Objective To explore the correlative factors of hypotension among hemodialysis patients and to come up with nursing interventions.Methods The histories of 49 maintenance hemodialysis patients were retrospectively reviewed to find out the correlative factors of hypotension and summarize the nursing strategies.Results The major factors for hypotension included large volume of dehydration and fast speed of dehydration in 22 cases,malnutrition and hypoproteinemia in 8 cases,severe anemia in 6 cases,dysfunction of the autonomic nervous system in 5 cases,low concentration of sodium or high temperature of dialysate in 4 case and medication errors and eating too much before or during dialysis in 4 cases.Conclusion The nursing strategies including control of weight,correct assessment of dry weight,right performance of low temperature hemodialysis and sodiun profile hemodialysis as well as mental care to those with depression are critical for prevention of hypotension development in patients undergoing maintenance hemodialysis.

Objective:To study the radiotherapy sensitization of recombinant human endostatin in patients with cervical cancer.Methods:Sixty patients with advanced cervical cancer (stage ⅡB to ⅣA) from July 2017 to November 2018 in the Second Affiliated Hospital of Dalian Medical University were selected. The patients were divided into experimental group and control group according to random number table with 30 cases each. The patients in experimental group were treated with recombinant human endostatin combined with concurrent chemoradiotherapy, while the patients in control group only received chemoradiotherapy. The serum levels of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) were measured 1 week before treatment and 1 week after treatment, and short-term efficacy was evaluated 3 months after treatment.Results:The objective remission rate (ORR) and disease control rate (DCR) in experimental group were higher than those in control group: 93% (28/30) vs. 87% (26/30) and 97% (29/30) vs. 93% (28/30), but there were no statistical differences between 2 groups ( P>0.05). There was no statistically significant difference in the occurrence of adverse reactions between 2 groups ( P>0.05). Compared with that before treatment, the serum VEGF and bFGF after treatment were significantly lower, experimental group: (88.07 ± 37.53) ng/L vs. (227.27 ± 142.61) ng/L and (21.03 ± 5.75) ng/L vs. (38.34 ± 18.17) ng/L, control: (120.04 ± 81.22) ng/L vs. (197.34 ± 142.41) ng/L and (24.04 ± 7.29) ng/L vs. (39.78 ± 13.35) ng/L, and there were statistical differences ( P<0.01); after treatment, the serum VEGF and bFGF in experimental group were lower than those in control group, but there were no statistical difference between 2 groups ( P>0.05). Conclusions:For patients with advanced cervical cancer, recombinant human endostatin combined with concurrent chemoradiotherapy can further decrease the serum levels of VEGF and bFGF, improve the sensitivity of chemoradiotherapy, and enhance the short-term efficacy.

Objective:To study the functional status of the monocytes-derived dendritic cells (DCs) plused with HBsAg from patients with chronic hepatitis B and their capacity of inducing the HBV- special cytotoxic T lymphocytes (CTLs),and explore a new method of inducing the special anti-HBV cell-mediated immunity.Methods:Monocytes of patients were isolated from peripheral blood and incubated with GM-CSF+IL-4+TNF-? to induce DCs generation. Those DCs were pulsed with HBsAg to induce HBV- special DCs. The phenotype of DCs including CD1a,CD80,CD83,CD86,CD40 and HLA-DR was characterized by FCM and the stimulating reaction of allogenic T lymphocytes was detected by MTT assay. The concentration of cytokines such as IL-12 and IL-6 in supernate was tested by ELISA and the cytotoxicity of CTLs inducing by the DCs against HepG2 2.2.15 cells,HepG2 cells and K562 cells were detected by LDH assay.Results:The expression of CD1a, CD80, CD83,CD86, CD40, HLA-DR molecules on the DCs pulsed with HBsAg was higher than those of the control group (P

Objective:To analyze the expression of long non-coding RNA (lncRNA) ZFPM2-AS1 in bladder cancer tissues and cell lines, and to observe the effect of down-regulating ZFPM2-AS1 on the migration and proliferation of bladder cancer cells and explore its molecular mechanism.Methods:Real-time quantitative fluorescent polymerase chain reaction (qRT-PCR) was used to detect the expression of ZFPM2-AS1 in 51 pairs of bladder cancer tissues and adjacent tissues, bladder cancer cell lines (J82, 5637, BIU-87, T24) and human normal bladder epithelial cells SV-HUC-1. The bladder cancer cells with the highest ZFPM2-AS1 expression were selected and transfected with the small interfering siRNA-ZFPM2-AS1 plasmid and the negative control plasmid, respectively, and defined as the experimental group and the control group. qRT-PCR was used to detect the expression of ZFPM2-AS1 in two groups of cells. Transwell migration test and tetramethylazozole blue (MTT) method were used to detect the cell migration ability and proliferation ability of the two groups. qRT-PCR was used to detect the expression of Up-frameshift mutant 1 (UPF1) mRNA in two groups of cells. Western blot was used to detect the expression of UPF1 and mTOR signaling pathway proteins in the two groups of cells.Results:The expression of ZFPM2-AS1 in bladder cancer tissues was significantly higher than that in adjacent tissues ( P<0.01). The expression of ZFPM2-AS1 in bladder cancer cell lines was significantly higher than that in human normal bladder epithelial cells ( P<0.01), and ZFPM2-AS1 had the highest expression in BIU-87 cells ( P<0.01). Compared with the control group, the expression of ZFPM2-AS1 in BIU-87 cells in the experimental group was significantly reduced [(1.01±0.06) vs (0.16±0.04), t=12.28, P<0.01]. Compared with the control group, the migration ability of BIU-87 cells in the experimental group was decreased ( P<0.05), and the proliferation ability of BIU-87 cells was significantly decreased from the second day ( P<0.05). Compared with the control group, UPF1 mRNA expression in BIU-87 cells in the experimental group was significantly decreased [(1.00±0.02) vs (0.28±0.04), t=15.49, P<0.01]. Western blot results showed that UPF1 protein expression and mammalian rapamycin target protein (mTOR), GRB2, IRS1 and p-PI3K signal pathway protein expression were decreased in BIU-87 cells. Conclusions:ZFPM2-AS1 is highly expressed in bladder cancer tissues and cell lines. Down-regulating ZFPM2-AS1 can inhibit the migration and proliferation of BIU-87 cells. The molecular mechanism may be related to the inhibition of UPF1 gene expression.

The paper introduced the background and concepts of municipal trusteeship of district-launched medical institutions, with the trusteeship of women and children′s hospital of Shunyi district as an example.In addition to the main approaches and contributions in improving hospital management, delivery of quality medical resources to primary care, and capacity building, the authors called for the support for standardized healthcare, respect for original hospital culture, and sustained government support to the hospital in question among other points, for reference of further public hospital reform.

Objective To study the genetic diversity of different geographical populations of Houttuynia cordata in China.Methods The genetic diversity of 15 geographical populations of H.cordata from 13 provinces in China was estimated using amplified fragment length polymorphism(AFLP) markers.The data of amplified bands were analyzed by the software POPGENE and MEGA.Results The ten AFLP primers employed produced a total of 110 discernable and reproduceable amplified fragments.The percentage of polymorphic bands within different populations was 70.51%.Genetic diversity analysis showed that effective number of alleles(Ne) was 1.210,Nei′s gene diversity(H) was 0.119,and Shannon′s genetic diversity index(I) was 0.186.The coefficient of genetic distance was 0.008 9—0.181 8 among populations.A UPGMA dendrogram based on Nei′s(1972) genetic distance visualized that the 15 populations were grouped into three different clusters,Emei population was one individual cluster group and the other populations were grouped into two different clusters corresponding to the different geographical areas.Conclusion The genetic diversity within different geographical populations of H.cordata in China is plentiful.

Objective To investigate the effectiveness and safety of applying compound lidocaine cream on tracheal mucosa as topical anesthesia to reduce the stress reaction during extubation of tracheal tube. Methods Sixty patients (aged 18-65yr,body weight 40-80kg,ASA Ⅰ-Ⅱ) scheduled for elective surgery under general anesthesia were selected,and they were randomly divided into compound lidocaine cream group (group L,n=30) and control group (group C,n=30). Orotracheal intubation was performed in all the patients. Compound lidocaine cream was uniformly smeared on the foremost third of endotracheal tubes before intubation in group L,and no drug was coated on endotracheal tubes in group C. The changes in blood pressure and heart rates during extubation,the use of hypotensive drugs,cough reflex,breath holding,sore throat and pharyngeal discomfort after extubation were compared between the two groups. Results The operation and intubation time of the two groups showed no significant difference. The blood pressure and heart rate during extubation,the rate of using hypotensive drugs,and the incidence of cough reflex and breath holding were lower in group L than in group C,while the foreign body sensation in pharynx were after extubation was more frequent in group L than in group C. The incidence of pharyngodynia was similar in the two groups,and the pharyngodynia and foreign body sensation in pharynx markedly improved one day after operation in both groups. Conclusion Topical anesthesia of tracheal mucosa using compound lidocaine cream may reduce the cough reflex and breath holding during extubation,and inhibit the stress reaction.

Objective To investigate the clinical, pathological features of Casfleman's disease (CD)and evaluate the treatment and prognosis. Methods Twenty six cases of CD diagnosed by pathological examination from January 2003 to October 2008 were analyzed retrospectively. Results The ratio of male to (76.9 %) patients are local CD(LCD) and six (23.1%) are multicentric CD (MCD). Two of them show the inereaseot reactive plasma cells in bone marrow. One patient was complicated with autoimmunal disorder. One patient complicated diffused Interstitial lung change. According to the pathological classification, twenty four patients (92.3 %) are hyaline vascular type (HV), and two (7.7 %) are plasma cell type (PC). For treatment,ninety patients (73 %) that totally LCD type accepted completely resection, three patients (11.5 %) accepted uncompleted resection, four patients (15.4 %) accepted chemotherapy COP, CHOP, ECHOP. Follow-up toOctober 2008, all the patients are alive and average survival time is 5 years. Conclusion CD is a rare lymphoproliferative disorder, there are slightly more female patients than male in morbility, no age difference is found in CD. Lymphomegaly and no pain is the common symptoms. Single lymphomegaly is more often,system symptoms are commonly occurred in MCD. Pathological examination is the golden standard in diagnosis. HV type is more than PC. PC type can complicated reactive plasma cells and increase autoimmunal disorder. The patients of LCD would be cured with completely excision, and chemotherapy such as COP will significantly reduced the lymphomegaly but lightly to the systematical symptoms for MCD type.

Objective To investigate the correlation of dynamic contrast-enhanced (DCE) MRI features with microvessel density (MVD) and vascular endothelial growth factor (VEGF) in non-small cell lung cancer(NSCLC).Methods Conventional MR imaging and dynamic contrast-enhanced scan in thirty-three patients with NSCLC confirmed by pathologyn were performed. MVD and VEGF were stained with immuno-histochemical technique in all cases. Some parameters of DCE MRI, including maximum slope(Smax) and time to peak(TTP) were put more analysis. The relationship between the results of DCE MRI (Smax and TTP) and that of immuno-histochemistry (MVD and VEGF) was analysed.Results The Smax of adeno carcinoma was higher than that of squamous cell carcinoma,but TTP was lower. The difference was obvious difference(t=3.22,P

Objective To evaluate the diagnostic value of 2D-FIESTA sequence of MRI in the detection of the biliary tract lesions in infant and young children patients(less than 3 years).Methods 8 infant and young children patients were examined by MRI to evaluatetheir biliary tract.Images were obtained with a 1.5T whole body MRI system(GE Medical System,Milwakee,Wis,USA),using theCARDIAC coil.The patients were sedated by chloral hydrate orally or by pentobarbital sodium intravenously.No contrast agents wererequired.All of the axial,coronal and sagittal images were reviewed on an independent workstation and maximum intensity projection(MIP) and multiplanar reformations(MPR) techniques were applied.Results The 2D-FIESTA pulse sequence results in images in which the hepatic vascular structures and the biliary tract were highlighted.In this way,a clear visualization of the hepatic vessels and biliarytract could be obtained in all 8 cases.MRI could demonstrate the anatomy and pathology of post-transplantation changes in 3 patients,choledochal cysts in 2 patients,anomalous connection between the bile and pancreatic ducts in 1 patient.All the abnormalities were proved by operation.2 examinees were diagnosed normal by MRI and were confirmed by follow-up.Conclusion 2D-FIESTA is a fast sequence that allows the high quality images to be generated without breath-hold and without administration of contrast material.It has a potential wide application in the evaluation of biliary tract in the infant patients.