Objective To deposit degradable amino-hybrid mesoporous silica(AHMS)in situ on the surface of tita-nium nanotube(TNT)and explore its protective effect on nanomorphology and osteogenesis.Methods TNT and TNT@AHMS were sequentially prepared via an anodizing method:the oil-water two-phase method(experimental group)and the acid-etched titanium method[control group(Ti)].The parameters for synthesis were explored by changing the silicon source dosage ratio(3∶1,1∶1,1∶3);the surface morphology was observed by scanning electron microscope(SEM),hydrophilicity was detected by Water Contact Angle Tester,elemental composition was detected by X-ray photo-electron spectroscopy(XPS);nanoindentation test and ultrasonic oscillator were used to observe the morphological hold-ing effect as mechanical strength of TNT@AHMS in vitro;simulated immersion experiments in vitro was used to observe the degradation behavior of the material.the MC3T3-E1 cell line was used to observe the effect of cell adhesion,prolif-eration and differentiation on the material;and an SD rat femoral implant model and micro-CT were used to verify the protective effect and osseointegration effect of AHMS on TNT morphology.Results The morphologies of TNT and TNT@AHMS were successfully prepared,and the silicon source ratio was 1∶3.SEM showed that the titanium nanotubes were uniformly covered with AHMS coating,and the mesoporous pore size was about 4 nm.After AHMS was incorporat-ed,the surface of the material was hydrophilic(12.78°),the presence of amino groups(NH2-)was detected,the material was completely degraded within 12 h in vitro,and the active morphology of the TNT was re-exposed with a cumulative silicon release of 10 ppm.Nanoindentation test showed that TNT@AHMS exhibited more ideal surface mechanical strength.SEM revealed that TNT maintains its own morphology under the protection of AHMS,and the TNT group suf-fered severe exfoliation.In addition,the early adhesion and proliferation rates,ALP activity,and bone volume fraction of cells on the TNT@AHMS surface 4 weeks after implantation were significantly higher than those in the TNT group.Con-clusion By depositing AHMS on the surface of TNT,the nanotopography can be protected.It not only prevents the ac-tive base topography from exerting subsequent biological effects but also further endows the material with the ability to promote bone regeneration,laying a foundation for the future development of nanotopography-modified titanium im-plants.

Objective:To analyze the trends of overweight and obesity prevalence in Chinese children, aged from 6 to 15 years old among 4 provinces and cities from 2009 to 2019.Methods:Reviewed the national multi-center epidemiological survey data of children from the National Key Technology R&D Program of China during the Eleventh Five-Year Plan (2009 to 2010) and the National Key Research and Development Program of China during the Thirteenth Five-Year Plan (2017 to 2019). The participants′ data were selected from four provinces,municipalities and autonomous region,including Beijing, Tianjin (Northern region), Zhejiang (Eastern region), and Guangxi (Southern region). Totally 14 597 pairs of 6-15 year-old children were surveyed. According to the body mass index (BMI) and standard deviation score (SDS) of children among different genders, ages, and regions, t test or chi-square test was used to evaluate the changes in overweight and obesity over a 10-year span. Results:Totally 7 721 pairs of boys and 6 876 pairs of girls were collectted in this study, whose mean age was (10.7±2.5) years. In the past 10 years, the overall BMISDS were 0.39±1.24 and 0.36±1.31 and the overall obesity rate were 11.8% ( n=1 773) anel 12.5% ( n=1 813) of children in the 4 administrative regions did not have statistically significant differences (all P>0.05). However, the overall overweight rate rose from 17.1% ( n=2 496) to 19.1% ( n=2 781) (χ2=18.657, P<0.01), and the average annual growth rate was 0.20%. The BMISDS in the Eastern region increased from 0.10±1.07 to 0.19±1.22 ( t=-4.095, P<0.01), and the overweight rate and obesity rate increased by 3.8% ( n=202) and 3.1% ( n=169) respectively (both P<0.01); the BMISDS in the Northern region and the obesity rate did not have statistically significant differences(all P>0.05), but the overweight rate rose from 20.5% ( n=1 233) to 22.8% ( n=1 365) significantly (χ2=7.431, P<0.01); BMISDS in the Southern region was significantly decreased from 0.30±1.19 to 0.09±1.25 ( t=1.426, P<0.01), and the rate of obesity decreased from 9.8% ( n=315) to7.9% ( n=256) (χ2=6.46, P<0.05), the overweight rate was not stafistically significant ( P=0.10), respectively. The obesity rate of boys had risen from 16.4% ( n=1 265) to 18.2% (1 407) (χ2=8.997, P<0.01) in the past 10 years, and the overweight rate had risen from 18.0% ( n=1 393) to 20.5% ( n=1 579) (χ2=14.26, P<0.01). The overweight+obesity rate rose from 34.4% ( n=2 658) to 38.7% ( n=2 986) (χ2=29.859, P<0.01), and the weight problem in the age group of 8 to 11 years was particularly severe (all P<0.01). The obesity rate of girls dropped from 6.8% ( n=468) to 5.9% ( n=406) (χ2=4.546, P<0.05), the overweight rate rose from 16.0% ( n=1 103) to 17.5% ( n=1 202) (χ2=5.006, P<0.05), and the overall overweight+obesity rate rose from 22.8% ( n=1 571) to 23.4% ( n=1 608) (χ2=0.53, P>0.05). Conclusions:The growth rate of obesity among children in China had slowed down from 2009 to 2019, but the overweight rate was still on the rise. The overall base of overweight and obesity population continued to expand. The weight problem of peri-adolescent boys was particularly prominent. The current status of obesity epidemics in different regions, ages, and genders are significantly different and had their own characteristics. It is necessary to establish a personalized prevention and control strategy.

Objective:To evaluate the effectiveness of strengthening management in the bronchial asthma control among community patients.Methods:One hundred and eighteen community patients with bronchial asthma were recruited from January 2017 to January 2018. The patients were divided into community strengthening management group ( n=60) and control group ( n=58), the annual times of acute attack, time to first exacerbation and annual medical expenses were compared between the two groups. The proportion of inhaled corticosteroid (ICS) administration was documented; the Asthma Control Test (ACT), the Mini Asthma Quality of Life Questionnaire (MiniAQLQ), Leicester Cough Questionnaire (LCQ), Fractional exhaled nitric oxide(FeNO) and pulmonary function were evaluated in two groups. Results:The management group had greater improvements in the proportion of ICS administration [45(75.0%) vs.36(62.1%), χ 2=4.143], ACT [(20.7±3.9) vs.(18.1±4.1), t=3.213], LCQ [(13.5±5.3) vs.(10.8±3.0), t=2.603], FeNO [(29.8±12.8) vs. (37.1±11.1), t=2.018] than the control group after six months of management (all P<0.05). There were significantly greater improvements in proportion of ICS treating [50(83.3%) vs. 34(58.6%), χ 2=5.748], ACT [(22.1±2.8) vs. (19.5±2.3), t=2.241], LCQ [(16.5±4.2) vs. (11.6±3.2),=5.603], miniAQLQ [(83.2±11.1) vs.(68.1±13.3), t=3.186] and FeNO [(28.2±13.1) vs.(38.1±16.3), t=2.176] in management group than those in control group after one year of management (all P<0.05); but no differences were seen in FEV 1%, FVC%, FEV 1/FVC (all P>0.05) between two groups. The LCQ score [(16.5±4.2) vs. (13.5±5.3), t=3.186] and the MiniAQLQ score [(83.2±11.1) vs. (69.1±14.3), t=5.603] of the management group were significantly improved after 1 year of management than those after 6 months. There was significant improvement in time to first exacerbation [182(92, 284) vs. 92(58, 176), Z=4.384] and the annual exacerbation was significantly reduced [0(0, 1) vs. 2(1, 3), Z=-3.187], annual medical costs of management group were significantly lower than those of control group [(10 523.0±550.5)Yuan vs. (15 787.1±1 421.2)Yuan, t=2.653]. Conclusion:The strengthening management can effectively improve the control rate of bronchial asthma, reduce acute exacerbation, improve clinical symptoms and improve the quality of life in community patients with bronchial asthma.

Objective To explore the influencing factors of career planning for nurses aged 30 to 40 years old. Methods Based on descriptive qualitative study, purposive sampling and the maximum variation strategy were used, nurses aged 30 to 40 years old who work at hospitals in Zhejiang province were selected as participants. Face-to-face semi-structured interviews were conducted focusing on influencing factors of career planning and field notes were written. Traditional content analysis was used for analyzing the data, and themes were extracted. The sample size was based on the criteria of saturation. Results A total of 12 participants were included. After analysis, the main influencing factors of career planning were identified: self- perception (such as their own personality, interests and expertise, professional ability, physical condition), knowledge of nursing work (including the cognition of nursing specialty and the nature of nurses' work), career development space (such as career development platform, career development path, career development bottleneck, learning and promotion opportunities), family factors (including family support and family outlook), hospital culture(including interpersonal relationships, leadership support, management style), career planning knowledge(including knowledge of career planning and guidance on career planning in work). Conclusions There are many factors influence career planning. Relevant departments and nursing managers should assist these nurses in making reasonable career planning according to their situation.

Objective To investigate the predictive value of plasma gelsolin in the prognosis of patients with ST-sgement elevation myocardial infarction ( STEMI ) and undergone primary percutaneous coronary intervention ( PCI ) .Methods The study included 206 patients with STEMI and undergone primary PCI, 148 patients with stable angina pectoris and received elective PCI and 80 healthy volunteer as the health population (NP) control.Blood samples were taken at admission on day 1, 3, 5, 7 and 9 to determine the plasma gelsolin level .Patients′baseline clinical characteristics , blood biochemistry tests results , details of operation and their cardiovascular risk factors were recorded .Major adverse cardiovascular events (MACE) within one year were recorded.Results (1) Compared to the stable angina group and the NP group, the level of plasma gelsolin of STEMI patients were obviously decreased at various time points ( all P<0.05 ) .There were no statistical differences between the stable angina group and the NP group .( 2 ) Patients with STEMI were catagorized into MACE group (n=78) and non-MACE group (n=128) according their follow up record in 1 year.The level of plasma gelsolin in patients with MACE were lower than the non-MACE group ( P <0.05 ) with the minimum value detected on day 7.Among patients complicated with MACE (n=78), they were further devided into the deceased group (n=18) and the survival group (n=60).Plasma gelsolin levels were lower in the deceased group with satistical differences found on day 5, 7 and 9.(3) Single factor Logistic regression analysis showed that the level of plasma gelsolin on day 7 was independent risk factor of MACE within one year ( P =0.014 ) .( 4 ) Setting the cutoff value of plasma gelsolin on day 7 as 21.7 mg/L,the sensitivity and speciticity for the MACE in STEMI patients treated with primary PCI within one year were 82.1%and 81.4%respectively , with the area under the receiver operator characteristic curve ( ROC ) was 0.854 ( 95% confidence interval 0.732 -0.961 , P <0.01 ) . Conclusions Plasma gelsolin levels are correlated with the severity of STEMI lesions and plasma gelsolin can be used as predicting factor of prognosis .

Objective To discuss the value of Valsalva experiment combined with improved MRI tilt tomography applying on the pharyngeal ostium of eustachian tube opening function of patients with nasopharyngeal carcinoma.Methods 1 7 cases with patholog-ically proved NPC underwent conventional MRI plain and enhanced scan.In the eustachian tube area oblique transection T2 WI and T1 WI scanning was done before and after the Valsalva experiment.The invasion of eustachian tube and its surrounding structures was analyzed and the eustachian tube function was evaluated.Results Valsalva experiments combined with improved MRI trans-verse oblique scan could clearly display the whole structure of the eustachian tube and surrounding tissue invasion compared with conventional scanning MR scan.And it could better evaluate the eustachian tube opening function for patients suffered nasopharynge-al carcinoma.Conclusion Valsalva experiments with improved MRI oblique transverse imaging could achieve individualized scan of the eustachian tube,and could be used for evaluating the pharyngeal opening function of eustachian tube in patients with nasopharyn-geal carcinoma.

Described in this paper are the problems in the old information integrated system, the principles and component parts of the improved information integrated system, and the changes in information service brought by the improved informationintegrated system such as improved service in electronic〗reading room, expanded hospital resource service and scientific navigation service, in Library of First Affiliated Hospital of Kunming Medical University.

Objective To analyze the diagnosis and treatment for complications of renal caliceal diverticulum with calculi or infection. Methods A retrospective investigation was performed on 29 cases with renal caliceal diverticulum. The 29 cases included 11 males and 18 females aged 18 to 61 years. Among the study group, 3 cases were simple renal caliceal diverticulum, 12 cases were diagnosed as diverticular calculi and 14 cases presented recurrent urinary tract infections including 3 cases with urinary fistula after unroofing and decompression as renal simple cyst from another hospital. Ten cases underwent an open operation that unroofed and decompressed the cyst, and sutured the diverticular neck. Eight cases underwent laparoscopic operation similar to the open operation, including lithotomy in caliceal diverticulum in 2 cases. Eleven cases diagnosed with caliceal diverticular calculi were taken one-stage percutaneous nephrolithotomy including dilating the diverticular neck, remaining the nephrostomy catheter and Double-J ureteral stents, and 1 case was transferred to open operation.Results The open and laparoscopic operations were performed successfully. One case was cured by Double-J ureteral stenting after postoperative urinary leakage. One case was transferred to open operation for the failure of percutaneous puncturation. X-ray examination revealed that there were no remaining stones after the operation. All the patients were followed up for 6 to 24 months without calculi and infection recurrence. Conclusions Stones and infection are common that complications of renal caliceal diverticulum. Percutaneous nephrolithotomy, laparoscopy and other operations were effective and feasible treatment options for cases with complications of renal caliceal diverticulum. Exact diagnosis was very important for treatment of renal caliceal diverticulum before operation.

Objective To characterize the features of Nasopharyngeal non-Hodgkin's lymphoma (NHL) on MR imaging and find the main points to differentiate it from the other nasopharyngeal tumors.Methods The MR images of 41 patients with pathologically and immunohistochemically proven nasopharyngeal NHLs were reviewed retrospectively. Images were assessed by the size, invasive extent,signal intensity of primary nasopharyngeal tumor, and the distribution of cervical lymphadenopethy. The difference of regional tissues invasion and cervical lymphadenopathy distribution between the patients with B-cell NHLs and the patients with T-cell or NK/T-cell NHLs were analyzed by Pearson's Chi-Square test or Fisher's exact test Results Of the 41 patients, 26 patients had mature B-cell lymphoma, two patients with mature T-cell Iymphoma, and thirteen patients showed Nature killer/T-cell lymphoma in nasopharynx. MRI revealed that NHLs of nasopharynx can be showed as thickening of nasopharyngeal mucosa and (or) lumps in nasopharynx, which were slightly hyper-intensity on T2-weighted images, and intermediate signal intensity (similar to muscle) on T1 -weighted images, with mild or moderated enhancement following contrast medium administration. Twenty four cases had symmetrical disease of all walls of nasopharynx, and 17 cases had unsymmetrical tumor. Of all cases, 5 cases had superficial ulcerations, 9 cases had exceed nasoharynx invasion spreads superficially along the mucosa, 23 cases had invasion of lingual and (or) palatine tonsils,20 cases showed invasion of parapharygeal muscles, 12 cases suffered from skull base bone infiltration,25 cases had retropaharyngeal lymphadenopathy, and 27 cases had cervical lymhadenopathy. Patient with nasopharyngeal Nature killer/T-cell lymphoma had a higher incidence of exceed nasopharynx invasion,parapharyngeal structures invasion, and superficial ulcerations (the cases were 8, 11, 4 in patient with T-cell or N K/T-cell lymphoma, and 4, 10, 1 in patients with B-cell lymphoma, respectively). Patients with nasopharyngeal B-cell lymphoma had a higher incidence of inasion of lingual and (or) palatine tonsils.Conclusions Nasopharyngeal NHL is a homogeneous tumor that tends to diffusely involve all walls of the nasopharynx and spread in an exophytic fashion to fill the airway, rather than infiltrating into the deep tissues. Different pathological types of nasopharyngeal NHLs have some different appearance on MRI between each other. A large tumor in nasopharynx that fills the nasopharynx cavity, with no or minimal invasion into deep structures, but with invasion extend down into the lingual and(or)palatine tonsils, may suggest the diagnosis of nasopharyneal NHL.

Objective To study the imaging features of Kimura disease to improve diagnostic ability prior to surgery.Methods The clinical manifestations and CT and MR findings of 11 patients with histologically confirmed Kimura disease were retrospectively analyzed.All 11 tumors originated from (or involved)the parotid region in 7 cases, the maxillofacial region in 2 cases, the palate in one case and the groin in one case.Clinically, the lesions showed asymptomatic tumors with the mean clinical course over 2 years.The increase of cosinophilic granulocyte was found in all 11 cases.Results On CT and MRI,5 patients were single masses and others were muhi-nodular masses.The smallest lesion was 6 mm×3 mm,and the largest lesion was 60 mm × 34 mm.The lesions were almost ill-defined in the subcutaneous tissue,especially 10 locating underlying superficialfascia in head and neck.On CT,the lesions showed homogeneous hypodense to the muscle in 9 patients.The lesions appeared isointeuse signal or slightly hypointense on MR T1WI and slightly hyperinteuse on T2WI in 3 patients.All lesions revealed moderate or marked, and homogeneous or inhomngeneous enhancement.Regional lymph nodes (eight cases in the maxillofacial region and one in the groin) enlarged without necrosis and fusion, and with marked enhancement.Conclusion The clinical and imaging findings of Kimura disease have some characteristics, the diagnosis can be made combined with the laboratory examination.