OBJECTIVE:To observe the efficacy and safety of paclitaxel combined with cisplatin and fluorouracil for gastric cancer with liver metastases via indwelling hepatic arterial catheter. METHODS:56 gastric cancer patients with liver metastases were randomly divided into control group(28 cases)and observation group(28 cases). Control group received Paclitaxel injection 135 mg/m2,d1+Cisplatin injection 75 mg/m2,d1+Fluorouracil injection 750 mg/m2,d1-5,pumping administrated via central venous. Ob-servation group received Paclitaxel injection 135 mg/m2,d1+Cisplatin injection 75 mg/m2,d1+Fluorouracil injection 750 mg/m2,d1-5, administrated via indwelling hepatic arterial catheter. 3-4 weeks were a course,it lasted 8 courses at most. Magnesium isoglycyrrhiz-inate injection 200 mg/d was intravenously infused for liver protection in 2 groups during treatment. Clinical efficacy,serum car-cinoembryonic antigen (CEA),alanine aminotransferase (ALT),aspartate aminotransferase (AST) levels before and after treat-ment,and the incidence of adverse reactions in 2 groups observed. RESULTS:Short-term clinical efficacy in observation group was significantly higher than control group,with statistical significance(P<0.01). Before treatment,there were no significant dif-ferences in CEA,ALT and AST levels(P>0.05). After treatment,CEA,ALT and AST levels in 2 groups were significantly high-er than before,ALT and AST levels in observation group were significantly higher than control group,while CEA level in observa-tion group was lower than control group,with statistical significances(P<0.05). The incidences of bone marrow suppression,nau-sea,vomiting and fever in observation group were significantly lower than control group,with statistical significances (P<0.05). CONCLUSIONS:Paclitaxel combined with cisplatin and fluorouracil has good efficacy for gastric cancer with liver metastases via indwelling hepatic arterial catheter,while it exists liver dysfunction.

Most of the CHD patients reveal string pulse, mainly due to damage of heart function, lowering of arterial compliance and increase of total peripheral resistance. The common pulse in patients of blood diseases reveal frequent, tiny, string and slippery characteristic, mostly due to the increase of compensatory pumping action of the heart, shortening of ejection time of the left heart, with better vessel compliance and hemorheology, low total peripheral resistance.

Objective To explore the effect of three-dimensional seamless teaching model on training the emergency ability of nursing student and nurse in “emergency and critical nursing”.Methods One hundred and ninety-six nursing students from four classes of two academies in Grade 2008 were chosen and divided into the control group (n=100) and the study group (n=96).The control group from two classes of two academies received the routine teaching model , and the study group from the other two classes of two academies received the three-dimensional seamless teaching model including the first aid theory , operating skills and clinical practice in “emergency and critical nursing”.Results The scores of first aid theory , first aid operating skills , emergency ability and disease observation were respectively (90.2 ±5.2), (82.9 ±4.1), (89.9 ±5.1) and (89.6 ±4.4) in the study group, and were better than (57.8 ±8.5), (77.9 ±1.3), (56.8 ±9.3) and (71.2 ±6.1) in the control group, and the differences were statistically significant ( t=-34.10, -5.76,-23.60, -17.26, respectively;P<0.05).The satisfactions of doctors, nurses and patients in the study group were higher than those of control group , and the differences were statistically significant (P<0.01). Conclusions The three-dimensional seamless teaching model in “emergency and critical nursing” not only can improve the score of examination , but also can improve the emergency ability in clinical work .

Objective:To investigate the value of ultrasound in the diagnosis of secondary loss of response in children with Crohn′s disease at maintenance stage treated with Infliximab.Methods:From January 2017 to December 2021, 51 children with Crohn′s disease who received Infliximab treatment and clinical response in the Beijing Children′s Hospital Affiliated to Capital Medical University were retrospectively analyzed, and whether there was secondary loss of response during the maintenance period was observed. The ultrasound examination results at the 14th week of treatment were collected to understand the correlation between ultrasound examination of intestinal wall and peri-intestinal healing and secondary loss of response.Results:A total of 15 out of 51 patients (29.4%) experienced secondary loss of response during treatment follow-up up to 54 weeks. Compared to children with continuous response, children with secondary loss of response had a thicker intestinal wall at week 14 of treatment [5.0 (3.8, 6.0)mm compared to 3.0 (2.0, 4.0)mm, P<0.001], and a higher proportion of intestinal wall stratified structure disappearance [8/15 (53.33%) compared to 3/36 (8.33%), P<0.001]. When intestinal wall thickness>3.0 mm, the sensitivity was 0.955, and the specificity was 0.483. The sensitivity and specificity of clear diagnosis of secondary loss of response in intestinal wall stratification were 0.727 and 0.825, respectively. The sensitivity and specificity of combined diagnosis for secondary loss of response were 0.933 and 0.611, respectively. Conclusions:At the 14th week of treatment with Infliximab in children with Crohn′s disease, the thickness of intestinal wall measured by ultrasound being more than 3.0 mm and the disappearance of intestinal wall statified structure provide important information for the diagnosis of secondary loss of response.