In this paper,we summarized nursing care of 9 patients with cytokine release syndrome after receiving the chimeric antigen receptor T cells immunotherapy.Key points of nursing care were as follows:comfortable and effective antipyresis,preventive rehydration,multiple methods of blood oxygen saturation improvement,iatrogenic pressure ulcer prevention,frequent vital signs monitor,close observation of level of cytokine and inflammatory factors,timely and accurate medication,formulating personalized nursing plan according to patients' condition,close collaboration between doctors and nurses.At last,8 patients recovered and were discharged,and 1 case died due to multiple organ dysfunction syndrome.

Objective To study the distribution characteristics of radon progeny at different air quality index (AQI) and evaluate health risks for the exposed population.Methods EQF3120 Monitor was used to monitor the concentration of radon and its daughters.The relevant air quality data was provided by the environmental monitoring station at Suzhou Industrial Park.SPSS 16.0 software was used for statistical description,principal component analysis and simple correlation analysis.Environmental radon exposure-caused effective dose to lung region was estimated by using the radon dose formulas.Results Radon progeny in fog haze weather in winter of Suzhou Industrial Park had relationships with NO2,SO2,O3,PM10 and PM2.5.The correlation coefficient of 214Bi were 0.741,0.681,-0.431,0.597 and 0.675.The correlation coefficient of radon progeny with PM2.5 was greater than that with PM10.When AQI ＞ 200,the effective dose to residents outdoor from radon and its short-lived progeny was 0.63 mSv/a.Conclusions Higher AQI results in higher concentration of attached radon progeny.There is little variation in concentration of unattached radon progeny.Fog and haze can increase exposure of the population to inhalated radon.

Obiective To investigate the effects of antidepressant therapy on whole regulating function of serotonin and tryptophan hydroxylase 2 system in ovariectomized(OVX) rats with depressive disorder.Methods seventy-two female Sprague-Dawley rats were used as subjects.The rats were randomly divided in-to 8 groups as following:Sham operation group (Sn),depression group (Dn),the OVX group (On),OVX with depression group (ODn),OVX with depression + sertraline group (ODs),OVX with depression + citalopram group(ODx),OVX with depression+ venlafaxine group(ODw),OVX with depression+ reboxetine group(0Dr).Rats in group OVX and group OVX with depression were ovariectomized.Rats in group with depression were exposed to the chronic unpredictable mild stress (CUMS).Open-field test and sugar consumption experiment were tested on all rats before the experiment and the 28th day of experiment.The expression of TPH2 mRNA was measured with RT-PCR,and the expression of TPH2 protein was detected by Western blot.The concentration of 5-HT was detected by ELISA.Results (1) After exposure of CUMS,the scores of motion and percentage of sugar consumption experiment in Dn group were decreased contrast to the Sn group (P＜0.05),and the scores in ODn group were decreased compared with the on group(P＜0.05).(2)The protein and gene expression of THP2 in On and Dn group were decreased contrast to the Sn group (P＜0.05).The protein and gene expression of THP2 in ODn were decreased compared with the on group (P＜0.05).The protein and gene expression of THP2 in ODs (protein (0.68±0.07);gene (0.87±0.09)),ODx (protein (0.71 ±0.05);gene (0.84±0.17)),ODw(protein (0.69±0.04);gene (0.88±0.16)) and ODr(protein (0.53±0.07);gene (0.70±0.15)) were increased compared with the ODn(protein (0.31±0.09);gene (0.56±O.16)) group (P＜0.05).(3)The concentration of 5-HT of hippocampus and serum in Dn and On group were decreased contrast to the Sn group (P＜0.05).The concentration of 5-HT of hippocampus and serum in ODs,ODx,ODw and ODr group was increased compared with the ODn group (P＜0.05).Conclusion The antidepressants can up-regulate the expression of THP2 and the concentration of 5-HT in the OVX rats with depressive disorder.Sertralin is stronger however Reboxetine Mesylate is the poorest.

Objective: To determine plasma levels of soluble tumor necrosis factor-related apoptosis inducing ligand (sTRAIL) and its soluble death receptor (sDR4, sDR5) in essential hypertension (EH) patients with left ventricular hypertrophy (LVH). Methods: Enzyme linked immunosorbent assay (ELISA) was used to measure plasma levels of sTRAIL, sDR4 and sDR5 in 50 EH + LVH patients (EH + LVH group), 50 EH patients without LVH (EH group) and 50 healthy subjects (healthy control group), and the results were compared and analyzed among three groups. Results: ① Compared with healthy control group and EH group, there were significant increase in plasma levels of sTRAIL [(0.95±0.11) ng/ml vs. (1.12±0.86) ng/ml vs. (1.74±1.19) ng/ml], sDR4[(2.38±0.32) pg/ml vs. (5.63±1.05) pg/ml vs. (8.72±1.14) pg/ml] and sDR5[(< 6 pg/ml) vs. (39.19±8.23) pg/ml vs. (78.21±11.2) pg/ml] in EH + LVH group, P<0.01 all; and levels of sDR4 and sDR5 in EH group were significantly higher than those of healthy control group (P<0.01 both), but there was no significant difference in sTRAIL level between the two groups (P>0.05); ② Pearson correlation analysis indicated that there were significant positive correlation among levels of sTRAIL, sDR4 and sDR5 in EH + LVH patients (r=0.325~0.410, P<0.05 or <0.01). Conclusion: Plasma levels of sTRAIL, sDR4 and sDR5 may be valuable indexes for prediction of left ventricular hypertrophy in patients with hypertension.

Aim To investigate the effects of an angiotensin Ⅱ receptor blocker,candesartan, on aorta oxidative stress-LOX-1 pathway in salt-loaded stroke-prone spontaneously hypertensive rats (SHRSP).Methods 12-week-old salt-loaded SHRSP were treated with candesartan(1.0 mg?kg-1?d-1)or a diuretic, trichlormethiazide(TCM,1.6 mg?kg-1?d-1) or no treatment(n=6) in each for 2 weeks. Age-matched salt-loaded WKY rats were served as control(n=6).Systolic blood pressure(SBP)was measured weekly throughout the 2-week period by means of the tail-cuff method.Thoracic aortas were extracted and 24 h urine was collected.NAD(P)H oxidase subunits(p22 phox, p47 phox and gp91 phox)mRNA expression in aorta were assayed by real-time PCR. LOX-1 and type Ⅳ collogen mRNA expression were examined by RT-PCR. gp91 phox and LOX-1 protein expression in aorta were assayed by immunohistochemistry.Urinary albumin excretion was examined by ELISA.Results At the end of the 2nd week, SBP was significantly higher in salt-loaded SHRSP than that in salt-loaded WKY rats. Treatment with candesartan and TCM significantly decreased SBP in salt-loaded SHRSP at similar levels.NAD(P)H oxidase subunits (p47 phox and gp91 phox)and LOX-1 mRNA expression in aorta were markedly higher in salt-loaded SHRSP than those in salt-loaded WKY rats.Candesartan and TCM had the effect of reducing the systolic blood pressure at similar levels. Candesartan significantly down-regulated aorta p22 phox, gp91 phox,LOX-1 and type Ⅳ collogen mRNA expression and decreased urine albumin excretion in salt-loaded SHRSP(P

Objective To investigate the level and influencing factors of falls efficacy among older patients with type 2 diabetes (T2DM) .Methods A total of 218 older patients with T2DM were investigated by the modified falls efficacy scale(MFES) and Morse Fall Scale (MFS) ,questionnaire and observation were both used .Results The average score of falls efficacy was 8 .15 ± 2 .91 .The scores were lowest in the items of walking up and down stairs and going to bed and getting out of bed ,and highest were in the items of dressing and sitting down and standing up from a chair .The multivariate linear regression analysis showed that dura‐tion of diabetes ,diabetic complications and fall history were the main factors influencing their falls efficacy .Conclusion Falls in eld‐erly T2DM patients were in the medium level ,and it′s closely related with duration of diabetes ,its complications and fall history .

Objective To approach the efficiency and feasibility of preserving the fertility for patients with placental site trophoblastic tumor ( PSTT ).Methods Totally 2 086 cases of gestational trophoblastic neoplasm ( GTN) patients registered in Peking Union Medical College Hospital between 1998 and 2013.Fifty-seven of them were PSTT patients , 40 cases of which suffered hysterectomy , the rest 17 PSTT patients who preserved their fertility were analyzed retrospectively.The computerized database of clinical and pathological reports was reviewed in this cohort.Results The clinical manifestation of PSTT was not specific compared to other types of GTN.The average age of the 17 patients was 29.5 years old (range 22-39 years).The most common antecedent pregnancy was term birth (8 cases), the others were spontaneous abortion in 4 case, artificial abortion in 3 cases and molar pregnancy in 2 cases.The baseline serum β-hCG was slightly elevated and 12 patients (12/15) were less than 1 000 U/L.In this cohort, nine of the patients were in stage Ⅰ, while the other eight cases were in stage Ⅲ .The patients suffered conservative surgery, including dilation and curettage of uterus in 7 cases, open abdomen uterine lesion excision in 4 cases, laparoscopic uterine lesion excision in 3 cases, hysteroscopic uterine lesion excision in 1 case, and pulmonary lobectomy in 2 cases.Two of the patients didn′t received chemotherapy , while the other 15 cases suffered combination chemotherapy.Compared with 40 patients who suffered hysterectomy during the same interval , fertility preservation group did not result in poor outcomes or high risk of relapse rate.Six subsequent pregnancies happened after the therapy , two of them were during their second-trimester, while four patients had healthy babies by vaginal delivery in two and cesarean section in two .The scar of the uterus was fairly well during the cesarean sections.Conclusions Reservation of fertility therapy could be considered in highly-selected patients for young women who strongly desired to preserve their fertility and with localized lesion.Exactitude follow-up after therapy should be recommended.Contraception should also be recommended for at least one year after the chemotherapy.Vaginal delivery could be an option for the future pregnancies.

Objective To investigate the effect of ultrashort wave therapy on edema and inflammatory reaction after spinal cord injury (SCI) in rats. Methods 56 Sprague-Dawley rats were divided into sham-operated group (n=8), model group (n=24) and ultrashort wave group (n=24). The model was established with Allen's method. The sham-operated group was exposed endorhachis without hit. The ultra-short wave group was exposed to ultrashort wave radiation 7 minutes, once a day, 24 hours after modeling until the animals were sacrificed. Locomotors functional recovery was assessed every week post operation period by BBB score. Immunohistochemical staining was per-formed to observe the expression of the aquaporin-4(AQP-4) and ED-1. Results The BBB scores increased in the model group and the ultra-short wave group after treatment, and was higher in the ultrashort wave group than in the model group from 1 week after treatment (t>3.368, P<0.01). The expressions of AQP-4 and ED-1 were higher in the model group and ultrashort wave group than in the sham-operated group, and decreased as time went on. They were lower in the ultrashort wave group than in the model group(t>3.156, t>4.466, P<0.05). Conclu-sion Ultrashort wave therapy can alleviate the edema after SCI, reduce the activation and infiltration of inflammatory cells, and promote the recovery of neurological function.

This study was aimed to evaluate the feasibility of wind-warm lung-heat disease (non-severe community-acquired pneumonia, CAP) from the clinical curative effect, hospitalization days, medical expenses and other aspects. This study selected 198 wind-warm lung-heat disease (non-severe CAP) inpatients from January, 2012 to December, 2012 with the conventional therapy in the Respiratory Department, Wuhan Integrated Traditional Chinese Medicine (TCM) & Western Medicine Hospital as the control group. And another 179 wind-warm lung-heat disease (non-severe CAP) inpatients were selected from January, 2013 to December, 2013 with the TCM clinical pathway treatment in the Respiratory Department of the same hospital as the treatment group. Retrospective analysis was used to compare the clinical curative effects, hospitalization days, and medical cost differences. The results showed that TCM clinical pathway for wind-warm lung-heat disease (non-severe CAP) can shorten the hospitalization days and reduce patients’ medical costs, and ensure the clinical curative effects. It was concluded that the standardized TCM clinical pathway had positive effect on wind-warm lung-heat disease (non-severe CAP). Therefore, the formulation and implementation of TCM clinical pathway was of great significance in the treatment of wind-warm lung-heat disease (non-severe CAP).

Objective To investigate the effects of bone marrow stromal cells(BMSCs)transplantation combined with low dose ultrashort wave (USW)radiation on functional recovery and the expression of glial fibrillary acidic protein(GFAP)and ED?1 after spinal cord injury(SCI)in rats,and further discuss its action mechanism. Methods Female Sprague?Dawley rats(n=30)were randomly divided into 5 groups:sham?oper?ated,as well as control,USW,BMSCs,and USW+BMSCs that were subjected to spinal cord injury(SCI). Basso?Beattie?Bresnahan(BBB)tests were carried out before the operation and at 1 d,1 week,2 weeks,3 weeks,4 weeks after SCI. 4 weeks later,animals were sacrificed and tissues were collected to make paraffin section. Immunohistochemical staining was performed to observe the expression of GFAP and ED?1. Results 4 weeks after SCI,BBB scores were significantly higher in the USW and USW+BMSCs groups than in the control group(both P<0.001). No signifi?cant difference was observed between the BMSCs group and control group. On the expression of GFAP ,only USW+BMSCs group showed signifi?cantly decreased compared with the control group(P<0.05). All treatment groups exhibited lower ED?1 expression than the control group(all P<0.05). Conclusion Our results indicate that USW radiation alone can obviously improve neural functional recovery after SCI. The USW radi?ation and BMSCs transplantation treatment can reduce inflammation ,and USW radiation is more effective. The combination therapy did not show a synergistic action on promoting functional recovery ,but do have an effect on reducing the inflammatory response and glial scar formation.