This paper introduces the perioperative nursing of 47 patients undergoing intraperitoneal parastomal hernia repair.After the surgery,two cases suffered from incision infection and two cases with subcutaneous hydrops.Three patients suffered from chronic pain or foreign bodies sensation,which disappeared at 3-6 months later.No recurrence occurred at 6-24 months after the surgery.It is suggested that the key points of perioperative nursing were careful preoperative symptom care and bowel preparation,as well as postoperative observation and correct discharge instruction.

Objective To investigate the expression and clinical significance of CDx2 and hepatocyte antigen(Hep) in gastric carcinoma.Methods The expression of CDx2 and Hep in 9 cases of nomal gastric mucosa,15 cases of small intestinal mucosa,8 cases of colon mucosa,15 cases of intestinal metaplasia of the stomach and 130 cases of gastric carcinoma were detected with immuohistochemical EnVisionTM Systems measures.Results The positive rates of CDx2 expressed in the nomal gastric mucosa were 0,small intestinal mucosa 80%(12/15),colon mucosa 87.5%(7/8),intestinal metaplasia of the stomach 86.7%(13/15),gastric carcinoma 37.7%(49/130);The positive rate of Hep was 11.1%(1/9),86.7%(13/15),12.5%(1/8),100%(15/15),55.4%(72/130) respectively.There was much higher positive expression of CDx2 in intestinal-type carcinoma than in diffuse-type gastric carcinoma(P

Objective To define the role of HCV-specific cytotoxic T lymphocytes (CTL) in chro-nic hepatitis C virus (HCV) infection. Methods HCV-specific CTL activity (HCV-CTL) was assessed in the liver and peripheral blood cells in 62 patients with chronic hepatitis C and 8 non-HCV-infection controls by using bulk-expanded liver/peripheral blood mononuclear lymphocytes (PBMC)-derived CD8+ cells as effector cells, EBV-transformed B cells as autologous target cells and recombinant vaccinia vectors expressing various regions of the HCV genome as transduction vector, in a standard chromium release assay. Results HCV-CTL activity was detected from the liver in 28 of the 60 patients (46.7%), but not from PBMC. CTL activity could not be detected from the liver and PBMC in all non-HCV-infection controls. Five patients with non-type 1 HCV infection were found to have HCV-specific CTL activity against HCV type 1 epitope. Compared with the patients without detectable HCV-specific CTL activity based on our assay, those exhibiting CTL activity had higher serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels, higher histologic activity indices and lower levels of HCV RNA (all P

Objective To determine the influence of viral factors and host cellular immunity on the response to interferon in the patients with chronic hepatitis C. Methods Forty patients with chronic hepatitis C were treated with interferon ?. The relationships between response to interferon a and HCV genotype, quasispecies heterogeneity, HCV RNA level and HCV specific cytotoxic T lymphocyte (HCV CTL) activity in the liver were analyzed. Results After 6 months of therapy, 21 patients had obtained end of treatment response (ETR), 10 Patients of which had obtained sustained response (SR). The other 19 patients got no response (NR). ETR rate in patients with genotype HCV1 infection (43.3%, 13/30) was significantly lower than that in patients with non HIV1 infection (80%, 8/10) [ P

Objective To investigate the expression of p73 protein in normal skins and lesions of benign and malignant epidermal tumors. Methods By immunohistochemical staining, the expression of p73, p53 and Ki67 was examined in 19 cases of seborrheic keratosis (SK), 16 basal cell carcinoma (BCC), 11 Bowen's disease (BD), 5 squamous cell carcinoma (SCC),as well as in 10 normal skin controls. Results In normal skin, p73 protein was found to distribute in the basal cells of the epidermis, basal cells in the outer root sheath of the hair follicles, and the germinative cells in the sebaceous glands. p73 was expressed strongly in the basal cell-like cells of BCC and SK lesions, and in the atypical cells of BD lesions, but weakly or even negatively in the tumor cells of SCC lesions and the squamous cell-like cells of SK lesions. There was significant difference in the expression of p73 among the SK, BD, BCC and SCC lesions (H=12.71 ,P

Objective To study the signification of p57kip2 immunostaining to distinguish molar gestations from hydropic abortions.Methods To observe the p57kip2 immunohistochemical expression in 58 cases of histological hydropic villi which were divided into complete mole(18 cases) ,partial mole(19 cases),hydropic abortion(11 cases)and undetermined hydropic abortion or molar gestations(10 cases) and in 3 normal placentas.Results Normal villi,partial mole and hydropic abortions show positive staining for p57kip2, which expressed in the nuclei of cytotrophoblast and villous mesenchyme,and complete moles show complete absence of staining in the cytotrophoblast and villous mesenchyme.According to the comparison of the diagnosis based on morphology and the one based on p57kip2 stai-ning,the later whose sensitivity is 96% (46/48) confirmed the earlier diagnosis in 58 cases studied and the later conformed to the earlier very well.Conclusion The immunohistochemical staining for p57kip2 is a valuable diagnostic mean to distinguish molar gestations from hydropic abortions and is a sensitive and specific marker for the diagnosis of complete mole.

Objective To investigate the clinical efficacy of intravitreal injection of Lucentis combined with pan retinal photocoagulation and trabeculectomy for neovascular glaucoma(NVG). Methods Seventeen eyes of 15 patients with NVG were treated by 0.5 mg Lucentis intravitreal injection first. Trabeculectomy was performed 7 days later and Pan retinal photocoagulation 2 weeks later. Iris,anterior chamber angle neovascularization,intraocu?lar pressure ,and visual acuity were observed in the following 6 months. Results Iris and anterior chamber angle neovascularization were completely regressed 7 days after the injection in 17 eyes. Six months after photocoagulation, 6 eyes had different degrees of improvement in visual acuity,10 eyes no change in visual acuity and 1 eye decreased from anterior index to immediate manual. There was significant difference in pre?treatment IOP and postoperative IOP( t = 12.75 ,10.26 ,9.73 ,10.77 ,P < 0.01 ). No serious complications were observed after intravitreal injec?tion and trabeculectomy. Conclusions Intravitreal injection of Lucentis could significantly accelerate the regres?sion of iris and anterior chamber angle neovascularization ,which could improve the successful rate of trabeculecto?my and pan retinal photocoagulation. Intravitreal injection of Lucentis combined with trabeculectomy and panretinal photocoagulation is safe and effective for NVG.

Objective To evaluate the effect of dexmedetomidine on the quality of recovery from sevoflurane-based anesthesia in the patients undergoing abdominal surgery.Methods Eighty patients of both sexes, aged 30-64 yr, weighing 45-80 kg, with American Society of Anesthesiologists physical status Ⅰ or Ⅱ , scheduled for elective abdominal surgery, were randomly assigned into 2 groups (n =40 each) using a random number table: control group (group C) and dexmedetomidine group (group D).After routine induction of anesthesia, all the patients were tracheally intubated, and mechanically ventilated.Anesthesia was maintained with sevoflurane inhalation and intermittent iv boluses of sufentanil and cisatracurium besylate, and bispectral index values were maintained at 45-60.After induction of anesthesia, dexmedetomidine was infused in a dose of 1 μg/kg over 15 min, followed by a continuous infusion of 0.6 μg · kg-1 · h-1 until 30 min before the end of surgery in group D.Group C received normal saline instead.Heart rate (HR) and mean arterial pressure (MAP) were recorded at the end of surgery, and at 1 min before and after extubation.The emergence time, extubation time, and occurrence of bucking during extubation, and nausea and vomiting, respiratory depression, and agitation during recovery from anesthesia were recorded.Results Compared with group C, MAP and HR were significantly decreased at 1 min before and after extubation, the emergence time and extubation time were shortened, the incidence of bucking, nausea and vomiting, and agitation was decreased, and no significant change was found in the incidence of respiratory depression in group D.Conclusion Dexmedetomidine infused in a dose of 1 μg/kg after routine induction of anesthesia, followed by a continuous infusion of 0.6 μg · kg-1 · h-1 until 30 min before the end of surgery, can significantly increase the quality of recovery from sevoflurane-based anesthesia in the patients undergoing abdominal surgery.

Objective:To investigate the cellular immunological regulation mechanism of Zhongjiling tablet on the myasthenia gravis(MG) patients.Methods:The myasthenia gravis patients were randomly divided into 2 groups, the curing group and the control group, 30 cases per group. Patients of curing group administered Zhongjiling tablet and prednisone placebo, patients of control group administered prednisone tablet and Zhongjiling tablet placebo. Course of treatment was 12 weeks. The distribution of T lymphocyte subgroup of myasthenia gravis patients was detected by flow cytometry. The content of IFN-?, IL-4 and TGF-? of the patients’ peripheral blood mononuclear in vitro were detected by ELISA kits.Results:After treatment, CD4+T cell percentage and the ratio of CD4+/CD8+ decreased significantly(P0.05). The IFN-? and IL-4 of treating group depressed, compared with that of pre-treatment, significant difference exited(P

0.05). Furthermore, the patients with retinopathy had higher serum ACE levels compared with those without retinopathy ( t=12.722,P