Objective To discuss effect of different kinds of dressings on complications after periph-erally inserted central catheter(PICC). Methods Patients with skin hypersensitiveness after PICC adopt-ed sterile bandage and Anshutuo IV3000 transparent dressing to carry out local dressing change respective-ly. Incidence of catheter infection,slippage and complications were compared. Results The rate of catheter infection was 19.4%( 0 cases) and catheter slippage was 6.5%(7 cases) by using sterile bandage.While the rate of catheter infection was 3.2%(1 case) and catheter slippage was 3.2%(1 case) by using Aashutuo IV3000 transparent dressing. Conclusions Using Anshutuo IV3000 transparent dressing on local dressing change solved the shortcomings of common dressings and sterile bandage,reduced the inci-dence of complications after PICC and prolonged the using time of catheter.

Objective To explore the new ways for treating multiple-ulcer treatment of breast tuberculosis. Methods The clinical data fo 10 cases of muhiple-ulcers summary of TB breast-conserving surgery and breast sur-gery purely traditional procedure were retrospectively analyzed. Results Surgical incision of 10 patients were healed stage Ⅰ, 2 patients experienced abscess drainage before admission to hospital and local incision healing was poor, who were healed through the out-patient dressing, and no skin ischemic necrosis occurred as well as the breast was in good shape. Follow-up lasted 3 to 26 months, during which period there was no recurrence, and patients and their families present with 100% satisfaction. Conclusion Conserving surgery with anti-TB rules is the new way of muhi-ple ulcer type of breast tuberculosis treatment,which is minimally invasive, effective, safe, with less complications and economical and practical advantages.

Objective To investigate the effect of comfort nursing on dysphoria patients in neurosurgical department.Methods Thirty-six patients with dysphoria in the neurosurgical department were treated with comfort nursing. The degree of dysphoria after implementation of comfort nursing and the incidence of nursing-related adverse events were investigated.Results The degree of dysphoria in the patients after implementation of comfort nursing was lower than that after the implementation(P<0.05).There were 3 cases(8.33%)of nasogastric tube slippage and skin injury,2 cases(5.56%)of urinary catheter slippage and no case of falling out of bed.Conclusions The implementation of comfort nursing can stabilize the mood of patients and comfort the patients. It is helpful for abating the degree of dysphoria of patients,reducing the adverse effects of nursing work and ultimately improving the quality of nursing.

OBJECTIVE: To provide reference of the ideal entry point for antegrade femoral nailing according to analysis correlation between highest point of greater trochanter and the middle line of the medullary cavity in adults by three-dimensional images. METHODS: From January 2016 to January 2017, 107 adults who underwent continuous computed tomography (CT) scans were ultimately enrolled, including 64 males and 43 females with an average age of (51.7±16.4) years old;54 patients on the left side and 53 patients on the right side. Three-dimensional images were built by using image-processing software (Volume Viewer) to reconstruct geometry of cortex and medullary canal. All people weregrouped according to different femoral greater trochanter morphology, such as anterior apex (AA), posterior apex (PA), middle apex (MA) and none apex (NA). Forwards inclination was adjusted to apparent neck shaft angle (ANSA) and true neck shaft angle (TNSA) on the coronal and saggittal view, recorded as C-ANSA, C-TNSA, S-ANSA, S-TNSA respectively, vertical distance from the middle line of femur medullary cavity to the highest point of greater trochanter of femur on the 4 positions were measured and performed statistical analysis, multiple linear regression was applied to analysis relationship between clinical data and VD value. RESULTS: (1)Comparison of VD value among 4 groups on the 4 positions, there were no difference in VD value between AA and MA groups on the S-ANSA position;and no differences in VD value among AA, MA and NA groups on the C-ANSA and C-TNSA position. (2)There were differences in VD value among AA, MA and NA groups on the sagittal plane;while had difference in VD value between PA and NA group on the coronal plane. (3)Prediction equation of VD value on S-ANSA and S-TNSA position by multiple linear regression showed R=0.343, F=3.409, =0.012 on the S-ANSA position;R=0.317, F=2.846, =0.028 on the S-TNSA position; neck shaft angle and sex were risk factors of VD value on the sagittal plane, while no difference in VD value on the coronal position. CONCLUSION (1)When indentify insertion point in adult femoral nail according to the highest point of greater trochanter as anatomic landmark, the morphology of greater trochanter of femur should be distinguished to certain observation position, then evaluate migration before and after on the sagttial plane and lateral offset on the coronal plane. (2)Migration before and after on the sagttial plane is increase with increase of neck shaft angle, and the degree of migration of female before and after is less than that of male.
Adult ; Aged ; Female ; Femur ; Fracture Fixation, Intramedullary ; Humans ; Image Processing, Computer-Assisted ; Imaging, Three-Dimensional ; Male ; Middle Aged ; Tomography, X-Ray Computed

Aim To investigate the molecular mechanism of the protection of vascular smooth muscle cells by the regulation of endoplasmic reticulum stress and autophagy by Fufang Danshen dripping pills.Methods Fifty patients with atherosclerosis were randomly divided into two groups; one group received normal treatment,while the other group was added Fufang Danshen dripping pills,and the clinical efficacy was observed.Vascular smooth muscle cells were divided into control,ox LDL model,Fufang Danshen dripping pill group,Fufang Danshen dripping pill+endoplasmic reticulum stress inhibitor group,and Fufang Danshen dripping pill+endoplasmic reticulum stress inducer group.Proliferation was detected,and vasodilator function factors and oxidative stress were measured in each group,ER stress marker proteins,autophagy marker proteins and apoptosis related protein expression were detected,and activation of the IRE1-TRAF2-ASK1-JNK signaling pathway was detected.Results Compared with control group,various indicators of cells in ox-LDL model group showed that they were under ER stress,high oxidative stress,high autophagy status,and the IRE1-TRAF2-ASK1-JNK pathway was found to be over activated.However,compared with ox LDL model group,the above indicators in Fufang Danshen dripping pill group and Fufang Danshen dripping pill+endoplasmic reticulum stress inhibitor group were significantly better,the IRE1-TRAF2-ASK1-JNK pathway was over activated,and the endoplasmic reticulum stress inhibitor was more obvious,and Fufang Danshen dripping pill+endoplasmic reticulum stress inducer group significantly reversed the improved effects of Fufang Danshen dripping pills.Conclusions Fufang Danshen dripping pills protect vascular smooth muscle cells by inhibiting excessive activation of the IRE1-TRAF2-ASK1-JNK pathway,decreasing endoplasmic reticulum stress,maintaining proper autophagy,and inhibiting abnormal cell proliferation and apoptosis.

To investigate the expression of hypoxia-inducible factor 1α (HIF-1α) and CD133 in predicting pathologic remission and survival of patients with locally advanced rectal cancer undergoing neoadjuvant chemoradiotherapy.One hundred and fourteen patients with locally advanced rectal cancer undergoing neoadjuvant chemoradiotherapy from January 2010 to December 2015 in Jinhua Municipal Central Hospital were enrolled in the study. RT-PCR and immunohistochemistry methods were used to detect the mRNA and protein expression of HIF-1α and CD133 before and after chemoradiotherapy. Spearman rank correlation was used to analyze the correlation between HIF-1α and CD133 mRNA expression. Univariate and logistic multivariate analyses were used to determine the factors related to pathological complete response (pCR). Logistic regression analysis and Cox's proportional hazard model were used to determine factors related to overall survival and recurrence-free survival.The expression of HIF-1α and CD133 mRNA was correlated with pT, ypTNM, pCR, recurrence and metastasis of rectal cancer, while not correlated with sex, age and BMI of patients. HIF-1α mRNA expression was positively correlated with CD133 mRNA expression (=0.579,=0.000). Immunohistochemistry analysis showed that residual cancer cells strongly expressing HIF-1α also expressed CD133 strongly. Univariate analysis showed that HIF-1α mRNA and CD133 mRNA were significantly correlated with pCR (=0.001,=0.022, respectively). Multivariate analysis showed that HIF-1α and CD133 mRNA expression were independent prognostic factors of pCR (=0.012,=0.047, respectively). Cox regression analysis showed that the expression of HIF-1α mRNA and CD133 mRNA were independent predictors of recurrence-free survival and overall survival (=0.025,=0.033, respectively).The study indicates that HIF-1α and CD133 can predict pathological complete remission and survival of patients with locally advanced rectal cancer.
AC133 Antigen ; analysis ; genetics ; Biomarkers, Tumor ; analysis ; Chemoradiotherapy ; Disease-Free Survival ; Female ; Humans ; Hypoxia-Inducible Factor 1, alpha Subunit ; analysis ; genetics ; Male ; Neoadjuvant Therapy ; Neoplasm Grading ; Neoplasm Metastasis ; diagnosis ; Neoplasm Recurrence, Local ; epidemiology ; genetics ; Neoplasm, Residual ; genetics ; Prognosis ; Proportional Hazards Models ; Rectal Neoplasms ; chemistry ; epidemiology ; genetics ; therapy ; Survival Rate

OBJECTIVE: To explore the effect of metabolic syndrome on 15 days postoperative adverse events of femoral intertrochanteric fractures with internal fixation. METHODS: From January 2011 to June 2019, 986 elderly patients with intertrochanteric fracture were treated with internal fixation, including 312 males and 674 females, with an average age of(77.71± 7.58) years old. And there were 97 patients with metabolic syndrome and 889 patients without metabolic syndrome. Through the electronic medical record system, the patient's age, gender, fracture type, cause of trauma, body mass index, smoking history, preoperative comorbidities, preoperative bloodtransfusion, operation timing, ASA classification, anesthesia method, internal fixation type, operation duration, and 15 days postoperative adverse events, which include surgical site infection, acute heart failure, acute respiratory failure, pulmonary infection, acute renal failure, DVT, embolism in important organs, urinary tract infection, death, and blood transfusion after surgery were collected. The differences of preoperative and intraoperative baseline datas and 15 days postoperative adverse events between the two groups were compared and analyzed by t text or univariate RESULTS: There were statistical differences in age, body mass index, history of cardiac insufficiency, history of COPD, history of renal insufficiency, operation timing, ASA classification, operation duration, surgical site infection, acute heart failure, DVT, urinary tract infection and blood transfusion between two groups ( CONCLUSION Elderly patients with intertrochanteric fracture with metabolic syndrome had higher postoperative surgical site infection rate, DVT incidence rate, urinary tract infection rate, and postoperative blood transfusion rate. Therefore, the orthopedic treatment team should give more attentionand optimize the treatment plan during the perioperative period with the cooperation of internal physician and anesthesiologist.
Aged ; Aged, 80 and over ; Bone Nails ; Female ; Fracture Fixation, Internal/adverse effects* ; Fracture Fixation, Intramedullary/adverse effects* ; Hip Fractures/surgery* ; Humans ; Male ; Metabolic Syndrome/complications* ; Retrospective Studies ; Treatment Outcome

Objective To evaluate the effectiveness of aspirin in preventing peripherally inserted central venous catheter (PICC) -related thrombosis. Methods Totally 360 cancer patients who had undergone routine PICC placement were equally randomized into aspirin group (receiving conventional PICC maintenance plus oral administration of aspirin; 100 mg/d, for consecutively 21 days) and control group (conventional PICC catheter maintenance). The incidences of phlebitis and thrombosis were observed in both two groups. Results The incidences of phlebitis and thrombosis were 3.3% and 0 in aspirin group, which were significantly lower than those in control group (8.9% , P = 0. 025; 1.7% , P = 0. 025). Conclusion The oral administration of aspirin after the PICC placement can reduce PICC-related thrombosis and phlebitis.

Objective To establish a HPLC method for determination of naringenin and apigenin in Premna fulva. Methods The SHISEIDO￣SPOLAR C18(250 mm×4.6 mm,5μm) was used as analytical column.The mobile phase consisted of methanol￣0.2% phosphoric acid (42:58) with isocratic elution at a flow rate of 1.0 mL.min-1 .The detection wavelength of naringenin and apigenin was 288 nm and 340 nm, respectively.Column temperature was set at 35 ℃ , the injection Volume was 10 μL. Results Naringenin and apigenin had a good linear relationship in the concentration range of 0.180 ~ 3.60 μg (r =0.999 9) and 0. 0052 ~ 0. 1040 μg ( r = 0. 999 9), respectively. Conclusion The method is accurate and reliable. It is appropriate for the quantitative determination of naringenin and apigenin in Premna fulva and its preparations.

Objective To examine neuroinflammation,oxidative damage and neuron loss in the contralateral parie-tal lobecortex of TBI model mice, and to investigate effects of berberine chloride on such secondary damage.Methods TBI model was established by a weight-drop hitting device and mice in berberine group were administered intragastrically with berberine chloride (50mg/kg.day) for 21 days.Immunofluorescence staining was used to assess activity of microglia and astrocyte.Immunohistochemistry was used to assess DNA oxidative damage, neuron loss and expression of COX-2 and iN-OS.Results Activation of microglia and astrocyte, expressions of COX-2 and iNOS and DNA oxidative damage were ob-viously increased by TBI,(19.82 ±1.88)and(16.96 ±1.69)、(13.79 ±4.32)and(8.67 ±0.96)、(27.86 ±5.38) and (16.00 ±7.59)、(31.92 ±6.57)and(24.79 ±2.78)respectively (P<0.01 or P<0.05).Activation of microglia and ex-pressions of COX-2 and iNOS were significantly suppressed by berberine ,(15.49 ±1.88)and(19.82 ±1.88)、(16.83 ± 7.89)and(27.86 ±5.38)、(26.25 ±2.41)and(31.92 ±6.57) respectively(P<0.01 or P<0.05).There was no differ-ence in neuron loss among three groups, (49.05 ±4.38),(48.56 ±3.56)and (47.75 ±4.14) respectively (P>0.05). Conclusions TBI can cause neuroinflammation and oxidative damage but not neuron loss in the contralateral parietal lobe cortex.Berberine chloride can significantly suppress neuroinflammtion in the contralateral parietal lobe cortex after TBI.