Objective To investigate the influence factors of central venous catheter related infections (CVC-RI) in postoperative patients with gastric carcinoma treated with parenteral nutrition,in order to provide scientific basis for prevention and treatment.Methods Using the retrospective study method,150 patients who treated with parenteral nutrition after operation of gastric carcinoma from December 2013 to March 2014 were selected.Information including age,sex,anamnesis,catheter indwelling time,infusion rate of nutrient solution,and so on were collected.Patients with central venous catheter related infections were set as infection group,patients without infection as the control group,and the group logistic regression analysis was used to analyze the collected data.Results 21 patients in infection group had CVC-RI,and the incidence was 14.00％ (21/150),while 129 patients in control group had CVC-RI.Univariate analysis showed there was significant difference between infection group and control group in age,anamnesis,catheter indwelling time and infusion rate of nutrient solution (x2=17.126,5.447,12.795,7.973,P＜0.05),however there was no significant difference in sex,health insurance,the success rate of catheterization and whether glutamine was in nutrient solution (P＞0.05);the group logistic regression analysis showed that age (OR=15.927,95％CI 3.305-76.756,P＜0.05)and catheter indwelling time (OR=3.511,95％CI 1.028-11.992,P＜0.05) were independent risk factors for CVC-RI,however infusion rate of nutrient solution (OR=0.140,95％CI 0.033-0.597,P＜0.05) was a protective factor.Conclusions For the postoperative patients with gastric carcinoma treated with parenteral nutrition,CVC-RI is closely related to age,catheter indwelling time and infusion rate of nutrient solution.So reducing catheter indwelling time,restoring the enteral nutrition under condition permission as so on as possible can reduce infection of elderly patients.

Objective The study aimed to explore the growth status of children under 3 years of age in Nankai district of Tianjin city,provide reference evidence for children's health care work of the local area.Methods Convenience sampling was used to collect physical examination records of children under 3 years old from Wangdingdi hospital in Nankai district of Tianjin city.The records of 2 880 children' physical examination data were collected.Results The median scores of weight for height (WHZ) of children of 6,9,12,18 months old were 0.74 (0.01,1.49),0.73 (0.08,1.38),0.58 (0.11,1.27),0.54 (0.14,1.22),while children of 3,24,36 months old were 0.29 (0.45,1.03),0.17 (0.61,0.95),0.22 (0.36,0.80),the difference between them had statistical significance,x2=21.71,P＜0.05.The median scores of height for age (HAZ) of children of 3,6,9,12,16 months old were 1.05 (0.33,1.76),1.09 (0.32,1.85),1.22 (0.41,2.02),1.00 (0.20,1.79),1.09 (0.19,1.99),while children of 18,24 months old were 0.79 (0.06,1.51),0.86 (0.15,1.56),the difference between them had statistical significance,x2=27.83,P＜0.05.The median scores of weight for age (WAZ) of children of 3,12,18,24,36 months old were 0.88 (0.29,1.46),0.96 (0.31,1.61),0.85(0.19,1.51),0.64 (0.04,1.23),0.91 (0.28,1.54),while children of 6,9 months old were 1.10 (0.43,1.76),1.09 (0.43,1.74),the difference between them had statistical significance,x2=36.95,P＜0.05.The prevalence of stunting,wasting and overweight were 0.3％ (10/2 880),0.8％ (22/2 880) and 9.3％ (267/2 880).The physical condition between premature and full term infants and post-mature infants had statistical significance,t=140.23,100.64,P＜0.05.Conclusions The growth and development status of children in Tianjin Nankai district under 3 years old was generally good,and there was no significant difference between boys and girls,however,overweight has been the most serious problem at present.Compared with full-term and post-mature infants,the physical condition of premature newborn was lower.

Objective To understand the characteristics of population distribution,risk factors and risk links of occupational exposure among health care workers(HCWs)in a hospital.Methods Occupational exposure among HCWs between January 2011 and June 2014 were monitored,data about occupational categories of HCWs,expo-sure locations,exposure links and exposure modes were analyzed statistically.Results Among 286 occupational ex-posure cases,the female and male HCWs accounted for 22.03% (n=63)and 77.97% (n=223)respectively;the incidence of occupational exposure in 2011 ,2012,2013 and January-June of 2014 was 38.81 %(n=111),26.22% (n=75),23.43% (n=67)and 11 .54% (n=33)respectively;occupational exposure of junior nurses,doctors,nurs-ing attendants,technicians,senior nurses and cleaners was 31 .97%,19.90%,15.79%,7.64%,4.17%,and 2.84% respectively;exposure mainly occurred at the time of sorting waste,withdrawing or changing needles,dis-carding sharps into sharps containers,surgical suturing or instruments passing,and puncturing (including drawing blood),the constituent ratio was 22.38%,19.58%,14.34%,12.94% and 11 .19%,respectively;the main loca-tions where exposure occurred were wards,operating rooms and injection (treatment)rooms,the constituent ratio was 51 .40%,19.58% and 11 .54% respectively.Conclusion Hospital should establish comprehensive occupational exposure monitoring and risk management system,strengthen standard prevention,enhance the training about occu-pational exposure among high-risk population,and monitor and intervene on risk factors and links,so as to reduce the incidence of HCWs’occupational exposure.

The metabolic profiles of control and MCF-7 cells treated with luteolin were analyzed separately using gas chromatography/mass spectrometry ( GC/MS ) to study the mechanism of the luteolin treatment on MCF-7 cells. Cell viability assays showed that luteolin had inhibition effect on MCF-7 cells. Partial least square discriminant analysis ( OPLS-DA) was used to process the metabolic data. Since cells in phase of S were increased significantly, we speculated that luteolin had a blocking effect on pentose phosphate pathway of MCF-7 cells, which contributed to its inhibition effect on proliferation of MCF-7 cells.

Objective To explore the clinical effect of new type rectal cancer radiotherapy individualized fixation device in the radiotherapy of rectal cancer. Methods From June 2015 to December 2016,60 patients with rectal cancer who accepted the external irradiation in Zhejiang Tumor Hospital were divided into two groups by random number table method. A group(31 cases) received new type rectal cancer radiotherapy position fixation devices with thermoplastic film. B group(29 cases) received simple foam pad with thermoplastic film. Before each treatment,Cone beam CT(CBCT) scan was conducted. The applied CBCT image and the planned reconstruction image were compared in the direction of X(left and right),Y(upper and lower)and Z(front and rear) axis. The setup error was recorded, and the correlation between the two groups was analyzed. Results The average setup error of patients in A group in X (left and right),Y(upper and lower),Z(front and rear) axis were (1. 61 ± 0. 18)mm,(1. 82 ± 0. 13)mm,(1. 91 ± 0. 11)mm,respectively. The average setup error of patients in B group in X(left and right),Y(upper and lower),Z (front and rear) axis were (2. 22 ± 0. 13)mm,(2. 43 ± 0. 14)mm,(2. 36 ± 0. 13)mm,respectively. There were statistically significant differences between the two groups(t=14. 958,17. 501,11. 283,all P＜0. 001). Conclusion The new type of rectal cancer radiotherapy position fixing device is more comfortable than the simple foam pad,and the setting error is smaller than the simple foam pad.

Objective To explore the set-up errors of position fixation with simple perforated foam pad in colorectal cancer radiotherapy and their causes as well as the improvement measures.Methods Sixty cases of color-ectal cancer patients undergoing radiotherapy were collected.Prone position was adopted with the position fixed by perforated foam pad and membrane.CBCT imaging was taken weekly before treatment,setup errors were corrected if necessary.Errors throughout the course of treatment for each patient were recorded and compared between patients, followed by analyzing the reasons of errors.Results Before calibration,the maximum errors on the direction of left and right (X-axis),front and back (Z),upside and downside (Y)in these 60 patients were 0.5cm,0.9cm and 0.7cm respectively with the average errors of (0.22 ±0.03)cm,(0.38 ±0.03)cm and (0.27 ±0.04)cm respec-tively.Conclusion The method of applying perforated foam pad and thermoplastic mask in colorectal cancer radio-therapy is currently the most commonly used in the clinical position fixation techniques,by which the small intestine, bladder and other pelvic tissues can be well protected.Due to poor comfort prone position,it is necessary to further improve perforated foam pad through improving the quality of the foam pad,thus improving patients comfort and posi-tioning repeatability and reducing position fixation errors.

According to 'National Standard of Undergraduate Teaching Quality for Nursing Science', the mode of community nursing practice was explored and implemented by the School of Nursing in Tianjin Medical University. Focus on competency, the syllabus of community nursing practice was revised. Optimizing the management system of community nursing practice, developing the team of high-quality teachers, building standardized community nursing practice bases, and improving the evaluation system of community nursing practice aimed to enhance comprehensive quality of nursing undergraduates and the quality of community nursing practice. Within the concept of "big health", our school is exploring the new mode of combining community nursing practice with health management-oriented nursing personnel training, which lays an important foundation for training applied nursing talents to meet the needs on development of community health services.

Background and Purpose:Prostate cancer is one of the most common cancers and the second leading cause of cancer-related death in Europan and North American males.The incidence of prostate cancer has also been increasing during the past few decades in China.It is widely accepted that this heterogeneity,which results from the tumor progression driven largely by genomic instability(genetic and/or epigenetic alterations)of tumor cells in primary tumor,endows specific populations of tumor cells with the unique character needed for invasion,migration,and metastasis colony formation in other organs and only these subpopulations possessing thost character can survive the potentially destructive journey from the primary tumor to the sites of metastases.The purpose of the present study was to explore the genes associated with invasion and metastasis of human prostate cancer cell line PC-3M in nude mice.Methods:After PC-3M cells were inoculated into orthotopic site(prostate) in a male nude mouse for two months,tumor cells were isolated from the primary tumor and lymph node metastasis,separately.Cell invasion and adhesion ability in vitro were first compared between two cells.Then metastasis-related genes differentially expressed between them were analyzed by utilizing cDNA microarray technique.Results:The in vitro cell invasion and adhesion potential of tumor cells from lymph node metastasis was significantly higher than those from primary tumor by 2.5 fold and 1.5 fold,respectively.Metastasis-related genes differentially expressed between those two sublines were identified,all of them were up-regulated in the tumor cells from lymph node metastasis and could be categorilized: 1.genes encoding cellular matrix-degrading proteolytic enzyme including cathepsin and MMP.2.genes encoding transcription factors.3.genes related to heterotypic adhesion of tumor cells.4.genes encoding cell surface receptors.Conclusions:There are significant differences in invasion and adhesion potential between cells from primary tumor and those from lymph node metastasis.Some differentially expressed molecules might be playing pivotal roles in promoting tumor cells to migrate from primary tumors to distant metastases,which may be helpful to elucidate the possible mechanism of metastasis in prostate cancer.

Objective To investigate the feasibility and safety of "G"-shaped surgical approach in laparoscopic pancreaticoduodenectomy.Methods The clinical data of 33 patients who received " G"-shaped laparoscopic pancreaticoduodenectomy in the First Hospital of Shanxi Medical University from April 2015 to March 2018 were retrospectively analyzed.Results All patients underwent surgery successfully.The time required for surgery ranged from 340 to 498 min,the blood loss ranged from 150 to 800 ml,and the specimen resection time ranged from 135 to 270 min.There were 10 cases of biochemical leakage,3 cases of B grade pancreatic fistula and 1 case of bile leak.Postoperative pathology confirmed lower bile duct adenocarcinoma in 17 cases,duodenal papillary adenocarcinoma in 11 cases and poorly differentiated adenocarcinoma of the pancreatic head in 5 cases.Conclusions " G"-shaped approach as a simple,effective and safe way for LPD,is particularly helpful for inexperienced hands.

ObjectiveTo investigate whether paeonol exerts a protective effect on mice with alcoholic liver injury by regulating the takeda G-protein-coupled receptor 5 （TGR5）/protein kinase A （PKA）/cAMP response binding element （CREB） signaling pathway mediated by Eubacterium. MethodC57BL/6 mice were randomly divided into five groups： normal group， model group， paeonol group （480 mg·kg^-1）， antibiotic group （Abs group）， and antibiotic + paeonol group. Lieber-DeCarli liquid was used to feed C57BL/6 mice on the second day of modeling for 10 days. The blood lipids， liver function， inflammatory factors， and oxidative stress levels in mice were measured. Hematoxylin-eosin staining （HE） and oil red O staining were used to observe the morphological changes and fat accumulation in liver tissue. 16S rDNA sequencing was used to detect the diversity of intestinal microbiota in the blank， model， and paeanol groups. Western blot was used to detect the effect of paeonol on the expression levels of protein related to the signaling pathway of atresia band protein 1 （ZO-1）， Claudin-1， and TGR5/PKA/CREB in mouse ileal tissue. ResultCompared with those in the blank group， the blood lipids， liver function， oxidative stress levels， and the expression of inflammatory factors in the model group increased （P<0.01）， and the liver fat vacuoles were obvious. The ileal mucosa was seriously damaged， and the protein contents of ZO-1， Claudin-1， and TGR5/PKA/CREB in the ileal tissue decreased significantly （P<0.01）. The intestinal microbiota changed， and the proteobacteria phylum increased significantly. The ratio of Bacteroidetes to Firmicutes decreased. The relative abundance of Dubosiella newyorkensis， Lactobacillus， Bifidobacterium， and other genera decreased， while the relative abundance of Escherichia-Shigella， Morganella， Providencia， and Proteus increased significantly. Compared with the model group， paeonol significantly reduced the blood lipids， liver function， oxidative stress levels， and expression of inflammatory factors in mice with alcohol diet-induced liver injury （P<0.05）， decreased liver fat vacuoles， improved and restored the ileal intestinal barrier， and restored the normal structure of hepatocytes and ileal cells. The intestinal microbiota disorder caused by alcohol was improved， and the relative abundance of beneficial bacteria such as Eubacterium spp. was increased. The protein expression levels of ZO-1， Claudin-1， and TGR5/PKA/CREB in ileal tissue were increased （P<0.05）. ConclusionPaeonol has a protective effect on alcoholic liver injury in mice， and the mechanism of action is achieved by regulating the Eubacterium-mediated TGR5/PKA/CREB signaling pathway to ensure anti-inflammatory effect and improve the intestinal barrier.