Objective To investigate the classification,clinical manifestations,diagnosis,differential diagnosis and treatment of oral lichenoid lesions and provide a reference for clinical practice.Methods Hospital ethical approval and patient informed consent were obtained.We report a case of oral lichenoid lesion in children and review the diagno-sis and treatment of oral lichenoid damage in the literature.Results The patient experienced repeated rupture of the dorsal surface of the tongue with pain for more than 3 years.There was a large area of tongue back surface erosion with an irregular shape,surrounded by pearly-white lines.The left erosive area was accompanied by tissue hyperplasia,which was approximately 1.5 cm × 2.0 cm,with tough texture and broad masses.The pathological diagnosis of the pa-tient was oral lichenoid lesion.After biopsy of the dorsal surface of the tongue,the pathological diagnosis of the patient was granulomatous inflammation.The final diagnosis of lichenoid granulomatous stomatitis was made on the basis of the patient's intraoral damage features,systemic history,medication history and histopathological findings.A review of the literature suggests that oral lichenoid lesions have an unknown etiology and need to be clinically differentiated from oral lichen planus,oral lichenoid drug reactions,oral lichenoid contact damage and chronic ulcerative stomatitis.The clini-cal treatment of oral lichen planus is based on the topical and/or systemic use of glucocorticoids.Conclusion There are still no uniform criteria for the classification and diagnosis of oral lichenoid lesions.They rely mainly on history tak-ing,clinical manifestations and histopathological findings,and the treatment is mainly based on the topical and/or sys-temic use of glucocorticoids.

Purpose/Significance To investigate and analyze the current status and influencing factors of digital health literacy(DHL)of the elderly,and to provide references for relevant departments.Method/Process The eHEALS scale is used to investigate the DHL status of 419 elderly people aged 60 and above in Shanghai through convenience sampling,and the influencing factors are explored through binary logistic regression analysis.Result/Conclusion Low education,smoking,and health anxiety are risk factors,while regular physical exami-nation is protective factor.Relevant departments should focus on the elderly people with lower education,and strengthen research and edu-cation on health examinations,smoking hazards,and the alleviation of anxiety.

This paper introduces the concept of natural language processing, summarizes the status quo and advantages of the application of natural language processing based on electronic health records in symptom management of cancer patients, points out the existing shortcomings, and puts forward corresponding suggestions, aiming to provide reference for further improving the quality of nursing services for cancer patients in China and promoting the informatization and digitization of hospice care.

BACKGROUND: Legg-Calvé-Perthes disease (LCPD) is still a refractory disease in children’s orthopedics. With the introduction of the concept of ‘‘osteoimmunology’’, the immune-inflammatory mechanisms between bone and immune system have become a research focus of LCPD. However, few studies have reported on the pathological role of inflammation-related receptors such as toll-like receptors (TLRs) as well as immune cells such as macrophages in LCPD. This study was for investigating the mechanism of TLR4 signaling pathway on the direction of macrophage polarization and the repair of avascular necrosis of femoral epiphysis in LCPD. METHODS: With GSE57614 and GSE74089, differentially expressed genes were screened. Through enrichment analysis and protein–protein interaction network, the functions of TLR4 were explored. Furthermore, immunohistochemistry, enzyme-linked immunosorbent assay (ELISA), hematoxylin & eosin (H&E) staining, micro-CT, tartrate-resistant acid phosphatase (TRAP) dyeing and western blotting were performed for determining the influences of TAK-242 (a TLR4 inhibitor) on the repair of avascular necrosis of femoral epiphysis in rat models. RESULTS: Totally 40 co-expression genes were screened as well as enriched in TLR4 signaling pathway. Immunohistochemistry and ELISA analyses certified that TLR4 facilitated macrophage polarization toward the M1 phenotype and prevented macrophage polarization toward the M2 phenotype. Besides, the results of H&E and TRAP staining, micro-CT, and western blotting showed that TAK-242 can inhibit osteoclastogenesis and promote osteogenesis. CONCLUSION Inhibition of TLR4 signaling pathway accelerated the repair of avascular necrosis of femoral epiphysis by regulating macrophage polarization in LCPD.

Obiective: To explore the method and clinical effect of epicanthal plasty. Methods: Transverse incision of epicanthus was applied on the horizontal line of the epicanthus to separate and release the orbicularis oculi muscle and the fibrous tissue and moderately remove the abnormal orbicularis oculi muscle. The redundant triangular flap under the incision was removed, and the superficial ligament of epicanthus was sutured and fixed to the dorsal nasal fascia with 1 stitch, so as to achieve correcting the epicanthus. Results: The epicanthus of the 121 patients was corrected after the surgery with their lacrimal caruncle exposed. The appearance of the endocanthion is pleasing, the skin of the endocanthion is smooth, the scar is invisible, and the oculi rimae is lengthened 1 to 3 mm. Conclusions The operation has achieved a satisfactory effect. Therefore, the horizontal transection to remove the triangular flap is applicable for most epicanthus due to its simplicity and practicality, as well as the invisible scar and simultaneous manipulation with other operations. These features might be significant for a wider clinical application.

Objective To investigate the regularity and predictors of weight loss during concurrent chemo-radiotherapy for nasopharyngeal carcinoma patients. Methods A retrospective study was carried out on 82 patients with nasopharyngeal carcinoma ,with average age of 45 years ,who received concurrent chemoradiotherapy at the Affiliated Cancer Hospital of Guangzhou Medical University. Paired t-test was used to analyze the weight loss pattern during chemoradiotherapy. The Spearman′s rank correlation analysis was used to investigate the correlation between high weight loss(HWL)and the clinical factors. Results The paired t-test showed that the weight of the patients decreased continuously every week during chemoradiotherapy(P < 0.05),and the value dropped most significantly during the 4th week. Among these 82 patients,32 were determined as HWL(weight loss > 10%). Spearman′s rank correlation analysis showed that HWL was associated with older age,female,higher T and TNM stage,3D-CRT technology,the higher dose of radiotherapy in nasopharynx and in neck lymph node,and decreases of leukopenia and hemoglobin over degree Ⅱ(P<0.05). Conlousions Weight may decrease continuously every week during chemoradiotherapy for nasopharyngeal carcinoma patients. Age,gender,T stage,TNM stage,radio-therapy dose,and leukopenia and hemoglobin decreases may be predictors for weight loss degree during concurrent chemoradiotherapy for nasopharyngeal carcinoma patients.

Objective To investigate the clinical value of bone metabolism biochemical marker N-MID,TP1NP and beta-CTx combined with whole body bone scintigraphy in early diagnosis of bone metastasis of tumor.Methods The concentration of the 3 markers were measured by the electrochemical luminescence analysis method in 30 cases of healthy control group and 210 cases of patients with malignant tumor,which were divided into non bone metastasis group(45 cases) and bone metastasis group(165 cases).The bone metastasis group were divided into 4 grades(0-grade Ⅲ) by Soloway classification according to whole body bone imaging.Results The levels of serum N-MID,TP1NP and beta-CTx in 165 malignant tumor patients with bone metastasis were significantly higher than in 45 malignant tumor patients with bone metastasis and in 30 healthy control group,the difference was statistically significant(P<0.05).With the increase of the number of metastatic lesions in the bone metastasis group,the serum levels of N-MID,TP1NP,and beta-CTx were increased gradually,and they were positively correlated with the progression of the disease.According to the analysis of ROC curve,the cut-off value,sensitivity and specificity in the diagnosis of tumor bone metastasis were 17.59 ng/mL,70.3％,88.9％ for serum N-MID,43.04 ng/mL,78.2％,95.6％ for TP1NP,and 0.48 ng/mL,73.9％,93.3％ for beta-CTx.Under the ROC curve(AUC) was 0.831 for serum N-MID,0.890 for TP1NP,and 0.869 for beta-CTx.The sensitivity and specificity of three bone metabolic markers in the diagnosis of bone metastasis of malignant tumor were significantly higher.Conclusion Bone metabolism biochemical markers:Serum N-MID,TP1NP and beta-CTx for diagnosis of bone metastasis of malignant tumor are sensitive,accurate and simple,which can significantly improve the efficiency of diagnosis of bone metastasis,and can be combined with whole-body bone scintigraphy in early diagnosis of bone metastasis with malignant tumor.

Objective To observe the clinical cure effect of Zhilong Tongluo Decoction on chronic obstructive pulmonary disease in acute exacerbation(AECOPD). [Method] Take prospective research method to randomly divide 70 cases of AECOPD into 2 groups, the control one(35 cases) take routine western medicine(WM) for treatment, the treatment group(35), added with Zhilong Tongluo Decoction on the basis of control one. After being treated for 14d, compare their PH value, PaO2, PaCO2, HCT, ESR, CRP and clinical effect and side effects before and after treatment. [Result] The comparison of both groups had no difference of statistical meaning on PH,PaO2,PaCO2,HCT,ESR,CRP; after treatment, the PH and PaO 2 markedly increased, PaCO2 obviously decreased(P<0.05), so did HCT,ESR,CRP(P<0.05,P<0.01); the treatment group was much better than control one on improvement, so was the effective rate. Both had no marked side effects. [Conclusion] Zhilong Tongluo Decoction controls inflammation and improves ventilation and blood flow with its Tongluo(stretch col aterals), having obvious effect on AECOPD.

Objective To investigate integrated status of community inpatients with type 2 diabetes mellitus.Methods 240 cases of type 2 diabetic patients in the Zhangjiagang Aoyang Hospital were included in the study from May 1,2007 to Dec 31,2008.A uniform questionnaire was applicated.Gender,disease duration,age,academic qualifications,occupation,education,height,weight,waist circumference,hip,relevant medical history and so on were collected.Results The onset age of inpatients with type 2 diabetes was (48.91 ± 12.38),onset age of male was(46.32 ±12.08),which was significantly lower than female (52.42 ± 11.97) (P ＜ 0.01).The onset age female and male proportion also had significant differences,age onset of male was in advance.The average body mass index was (24 ±3.47)kg/m2,most of the inpatients were workers and farmers,the level of education was primary and secondary.Multiple regression analysis hints,risk factor of onset age is the family history of diabetes,the history of hypertension,male,low academic qualifications.Percentage of newly diagnosed patients was 28.3％,about one-third in patients were with the metabolic syndrome,hyperlipidemia,high blood pressure,fatty liver.Conclusions Education level of the inpatients was lowe in the community,so strengthening diabetes education was required.The persons in the commuities who were male,or with the family history of diabetes,with high blood pressure history were of the communities require for early screening of diabetes mellitus,so the occurrence and development of diabetes woule be controlled.

Contents of laboratory diagnosis is complex.Traditional teaching method cannot arouse students' interest in study and the teaching effect is poor. Teachers should choose different teaching emphasis for students in different specialty,increase and decrease theory teaching contents according to the demands of students' future actual work,introduce case analysis,train students' capability of clinical logical thinking,enhance students' perceptual knowledge of theory through the training of experiment skills and using PBL teaching method to make students truly participate in teaching course so as to arouse their enthusiasm,These reforming measures will benefit the improvement of teaching quality.