Objective To understand the cognition of ICU syndrome by ICU nurses in Guangdong province. Methods Through questionnaire filling in, this investigation was made on the first hatch of ICU nurses dispatched to Hung Kong for ICU specialized training by Guangdong province. Information collected included the nurses' personal information and their knowledge about ICU syndrome. Results The sub-jects' knowledge about ICU syndrome was scanty, and was not related to their years of work, professional ti-tles, academic degrees or administrative duties. The overwhelming majority of the subjects had not paid at-tention to the disease in clinical work. Most departments had not formulated guidelines whatsoever on nurs-ing for ICU syndrome. In assessing the ICU syndrome, the vast majority of nurses relied on their clinical experience, with none of them relying on the confusion assessment method for the intensive care unit (CAM-ICU). Only very few of the subjects acquired some knowledge about the syndrome during their study at colleges. Conclusions The ICU nurses in Guangdong province should attach importance to ICU syn-drome and strengthen the study of related knowledge in their work and study. And it is essential to popular-ize CAM- ICU and to build a standard assessment system and work out the intervention measures for ICU syndrome.

Objective To study expression and clinical significance of nm23 genes in primary breast carcinomas. Methods The expression of nm23 was detected by immunohistochemical S-P method in 286 cases of primary breast carcinomas. Results The positive rate of nm23 expression was 65.7%. There was not a significant correlation between the positive rate of nm23 and patients' age, tumor pathological types. There was a significant relation between the expression of nm23 and tumor clinical stage, axillary lymph node metastasis, and the positive rate of nm23 expression in the cases of clinical stage I without axilliary lymph node metastasis was significantly higher than that in the cases of clinical stage III with axilliary lymph node metastasis. Conclusion The expression of nm23 gene was negatively related with clinical stage and axilliary lymph node metastasis in breast carcinomas, which indicated that nm23 gene expression may serve as an index for predicting lymph node metastasis and the prognosis of breast carcinoma.

ObjectiveTo explore the effect of ultrasonic harmonic scalpel on stress after radical resction of esophageal carcinoma.MethodsAll 115 patients of esophageal carcinoma undergone radical esophagectomy were analyzed retrospectively.60 patients were performed with ultrasonic harmonic scalpel,the other 55 patients were performed with electrotome.The drainage volume of 72h after operation,postoperative complications and hospital days were analyzed.White blood cell count,Neu,CRP and blood glucose level were tested 2 days after operation.ResultsThere was significant difference in the drainage volume of 72h after operation (P ＜ 0.05 ),but the postoperative complications and hospital days had no obvious difference.White blood cell count,Neu,CRP and blood glucose were obviously increased after operation( all P ＜ 0.05 ) ;the barmonic scalpel group was dramatically decreased as compared with the electrotome group except blood glucose ( all P ＜ 0.05 ).ConclusionRadical resection of esophageal carcinoma using ultrasonic harmonic scalpel appears to decrease the drainage volume of 72h after operation and less the stress.

Objective To investigate the significance of preoperative and postoperative enteral nutrition support in gastric cancer patients with nutritional risk.Methods The clinical data of 72 gastric cancer patients with nutritional risk admitted in our department were analyzed.All the patients were randomly allocated into two groups.36 patients in the control group received only intravenous nutrition postoperatively (PN group).36 patients in the treatment group received enteral nutrition support from the fifth day before operation to eighth day after operation (EN group).The body weight,total protein,albumin,transferrin and prealbumin were measured on the fifth day before operation,the operation morning,the first day and the eighth day after operation.Results On the operation morning,the transferrin and prealbumin of the EN group were higher than those in PN group significantly(P ＜0.05).In the eighth day after operation.the treatment group patients showed significant increase in the body weight,total protein,albumin,transferrin and prealbumin compared with those in the control group(P ＜ 0.05).On the operation morning,the transferrin and prealbmnin of EN group were increased significantly than on the fifth day before operation(P ＜ 0.01).Conclusion The preoperative and postoperative enteral nutritional support can improve the nutritlonal condition in the gastric cancer patients with nutritional risk.The preoperative enteral nutritional support can improve the patients' nutritlonal condition and reserves before operation,and reduce adverse reaction of enteral nutrition.

Objective To detect the effect of oridonin(ORI)on the gene expression of human esophageal carcinoma cell SHEEC and to screen the tumor cell apoptosis target genes.Methods The gene expression of human esophageal carcinoma cell SHEEC without and with ORI induction for 1 hours and 8 hours were detected with microarray technique,respectively.The differentially expressed genes were identified and verified with fluorecent quantitative PCR.Results A total of 1011 genes showed up or down regulation more than twice after ORI induction(including 280 genes after 1 hour and 731 genes after 8 hours induction respectively).In these genes,17 genes with the top extent of up or down regulation were identified,which were involved in the cell signal transduction,transcription regulation,and cell apoptosis.These 17 differentially expressed genes were verified with real-time PCR,and 12 genes were statistically significant.Conclusion In the 12 differentially expressed genes with statistically significance,there may have tumor cell apoptosis target genes induced by ORI through mitochondrion route.

Objective To investigate the effect of over-expression of ROBO4 on permeability of human renal glomerular endothelial cells (HRGECs) in high glucose medium.Methods HRGECs infected with recombinant lentiviral vector ROBO4 were cultured in high glucose or low glucose medium in vitro.The protein levels of ROBO4 and ARF6 in each group were detected by Western blotting.The endothelial permeability was measured by the effiux of fluorescein isothiocyanate-dextran (FITC-Dextran)permeated through the monolayer endothelial cells using Transwell cell model system.The cell viability after lentivirus transfection was measured by CCK8 assay.Results The transfection rate of lentiviruses in HRGECs reached 80％ 72h after,and obvious overexpression of ROBO4 protein was in transformed cells compared with the empty vector group (P＜0.05).The lentivirus-mediated ROBO4 transfection did not affect cell viability of HRGECs.Compared with the low glucose group,the expression of ROBO4 increased obviously after 12h,but declined after 24h (P＜0.05),and reached to minimun after 72h (P＜0.05).On the contrary,the expression of ARF6 increased after 12h,and the increase reached to the maximum after 72h (P＜0.05).Furthermore,the vascular permeability increased gradually after 24h,and reached to the maximum after 72h (P＜0.05) in high glucose group.Compared with the empty vector group,the over-expression of ROBO4 inhibited the expression of ARF6 significantly,and the FITC-Dextran permeability reduced obviously.Conclusion Over-expression of ROBO4 may significantly enhance the barrier functions of HRGEC in high glucose medium,and ROBO4 activation may be a potential therapeutic approach in diabetic nephropathy.

Objective To estimate the relationships between lipoprotein-associated phospholipase A2 (Lp-PLA2) activity and cerebral feeding artery athemsclemsis.Methods The blood samples were obtained from 148 atheroselerosis patients (atheroselerosis group) and 40 normal controls (control group).Activity of plasma Lp-PLA2 and traditional factors were determined.Logistic and regression model was adopted to analyze the roles of Lp-PLA2 and generally inflammatory risk factors in athemselemsis.Results Lp-PLA2 activity was significantly higher in atheroselerosis group than that in control group [(29.84±3.50)lesion number showed positive correlation with Lp-PLA2 (r=0.491,P＜0.01 and r=0.249,P=0.026).Adjusted other risk factors,Lp-PLA2 was an independent risk factor in cerebral feeding artery atherosclerosis.Conclusion Lp-PLA2,a novel inflammatory marker,is an independent risk factor of cerebral feeding artery atherosclerosis.

Objective To establish a function model to modulate the tube current according to the chest circumference at Coronary CTA scan,and to evaluate the feasibility of using the function model individually.Methods Sixty-eight consecutive patients who underwent thoracic scan with automatic current modulation were studied to establish a function model of tube current and chest circumference.The other 64 consecutive patients underwent coronary CTA scan using the new function model.The image quality was scored,and the noise,tube current and radiation dose were recorded and statistically evaluated.Results The POW function model was the best one to adjust tuber current to the chest circumference (R2 =0.691,P ＜ 0.05).The mean image quality score,noise,tube current,radiation dose (CTDIvol) and dose-length product (DLP) were (3.38±0.72) scores,(31.02 ±3.97) HU,(390.63± 89.30) mA,(34.83±10.72) mGy,(751.67 ±175.16) mGy·cm,respectively.Conclusions Tube current modulation based on the chest circumference would be feasible to reduce the radiation dose individually in coronary CT angiography.

Objective To investigate the effects of infrasound at different frequencies on the pathological morphology of mouse testes and to explore the possible involvement of β-cateinin in the mechanism of injury. MethodsSixty adult BALB/C mice were randomly divided into 2 groups.One group of 6 mice were the controls without infrasound exposure.The other group with 54 mice was evenly divided into 3 subgroups of 18 exposed to 130 dB infrasound at 4 Hz,8 Hz or 20 Hz for 2 hours daily.The pathological morphology of the mice's testes was observed 3,9 and 21 h after exposure.Immunohistochemical staining was used to examine β-catenin expression 3 h after exposure.ResultsMarked damage was observed in the morphology of the testicular cells of rats in the 8 Hz group.Cell denaturation was found in germinal cells.The cell structure was loosened and the cell junctions had decreased or disappeared.The damage was most serious at 3 h after exposure.But at the same time point,pathological damage of testicular cells was not obvious in the 4 Hz group,with only a few testes cells swollen.The morphology of testicular tissue of mice in the 20 Hz subgroup exhibited no significant difference from the control group.β-catenin was mainly found in the membranes of Leydig cells,Sertoli cells and myoepithelial cells in all of the mice,and there was no significant change in the expression level or distribution pattern between the exposed mice and the controls.No expression ofβ-catenin was found in spermatogenic cells. ConclusionInfrasound at 4 Hz or 8 Hz can damage testicular tissue,at least in mice.At 20 Hz there is no significant effect on the testes.The loosened cell structure might have been caused by the mechanical force produced by the infrasound and not by any decrease of β-catenin.

Objective To improve detectable rate of gastric schwannoma by endoscopic ultrasonography (EUS). Method Clinical data and endoscopic ultrasonography (EUS) imaging features of 4 cases were retrospectively ana-lyzed which diagnosed as gastric schwannoma pathologically and immunohistochemically while diagnosed as gastric stromal tumor by EUS from May 2008 to June 2015 and reviewed the literature. Results 4 cases of gastric schwan-nomas are female and benign, all 4 lesions are solitary, 3 in gastric body, and 1 in fundus by endoscopic. By EUS, all lesions are originated from muscularis propria, hypoechoic change, even echoes and clear board without calcifica-tion or cystic changes. 2 cases have halo artifacts around the lesion. Literature review found that gastric schwannoma tended to occur in female, halo artifacts could be the feature of gastric schwannoma, calcification or cystic changes were rare in gastric schwannoma which were common in gastric stromal tumors. Conclusion It was difficult to distin-guish gastric schwannoma and gastric stromal tumors that originated from muscularis propria by EUS. For female patients with lesions originated from muscularis propria, originated from muscularis propria and occurred in gastric body, it was necessary to observe lesions whether there was being calcification or cystic and halo artifacts. Integrated all these performance, we should be in consideration of gastric stromal tumors, meanwhile, excluding the possibility of gastric schwannoma.