Objective To observe the application effect of critical care professional nursing team applied to sequential mechanical ventilation in the treatment of chronic obstructive pulmonary disease (COPD) with respiratory failure. Methods Totally 80 patients of COPD with respiratory failure from May 2014 to April 2015 were divided into study group and control group by random number table method, 40 patients in each group. Study group was applied to critical care professional nursing team. Control group was given routine nursing. The two groups were treated for 4 weeks. The clinical indicators of positive end expiratory pressure (PEEP), pressure support ventilation (PSV), carbon dioxide partial pressure (PaCO2), oxygen partial pressure (PaO2), forced expiratory volume in one second (FEV1), heart rate, arterial systolic blood pressure, respiratory rate in two groups were compared. The clinical indicators such as the duration of the stay, the duration of the total ventilation, and the time of invasive ventilation, etc, in two groups were compared;and nursing satisfaction was also compared. Results Before nursing, there were no statistical differences between the study group and the control group in PaCO2, PaO2, FEV1, heart rate, systolic arterial blood pressure, respiration rate and PEEP, PSV indicators (t=0.04-0.63, P>0.05). And after the intervention, the above indicators of the study group were (36.4±2.0) mmHg (1 mmHg=0.133 kPa), (94.7± 4.8) mmHg, (45.2 ± 16.0) %, (84.2 ± 4.3) beats/min, (94.2 ± 5.3) mmHg, (15.2 ± 3.0) times/min, (3.6 ± 1.2) mmHg, (10.2 ± 2.0) ml and (48.5 ± 5.3) mmHg, (88.3 ± 4.1) mmHg, (36.9 ± 14.1)%, (92.4 ± 6.2) beats/min, (110.4 ± 6.2) mmHg, (20.9 ± 4.1) times/min, (4.2 ± 1.6) mmHg, (13.9 ± 2.4) ml in the control group. The differences were statistically significant (t=4.37-13.51, P<0.01). After nursing care, the study group of patients with clinical indicators such as admission time, total duration of ventilation, the time of invasive ventilation were (12.5±1.5) d,(10.2±2.6) h,(5.2±2.1) h,while (18.2±2.6) d,(15.9±1.1) h,(7.9±2.9) h in the control group, the differences were statistically significant (t=12.01, 12.77, 4.77, P<0.01).The nursing satisfaction rate was 80.0% (32/40) in the study group while 62.5% (25/40) in the control group, the difference was statistically significant (χ2=6.30, P < 0.01). Conclusions Sequential mechanical ventilation therapy and nursing care in patients with COPD can significantly improve the clinical symptoms, improve nursing satisfaction, it is worthy of clinical promotion.

Objective To investigate the ultrasonographic features of normal rectal walls.Methods Ten removed rectal specimens were scanned with high frequency (4-13 MHz) linear array probe to obtain ultrasound images of various layers and having each layer marked,and separated,followed by histological examination respectively.Results Ultrasound demonstrated seven layers of structure which were identified by alternative high and low echoes.From innermost layer towards the outer layers,they were divided as:high-echo acoustic interface,low-echo mucous layer,high-echo sub-mucous layer,low-echo circular muscle layer,high-echo fibrous connective tissue layer,low-echo outer longitudinal muscle layer and high-echo outer membrane layer.All these findings were justified by histological examination.Conclusions High-frequency ultrasound demonstrated 7 layers of echoes in normal rectal walls.This provides imaging basis for diagnosis and judge the invasion degree of rectal cancers.

OBJECTIVE: To evaluate the preoperative utilization of antibacterial in orthopaedic patients in our hospital. METHODS: The preoperative use of antibacterial in 300 orthopaedic patients in our hospital in 2008 was reviewed. RESULTS: Of the 300 patients in our study, 100% of them were recieved preoperative antibacterial. Two of the most widely used antibacterials were clindamycin and cefuroxime sodium. The use of antibacterial in 228 patients were overtime after operation (76.00%), of which the use of antibacterial in 161 patients in type Ⅰ incision exceed 24 hour(70.61%), 56 patients in type Ⅱ incision exceed 2 days(24.56%) and 11 patients in type Ⅲ incision exceed 7 days (4.82%). CONCLUSION: The usage of preoperative antibacterial was inappropriate and the duration of administration is too long, which should be standardized.

Many studies show that transforming growth factor-β (TGF-β) can suppress tumor by inhibiting proliferation and dedifferentiation of cells and promoting cell apoptosis at early stage.But during the progression of tumor,its tumor-promoting action will be more and more obvious with the variation of TGF-β itself and its signal path.TGF-β signal path inhibitors have anti-tumor activity,but the clinical effects and side effects still need to be observed.

Objective To evaluate the effectiveness of loop electrosurgical excision procedure(LEEP) for the management of cervical intraepithelial neoplasia(CIN) grade Ⅱ. Methods A total of 28 patients were pathologically diagnosed as having CIN grade Ⅱ by colposcopic cervical biopsy.High-risk human papillomavirus(HPV) DNA testing showed positive results in 96.4% of the patients(27/28).The procedure was conducted under surface anesthesia.A loop electrode was used to cut through the cervical tissues,and then a square-shaped electrode or a small-sized loop electrode was utilized to complete the resection of lesions,including parts of the cervical canal.All the patients were followed postoperatively. Results The intraoperative blood loss was 0~20 ml,and the operation time was 5~10 min.Out of the 28 patients,postoperative abnormal vaginal bleeding was found in 3 patients.No other complications occurred.The resected tissues showed no obvious charring changes.The lesions of CIN completely disappeared in 15 patients(53.6%),subsided to grade Ⅰ in 5 patients,remained in grade Ⅱ in 5 patients,and progressed to grade Ⅲ in 3 patients.Follow-up examinations in the 28 patients for 6~24 months(mean,16 months) found no residual lesions or recurrence.The high-risk HPV DNA findings turned negative in 23 patients. Conclusions LEEP is a safe and effective procedure for the treatment of CIN grade Ⅱ,with advantages of little invasion,simplicity of performance,and no need of hospitalization.

Objective To assess and compare the overall diagnostic value of positron emission tomography(PET)-CT and DWI in lymph node staging in patients with prostate cancer by using Meta-analysis.Methods Relevant English articles published on PubMed,EMBASE,Cochrane Library and SCI database were searched.Subsequently,the characteristics of the included articles were appraised and extracted.Statistical analysis was performed employing Meta Disc version 1.4.Heterogeneity of the included articles was tested,which was used to select proper effect model to calculate the pooled sensitivity and specificity and the corresponding 95％ CI,summary receiver operating characteristics(SROC) curve was performed and the area under the curve was calculated.The diagnostic performanceincluding the sensitivity,specificity,and the area under the curve was compared between the two groups via x2 test and Z test respectively.Results Eleven of 182 retrieved articles were included,in which 3 articles used two methods of imaging examination at the same time.In PET-CT group,there were eight articles using 11C-Choline as imaging agents,three with 18F-Fluorocholine.The pooled sensitivity and specificity and area under SROC curve for PET-CT were 0.64 (0.574.71),0.93 (0.90-0.96),and 0.8795 respectively.They were 0.59 (0.47-0.70),0.82 (0.70-0.91),and 0.7707 for DWI group.The specificity of PET-CT was significantly higher than that of DWI (x2=5.531,P＜0.05).No significant differences were found in the sensitivity and AUC between the two groups (x2=0.528,Z=1.699,P＞0.05).Conclusion For lymph node staging in patients with prostate cancer,PET-CT has an equal sensitivity and a higher specificity,a better diagnostic performance compared with DWI.

Objective To explore the effect of leukotriene receptor antagonist on the airway inflammation in bronchiolitis after respiratory syncytial virus(RSV)infection and the prevention of post-bronchiolitis asthma by studying the changes of serum concentration of inflammatory cellular factors including ECP,IL-12,IL-13 and LTE4.Methods 156 children with mild and moderate RSV bronchiolitis were recruited in the study and they were randomly divided into three groups after alleviation of asthmatic symptoms:the intervention group with montelukast sodium tablets oral;hormone intervention group with Budesonide suspension spray;control group.Blood samples were collected on the first day on admission,before treatment,3 months after medication.Serum concentrations of ECP,IL-12,IL-13 and LTE4 were measured by ELISA.Clinical and telephone follow up was done for one year.Results Compared to control group,the ECP,IL-13 and LTE4 levels of 156 RSV bronchiolitis in acute phase and recovery phase were signifieantly increased,while the IL-12 level was significantly decreased.The ECP,IL-13levels of singulair intervention group and the hormone intervention group were decreased after intervention,and the IL-12 level rise to normal;the LTE4 level of singulair intervention group and the hormone intervention group decreased significantly than before intervention,singulair intervention group recovered to normal levels(t=1.0866,P＞0.05),but hormone treatment group did not recover to normal levels(t=3.4355,P＜0.01).Singulair intervention group had lower recurrence of asthma(χ2=7.8156,P＜0.01).Conclusion The leukotriene receptorantagonists could regulate the imbalance of Th1/Th2,reduce the release of LTE4 and the activation of eosinophils,alleviate airway inflammation and airway hyperreactivity,reduce wheezing,and it play a role in the prevention of asthma.

Objective:This study aimed to analyze the feasibility, safety, and efficacy of cryoablation in treating pain caused by malignant paravertebral and mesenchymal tumor. Methods:Cryoablation was performed in 31 patients with unresectable and painful malignant paravertebral and mesenchymal tumors whose pain was poorly controlled by conventional treatment methods. Tumors ranged in size from 3 cm to 20 cm. Pain experienced by the patient was assessed using the Brief Pain Inventory (BPI) at 0, 1 day, 1 week, 1 month, and 3 months post-cryoablation. Results:BPI scores were divided into two categories, i.e., the influence and the se-verity of pain. Both categories showed downward trend after cryoablation. Pain severity score significantly decreased (P=0.001, t=3.862;P=0.031, t=2.261) 1 day and 1 month after cryoablation. Pain influence score also significantly decreased (P=0.016, t=2.566;P=0.036, t=2.195) 1 day and 1 week after cryoablation. Two patients (6.45%) had mild complications, and no serious complication was ob-served. Conclusion:Cryoablation is a low-risk and well-tolerated topical treatment for pain caused by unresectable malignant paraverte-bral and mesenchymal tumors.

Objective:To investigate the clinicopathological features and prognosis of IgA nephropathy (IgAN) patients with gross hematuria.Methods:The clinical and pathological data of 490 primary IgAN patients admitted in the Affiliated Hospital of Qingdao University from January 2010 to June 2019 were analyzed. Patients were divided into gross hematuria group and non-gross hematuria group. The clinical and pathological features and prognosis were compared between the two groups. All patients were diagnosed by kidney biopsy, and followed up until June 30, 2020. Kaplan-Meier survival curve was used to examine the renal survival,and Cox regression model was used to analyze the risk factors affecting renal survival in two groups.Results:Among 490 patients there were 111 patients (22.7%) in the gross hematuria group and 379 patients (77.3%) in the non-gross hematuria group. Age, hypertension, 24-h urine protein, serum creatinine, blood uric acid, blood triglycerides, total blood cholesterol level, mesangial cell hyperplasia (M1), the proportion of renal tubular atrophy or renal interstitial fibrosis (T1/2) in gross hematuria group were lower than those in non-gross hematuria group ( P<0.05), while the estimated glomerular filtration rate (eGFR) in gross hematuria group was higher than those in non-gross hematuria group ( P<0.05). Four hundred and twenty six patients (86.9%) were followed up for at least 6 months, including 93 patients in gross hematuria group and 333 patients in non-gross hematuria group. There was no statistically significant difference in treatment method between the two groups ( P>0.05). The incidence of end-point events in non-gross hematuria group was higher than that in gross hematuria group [18.6%(62/333) vs. 6.5%(6/93), χ2=8.023, P<0.05]. Kaplan-Meier survival analysis showed that the cumulative renal survival rate of the gross hematuria group was higher than that of the non gross hematuria group (χ2=11.44, P<0.001). Multivariate Cox regression analysis showed that urine protein>1 g/24 h, eGFR<60 ml·min -1·(1.73 m 2) -1, hypertension, hyperuricemia and the elevated serum IgA/C3 were risk factors for renal survival [ HR(95% CI)=3.457(1.137-10.514),2.736(1.073-6.977),2.720(1.144-6.465),2.789(1.102-7.060),1.070(1.009-1.135), all P<0.05]. Conclusions:IgAN patients with gross hematuria has less severe kidney damage and higher cumulative renal survival rate than non-gross hematuria patients. Urinary protein>1.0 g/d, hypertension, hyperuricemia and the elevated serum IgA/C3 are risk factors for adverse end-point events, to which timely attention and corresponding treatment should be given.

Objective To investigate the effect of incomplete cryoablation on the biological behavior of prostatic cancer RM-1 cells and its mechanism.Methods RM-1 cells of prostatic cancer were placed in -20℃ icebox to be frozen for 5 min.After the recovery of the cell state,the RM-1 cells were frozen again for 10 min and 15 min successively.After culture for one day,the cellular morphology was microscopically examined.A total of 20 C57/BL mice were used to establish the tumor-bearing models,which were randomly and equally divided into the control group and the incomplete cryoablation group with 10 mice in each group.At scheduled time points the tumor lesion size was measured for all mice.The mice were sacrificed at 14 days,the lung tissues were collected and were stained with lE;the numbers of metastatic lesions in the lung were calculated.Transwell assay was used to test the cell migration and invasion,immuno-blotting method was adopted to determine the epithelial-mesenchymal transition-related (EMT-related) protein expression level,and the enzyme-linked immunosorbent assay (ELISA) was employed to check the secretion volume of transforming growth factor-beta (TGF-β).Results After incomplete cryoablation,RM-1 cells became disorderly arranged,their morphology was changed,and antenna structure might be formed.At 3 and 7 days after cryoablation,the tumor size in the incomplete cryoablation group was slightly smaller than that in the control group,but only the difference at 7 days after cryoablation was statistically significant between the two groups (P=0.019).At 10 and 14 days after cryoablation,the tumor volume of the two groups was almost equal.The pulmonary metastatic lesions in the incomplete cryoablation group were obviously much more than those in the control group (P＜0.001).Transwell assay indicated that the cell migration and invasion ability in the incomplete cryoablation group was stronger than that in the control group (P＜0.05).Immuno-blotting test revealed that,when compared with the control group,in the incomplete cryoablation group the expressions of N-cadherin,MMP-9 and Vimentin were up-regulated,while the expression of E-cadherin was downregulated.ELISA test showed that increased secretion of TGF-β was observed in the incomplete cryoablation group.Conclusion Incomplete cryoablation can enhance the migration and invasion ability of RM-1 cells,increase the number of pulmonary metastatic lesions in tumor-bearing mice,and affect the EMT-related protein expression level.