Objective To probe into the effect of early psychological care on negative emotions and sleep of elderly patients with chronic heart failure. Methods 96 patients elderly patients with chronic heart failure were selected from June 2009 to June 2010, and were randomly divided into the study group and the control group with 48 patients in each group. Two groups of elderly patients were given traditional routine care after diagnosis, and elderly patients in the study group were given early comprehensive psychological nursing intervention additionally. Clinical index such as negative mood and sleep were analyzed. Results Compared with the control group, anxiety and depression scores of the study group were significantly decreased, somatization, obsessive-compulsive symptoms, depression and anxiety were significantly decreased, awakening time, and arousals were significantly lower, and sleep efficiency and sleep maintenance rate was significantly increased, there were significant differences. Conclusions Early psychological care for elderly patients with chronic heart failure is very important to improve negative mood and sleep quality for them, and is worth further clinical promotion and application.

Objective To compare the effects of ephedrine and dopamine in the prevention of hypotension during combined spinal and epidural anesthesia (CSEA)for cesarean delivery.Methods Fifty ASAⅠorⅡ patients undergoing elective cesarean delivery were randomly divided into the two groups,Ephedrine group (n=5 1 ):intrave-nous injection of 10mg ephedrine before anesthesia;Dopamine group(n=52):continuous intravenous infusion at the speed of 5μg·kg-1 ·min-1 .During the whole process,we investigated the incidence rate of adverse effects,com-pared the Apgar score of neonate and analyzed blood gas of umbilical artery and vein.Results Compare to the dopa-mine group,the incidence rate of hypotension was lower in the ephedrine group (43.1% vs 69.2%,χ2 =7.06,P=0.00).The pH value of umbilical artery and 1 min Apgar score of neonate in the ephedrine group was lower compare with that in the dopamine group[(7.22 ±0.03)vs (7.27 ±0.06),t=0.62,P=0.02],there are no significant difference of 5 min Apgar score in the two groups.Conclusion Compared with dopamine,ephedrine is a useful drug in the prevention of hypotension during combined spinal and epidural anesthesia (CSEA)for cesarean delivery and there are no significant differences of adverse effects of dopamine and ephedrine.Ephedrine has transient effect on the neonate,while the effect of dopamine is minor.

Objective To evaluate stepping DSA technology in lower extremity artey disease. Methods 12 cases performed with stepping DSA in lower extremity artery were examined with TOSHIBA Infinixi digital subtraction angiography system, of which, 8 ones were also examined with conventional DSA. Results Stepping DSA technology could decrease the dosage of contrast agent and the examination.

Objective To evaluate the application of 3D DSA in diagnosis of intracranial aneurysm. Methods Conventional DSA and 3D DSA were performed in 15 cases with subarachnoid hemorrhage. Results Of 15 cases, by 3D DSA, 12 ones were diagnosed as intracranial aneurysm, and the remaining 3 ones were suspected, while 7 ones could be diagnosed by conventional DSA. Conclusion 3D DSA can improve the diagnosis of intracranial aneurysm.

Objective To detect the expressions of Six1 ,TGF‐βand their common induced VEGF‐C in human laryngeal squa‐mous cell carcinoma ,and to explore their significance in the occurrence ,development ,metastasis and prognosis of laryngeal squa‐mous cell carcinoma .Methods The clinical data and preserved paraffin samples of 96 patients with laryngeal squamous cell carci‐noma confirmed by postoperative pathology were collected .The protein expression of Six1 ,TGF‐βand VEGF‐C was determined by adopting immunohistochemistry and Western blotting .Results The positive expression rates of Six1 ,TGF‐β and VEGF‐C in the laryngel squamous cell carcinoma tissue samples were 84 .4% (81/96) ,89 .6% (86/96)and 91 .7% (88/96)respectively .The positive expression rate of Six1 was significantly higher in the patients with poor differentiation and lymph node metastasis ;the positive ex‐pression rate of TGF‐βwas significantly higher in the patients with lymph node metastasis and had no relationship with the degree of differentiation ;the positive expression rate of VEGF‐C was significantly higher in the patients with poor differentiation and lymph node metastasis ;there was a positive correlation between expression of Six 1 and VEGF‐C in the laryngel squamous cell canc‐er tissue .Conclusion The high expression of Six1 ,TGF‐βand VEGF‐C may promote lymphatic metastasis of laryngeal squamous cell carcinoma .Six1 expression may be one of the important influencing factors of the expression change of VEGF‐C .The combined detection of Six1 ,TGF‐βand VEGF‐C has an important clinical significance for judging the metastasis and prognosis of LSCC .

Objective To evaluate angiography and interventional embolization in diagnosis and treatment of massive hemobilia.Methods During 10 years,9 patients with massive hemobilia underwent emergency selective hepatic artery angiography to find the bleeding points,and then embolized the feeding branches.Results All cases demonstrated clearly on angiography about the arterial hemorrhage,and extravasation of contrast-medium.Hemorrhage was stanched immediately after embolization of the feeding branches of the hepatic artery.Conclusion Selective hepatic angiography and interventional embolization for massive hemobilia is a safe and efficient diagnostic and therapeutic method.(J Intervent Radiol,2006,15:213-214)

Objective To investigate the effect of continuous care provided by midwife group personnel to pregnant women.Methods 100 cases of pregnant women were screened out and divided into the study group and the control group with 50 patients in each group randomly.The study group received continuous care provided by midwife group personnel,the control group received traditional nursing.Effect of different nursing measures on mothers and neonates were compared.Results Antenatal cognition and rate of natural delivery of the study group were higher than the control group.The rate of neonatal asphyxia and postpartum depression occurred in the study group were lower than the control group,Maternal and family sarisfaction and rates of breasffeeding of the study group were higher than the control group.Conclusions Continuoas care provided by midwife group personnel can increase antenatal cognition and rate of natural delivery,maternal and family satisfaction.breast feeding rates and the overall quality of nursing staff,reduce rate of neonatal asphyxia with few postpartum depression,then improve the quality of perinatal care.

Objective To investigate the analgesic effect and adverse reactions of patient-controlled intravenous analgesia (PCIA) in breast cancer patients with radical mastectomy.Methods A total of 210 breast cancer patients who underwent radical mastectomy was randomly divided into two groups,experimental (group A) and control (group B) groups (n =105 cases per group).Patients in group A was used PCIA for 48 hours analgesia,while group B weas applied routine intramuscular injections of pethidine.Visual analogue score (VAS) at 4,8,12,24,and 48 hours after operation were recorded.Pulse,respiration,and blood pressure were monitored and side effects e.g.existed skin itching,nausea,vomiting,and respiratory repression were observed.Results The VAS of group A patients on 4,8,12,24,and 48 hours were2.02 ± 1.47,1.73 ± 1.38,1.68 ± 0.91,1.44 ± 0.65,and 1.21 ± 0.61,respectively;and the VAS of group B patients were 6.95 ± 1.96,6.42 ± 1.57,5.63 ± 1.66,4.99 ± 1.62,and 3.72 ± 1.46,respectively.The VAS was significantly lower in group A patients than in group B (P ＜ 0.05).The incidence of skin itching,nausea,vomiting,and respiratory repression was also distinctly decreased in group A than in group B (P ＜0.05).The overall satisfaction of patients in group A (96.2％) was remarkably higher than in group B (67.6％) (P ＜0.01).Conclusions Patient-controlled intravenous analgesia pump can more effectively alleviate the degree of pain,reduce the incidence of skin itching,nausea,vomiting and respiratory repression,improve the satisfactory degree for analgesia in breast cancer patients with radical mastectomy compared to traditional intramuscular way.

Objective To analyze the clinical characteristics of pneumomediastinum in patients with dermatomyositis and polymyositis for demonstrating its pathogenesis and for predicting its prognosis. Methods The clinical records of 96 patients with PM/DM were reviewed, focusing on for perdicting its pneumomediastinum. Five patients with pneumomediastinum are described in detail. Case reports of pneumomediastinum in PM/DM in English publications are reviewed. Results Five DM cases complicated by pneumomediastinum all had lung infections. Twenty-nine cases (including our five cases) of DM/PM with pneumomediastinum have taken methylprednisolone, four cases alive, and six died. Nine cases have taken CsA,seven cases alive and two died. Conclusion The infections was strongly suspected as being responsible for the pneumomediastinum. Methylprednisolone has poor effect. CsA can be an effective therapeutic agent in PM/DM.

Objective To observe the change of JAK-STAT-SOCS signal molecules after interferons alpha acting on the cancerous oral cells in 3 different degrees,namely NOK,DOK and KB cells,and to provide research foundation for the deep understanding of OSCC (oral squamous cell cancer) tumor ceils immune escape mechanism.Methods NOK,DOK,and KB cells were all cultured respectively,and then the third passage cells in the logarithmic growth phase were inoculated in cell culture plate.Blank control group of each hole was added 2 ml complete medium containing 10 ％ FPS.DMSO control group of each hole was added 2 ml complete medium containing 0.1％ DMSO.And in experimental groups containing 10 U/ml,100 U/ml,and 500 U/ml interferons,complete culture medium were added to each hole containing different concentrations of interferons alpha.CP-690550 (100 μmol/L) was added before interferons alpha was added 1 h.All were detected by RT-PCR test and Western blot test after conventional cultured for 24 h.Results RT-PCR detection showed that JAK1 and JAK2 in NOK cells had a small amount of expression,interferons alpha and CP-690550 cells could not influence the expression of JAK1 and JAK2 of NOK group,and there was no statistically significant difference (P ＞ 0.05).Interferons alpha in 100 and 500 U/ml could stimulate the increase of JAK1 and JAK2 expression in DOK and KB cells,and the differences were statistically significant (P ＜ 0.05).CP-690550 could effectively reduce the JAK1 expression of DOK and KB cells,while had no effect on the expression of JAK2,and the differences were statistically significant (P ＜ 0.05).Western blot showed that STAT1,STAT3 and pSTAT3 (Tyr705) all expressed in the control group,while pSTAT1 (Tyr701) didn't express in the control group.Interferons alpha and CP-690550 cells had no effect on STAT1,STAT3 and pSTAT3 (Tyr705) expression of NOK group,and there was no statistically significant difference (P ＞ 0.05).100 U/ml and 500 U/ml of interferons alpha could stimulate the increases of pSTAT3 (Tyr705) expression of DOK and KB cells,and the differences were statistically significant (P ＜ 0.05).While they had no effect on pSTAT1 (Tyr701) expression.CP-690550 could effectively reduce the pSTAT3 DOK and KB cells (Tyr705) expression,and the differences were statistically significant (P ＜ 0.05).Western blot showed that there were expression of SOCS1 and SOCS3 in control group.Interferons alpha and CP-690550 had no effect on SOCS1 and SOCS3 expression of NOK cell group,and there was no statistically significant difference (P ＞ 0.05).100 U/ml and 500 U/ml of interferons alpha could stimulate the increase of SOCS 1 expression of DOK and KB cells,and differences were statistically significant (P ＜ 0.05).For the expression of SOCS3,no influence.CP-690550 could effectively reduce the expression of SOCS1 of DOK and KB cells,and the differences were statistically significant (P ＜ 0.05).Conclusions Interferons alpha activate DOK JAK1 and KB cells and the expression of JAK2,mainly JAK1 activation.Interferons alpha,by activating DOK JAK1 and KB cells and the expression of JAK2,promote STAT3 phosphorylation in Tyr705 locus.Interferons alpha,by promoting STAT3 phosphorylation,further promote the expression of SOCS1,which plays the role in inhibiting interferons alpha and reducing the apoptosis.