Objective To investigate the influence of preoperative serum heat shock protein 90α (HSP90α) level on the survival time of patients with hepatocellular carcinoma treated by transarterial chemoembolization (TACE). Methods A retrospective analysis was performed for the clinical data of 97 patients with hepatocellular carcinoma who received TACE alone in Department of Hepatobiliary Surgery, The Affiliated Hospital of Southwest Medical University, from January 1, 2019 to June 1, 2020. With the median of serum HSP90α level as the cut-off value, the patients were divided into high-level group with 48 patients (HSP90α > 135 ng/L) and low-level group with 49 patients (HSP90α ≤135 ng/L). The chi-square test was used for comparison of categorical data between groups. The Kaplan-Meier method was used to calculate the median survival time, and the log-rank test was used for comparison between groups. The log-rank univariate analysis and multivariate Cox regression analysis were used to explore the influencing factors for the survival time of patients after surgery. Results There were significant differences between the high-level group and the low-level group in Child-Pugh class ( χ 2 =19.356, P <0.01), tumor necrosis ( χ 2 =9.964, P =0.002), BCLC staging ( χ 2 =22.356, P <0.01), and ECOG score ( χ 2 =6.644, P <0.05). The high-level group had a significantly shorter median survival time than the low-level group ( χ 2 =15.551, P <0.01). HSP90α level (hazard ratio [ HR ]=1.690, P <0.05) and BCLC staging ( HR =2.373, P <0.05) were independent influencing factors for the survival time of patients with hepatocellular carcinoma after TACE. Conclusion Preoperative serum HSP90α level is an independent influencing factor for the survival time of patients with hepatocellular carcinoma after TACE, and it is expected to become one of the potential indicators for evaluating the prognosis of patients with hepatocellular carcinoma treated by TACE.

Objective To understand the hospital discharge readiness and discharge instruction quality in chronic disease patients and to analyze the correlation between them. Methods Totals of 602 chronic disease patients of related departments from 7 ClassⅢGrade A hospitals in Shanghai were selected by convenience sampling. All of them were investigated with the general information questionnaire, Readiness for Hospital Discharge Scale (RHDS) and Quality of Discharge Teaching Scale (QDTS), and their data were analyzed. Results Among those patients, the scores of hospital discharge readiness and discharge instruction quality were (8.01±1.41) and (8.65±1.29) out of 10 respectively. The score of hospital discharge readiness had a positive correlation with the score of discharge instruction quality with a statistical difference (r=0.507, P＜ 0.01). Conclusions Hospital discharge readiness and discharge instruction quality of chronic disease patients are all in high levels and with a positive correlation. Nurses should enrich the content of discharge instruction to improve the quality of discharge instruction by appropriate instruction skills and to improve the hospital discharge readiness.

The concept and significance of readiness for hospital discharge, measuring tools, application status, shortcomings and prospects of readiness for hospital discharge among patients with chronic diseases were reviewed in this article, with attempts to draw more attention to the readiness for hospital discharge among patients with chronic diseases in clinical practice and provide theoretical basis for forming the intervention plan suitable for China.

Objective To investigate the factors affecting the efficacy of leflunomide combined with medium/low dose corticosteroids in the treatment of progressive IgA nephropathy (IgAN).Methods Clinical and pathological parameters were collected retrospectively in patients of primary IgAN with proteinuria＞ 1.0 g/24 h and chronic kidney disease (CKD) stage 1-3 treated with leflunomide combined with medium/low dose corticosteroids in Ren Ji Hospital,School of Medicine,Shanghai Jiao Tong University from Jan 2005 to Dec 2010.According to the treatment effects,patients were divided into complete remission group and non-complete remission group.The biochemical and pathological indexes of the two groups were compared.Results A total of 42 patients were included.The remission rates at 3,6,9 and 12 months were 62％,64％,67％ and 74％,respectively.Seventeen (40.5％) and fourteen (33.3％) patients achieved complete and partial remission after one-year treatment,and the remission rate remained stable within one year after withdrawal of drugs.The 24hour proteinuria was 1.50 (0.67,2.66) g,which was significantly reduced compared with the baseline 2.44 (1.36,3.74) g (P ＜ 0.01).The decrease rate was 31.3％.There was a slight decrease in proteinuriawithin one year after withdrawal of drugs.Estimated glomerular filtration rate (eGFR) remained stable during the treatment and a year of follow-up.No serious adverse event was observed during the followup period.Among 31 responder patients,6(19.4％) patients relapsed.Logistic multivariate regression analysis suggested that the degree of renal interstitial inflammatory infiltration was an independent predictor of complete remission with one-year treatment of leflunomide combined with medium / low dose corticosteroids (HR=0.067,95％ CI 0.008-0.535,P=0.011).Conclusions IgAN treated with leflunomide and medium/low dose corticosteroids can achieve remission in early stage,and the remission rate remains stable after withdrawal of drugs.It is a safe option for the treatment of IgAN.Renal interstitial inflammatory infiltration is an independent predictor of complete remission.

Objective To explore the effect of biological resonance technique in the detection and treatment of milk protein induced allergic diarrhea in infants .Methods A total of 60 infants with protein allergic diarrhea were detected by bio-resonance technique of German -made Bikang Biotherapeutic Instrument .The statistical bio-reso-nance technique was used to detect the distribution of allergy in infantile milk allergic diarrhea and treatment effect . Results Bio-resonance technique for detection of infantile milk protein allergic diarrhea ,the first six allergies were milk,milk protein,fish mixture,normal intestinal flora,mite and breast milk.The total effective rate was 95.00％,the effective rate was 95.83％ in the female group and 94.44％ in the male group,the difference was not statistically significant(χ2 =0.142,P>0.05).There was no significant difference between the 9th and 6th month group(χ2 =0.671,P >0.05).After treatment for 1 month,the follow -up showed no recurrence.Conclusion Resonance technology is one of the best technique to detect and treat allergic diarrhea in infants and young children , which is suitable for clinical use .

Objective To realize centralized supply of hospital compressed air to reduce repeate investment.Methods Air turned into compressed one after passing through air pressure pump, which undergoes preliminary cooling and drying by refrigerated drier, then the compressed air went into air tank for further cooling and storage, and finally was transmitted into hyperbaric oxygen chamber, ICU and operating room as desired.Results Centralized supply was realized for hospital compressed air with little technical modification and investment.Conclusion The compressed air of hyperbaric oxygen chamber is introduced into ICU and operating room and gains economic and social benefits, and thus is worth popularizing practically.

OBJECTIVETo evaluate the long-term clinical outcomes of fractional flow reserve (FFR)-guided versus intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) for intermediate coronary lesions.

METHODSA total of 226 patients with 293 intermediate coronary artery lesions (stenosis of 40%-70%) confirmed by coronary angiography were randomized into 3 groups to undergo PCI for a minimal lumen cross sectional area (MLA)<4 mm(2) (IVUS group, 98 lesions) or for a FFR<0.80 (FFR group, 101 lesions), or to receive standard medical treatment (medication group, 94 lesions). The primary outcome was major adverse cardiac events including death, myocardial infarction, and ischemia-driven target vessel revascularization at 1 year after the index procedure.

RESULTSThe baseline percent diameter stenosis and lesion length were similar between the 3 groups, but more patients in IVUS group than in FFR group received PCI (P<0.001). No significant difference was found in the incidence of major adverse cardiac events between the 3 groups (P=0.182).

CONCLUSIONBoth FFR- and IVUS-guided PCI strategy for intermediate coronary artery disease are associated with favorable outcomes, but IVUS-guided PCI based on the single index of MLA can increase the rate of revascularization therapy.

Objective To evaluate the long-term clinical outcomes of fractional flow reserve (FFR)-guided versus intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) for intermediate coronary lesions. Methods A total of 226 patients with 293 intermediate coronary artery lesions (stenosis of 40%-70%) confirmed by coronary angiography were randomized into 3 groups to undergo PCI for a minimal lumen cross sectional area (MLA)<4 mm2 (IVUS group, 98 lesions) or for a FFR<0.80 (FFR group, 101 lesions), or to receive standard medical treatment (medication group, 94 lesions). The primary outcome was major adverse cardiac events including death, myocardial infarction, and ischemia- driven target vessel revascularization at 1 year after the index procedure. Results The baseline percent diameter stenosis and lesion length were similar between the 3 groups, but more patients in IVUS group than in FFR group received PCI (P<0.001). No significant difference was found in the incidence of major adverse cardiac events between the 3 groups (P=0.182). Conclusions Both FFR-and IVUS-guided PCI strategy for intermediate coronary artery disease are associated with favorable outcomes, but IVUS-guided PCI based on the single index of MLA can increase the rate of revascularization therapy.

Objective To evaluate the long-term clinical outcomes of fractional flow reserve (FFR)-guided versus intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) for intermediate coronary lesions. Methods A total of 226 patients with 293 intermediate coronary artery lesions (stenosis of 40%-70%) confirmed by coronary angiography were randomized into 3 groups to undergo PCI for a minimal lumen cross sectional area (MLA)<4 mm2 (IVUS group, 98 lesions) or for a FFR<0.80 (FFR group, 101 lesions), or to receive standard medical treatment (medication group, 94 lesions). The primary outcome was major adverse cardiac events including death, myocardial infarction, and ischemia- driven target vessel revascularization at 1 year after the index procedure. Results The baseline percent diameter stenosis and lesion length were similar between the 3 groups, but more patients in IVUS group than in FFR group received PCI (P<0.001). No significant difference was found in the incidence of major adverse cardiac events between the 3 groups (P=0.182). Conclusions Both FFR-and IVUS-guided PCI strategy for intermediate coronary artery disease are associated with favorable outcomes, but IVUS-guided PCI based on the single index of MLA can increase the rate of revascularization therapy.

Objective To evaluate the nutritional status in maintenance hemodialysis patients using objective score of nutrition on dialysis.Methods Patients on maintenance hemodialysis were randomly selected and divided into three groups based on objective score of nutrition on dialysis:normal nutritional status group,moderate nutritional status group,and low nutritional status group.Logistic regression analysis was performed to identify factors of malnutrition.Furthermore,the results were compared with those of subjective global assessment.Results Totally 75 patients(male:female =1.13∶1)with a mean age of(54.90 ± 12.10)years and a mean vintage of (85.37 ± 54.17)months were enrolled.As determined by objective score of nutrition on dialysis,15 patients (20％)were divided into normal nutritional status group,42(56％)into moderate nutritional status group,and 18(24％)into low nutritional status group.Compared with the normal nutritional status group,the low nutritional status group had significantly different body mass index[(19.81 ± 2.22)vs(23.90 ± 2.44)kg/m2,P =0.030]and dry weight[(50.85 ± 7.60)vs(59.94 ± 10.89)kg,P =0.020].In addition,compared with normal nutritional status group,the moderate nutritional status group and low nutritional status group had significantly different total cholesterol[(4.60 ± 0.84)and(3.73 ± 0.68)mmol/L vs(5.71 ± 1.64)mmol/L,P =0.011,P =0.000],normalized protein catabolic rate[1.17 and 1.15 g/(kg · d)vs 1.45 g/(kg · d),P =0.030,P =0.010],triceps skinfold thickness[(1.44±0.77)and(1.00±0.41)cmvs(1.80±0.63)cm,P=0.032,P=0.020],mid-ann circumference[(24.85±1.48)and(21.66±1.48)cmvs(24.99 ±2.30)cm,P=0.046,P =0.037].Logistic regression analysis indicated C-reactive protein(OR =12.482,95％ CI =0.190-130.928,P =0.035)and normalized protein catabolic rate(OR =0.128,95％ CI =0.022-0.736,P =0.021)were significantly correlated with malnutrition.Conclusion Malnutrition is common in hemodialysis patients,with inflammation and low protein intake being its independent factors.