Objective The objectives of this study were to investigate the relationship between DKK1 protein expression and lymph node invasion,and prognosis in patients with intrahepatic cholangiocarcinoma.Methods From January 2005 to December 2012,78 patients with intrahepatic cholangiocarcinoma were treated with endoscopic resection.Tissue microarray of intrahepatic cholangiocarcinoma and adjacent tissues were done and biochemical indexes were measured before operation.The patients were recruited every 3 months after operation.The Kaplan-Meier method was used to analyze the recurrence-free survival curve and the overall survival curve.The Cox proportional hazards regression model was used to analyze the multivariate analysis and to determine the factors that affect the disease-free survival(RFS)and overall survival(OS).Results There were significant differences in the expression of GGT,hepatic portal lymph node invasion,Child-Pugh grade,MMP9 and DKK1 protein in the negative and positive expression of intrahepatic cholangiocarcinoma(P ＜ 0.05).The positive expression rate of DKK1 protein in intrahepatic cholangiocarcinoma was 35.90％ (28/78),and the positive expression rate of DKK1 protein in hilar cholangiocarcinoma was 14.10％ (11/78).RFS and OS in 78 cases of intrahepatic cholangiocarcinoma were 51.28％ (40/78) and 50.00％ (38/78),41.03 ％ (32/78) and 38.46％ (30/ 78),25.64％ (20/78) and 23.08％ (18/78) after surgery for 1,3 and 5 years,respectively.The results from univariate and multivariate analysis showed that GGT,CA19-9,CEA,tumor size,DKK1 and hilar lymph node invasion were the prognostic factors of OS in patients with intrahepatic cholangiocarcinoma.CEA,tumor size,DKK1 and hilar lymph node involvement were prognostic factors for RFS in patients with intrahepatic cholangiocarcinoma.DKK1 protein expression positive and negative OS curve or RFS curve showed that 5 years after intrahepatic cholangiocarcinoma patients DKK1 protein expression positive and negative OS were 28.20％ and 20.51％;RFS were 24.36％ and 21.79％.Conclusion The expression of DKK1 protein is closely related to lymph node invasion in patients with intrahepatic cholangiocarcinoma.The expression of DKK1 protein is the prognostic factor of OS and RFS in patients with intrahepatic cholangiocarcinoma.

Objective To identify the sounces of occupational stress and explore the relationship between occupational slreas and social support for nurses in ICU.Methods A descriptive and correlation design was used in this study.From July to October in 2007,159 nurses from 8 ICU and 160 nurses from common wards completed the questionnaires.Statistical analysis was performed for the investigation results.Results The ayes age score of occupational stress for nurses in ICU was (3.41±0.73),which was in a moderate to high level.The main stress was that they regarded nursing as a high risk career,maximums working intensity,always overload work and frequent night-shift.While the average score of occupational stress for nurses in common wards was (3.29±1.05).The main stress was that they regarded nursing as a high risk career,Score of occupational stress between nurses in ICU and com wards had no statistical difference(P＞0.05).There was a significant negative correlation between occupational stress and social support for nurses in ICU(r=-0.159,P＜0.05).And the sup port by friends was into the equalion by multi-linear regression.Conclusions The level of occupational stress for murses in ICU was fairly hish.Scientific management of human resource,reducing work pressure of nurses and workloed,exerting various social support will benefit for reducing the stress of nurses in ICU.

Objective To study the effect of angiotensin Ⅱ and aldosterone (ALD) in patients with congenital heart disease by preoperative nursing interventions at high altitude area. Methods 86 patients with congenital heart disease were divided into the experimental group and the control group on average by random. The experimental group was treated with preoperative nursing interventions and routine nursing before operation and the control group was treated with routine nursing only. Angiotensin Ⅱ and aldosterone were detected before anesthesia, 30min after operation and after pulling out of endotracheal tube respectively. Results The concentration of Angiotensin Ⅱ and aldosterone was significantly lower in the experimental group than the control group. Conclusions The risk of open surgical operation for congenital heart disease at high altitude can be reduced by preoperative nursing interventions.

Objective To analyze risk factors for surgical site infection(SSI) in cardiac surgery patients,so as to provide basis for making control measures.Methods 215 patients who underwent cardiac surgery in a hospital between January 2012 to December 2014 were investigated,univariate analysis and multivariate logistic regression analysis were used to analyze the related risk factors for postoperative SSI.Results The incidence of postoperative SSI in cardiac surgery patients was 16.28％ (35/215).Univariate analysis showed that the incidence of postoperative SSI was relatively higher in patients aged＞65 years,duration of operation＞5 hours,continuous operation,preoperative hospitalization time ＞7 days,irrational perioperative antimicrobial use,as well as patients with underlying diseases such as hypertension and diabetes mellitus.Multivariate logistic regression analysis indicated that the age,duration of operation,continuous operation,preoperative hospitalization time,irrational perioperative use of antimicrobial agents,and patients with underlying diseases were independent risk factors for SSI in patients who underwent cardiac surgery.Conclusion Incidence of SSI is higher in patients with cardiac surgery,preventive measures should be taken to control risk factors such as duration of operation,so as to reduce the incidence of SSI.

Objective To study the preventive effects of rh ub arb and dexamethasone(DXM) on stress ulcer. Methods A total of 80 healthy SD rats were made into stress ulcer animal model with tend cold. They were randomly assigned into four groups, including normal control group(20) , DXM intervention group(20), rhubarb intervention group(20) and rhubarb & DXM i ntervention group(20).All of them were observed for the incidence of stress ulce r. Results The stress ulcer incidence were the same in DXM stress ulcer group and normal control group. The stress ulcer incidence in rhuba rb and DXM group was the lowest. Conclusion The DXM doesn't increase the incidence of stress ulcer, while the rhubarb with DXM does decreas e the incidence of stress ulcer.

Objective Mongolian gerbil can make themself urine concentration for saving water and adapt to the harsh desert environment, due to their very unique moisture control system in the body.Methods Mongolian gerbil is resistant to drought on account of their special kidney. Histology of the kidney, ureter and bladder in Meriones Unguiculataus were observed by light microscopy using HE staining.Results The results showed that compared with rats and mice, the Mongolian gerbils have more developed distal tubules, and well developed inner renal medulla.Conclusions We hope that the findings of this study enrich our understanding of the histology of urinary system in Mongolian gerbils and provide support for the laboratory animalization of this animal.

ObjectiveTo investigate the effects of minimally invasive key-hole drainage for treating acute subdural hematoma.MethodsThirty-five patients with acute subdural hematoma treated by key-hole drainage were retrospectively analyzed.CT-oriented key-hole drainage was performed to aspirate,liquefy and drain hematoma.The transfixion pin was removed after hematoma was basically cleared within 1 to 3 days.ResultsHematoma volume decrease was greater than 80％ by follow-up CT 24 hours postoperatively.Headache and vomiting in the preoperative conscious patients were significantly relieved after key-hole drainage.Glasgow Outcome Score (GOS) was 5 points in 16 patients,4 points in 15 and 3 points in four six months postoperatively.One patient was complicated with hydrocephalus and two with epilepsy.ConclusionsKey-hole drainage with disposable transfixion pin selective employed for patients with acute subdural hematoma is effective and has few complications.The treatment notably improves prognosis of the patients.

Objective To evaluate the efficacy of Jianpi-Xiaozheng recipe combined with chemotherapy in patients with late gastric cancer. Methods A total of 124 patients with late gastric cancer were randomly divided into a control group and a treatment group by random number table method, with 62 cases in each group. The patients in the control group received chemotherapy with S-1 and oxaliplatin (SOX), and those in the treatment group received Jianpi-Xiaozheng recipe combined with SOX chemotherapy. The treatment response was evaluated using the response evaluation criteria in solid tumors. The quality of life and physical status were evaluated with the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (QLQ-C30) and Karnofsky Performance Status (KPS), respectivly. The serum levels of tumor biomarkers, carbohydrate antigen 199 (CA199) and carbohydrate antigen 72-4 (CA72-4) were detected before and after treatment. Results The response rate (complete or partial response) in the treatment group was significantly higher than that in the control group (62.9%vs. 43.5%;χ2=4.665, P=0.031). The scores of QLQ-C30 (46.8 ± 6.3 vs. 42.2 ± 5.9;t=4.196, P=0.001) and KPS (79.1 ± 7.8 vs. 72.0 ± 7.5;t=5.167, P=0.000) in the treatment group were significantly higher than those in the control group. The serum levels of CA199 (61.7 ± 16.5 U/ml vs. 113.3 ± 21.4 U/ml;t=15.036, P=0.000) and CA72-4 (27.9 ± 9.6 U/ml vs. 34.3 ± 9.7 U/ml;t=3.693, P=0.001) in the treatment group were significantly lower than those in the control group. Conclusions Jianpi-Xiaozheng recipe combined with chemotherapy can increase response rate, decrease the serum levels of tumor biomarkers, and improve the quality of life in patients with late gastric cancer.

ObjectiveTo estimate the clinical efficacy and immunomodulatory effect of polysaccharidenucleic acid fraction of bacillus calmette guerin(BCG-PSN) combined with a traditional Chinese medicine in patients with vitiligo.MethodsThis study recruited 99 patients with vitiligo aged from 13 to 65(35,6 ± 5.8) years.The patients were classified into 3 groups to be treated with BCG-PSN and a traditional Chinese medicine (Baidianfeng granules) alone or in combination.BCG-PSN was intramuscularly injected at a dose of 2 ml every other day and baidianfeng granules were given orally thrice a day,for 3 months.Peripheral blood samples were obtained from the patients at the baseline and after the end of treatment and from 30 healthy controls.Flow cytometry and enzyme linked immunosorbent assay(ELISA) were performed to detect T cell subsets and expression level of Fas and Fas ligand(FasL),respectively.Data were analyzed by t test and chi-square test.Results The response rate was significantly higher in patients treated with BCG-PSN combined with Baidianfeng granules than in those with BCG-PSN alone(82.86％ vs.40.63％,P ＜ 0.01 ).Before the treatment,patients showed a lower percentage of CD3+ cells,CD3+CD4+ cells and CD3+CD8+ cells in peripheral blood(all P ＜0.01 ),weaker expression of Fas (P ＜ 0.01 ),but a higher CD4/CD8 ratio (P ＜ 0.01 ) compared with the controls.The treatment with BCG-PSN and Baidianfeng granules alone or in combinatiou all induced an increase in the percentage of CD3+ cells,CD3+CD4+ cells and CD3+CD8+ cells in peripheral blood(P ＜ 0.05) and in the expression of Fas(P ＜ 0.01),but a decrease in CD4/CD8 ratio(P ＜ 0.05).ConclusionsBCG-PSN may induce the normal apoptosis in lymphocytes via reversing the abnormality in the expression of Fas/FasL by peripheral blood lymphocytes,and the effect of BCG-PSN may be enhanced by a traditional Chinese medicine,Baidianfeng granules.

Objective To assess the health status of rodent laboratory animals by pathological diagnosis, our lab has being take apart in investigating the quality of laboratory animals in Beijing area for years and offer some advices for standardized breeding to ensure accurate results of scientific research.This paper focuses on the analysis of laboratory rodent samples that collected in October 2014.Methods We collected the heart, liver, spleen, lung, kidney, large intestine and small intestine, and put these organs into 10%Calcium formaldehyde solution for fixation, and then prepared into two different sections for optical microscopy observation including all paraffin specimens stained with H&E and the frozen sections stained with Oil Red-O and PAS.Results The vast majority of laboratory rodents were up to standard, but there still a problem in individual units.The main problem is liver and lung disease.The rate of Hepatocyte swellingis 6%(mouse), 2.5% (rat), 8.2% (guinea pig), moreover part of them were lipidosis, according to Oil Red-O stain.the mainly problem of lung is congestion ,edema and Interstitial pneumonia ,the detectable rate of pulmonarydiseases is 15.5%(guinea pig).Conclusions The vast majority of laboratory rodents were pathologically diagnosed as healthy animals.The liver disease may be caused by improper feeding.And disease of lung may led by haze, unqualified bedding and low temperature.