Objective To determine the characteristics of early cognitive dysfunction and N300 event-related potentials(ERPs)in patients with acute cerebral infarction(ACI).Methods Thirty patients with ACI and thirty normal healthy elderly people were studied.The two groups were examined with a picture recognition test and EEG waveforms were recorded.The ERPs were analysed statistically.The mini-mental state examination(MMSE) was used to evaluate cognitive function,and the results were correlated with the ERPs. Results The average MMSE scores of the ACI and control groups were significantly different.Reaction times(RTs)in the picture recognition test were(798.63±49.32)ms in the ACI group and(765.21±35.67)ms in the control group,a difference significant at the 5% confidence level.The average accuracy rates,(59.75±8.45)%and(65.26±9.28)%,were also significantly different.Average N300 ERPs the in the ACI group were significantly lower than those in the control group,and the average latencies were significantly longer.Both latency and amplitude in the ACI group showed a linear correlation with MMSE scores. Conclusion The ERPs of ACI patients have some clinical significance,and can be used as a scale-based assessment of cognitive function.

Objective To analyze the impact and its mechanism of down-regulation of AnnexinA2 expression on prostate cancer(PCa) invasion and metastasis.Methods The expression of AnnexinA2 in three prostate cancer cell lines with different metastasis ability,including LNCaP (lower metastasis ability),PC3 (lower metastasis ability),C4-2B (higher metastasis ability) were detected by Western blot.The correlations between the expression of AnnexinA2 and the metastasis ability of prostate cancer cells were also evaluated.The siRNA was used in PC3 cells to down-regulate the expression of AnnexinA2,the cell proliferation assay was performed by MTT method,the cell apoptosis level was detected by flow cytometry,the expression of MMP-2 and MMP-9 were detected by Westrn blot,the in vitro invasiveness of PC3 was detected by transwell cabinet test,and the migration ability of PC3 cells was detected by scratch test,respectively.Results The grayscale value of AnnexinA2 expression in C4-2B cells is 0.22,in contrast with the internal reference,which was obviously lower than those of LNCaP and PC3 cells with lower metastasis potency(relative grey value is 0.93 and 0.95,respectively.P＜0.01).After RNAi was used in PC3 cells to down-regulate the expression of AnnexinA2,the growth became faster for PC3-ANXA2-siRNA cells than PC3,PC3-Lip and PC3-empty vector cells (P＜0.05).After RNAi was used in PC3 cells to down-regulate the expression of AnnexinA2,the ratio of apoptosis was detected by flowcytometry in PC3,PC3-Lip,PC3-empty vector and PC3-ANXA2-siRNA cells,and the apoptosis ratio in PC3-ANXA2-siRNA cells was the highest.However,the difference was not significant compare to others (P＞0.05).After RNAi was used in PC3 cells to downregulate the expression of AnnexinA2,the expression of AnnexinA2 in PC3-ANXA2-siRNA cells was decreased while the expression of MMP-2 and MMP-9 were increased.After RNAi was used in PC3 cells to down-regulate the expression of AnnexinA2,invasiveness of PC3-ANXA2-siRNA cells detected by transwell cabinet test was increased in vitro,and migration of PC3-ANXA2-siRNA cells detected by scratch test was increased in vitro.Conclusions The down-regulation of expression of AnnexinA2 could increase the invasive and metastatic ability of prostate cancer,and this may attribute to the up-regulation of MMP-2 and MMP-9 expression in prostate cancer.

The ketogenic diet(KD) treatment program planned for a 2 years old and 5 months boy suffered from severe cerebral complications after ependymoma operation in the Children′s Hospital of Nanjing Medical University at December 2018 was analyzed retrospectively.The patient developed various complications, including cerebral hemorrhage, hydrocephalus and hernia after the operation of ependymoma, with coma, fever and convulsion, and 1 month of anti-infection and antiepileptic treatment was ineffective.After 2 weeks of 4∶1 KD, fever and convulsion were effectively relieved without obvious side effects.One month later, the patient regained consciousness, demonstrating that KD can be applied to treat severe cerebral complications after ependymoma operation.

Objective:To investigate the reasons of the tension of doctor-patient relationship and the medical violence from the perspective of the doctors, in order to provide a reference for finding a viable solution. Methods:Questionnaires survey were conducted about doctors' working conditions in 45 hospitals of 9 provinces. Results:On-ly 3. 6% medical staff had a harmonious doctor-patient relationship, the causes for the tense doctor-patient rela-tionship were poor communication with patients (75%), medical limitations (46. 2%);From the patients perspec-tive, the patients 'unpleasant caused by overtreatment due to complex illness accounted for 54. 2%;Institutional health-related reasons accounted for 82 . 6%. Conclusions:In the past five years after the new health care re-form, the tense doctor-patient relationship has not been released. So, should focus on training to enhance the com-munication skills of medical personnel and medical humanities education while the implementation of the national health care reform, in order to reduce iatrogenic conflicts.

The harmonious medical cooperation based on mutual respect and mutual trust is an important part of modern ICU medical care activities,throughout the whole process of ICU medical and nursing work.Whether the relationship between doctors and nurses is harmonious or not directly affects the prognosis of ICU patients.With the change of medical model,the relationship between doctors and nurses is changing. This paper analyzed the influencing factors of doctor nurse cooperative relationship and the significance of good doctor nurse communication and cooperation,summarized the methods and strategies to promote cooperation between doctors and nurses at home and abroad,which would provide reference for clinical cooperation between doctors and nurses in theory and practice.

Disability-adjusted life years (DALYs) has been increasingly used to estimate burden of disease worldwide. By giving a particular attention to DALYs, the objectives of the study were to review various data sources and to conduct an extended estimation on the burden of cancer in China. Based on the publications released by the GLOBOCAN 2008 program and the Global Burden of Disease 2010 (GBD 2010) program, we reviewed the methodological information and gathered DALY data associated with burden of cancer in China, and then we extracted and summarized the data and conducted an extended analysis. From a methodological perspective, both of the programs applied the utility weights mainly from populations other than China. The data from GLOBOCAN 2008 suggests that liver cancer has replaced lung cancer and became the leading cancer in males in China when using DALY rather than mortality rate as the indicator (6.3 million and 5.4 million DALYs, respectively); although the ranking is different, data from the GBD 2010 project shows DALYs caused by liver cancer is comparable to that associated with lung cancer (7.9 million and 8.0 million, respectively). The years lived with disability (YLDs) comprised 26% and 12% of the total DALYs associated with breast cancer and colorectal cancer in China. Both projects suggest that liver cancer might have become or is becoming the leading contributor to males' DALYs in China. There are indications that, along with economic development, YLD will play a more important role in estimation of burden of cancer in China; it suggests that China should consider introducing DALY into the estimation system as early as possible. It also suggests that research on quality of life and utility associated with the major cancers in China need to be systematically conducted to facilitate more accurate DALY estimation.
China ; Cost of Illness ; Disabled Persons ; Humans ; Liver Neoplasms ; Male ; Neoplasms ; Quality of Life ; Quality-Adjusted Life Years ; Regression Analysis ; Research

Objective:Based on a cross-sectional survey about the status of analgesia and sedation nursing behavior of PICU nurses in Northeast China and Inner Mongolia, to analyze the influencing factors and to provide reference for further constructing standardized training programs and developing standardized for analgesia and sedation nursing process.Methods:The self-designed questionnaire was made for investigation from 435 PICU nurses in 18 hospitals in Northeast China and Inner Mongolia.Results:The average questionnaire score of the analgesia and sedation nursing behavior of PICU nurses was(70.54±13.63)in Northeast China and Inner Mongolia.The behavioral scores were different in each group between different age, nursing age, PICU nursing age, educational background, professional title, and whether was the intensive care unit nurse, whether trained in analgesia and sedation, whether have experience in caring children with analgesia and sedation, and the differences were all statistically significant( P<0.05). The main factors influencing the analgesia and sedation behavior of PICU nurses were whether have received training in analgesia and sedation, whether have experience in caring children with analgesia and sedation treatment and their attitude score to analgesia and sedation. Conclusion:There is still much space for development in analgesia and sedation nursing behavior of PICU nurses in Northeast China and Inner Mongolia.The more analgesia and sedation training PICU nurses take participate in, the more experience and positive attitudes they have in nursing children with analgesia and sedation, their clinical nursing practice ability could become more stronger.

Objective To investigate the development and application of blood purification in PICU. Methods The demographic data,diagnosis,length of stay,prognosis,patterns and frequency of blood purifi-cation and complications of PICU patients treated with blood purification in our hospital from 2010 to 2017 were retrospectively analyzed. Results The patients with blood purification accounted for 3. 1％ of hospital-ized children in the same period. From 2010 to 2017,the patients and times with blood purification increased by 370. 6％ and 398. 3％ respectively. The times of continuous veno-venous hemodiafiltration(CVVHDF), plasma exchange and hemoperfusion increased by 135. 2％,6300％ and 1600％ respectively. The frequency of CVVHDF,plasma exchange and hemoperfusion accounted for 42. 8％(492/1151),33. 5％(386/1151), and 23. 7％ (273/1151) respectively. Drug and toxic poision accounted for the highest proportion of 28. 6％(81/284),neurological diseases accounted for 20. 8％(59/284),sepsis with multiple organ dysfunction syn-drome accounted for 18. 0％( 51/284 ) , digestive system diseases, autoimmune diseases, renal diseases and metabolic diseases accounted for 14. 4％( 41/284 ) ,4. 9％( 14/284 ) ,4. 9％ ( 14/284 ) and 4. 2％( 12/284 ) respectively. The cure rate was 63. 8％. Complication included thrombus. Conclusion Blood purification has become the preferred modality for the management of critically ill children. Pediatric blood purification tech-niques have developed rapidly in our PICU and domestic pediatric. Further specification is required,so that it may represent the adequate choice for critical ill children.

Objective To evaluate the applicability of a modified U-shaped forearm flap for the repair of small-and medium-sized defects in the oral and maxillary areas to provide a reference for clinicians.Methods This study was re-viewed and approved by the Ethics Committee,and informed consent was obtained from the patients.Ten patients with small-and medium-sized defects in the oral and maxillary areas underwent surgical repair using modified U-shaped fore-arm flaps.There were 8 males and 2 females aged 43-72 years.The donor site was apposed primarily after harvesting the modified U-shaped forearm skin flap.The flaps ranged from 6 cm × 4 cm to 8 cm × 5 cm in size.Six months after the operation,hand movements(finger extension,fist clenching,wrist rotation upward and wrist rotation downward),the forearm donor site,hand sensations and the satisfaction score for the postoperative quality of the scar at the donor site were evaluated(0 to 10;0:very unattractive,10:very satisfactory).Results A total of 10 patients with modified U-shaped forearm flaps survived.One patient developed venous crisis 24 hours after surgery and survived after surgical ex-ploration.Delayed healing occurred at the donor site of the forearm in 1 patient,and the wounds at the donor site of the forearm in the other patients all healed in the first stage.One patient presented with dysesthesia in the hand 2 weeks af-ter surgery and recovered within 3 months.Six months after surgery,all patients had no limited hand movement and no paresthesia at the forearm donor site or hand.The patients were basically satisfied with the appearance of the donor site,and the average satisfaction score of the subjective questionnaire was 8.4 points.Conclusion Modified U-shaped fore-arm flaps can directly close forearm donor site wounds,which avoids surgical trauma to the secondary donor site and sig-nificantly reduces related complications.Modified U-shaped forearm flaps provide an alternative to conventional forearm flaps for the repair of small-and medium-sized defects in the oral and maxillary areas.

Disability-adjusted life years(DALYs) has been increasingly used to estimate burden of disease worldwide. By giving a particular attention to DALYs, the objectives of the study were to review various data sources and to conduct an extended estimation on the burden of cancer in China. Based on the publications released by the GLOBOCAN 2008 program and the Global Burden of Disease 2010(GBD 2010) program, we reviewed the methodological information and gathered DALY data associated with burden of cancer in China, and then we extracted and summarized the data and conducted an extended analysis. From a methodological perspective, both of the programs applied the utility weights mainly from populations other than China. The data from GLOBOCAN 2008 suggests that liver cancer has replaced lung cancer and became the leading cancer in males in China when using DALY rather than mortality rate as the indicator (6.3 million and 5.4 million DALYs, respectively);although the ranking is different, data from the GBD 2010 project shows DALYs caused by liver cancer is comparable to that associated with lung cancer(7.9 million and 8.0 million, respectively). The years lived with disability(YLDs) comprised 26% and 12% of the total DALYs associated with breast cancer and colorectal cancer in China. Both projects suggest that liver cancer might have become or is becoming the leading contributor to males' DALYs in China. There are indications that, along with economic development, YLD will play a more important role in estimation of burden of cancer in China; it suggests that China should consider introducing DALY into the estimation system as early as possible. It also suggests that research on quality of life and utility associated with the major cancers in China need to be systematically conducted to facilitate more accurate DALY estimation.