Objective To share our experience in the placement of a peripherally inserted central cathe -ter ( PICC) in critically ill patients intensive care unit ( ICU) .Method The clinical data of a critically ill pa-tient placed with PICC from neurosurgery department were collected and analyzed .Result A 78-year-old male patient diagnosed with type I respiratory failure , aspiration pneumonia , hypertension , and cerebral infarction sequelae successfully received ultrasound-guided modified Seldinger puncture technique for PICC and was trea-ted with intravenous nutrition after repeatedly vascular puncturing failure .Conclusion PICC placement is an effective method for patients in ICU to protect the peripheral vein and lower the incidence of catheter related in -fections.

Objective To investigate the expressions of apoptosis associated protein 3 (APR3) and nuclear factor 3 of activated T-cell (NFAT3) in the tissue of epithelial ovarian tumors and its correlation with the clinicopathological features.Methods 92 patients with epithelial ovarian tumor were collected,23 cases with malignant tumor,24 cases with borderline tumor,45 cases with benign tumor.The expressions of APR3 and NFAT3 were detected by immunohistochemical methods,and the differences of different types of epithelial ovarian tumor were compared.The correlation of the expressions of APR3 and NFAT3 with the clinicopathological features of epithelial ovarian tumor was analyzed.The correlation of the expressions of APR3 with the expressions of NFAT3 in epithelial ovarian tumor was analyzed.Results The positive expression rate of APR3 in patients with malignant epithelial ovarian tumors (78.26％) was significantly higher than borderline tumors (41.67 ％) and benign tumors (22.22 ％),the differences were statistically significant (x2 =5.864,7.632,all P ＜ 0.05).The expression of APR3 in patients with malignant epithelial ovarian tumors was significantly correlated with differentiation,clinical stage,lymph node and abdominal organs metastasis and ascites (x2 =7.425,7.262,8.421,5.031,all P ＜ 0.05).The positive expression rate of NFAT3 in patients with malignant epithelial ovarian tumors (56.52％) was significantly higher than borderline tumors (29.17％) and benign tumors(17.78％),the differences were statistically significant (x2 =6.829,7.547,all P ＜0.05).The expression of NFAT3 in patients with malignant epithelial ovarian tumors was significantly correlated with differentiation,clinical stage,lymph node and abdominal organs metastasis (x2 =5.253,6.367,8.021,all P ＜ 0.05).The expressions of APR3 and NFAT3 in patients with malignant epithelial ovarian tumors were positively correlated (r =0.032,P ＜ 0.05).Conclusion The expressions of APR3 and NFAT3 in the tissue of malignant epithelial ovarian tumor obviously increase,are significantly correlated with differentiation,clinical stage,lymph node and abdominal organs metastasis and are positively correlated,and it may be correlated with the development and progression of malignant epithelial ovarian tumor.

AIM: To investigate the potassium channel gene expression of myocardial sleeves of pulmonary vein and effects of amiodarone on rabbits with rapid atrial pacing.METHODS: Rabbits were divided into three groups(n=10),(1) the control group with sham operation and placebo;(2) the right atrial pacing(RAP) group at 600 beats/min with the placebo;(3) the amiodarone group treated for seven days with oral amiodarone at 100 mg ? kg-1 ? d-1.Based on RAP simultaneously,the messenger ribonucleic acid(mRNA) of specimen was measured by reverse transcription-polymerase chain reaction.RESULTS: Compared with the control group,Kv4.3(transient outward K+ current,Ito1) mRNA expression in RAP group was reduced by 51%(P

Objective: To understand the health literacy and healthy city satisfaction of residents in Ningbo,and to provide a basis for further development of healthy city . Methods: The permanent residents aged 15 years old and above in six urban districts of Ningbo were selected by stratified multi-stage sampling and probability-proportionate-to-size sampling method. The health literacy and healthy city satisfaction of residents were surveyed by a self-designed questionnaire. Multivariate linear regression model was used to analyze the correlation between health literacy and healthy city satisfaction . Results: A total of 3 300 people were investigated and 3 035 valid questionnaires were returned,with an effective rate of 91.97%. The scores of health literacy were 22.67±4.83 in males and 23.04±3.13 in females;the scores of healthy city satisfaction were 3.30±0.32 in males and 3.31±0.33 in females;there were no statistically significant differences in the scores above between genders（P>0.05）. The scores of health literacy were 25.65±4.14 in the residents aged 35-44 years and 20.34±3.54 in the residents aged 15-34 years;the scores of healthy city satisfaction were 3.16±0.32 in the former and 3.45±0.31 in the latter;the former scored higher in health literacy but lower in healthy city satisfaction than the latter （both P<0.05）. The scores of health literacy were 23.80±3.90 in the married residents and 18.94±3.22 in the single,divorced or widowed ones;the scores of healthy city satisfaction were 3.35±0.33 in the former and 3.22±0.32 in the latter;the former scored higher both in health literacy and healthy city satisfaction than the latter （both P<0.05）. The results of multivariate linear regression analysis showed that the higher the scores of health literacy,the higher the scores of healthy city satisfaction （β'=0.028,P<0.05） . Conclusion Improving health literacy of residents could improve their satisfaction with healthy city construction.

creatinine concentration. Conclusion Bisphosphonates can decrease serum total calcium levels in hypercalcemia crisis caused by PHPT effectivelywith mild adverse events.

Objective To observe the effects of enhanced exercise and combined vitamin D and calcium supplementation on muscular strength and fracture occurrence in postmenopausal women with a high risk of osteoporosis.Methods Totally 614 postmenopausal women at high risk factors of osteoporosis were enrolled in Dongcheng district of Beijing and randomized into four groups:group A(control group,n=173),group B(regular Tai Chi exercise,n=171),group C(calcium 600 mg/d+VitD800 U/d,n=139),and group D[calcium 600 mg/d+25 hydroxyl vitamin D(25OHD) 0.25 μg/d,n=131].Muscular strength was measured at baseline and one and two years after intervention.Bone turnover markers were measured at baseline and during the two-year follow-up.Falls and fractures were recorded.Results The incidence of 25OHD<50 nmol/L was approximately 92.6%.During the follow-up,the left grip strength decreased significantly two years after intervention(t=-3.252,P=0.001)in group A.Right grip strength decreased significantly in group B(t=2.460,P=0.015)while left grip strength improved significantly in group C(t=-2.051,P=0.043)one year after intervention.In group D,muscular strength in both 12-month and 24-month did not change compared with baseline(both P>0.05).Furthermore,serum procollagen type I N-terminal propeptide elevated significantly in group A(t=-2.962,P=0.004),group B(t=-2.888,P=0.005),and group C(t=-2.441,P=0.016),whereas β-C-terminal telopeptide of type I collagen decreased significantly in group B(t=2.285,P=0.024)and group D(t=2.596,P=0.011)two years after intervention.Conclusion Enhanced exercise and combined calcium vitamin D supplementation may help sustain muscle strength in postmenopausal women,while calcium and vitamin D supplementation may improve muscular strength within a short period of time.

Objectives To observe the changes of autophagy of acinar cells in hypertriglyceridemia (HTG) associated acute necrotic pancreatitis(ANP) rats,and investigate the effects of HTG on autophagy and AP. Methods Forty SD rats were randomly divided into 4 groups using random number method, including control group,ANP group,hyperlipemia(HL) group,hyperlipidemia associated acute necrotizing pancreatitis (HANP) group. Control group and ANP group were fed with normal diet for 2 weeks,while the rats in HL and HANP group were fed with a high-fat diet for 2 weeks,and after the blood collection ANP and HANP rats were induced by 3.5% sodium taurocholate retrograde injection into the pancreaticobiliary duct to establish the ANP model. Rats in control group and HL group were intraperitoneally injected with equal volume of normal saline solution. ALL rats were sacrificed at 48 h after the model establishment. Serum triglyceride (TG), total cholesterol (TC) and serum amylase levels were measured; pancreatic tissue was histologically examined and scored; Transmission electron microscope were used to observe the intracellular ultrastructure changes and calculate the number of autophagosome and autophagic lysosome;the expressions of autophagy related proteins such as LC3,LC3Ⅱ, LC3Ⅰ, p62 and Lamp-2 were determined by Western-blot. Results After 2-week high fat diet, serum levels of TG and TC in HANP and HL groups were obviously higher than those in the control and ANP group;Serum amylase levels in HANP group and ANP group were higher than the control and HL group,and the differences were statistically significant (all P<0.05). Transmission electron microscope showed that the number of autophagosomes in ANP group was significantly higher than those in other three groups and the difference was statistically different(all P<0.05);and the autophagy activity in HANP group was impaired compared with ANP group. Compared with the control group, in ANP group the protein expressions of LC3 Ⅱ/Ⅰ ratio and p62 in pancreatic tissue were up-regulated (2.11 ± 0.03 vs 1.70 ± 0.08, 9 420 ± 624 vs 4 973 ± 577),but LAMP-2 was down-regulated(20 533 ± 578 vs 23 231 ± 1 155). Compared with ANP group,the proteins expression levels of LC3Ⅱ/Ⅰand p62 in HANP group was obviously decreased (20 533 ± 578 vs 23 231 ± 1 155), and the difference was statistically significant (all P<0.05). Conclusions Hypertriglyceridemia can worsen the pathology injury of AP,and the mechanism may be related to the decreased autophagy related proteins LC3Ⅱ/Ⅰ and p62 and decreased number of autophagosome.

Objective:To describe the status and influencing factors of the empowerment of caregivers after gastrointestinal tumor.Methods:From March 2019 to October 2019, using convenience sampling method, 124 pairs of gastrointestinal tumor patients and caregivers who were hospitalized in the general surgery and anorectal surgery of the department of Shandong Tai′an City Central Hospital and the Second Affiliated Hospital of Shandong First Medical University were selected as the subjects. A general information questionnaire, Main Caregivers′Empowerment Measurement were used as research tools. To investigate the empowerment ability of caregivers of patients with gastrointestinal tumors after operation.Results:The total caregiver′s empowerment score was 168.81 ± 19.49. The scores of each dimension ranged from high to low: relationship with caregivers (3.83 ± 0.43), expectation of care outcomes (3.80 ± 0.43), awareness of caregiving roles (3.70 ± 0.51), caregivers′ subjectivity (3.37 ± 0.60), caregiving beliefs (3.34 ± 0.67), caregiving knowledge and skills (3.27 ± 0.73), personal resources (2.94 ± 0.65), goodwill caregiving (2.85 ± 0.65) , the scruples around (2.75 ± 0.88). Multiple linear regression results showed that, patient gender, whether the disease is first attack, whether the patient is aware of the disease, the caregiver marriage, and the caregiver working status were the influencing factors of the caregiver′s empowerment ability after gastrointestinal tumor operation ( t values were -8.15-8.72, R2=0.62, all P<0.05). Conclusions:There is room for further improvement in the empowerment of caregivers after gastrointestinal tumor surgery, especially in personal resources, goodwill care and scruples around. The results suggest that medical staff should guide caregivers to emancipate their minds, enhance the breadth of empowerment, and promote self care and fast rehabilitation of patients.

Objective To evaluate the diagnostic efficacy of mDIXON Quant for vertebral metastasis. Methods We retrospectively analyzed MRI images of 152 patients with clinically diagnosed malignant tumors and vertebral metastases. Scanning sequence included T1WI, STIR, mDIXON Quant and enhanced T1WI. We compared the diagnostic efficiency between T1WI and FF images for vertebral metastases. FF values between normal vertebral body and vertebral metastases were quantitatively compared, and the diagnostic efficacy of FF value was evaluated by ROC curve. Results The sensitivity, false positive rate, false negative rate, negative predictive value and accuracy of FF images in the diagnosis of vertebral metastases were all higher than those of T1WI images. The FF value of vertebral metastasis was significantly lower than that of normal vertebral body (Z=-21.792, P < 0.05), and the area under ROC curve was 0.987 and the cutoff value was 9.87%. The diagnostic sensitivity and specificity of vertebral metastasis were 99.6% and 92.0%. Conclusion mDIXON Quant can quantitatively determine the fat content of vertebral metastasis and has a high diagnostic efficiency for vertebral metastases.

Objective To explore the effect of ginsenoside Rd on regulatory T cells (Tregs) /helper T cell 17 (Th17) imbalance in experimental autoimmune encephalomyelitis (EAE) mice models.Methods Fifty-four female C57BL/6 mice,aged 6-8 weeks,were randomly divided into ginsenoside Rd group,phosphate buffered saline (PBS) group and blank-control group (n=18).The EAE mice models in the first two groups were induced by classical Mog35-55 peptide immunoinduction method;ginsenoside Rd of 40 mg/ (kg·d) was dissolved in PBS and intraperitoneally injected into the mice daily in the ginsenoside Rd group on 13th d of immunization;the mice in the PBS group and control group were intraperitoneally injected with same dose of PBS.Daily clinical symptom scale scores were obtained from the first d to the 20th d of immunization,and the lumbar spinal cords of the mice were taken for histological evaluation (inflammation scale and demyelinating scale) after the last symptom scale.On the 20th d of immunization,the spleens of each group were taken for cultivation;splenocytes were cultured in vitro for 48 h,and the culture supematant was taken for detecting interleukin (IL)-10 and IL-17 levels by enzyme-linked immunosorbent assay (ELISA);the proportions of Tregs and Thl7 in spleen tissues were detected by flow cytometry;real-time quantitative PCR was used to detect the mRNA expressions of Janus kinase 1 (JAK1),Janus kinase 2 (JAK2),signal transduction and activator of transcription 3 (STA T3),retinoic acid-related orphan nuclear receptors γt (ROR-γt) and forkhead gene p3 (Foxp3) in the lumbar spinal cords of mice in each group.Results (1) The clinical symptom scale scores and inflammation scale scores of ginsenoside Rd group were significantly lower than those of PBS group (P＜0.05);there were a large number of inflammatory cells infiltration and loss of myelin in the lumbar spinal cord of PBS group,while the loss of myelin sheath in ginsenoside Rd group was obviously decreased as compared with that in PBS group;the demyelination scale scores between the two groups showed statistical differences (P＜0.05).(2) As compared with those in the PBS group,the IL-10 level was significantly increased and the IL-17 level was significantly decreased in the splenocyte culture supernatant of ginsenoside Rd group (P＜0.05).(3) As compared with the PBS group,the ginsenoside Rd group had significantly decreased proportion of CD4+IL-17+ cells and significantly increased proportion of CD4+CD25+Foxp3+ cells in the spleen (P＜0.05).(4) As compared with those in the PBS group,the mRNA expression levels of JAK1,JAK2,STA T3 and ROR-γt were significantly decreased,and Foxp3 mRNA expression level was significantly increased in the lumbar spinal cords of the ginsenoside Rd group (P＜0.05).Conclusion Ginsenoside Rd can improve the condition of EAE mice models by altering the expressions of Foxp3/RORγt/STAT3 signaling pathway molecules related to differentiation of Tregs/Th 17,increasing the IL-10 level and Tregs ratio,and decreasing the IL-17 level and Th 17 ratio.