Objective To analyze the clinical features and evaluate outcomes of active pulmonary tuberculosis(TB)patients in floating population.Methods Retrospectively analyzed the clinical data of 68 active pulmonary TB patients in floating population,in comparison with 123 cases of TB patients of local which was treated as control group.Evaluated the outcomes by analyzing the composition of sex and age,tuberculosis type,positive phlegm germ.males and 33 females;so the male to female ratio was 2.73:1,the difference between two groups was statistically significant(x2=3.37,P＜0.05).The age in study group ranged from 18 to 62,the average was(30.23±18.52),and it ranged from 18 to 70 in control group,the average was(46.46±31.50),the difference between two groups was statistically significant(t=25.14,P＜0.05).Among those aged 21 to 30,the incidence in study group was 44.11%(30/68),and in control group it was 24.39%(30/123),the difference between two groups had statistical significance(x2=9.91,P＜0.05).In study group,there were 68 sputum smears,47 of them were positive,and the proportion was 69.11%;In control group,there were 123 sputum smears,70 of them were positive,and the proportion was 56.91%.The difference between two groups had statisticall significance.In study group.there were 22 patients who stopped by themselves accepting treatment,accounting for 34.92%;At same time,in control group,there were 23 patients who stopped by themselves accepting treatment,accounting for 18.67%.The difference of treatment compliance between two groups had statistical significance(x2=6.890,P＜0.05).After 6 months treatment,41 cases were treated in study group,of them 37 cases sputum bacterium turns negative,accounting for 90.24%;the same time 100 cases were treated in control group,of them 92 cases sputum bacterium turns negative,accounting for 92.00%.The difference of sputum bacterium conversion rate in two groups had no statistical significance(x2=0.1 10,P＞0.05).Conclusion The incidence rate of tuberculosis was high in floating population of Pinghu City.The TB patients in floating population could receive the same treatment as those in local population through DOTS treatment.

Objective:To evaluate the rationality of medical order in oncology department of our hospital and analyze the intervention effect of clinical pharmacist.Methods:Totally 180 medical orders in oncology department of our hospital from January to June in 2013 were selected as the pre-intervention group,and those with the same number from January to June in 2014 were selected as the post-intervention group.The rationality of medical orders including drug selection,administration routes,usage and dosage was investigated and compared between the groups. Results:The unreasonable rate was 41.11% before the intervention and 8.33% after the intervention with statistically significant difference(P<0.05).The irrational drug use included inappropriate indications,usage and dosage,improper drug replacement and combination,and inappropriate adjuvant drug use.Conclusion:Irrational drug use in oncology department can be significantly reduced and the level of rational drug use can be improved through the intervention of clinical pharmacist.

Objective To probe the advantages and characteristics of imaging on dual-energy CT boneless and digital sub- traction brain angiography through comparative analysis. Methods Siemens 64-slice dual-source spiral CT and double high pressure syringe; The 200 patients were randomly divided into dual-energy group(n=100) and DSACT group(n=100); Every patient was injected 50 ml contrast medium and 50ml normal saline, injection rate was 4ml/s. Results The groups of cere- bra-vascular imaging without interference, and completely boneless; but experimental group has more boneless defects and vascular surface definition less. The cerebral arteries were interfered by the venous shadow in dual-energy group, and the dual-energy group received low-dose radiation. Conclusion The DSACT imaging quality is superior to dual-energy CT boneless imaging. The radiation dose of the dual -energy CT is lower than DSACT.

Objective To explore the association of arachidonic acid (AA) level in gastric cancer (GC) tissue with tumor differentiation and patients' gender.Methods The contents of AA in GC tissue and adjacent matched normal mucosa were measured using gas chromatography/mass spectrometry.The relationships of AA with GC differentiation and patients' gender were analyzed.Results The level of AA significantly decreased in GC tissue (0.190％ ± 0.255 ％) compared with normal tissue (0.274％ ± 0.254％,n =30,P =0.011 ),while the level of AA had no significant difference in the tissues of matched normal mucosa and different TNM stages or among different TNM stages ( all P ＞ 0.05).The AA levels in well and moderately differentiated adenocarcinoma (0.173％ ±0.244％ ) and in poorly differentiated adenocarcinoma (0.195％ ±0.264％) were significantly decreased when compared with those in the paired normal mucosa (0.334％ ± 0.170％,P =0.018; 0.256％ ± 0.275％,P =0.043,respectively),while no significant difference was observed between the different differentiated grades (P =0.895).The level of AA significantly decreased in male patients (0.137％ ± 0.209％ ) as compared with paired normal mucosa (0.275％:± 0.238％,P =0.010),while no positive correlation was observed in female patients as compared with normal group (P=0.477) or in the comparison between male and female groups (P =0.139).Conclusions The AA level remarkably decreases in GC tissue,which may be associated with differentiated grades and patients'gender.In addition,more AA is utilized in male GC patients than female patients.

Objective:To investigate effect of Galangin on inflammatory response in autoimmune thyroiditis(AIT)rats by regulating chemokine ligand 2(CCL2)/chemokine receptor 2(CCR2)pathway.Methods:A total of 84 rats were randomly grouped into control group,model group,Galangin low dose group,Galangin medium dose group,Galangin high dose group,selenium yeast tablet group,Galangin high-dose+rat CCL2 recombinant protein(rCCL2)group,with 12 rats in each group.Except for control group,AIT models were constructed in rats of all other groups.After successful modeling,medication was administered once a day for 8 weeks.ELISA was applied to detect levels of thyroglobulin antibody(TGAb),thyroid peroxidase antibody(TPOAb),free thyroxine(FT4),free triiodothyronine(FT3)in rats serum and TNF-α,IL-6 and IL-1β in thyroid tissue;HE staining for pathological changes in rat thyroid tissue and scoring of inflammation in thyroid tissue;qRT-PCR was applied to detect expressions of CCL2 and CCR2 mRNA in thyroid tissue;Western blot was applied to detect expressions of CCL2 and CCR2 proteins in thyroid tissue.Results:Com-pared with control group,pathological damage to thyroid tissue of rats in model group was severe,inflammation score,levels of TGAb,TPOAb,FT4,FT3,TNF-α,IL-6,IL-1β,expressions of CCL2,CCR2 mRNA and protein were increased(P<0.05);com-pared with model group,pathological damage of thyroid tissue of rats in Galangin low dose group,Galangin medium dose group,Galangin high dose group and selenium yeast tablet group were reduced,inflammation score,levels of TGAb,TPOAb,FT4,FT3,TNF-α,IL-6,IL-1β,expressions of CCL2,CCR2 mRNA and protein were decreased(P<0.05);compared with Galangin high dose group,pathological damage of thyroid tissue in Galangin high dose+rCCL2 group was aggravated,inflammation score,levels of TGAb,TPOAb,FT4,FT3,TNF-α,IL-6,IL-1β,expressions of CCL2,CCR2 mRNA and protein were increased(P<0.05).Conclusion:Galangin may inhibit inflammatory response of AIT rats by inhibiting CCL2/CCR2 signaling pathway.

Objective Based on the limited time theory,taking tonsillectomy day operation as an example,the whole process nursing list of day operation was constructed,and its application effect was evaluated.Methods The nursing service list of tonsillectomy was constructed based on literature research,field observation and expert correspondence.A total of 197 patients who underwent tonsillectomy in the day ward of a tertiary A general hospital in Hangzhou,Zhejiang Province were selected.Among them,98 patients from April to June 2023 were taken as an experimental group and treated with the whole-process nursing list of daytime tonsillectomy constructed in this study,and 99 patients from January to March 2023 were taken as a control group and routine nursing was adopted.The anxiety degree,postoperative pain score,postoperative complication rate and patients'satisfaction with nursing service were compared between the 2 groups.Results Anxiety scores before operation and at discharge,pain scores at 6 h,12 h and 24 h after operation,and incidence of complications such as infection and gastrointestinal reaction within 14 days after operation in the experimental group were lower than those in the control group,with statistical significance(P＜0.05).The satisfaction of nursing service in the experimental group(99.40±0.69)score was significantly higher than that in the control group(90.36±1.04)score,and the difference was statistically significant(P＜0.001).Conclusion The use of tonsillectomy day whole-process nursing list can improve perioperative anxiety,relieve postoperative pain and reduce the incidence of postoperative complications,and improve patient satisfaction.

During pandemic of corona virus disease 2019 (COVID-19), emergency orthopedic trauma is commonly seen. It is particularly important to ensure the emergency treatment quality of orthopedic trauma but avoid cross-infection between doctors and patients. The double-buffered diagnosis and treatment mode refers to the model of patients first undergoing medical observation in the comprehensive buffer ward and the inpatient buffer rooms of various disciplines after admission to confirm the exclusion of COVID-19 and then receiving specialist diagnosis and treatment. The authors summarize the experiences of using the double-buffered diagnosis and treatment model in the Department of Orthopedics, Renmin Hospital of Wuhan University during the prevention and control of COVID-19 pandemic so as to provide a reference for treatment of orthopedic patients.

Objective:To analyze the feasibility, safety and clinical efficacy of laparoscopic side-to-side jejunoileal anastomosis in the treatment of non-obese type 2 diabetes patients (BMI≤32.5 kg/m 2). Methods:The clinical data of 135 patients who underwent laparoscopic side-to-side jejunoileal anastomosis at our hospital from Jan 2018 to Oct 2018 were retrospectively analyzed. They were followed up for 12 months until the end of Oct 2019. SPSS software was used to compare patients′ fasting blood glucose, glycosylated hemoglobin, c-peptide, insulin, body weight, BMI with the values after 12 months of the surgery, and then evaluate factors affecting the prognosis.Results:135 patients successfully completed laparoscopic side-to-side jejunoileal anastomosis without conversion to open surgery. After 12 months of the operation, the patients′ fasting blood glucose was (5.80±0.18)mmol/L, glycosylated hemoglobin was 5.9%±0.4%, fasting c-peptide was(1.32±0.21) nmol/L, and fasting insulin was (42±54) mU/L ( t=10.654, 12.657, 11.214, 10.698, all P<0.05). The body weight was (72.4±9.9)kg, BMI was( 25.6±2.8)kg/m 2, and the difference was not statistically significant ( t=7.658, 6.958, P>0.05). In patients with preoperative glycosylated hemoglobin controlled below 8% and the duration of T2DM less than 10 years, the chances being cured was better than that of those with glycosylated hemoglobin>8% and the medical history >10 years. Conclusion:Laparoscopic side-to-side jejunoileal anastomosis in the treatment of non-obese type 2 diabetes is effective, safe and reliable.

Objective:To evaluate the complications of complex intracranial aneurysms after intervention with flow-diverter (FD) devices.Methods:Sixty patients with complex intracranial aneurysms accepted FD devices in Department of Cerebrovascular Diseases, Second Affiliated Hospital of Guilin Medical University from July 2018 to June 2021 were chosen. Clinical and imaging data of these patients were retrospectively analyzed, and complications were recorded: procedure-related adverse events, early postprocedural complications, complications during follow-up, and covered branch occlusion.Results:A total of 61 FD devices (47 Pipeline Flex, 10 Tubridge, 4 Surpass Streamline) were implanted in 60 patients. Incidence of procedure-related adverse events was 8.3% (5/60), including 3 with incomplete stent apposition, 1 with intraoperative bleeding, 1 with aneurysm neck not covered by stent; incidence of early postprocedural complications was 6.7% (4/60), including 3 with hemorrhagic complication and 1 with ischemic complication. DSA follow-up ([22.7±16.8] months) was completed in 54 patients; aneurysm healed rate was 83.3% (45/54). First DSA follow-up 6 months after surgery showed that in-stent restenosis was 7.4% (4/54), of which 2 deteriorated to parent vessel occlusion at 2- and 3-year after procedure, respectively. A total of 78 branch arteries were covered by FD devices, and only 1 (1.3%, 1/78) demonstrated branch artery occlusion at last follow-up, without clinical symptoms.Conclusion:The complications of complex intracranial aneurysms after intervention with FD devices should be recognized; incomplete stent apposition is the main procedure-related adverse event, and hemorrhagic complication mainly appear in the early postprocedural period; in-stent restenosis should be vigilant during follow-up.

OBJECTIVETo evaluate the association of colorectal adenoma with metabolic syndrome (MS) and relevant parameters.

METHODSClinical data of 289 subjects who underwent screening colonoscopy in the University of Hong Kong-Shenzhen Hospital from January 2014 to June 2015 were retrospectively analyzed, including 130 normal subjects (normal group) and 159 cases with colorectal adenoma confirmed by pathology(adenoma group). Levels of MS-associated parameters were compared between the two groups, and the association of metabolic diseases with colorectal adenoma was examined.

RESULTSThe gender, smoking and drinking habit, regular physical activity, family history of colorectal cancer, and consumption history of long-term non-steroidal anti-inflammatory drugs were not significantly different between two groups (all P>0.05). As compared to normal group, adenoma group had higher body mass index (BMI) [(23.5±3.2) kg/m(2) vs. (22.7±2.8) kg/m(2), t=1.97, P=0.050], larger abdominal circumference [(83.4±10.3) cm vs. (79.6±13.8) cm, t=2.46, P=0.015], higher serum high-density lipoprotein level [(1.3±0.3) mmol/L vs. (1.2±0.3) mmol/L, t=2.03, P=0.044], and higher serum cholesterol [(5.4±1.0) mmol/L vs. (5.0±1.1) mmol/L, t=2.39, P=0.018]. No significant difference was demonstrated in comparing hip circumference and waist-hip ratio, as well as serum fasting glucose and triglyceride(all P>0.05). Higher incidence of colorectal adenoma was found in subjects with MS [69.8%(37/53) vs. 1.7%(122/236), P=0.017], overweight or obesity [65.1% (56/86) vs. 50.7%(103/203), P=0.025], hypertension [67.3%(37/55) vs. 52.1%(122/234), P=0.046] and hypercholesterolemia [66.7%(64/96) vs. 49.2%(95/193), P=0.005].

CONCLUSIONSMetabolic syndrome increased the risk of developing colorectal adenoma. The mechanism may be related to higher serum cholesterol and high density lipoprotein, which may lead to the elevated catabolism of serum cholesterol. Screening colonoscopy should be performed for patients diagnosed as metabolic syndrome, especially for those with central obesity and hypercholesterolemia, thus early diagnosis and treatment of colorectal adenoma may be available.

Adenoma ; epidemiology ; Blood Glucose ; chemistry ; Body Mass Index ; Case-Control Studies ; Colonoscopy ; Colorectal Neoplasms ; epidemiology ; Humans ; Hypercholesterolemia ; epidemiology ; Hypertension ; epidemiology ; Mass Screening ; Metabolic Syndrome ; epidemiology ; Obesity ; epidemiology ; Overweight ; epidemiology ; Retrospective Studies ; Triglycerides ; blood