Objective To understand the medical staff's real experience after implementing patients participate and interactive health education method.Methods A qualitative method was conducted with 2 doctors and 7 nurses.Data were analyzed based on Colaizzi phenomenotogical research method.Results 3 themes were extracted:conflict,including the role and the education methods;the benefits of patients participate and interactive health education method,such as palliative the relationship between medical workers and patients,and help patients to manage diseases,etc;and obstacles as work burden and time limit of medical staff,patients with low health literacy,negative psychology,lack of supervision and timely feedback on both sides.Conclusions Patients participate and interactive health education method is beneficial and feasible,but some obstacles we should faced in the implementation process.Its smooth implementation needs medical staff change idea,and also needs the support of some objective factors.

ObjectiveTo observe the effects of clopidogrel on inflammatory cytokines in patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI). Methods68 cases diagnosed of CHD were randomly divided into clopidogrel 1 month group( group A), clopidogrel 6 months (roup B), every group had 34 cases. Before and after treatment adopt fasting blood respectively and in determination of serum interleukin-18 (IL-18)and C-reactive protein(hs-CRP). ResultsIL-18 and CRP were reduced more apparently in group B. Compared with group A,there were significant differences (P ＜ 0.05 ). ConclusionClopidogrel could significandy reduce coronary heart disease patients in which based on conventional treatment postoperative PCI inflammatory reaction, reduce the patients with coronary artery disease postoperative PCI vascular inflammatory reaction.

Background and purpose:Lung cancer is the leading cause of morbidity and cancer-related mortality worldwide. A variety of driver genes were detected in lung cancer. Studies have shown that different gene mutations of lung cancer were found between different races. Most of Uyghurs live in Xinjiang, accompanied by a high morbidity of lung cancer. This study aimed to investigate the expression of driver genes in Uyghur patients with lung cancer in Xinjiang, China.Methods:This study collected the tissue specimens of 43 Uyghur patients with lung cancer, with a very different method to detectEGFR gene expression. real-time fluorescent quantitative polymerase chain reaction(RTFQ-PCR) was used to detectK-ras,ALK,ROS1, mutatedBRAF andPIK3CA gene expression. Analysis of the correlation between lung cancer gene mutations in Uyghur and clinical features of patients with lung cancer were performed.Results:Among 43 cases of specimens,EGFR mutation rate was 11.63%, while theEGFR gene mutation rates in adenocarcinoma and squamous cell carcinoma were 26.67% and 4.76%, respectively.EGFR gene mutation was not detected in large cell carcinoma, adenosquamous carcinoma and small cell lung cancer.EGFR gene mutation rate in patients with adenocarcinoma (26.67%) was signiifcantly higher than that in other types of lung cancer (3.57%). The difference was statistically signiifcant (P=0.024). There were 6 patients withK-ras12/13 heterozygous mutation, and the mutation detection rate was 16.28% (6/43). There were 2 patients withPIK3CA heterozygous mutation, and the mu-tation detection rate was 4.65% (2/43).EGFR andK-ras mutations occurred simultaneously in 1 case. No relationship was found betweenEGFR mutations and age, gender, smoking status, TNM staging, ECOG score among Uyghur lung cancer patients. This study did not ifnd mutation inALK,ROS1 fusion gene andBRAF gene among the 43 specimens. Conclusion:Compared with Asian populations, Xinjiang Uyghur patients with lung cancer have a lower rate ofEGFR mutations and a higher rate ofK-ras mutations, which is similar to the characteristics of European Caucasians.

Objective To investigate the myocardial protection effect of dexmedetomidine hydrochloride during off-pump coronary artery bypass graft surgery. Methods Forty patients undergoing off-pump coronary artery bypass grafting were randomly divided into two groups:control group (group C) and dexmedetomidine group (group D).Dexmedetomidine hydrochlo-ride was given at a loading dose of 0. 5 μg?kg-1 to patients in group D, and then infused continuously at a rate of 0.5 μg?kg-1?h-1.The same amount of saline was given to patients in group C. After loading dosing,general anesthesia was per-formed with TCI technique.Trans-esophagus Doppler monitoring was conducted to monitor the blood volume and heart function, and close monitoring of fluid infusion to maintain stable circulation.Invasive blood pressure and heart rate were recorded every 5 min. Blood samples were taken for detection of cTnI,CK-MB,TNF-αand IL-6 contents at the following time points:after induction ( t0 ) ,before operation ( t1 ) ,after operation ( t2 ) ,12 h postoperation ( t3 ) and 24 h postoperation ( t4 ) . Results The blood pressure and heart rate decreased significantly at t0 and t1 in group D compared with group C,and there were no significant differ-ences in the two indexes at other time points between the two groups.Blood CK-MB,cTnI and inflammation factors TNF-α,IL-6 were much higher at t2,t3,t4 than at t0 and t1 in both groups(P<0.05).They were significantly decreased at t2,t3,t4 in group D relative to group C (P<0.05).Vessel active medicines were less given after the operation in group D (P<0.05). Conclusion Dexmedetomidine hydrochloride can mitigate the inflammation responses caused by off-pump coronary artery bypass grafting,re-duce the myocardial injury and improve the cardiac function of the patients.

Objective To investigate the expression of Polo-like kinase 1 in renal clear cell carcinoma and tissue adjacent to carcinoma;impact of BI2536 on the cell proliferation of renal clear cell carcinoma A498 cell line.Methods We select 12 cases of renal cancer Specimens of randical surgery between January 2013 and December 2014.The study included 7 male patients and 5 female patients,whose age ranged from 41 to 68 years(mean 49 years).Tumors were single and the location of tumor included 5 in left kidney,7 in right kidney.The size of renal tumor ranged from 2.1 to 6.3 cm.All patients did not have radiotherapy and chemotherapy preoperative who have no local and distant matastasis.The pathological results demonstrated renal clear cell carcinoma in 12 cases.At the same time,we collect the tissue 2 centimeters away as control,which pathological results demonstrated normal tissue.The expression of PLK1 was detected by western bloting in tissues from 12 cases of renal clear cell carcinoma and tissue adjacent to carcinoma and quantitative analysis was made.Cell proliferation of A498 cell line at the different concentrations of BI2536 were assayed by flow cytometry (0,20,40,60μg/L).Results The expression of PLK1 in renal clear cell carcinoma tissue are 0.74 ±0.2 and 0.21 ±0.13.The carcinoma tissue is higher than tissue adjacent to carcinoma (P =0.02).BI2536 act on A498 after 48 hours,the A498 cell number were arrested at G2/M phase at 0μg/L,20μg/L,40μg/L and 60μg/L were (10.28 ± 0.47) ％,(14.35 ± 0.85) ％,(20.49 ± 0.78) ％ and (23.90 ± 0.54) ％,respectively.The A498 cell number were arrested at G2/M phase increase when we incearse the concentrations of BI2536 at 48 hours (P ＜ 0.05).Conclusions The higher expression of PLK1 in renal clear cell carcinoma and the proliferation of the renal clear carcinoma cell can be repressed by BI2536 both reveal PLK1 may be used as the molecular maker and therapeutics target of renal clear cell carcinoma.

OBJECTIVE:To observe the influence of capecitabine combined with radiotherapy on postoperative survival rate, relapse rate and survival quality of elderly patients with rectal cancer at Ⅱ-Ⅲ stage. METHODS:110 patients with rectal cancer atⅡ-Ⅲ stage were selected and randomly divided into control group and observation group with 55 cases in each group. Both group received radical resection of rectal carcinoma. Control group was given three dimensional conformal radiation therapy(3DCRT)af-ter operation;observation group was additionally given capecitabine 1 500 mg/m2,d1-14,qd,on the basis of control group. A treatment course lasted for 21 d,and both groups received 2 courses of treatment and followed up for 3 years. The survival rate and metastasis and recurrence rate of 2 groups were compared as well as KPS score before and after treatment. Toxic reaction of 2 groups was also observed. RESULTS:The follow-up total survival rate and disease-free survival rate of observation group were 89.09%and 76.36%,which were significantly higher than 74.55%and 54.55%of control group;the distant metastasis rate and lo-cal recurrence rate were 12.73% and 5.45%,which were significantly lower than 30.91% and 21.82%,with statistical significance (P<0.05). KPS score of 2 groups were increased significantly,between 2 groups before and after treatment ,with statistical signifi-cance(P<0.05);Comparison between groups(P>0.05). There was no statistical significance in the incidence of nausea and vom-iting,diarrhea and urinary tract reaction between 2 groups (P>0.05);but the incidence of bone marrow arrest in observation group was significantly higher than control group(P<0.05). CONCLUSIONS:Capecitabine combined with 3DCRT can effectively improve postoperative distant survival rate of patients with rectal cancer at Ⅱ-Ⅲ stage,and reduce the metastasis and recurrence risk;do not lower life quality and induce serious adverse reactions.

To investigate the role of NADH in preventing apoptotic damage of human hepatic cells induced by chemotherapy drug cisplatin, the ultrastructural changes in hepatic cells were examined with transmission and scanning electron microscopy, propidium iodide (PI) staining was used to measure the apoptotic rate with flow cytometry, the expressions of p53 and bcl 2 gene were detected with RT PCR, the change in caspase 3 and caspase 8 of apoptotic molecules was examined with colorimetric assay. The results showed that, compared with the group of cisplatin, morphological apoptotic changes were not obvious, the apoptosis rate was significantly decreased, p53 mRNA expression was decreased, bcl 2 mRNA expression was increased, caspase 3 and caspase 8 activity levels were kept in a low level in the group of NADH /DDP. The study indicates that NADH can prevent apoptosis of human hepatic cells, and increase the possibility of using NADH to reduce side effects of chemotherapy.

Objectives To analyse the predisposing cause and clinical manifestasion of diabetic ketoacidosis (DKA) complicated with multiple organic failure (MOF),in order to diagnose early and management timely.Methods 537 diabetic patients admitted in our hospital from 1997 to 2000 were included in this cases retrospective study. 182 cases of them complicated with DKA or DKA complicated with MOF (58) were further analyzed by cause, clinical manifestation, number of organs in MOF and the prognosis. Results Analysis showed that the main cause of MOF in DKA patients was infection (84 5%). The higher incidence of MOF in older DKA patients than those of younger. The possible involved organs in MOF were kidney, heart and brain etc. Involving organs of MOF were much, the mortality was closely correlated with the number of involved organs. Conclusions The possible way to reduce the incidence of MOF in DKA patients is intensive preventing and treating infection. To avoid MOF occurring in DKA patients, complications of kidney, heart and brain should be timely diagnosed and managed.

Objective To explore the outcome and diagnostic methods of umbilical cord winds of the perinatal. Methods Retrospective analysis of 2350 cases of umbilical cord winds in our hospital was conducted. We selected 2400 cases as control. We calculated both the incidence rate of cesarean section, fetal distress and neonatal hypoxic - ischemic encephalopathy. Results Umbilical cord winds accounted for 20.1 percent of the total number of deliveries in the same period. The incidence rate of fetal distress and cesarean section was significantly high. Bsound ultra was 98.9% diagnosis. The electronic fetal care was 99.7% in diagnosis. Color Doppler ultrasound was 100% in diagnosis. Conclusion Umbilical cord winds is a common complication of pregnancy, and decision is also an important factor for delivery mode. Umbilical cord winds will increase obviously in the incidence of fetal distress and perinatal morbidity. The main method for prenatal diagnosis is the color Doppler ultrasound examination, such as B - and E - fetal care. Color Doppler ultrasound technique is the best way for non - invasive is observation of intrauterine blood circulation changes. In helpful for the judge of the progress and outcome of pregnancy, fetal growth and development of the situation.

Objective To study the effect of Tongbiding freezing-dryied powder for injection on the function of WDR neuron of spinal cord in living rats with chronic constriction injury (CCI),and clarify its analgesia mechanism in spinal cord center,and further explore whether it has the drug dependence at the cellular level. Methods Electricity physiology extracellular recording technique was used ,in the CCI living rat's expanded spinal cord waist stage the electricity activity of identical WDR neuron cells was recorded before and after administration of 20 mg?kg-1 Tongbiding. The electric discharge number of C response was observed before and 2,4,8,10 min after administration. The spontaneous electric discharge number. was observed before and 1,2,4,6 min after administration; wind-up phenomenon was also observed.Results The electric discharge number of C response was obtained in 8 WDR neurons,three were significant differences of the mean electric discharge number of C response between 2,4,8 min after administration and before administration (P