Objective To analyze the clinical value of sTNFR-1,sIL-2Ra and IGF-1 on depression in patients with esophageal cancer by comprehensive nursing intervention and explore the possibility of serum indicators to replace DSI and HAMD. Methods 120 patients with pathologically confirmed esophageal cancer were included in the study.Zung depression status inventory (DSI)and hamilton depression rating scale (HAMD)were used to assess depression.Serum sTNFR-1,sIL-2Ra and IGF-1were detected by enzyme-linked immunosorbent assay (ELISA).Results 69 patients were classified as anxiety and depression group,51 patients were as normal control group.There were 32 patients with depression.Serum sTNFR-1, sIL-2Ra and IGF-1 levels in study group was higher than that in the control group (P<0.05)and these serological indexs increased from the minimal depression,mild-to-moderate depression group to severe depression group (P<0.05).Conclusion Serum sTNFR-1,sIL-2Ra and IGF-1 levels may be used as evaluation index of nursing intervention,but need further clini-cal validation.

Objective:To investigate the effects of perioperative whole course thermal insulation strategy on extubation, recovery time, coagulation index and the incidence of complications in patients undergoing thoracoscopic surgery.Methods:A total of 121 patients who underwent thoracoscopic surgery who received treatment in Zhoushan Hospital from October 2016 to February 2018 were included in this study. Among them, 59 patients who underwent thoracoscopic surgery from October 2016 to February 2017 were included in the simple thermal insulation group, and 62 patients who underwent thoracoscopic surgery from October 2017 to February 2018 were included in the whole process thermal insulation group. Before and 24 hours and 72 hours after surgery, platelet count, prothrombin time, activated partial thromboplastin time and thrombin time were compared between the two groups. Postoperative extubation time and recovery time were recorded. The incidence of shivering, restlessness and other complications was analyzed.Results:Postoperative extubation time and recovery time in the whole process thermal insulation group were significantly shorter than those in the simple thermal insulation group [(8.06 ± 4.60) min vs. (13.98 ± 7.22) min, (47.19 ± 12.97) min vs. (56.84 ± 17.49) min, t = 5.40, 3.47, both P < 0.05). At 24 and 72 hours after surgery, platelet count and activated partial prothrombin time in the whole process thermal insulation group were significantly shorter than those in the simple thermal insulation group [(12.55 ± 0.88) s vs. (13.11 ± 0.97) s, (27.44 ± 2.43) s vs. (29.03 ± 2.14) s, (11.42 ± 0.73) s vs. (11.87 ± 0.74) s, (27.44 ± 1.96) s vs. (28.80 ± 2.22) s, t = 3.32, 3.81, all P < 0.05). The incidence of postoperative shivering and restlessness in the whole process thermal insulation group was significantly lower than that in the simple insulation Group (7 cases vs. 27 cases, 5 cases vs. 22 cases, χ2 = 17.782, 14.894, 3.33, 3.57, all P < 0.05). Conclusion:Perioperative whole course thermal insulation strategy can shorten extubation and recovery time, inhibit perioperative coagulation dysfunction, and decrease the incidence of perioperative restlessness, shivering and other complications caused by hypothermia. The effect of perioperative whole course thermal insulation is superior to that of simple thermal insulation.

Objective To explore the difference of PICC utilization in different time on phlebitis occurrence among patients with tumor by chemotherapy. Methods According to peripheral venous chemotherapy, 325 cases had been divided into chemotherapy group (n = 93) and the first time chemotherapy group (n = 232). We observed the occurrence of patients with phlebitis in two groups after PICC implantation. Results The probability of phlebitis occurrence in patients after PICC placement in chemotherapy group was 26. 9% and that in the first time chemotherapy group was 12. 5% (χ2 = 9. 91,P < 0. 05). ⅠandⅡ grade of phlebitis incidence rates of patients in chemotherapy group were 18. 3% and 8. 6% , but that in the first time chemotherapy group were 9. 5% and 3. 0% (P > 0. 05), there were no Ⅲ grade phlebitis happened in both groups. Conclusions The PICC should be adopted by the patients as early as possible for patient with the first time chemotherapy to reduce the peripheral venous stimulation and reduce the phlebitis occurrence.

Objective To explore the effects of whole process management pattern on the complication of PICC among cancer patients. Methods From October 2012, we started to build up the whole process management pattern to plan, implement, check and cope with integration of 4 stages key element including environment, safety, quality and patient′s health for PICC patients, and it carried out in the whole hospital. We compared the number of PICC cases, success rate of first PICC insertion and incidence of complication between the time of January to October 2012 and the time of November 2012 to December 2013, and compared the patients′satisfaction of nursing quality. Results After the whole process management pattern used, the total number of PICC climbed from 275 cases to 475 cases and the success rate of first PICC insertion increased from 94. 9% to 98. 9% with statistical difference (χ2 =11. 58,P<0. 01). The incidences of complication declined, of which the rate of mechanical phlebitis was 1. 8%, infection related catheter 2. 1%, and all complications were lower than before the whole process management pattern used (χ2 =5. 99,25. 17, respectively; P <0. 01). The patients′satisfaction increased from 93. 1% to 97. 1% with statistical difference (χ2 =6. 53,P<0. 05). Conclusions The whole process management pattern declines the complications of PICC among cancer patients, and promotes patients safety, releases clinical pressure and enhanced patients′satisfaction and quality of specific nursing.

Clinical and endoscopic data of 6 patients with colorectal mucosa associated lymphoid tissue (MALT) lymphoma who were diagnosed by endoscopy in the Digestive Endoscopy Center of Jiangsu Province Hospital of Chinese Medicine from January 2015 to June 2021 were retrospectively analyzed. There were 2 males and 4 females with aged from 62 to 87 years. The lesions were located in rectum in 3 cases, transverse colon in 1 case, sigmoid colon in 1 case, and sigmoid colon and rectum in 1 case. There were 1 case of polyposis type, 2 cases of inflammation type, and 3 cases of submucosal tumor type. The "tree-like appearance (TLA)" found in 5 cases. Endoscopic resection, surgery combined with chemotherapy, Helicobacter pylori eradication and follow-up were performed on 2, 1, 1 and 2 cases, respectively. Five cases had a good prognosis after 21-73 months follow-up, and 1 case had lost to follow-up. No recurrence was found in endoscopic and imaging review. Colorectal MALT lymphoma should be considered when colonoscopy detects a submucosal lesion with TLA sign on the left colon. Endoscopic resection has the potential to be a first-line treatment in the context of early diagnosis.

OBJECTIVE：To establish an HPLC fing erprint of Ginsen g Radix et Rhizoma Rubra ，and to optimize its processing technology. METHODS ：HPLC method was adopted. The determination was performed on Waters SymmetryShield TM RP18 column with mobile phase consisted of acetonitrile-water （gradient elution ）at the flow rate of 1.0 mL/min. The column temperature was set at 30 ℃，and the detection wavelength was 203 nm. The sample size was 10 μL. Using ginsenoside Rb1 as reference peak ，HPLC fingerprints of 10 batches of Ginseng Radix et Rhizoma Rubra was established. The similarity of them was evaluated by using Similarity Evaluation System of TCM Chromatogram Fingerprint （2012 A edition ） to confirm common peak. With steaming temperature，time and drying method as factors ，using the content of ginsenoside and fingerprint similarity as index ，the processing technology was optimized with L 16（43）orthogonal test design and verified. Cluster analysis was conducted with SPSS 19.0 statistical software of 10 batches of Ginseng Radix et Rhizoma Rubra and 3 batches of optimal processed sample. RESULTS ：There were a total of 13 common peaks in the fingerprints of 10 batches of Ginseng Radix et Rhizoma Rubra. The similarity was more than 0.920；3 common peaks were identified ，such as ginsenoside Rg 1，ginsenoside Re ，ginsenoside Rb 1. The optimal processing technology included that steamed at 100 ℃ for 150 min，dried at 60 ℃. The results of validation test show that the contents of ginsenoside Rg 1，Re and Rb 1 were 0.26％-0.29％，0.17％-0.20％，0.47％-0.54％，and the similarity between 3 batches of Ginseng Radix et Rhizome Rubra optimal processed sample and the control fingerprints was more than 0.970. The results of cluster analysis showed that 10 batches of Gimseng Radix et Rhizoma Rubra and 3 batches of optimal processed sample could be clustered into two categories；HS3-HS10 could be clustered into one category ，and 3 batches of optimal processed sample ，HS1 and HS 2 be clustered into one category. CONCLUSIONS ：Established fingerprint can be used for the optimization of processing technology of Gimseng Radix et Rhizoma Rubra ，and characterize the correlation between f luctuation of technology parameter and quality of medicinal material；the optimal processing technology is reasonable an d