ObjectiveTo investigate the lethal effect of hyperthermic CO2 pneumoperitoneum on gastric cancer cells and then further study the feasility and safety of inflating hyperthermic CO2 in gastric cancerpatients when performing laparoscopic operation.MethodsAn in vitro hyperthermic CO2 pneumoperitoneum experimental model was built,then according to the experimental purpose,the stomach carcinoma cell-7901 was grouped:hyperthermic CO2 pneumoperitoneum group; pure hyperthermia group; pure CO2 group;control group.After processing according to groups,cell proliferation was detected by Cell Counting Kit-8(CCK-8),cell apoptosis was detected by Annexin V-fluorescein isothiocyanate/propidium iodide flow cytometry and Hoechst 33342/propidium iodide fluorescent microscopy.ResultsThe reaults of cell proliferation detection showed that hyperthermic CO2 pneumoperitoneum could significantly inhibit proliferation of stomach carcinoma cell-7901 when compared with pure hyperthermia group,pure CO2 group and control group (P ＜ 0.05 ).The results of apoptosis detection showed that hyperthermic CO2 pneumoperitoneum could significantly induce apoptosis of stomach carcinoma cell-7901 and the gastric cancer cells apoptosis showing bright blue under the fluorescent microscope.ConclusionsHyperthermic CO2 pneumoperitoneum could significantly inhibit proliferation of stomach carcinoma cell-7901 and probably kill it by inducing apoptosis.

This study was aimed to build up a diagnosis and treatment procedure of traditional Chinese medicine (TCM) for HIV/AIDS headache. Domestic and foreign articles correlated to HIV/AIDS headache diagnosed and treat-ed by TCM were summarized. The specialist questionnaire of clinical diagnosis and treatment standard operating pro-cedures of TCM for HIV/AIDS headache was designed by focus group discussions. And the national specialist ques-tionnaire survey was carried out twice. The results showed that the standard operating procedure of TCM clinical di-agnosis, treatment, nursing and therapeutic efficacy assessment for HIV/AIDS headache was preliminarily established. It was concluded that this regulation identified concept, etiology and pathogenesis of HIV/AIDS, established TCM standard diagnosis and treatment service. It also demonstrated features of propaganda and education, follow-ups, con-secutive diagnosis and treatment inside or outside the hospital.

Objective:To investigate the impact of human umbilical cord-derived mesenchymal stem cells on the activation ,the survival of human peripheral blood mononuclear cell ( hPBMC) and the proportions of each human lymphoid subgroup .Methods:PB-MC were isolated from healthy donors by density gradient centrifugation , then cultured in MSC-CM as treatment group after being acti-vated by OKT3.Each lymphoid subgroup proportion was analyzed by flow cytometry to observe the difference between treatment and control group .The effect of MSC-CM on activated PBMC for the production of IFN-γand IL-10 were tested by ELISA .The level of ap-optosis was assessed by flow cytometry with Annexin-V/PI as fluorescent marker .Results:Compared with the control group , MSC-CM down-regulated the ratio of CD4 +T cell to CD8 +T cell, and increased the proportion of CD4 +CD25 +CD127low Treg cell, thus other subgroup had no significant difference .MSC-CM inhibited the production of IFN-γby PBMC, but promoted the secretion of IL-10, and protected PBMCs from apoptosis when activated with OKT 3.Conclusion:hUC-MSC may play a role of immunosuppression by promo-ting the proliferation and activation of Treg cell .This kind of inhibitory activity is neither relied direct or indirect contact with the lym -phocytes , nor influenced by inducing immune cells apoptosis .

Objective:To explore the application effect of segmented teaching combined with Kirkpatrick model evaluation in the teaching of specialized nurses of peripherally implanted central venous catheter (PICC).Methods:A total of 60 trainees in the PICC specialized nurse training class in PICC Clinic of Cancer Hospital Affiliated to Nantong University from June 2020 to September 2020 were selected in the study, and they were randomly divided into a control group and a study group, with 30 nurses in each group. The control group conducted traditional training for PICC specialized nurses, and the research group used segmented teaching. After training, the Kirkpatrick model was used to evaluate the response level, learning level, behavior level and result level of the training effect of the two groups of PICC specialized nurses. SPSS 22.0 was used for t test and chi-square test. Results:Through the segmented teaching training, the evaluation results of the Kirkpatrick model showed that the effect of the PICC specialized nurse training was significantly better in the study group than that in the control group in terms of response level, learning level, behavior level and result level. The study group's satisfaction with the training program and teaching content scored higher than that of the control group, with statistically significance ( P<0.001). The research group nurses' mastery of theoretical knowledge and practical skills and humanistic care scores were higher than those of the control group, with significant differences ( P<0.001). After the training, the self-behavior assessment scores of the two groups increased, and the improvement of the research group was more obvious. When the nurses of the research group returned to the hospital clinical work after training, their professional identity, PICC teaching and guidance ability, treatment, nursing service quality, the recognition of patient and family members and the effectiveness of the department were improved to varying degrees, the corresponding measures could be carried out in the hospital, and the development of PICC technology was promoted. Conclusion:The combination of segmented teaching and Kirkpatrick model evaluation can effectively meet the training needs of PICC specialized nurses and make a full range of effect evaluations to improve the quality of PICC specialized nursing services.

BACKGROUND:Orthopedic osteotomy at the apex of kyphosis is best for treatment of ankylosing spondylitis from a biomechanical aspect, but there is a high risk for intraoperative spinal cord injury.
OBJECTIVE:To explore the clinical efficacy of vertebral plate osteotomy+vertebra osteotomy+long-segment pedicle screw fixation in the treatment of ankylosing spondylitis with kyphotic deformity.
METHODS:Thirty-six patients with ankylosing spondylitis were subjected to pedicle subtraction osteotomy and Smith-Peterson osteotomy, and then fol owed up for 3 months to 2 years.
RESULTS AND CONCLUSION:After implantation, sagittal imbalance did not occur in 36 patients, and the improvement rate of sagittal imbalance was 64%. The improvement rates of thoracolumbar kyphosis and chin-brow vertical angle were 60%and 98%, respectively. The pain relief rate was 64%, and the Oswestry Disability Index was 95%. There were no pul ed nails, broken nails and broken robs after implantation. These findings indicate that the combination of selective osteotomy technique and long-segment internal fixation can achieve stable fixation effects, prevent sagittal imbalance, and avoid the occurrence of pul ing nails, breaking nails and breaking robs caused by osteoporosis.

BACKGROUND:Clinical treatment of hemivertebrae-induced congenital scoliosis is a complex medical problem. OBJECTIVE:To find the optimal treatment for hemivertebrae accompanied by congenital scoliosis.
METHODS:Total y 142 hemivertebrae patients who had received surgical treatment in the Department of Orthopedics, the 306 Hospital of Chinese PLA, China from 2010 to 2012 were enrol ed. The main surgical treatment was hemivertebrae resection and bone fusion with internal fixation, apical osteotomy for severe scoliosis and spinal shortening with internal fixation, one-stage posterior thoracolumbar osteotomy with internal fixation, spinal decompression with internal fixation.
RESULTS AND CONCLUSION:After treatment, the average correction rate was 70.9%for scoliosis and 71.7%for kyphosis. The fol ow-up period was 14-35 months, with an average of 23.4 months. By the end of the final fol ow-up, the loss rate for Cobb’s angle was 7.3%for scoliosis and 7.7%for kyphosis. Fol ow-up X-ray films showed bone fusion and internal fixation without loosening, fracture, and decompensation. Implementation of one-stage posterior thoracolumbar osteotomy with internal fixation can effectively correct hemivertebrae-induced kyphoscoliosis to obtain a satisfactory spinal sagittal and coronal balance.

Angiotensin II ; pharmacology ; Animals ; Base Sequence ; Cell Division ; Collagen ; biosynthesis ; Liver ; cytology ; metabolism ; Liver Cirrhosis ; etiology ; Molecular Sequence Data ; Proline ; metabolism ; RNA, Messenger ; analysis ; Rats ; Receptor, Angiotensin, Type 1 ; genetics

Objective To evaluate the clinical efficacy and analyze the prognostic factors of radiotherapy after breast-conserving surgery for stage Ⅰ-Ⅱ breast cancer patients.Methods Clinical efficacy of adjuvant radiotherapy in 1 376 patients with stage Ⅰ and Ⅱ (T1-2 N0-1 M0/T3NoM0) breast cancer after undergoing unilateral breast-conserving surgery between 1999 and 2013 was retrospectively reviewed.Among them,930 patients (67.6％) received radiotherapy combined with chemotherapy including 517 receiving radiotherapy followed by chemotherapy and 413 receiving chemotherapy followed by radiotherapy.In total,1 055 patients (76.7％) were treated with endocrine therapy.Eighty-six patients (39.6％) positive for HER-2 received targeted therapy.The overall survival (OS) and disease-free survival (DFS) rates were calculated using the Kaplan-Meier method.Univariate analysis was performed by Log-rank test and multivariate analysis was conducted by Cox regression method.Results The median follow-up time was 55 months.The quantity of patients receiving follow-up for ≥ 10 years was 90.The 5-and 10-year OS rates for all patients were 98.6％ and 91.5％,and 94.6％ and 82.8％ for 5-and 10-year DFS rates.Mutivariate analysis revealed that age (P=0.016),T staging (P =0.006),N staging (P =0.004),lymphovascular invasion (P =0.038) and time interval between radiotherapy and surgery (P=0.048) were independent prognostic factors for DFS rate.Multivariate analysis demonstrated that N staging (P=0.044) and ER (P=0.026) were independent prognostic factors for DFS in the radiotherapy alone group.Conclusions The radiotherapy-based comprehensive treatment yields favorable clinical outcomes for stage Ⅰ-Ⅱ breast cancer patients after undergoing breast conserving surgery.The prognostic factors for DFS include age,T staging,N staging,lymphovascular invasion and the time interval between radiotherapy and breast-conserving surgery.In the radiotherapy alone group,DFS rate is associated with N staging and ER level.

Objective: To analyze the effect and adverse reactions of radiotherapy in patients with primary orbital lymphoma. Methods: A total of 28 patients with primary orbital lymphoma from Tianjin Union Medical Center, the First Central Hospital of Tianjin and Tianjin Dagang Oil Company Hospital between March 2006 and August 2012 were retrospectively analyzed. All the patients received orbital tumor dissection or biopsy, then received radiation therapy. Three patients received chemotherapy with CHOP protocol before radiotherapy. Radiotherapy was delivered routinely with 3D-conformal radiation therapy (CRT) technique with daily 2-2.5 Gy for 5 times per week and 3-5 fields. Total dosage was 20-50 Gy. There were 18 cases of 30 Gy, 1 case of 22 Gy, 1 case of 25 Gy, 1 case of 20 Gy, 1 case of 28.8 Gy, 3 cases of 40 Gy, 1 case of 42 Gy, 1 case of 46 Gy and 1 case of 50 Gy. Results: All the patients had complete remission (CR) after radiotherapy during follow-up. One patient recurred after radiotherapy of 4 months and received CR with radiotherapy again. One patient died of lung infiltration. Acute complications during radiotherapy were conjunctivitis (28 cases, 100.0%) and keratitis (1 case, 3.6%), long-term complications with ophthalmoxerosis (10 cases, 35.7%) and decreased visual acuity (1 case, 3.6%). Conclusion Radiotherapy is an effective method for primary orbital lymphoma, and the adverse reactions can be tolerated for most patients.