To investigate the effect of propofol on the plasma contents of endothelin(ET) and calcitonin gene related peptide(CGRP).Twelve monkeys with hemorrhagic shock were divided randomly into two groups.The monkeys in propofol group(PG) were administered propofol to 8mg/L plasma concentration by target control infusion with computer,while monkeys in control group(CG) were not .Venous blood were collected to determine plasma ET and CGRP contents by radioimmunoassay before bleeding, 2 hours after hemorrhagic shock and 2h after resuscitation. Compared with control group,the CGRP level and CGRP/ET of PG were significantly increased at 2h after hemorrhagic shock and 2h after resuscitation,while ET level of PG at 2h after resuscitation was significantly lower than that of CG. These findings indicate that propofol can increase the plasma content of CGRP and decrease the plasma content of ET in monkeys after hemorrhagic shock and resuscitation, and ET may play an important role in the development of hemorrhagic shock.

Objective To find out the cause of lung injury due to hemorrhagic shock and resuscitation, and the mechanism of propofol protecting Rhesus macaques from lung injury. Methods Twelve healthy Rhesus macaques were randomly divided into two groups: propofol group and control group. The animal model was made by 2-hour hemorrhagic shock and 2-hour resuscitation. Rhesus macaques in propofol group were given propofol at a plasma concentration of 8 mg/L all through by the technique of target controlled infusion. Hemodynamic parameters, gas analysis and RBC, WBC, HB and PLT contents from collected arterial blood were respectively determined before bleeding, 2 h after hemorrhagic shock and 2 h after resuscitation. Results Mean pulmonary arterial pressure and pulmonary vascular resistance index in propofol group 2 h after hemorrhagic shock and 2 h after resuscitation were significantly lower than those in control group (P

Objective To identify the association between human glucocorticoid receptor gene G166T polymorphism and essential hypertension(EH).Methods DNA samples from 71 normotensive cases and 48 EH cases were analyzed by a polymerase chain reaction(PCR) for restriction fragment length polymorphism(RFLP) to determine the intron 4 variant of human glucocorticoid receptor gene.Results No association was observed between EH group and control group.However,in females,a little association was observed between the EH group and control group.Frequencies of allele G were 0.64 in EH group and 0.46 in control group.Conclusion The G allele may be a predisposing gene marker,HGR gene intron 4 polymorphism contributes to the development of EH in females.

Hilar cholangiocarcinoma (HCCA) is a malignant tumor from the biliary epithelium.Its incidence is concealed,the anatomical structure is relatively complex,and the prognosis is poor.Surgical treatment is the only way to get a cure.At present,there are still many controversies in the preoperative evaluation and surgical treatment of HCCA at home and abroad.Further research on preoperative imaging diagnosis of HCCA,preoperative biliary drainage,portal vein embolization,scope of surgical resection,vascular resection and reconstruction,and orthotopic liver transplantation may provide a new reference for clinical treatment of HCCA.

Objective To analyze the prognostic factors in the surgical treatment of hilar cholangiocarcinoma.Methods The retrospective case-control study was conducted.The clinicopathological data of 93 patients [61 males and 32 females,age (64±8)years with the range of 43-84 years] with hilar cholangiocarcinoma who underwent surgical treatments in the General Hospital of the Northern Theater from January 2010 to December 2017 were collected.According to preoperative different staging and intraoperative exploration of hilar cholangiocarcinoma,corresponding operations were performed.Observation indicators:(1) surgical treatment situations;(2) tumor typing,staging and degree of differentiation:① tumor typing and staging,② degree of tumor differentiation;(3) follow-up situations;(4) analysis of prognostic factors:① univariate analysis,② multivariate analysis;(5) subgroup analysis.Follow-up using outpatient examination and telephone interview was performed to detect survival time and survival rate of patients up to December 31,2017.Kaplan-Meier method was used to calculate survival time and survival rate and to draw survival curves.Survival situations were analyzed byLog-rank test.The univariate analysis and multivariate analysis were performed using the Log-rank test and COX proportional hazard model respectively.Results (1) Surgical treatment situations:93 patients underwent surgical treatments,including 51 undergoing radical resection,23 undergoing palliative resection,16 undergoing internal biliary drainage or external drainage,3 undergoing abdominal laparotomy and intraoperative biopsy.(2) Tumor typing,staging and degree of differentiation.① Tumor typing and staging:of the 93 patients with hilar cholangiocarcinoma,Bismuth-Corlette type Ⅰ,Ⅱ,Ⅲa,Ⅲb and Ⅳ were detected in 26,22,9,18 and 18 patients.TNM stage Ⅰ,Ⅱ,Ⅲ and Ⅳ were detected in 7,34,22 and 30 patients,Mayo Clinic stage 1,2,3,4 were detected in 20,19,51 and 3 patients.② Degree of tumor differentiation:results of pathological examination showed 16 of 93 patients with highly differentiated adenocarcinoma,35 with moderately differentiated adenocarcinoma,37 with poorly differentiated adenocarcinoma,4 with mucinous adenocarcinoma and 1 with papillary adenocarcinoma.(3) Follow-up situations:93 patients were followed up for 6-36 months,with a median time of 24 months.The survival time of 93 patients was (21.4±2.1)months and the 1-,2-,3-year overall survival rates were 62.2％,34.9％ and 17.1％,respectively.(4) Analysis of prognostic factors:① results of univariate analysis showed that preoperative level of TBil,preoperative level of CA19-9,preoperative level of CA24-2,surgical methods,lymph node metastasis,vascular invasion,TNM staging,Mayo Clinic staging,degree of tumor differentiation were related factors affecting prognosis of patients with hilar cholangiocarcinoma (x2 =6.321,7.357,6.590,22.088,11.173,22.914,23.326,25.966,39.512,P＜0.05).② Results of multivariate analysis showed that preoperative level of TBil,preoperative level of CA 19-9,surgical methods,vascular invasion and degree of tumor differentiation were independent factors affecting prognosis of patients with hilar cholangiocarcinoma (odds ratio=1.002,1.001,2.690,2.626,0.420,95％ confidence interval:1.000-1.004,1.000-1.002,1.474-4.910,1.333-5.134,0.206-0.854,P＜0.05).(5) Subgroup analysis:of the 93 patients,the survival time of 51 undergoing radical resection was (28.0±2.3)months,and the 1-,2-,3-year survival rates were 75.3％,57.5％ and 25.7％,respectively;the survival time of 23 undergoing palliative resection was (14.0±2.4)months and the 1-,2-,3-year survival rates were 60.9％,13.0％,0,respectively;the survival time of 19 undergoing biliary drainage or open exploration was (8.0±2.9) months and the 1-,2-,3-year survival rates were 31.6％,7.9％,0,respectively.The survival of patients undergoing radical resection was significantly different from that of patients undergoing palliative resection,biliary drainage and open laparotomy respectively (x2 =10.939,18.343,P＜0.05).The survival of patients undergoing palliative resection was not statistically significant different from that of patients undergoing biliary drainage or exploration group (x2 =2.803,P＞0.05).Of the 35 patients with vascular invasion,the overall survival time was (7.0±2.0)months and 1-,2-,3-year survival rates were 14.5％,7.3％,0 respectively in 18 with portal vein invasion only,(10.0± 2.1)months and 37.5％,18.8％,and 18.8％ respectively in 8 with hepatic artery invasion,showing no statistically significant difference between the two groups (x2 =0.905,P＞0.05).Conclusions Preoperative level of TBil,preoperative level of CA19-9,surgical procedures,vascular invasion and degree of tumor differentiation are independent prognostic factors for patients with hilar cholangiocarcinoma.Radical resection can prolong the survival time of patients compared with other surgical treatments.

This study retrospectively analyzed the clinical data of 28 male patients with urethral stricture who had complications during urethrography, including 14 cases of infection, 8 cases of urethral bleeding, 5 cases of contrast agent hypersensitivity, and 1 case of bladder rupture. The infection manifested as acute cystitis in 11 cases, acute pyelonephritis in 1 case, acute epididymitis in 1 case, and sepsis in 1 case. Hypersensitivity reaction was mild in 3 cases, moderate and severe in 2 cases. A child with bladder rupture was immediately transferred to open surgery for bladder repair. All patients were cured by corresponding treatment. The complications of urethrography have various manifestations and different degrees of severity, so we should pay attention to prevention and proper treatment.

Objective:To investigate the relationship between smoking status and the onset age of stomach cancer patients and estimate the patients’ direct medical cost burden of stomach cancer due to smoking in Anhui province.Methods:The information about the primary stomach cancer patients and their direct treatment expenditures in 10 cancer-registered areas in Anhui were collected in 2017. The association between smoking status and the age of onset of stomach cancer patients was analyzed by univariate regression and multivariate logistic regression models. The median and smoking-attributed risk method was used to describe the direct treatment expenditure of stomach cancer patients in Anhui due to smoking.Results:A total of 736 patients with stomach cancer were analyzed in this study. Univariate regression analysis showed that rural household registration ( t=2.091, P=0.037), smoking ( t=-2.357, P=0.001 9) and alcohol consumption ( t=-2.036, P=0.042) were related to the age of onset of stomach cancer. After adjusting for gender, alcohol consumption, body mass index and household registration type, the risk of early stomach cancer in people who quitted smoking cessation was lower than that in smokers ( OR=0.36, 95 %CI: 0.17-0.75). The total direct medical cost burden of 736 newly diagnosed stomach cancer patients was 6.939 6 million RMB. The direct medical expenditure in stomach cancer patients who had smoking behavior was higher than that in stomach cancer patients who quitted smoking and never smoked. Conclusions:Smoking is one of the risk factors for the earlier onset of stomach cancer in Anhui. It is necessary to strengthen tobacco control to reduce the economic burden of patients with stomach cancer.

Objective To discuss the advantages of electronic questionnaire in nurses′satisfaction survey and evaluate its application effect .Methods Electronic questionnaire was designed and used to investigate nurse satisfaction .The time spent in each step of survey between traditional paper questionnaire and electronic questionnaire was compared .Results There were differences in the time of printing , binding, issuing, designing, inputting and summarizing results between two kinds of questionnaire , and there were differences in the recovery rate , effective rate and the number of nurses who put forward of written opinions and suggestions questionnaires between two kinds of questionnaire (P<0.001).The differences in the results of satisfaction between two kinds of questionnaire were statistically significant ( P<0.001 ) .Conclusions The application of electronic questionnaire make the data collection process of nurse satisfaction more smoothly , and nursing managers can understand the nurse satisfaction timely and effectively .It has positive significance in improving the level of hospital management .

Objective To Explore low seniority psychiatric nurses′ system, standard, professional training effect, improve the overall level of psychiatric nursing team. Methods A total of 68 healthy nurses, who recruited from October 2011 to June 2013, were selected and randomly divided into experimental group (n=34) and control group (n=34). Experimental group members had rotated training who went to different departments ( each departments for 3 months and 1 year totally) including male ward, female ward, open ward and MECT room with specific teaching and counseling. The control group nurses given routine training. We compared the result of training by specialized theory knowledge assessment of psychiatric, technical operation evaluation, emergency ability and comprehensive quality assessment, nursing staff discussion, job satisfaction surveys and daily work of observation and measurement before and behind training. Results After Low seniority nurses rotated training, nurses in the experimental group compared with before training, specialized subject theoretical level, operation skill, emergency ability and comprehensive quality significant difference ( t =-11. 677, -3. 049, -10. 717, -12. 581;P<0. 01). The experimental group compared with control group, specialized subject theoretical level, comprehensive quality difference was statistically significant ( t=3. 916, 4. 511;P<0. 01), while operating skills, emergency ability (t=3. 916, 4. 511,P<0. 01). After implementing of rotated training, nurses′ satisfaction was 94. 12%, beyond 61. 76% before the implementation, and the difference was statistically significant (χ2 =10. 350,P < 0. 01). Conclusions Implementation of rotated training can effectively improve psychiatric low qualification nurses specialized theoretical level and the comprehensive quality of the psychiatric clinical practical ability, communication and cooperation ability and the improvement of humanistic quality, etc.

Bladder cancer is one of the most common malignancy in the urinary system over the world. Urine cytology and cystoscopy are important tools for bladder cancer diagnosis and recurrence monitoring. However, due to the limited sensitivity and invasive procedure, there is an urgent need to develop new non-invasive and highly sensitive liquid biopsy approaches. Urine biopsy is a research focus in the field and has great potential. This review focused on protein-based urine markers (including NMP22, BTA and UroVysion etc.) and DNA or RNA-based urine markers (including cfDNA, AssureMDx and Xpert BC Monitor etc.), which were used for bladder cancer diagnosis and recurrence monitoring, and summarized the sensitivity and specificity of each biomarker as well as their characteristics in the diagnosis and recurrence surveillance of bladder cancer. This study provides theoretical and empirical support for further optimization and application of these biomarkers in clinical practice.