Objective To investigate the treatment effect and some related fators of the improved lacrimal duct flushing technique for the adult patients with chronic dacryocystitis in the primary hospital.Methods Fifty -seven adult patients (fifty -seven eyes) with chronic dacryocystitis received the improved lacrimal duct flushing treatment.Fifty -seven patients were divided into two groups according to the first time to see a doctor and receive the improved lacrimal duct flushing treatment cooperated with drug application and assistant therapies.The effect and safety of the treatment and some related factors were analyzed.Results There was no statistical difference between the overall efficency of the two groups(A group 76.2%,B group 72.2%,χ2 =0.108,P =0.987 >0.05).The innero-cular pressures showed no statistical difference between pre -treatment and 1 month after treatment(the pre -treat-ment innerocular pressure:18.470,the post -treatment innerocular pressure:18.512,t =-0.315,P =0.754 >0.05).The correlation analysis between the conditions of lacrimal passages and treatment effect(r =0.814,r2 =0.663,P =0.002 <0.05),between the germiculture of the discharge of lacrimal sac and treatment effect(r =0.814, r2 =0.663,P =0.000 <0.05) showed statistical significance.Conclusion The improved lacrimal duct flushing technique cooperated with drug application and assistant therapies is safe and well effective to the adult patients with chronic dacryocystitis in the early stage.

OBJECTIVE To reduce the cross infection during gastroscopy and probe into the(administrative) measures in preventing infection.METHODS The hidden infection of sterilizing gastroscope was analyzed in order to work out the measures to prevent infection.RESULTS Choosing the correct methods of sterilizing gastroscope could(avoid the) incomplete sterilization and reduce the cross infection.CONCLUSIONS Be strict in sterilizing(procedure)s and protecting measures,and prevent the interactive infection in the hospital during gastroscopy.

Objective To investigate the clinical value of tumor necrosis factor-alpha ( TNF-) and hypersen-sitivity-C reactive protein ( hs-CRP ) in elderly patients with chronic heart failure ( CHF ) .Methods 85 elderly patients with CHF were randomly selected as the CHF group ,and 85 healthy pepole were chosen as the healthy control group .All subjects were taken fasting blood in the morning ,the TNF-αand hs-CRP levels were detected and compared between the two groups .The differences of plasma TNF-αand hs-CRP levels in different grades of CHF patients were also observed .Results The TNF-αand hs-CRP levels of the CHF group were significantly higher than those of the healthy control group(t=110.86,25.63,all P<0.05).With the elevation of heart function classification ,the TNF-αand hs-CRP levels gradually increased ,and compared with the previous grade ,the differences were statistically signifi-cant(F=7.65,16.75,all P<0.05).The results of linear correlation analysis showed that the levels of TNF-αand hs-CRP were negatively correlated with the LVEF (r1 =0.78,P<0.05;r2=0.71,P<0.05).The TNF-αand hs-CRP were positively correlated (r =0.83,P <0.05).Conclusion The plasma TNF-αand hs-CRP levels of elderly patients with CHF are increased ,and their levels are closely related with the heart function .

Objective To investigate the the efficacy and safety of recombinant human brain natriuretic peptide (rhBNP) in the treatment of acute non-ST-segment elevation myocardial infarction patients with heart failure.Methods 80 patients with heart failure caused by acute non-ST-segment elevation myocardial infarction were chosen,they were divided into the observation group and control group based on a random number table,each group included 40 patients.The observation group were treated with intravenous injection of recombinant human brain natriuretic peptide,the control group were treated with intravenous nitroglycerin.vital signs,dyspnea,brain natriuretic peptide (BNP),associated hemodynamic changes and adverse reactions of two groups were compared before and after treatment.Results The total effective rate in observation group was 87.5％ (35/40),which were significantly higher than 50.0％ (20/40) of the control group,there were significant difference (x2 =13.09,P ＜ 0.05).In the observation group,after treatment,the left ventricular ejection fraction (LVEF) and average hourly urine output were significantly higher than those of before treatment (t =26.40,3.22,all P ＜ 0.05),and the brain natriuretic peptide (BNP) concentration levels were significantly lower than those of before treatment (t =14.11,all P ＜ 0.05).The control group before and after treatment LVEF,BNP and changes in urine levels were not significantly.Conclusion In the treatment of heart failure caused by acute non-ST-segment elevation myocardial infarction,the recombinant human brain natriuretic peptide (rhBNP) has significant effect,feasible and safe with few side effects,which has a high clinical value.

The TCM theory over body constitution has been greatly developed in the past several decades.However,the body constitution for children still lacks a standard classification.Available studies often ignored the impacts of the factors,such as region,climate and diet,on the body constitution of children.Given this situation,the present review focused on the research progress on the discipline of TCM body constitution and its classification and differentiation in Chinese children,and put forward the development on this issue based on current state policy and our own research experience.It was suggested that scholars develop a well-recognized classification method for the TCM body constitution for children in a particular region before investigating interventions according to TCM body constitution.

OBJECTIVE: To summarize clinical features, diagnosis, differential diagnosis, treatment and prognosis of basal cell adenocarcinoma. METHOD: A retrospective study were subjected to one case with basal cell adenocarcinoma of the nasal septum, and the related literature were reviewed. RESULT: Basal cell adenocarcinoma often occurred in the salivary glands and minor salivary glands of salivary palate and other parts. The symptoms mainly presented with a local lump. Major treatment method was radical surgical resection and, if necessary, supplemented by radiotherapy. CONCLUSION Basal cell adenocarcinoma is rare seen in the salivary gland tumors. It has a tendency of low-grade malignancy but need long-term follow-up of a large samples.
Adenocarcinoma ; radiotherapy ; surgery ; Aged ; Humans ; Male ; Nasal Septum ; pathology ; Nose Neoplasms ; radiotherapy ; surgery ; Retrospective Studies

Objective To investigate the influencing factors of in-hospital delay using alteplase for intravenous thrombolytic therapy in patients with acute ischemic stroke.Methods From January 2006 to May 2015,220 consecutive patients with acute ischemic stroke admitted to the Department of Neurology,Tangshan Gongren Hospital Affiliated to North China University of Science and Technology were enrolled retrospectively.They all received alteplase for intravenous thrombolytic therapy.Their mean National Institutes of Health Stroke Scale (NIHSS) score on admission was 16±8.According to door-to-needle time (DNT),they were divided into either a delay group (DNT >60 min;n=151) or a non-delay group (DNT ≤60 min;n=69).The baseline data,laboratory tests,onset-to-door (OTD) time,imaging,and etiology classification of trial of org 10172 in acute stroke treatment (TOAST) of both groups were recorded.Univariate analysis was performed on both groups,and further multivariate logistic analysis was performed.Results (1) The proportion of the past history of transient ischemic attack,blood glucose level on admission,time from onset to hospital in the non-delay group were significantly higher than those of the delay group.There were significant differences between the two groups (43.5%[30/69] vs.3.3%[5/151],7.9±3.0 mmol/L vs.6.9±2.1 mmol/L,95±53 min vs.80±34 min,all P<0.05).There were significant differences in the constituent ratio of TOAST classification between the two groups (P<0.05).There were no significant differences in other baseline data and clinical features between the two groups (all P>0.05).(2) Multivariate Logistic regression analysis showed that the risks of patients with the past history of transient ischemic attack (OR,0.330,95%CI 0.109-0.998,P=0.046),elevated blood glucose levels on admission (OR,0.775,95%CI 0.657-0.914,P=0.005),prolonged onset-to-door time (OR,0.648,95%CI 0.504-0.831,P=0.013),internal carotid artery lesions (OR,0.192,95%CI 0.038-0.960,P=0.044) for occurring in-hospital delay after thrombolysis were low.Systolic pressure on admission(OR,1.275,95%CI 1.091-1.491,P=0.027)and cardioembolism(OR,3.892,95%CI 1.661-9.112,P=0.006) for occurring in-hospital delay after thrombolysisin were high.Conclusion The patients with past history of transient ischemic attack,higher blood glucose,prolonged onset-to-door time,and having internal carotid artery lesions may be cause the attention of family members and doctors,and were less prone to having thrombolytic in-hospital delay,whereas those with higher systolic blood pressure on admission and cardioembolism were prone to having in-hospital delay.

Objective:To explore the influence of nursing organization atmosphere on clinical nurses' workplace loneliness, verify and analyze the mediating role of psychological capital between nursing organization atmosphere and workplace loneliness.Methods:This study was a cross-sectional survey, using the convenience sampling to select clinical nurses from two Class Ⅲ Grade A hospitals in Shanxi Province from October to December 2019 as the research object. The survey was conducted using the General Information Questionnaire, Organizational Climate Scale for Nursing, Questionnaire about Workplace Loneliness, and Psychological Capital Scale. The structural equation model was used to analyze the mediating effect of psychological capital between nursing organization atmosphere and workplace loneliness. A total of 1 035 questionnaires were collected in this study, with 963 valid questionnaires, and the effective response rate was 93.04%.Results:Among 963 clinical nurses, the total scores of Organizational Climate Scale for Nursing, Questionnaire about Workplace Loneliness, and Psychological Capital Scale were (88.08±10.08) , (30.42±5.23) and (83.21±12.62) respectively. The structural equation model showed that the nursing organization atmosphere had a direct and indirect predictive effect on nurses' workplace loneliness, and the path coefficients were -0.27 and -0.22 respectively. Psychological capital had a mediating effect between the nursing organization atmosphere and workplace loneliness.Conclusions:Psychological capital plays a mediating role between nursing organization atmosphere and workplace loneliness. Nursing managers should take effective measures to create a good organizational atmosphere, improve the level of psychological capital of clinical nurses, and reduce nurses' workplace loneliness.

Objective:To investigate whether the deficiency of death associated protein kinases (DAPK) 3 can reduce vascular calcification by inhibiting endoplasmic reticulum stress.Methods:The method of prospective cohort study was used to observe and analyze the cell culture in vitro.Human aortic vascular smooth muscle cells (VSMC) were cultured in F10K Kaighn′s modified medium, and divided into calcified group and non-calcified group according to whether β-phosphoglycerin (10 mmol/L) was added into the medium.The cells in calcified group and non calcified group were divided into DAPK3 inhibition group and its control group, endoplasmic reticulum stress inhibition group and its control group, mitogen-activated protein kinase (MAPK) activation group and its control group, DAPK3 inhibition + AMP-activated protein kinase (AMPK) inhibition and blank control group, respectively. DAPK3 mRNA and protein concentration, calcium content, alkaline phosphatase, protein concentration of VSMC differentiation marker genes (SM22α, α-SMA), osteogenic differentiation transcription factor (Runχ2, bone morphogenetic protein-2, BMP-2), endoplasmic reticulum stress markers (AFT4, GRP78, GRP94 and CHOP) and p-PAMK protein expression were measured.Results:The mRNA level(highest value was 15.24±0.72 on the 14th day ) and protein level(highest value was 11.31±0.38 on the 14th day) of DAPK3 were significantly higher than those in non calcified cells(5.63±0.62, 2.59±0.33, respectively). The difference was statistically significant ( P< 0.001). In the calcified cells, calcium content (86.54±8.21) mmol/g in dapk3 deficient group was significantly lower than that in control group (194.63±8.54) mmol/g ( t=22.35, P<0.001), alkaline phosphatase activity was significantly decreased((96.27±10.28) IU/g vs.(224.67±10.94) IU/g, t=20.951, P<0.001), the expression of the VSMC differentiation marker genes (SM22α, α-SMA) were upregulated significantly (SM22α: (0.82±0.14) vs.(0.44±0.13), t=4.872, P=0.001; α-SMA: (0.95±0.18) vs.(0.56±0.13), t=4.303, P=0.002), the level of bone differentiation transcription factor (Runχ 2, BMP2) was significantly decreased (Runχ 2: (1.12±0.28) vs.(2.21±0.35), t=5.957, P<0.001; BMP2: (0.82±0.12 ) vs.(1.26±0.16), t=5.39, P<0.001), MAPK level was up-regulated (DAPK3 inhibited group 0.74±0.12 of calcified cells, 1.04±0.14 of non calcified cells, higher than the control group 0.44±0.10 of calcified cells, 0.78±0.12 of non calcified cells, t=4.704, P=0.001; t=3.454, P=0.006), and the inhibited calcium content of ESR calcified cells significantly reduced (after inhibition of AMPK pathway, cells transfected with shRNA group 150.21±11.98, cells transfected with shRNA group 83.21±12.12 were lower than those transfection blank control group 164.82±12.34, P<0.001). The activity of alkaline phosphatase was significantly reduced (226.54±16.57) IU/g protein in the shRNA group and (112.34±15.96) IU/g protein in the shRNA group were significantly lower than 242.32±16.32 in the blank control group, P<0.001); calcium content and ALP activity in the calcified MAPK cells were significantly reduced ( P<0.001). Conclusion:DAPK3 deficiency can inhibit endoplasmic reticulum stress through AMPK signaling pathway to slow down VSMC calcification.

Objective To investigate the efficacy and safety of rotational atherectomy(RA)combined with drug eluting stent(DES)implantation in the treatment of severe coronary artery calcification,and analyze key operation points.Methods The clinical data of sixty-two patients(68 lesions)treated with RA combined with DES from January 2014 to December 2015 were retrospectively analyzed,including the characteristics of operation,postoperative curative effect,complications,incidence of major adverse cardiovascular events(MACE) during hospitalization and follow-up period.Results A total of 75 rotary blur were used in the 62 cases,with an average of(1.18±0.27)per case,the blur diameter/target vessel diameter was(0.54±0.07),the success rate of RA was 98.4%(61/62);A toal of 103 DES were implanted in 61 patients,with an average of(1.67±0.55)per case,average length was(44.5 ± 11.8)mm,immediate DES success rate was 100%.After RA,target vessel diameter was(2.33± 0.52)mm,target vessel narrow degree was(29.6 ± 4.8)%,thrombolysis in myocardial infarction grade Ⅲ blood flow ratio was 66.2%,which have been significantly improved compared with preoperation((0.75±0.21)mm,(82.5±7.2)%,10.3%)(P<0.05),the target vascular lumen diameter and stenosis of target vessel continued to improve after DES((3.26 ± 0.43)mm,(8.7 ± 2.1)%,98.5%)(P<0.05);At 3 days after operation,the left ventricular ejection fraction was significantly higher than that before the operation((60.5±5.5)% vs.(56.8±4.7)%)(P<0.05).The incidence of complications associated with interventional procedures was 9.7%,in which 1 case with burr incarceration switched to coronary artery bypass grafting.The incidence of major adverse cardiovascular events incidence during hospitalization was 4.8%,the follow-up period was 9.0-22.0 months.The incidence of major adverse cardiovascular events incidence during follow-up was 8.2%.Conclusion DES implantation following RA in the treatment of severe coronary artery calcification can further improve blood flow and artery stenosis,medium-term efficacy is safe and reliable;standardized RA operation is the key to ensure the success of interventional therapy.