Objective To research the clinical significance of acetated Ringer solution and succinylated gelatin in the fluid resuscitation of sepsis patients.Method Fifty-nine sepsis patients were divided into two groups:lactic acid Ringer solution and hetastarch (group A,27 cases)and acetated Ringer solution and suecinylated gelatin (group B,32 cases),compared the fluid resuscitation and other parameter.Results There were no significant difference in the central venous pressure,mean arterial pressure and the dose of noradrenaline (P ＞ 0.05).The activated partial thrombeplastin time in group A was longer than that in group B[(58±10),(74±13)s vs(48±7),(54 ±11) s in 6,24 hours],fibrinogen concentration was lower than that in group B [(3.3 ±0.8),(1.6±0.3)g/L vs (4.2±1.1),(2.1±0.2)g/L in 6,24 hours] (P＜0.05).Serum lactic acid,creatinine,calcium concentration in group A [(6.9±0.8)retool/L,(289 ~ 27)μ mol/L,(2.1 ±0.3)mmol/L]were higher than those in group B [(3.2 ±1.1)mmol/L, (193 ±42)μmol/L, (1.7±0.2)mmol/L](P＜0.05),there was no difference in APACHE Ⅲ scores on the third day between two groups (P＞0.05).Conclusions Acetated Ringer solution and succinylated gelatin in the fluid resuscitation of sepsis patients has the same effect,but fewer impacts on serum coagulation,serum lactic acid and renal function than lactic acid Ringer solution and hetastareh.They may be more suitable for fluid resuscitation of sepsis patients,but hypecalcemia is easy to happen,and there is no significant evidences proving the prognosis.

Objective To study the macrophage immune response after the percutaneous microwave coagulation therapy (PMCT) under the ultrasound guide. Methods Eighty-nine cases of primary hepatic carcinoma patients were treated by PMCT. At the time of the fourth week after PMCT and before PMCT, the patients were given percutaneous biopsy under ultrasound guide. And the samples were stained by immunohistochemical methods. Then the infiltration of macrophage on local treatment areas were compared before and after the treatment. Moreover the function of immunocytes were observed by electronic microscope. Results The infiltration of macrophage increased significantly in post-PMCT as compared with that in pre-PMCT. And there were more protuberance from the macrophage and much more lysosome and endoplasmic reticulum and mitochondrium observed by electronic microscope. Conclusion The local macrophage cellular immunity can be more improved after the primary hepatic carcinoma treated by PMCT.

Background and purpose:Tumour cell is recognized and rejected by immunocytes.The local infiltration of immunocytes and the clinical curative effect after the percutaneous microwave coagulation therapy(PMCT) is worthy of further study.We investigated the local immune response after PMCT under ultrasound guidance and evaluated if the local immune response had any influence on the prognosis of patients.Methods:89 cases of patients with hepatocellular carcinoma were treated by PMCT.At the time of the fourth week after PMCT and before PMCT,the patients were given percutaneous biopsy under ultrasound guidance.And the samples were stained by immunohistochemical methods.Then the infiltration of CD4+、CD57+ and CD68+ of local treatment areas were compared before and after the treatment of PMCT.Meanwhile,the patients underwent follow-up to survey the possibility of recrudescence.Moreover,the authors analyzed the relation between the infiltration of immunocytes and recrudescence.Results:A few CD4、CD57 and CD68 positive cells were observed in the cancer stoma and tissues surroundings the liver before PMCT.After PMCT,the immunocytes of CD4、CD57 and CD68 positive cells were significantly increased both in the cancer and the adjacent liver tissue.These immunocytes were enlarged in size.The infiltration of CD4+、CD57+ and CD68+ increased significantly in post-PMCT as compared with those of pre-PMCT(P

Objective To investigate the effect of advanced oxidation protein products (AOPPs) on human renal tubular epithelial cells(HK-2) autophagy.Methods HK-2 cells were stimulated with AOPPs.RT-qPCR and Western blot were used to determine the expression of autophagy related protein LC3-Ⅱ/LC3-Ⅰ,Beclin1 and p62;Western blot was utilized to examine the activation of p38 MAPK pathway.Then p38 MAPK inhibitor (SB203580) was added and co-processed with AOPPs.The change of autophagy was observed Also,autophagy inducer rapamycin was added and co-processed with AOPPs.RT-qPCR and Western blot were used to detect the expression of cell cycle inhibitory protein p27.The cell total protein level was detected by the bicinchoninic acid (BCA) method.The hypertrophy change was observed.Results AOPPs down-regulated the expression of LC3-Ⅱ/LC3-Ⅰ and Beclin1,up-regulated expression of p62 and activated p38 MAPK pathway;in comparison with the AOPPs alone treatment group,the expression of LC3-Ⅱ/LC3-Ⅰ and Beclin in the SB203580 co-processing group was increased,while p62 was decreased;the p27 expression and cells total protein in the sirolimus co-processing group were down-regulated.Conclusion AOPPs inhibits the autophagy of HK-2 cells by activating p38 MAPK pathway and the autophagy inhibition participates in HK-2 cell hypertrophy.

This paper summarized the main problems in nursing qualitative research papers, including the insufficient number or representativeness of samples, improper setting of some items in the interview outline, insufficient theme condensation or lack of pertinence, insufficient discussion, and put forward corresponding writing suggestions, with a view to providing some reference for the standardized writing of nursing qualitative research papers.

Objective To explore the influences of continued nursing care on the recovery of intra-articular fractures of joint function of limbs and the quality of life after operation. Methods A total of 493 intra-articular fracture of limbs postoperative patients,who were discharged from our department from January 2015 to December 2016,were randomly divided into observation group and reference group.After operation,the reference group used self-management mode to practice joint functional exercise,while the observation group uses continued nursing mode to guide physical therapy to recover joint functions.After they discharged 12 weeks,we compared these two groups of patients with satisfaction of nursing care,joint function recovery and quality of life. Results After 12 weeks of operation, in observation group, the patients' joint function recovery rate was close to 79.27%(195/246), which was significantly higher than the rates 55.47%(137/247)in reference group,the difference was statistically significant(χ2=32.947,P<0.01). Respectively, the physiological function score,vigor score, mental health score, physiology role score, body pain score, health condition score, social function score and health score of the observation group in the quality of life assessment were (72.66 ± 4.41), (89.27 ± 4.10), (93.01 ± 3.05), (88.03 ± 3.19), (91.68±3.99),(76.78±4.86),(79.11±4.68),(85.57±7.07).The scores of control groups were(65.71±3.41),(64.02±4.51),(61.43±4.29),(66.49±4.52),(64.24±4.30),(62.02±6.24),(62.94±4.50),(65.02±7.72).The comparative difference of the two groups has statistical significance (t=12.48- 60.15, P<0.05). Meanwhile,in the satisfaction rate of nursing care,the great satisfaction rate of observation group(70.73%, 174/246) was much higher than reference group (37.65%, 93/247), the difference was statistically significant (χ2=59.789, P<0.01). Conclusion Offered outside continued nursing care to the intra-articular fracture of limbs postoperative patients can effectively improve the joint function of patients,their qualities of life and can considerably increase satisfaction of nursing care. Thus,it should to be clinically promoted.