Background and purpose:It is verifi ed that MCM2 is a specifi c marker in the cell cycle,and expressed in all cells entering into the cycle,however,no expression is found in the differentiated cells and static period cell.Therefore,in the abnormally proliferative developmental cells and mutagenic cells,MCM2 could be used to mark the status of the cells as a cellular proliferative marker,and then to be a diagnostic tool for some heterotypical pathological changes and tumors.Our study demonstrated that the expression and clinical significance of MCM2 in bladder transitional cell cancer(BTCC).Methods:The expression of MCM2 was examined by immunohistochemistry Streptavidin-Peroxidase method in 12 cases of normal bladder tissues and 42 cases of BTCC.Results:The positive expression of MCM2 in BTCC was 100%,whereas in normal tissues,no positive expression was found(P0.05).The expression of MCM2 was closely associated with tumor pathological grade(P

Objective:To investigate the effect of enhanced recovery after surgery (ERAS) on the surgical treatment of radiation enteritis with intestinal obstruction.Methods:A total of 80 patients with radiation enteritis and intestinal obstruction admitted to the Department of General Surgery, the Eighth Center of Chinese PLA General Hospital from June 2015 to December 2019 were selected and divided into observation group and control group according to the principle of baseline feature matching, with 40 cases in each group.Fourty cases in the control group received conventional surgical treatment combined with conventional rehabilitation intervention, while 40 cases in the observation group received conventional surgical treatment combined with ERAS intervention.According to hemoglobin (HGB), albumin (ALB), prealbumin (PA), transferrin (TRF), the nutritional status of patients in the two groups was compared before and after intervention.According to interleukin-2 (IL-2), interleukin-6 (IL-6), interleukin-8 (IL-8), hypersensitivity C-reactive protein (hs- CRP), tumor necrosis factor-α (TNF-α), the changes of inflammatory factors in the two groups was compared before and after intervention.The immunoglobulin (Ig) A, G and M of the two groups was compared before and after intervention.The postoperative recovery and the incidence of postoperative complications was observed in the two groups.Results:After the intervention, the level of HGB(125.56±11.18) g/L, ALB(42.46±3.95) g/L, PA(0.28±0.03) g/L and TRF(2.60±0.30) g/L in the observation group was higher than that in the control group (102.95±11.12), (36.28±4.25), (0.20±0.05), (2.09±0.27) g/L, respectively, and the differences between the two groups were significant (all P<0.001). After the intervention, the level of IL-2(3.69±0.79) ng/L, IL-6(15.79±7.17) ng/L, IL-8(6.24±1.25) ng/L, hs-CRP(12.51±2.34) ng/L, TNF-α(1.51±0.68) μg/L in the observation group was lower than that in the control group(7.26±1.23) ng/L, (23.82±6.95) ng/L, (9.13±1.71) ng/L, (17.63±2.27) ng/L, (2.02±0.81) μg/L, respectively, and the differences between the two groups were significant ( P<0.001, P<0.001, P<0.001, P<0.001, P=0.003). After the intervention, the level of IgA(1.92±0.63) g/L, IgG(11.36±1.26) g/L, IgM(2.01±0.57) g/L in the observation group was higher than that in the control group (1.62±0.49), (9.58±1.23), (1.60±0.47) g/L, respectively, and the differences between the two groups were significant ( P=0.020, <0.001, =0.001, respectively). In the observation group, the hospital stay(12.1±1.7) d, postoperative ambulation time (1.9±0.6) d and exhaust time (3.1±0.4) d was less than that in the control group(17.2±2.4) d, (2.8±1.0) d, (4.2±0.8) d, respectively, and there were significant differences between two groups(all P<0.001). The postoperative complication rate of 5.0%(2/40) in the observation group was significantly lower than 25.0%(10/40) in the control group (χ 2=6.275, P=0.012). Conclusion:The patients with radiation enteritis and intestinal obstruction treated by conventional surgery were given eras intervention, which improved the nutritional level, immune function and inflammatory stress reaction of the patients, improved the treatment effect of the patients, and shortened the hospitalization time.

Objective The plasma levels of fibrinogen degradation products (FDP),D-dimer(DD) and fibrinogen (Fg) in patients with rheumatoid arthritis (RA) were tested and the relationship between the upregulated coagulation system and disease activity were explored.Methods Patients were divided into the active group and the remission group and 50 patients were included in each group.Hematological variables,including FDP,DD,Fg,and disease activity parameters including erythrocyte sedimentation rate (ESR),C-reactive protein (CRP) levels and rheumatoid factor (RF) titer were measured.Two-sample t-test,linear correlation test and Chi-square test were nsed for data analysis by SPSS 11.0 software.Results Age and sex were comparable in the two groups (P＞0.05).The FDP,DD and Fg were significantly higher in patients with active disease [(12.0±8.2) μg/ml, (3.1±3.1) μg/ml, (4.6±1.4) g,/L] than those in patients with remission [(2.1±1.1) μg/ml, (0.4±0.4) μg/ml, (3.0±0.6) g/L,all P＜0.01 ].There was no difference in gender distribution in FDP and DD (P＞0.05).However,Fg was significantly higher in men than that in women (P＜0.05).FDP showed a significantly positive correlation with DAS28 (r=0.48,P＜0.01) and ESR(r=0.28,P＜0.05).DD correlated positively and significantly with ESR and DAS28 (r=0.69,0.52,all P＜0.01).Fg was significantly positively correlated with DAS28,CRP and ESR (r=0.57,0.64,0.68,all P＜0.01).FDP,DD and Fg were not correlated with RF (r=-0.07,0.06,-0.01,all P＞0.05).Conclusion FDP and DD correlate well with disease activity and may be important disease activity parameters for RA.The rank of sensitivity of FDP,CRP,DD,ESR,Fg and RF for disease activity assessment of RA presents in a declined manner.

Objective:To evaluate the efficacy of chemotherapy for advanced biliary tract carcinoma and the factors that influence sur-vival. Methods:A total of 91 cases of advanced biliary tract carcinoma from January 2010 to April 2015 were enrolled in our study. The patients' characteristics, chemotherapy regimens, and effects were analyzed. Results:We enrolled 56 males and 35 females with a me-dian age of 57 years. A total of 90 patients were assessable for their responses to first-line chemotherapy. A total of 69 patients re-ceived the GP regimen, whereas 21 patients received some other regimens. The disease control rate (DCR), median progression free survival (mPFS), and median overall survival (mOS) were 68.1%versus 52.4%, 5.10 months versus 2.50 months (P=0.025), and 13.00 months versus 7.20 months, respectively. Only 31 patients received S-1 based regimens, and 12 patients received some other regi-mens as second-line chemotherapy. The DCR, median PFS, and median OS showed no statistical differences. Only four patients re-ceived S-1 based regimen plus bevacizumab as second-line chemotherapy (median PFS 5.3 months;median OS 7 months). Hematologi-call toxicity was the most common side effect in the first-line GP regimen. The side effects of the S-1 based chemotherapy regimen was relatively less. Conclusion:The GP regimen is an effective first-line chemotherapy for advanced biliary tract carcinoma, whereas S-1 ap-pears as an effective second-line chemotherapy drug. Bevacizumab-based regimens may be effective and require further validation.

Objective To evaluate the efficacy, advantages and shortcomings of micro-percutaneous nephrolithotomy in treatment of uncomplicated ureteral calculi.Methods Clinical data were collected from 126 patients with a failure treatment of history by ESWL (extracorporeal shock wave lithotripsy) and RIRS (retrograde intrarenal surgery) in treatment of upper ureteral calculi (< 3.0 cm) from June 2015 to May 2016. Antegrade percutaneous access was obtained by B-type ultrasound guidance. Micro-PCNL was done using YAG laser fiber or pneumatic through the ureteroscope (F4.5~F6.5、F6.0~F7.5, 315 mm) to disintegrate the stones. The calculi clearance rate, operation time, operative hemorrhage, length of hospital stay and complications of the patients were analyzed after operation.ResultsThe calculi clearance rate was 88.9%, the operation time was 15~75 min, the operative hemorrhage was 15~35 ml, the length of hospital stay was 5~10 d. Only one patient need the second stage surgery because of intraoperative hemorrhage affected the surgical ifeld. No patients occurred massive hemorrhage, pneumothorax, bowel and other complications such as organ damage.Conclusion Micro-PCNL had a good clinical curative effect and security in treatment of uncomplicated ureteral calculi, which was worthy of promoting clinically.

Objective To explore the psychological experience of ICU nurses who had worked follow different work patterns, and find the most appropriate staffing model. Methods A phenomenological approach of qualitative research was conducted in 5 ICU nurses by intensive interview,then the data collected were read, analyzed, reflected,finally the theme was got. Results In the work pattern of shifted every 12 hours, with low work frequency and strong feeling of fatigue. In the work pattern of shifted every 8 hours, with high work frequency and the disadvantage of nurse- patient relationship. In the short-time continuous APN work pattern, with continuous management of patients' condition, promotion of nurse-patient relationship, improvement of doctor-nurse relationship, comparatively stable biological clock. Conclusions The short-time continuous APN work pattern can concentrate nurses' work and rest time, relieve the press that caused by the shifted work, at the same time, promote the patients',patients' family and doctors' satisfaction degree with nursing work, increase nurses' effect in the ICU team, guarantee the quality of care, eventually ensure the patients' safety.

Objective: This study aims to investigate the impact of individual and family factors on anxiety and loneliness of middle school students during quarantine in the COVID-19 pandemic and to provide reference for discussing the possible effective intervention paths in the stress process of public health emergencies. Methods: A total of 11 596 students from junior and high schools in Shanghai were selected to complete the questionnaire with the stratified random cluster sampling method. Generalized Anxiety Disorder(GAD-7) and UCLA Loneliness Scale, University of California at Los Angeles(ULS-6) were used for the survey. Results: The prevalence of anxiety and loneliness were 34.78% and 52.44% respectively. The rate of anxiety and loneliness in girls (36.13%, 54.62%) was higher than that of boys (33.44%, 50.28%)(χ 2=17.03, 21.82, P<0.05). Logistic regression analysis showed that graduates (OR=1.34, 95%CI=1.18-1.52), students ranking in the middle (OR=1.25, 95%CI=1.08-1.45) or in the bottom 25% (OR=1.76, 95%CI=1.50-2.05), non only children in the family (OR=1.25, 95%CI=1.09-1.43) and low socioeconomic status (OR=1.42, 95%CI=1.23-1.65) were associated with increased risk of moderate and severe level of anxiety(P<0.05). Girls(OR=1.20, 95%CI=1.12-1.30), graduates(OR=1.13, 95%CI=1.04-1.24), non residents(OR=1.20, 95%CI=1.09-1.33), lower level of grades(OR=1.72, 95%CI=1.55-1.91) and not living with parents(OR=1.32, 95%CI=1.18-1.48) were associated with increased risk of loneliness(P<0.05). Conclusion During the quarantine period caused by the COVID-19 pandemic, negative emotions such as anxiety and loneliness among adolescents need attention, especially females, graduates, only children and students with low rankings or low socioeconomic status.

OBJECTIVE: To evaluate illness severity and to assess the prognosis with acute physiology and chronic health evaluation II (APACHE II) for patients after cardiovascular surgery. METHODS: APACHE II scores of 234 patients in the cardiac surgical intensive care unit (CSICU) were calculated, and the actual mortality and the predicted mortality were obtained based on the score. RESULTS: The APACHE II score of the 234 patients was 14.22±6.77. The difference in the APACHE II score between the survivors, the patients with complications and the death group was significant; the difference in the APACHE II score between patients with different preoperative cardiac functions was significant; the detention time in the CSICU was positively related to APACHE II scores; and the ROC area under the curve of APACHE II was 0.991±0.006. With the predicted rate >30% as the standard for death, sensitivity of APACHE II score for mortality risk prediction was 80.00%, specificity was 99.12%, and the accuracy was 98.72%. According to the score, we divided the patients into 3 groups (<10 points, 10-20 points, >20 points), forecast mortality in the >20 point group was in the 95% confidence interval of actual mortality. CONCLUSION APACHE II is a good index for illness severity and prognosis assessment for patients after cardiovascular surgery.
APACHE ; Adolescent ; Adult ; Aged ; Cardiac Surgical Procedures ; Female ; Forecasting ; Humans ; Intensive Care Units ; Male ; Middle Aged ; Mortality ; Prognosis ; Sensitivity and Specificity ; Severity of Illness Index ; Young Adult

Medicinal animals are important part of Traditional Chinese medicine resources in China. Cytochrome c oxidase subunit I (COI) was selected as the standard DNA barcoding sequence for animal medical materials. In this study, the 51 animal species from 45 animal medical materials in the Chinese Pharmacopoeia were selected and the intra-specific variation and the inter-specific divergence, the barcoding gap, the identification efficiency of their COI sequences were analyzed. The results showed that the inter-specific divergence is higher than intra-specific distance. The barcoding gap existed between inter-specific sequence divergence and intra-specific dis-tance. The identification efficiencies were 100% both at the genus and species level except the Arthropoda. The cluster dendrogram exhibited that different species distinguished from others. Therefore, COI sequence as a bar-code is suitable to identify the species of animal medical materials in Chinese Pharmacopoeia.

Objective:To explore the clinical effect of intestinal obstruction catheter in patients with tuberculous peritonitis complicated with intestinal obstruction and its influence on inflammatory factors.Methods:Sixty-two patients of tuberculous peritonitis with intestinal obstruction were admitted to the general surgery department of the Eighth Medical Center of Chinese PLA General Hospital from June 2015 to January 2020 in this prospective study.According to the method of digital table, cases were randomly divided into control group and treatment group, 31 cases in each group.The control group was given conventional treatment, while the treatment group was treated with intestinal obstruction catheter on the basis of conventional treatment.The clinical indexes such as abdominal pain relief time, antipyretic time, exhaust time, gas-liquid level disappearance time and hospitalization time were compared between the two groups.According to the levels of C-reactive protein(CRP), Interleukin-6(IL-6), Interleukin-8(IL-8) and Interferon-γ(IFN-γ), the inflammatory stress state of the two groups before and after treatment was compared.The changes of gastrin, motilin, vasoactine intrestinal peptide(VIP) were compared between the two groups before and after treatment.Results:The time to relieve abdominal pain(2.08±1.17) d, the time to reduce fever(3.36±1.89) d, the time to exhaust gas(2.12±1.45) d, the time to disappear gas-liquid level(2.58±1.61) d and the time to stay-in-hospital(9.22±2.13) d in the observation group, and those in the control group were (6.26±2.52), (5.68±2.44), (6.18±2.24), (7.34±2.23), (17.49±3.46) d, respectively.The difference between the two groups was statistically significant( P=0.013, 0.024, 0.035, 0.014 and 0.002, respectively). Before treatment, CRP, IL-6, IL-8, IFN-γ in the control group were (105.62±11.96) mg/L, (657.31±49.67) ng/L, IL-8 (463.53±31.74) ng/L and (47.24±9.66) ng/L , and (106.07±12.03) mg/L, (678.46±51.19) ng/L, (471.68±32.03) ng/L and (46.84±9.28) ng/L in the observation group respectively, and there were no significant differences between the two groups before treatment ( P>0.05). After treatment, CRP, IL-6, IL-8, IFN-γ were (86.25±9.16) mg/L, (373.25±24.18) ng/L, (211.26±20.83) ng/L and (35.42±7.52) ng/L in the control group, and (53.72±7.68) mg/L, (184.27±16.92) ng/L, (82.51±11.35) ng/L and (19.65±3.46) ng/L in the observation group, respectively.After treatment, there were significant differences in the indicators between the two groups ( P=0.021, 0.015, 0.029, 0.011, respectively). There was no difference in the levels of gastrin((180.89±21.17) vs(192.32±21.69) ng/L), motilin((336.73±7.23) vs(357.46±7.29) ng/L) and VIP((102.87±13.49) vs(109.31±13.53)pg/L) between the observation and control group before treatment( P>0.05, respectively). After treatment, the levels of gastrin(65.57±8.72) ng/L, motilin(135.71±14.38) ng/L and VIP(55.07±7.15) pg/L in the observation group were lower than those in the control group((110.35±13.86) ng/L, (231.93±21.95) ng/L, (81.56±10.59) pg/L, respectively), and the differences were statistically significant( P=0.013, 0.021 and 0.014, respectively). Conclusion:Intestinal obstruction catheter can effectively improve the clinical effect, reduce the inflammatory stress response, and promote the recovery of gastrointestinal function in patients with tuberculous peritonitis complicated with intestinal obstruction.