Objective To analyze the risk factors of bleeding after endoscopic resection of colorectal polyps.Methods 342 cases of colorectal polyps treated by endoscopic surgery in our hospital were taken as the research objects. The incidence of bleeding after endoscopic surgery was statistically studied. All the patients were divided into bleeding group and no hemorrhage group, with postoperative bleeding as the dependent variable, and related factors which may be induced postoperative bleeding (gender, age, diabetes mellitus, with hypertension and hyperlipidemia history, drinking history, polyp occurrence location, polyp pathology type, polyp size, morphology of colonic polyps, polyp number) as the independent variable to make advanced single factor regression analysis. Then using the logistic regression analysis tool for multivariate analysis.Results The incidence of postoperative bleeding was 7.60% (26/342) in 342 patients. Single factor analysis showed that the bleeding in the proportion of patients with hypertension was higher than that of without complication (P < 0.05), with history of high blood lipid ratio is higher than that of without complication (P < 0.05) and polyp diameter >2.0 percentage higher than that without complication (P < 0.05) and polyp morphology with pedunculated polyps proportion is higher than that without complication (P < 0.05). Multivariate analysis showed that the risk factors for bleeding after endoscopic resection of colorectal polyps were high blood pressure, high blood fat, polyp diameter >2.0 cm, and polyps were the risk factors of postoperative hemorrhage (P < 0.05).Conclusion The risk factors of bleeding after endoscopic resection of colorectal polyps, including hypertension, high blood fat, polyp diameter >2.0 cm, polyp morphology of pedicle polyps.

Chemotherapy is the basic therapy in non small cell lung cancer, but combined chemotherapy has a response rate that still remains in the range of 30%-40%. Resistance of cancer cells to the anti tumor drugs is the main factor that reduces the efficacy of the chemotherapy. The mechanism of the drug resistance of lung cancer cells is very complex involving changes of drug resistance gene MDR1, MRP, LRP,GST, change of quality and quantity of toposomerase Ⅱ, ? tubulin gene mutation and fibroblast growth factor. Prospective measurement of the molecular marker as a guide for clinical chemotherapy is a key factor that can facilitate the individualization of the regime and thus increase the response rate.

Objective To investigate the methods for the detection of serum samples with low-concentration HBsAg and its clin-ical value.Methods Serum samples with HBsAg weak positive were measured by ELISA or using Roch cobas e601 were collected from the clinical laboratory.The samples with low-concentration HBsAg were confirmed by neutralization assay by using Lizhu ELISA reagent Kit or Roch cobas e601 analyzer.at the same time,ALT/AST concentrations and HBV DNA copies were also deter-mined.Results Among 53 samples that showed weak positive reaction by using Kehua reagent kit,37 samples were positive in neu-tralization test,while the other 16 samples were negative.Among 18 samples that showed weak positive reaction tested by using Roch cobas e601 analyzer,13 samples showed positive in neutralization test,and the other 5 samples showed negative.Conclusion The results of HBsAg test varies in different detection System.The clinical significance of samples with low-concentration HBsAg needs further study.

Objective to investigate the situation of occupational health of nurses,so as to provide a reference for protecting the health of nurses. Methods Cluster sampling method was employed in this study. totally 1 204 nurses of two three-level general hospital and a cancer hospital in Bei-jing were randomly surveyed with homemade health of nurses′cross-sectional questionnaire,and a nurse medical examination report was access at the same time. Results there was statistically significant difference in the incidence of nurses work pressure and work fatigue in different hospitals and different departments(P < 0.05). 95.18% of the nurses undergo regular medical examinations,of which 56.97% were found abnormal. the dif-ferences in the incidence rate of abnormal medical examination results in nurses were statistically significant among different hospital and different de-partments(P < 0.05). Conclusion Great job stress and work fatigue are observed in nurses,and they have health problems. It is necessary for the hospital to take appropriate interventions to improve physical and mental health nurses.

OBJECTIVE:To prepare osthole microemulsion and investigate its in vitro transdermal absorption ability.METHODS:The blank microemulsion formula was optimized based on the solubility of osthole in different oil phase,emulsifier,co-emulsifier and pseudo-tertiary phase diagrams.The viscosity,conductance and particle size of osthole microemulsion were investigated.The permeation rate of osthole was determined using drug diffusion apparatus.RESULTS:The viscosity,conductance and mean particle size of osthole microemulsion were 8.07 mpa?s,123 ?S?cm-1,58.0 nm,respectively.The steady permeation rate of osthole microemulsions reached(33.042?3.1)?g?cm-2?h-1(r=0.995 0)and it was 25.5 times over that of saturated osthole solution.CONCLUSION:The result indicates osthole microemulsion with high permeation rate may be used as new osthole preparation with transdermal delivery.

Examination is usually used to evaluate the students' understanding of the knowledge and skills.It is also the evaluation of teachers'clinical teaching effects to some extent.The objective of this paper is to discuss the new mode of clinical teaching according to the influence of clinical teaching of pediatric on examination.

Objective To express human inducible eostimulator (ICOS) extracellular region and IgG Fc fusion protein, and analyze their function in allogenie lymphocyte proliferation in vitro and in vivo. Methods Human ICOS extraeellular region and IgG Fc fragment were cloned into a soluble expression vector. ICOS-Ig fusion protein was expressed and purified in CHO cells. To monitor primary MLR, Balb/c spleen T cells were isolated as responder cells, and irradiated C57BL/6 spleen cells as stimulator cells. 50 μg/ml ICOS-Ig or IgG was added to primary MLR cultures. The cells responsive rates were detected by 3 H-TdR methods. ELISA tested supernatants for eytokines (IL-2,IL-4, IL-10 and IFN-γ). T cells of each group in primary MLR were cultured as responder cells for secondary MLR, and irradiated C57BL/6 (donor) or C3H (third party) spleen cells as stimulator cells. Similar indexes were detected in secondary MLR. Then vital dye CFSE was used to study alloreactive T cell proliferation in vivo. CFSE-labeled C57BL/6 spleen cells were transferred to irradiated Balb/c mice. Mice were then intraperitoneally injected with 0. 2 mg IgG, ICOS-Ig or CsA each day.At the 3rd day after transfection, the spleen cells of the mice were harvested to detect CD4+ CFSE+ and CD8+ CFSE+ by FACS. Results In primary MLR, ICOS-Ig inhibited allogenic T-cell proliferation with inhibition rate being (58 ± 8)% in 50 μg/ml, and increased IFN-γ secretion. In secondary MLR, ICOS-Ig specifically inhibited the proliferation of donor spleen cells with inhibition rate being (42±8)%, and in ICOS-Ig group the levels of IL-4 and IL-10 were lower and the level of IFN-γ higher than in IgG group. However, ICOS-Ig didn't inhibit the proliferation of third-party spleen cells. In the CFSE dye assay, CFSE intensity of CD4+ and CD8+ T cells in ICOS-Ig and CsA groups was stronger than that in control group (P < 0. 05), while CFSE intensity in combined treatment group were even stronger than that in ICOS-Ig and CsA groups (P<0. 05). Conclusion ICOS-Ig could inhibit allo-reactive T cell proliferation in vitro and in vivo, and induce donor-specific T cell hyporesponsiveness specifically.

Objective To study the relationship between the cancer patients'right to know the true diagnosis and their satisfaction degree with nursing service. Methods We randomly selected 746 patients from the tumor center, the circulation department,the respiration department and surgery department.Questionnaires were designed according to patients'right to know the true diagnosis and the results were analyzed. Results Cancer patients who don't know the true diagnosis wanted to acquire the true information about their diseases but nurses were supposed to keep secret of the actual diagnosis.This contradiction led to the impediment of communication between patients andf nurses compared with other department(P<0.05). Conclusion The right to know their true diagnosis proved to be important for cancer patients in that it could increase the compliance of patients and promote communications so that patients would accept nursing service and the satisfaction degree with nursing service would improved.

To explore the observation and nursing of complications in operative patients with massive and rapid transfusion,32 cases were studied,the author summarized that the observation and nursing experience in prevention and treatment of some complications,such as overloading circulation、bleeding tendency、hypokalemia and hypothermia.

Objective To study the endoscopic anatomy of operative fissures in the sellar region related to pterional key-hole approach and to provide the anatomic basis for endoscope-assisted microneuro-surgery in the region. Methods Fifteen cadaver heads were dissected via pterional key-hole approach and the five operative fissures(Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ) were studied with both microscope and endoscope, by which the outcomes observed were recorded and compared. Results The basic information obtained by the pterio-nalkeyhole approach was comparable to that of the classic ptefional approach. According to the anatomic guideposts under neuroendoscope, the microstructures of the five fissures and Willis' circle would be well demonstrated. It is better to display the various anatomic structures in sellar region by neuroendoscope rather than microscope, particularly some important microstructures. Angled endoscope can be used to inspec thidden but important structure behind the arteries and nerves. Conclusion According to the anatomic guideposts, an endoscopy can be used to enhance the visible field of an operative microscope related to pterional key-hole approach. The endoscope-assisted microsurgery can reduce complications and injury of the important structures and increase the curative effect on the lesions in the sellar region.