Objective To discuss effect and nursing process of endoscopic biliary stent implantation for treatment of patients with malignant biliary obstruction.Methods To evaluate efficiency of the operation and to observe nursing situation of 47 cases treated by the way of endoscopic biliary stent implantation in our hospital.Results In 47 patients,31 patients used EMBE,16 patients were given ERBD,the total rate of treatment efficiency reached 100％.Positive and effective nursing measures were given to two groups during operation period,which ensured the smooth process and increase the success rate of operation.Conclusions Endoscopic biliary stent placement for malignant biliary obstruction has gradually become an effective substitution of normal operations.And active and reasonable nursing can increase the success rate of operation and decrease postoperative complications.

Objective To investigate the requirement status and effect of relevant knowledge education in patients undergoing painless colonoscopy examination. Methods 230 cases of patients undergoing painless colonoscopy were chosen.The requirement status of relevant knowledge of painless colonoscopy examination was taken for investigation.The patients were randomly divided into the control group (90 cases) and the observation group( 140 cases).The control group was given basic nursing of painless bowel endoscopy and passively answering the questions raised by patients.The observation group was given active,systematic and designed knowledge education and psychological support for patients and their families on the basis of the control group.The knowledge level,coordination degree with examination and satisfaction degree of patients with painless colonoscopy were taken for statistics. Results The patients and their families were most concerned about security of painless colonoscopy,followed by instruction and compliance points before and after the examination,and the knowledge of anesthesia was rarely concerned about.The related knowledge of painless colonoscopy for the two groups of patients before the examination improved significantly than that after newly diagnosed,but the observation group was better than the control group.The compliance and inspection time in the observation group were significantly better than the control group.The satisfaction degree of patients and their families in the observation group were significantly higher than the control group. Conclusions The security for painless colonoscopy and instruction and compliance points before and after the examination were urgently needed by patients.Systematic knowledge education has pivotal significance in ensuring examination quality,improving satisfaction degree of patients,which is worthy of clinical application.

Objective To explore the lung developmental disorder of rats with gestational diabetes mellitus (GDM) via investigating the GDM rat fetal lung structures and expression of pulmonary surfactant proteins (SP)-B,SP-C,thyroid transcription factor (TTF)-1 and pleiomorphic adenoma gene like (PLAGL)-2.Methods Sprague-Dawley rats were used to construct the GDM model.Twenty GDM rats were used as GDM group and 20 normal pregnant rats as control group.Cesarean section was performed on day 21 of gestation and random blood sugar was detected,and fetal rats were counted and weighed.Ultrastructure of the fetal lungs was studied by transmission electron microscopy.Sixty fetal rats were selected randomly in each group,and 360 paraffin sections were made from fetal lungs.One hundred discontinuous paraffin sections were picked up in each group to observe morphological and structural changes under optical microscope.The other one hundred discontinuous paraffin sections were picked up in each group to detect the location and expression of SP-B,SP-C,TTF-1 and PLAGL-2 protein by immunohistochemistry.Nine fetal rats were selected randomly to detect the expression level of SP-B,SP-C,TTF-1 and PLAGL-2 proteins in fetal lung tissues by Western blotting.Twenty seven fetal rats were selected randomly to detect the mRNAs level of SP-B,SP-C,TTF-1 and PLAGL-2 by real-time quantitative polymerase chain reaction.Independent sample t-test was used for statistical analysis.Results The average random blood glucose level in GDM group was significantly higher than that in control group [(26.8± 2.8) vs (4.9± 0.5) mmol/L,t=-34.05,P=0.00].The average weight of fetal rats in GDM group was higher than that in control group [(5.6±0.6) vs (5.2±0.5) g,t=-1.97,P=0.03].Alveolar number (10.1 ± 1.6 vs 12.1 ± 1.3) and alveolar area [(986.9 ± 5.5) vs (1 257.3± 5.0) μ m2] in GDM group was less than that in control group (t=9.84 and 27.53,both P ＜ 0.05).Alveolar septum [(11.5±6.2) vs (9.9±4.3) μm] in GDM group was higher than that in control group (t=-2.17,P ＜ 0.05).Microvillus in type] cells were short and the number of lamellar bodies was significantly decreased in GDM group.SP-B,SP-C,TTF-1 and PLAGL-2 proteins were distributed in the cytoplasm in granular form.The average value of absorbance of SP-B,SP-C,TTF-1 and PLAGL-2 proteins in GDM group was 1.15±0.12,1.23±0.06,0.87±0.21 and 1.21 ±0.18 respectively;and that in control group was 1.22±0.05,1.31 ±0.14,1.12±0.09 and 1.33 ±0.07 respectively.The value in GDM group was lower than that in control group (t=2.40,2.35,4.89,and 2.77 respectively,all P ＜ 0.01).The expression level of SP-B,SP-C,TTF-1 and PLAGL-2 proteins in GDM group was 0.57± 0.09,0.45±0.03,1.50±0.04 and 1.11 ±0.04 respectively;and that in control group was 0.81 ±0.03,0.66±0.04,1.69±0.05 and 1.46±0.07 respectively.The value in GDM group was lower than that in control group (t=1 1.77,11.09,8.80 and 13.37,respectively,all P ＜ 0.01).The mRNA level of SP-B,SP-C,TTF-1 and PLAGL-2 in GDM group was 0.60±0.04,0.79±0.04,0.81 ±0.03 and 0.79±0.05 respectively;and that in control group was 1.06±0.19,1.03±0.24,1.03±0.18 and 1.02±0.19 respectively.The value in GDM group was lower than that in control group (t=6.80,2.98,3.54 and 3.54 respectively,all P ＜ 0.01).Conclusions The protein expression level of SP-B and SP-C in fetal lungs of GDM rats decreases obviously,possibly because of the down-regulation of the gene expression of TTF-1 and/or PLAGL-2.The pathological changes in fetal lungs of GDM rats might be associated with the descending level of SP-B and SP-C protein.

Objective To analyze the difference of salivary microbiome between the patients with functional dyspepsia and healthy controls.Methods Saliva samples were collected from the patients with functional dyspepsia and healthy control.Genomic DNA of the samples was extracted,and the high-throughput sequencing technology was used to conduct DNA sequence of 16S rRNA-V4 region.Subsequently,all the data were performed by the bioinformatic analysis.Results The salivary microbiome in the functional dyspepsia group was dominated by Proteobacteria,while Bacteroidetes was the top microbiota in the heathy control group.In the functional dyspepsia group,the Chao1 index,ACE index,Shannon index and Simpson index were 1 295,1 351,4.93 and 0.90 respectively.In the healthy control group,the above indexes were 1 001,1 351,5.28 and 0.92 respectively.The PCoA ba sically separated the microbiome composition of the two groups.Sixteen kinds of microbiota were significantly different between two groups using linear discriminant analysis effect size tool,including Bacteroidetes,Prevotella,Prevotellaceae,Neisseria,Betaproteobacteria and Proteobacteria,etc.Conclusion Saliva in the patients with functional dyspesia has characteristic microbiome composition,which is dominated by Proteobacteria,but the richness and diversity between the two groups have no difference.Neisseria is one of the significantly different bacteria between the two groups.

Objective: To study the factors affecting the survival and prognosis of patients with intracranial ependymoma. Methods:From January 2008 to January 2018, the prognoses of 276 patients with intracranial ependymoma were analyzed using Log-rank and Cox model analysis. The variables included sex, age, tumor location, tumor diameter, resection extent, pathological grade, Ki-67 index, postoperative radiotherapy, and postoperative chemotherapy. Results: Tumor location, resection extent, and postoperative radiothera-py could all affect the overall survival (OS) and progression-free survival (PFS) of patients with intracranial ependymoma (P<0.001) and independently affected the OS (P<0.001, P<0.001, and P=0.002, respectively) and PFS (P<0.001, P<0.001, and P=0.001, respectively). The Ki-67 index was an independent factor affecting PFS in patients with intracranial ependymoma (P<0.001). The supratentorial loca-tion and Ki-67 index≥10% were independent risk factors indicating poor prognosis (P<0.001). Total resection and postoperative radio-therapy were protective factors (P<0.001 and P=0.001, respectively). Conclusions: Tumor location, resection extent, Ki-67 index, and postoperative radiotherapy are independent factors affecting the prognosis of intracranial ependymoma. It is helpful to extend the PFS and OS of patients through complete tumor resection or postoperative radiotherapy.

Objective The objective of this study was to compare the short-term efficacy and adverse reactions of nituzum-ab combined with synchronous radiotherapy and chemotherapy and bevacizumab combined with synchronous radiotherapy and chemo-therapy in the treatment of locally advanced cervical cancer.Methods A total of 100 locally advanced cervical cancer patients with pathological type of squamous cell carcinoma were collected from 1 September 2020 to 31 December 2021.They were divided into a control group(synchronous radiotherapy and chemotherapy group),a nituzumab group(nituzumab combined synchronous radiotherapy group)and a bevacizumab group(bevacizumab combined synchronous radiotherapy and chemotherapy group).The total effective rate of short-term treatment,changes in tumor volume before and after treatment,serum squamous cell carcinoma antigen(SCC)levels be-fore and after treatment,and adverse reactions after treatment were compared among patients of the three groups.Results The short-term total effective rates of the Nitro group,Bevar group and control group were 90.3％,87.2％and 60.0％,respectively.The total effective rates of the Nitro and Bevar groups were significantly higher than those of the control group,and the differences were statisti-cally significant(P＜0.001).There was no statistically significant difference in the total effective rates of the Nitro and Bevar groups(P＞0.05);The degree of tumor volume reduction and SCC reduction in the Nituo group and Bevac group after treatment was higher than those in the control group(P＜0.05),and there was no statistically significant difference between the two groups(P＞0.05).The incidence of hypertension in the Bevar group was 33.4％,significantly higher than that in the control group(10.0％)and the Ni-tro group(12.9％)(P＜0.05).There was no statistically significant difference in the incidence of hypertension between the Nito group and the control group(P＞0.05);There was no statistically significant difference in the incidence of adverse reactions among the three groups except hypertension(P＞0.05).Conclusion Nituzumab combined with synchronous radiotherapy and chemothera-py,as well as bevacizumab combined with synchronous radiotherapy and chemotherapy,can improve the short-term efficacy of locally advanced cervical cancer,effectively reduce tumor volume and inhibit the expression of tumor markers,both of which are superior to synchronous radiotherapy and chemotherapy alone.Compared to bevacizumab,nituzumab has fewer adverse reactions.For patients with locally advanced cervical cancer,the combination of nituzumab and concurrent radiotherapy and chemotherapy is more reliable in terms of safety.

Objective To evaluate the effect of surgery-radiotherapy interval (SRI) on clinical prognosis of locally advanced stage c Ⅱ-Ⅲ breast cancer patients treated with neoadjuvant chemtherapy and modified radical mastectomy.Methods Clinical data of 1 087 breast cancer patients treated with neoadjuvant chemotherapy and modified radical mastectomy from 11 hospitals in China were retrospectively analyzed.The optimal threshold value of SRI upon clinical prognosis was determined by maxstat method.The effect of SRI on clinical prognosis was evaluated by using multivariate Cox regression analysis and propensity score matching (PSM).Results The median follow-up time was 72.9 months.The 5-year disease-free survival (DFS) and overall survival (OS) rates were 68.1％ and 81.8％.All patients were divided into SRI ≤18 weeks (n=917) and SRI＞ 18 weeks groups (n=170).Multivariate Cox regression analysis demonstrated that hormone receptor status (P＜0.001),pathological T stage (P＜0.001),pathological N stage (P＜0.001) and SRI (P=0.023) were independent influencing factors of DFS.Hormone receptor status (P=0.013),pathological T stage (P=0.006),pathological N stage (P＜0.001),endocrine therapy (P=0.013) and SRI (P=0.001) were significantly associated with OS.After balancing the clinical and pathological factors with PSM,patients with SRI＜ 18 weeks had superior DFS and OS to those with SRI＞ 18 weeks.Conclusions SRI affects the clinical prognosis of locally advanced breast cancer patients treated with neoadjuvant chemotherapy and modified radical mastectomy.Radiotherapy should be performed within 18 weeks after mastectomy.

Protein tyrosine phosphatase H-type receptor (PTPRH) gene encodes a gastric cancer associated protein, which exerts its biological function through tyrosine phosphorylation in the post-translational COOH- terminal region. PTPRH is abnormally expressed in a variety of tumors, and its biological function is closely related to the occurrence, development and prognosis of tumors.
Humans ; Phosphorylation ; Protein Tyrosine Phosphatases ; Proteins ; Stomach Neoplasms ; Tyrosine