Objective To study the clinicopathological features and biological behavior of inflammatory pseudotumor-like follicular dendritic cell tumor.Methods We studied the clinical data,HE sections,immunohistochemical staining,Epstein-Barr virus encoded nuclear RNA(EBER)in situ hybridization and outcome of one patient with inflammatory pseudotumor-like follicular dendritic cell tumor of liver,and thirteen patients with inflammatory pseudotumor of liver and spleen treated at the Shengjing Hospital of China Medical University from 2001 to 2010.Results Among the thirteen inflammatory pseudotumors,we diagnosed 1 patient with inflammatory pseudotumor-like follicular dendritic cell tumor of spleen and 1 patient with inflammatory pseudotumor-like follicular dendritic cell tumor of liver using immuno-histochemical staining and EBER in situ by hybridization.The liver case had pathological morphology consistent with those described in the literatures,but the splenic case had specific histologic features.They were both female,and were alive 2.5 and 6 years after operation.Conclusions Inflammatory pseudotumor-like follicular dendritic cell tumor should be distinguished from inflammatory pseudotumor.It is a rare tumor seen mainly in liver and spleen.The diagnosis depends on histopathological and immunohistochemical findings.Inflammatory pseudotumor-like follicular dendritic cell tumor is a low-grade malignant tumor.Surgical excision is the treatment of choice.The two cases provided evidence for its indolent behavior.

Objective The study was to investigate the activation of tumor necrosis factor α (TNF-α) mRNA transcription and protein expression in peripheral blood and activation of signal path PI3K/AKT in patients with chronic heart failure. Methods From February 2015 to April 2018, 244 patients with heart failure in the cardiovascular department of our hospital were selected as heart failure group, while 244 healthy cases were enrolled as the control group at the same time. The peripheral blood samples of two groups were collected. We detected the transcription and protein expression of TNF-α mRNA and the activation of PI3K, AKT in peripheral blood. The left ventricular ejection fraction (LVEF) were measured in two groups. The correlations between influencing factors and LVEF were analyzed. Results The levels of PI3K, AKT in the heart failure group were higher than those in the control group. The differences were statistically significant respectively (P < 0.05). The mRNA relative content and protein content of TNF-α in peripheral blood mononuclear cells of heart failure group were higher compared with those of control group (P < 0.05). The LVEF of heart failure group was significantly lower than that of the control group (34.50 ± 6.33) ％ versus (55.60 ± 2.49) ％, P < 0.001). Among 244 patients with heart failure, Spearman correlation analysis showed that there were significant positive correlations between TNF-a mRNA and protein expression levels and the levels of PI3K, AKT respectively (P < 0.05). Multiple factors unconditional Logistic regression analysis showed that the TNF-α mRNA, protein expression and PI3K, AKT levels in peripheral blood were independent risk factors for LVEF (P < 0.05). Conclusion The expression levels of PI3K, AKT and TNF-α are all significantly increased in chronic heart failure patients, which could participate in the occurrence and development of heart failure.

Objective To study application effect of setting up full-time supervision nurse and shift in neurosurgery patients discharge guidance. Methods Between March and August in 2014, a total of 408 patients were discharged from Neurosurgery Department, Huai′an First People′s Hospital, Nanjing Medical University, who were divided into control group ( 204 cases ) and observation group ( 204 cases ) according to the first treatment ward. Patients in control group received conventional discharge guidance, whereas observation group had an extra full-time supervision on discharge guidance. Full-time supervision personnel should visit the patients discharged that day in the ward, inform the patient or family invoicing process,attention about related disease, medication and dietafter discharge. Meanwhile, full-time supervision personnel should get to know the service attitude of nurses, nursing technology andwhether relevant health education had been grasped during the patients′ hospitalization, based which the full-time supervision personnel provided a targeted discharge guidance. One month later, we compared the two groups for mastering discharge health education and patient or family members′nursing satisfaction. Results Patients in observation grasped discharge health education better than those in control group (93. 30% vs 73. 89%;χ2 =26. 1168,P<0. 05). Patients or their family members in observation group were more satisfied with nursing than that in control group(96. 91% vs 86. 78%;χ2 =11. 236,P<0. 05). Conclusions Full-time supervision nurse and shift used in neurosurgery patients discharge guidance,which build a bridge between patients and health care members, can not only improve the quality of nursing service, but also elevate hospital′social efficiency with a good reputation.

ObjectiveTo discuss the effects of continuing nursing on the living condition of patients with severe craniocerebral injury in neurosurgery department.Methods A total of 303 patients with severe craniocerebral injury from January 2008 to December 2009 in neurosurgery department of Huai'an First People's Hospital,Nanjing Medical University were randomly divided into the control group (140 cases) and the intervention group (163 cases). Patients in the control group were followed up once by the phone at the first week after discharge. There was no longer follow-up after the first week and patients could call or visit hospital in case of problems. Patients in the intervention group received continuing nursing intervention by telephone follow-up visit,the establishment of continuing nursing WeChat group,family visit and the establishment of brain club. Patients were followed up from the first week after discharge until the death of patients or December 2015. Survival rate of two groups was evaluated by survival analysis.Results The survival rate of patients in the intervention group and the control group were 78.8% and 62.3%,which were calculated by the Kaplan-Meier method. The survival rate of patients in the intervention group was significantly higher than that in the control group (χ2=33.91,P<0.05).Conclusions Continuing nursing helps to improve the survival situation of patients with severe craniocerebral injury in the process of time.

Objective To evaluate the application effect of the clinical nursing pathway for stroke′s patients by using the Meta-analysis.Methods The databases of Wanfang Data,CMA,CHDL and CBM were searched.This control study compared clinical nursing pathway and traditional nursing including from January 1998 to March 2014.Data collection and literature evaluation were performed by two reviewers independently. RevMan 5.2 was used for the Meta-analysis.Results Fifteen literatures included in Meta-analysis showed the statistical difference between clinical nursing pathway and traditional nursing on stroke′s patients in the average length of stay, average hospitalization expenses, patient satisfaction and Barthel index (P<0.05).Most trials included in the review had low quality.Conclusions The clinical nursing pathway has a better implementation effect compared with routine nursing, but there is a higher risk of bias in the literatures, and the results need a large number of clinical nursing practice and higher quality literatures to support.In practice, randomized control trials should be designed according to scientific methods and strict implementation.

Objective:To provide references for the application of finite element model in the study of cervical vertebra by statistically analysing the frequency, numerical value, properties, and boundary setting of the finite element model and the corresponding material features as well as boundary settings in the literature.Methods:The literature on cervical vertebra-related finite element models was collected from CNKI, Wanfang, VIP, PubMed, Web of Science, and Embase databases from January 2013 to December 2023. The quality assessment was followed by manual screening. The data sources, application classification, material properties (Young’s modulus and Poisson’s ratio), and boundary conditions of cervical vertebra, cervical intervertebral, and cervical ligaments were statistically analyzed.Results:A total of 102 papers were included. The finite element models of the cervical vertebra were derived from medical image reconstruction modeling techniques, predominantly CT plain scan and magnetic resonance imaging. Among the 102 cervical vertebra models, the C3-C7 (lower cervical segment) model appeared with the highest frequency (19). The Young’s modulus of the cortical bone, cancellous bone, and posterior structure of cervical vertebrae were set at about 12 000 or 10 000, 440, and 3 600 MPa, respectively, and the Poisson’s ratios were mainly set at about 0.29 or 0.30, 0.29, and 0.29. The Young’s modulus of the cervical intervertebral disc endplate, nucleus pulposus, and annulus fibrosus were concentrated around 500 or 2 000, 1, and 100 MPa, respectively, and the Poisson’s ratios were set at about 0.40, 0.50, and 0.40, respectively. The Young’s modulus of the anterior longitudinal ligament, posterior longitudinal ligament, transverse ligament, ligamentum flavum, interspinous ligament, capsular ligament, and articular cartilage of the cervical spine were set around 30, 20, 20, 6-10, 4-8, 10 or 20, 10 MPa, and the Poisson’s ratios were set at aoubt 0.30, 0.30, 0.30, 0.30, 0.30, 0.40, and 0.30, respectively. The Young’s modulus of the upper cervical interdental ligament, lamina, cruciate ligament, nuchal ligament, and pterygoid ligament were set at about 10, 10, 10 or 20, 20, and 5 MPa, respectively, and the Poisson’s ratios were set at about 0.30. Head weight settings were more common at 50, 74, and 100 N.Conclusions:The finite element model of the cervical vertebra has great value in the study of cervical spondylosis, but further optimization is still needed in the assignment of material properties, mesh division, and model verification to improve the accuracy and clinical applicability of the model.