Objective To analyze the clinicopathologic features and prognosis of early stage cervical adenosquamous carcinoma and adenocarcinoma.Methods Clinical data of 62 patients with cervical adenosquamous carcinoma,149 patients with adenocarcinoma and 2 687 patients with squamous carcinoma of stage Ⅰ B-Ⅱ A,who received surgical treatment and adjuvant radiotherapy from June 2006 to February 2012 were retrospectively analyzed.The Chi-square test,Kaplan-Meier method,log-rank test and logistic regression were used for statistical analysis.Results In patients with adenosquamous carcinoma,adenocarcinoma and squamous carcinoma,the rates of lymph node metastasis were 33.6％ (50/149),29.0％ (18/62) and 22.0％ (591/2 687),deep stromal invasion were 64.4％ (96/149),75.8％ (47/62) and 55.3％ (1 486/ 2 687) and corpus invasion were 26.2％ (39/149),25.8％ (16/62) and 6.7％ (181/2 687),respectively.Those pathological parameters in adenosquamous carcinoma and adenocarcinoma were higher than those in squamous carcinoma (χ2 =12.170,P=0.002;χ2 =14.660,P=0.001;χ2 =97.732,P=0.000).There were no difference between adenocarcinoma and adenosquamous carcinoma in proportion of massive tumor (≥4 cm) [38.9％ (58/149) vs.35.5 (22/62),χ2 =0.220,P =0.639],lymph node metastasis (χ2 =0.410,P =0.522),corpus invasion (χ2 =0.003,P =0.956),deep stromal invasion (χ2 =2.595,P =0.107) and low differentiation[38.9％ (58/149) vs.48.4％ (30/62),χ2 =1.612,P=0.204].The median follow-up period was 45 (3-92) months.Multivariate analysis showed that corpus invasion (P =0.014,RR =3.393,95％CI:1.280-8.991),age (P=0.000,RR =1.077,95％ CI:1.037-1.117) and stage (P =0.007,RR =0.275,95％ CI:0.108-0.699) were prognostic factors of adenosquamous carcinoma.Age (P =0.006,RR =1.025,95 ％ CI:1.007-1.043) and lymph node metastasis (P =0.000,RR =2.525,95％ CI:1.547-4.120) affected the prognosis of adenocarcinoma.The median survival times for adenocarcinoma,adenosquamous carcinoma and squamous carcinoma were 45,46 and 56 months (adenosquamous carcinoma vs.squamous carcinoma:χ2 =1.347,P =0.246;adenosquamous carcinoma vs.adenocarcinoma:χ2 =1.808,P=0.179).There were no difference in recurrence rates between adenosquamous carcinoma and squamous carcinoma[14.0％ (7/50) vs.7.6％ (175/2 298),χ2 =1.968,P=0.161],and between adenosquamous carcinoma and adenocarcinoma [14.0％ (7/50) vs.22.1％ (27/122),χ2 =1.478,P =0.224].Conclusions Clinicopathologic features are similar between stage Ⅰ B-Ⅱ A cervical adenosquamous carcinoma and adenocarcinoma.Corpus invasion,age and stage are the leading indicators affecting the prognosis of adenosquamous carcinoma.Age and lymph node metastasis are the factors affecting the prognosis of adenocarcinoma.There are no difference in survival and prognosis between adenosquamous carcinoma and adenocarcinoma.

Objective To make an assessment method for the efficiency of spraying air cleaning products used in the indoor air. Methods 1.5 m3 chamber was used, the temperature was (21?2.5) ℃ and the relative humidity was (40?5)%. The formaldehyde of 10 times of the standard limit was added in the chamber, then the products were sprayed, the air cleaning efficiency was assessed at different times. Results The polluted indoor air by formaldehyde could be purified by air the cleaning products, the CADRq≥2.0?10-2 m3/(min?g) within 60 min. Conclusion The assessment method is accurate and applicable to the assessment of efficiency of spraying air cleaning products used in the indoor air cleaning.

Objective To determine and compare the daily cost of various ophthalmic solutions for glaucoma in China. Design Investigative study. Participants The majority ophthalmic solutions for glaucoma available in our country were included in the research. Methods Five bottles of each solution were tested separately by five researchers. After the number of drops and the actual volume for each bottle were calculated, the mean number of drops per bottle and the mean volume per bottle were determined. The volume per drop was calculated by dividing the mean volume per bottle by the mean number of drops per bottle, and the cost per drop was calculated by dividing the market price by the mean number of drops in a bottle. The number of days for both eyes usage per bottle was calculated by dividing the mean number of drops in a bottle by the number of drops required daily for both eyes. The cost per day was calculated by multiplying the cost per drop by the number of drops required daily for both eyes. Main Outcome Measures The number of days for both eyes usage per bottle and the daily cost: for both eyes usage per bottle. Results 1. The volume per drop ranged from 0.027 ml(Lumigan) to 0.053 ml(Chengrui and 0.5%Zhenrui). 2. The cost per bottle ranged from 5.7Yuan(Malaisuan Saimaluo'er) to 338Yuan (Xalatan). 3. The number of days for both eyes usage per bottle ranged from 52d (Lumigan) to 12d ( Zhenrui). 4. The daily cost for both eyes usage from expensive to cheap were Xalatan 7.51Yuan, Travatan 6.30 Yuan, Lumigan 3.84 Yuan, Alphagan 3.36 Yuan, Dilijian 2.97 Yuan, Pailiming 2.83 Yuan, 2%Zhenrui 2.34 Yuan, Betagan 2.11 Yuan, Beiteshu 2.0 Yuan, 0.5% Zhenrui 1.49 Yuan, 2%Huming 1.29 Yuan, Mikelan 1.21 Yuan,1%Huming 0.85 Yuan, Chengrui 0.63 Yuan, Malaisuan Saimaluo'er 0.23 Yuan. Conclusions The daily cost of ophthalmic solution for glaucoma ranged wildly. These data may be useful in selecting ophthalmic solution for glaucoma therapy.

Objective To explore a new training method of nursing skills under 24 hours shift system in the practical training base in the college. Methods The practical training base in the college was rebuilt into a simulated hospital. 120 three-year-course nursing students in grade 2007 were divided into the control class and the experimental class with 60 students in each class. The control class adopted routine teaching method, including teacher demonstration, single project training, concentrated training before clinical practice. The experimental class participated in the tutoring mode of nursing skills under 24 hours shift system in simulated hospital. The cases were pre-designed and students acted as patients by tums. One teacher led 4 students into nursing skill training by day shift, evening shift and mid-night shift. The teaching effect was compared between two classes. Results There was significant difference between the two groups in comprehensive technique test and graduation theoretical test score. Clinical nursing teachers thought the skill training in simulated hospital under 24 hours shift system can help students prepare for the nursing work in hospital ahead of time and improve their comprehensive capability. Conclusions Training mode of nursing skills in simulated hospital under 24 hours shift system is feasible for enhancing nursing skills.

Objective To explore the effects of fat emulsion made of fish oil for total parenteml nutrition on patients with systemic inflammatory response syndrome(SIRS).Methos Forty patients with SIRS in the intensive care unit(ICU),Liaocheng People's Hospital,from January to June 2007 were randomly divided into conventional total parenteral nutrition(TPN)group(group A,n=20)and fish oil emulsion+TIN group(group B,n=20).Patients of both groups received equal amount of nitrogen and calories.The energy give.Was 20 kcal/(kg·d),and nitrogen 0.2 g/(kg·d)for 7 days and the fish oil emulsion given was 1-2 ml/(kg·d)(Commoditieds:Omegaven,No.UK 1580,Wuxi,China SINO-SWEO Pharmaceutical CORP.Ltd.).The levels of serurn TNF-α,IL-1 and IL-6 were checked before TPN and 1 d,3 d and 7 d after TPN.The davs of ICU stay,the incidence of MODS and the mortality within 28 aays of two groups were also recorded.Data were analyzed wotj inde pent-saraples t test and paired-sarnples t test using the SPSS 10.34 software.Results There wsa no significant difference in APACHF-Ⅱ score between two groups of patients.Compared with group A,the levels of serum TNF-α,IL-1 and IL-6 in group B decreased markedly at different intervals(P<0.05,P<0.01).The duration of ICU slay shortened obviously in group B than that in group A[(11.5±2.4)days vs.(15.8±2.3)days,P<0.05].Conclusions The fat emulsion made of fish oil has protective effects on patients with SIRS by the mechanism of decrease in the levek of Serum TNF-α,IL-1 and IL-6,and thereby reduees the incidence of MODS,shortens the duration of ICU stay,increasing the survival rote of seriously ill patients.

Objective To comparatively study the difference status of lymphocyte subsets and activated T lymphocyte between preoperation and intraoperation,and to investigate the influence of operation on lymphocyte subsets and their activation in the pa-tients with malignant tumors.Methods The lymphocyte subsets and their activated cells were determined in 42 cases of common malignant tumors by the flow cytometry.Results The levels of CD3 + ,CD4 + ,CD8 + cells during intraoperation were obviously de-creased compared with preoperation,the difference in CD3 + and CD4 + had statistical significance(P <0.05),while the difference of CD8 + had no statistical significance(P >0.05).NK,CD19 + ,CD3 + HLA-DR+ were significantly increased,the difference of NK and CD19+ had no statistical significance(P >0.05),while the difference with CD3 + HLA-DR+ had statistical significance(P <0.05). Conclusion The cellular immune function in the patients with malignant tumor is in inhibitory status.Operation makes the cellular immune function to be further injured.The stress responses of operation and trauma increase the expression of NK,CD19 and acti-vated T lymphocytes.It is suggested that the patients with malignant tumor should use the immune response modifier before opera-tion to enhance the cellular immune function for ensuring the effect of postoperative radiochemotherapy sequential treatment.

Objective To investigate the dynamic changes of Th 17 ,NK and IFN-γ,IL-17 in periop-erative patients with lung cancer .Methods Twenty cases of patients with lung cancer surgery were chosen ran-domly.Ten cases of healthy were used as control .We detected the express of Th17,NK,IFN-γand IL-17.Re-sults Compared with the control group , the levels of Th17 and IL -17 increased significantly in lung cancer group(P<0.05);Compared with the pre -operation,the levels of Th17 and IL-17 increased significantly after 1st day of lung cancer surgery .However,the levels of NK and IFN -γdecreased significantly .The expression of Th17 and IL-17 decreased obviously after 5 days of lung cancer surgery .However,the levels of IFN -γin-creased significantly(P<0.05).The correlation analysis showed that there was a positive correlation between Th17 and IL-17A,NK and IFN-γof peripheral blood with lung cancer patients (P<0.01),negative correla-tion between Th17 and NK,IFN-γof peripheral blood with lung cancer patients (P<0.05).Conclusion The immune suppress before activating at perioperative ,it is important for lung cancer patients to detect the levels of Th17,IL-17,NK,IFN-γin peripheral blood .

Objective To study the changes of CD4 +/CD8 +T cells ratio and TGF -β,IL-4,IL-6 levels in lung cancer patients during the perioperative period and to analyze the clinical significance .Methods Flow cytometer and Elisa were used to analyze the CD 4 +/CD8 +T cells ratio and TGF-β,IL-4,IL-6 levels in peripheral blood sapmles from 20 patients with lung cancer during the perioperative period and 10 healthy con-trolsR. esults Before operation ,the ratios of CD4 +T and CD8 +T cells from 20 patients with lung cancer were (46.26 ±4.26)%and(43.15 ±5.18)%, respectively.On the fifth day after operation ,the ratios of CD4 +T and CD8 +T cells were(44.30 ±4.25)%and(39.80 ±2.53)%.TGF-β,IL-4 and IL-6 levels in 20lung cancer patients were(240.51 ±46.37)pg/mL,(19.85 ±2.52)pg/mL,and(129.28 ±33.06)pg/mL,respectively.On the fifth day after operation,TGF-β,IL-4 and IL-6 levels were(210.79 ±36.94)pg/mL,(17.37 ±2.57) pg/mL,and(107.28 ±27.83) pg/mL.The differences of above parameters between the preoperative period and the fifth day after operation were statistically significant ( P<0.05) . Conclusion The immune suppression oc-curs before its recovery during perioperative period ,the changes of CD4 +/CD8 +T cells ratio and TGF-β,IL-4 and IL-6 levels have significance on monitoring the progress and prognosis of patients with tumor .

Objective To investigate the efficacy of postoperative concurrent chemoradiotherapy for early-stage cervical adenosquamous carcinoma and adenocarcinoma.Methods A total of 62 patients with cervical adenosquamous carcinoma,149 patients with cervical adenocarcinoma,and 2687 patients with cervical squamous cell carcinoma,all of whom were in stage Ⅰ B-Ⅱ A and were treated from 2006 to 2012,were enrolled,and some of them received postoperative pelvic radiotherapy ± para-aortic extended field radiation ±afterloading radiotherapy.The chemotherapy regimen consisting of DDP,TP,and FP was given to these patients.The chi-square test was used for comparison of general clinical data,the Kaplan-Meier method was used for calculating survival rates,and the log-rank test was used for survival difference analysis.Results Cervical adenosquamous carcinoma and adenocarcinoma had no significant differences in clinicopathological features (P=0.107-0.639).The high-risk patients with adenocarcinoma had a higher recurrence rate than their low-risk counterparts even after adjuvant radiotherapy or chemoradiotherapy (P=0.000).In the patients treated with surgery and radiotherapy,those with adenosquamous carcinoma had the shortest median survival time,followed by those with adenocarcinoma and squamous cell carcinoma (P =0.134,0.787);in the patients treated with surgery and concurrent chemoradiotherapy,those with adenocarcinoma had the shortest median survival time,followed by those with adenosquamous carcinoma and squamous cell carcinoma (P=0.131,0.643),and the median survival time showed a significant difference between the patients with adenocarcinoma and those with squamous cell carcinoma (P =0.000).In the patients with adenosquamous carcinoma and adenocarcinoma,the patients treated with postoperative concurrent chemoradiotherapy had higher incidence rates of short-term adverse reactions than those treated with postoperative radiotherapy (P=0.037,0.003),but the incidence rates of long-term adverse reactions showed no difference between the two groups of patients (P=0.861,0.655).In the patients with adenosquamous carcinoma,the patients treated with postoperative concurrent chemoradiotherapy had a lower rate of distant metastasis (P =0.003) and prolonged median overall survival and disease-free survival (both increased by 17 months) (P=0.811,0.799),as compared with those treated with postoperative radiotherapy,while in the patients with adenocarcinoma,the median overall survival and disease-free survival were reduced by 11 and 9 months,respectively (P=0.330,0.115).Conclusions Compared with postoperative radiotherapy,postoperative concurrent chemoradiotherapy for early-stage high-risk cervical adenosquamous carcinoma can reduce the rate of distance metastasis.Compared with radiotherapy,postoperative concurrent chemoradiotherapy for adenosquamous carcinoma and adenocarcinoma cannot improve survival time.

OBJECTIVE To explore the nursing supervision experience in laminar air-flow operating room(OR) and to provide a very clean and safe operating environment for the surgical patients,in order to prevent the operation infection and raise operation quality.METHODS To take the measures of aseptic,clean,purificatory management,and compare the ratio of infection of incisional wound on aseptic operation and the air bacteria detection results with the general operating room simultaneously.RESULTS The ratio of infection of incisional wound on aseptic operation was 0.05% in the laminar air-flow OR(group A) and 0.15% in the general operating room(group B),P