriaof SS issued by the US-Europe consensus Group in 2002 or the classification criteria of American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) SS in 2016, and the diagnostic ASS was in accordance with the diagnostic criteria of Conners in 2010 or Solomon in 2011. Eight(100%) patients had a history of interstitial lung disease, and 7 (88%) patients had fever (oral temperature >38.5 ℃). All patients were positive for anti-Ro-52 antibody, 4 patients were positive for anti-PL-7 antibody, 2 patients were positive for anti-EJ antibody, 1 patient was positive for both anti-PL-7 antibody and anti-EJ antibody, and 1 patient was positive for anti-PL-12.Conclusion:pSS patients with severe interstitial lung disease or high fever of unknown causes should be screened for anti-synthase antibodies and the possibility of ASS.

BACKGROUND: Glaucoma is a kind of eye disease that can cause irreversible blindness which is characterized by visual field loss. Clinical research shows that the optic nerve head has changed before the visual field loss. The morphological changes of the optic nerve head have become the key to determine the early diagnosis of glaucoma and disease development. So it has important significance for us to study the morphological changes of the tissues of optic nerve head under the high intraocular pressure.
OBJECTIVE: To establish three-dimensional finite element model of optic nerve head which includes choroid, retina and lamina cribrosa, and analyze the thickness of the optic nerve head under the acute high intraocular pressure.
METHODS: (1) We chose healthy cats without refractive media and other eye diseases. The tomographic sequence images of the optic nerve head of a cat were obtained with the intraocular pressure of the normal value by using enhanced depth imaging spectral-domain optical coherence tomography. (2) The three-dimensional model of the retina, choroid and lamina cribrosa was obtained. Three-dimensional model of optic nerve head was established by assembling the model of the retina, the choroid and the lamina cribrosa. The thickness of the retina, choroid and lamina cribrosa was analyzed under different intraocular pressures by using the method of finite element analysis. (3) Animal model of acute ocular hypertension was established by methods of anterior chamber perfusion. The tomographic sequence images of the optic nerve head of a cat were obtained with different intraocular pressures by using enhanced depth imaging spectral-domain optical coherence tomography. Then, we measured the thickness changes of the choroid, retina and lamina cribrosa under different intraocular pressures, and compared with the results of finite element analysis.
RESULTS AND CONCLUSION: The thickness of the choroid, retina and lamina cribrosa trended to be thin, and the cup dish ratio of optic nerve head increased gradual y with the increased intraocular pressures. Regarding to the thickness changes of the choroid, retina and lamina cribrosa, the trend of experimental measurement results was consistent with finite element calculation results. Hence, it is feasible to analyze morphological changes of every fundus tissue under high intraocular pressure using the tomographic sequence images obtained by optical coherence tomography. We can predict the morphological changes of the optic nerve head tissue by finite element analysis, which has certain guiding significance in determining the progression of glaucoma.

Objective To observe the effects of high fat diet on ulcerative colitis(UC)and atypical hyperplasia in different periods induced by azoxymethane(AOM)/dextran sodium sulfate(DSS)and the changes of interleukin-6(IL-6)level in blood. Methods The mice in DSS,DSS+AOM,DSS+high fat diet,and DSS+AOM+high fat diet groups were given DSS for 3 days and sterilization water for 4 days as one cycle for 9 cycles, and the mice in normal control group were given sterilization water(n=12 in each group). The mice in DSS+AOM and DSS+AOM+high fat diet groups received intraperitoneal injection of AOM(10 mg/kg)in the every first day of the first 3 cycles. The mice in each group were sacrificed at different time points,and the disease activity index and pathohistological index were used to determine the degree of inflammation. ELISA method was used for the detection of serum IL-6 level. Results Simple administration of DSS could induce UC in the mouse model. After 9 circles of treatment,atypical hyperplasia was not found in normal control and DSS groups,and the rate of atypical hyperplasia was 25%(1/4)in DSS+high fat diet group,50%(2/4)in DSS+AOM group,and 75%(3/4)in DSS+AOM+high fat diet group. However,there were no significant differences in the rate of atypical hyperplasia between DSS and DSS+AOM groups ,DSS+high fat diet and DSS+AOM+high fat diet groups ,DSS and DSS+high fat diet groups,and DSS+AOM and DSS+AOM+high fat diet groups(all P>0.05). The histopathological score and the disease activity index in DSS+high fat diet and DSS+AOM+high fat diet groups were higher than those in DSS and DSS+AOM groups(P<0.05). The IL-6 level in DSS+high fat diet and DSS+AOM+high fat diet groups was higher than that in DSS and DSS+AOM groups ,but the difference was not statistically signifi-cant(P>0.05). Conclusion High fat diet may be one of the stimulating factors of UC and atypical hyperplasia.

A description of the contents, indexes, and method appropriateness for supervision and appraisal of the tobacco control management in hospitals, and an insight on the regularity and effectiveness of building tobacco-free hospitals. The dual indexes of intervention and outcome were ascertained from both dimensions of the management process and effect; in terms of methodology, the paper described the time appropriateness of the supervision focus, management effectiveness of the supervision and appraisal areas, priority of supervision objects, population appropriateness of the supervision and appraisal indexes, method appropriateness of the supervision, appraisal and penalty, as well as the conditional support for supervision and appraisal. It is pointed out that timely summary and appraisal, proper conditional support and circular work chain, can help consolidate tobacco control in hospitals.