Objective To discuss about the application of early restricted fluid resuscitation in dealing with thoracic and abdominal trauma combined with hemorrhagic shock.Methods 140 cases of patients with thoracic and abdominal trauma combined with hemorrhagic shock were divided into two groups stochastically,one group was dealt with conventional liquid resuscitation (the control group,71 cases),the other group was treated with limited fluid resuscitation (the limited group,69 cases).The patients of the control group were treated substantial rehydration therapy,the rehydration was carried out quickly and sufficiently in the early before hemostasis,to keep the mean arterial pressure (MAP) at 80～90 mmHg (1 mmHg=0.133 kPa); The amount and velocity of entering liquid of the limited group was under controlled,their MAP was kept at 55～65 mmHg,Adequate fluid resuscitation was carried out after bleeding was stopped.The average amount of infusion,the general situation,the incidences of complications and the death rates of two groups were compared.Results The average amount of infusion in the control group was significantly more than the limited group,the preoperative Hb and HCT of the control group were obviously lower than the limited group,the incidence of complications and the death rate of the control group were higher than the limited group.Conclusions If preoperative restricted fluid resuscitation for traumatic shock was used,the Harassing for Organism's compensatory mechanisms and internal environment could be avoided,the incidence of complications and the death rate will become lower,therefore,this method was worth to be extended in the clinical operation.

Objective To investigate the influence of family support and personality characteristics on quality of patients' life who underwent total laryngectomy. Methods Patients (68 eases)who underwent total laryngectomy were surveyed with Su life of quality scale,Hu family support scale, Gong personality test and the results were sent for statistical analysis. Results Scores of two family groups in family support and quality of life underwent t test, physical function and psychological state were statistically different (P<0.05), living ability,social relations, tracheal stoma were statistically different(P<0.01). Persona lity and quality of life were subjected to single-factor analysis, psychological states were obviously related with four dimensions.Family support and personality characteristics score of two family groups underwent t test, E(internal and external quality),P(spiritual quality),N(nerval quality)were statistically significant (P <0.01 ). Condusions Family support and personality characteristics as the internal and external environmental factors directly affected patients who underwent total laryngectomy. Three-openfour-guiding-five-integrated-care-intervention measures can overall improve their quality of life.

Objective:To explore an effective method of academic integrity commitment to reflect the management of hospital scientific research papers to avoid the occurrence of academic misconduct.Methods:The retrospective analysis method was adopted to compare the effectiveness of paper signed academic integrity commitment (paper sign method) and hospital network academic integrity commitment (the net sign method), main indicators including the medical personnel participation, commitment submission time spots, extraction/find commitment of time and paper into the achievements management system management system were taken into consideration for difference identification.Results:The comparison of the two groups' commitment to integrity and active participation was P<0.01, indicating that the online signature method could stimulate the agency and consciousness of the first author to fulfill the commitment to academic integrity. The time of submitting the commitment letter and the time of extracting/finding the commitment letter in both groups were all P<0.01, indicating that the network signature method could save a lot of time for waiting or shelving in the docking process of each link and improve the efficiency; The inclusion time of the two groups of papers into the outcome management system was P<0.05, which was positively correlated with the increase of the active participation rate of medical personnel by the online signature method. Conclusions:The net sign method can timely discover the risk factors of academic misconduct and prevent different forms of academic misconduct in the bud, which is of positive significance to the management of hospital scientific research results and even to boost the development of discipline construction. The method has the advantages of high participation, rapid approval and obtaining evidence according to law.

Objective:To investigate the role of LncRNA ZBED3-AS1 in osteoblast proliferation and differentiation in osteoporotic rats through regulating miR-339-5p/Notch 1.Methods:The rat models of sham operation (Sham) group and model (Model) group were established, and the bone mineral density (BMD) of rats was examined. Rat osteoblasts were isolated and the expression of ZBED3-AS1 and miR-339-5p was detected by qRT-PCR. The osteoblasts of rats in Sham group and Model group were divided into different groups and transfected. CCK8, alizarin red (AR-S) staining and alkaline phosphatase (ALP) staining were used to detect the proliferation and differentiation ability of cells in each group. The distribution of ZBED3-AS1 in cells was determined by FISH assay. Double luciferase report confirmed the relationship between ZBED3-AS1 and miR-339-5p as well as miR-339-5p and Notch 1.Western blot was used to detect the expression of Notch pathway related factors.Results:The bone mineral density of femur in Model group was significantly lower than that in Sham group ( P=0.0057) . Compared with Sham group, the expression of ZBED3-AS1 in osteoblasts of Model group was lower, while that of miR-339-5p was higher (all P<0.05) . Overexpression of ZBED3-AS1 could promote the proliferation and differentiation of osteoblasts, while knockdown of ZBED3-AS1 could inhibit the proliferation and differentiation of osteoblasts (all P<0.05) . ZBED3-AS1 could regulate miR-339-5p as ceRNA (all P<0.05) . Overexpression of miR-339-5p can inhibit the proliferation and differentiation of osteoblasts, which can be partially saved by overexpression of ZBED3-AS1. Notch 1 was confirmed as a target of miR-339-5p, at the same time, interfering with the expression of ZBED3-AS1/miR-339-5p can affect the expression of Notch-1 protein, and the regulation of ZBED3-AS1/miR-339-5p on osteoblasts may be realized through Notch pathway. Conclusion:ZBED3-AS1 can be used as ceRNA to regulate miR-339-5p, and then affect the proliferation and differentiation of osteoblasts in osteoporotic rats.

In recent decades, clinicians' research on the psychological distress of breast cancer patients mostly focuses on anxiety, depression and recurrence fear, and few researchers pay attention to the adverse effects of social constraints on breast cancer patients. This article briefly introduces the general situation of social constraints from the aspects of concept, characteristics, influencing factors and assessment tools, and summarizes the influence of social constraints on the psychological distress of breast cancer patients and intervention measures, in order to provide a theoretical basis for exploring effective intervention measures to help breast cancer patients who are psychologically distressed by social constraints.

Esophageal squamous cell carcinoma(ESCC)is a major histological subtype of esopha-geal cancer with a poor prognosis.Although several serum metabolomic investigations have been reported,ESCC tumor-associated metabolic alterations and predictive biomarkers in sera have not been defined.Here,we enrolled 34 treatment-naive patients with ESCC and collected their pre-and post-esophagectomy sera together with the sera from 34 healthy volunteers for a metabo-lomic survey.Our comprehensive analysis identified ESCC tumor-associated metabolic alterations as represented by a panel of 12 serum metabolites.Notably,postoperative abrosia and parenteral nutrition substantially perturbed the serum metabolome.Furthermore,we performed an examina-tion using sera from carcinogen-induced mice at the dysplasia and ESCC stages and identified three ESCC tumor-associated metabolites conserved between mice and humans.Notably,among these metabolites,the level of pipecolic acid was observed to be progressively increased in mouse sera from dysplasia to cancerization,and it could be used to accurately discriminate between mice at the dysplasia stage and healthy control mice.Furthermore,this metabolite is essential for ESCC cells to restrain oxidative stress-induced DNA damage and cell proliferation arrest.Together,this study revealed a panel of 12 ESCC tumor-associated serum metabolites with potential for monitor-ing therapeutic efficacy and disease relapse,presented evidence for refining parenteral nutrition composition,and highlighted serum pipecolic acid as an attractive biomarker for predicting ESCC tumorigenesis.