Objective To discuss the nursing points for patients with malignant obstructive jaundice who are receiving biliary stenting combined with linear 125I seeds strand implantation. Methods A total of 41 patients with malignant obstructive jaundice were enrolled in this study. Biliary stenting combined with linear 125I seeds strand implantation was performed in all the 41 patients. Sufficient preoperative preparation and psychological intervention were carefully implemented. During the operation, active cooperation with the surgical procedures and close observation of patient’s vital signs as well as adverse reactions such as nausea and vomiting were strictly carried out. After the treatment the management of PTCD drainage tube, the protection of radiation and the early detection of complications were further emphasized. Results The technical success rate of biliary stenting together with linear 125I seeds strand implantation was 100%. The serum total bilirubin levels, determined at one week, one and 3 months after the treatment, were significantly decreased when compared with the preoperative data. Clinically, the jaundice basically subsided. Bile-cardiac reflex occurred in one case and displacement of PTCD drainage tube in 2 cases. Twelve patients developed chills and fever after operation. Acute renal insufficiency occurred in one patient, which was relieved after effective management. The median survival time was 10.9 months. Conclusion Careful and comprehensive preoperative preparation can ensure a successful operation. Intraoperative close observation of patient’s condition and skilled cooperation with the operator, and high quality postoperative nursing measures and close observation for early signs of complications are essential nursing points to ensure that the patients can safely get over the rehabilitation period.

Objective To investigate the lonely behavior characteristics and related factors of chronic obstruetive pulmonary disease(COPD)patients.Methods 99 eases with stable patients with COPD and 90 healthy subjects were surveyed by SDS,ESLI.Relevant factors were analyzed.Results Patients with COPD showed difierent degrees of emotional isolation[(9.90±3.97),(6.15±5.22),F=82.539,P＜0.01)]and social intercourse isolation[(8.00±3.53),(4.31±2.46),F=73.540,P＜0.01)].Emotional isolation was mainly.Moderate emotional isolation and general social intercourse isolation were predominant,and emotional(r=0.399,t=3.476,P＜0.01)and social intercourse isolation(r=0.372,t=3.154,P＜0.01)were related to depression.Conclusion Patients with COPD presented obvious emotion and social intercourse isolation behavior.

To isolate and culture adipose stromal cells (ASCs), and study the effect of cytokines secreted by ASCs on endothelial cells, human adipose tissue was digested with collagenase type I solution and ASCs were derived by culture. The cells surface phenotype was examined by flow cytometry. ELISA was used to detect the secretion of VEGF, HGF, SDF-1 alpha and RT-PCR was employed to detect the expression of their mRNA. Then the ASC medium was utilized to culture human umbilical vein endothelial cells ECV304. Cells were counted by hemacytometer to determine the proliferation and Annexin V/ PI was employed for the examination of the apoptosis rate of ECV304. ASCs were derived by culture and expressed CD34, CD105 while they did not express CD31 or CD45. ASCs secreted cytokines such as VEGF, HGF and SDF-1 alpha so the ASC medium could stimulate proliferation and counteract apoptosis of endothelial cells (P < 0.05). Bcl-2 mRNA was also found to be up-regulated in the endothelial cells. It is concluded that ASCs can secrete cytokines and has significant effect on the proliferation of endothelial cells and apoptosis.

Objective:To evaluate influence of electroacupuncture combined point massage on aptients with cartid ar- tery arteriosclerosiss.Methods:A total of 106 patients with carotid atherosclerosis were randomly divided into rou- tine group (n=54,received health education based on routine therapy)and electroacupuncture+ massage group (n=52,received additional electroacupuncture and point massage based on routine group).Both groups were treated for two courses,20 times/course, 1 time/d.Carotid intima-media thickness (IMT)and thickness of carotid plaques were measured and compared between two groups before and after treatment.Results:There were no sig- nificant difference in thickness of carotid plaques and IMT between two groups before treatment,P>0.05 all. Compared with before treatment,after treatment,there were significant reductions in thickness of carotid plaques [left:(0.104±0.103)mm vs.(0.044±0.031)mm,right:(0.111±0.093)mm vs.(0.055±0.046)mm]in elec- troacupuncture + massage group,and they were significantly thinner than those of routine group [left:(0.190± 0.175)mm,right:(0.223±0.183)mm],P<0.01 all;significant reductions in carotid IMT [left:(0.096±0.021) mm vs.(0.086±0.019)mm,right:(0.091±0.019)mm vs.(0.087±0.018)]in electroacupuncture + massage group,and they were significantly thinner than those of routine group [left:(0.105±0.016)mm,right:(0.103± 0.020)mm],P<0.05 or <0.01.Conclusion:Electroacupuncture combined point massage can effectively reduce thickness of carotid plaques and carotid intima-media thickness.

Objective To explore the effects of long-term Tai Ji exercise on risk factors of cardiovascular diseases and incidence of chronic diseases. Methods The elderly involved were divided into control group (n=62) and Tai Ji group (n=63). Both of them received 2-years health education. The Tai Ji group exercised with the frequency of 30~40 minutes each time, 3 times a week, while the control group didn't change their daily behavior. They were observed 2 and 6 years later. Results 2 years later, the blood pressure, weight and waistline decreased in Tai Ji group compared with the control group (P<0.05). After 6 years followed, 1 people died and 4 people occured cardiovascular diseases in Tai Ji group, while 2 people died and 12 people occured cardiovascular diseases in the control group. The incidence of chronic diseases was lower in Tai Ji group (9.52%) than in the control group (33.87%) (P<0.01). And the blood pressure, waistline, and hipline in Tai Ji group decreased significantly compared with the control group (P<0.001). Conclusion Long-term Tai Ji Exercise can ameliorate the risk factors of cardiovascular diseases and reduce the incidence of chronic diseases.

Objective To evaluate the clinical effect of intervertional devascularization and surgical devascularization in treatment of patients with upper gastrointestinal hemorrhage .Methods Ninety-nine cases treated with intervertional devaacularization or surgical devascularization were retrospectively studied including 48 cases in intervertional group and 51 cases in surgical group.The postoperative resection, complications and rebleeding time were compared by X2 test and t test between two methods.Results The 12 months, 24 months and 36 months cumulative rebleeding rates after intervertional devascularization were 12.5% (6/47) ,24.5% (11/45), 27.9% (12/43) respectively.The rate after surgical devaacularization were 29.2% (14/48) ,44.7% (21/47), 48.9% (22/45) respectively.There were statistically significant differences between the intervertional and surgical groups (X2=3.843,4.150,4.083, P < 0.05).The complications of intervertional devascularization included fever 85.4% (41/48), bellyache 81.3% (39/48), portalvein thrombosis 4.2% (2/48), intraabdominal hemorrhage 2.1% (1/48), infection 2.1% (1/48) and death 2.1% (1/48).The complications of surgical devaacularization included fever 68.6% (35/51), bellyache 62.7% (32/51), generous hydroperitoneum 25.5% (13/51), portalvein thrombosis 37.3% (19/51), splenic vein thrombosis 11.8% (6/51), hepatic encephalopathy 3.9% (2/51), hepatorenal syndrome 2.0% (1/51), intraabdominal hemorrhage 2.0% (1/51), death 3.9% (2/51) and infection 15.7% (8/51).There were statistically significant differences of fever, bellyache, generous hydroperitoneum, portalvein thrombosis, splenic vein thrombosis between the intervertional and surgical groups(X2=4.174,3.098,16.199,6.011,5.536,14.085,P <0.05).Conclusions The intervertional devascularization procedure is simple, safe and effective method for treating upper gastrointestinal hemorrhage for portal hypertensive.The clinical effect is better than that of surgical devascularization.

Objective To evaluate the value of interventional embolism therapy for metastatic carcinoma of adrenal gland.Methods Fifty four patients with metastatic carcinoma of adrenal gland were treated with interventional catheterization perfusion and embolism therapy.Results Except one case with failure of finding the feeding artery, totally 76 sessions of interventional therapy were performed on 53 patients. Technical successful rate was 98.1% with 100% of complete release of clinical sign in 14 patients. Good deposition of iodized oil in tumor area reached 75.4% in three months after the procedure. Severe complication rate ocurred in 1.88%. Conclusion Interventional therapy seemed to be safe and effective for patients with metastatic carcinoma of adrenal gland.

[Objective] To explore the role of endothelin-3 (ET-3) on epithelial-to-mesenchymal transition in a malignant melanoma cell line A375.[Methods] A375 cells were cultured in vitro and classified into 3 groups to be treated with ET-3 at 100 nmol/L (ET-3 group),co-cultured with ET-3 at 100 nmol/L and endothelin receptor B (ETRB) antagonist BQ788 at 100 μmo1/L (ETRB antagonist group),or to remain untreated (blank control group).After additional 24-hour culture,Transwell chamber assay was used to detect the invasive capability of A375 cells,real time-PCR to measure the mRNA expressions of Twist and Slug,and Western blot to determine the protein expression of E-cadherin,vimentin,Twist and Slug.The changes in the morphology of A375 cells were observed.Data were assessed by analysis of variance and Scheffe's method.[Results] In the Transwell assay,the number of A431 cells permeating through the basement membrane was 4.200 ± 0.837,9.400 ± 0.548 and 3.400 ± 0.894 respectively in the blank control group,ET-3 group and ETRB antagonist group (F =88.44,P ＜ 0.01 ),suggesting that ET-3 could promote the metastasis of A375 ceils,while BQ788 could block the promotive effect of ET-3.The epithelial-to-mesenehymal transition was obvious in cells treated with ET-3 alone,but was inapparent in cells treated with ET-3 and BQ788.The ET-3 at 100 nmol/Lsignificantly decreased the protein expression of E-cadhefin from 0.33 ± 0.002 (blank control group) to 0.28 ±0.007,but increased that of vimentin from 0.83 ± 0.014 (blank control group) to 1.16 ± 0.003,while BQ788upregulated the E-cadherin expression to 0.42 ± 0.008 and downregulated the vimentin expression to 0.75 ±0.030,and significant differences were observed in the E-cadherin expression and vimentin expression among the ET-3 group,ETRB antagonist group and blank control group (F =329.98,262.94,respectively,both P ＜ 0.01 ).A significant increase was observed in the mRNA and protein expression of Slug (F=376.94,288.87,both P＜ 0.01 )and Twist (F=215.62,156.96,P＜ 0.01 and 0.05) in A375 cells after treatment with ET-3.[Conclusion] ET3/ETRB axis may promote the epithelial-to-mesenchymal transition in A375 cells likely by regulating the expression of E-cadherin,vimentin and two important transcription factors Twist and Slug.

Objective To investigate the value of muhiple inflammatory cells and clinical score in early diagnosis and prognosis assessment of trauma sepsis risks.Methods This retrospective control study enrolled 209 severe trauma patients admitted from January 2010 and May 2016.White blood cell count,lymphocyte count and percentage,monocyte count and percentage,neutrophil count and percentage,ratio of neutrophil to lymphocyte count (N/L),acute physiology and chronic health evaluation (APACHE) Ⅱ score,sequential organ failure assessment (SOFA),improved early warning score (MEWS),Glasgow coma score (GCS),multiple organ dysfunction syndrome (MODS) score and lactic acid (LAC) were collected on the day of admission and 3,5,7 days after trauma.These data were applied to construct weighted and biological score models for early diagnosis and prognosis of traumatic sepsis.Receiver operating characteristic curve (ROC) was performed and area under the curve (AUC) was calculated to measure the value of the two models in early diagnosis and prognosis of sepsis.Results AUC of the weighted model combined by APACHE Ⅱ score,SOFA score and MEWS was 0.729 on the day of admission.AUC of the weighted model combined by inflammatory cells was 0.680 and AUC of the biological score model was 0.800 3 days after trauma (P ＜ 0.05).AUC of the weighted models combined by inflammatory cells was 0.798 and AUC of the biological score model was 0.812 5 days after trauma (P ＜ 0.05).AUC of the weighted models combined by inflammatory cells was 0.706 and AUC of the biological score model was 0.713 7 days after trauma (P ＞ 0.05).AUC of the biological score model had significant difference 3 days and 5 days after trauma (P ＜ 0.05).Of the weighted model combined by APACHE Ⅱ score,MODS score,GCS and LAC to evaluate the prognosis of sepsis,the AUC showed significant difference on the day of admission (0.838),3 days after trauma (0.878),5 days after trauma (0.947) and 7 days after trauma (0.936) (P ＜ 0.05).Conclusions Biological score possesses better effect on early diagnosis of sepsis 3 days after trauma.Weighted model combined by APACHE Ⅱ score,MODS score,GCS and LAC can effectively predict the prognosis of sepsis 5 days after trauma.

Objective To discuss the method, safety and clinical value of biliary stenting combined with 125I seed implantation intracavitary irradiation in treating malignant obstructive jaundice. Methods A total of 36 patients with malignant obstructive jaundice were enrolled in this study. PTCD was carried out in all patients, which was followed by biliary stenting combined with 125I seed implantation intracavitary irradiation treatment. The results were analyzed. Results During the interventional management, displacement of the stent and 125I seeds were observed in two cases, and the displaced stent and 125I seeds were replaced to the right position with the help of biliary biopsy forceps. The technical success rate was 100%, and the remission rate of the jaundice was 100%. All the patients were followed up for 1-23 months. No radioactive particles leaking or complications such as radiation enteritis occurred. No in-stent obstruction due to tumor recurrence was observed although slight dilatation of intrahepatic bile duct was detected in 25%of patients, which was resulted from intimal hyperplasia at the stent mesh and/or biliary stone formation. The median survival time was 10.9 months. Conclusion For the treatment of malignant obstructive jaundice, biliary stenting combined with 125I seed implantation intracavitary irradiation is safe, reliable and effective. This technique can prolong stent patency time as well as the patient’s survival time.