Objective To compare the clinical effects of laparoscopic Nissen fundoplication (LNF)combined with highly selective vagotomy(HSV)(LNFHSV)in treatment of gastroesophageal reflux disease(GERD),and to provide reference for the clinical application of LNFHSV.Methods 22 patients with a history of GERD unrelieved by medication and underwent LNFHSV were selected.At the same time ,36 patients with GERD underwent LNF were used as control.The mean operation time,hospital stay,incidence of main operative complications,HSS complete remission and Demeester scores of the patients in two groups were retrospectively analyzed.Results The Demeester scores,hospital stay, incidence of main operative complications of the patients in two groups before operation had no significant differences(P>0.05).The mean operation time in LNFHSV group (90 min±35 min) was longer than that in LNF group(65 min± 21 min).The Demeester scores of the patients in two groups after operation had significant difference(P<0.05).The HSS complete remission rate of the patients in LNFHSV group was 91.1%,the part remission rate was 8.9%,and no effectiveness was 0;they were 83.3%,13.8%,and 2.8% in LNF group;there were significant differences between two groups(P<0.05).Conclusion LNFHSV has better effectiveness in controlling GERD than LNF procedure.

[Objective] To investigate the possible effect of microRNA-374 (miR-374) expression on tumor cells' proliferation and invasion and particular mechanism.[Methods] MiR-374 overexpression lentiviral vector (Lv-miR-374) and a control lentiviral empty vector (LEV) were stably transfected into human glioma U251 and U87 cells,to evaluate the effect of miR-374 on cell proliferation and invasion ability.Target relationship between miR-374 and PTTG were researched by dual luciferase report gene assay.Expression level of correlative signaling pathways of the downstream gene protein was analyzed by Western blot.[Results] We revealed that the overexpression of miR-374 dramatically suppressed glioma cell growth and invasion in vitro.Target relationship between miR-374 and PTTG was confirmed by dual luciferase report gene assay.And decreased protein expression of PTTG,bFGF,AKT,MMP2,and p70S6K was consistent with the effect of miR-374 overexpression.[Conclusion] Decreased miRNA-374 is an unfavorable prognosis marker and promotes glioma cell growth and invasion via direct targeting PTTG.Our findings provide new insights into the role of miR-374 in the development of gliomas,and implicate the potential application of miR-374 in cancer therapy.

Objective To investigate the relationship of lacunar infarction (LI) and white matter lesion with cognitive impairment in patients with subcortical ischemic vascular disease (SIVD) Methods Fifty-three patients were diagnosed as SIVD according to the criteria of Erkinjuntti. The symptoms and signs were recorded by an interview and examination, and neuropsychological assessment and magnetic resonance imaging (MRI) were performed. A semi-automated MRI quantitative method was used to measure the volume of white matter hyperintensity (WMH) and the number of LI was counted. Correlation and the partial correlation analysis were performed to examine the relationship of general cognitive function with the volume of WMH and the number of LI. Results The pseudobulbar paralysis symptom and the upper motoneuron injury sign were the most common in these patients (18.9% and 37.7%). Correlation analysis showed that there was positive correlation between the volume of WMH and age (r = 0. 518, P < 0. 05), and there was negative correlcction between mini-metal state examination (MMSE) scures and the volume of WMH (r=-0.514, P<0. 05), After controlling confounding factors, only age was positively correlated with the volume of WMH (r=0. 400, P=0. 004). There were negative correlation between the number of LI, the volume of WMH and MMSE scores(r=-0. 456,-0. 514,-0. 385,-0. 382;all P<0. 05), and the years of education was positively correlated with MMSE scores (r= 0. 518, P< 0. 001). Conclusions Age may not be the main risk factor for cognitive impairment in patients with SIVD. The volume of WMH and the number of LI are independent risk factors for cognitive impairment in patients with SIVD. Patients with severer SIVD or more LI show poorer performance on cognitive function.

Objective To investigate the relationships among current alexithymia, social relational quality and quality of life in breast cancer patients receiving chemotherapy. Methods By convenient sampling method, from April 2015 to September 2016, totally 151 patients were invited to complete demographic questionnaire, Toronto alexithymia scale, social relational quality scale and functional assessment of cancer therapy-breast. The Pearson correlation method was used to analyze the relationship among current alexithymia, social relational quality and quality of life. Results All of the patients got the average score (59.11±15.75) on Toronto alexithymia scale, which was moderate level. The total scores of social relational quality and life quality were (53.45±5.13) and (93.84±15.17). There was a negative relationship between alexithymia with social relational quality (r=-0.441) and quality of life (r=-0.597) (P<0.05). Conclusions Breast cancer patients has serious alexithymia after the operation. Nurses can carry out activities which gives patients more opportunities to express emotion, encourage patients to face difficulties and challenges, communicate with others actively, and get more support from others and encourage family members participate in the patient care process to reduce alexithymia and improve quality of life.

Objective:To investigate the current status of affective commitment and feedback-seeking behavior in junior nurses in three Class Ⅲ Grade A hospitals in Wenzhou and to explore the effect of affective commitment of junior nurses on feedback-seeking behavior.Methods:Methods Using the convenient sampling method, a total of 400 junior nurses in 3 ClassⅢ Grade A hospitals in Wenzhou in Zhejiang Province from October to December 2019 were selected as research objects. General data questionnaire, Affective Commitment Scale and Feedback-Seeking Behavior Scale were used to investigate the effect of affective commitment of junior nurses on feedback-seeking behavior. In this study, a total of 400 questionnaires were issued, and 372 valid questionnaires were collected, with an effective recovery rate of 93%.Results:The total score of Affective Commitment Scale for 372 junior nurses was (29.07±4.86) and that of Feedback-Seeking Behavior Scale was (40.47±6.47) . The results of univariate analysis showed that there were statistically significant differences in the feedback seeking behavior scores of junior nurses in terms of title, education background, department and employment mode ( P<0.05) . Pearson correlation analysis showed that the total score of Affective Commitment Scale for junior nurses was positively correlated with the total score of Feedback-Seeking Behavior Scale ( P<0.05) . Stratified regression analysis results showed that affective commitment had a predictive effect on feedback-seeking behavior of junior nurses ( P<0.05) . Conclusions:The affective commitment and feedback-seeking behavior of junior nurses are in the middle level and need to be further strengthened. Affective commitment positively affects feedback-seeking behavior, so nursing managers can improve the level of feedback-seeking behavior by strengthening the affective commitment level of junior nurses.

Objective To investigate the clinical pathological characteristics and prognosis of primitive neuroectodermal tumor (PNET) of breast.Methods Patients with breast PNET were retrieved from CNKI,Pubmed,Europe PMC and other databases from Jan.1980 to Dec.2016.The clinical data of one patient with breast PNET in our hospital were analyzed retrospectively.Results 18 cases had painless,rapid growth mass as the main clinical features.The pathological morphology showed small round cell tumors,PAS staining positive.Immunohistochemistry CD99 and Fli-1 characteristic expression were the main indexes for the diagnosis of breast PNET.The positive expression of Vimentin,NSE,Syn and negative expression of CK,EMA,Desmin,CgA,LCA,S-100 also played an important role in the diagnosis of breast PNET.The positive expression of genetic marker EWSRI was the golden standard for diagnosis of breast PNET.The size of the tumor,surgical treatment,lymph node metastasis,distant metastasis and chemotherapy were the important factors that affect the prognosis of the PNET.The survival rates of 1 and 3 years were 71.4％ and 33.3％ respectively.Conclusions Breast PNET is a rare tumor with poor prognosis,and its diagnosis is highly dependent on pathology.Surgery can significantly improve the prognosis of the patients.Surgery should be the main treatment,combined with radiotherapy and chemotherapy.The current study does not show evidence of effectiveness in terms of endocrine or targeted drug therapy for breast PNET patients.

Objective To explore the effect of modified anal injection on preventing fecal incontinence caused by glycerol enema and reliving constipation in elderly orthopedic patients. Methods A total of 78 aged patients with constipation was selected and divided into experimental group (38 cases, modified anal injection enema method) and control group (40 cases, traditional enema anus method) according to the random numbertable method. And then, we compared the situation of fecal incontinence and relieving constipation. Results In the control group, there were 10 patients with fecal incontinence, while there was no case of fecal incontinence in the experimental group, it was statistically significant between them (P<0. 01). After using the enema, there were 14 ineffective cases in the control group and 5 ineffective cases in the experimental group, and the differences were statistically significant between the two groups (P <0. 05). The effect in the experimental group was better than that in the control group. Conclusions Modified anal injection enema can prevent fecal incontinence caused by enema and relieve constipation in elderly orthopedic patients.

In the emergency of the outbreak of COVID-19 in December 2019, Shaanxi Provincial Health Committee mobilized several medical teams from major hospitals in the province, and, by relying on Xi’an Chest Hospital, jointly established an anti COVID-19 consortium to control and eradicate the epidemic in a short time. Information support is an important guarantee for winning this battle. In order to realize the efficient cooperation among multiple medical teams, we have carried out some exploratory and innovative information support services on the basis of the original information system of the chest hospital. In this process, we have gone through some detours. Some compromises were made on some problems that could not be solved in the short term. Finally, in an environment full of uncertainty, a set of information support management system with basically smooth operation was built through rapid trial and error adjustment. The system mainly includes the following aspects: support of the organizational structure and operation process of the anti-epidemic consortium, support for medical collaboration related businesses of multiple medical teams, and support for statistical reports and online meetings. Information support has played a very important role in this action, and this practice has also accumulated experience for us to deal with similar situations in the future.