Objective To investigate the social support of the elderly hospitalized individuals and its relationship with outcomes and to study its influential factors.Methods The elderly in-patients aged＞65 years old who were treated from April to June 2012 in Geriatric Department were recruited.The comprehensive geriatric assessment (CGA) that included social support scale (SSRS) was used.According to SSRS,the patients were assigned to the lower or higher score group.The participants were followed up for 1 year,and 12-month mortality and re-hospitalization were recorded.Student's t test,Chi-square test and multiple logistic regression were used for data analysis.Results The total score of social support was 26.58±8.99,which was significantly lower than the national norm (34.56±3.73,t =-7.52,P＜0.05).Those with advanced age,less household,depression,insufficient ability of daily life and instrument daily life showed relatively lower SSRS (t values were-2.54,8.22,-6.61,6.72 and 6.95,respectively; all P＜0.05).The patients with no spouse also got less social support (x2 =8.58,P＜0.05).At 1 year,no significant difference of re-hospitalization and mortality was found between the two groups (x2 values were 1.94 and 3.28,respectively; both P＞0.05).In multiple logistic regression analysis,fanily member,characteristics and living ability were the major influential factors of social support.Conclusions Medical staff should pay more attention to the elderly hospitalized patients and offer them sufficient social support to improve their quality of life.

Objective To investigate the clinical significance and effect of total hip arthroplasty (THA) in treatment of bony ankylosis of the hip in patients with ankylosing spondylitis (AS).Methods The study enrolled 23 patients (35 hips) undergone THA for bony ankylosis of the hip in AS between March 2008 and November 2012.Postoperative outcome was measured based on Harris hip score and Xray images.Results Preoperative Harris hip score of (27.6 ± 2.3) points increased to (86.7 ± 2.6)points postoperatively.Hip flexion and adduction deformity presented correction postoperatively.Total hip range of motion (flexion,adduction,abduction,and external rotation) improved from (45.7 ±5.3) o preoperatively to (206.9-±4.7) °postoperatively and mean hip flexion activity was 81 °.Hip activity achieved significant improvement and pain was relieved.X-ray films revealed proper position of prostheses without the presence of loosening or subsidence.Two patients (3 hips) experienced mild pain after a long period of walking.Four patients had heterotypic ossification including Brooker grade Ⅱ in one patient and Brooker grade Ⅰ in three.Conclusion THA is an effective treatment for bony ankylosis of the hip in AS,for it rebuilds joint function,relieves pain of the hip and improves patients' quality of life.

Objective To study the significance of expression of Cyclin E in hepatocellular carcinoma (HCC). Methods Cyclin E expressions were examined in 45 specimens of HCC and 30 specimens of paracancer tissues, and the relationship between Cyclin E with the clinico-pathological parameters was determined.Among the 45 patients ,19 were poor encapsulatic; 12 patients had portal vein thrombus; 11 had extrahepatic metastasis;12 had intrahepatic metastasis.Any patient had one or more of 4 conditions mentioned above was considered as invasion and metastasis. Results The overexpression of Cyclin E in HCC tissues was seen in 16 cases (35.6%) ,but not seen in paracancer tissues. Cyclin E overexpression occurred more frequently in HCC patients with poor differentiation and portal vein thrombus ( P 0.05). Conclusions Expression of Cyclin E is related with HCC carcinogenesis; differentiation , invasion and metastasis, detection of expression of Cyclin E may be helpful in the diagnosis, treatment and prediction of the prognosis of patients with HCC.

Objective To investigate the technique and clinical results of total hip arthroplasty in treating post-traumatic hip fusion ankylosis secondary to operation in acetabular combined with femoral head fracture.Methods From October 2009 to January 2015,7 patients (7 hips) with post-traumatic hip fusion ankylosis underwent total hip arthroplasty.There were 6 males and 1 female with an average age of 38 years (range,25-51 years).There were 4 hips on the left side,3 hips on the right side.Open reduction and internal fixation were performed on all patients.One patient had a postoperative deep infection and 6 patients underwent implant removal.The hip bony fusion ankylosis was developed secondary to post-traumatic arthritis after the surgery of ipsilateral acetabular combined with femoral head facture.The interval between internal fixation and total hip arthroplasty was 37.6 months on average (range,21-67 months).The hip bony fusion ankylosis was relieved by wedge shape osteotomy at femoral neck level.The cemenfless prostheses were implanted in suitable places based on the accuracy position of acetabular center.One infection case was treated via surgical debridement,removal of all the screws,and antibiotic-loaded cement spacer implantation in the first stage.The cementless prostheses were implanted in the second stage.Results The average operation time and blood loss was 108 min (90-150 min) and 320 ml (280-450 ml) respectively.The internal fixation devices were explanted completely,including plate and screw in 5 cases,only screw in 1 case,intramedullary nail and screw in 1 case.The mean fallow-up period was 32.5 months (range,15-48 months).The average Harris hip score improved from 48.8±6.5 points preoperatively to 92.6±5.1 points post-operatively (t=22.82,P=0.001).Osseointegration was developed in all of the acetabular and femoral components at 3 months post-operatively.Radiograph analysis showed satisfied position of acetabular cup and no evidence of implant migration or center of rotation change.Stem subsidence (＜1.0 mm) occurred in 2 cases and heterotopic ossification in 2 cases (Brooker type Ⅰ and type Ⅱ in 1 case,respectively) at one year postoperatively.No complication occurred,such as damages of vessels and nerve,dislocation,component loosening or infection.Conclusion The wedge shape osteotomy of femoral neck is a safe and reliable method in treating hip fusion ankylosis.Total hip arthroplasty can be achieved by reconstruction of acetabular center,suitable components implanted in anatomical position and ideal reconstruction of soft tissue around hip.

Objective To carry out hand hygiene(HH) quality control circle(QCC) activity by using WeChat group, improve HH compliance of health care workers(HCWs), and enhance the circle members' ability to solve problems.Methods In June 2015, 11 healthcare-associated infection control professionals in a hospital created HH WeChat group by using cellphones, activity cycle was once every two weeks, professionals analyzed the existing problems, and formulated countermeasures as well as implemented methods by group chat form, circle members introduced and implemented strategies to HCWs in their departments, so as to achieve the implementation effect.Results After the creating of WeChat QCC, HCWs' HH compliance increased from 56.71% before activity to 85.94% after activity, difference was statistically significant (X2=61.928, P<0.05);QCC members' responsibility, self-confidence, enthusiasm, harmony degree, team cohesiveness, quality control technique, communication, coordination, and problem-solving skill were all significantly improved.Conclusion Application of WeChat QCC activity can improve HH compliance of HCWs and the ability of circle members.

Objective To investigate the effects of comprehensive geriatric assessment (CGA) and health intervention on outcome in discharged patients.Methods Discharged patients in geriatric ward from May to July 2012 were randomly assigned to control (n=36) and intervention (n=36) groups.Patients in the two groups were given comprehensive geriatric assessment (CGA) before discharging from hospital.Both groups were followed up for 3 months.Patients in intervention group received health intervention when leaving hospital,at 1 week,3 weeks and 3 months after discharge from hospital,while patients in control group were not given any intervention.The comprehensive illness condition (MCIRS-G),ability of daily life (ADL and IADL),rehospitalization and survival rate were compared between the two groups 3 months after the intervention.Results After 3 months,the scores of MCIRS-G,ADL and IADL were significantly better in intervention group than in control group[(29.06±4.51) vs.(33.09±4.34),(75.69±16.57)vs.(63.86±19.37),(11.72±3.20) vs.(9.77±2.52),respectively,t=3.84,2.77,2.85,all P=0.01].The total times ofreadmission and readmission length were less in intervention group than in control group [3 vs.17,x2 =8.79,P=0.02; (1.94±6.68) days vs.(8.81±14.09) days,t=2.64,P=0.01].There was no difference in survival rate between the two groups [100％ (36/36) vs.97.2％ (35/36),x2=1.01,P=0.30].Conclusions Comprehensive geriatric assessment and health intervention can alleviate symptoms and improve the ability of daily life.

Objective To detect the tissue factor (TF) mRNA expression in hepatocellular carcinoma and to elucidate its significance. Methods TF mRNA was detected by reverse transcription-polymerase chain reaction (RT-PCR) in 27 cases of human hepatocellular carcinoma tissue specimen with their adjacent tissues and in 27 non-tumorous process tissues. Then the relationship between mRNA expression and pathological data were analyzed. Results The expression and the relative expression intensity of TF in hepatocellular carcinoma tissues were 62.96(17/27) and 0.567?0.268 respectively, which were significantly higher than those in their adjacent tissues 〔33.33(9/27), 0.469?0.184〕 and in 27 non-tumorous process tissue 〔29.63(8/27), 0.353?0.121〕, P0.05). Conclusion Expression of TF mRNA were significantly higher in hepatocellular carcinoma and in the invasive and metastatic tissue, which indicated that TF may play an important role in carcinogenesis, invasion and metastasis of hepatocellular carcinoma.

AIM:To detect tissue factor(TF)level both in plasma and in tissue of hepatocellular carcinoma(HCC)patients and to elucidate their association with clinical features.METHODS:Plasma TF levels of 50 cases of HCC patients and 30 cases of control were detected by ELISA.27 HCC tissue samples with their adjacent tissue samples and 27 normal liver tissues were detected by RT-PCR.RESULTS:① Plasma TF levels were increased significantly in HCC group when compared with control(P

Acclimatization ; physiology ; Adult ; Altitude ; Fatty Acid-Binding Proteins ; metabolism ; Humans ; Male ; Middle Aged ; Myelin Basic Protein ; metabolism ; Nervous System Diseases ; metabolism ; Occupational Exposure ; Succinate Dehydrogenase ; metabolism

Objective To explore the effects of lamotrigine on the cognitive function and the quality of life in epilepsy patients.Methods This was a prospective study and 91 newly diagnosed epilepsy patients were enrolled.The neuropsychological tests score and the quality of life in epilepsy inventory(QOLIE-31) were obtained before and after the treatment with lamotrigine.A battery of neuropsychological tests comprised the auditory verbal learning test(AVLT), the logical memory test(LMT), the digital symbol test(DST), the stroop color word test(SCWT), the trail making test(TMT), the verbal fluency test(VFT), the WAIS block design test(WBDT), the WAIS digital span test(WDST)and the Boston naming test(BNT). Results The repeated assessments in the patients taking lamotrigine were associated with significant improvements in many domains.The greatest changes were observed in the immediate and delayed recall of AVLT, DST, the time consuming of SCWT card C and TMT test A and B, the immediate and delayed recall of LMT, VFT, WBDT and BNT.For the quality of life, significant improvements were recorded in the fields of the seizure worry(38.81?16.06 vs 45.68?15.18), the overall quality of life(59.12?13.50 vs 64.99?13.33), the social function(64.59?25.14 vs 69.41?22.70)and the self-health evaluation (71.18?13.73 vs 76.75?11.30).Conclusion Improvements of the cognitive function and the quality of life can be observed in the initial period of medication with lamotrigine in epilepsy patients.