Objective To investigate the effects of humanistic care on primiparas' role competency during pregnancy and delivery.Methods Data of 21 cases were collected using semi-structured interviews and phenomenological qualitative method was used to analyze the data.Results The effects of humanistic care on maternal role competency during pregnancy included:to participate in related curriculum,to get ready for delivery actively.The effects of humanistic care on maternal role competency during delivery included:nurses' carefulness gave psychological support,nurses' instruction gave professional support,nurses' encouragement gave spiritual power,nurses' support enhanced belief,successful delivery experience gave.satisfaction.Conclusions Humanistic nursing is helpful to improve delivery experience,to increase maternal satisfaction and confidence,to promote matemal role competency and harmonious relationship between mothers and nurses.

Objective To demonstrate simultaneously on transcription and translate levels the tyrosine-hydroxylase(and somatostatin)gene expression and peptide storage in same intrinsic cardiac ganglionic neuron of bufo bufo gargarizans. Methods Using immunohistochemical method,in situ hybrodization method and in situ hybrodization/immunohistochemical double labeling method on freeze-sections of sinus venanum cavanum of bufo bufo gargarizans atrial posterior wall (30*!?m)to observe THmRNA and /or TH-IR and SSmRNA and /or SS-IR dyeing neurons of intrinsic cardiac ganglia. Results There are kinds of positive neurons:1.TH-IR positive neurons;2.THmRNA positive neurons;3.TH mRNA/TH-IR double positive neurons and 1.SS-IR positive neurons;2.SSmRNA positive neurons;3.SSmRNA/SS-IR double positive neurons.Conclusion 1.TH mRNA and TH appearing in same intrinsic cardiac ganglionic neuron demonstrate that a part of intrinsic cardiac ganglionic neurons are possibly adrenergic sympathetic neurons;2.SSmRNA positive neurons and SSmRNA/SS-IR double positive neurons indicat that SS could be a neurotransmitter of intrincic cardiac ganglinic neurons.It provides neuroanatomy evidence of regulating cardiac function(excitatory conduct、cardiac muscle secrete and contract)by intrinsic cardiac SS-nergic neuron.

Objective　To study the distribution of insulin-like Growth Factors (IGFs) in liver、 spleen、kidney、thymus and supraadrenal glands of fetus from 16 to 24 weeks.Method　Using ABC immunohistochemistry. Results　 IGF-I positive cells were found in these organs during this period of fetal life, but the differences of number and reaction intensity of IGF-I positive cells appeared in different organs and individuals.Conclusion　These organs tissues can express IGF-I during fetal development and play paracrine and/or autocrine role in cellular proliferation and differentiation of these fetal tissue.

Objective To assess the alterations of the systolic peak radial strain (RS) and the time to systolic peak radial strain(TRS) in ischemic myocardial segments with different extent of coronary artery stenosis using three-dimensional ultrasound speckle tracking imaging(3D-STI).Methods RS and TRS of 16 left ventricular segments were analyzed by 3D-STI in 87 patients,every left ventricular segment of all patients were divided into 5 groups according to coronary stenosis based on the results of selected coronary angiography:normal,≤25 ％,＞25 ％ - ≤50 ％,＞50 ％ - ≤ 75 ％,＞ 75 ％.All times were corrected by heart rate.Results In the coronary normal group,coronary stenosis extent ≤25％ group and coronary stenosis extent ＞25％ - ≤50％ group,the variance of RS was non-significant( P ＞0.05).Compared with the coronary normal group,coronary stenosis extent ≤25％ group and coronary stenosis extent ＞ 25％ -≤ 50％ group,RS was decreased in groups of coronary stenosis ＞50％ - ≤75％ and ＞75％.Between the coronary normal group and coronary stenosis extent ≤25 ％ group,the variance of TRS was non-significant( P ＞0.05).Compared with coronary normal and coronary stenosis extent ≤25 ％ group,TRS was increased in groups of coronary stenosis ＞25％ - ≤50％,＞50％ - ≤75％,＞75％.Compared with group of coronary stenosis ＞ 50％ -≤ 75％,TRS was shorter in group of coronary stenosis ＞ 75％,some variance was significant( P ＜0.05).Conclusions The RS was decreased along with the coronary stenosis increase,but TRS was increased along with the coronary stenosis increase.There is a tendency that TRS was decreased when the coronary stenosis is more than 75 ％ compared with the coronary stenosis ＞50％ - ≤75 ％ group.3D-STI can access the regional radial systolic function of the ischemic myocardial segment.

Objective To analyze the plasty of the tip framework and the nasal tip in insufficient-lining cases with auricular and septal cartilage.Methods The tip framework was formed by using septal extension graft (SEG) and columellar strut (CS) to construct the main framework of nasal tip,and then according to the size of the graft the next processes were chosen for supporting structure.When the graft size met the tip position,the caudal margin of the framework could be beyond the maximum stretch position of the lower lateral cartilage and reached or was close to the expected tip position.When the graft size was insufficient,auricular cartilage was used to hold the caudal margin of the framework to extend or to heighten the framework further.Refined plasty of nasal tip was as follows:when the end of framework was higher than or equal to the dome above 3 mm,auricular cartilage strip was used to reconstruct the dome;when less than 3 mm,multilayer onlay grafts were used to heighten the dome.Results From May 2013 to May 2015,42 cases were followed up from 6 months to 18 months.18 cases belonged to the type 1,including 13 cases using ear cartilage to reconstruct dome,5 cases using onlay graft;24 cases belonged to the type 2,including 14 cases using onlay graft and 10 cases using ear cartilage to reconstruct the dome.They all got good results.Conclusions To the insufficient lining cases,the appropriate method can be chosen to form stable tip framework according to the preoperative design and the graft size.Then onlay grafts or dome reconstruction technique is used to form the tip.Most of the insufficient-lining cases can get satisfactory results.

Objective To investigate the changes and significance of serum inflammatory factors in coronary heart disease (CHD) patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) ,and the treatment effects of continuous positive airway pressure (CPAP).Methods A total of 76 CHD patients in Renmin Hospital of Wuhan University from October 2007 to October 2008 were enrolled.Polysomnography (PSG) was performed in these CHD patients to identify if they were complicated by OSAHS.The levels of inflammatory factors including TNF-α, IL-6, high sensitive C-reactive protein (hs-CRP) in serum were determined in the CHD patients and 23 normal subjects.The CHD patients with mederate-severe OSAHS (AHI≥ 15 episodes/hour) were treated by Auto-CPAP for 3 months and all parameters above were measured again.Results There were 41/76 (53.9%) of CHD patients had mederate-severe OSAHS and were treated with CPAP.The levels of TNF-ct,IL-6 and hs-CRP were significantly higher in the CHD patients than those in the normal controls (all P <0.01) ,and were significantly higher in moderate-severe OSAHS patients than those in the non-OSAHS CHD patients.Auto-CPAP ventilation significantly decreased the levels of inflammatory factors in the CHD patients with moderate-severe OSAHS.Conclusions An obvious proinflammatory state is detected in CHD patients ,and is aggravated with OSAHS.CPAP is a useful treatment for CHD patients with mediate to severe OSAHS.

BACKGROUND: The role of p53 gene in human lung cancer has been confirmed. Since the discovery of p63 gene as the homologue of p53, its role and possible mechanism-have aroused the attention of investigators all over the world. But the principle concerning transcription and expression of p63 in small-cell lung carcinoma (SCLC) remains unclear.OBJECTIVE: To investigate the level of the expression of p63 gene in SCLC and lung adenocarcinoma tumor tissues, peri-carcinoma tissues and normal tissues, and observe the expression of p63 protein in these tissues so as to understand the principle and clinical significance concerning p63gene expression in SCLC and lung adenocarcinoma.DESIGN: Controlled experiment.SETTING: Department of Thoracic and Cardiovascular Surgery, Research Institute of Field Surgery of Daping Hospital of Third Military Medical University of Chinese PLA.PARTICIPANTS: Six SCLC specimens dissected during the surgical operation in Daping Hospital, Third Military Medical Univers ity of Chinese PLA, between October 2000 and September 2002 , were recruited. There were 4 male and 2 female patients aged 42 to 67 years (mean age of 50.7years); 15 specimens of lung adenocarcinoma were also collected at the same time. Tumor tissues, peri-carcinoma tissues and normal tissues were chosen in each specimen.METHODS: Reverse transcriptase polymerase chain reaction (RT-PCR)was used to detect and compare the transcription expression of two subtypes of p63 gene (TAP63 and △NP63)in the tumor tissues of 6 cases of SCLC and 15 cases of lung adenocarcinoma. At the same time, immunohistochemical staining technique was used to detect the expression of p63protein in the above tissues.MAIN OUTCOME MEASURES: ① Expression of p63 protein detected by RT-PCR in tissue specimens. ② Expression of p63 protein detected in tissue specimens detected by immunohistochemical staining technique.RESULTS: ① Expression of p63 protein detected by RT-PCR in tissue specimens: The positive expression of △Np63 gene could be found in 5cases (83%, 5/6) of SCLC cancer tissues and 1 case of SCLC peri-carcinoma tissues (17%, 1/6), and the expression of TAp63 was not observed in all of the tumor, peri-carcinoma and normal tissues of SCLC. There was no expression of △Np63 or TAp63 in tumor, peri-carcinoma and normal tissues of lung adenocarcinoma. ② Expression of p63 protein detected by immunohistochemical staining in tissue specimens: The positive expression rate of p63 protein in SCLC tumor tissues was significantly higher than that in lung adenocarcinoma tissues [83% (5/6), 17% (1/6), P ＜ 0.01].CONCLUSION: p63 gene shows positive expression in SCLC, among which the expression level of △NP63 is increased while the expression level of p63 protein is obviously higher in SCLC than in adenocarcinoma tissues, which may be related to its regulatory role in the occurrence and development of SCLC. It is presumed that△NP63 gene has high transcription expression level in SCLC, which might inhibit cellular apoptosis, promote the proliferation of tumors, play the role as an oncogene. It suggests that p63 may be one of the factors influencing the prognosis of SCLC.

Objective To compare the therapeutic effect of retrograde ureteroscopic Ho:YAG laser lithotripsy (UHL) and percutaneous nephrolithotripsy (PCNL) in treating patients with renal calculi of ≤3 cm.Methods From Feb.2008 to Apr.2011,a total of 109 cases (117 renal calculi in total) treated by either PCNL (50) or UHL (67) were retrospectively analyzed.Operative time,stone free rate,postoperative hospital stay,hospitalization expenses and complications were compared in the 2 groups.Results The mean stone burden of the UHL group and PCNL group was 2.5 cm (1.5-3.0) cm and 2.4 cm (1.3-3.0) cm,respectively.There was no significant difference in two groups.In UHL group,operations were performed successfully in all 67 calculi,of whom,43 patients needed combination of flexible ureteroscopy to break the stone fragments falling into the renal calices.No serious complication was recorded except postoperative fever in 3 cases.In PCNL group,all patients had been successful operated.Postoperative fever occurred in 2 cases.Obvious intraoperative and postoperative haemorrhage appeared in 1 case,and cured by selective renal artery embolization.The operation time of the UHL group and PCNL group was (117.0±36.5) min and (90.0±18.3) min respectively,and had no significant difference in two groups (P＞0.05).The stone free rate of the UHL group and PCNL group was 94％ (63/67) and 92％ (46/50) respectively,and had no significant difference in two groups (P＞0.05).Hemoglobin decline of the UHL group and PCNL group was (0.3±0.1) g/L and (20.6±8.1) g/L,and had significant difference in two groups (P＜0.05).Postoperative hospital stay of the UHL group and PCNL group was (5.0±2.4) day and (7.0±3.7) day,and had statistical difference in two groups (P＜ 0.05).Hospitalization expenses of the UHL group and PCNL group was (15 477.0±754.3) RMB and (27 453.0± 1763.5) RMB,and had statistical difference in two groups (P＜0.05).Conclusions Although UHL and PCNL have similar curative effect in treating renal stones of less than 3 cm,UHL have the advantages of lcss trauma and complication,lower expenses and fewer hospital stay.In treating renal stones of smaller than 3 cm,especially in the contraindication of PCNL,UHL may be a better choice.

ObjectiveTo evaluate the effects of cardiac resynchronization therapy (CRT) on improving left ventricle (LV) function and LV asynchrony in patients with dilated cardiomyopathy(DCM)using three-dimensional ultrasound speckle tracking imaging(3D-STI).MethodsTwenty one patients with DCM and 25 normal subjects were enrolled in this study.Parameters including LV mean longitudinal peak strain (MLS),LV mean circumferential peak strain (MCS),LV mean radial peak strain (MRS),LV ejection fraction(3D-LVEF),maximal temporal difference in area strain of LV 16 segments (A-MaxTs) and its standard deviation (A-Ts-SD) were investigated by 3D-STI.LV ejection fraction (ECT-LVEF) and LV phase angle width (LVW) were obtained by radionuclide ventriculography and phase image analysis.Results The indexes of MLS,MCS,MRS and 3D-LVEF were decreased and A-MaxTs,A-Ts-SD were prolonged in DCM group compared with those of control group.There was a slightly improvement in MRS and ECTLVEF 1 week after CRT,but other Parameters including MLS,MCS,A-MaxTs,A-Ts-SD and 3D-LVEF had no significant change.Compared with corresponding values before and 1 week after CRT,all parameters (MCS,MRS,A-MaxTs,A-Ts-SD,3D-LVEF and ECT-LVEF) were further improved 6 months after CRT.MLS,MCS,MRS and 3D-LVEF had good relationship with ECT-LVEF,and A-MaxTs,A-Ts-SD had good relationship with LVW in DCM group.Conclusions3D-STI is a simple and accurate method for evaluating effects of CRT on improving LV function and LV asynchrony in patients with DCM.

Objective　To estimate the value of applying left heart bypass technique in esophageal carcinoma resection and gastroesophageal reconstruction. Methods　The operation was performed under lef t he art bypass. Results　Applying left heart bypass during esophagea l carcinoma resection and gastroesophageal reconstruction increased the probabil ity of the resection. The patient lived better and without operative complicatio n. Conclusion　In case of esophageal carcinoma with invasion of descending aorta by carcinoma, left heart bypass may increase the probability of the resection and enhance the safety of surgical treatment.