Objective Discuss the integrate attendance′s effect on maintenance hemodiafiltration patient. Methods Our hospital implemented integrate attendance on 105 cases of maintenance hemodiafiltration patients during January 2004 to December 2005, to observe the patient′s blood pressure abnormal change occurence rate, puncture success rate,internal leakage obstruction rate, hospitalization rate, satisfaction rate; examined the Blood albumin(ALB) , blood serum albumin (PA) ,hemoglobin(Hb) and so on.There were 96 hemodiafiltration patients without integrate attendance in our hospital during January 2002 to December 2003.Then make a comparison between them with related data. Results Blood albumin , blood serum albumin ,hemoglobin and so on figures have a obvious rise after the implementation of integrate attendance(P

Objective Observe the influence of using PCEA on the recovery of postoperative patient with cesearn section.Methods Observe the analgesic effect in advance of PCEA analgesia with 110 cases,and analgesic effect of non-PCEA analgesia for selective cesarean section 67 patients.Results PCEA analgesic effectiveness for cesarean section postoperative 6 hours and 24 hours respectively are 98% and 94%,the difference is remarkable(P0.05).Conclusion PCEA uses for cesarean section postoperative analgesia,has a good analgesic effects and highly safety.

OBJECTIVE:To investigate the pathogen distribution and drug resistance situation in bronchoalveolar lavage fluid (BALF) from patients with refractory pulmonary infection,and provide reference for clinical rational drug use. METHODS:The sputum and BALF specimen of 136 inpatients with refractory pulmonary infection from the First People’s Hospital of Zhenjiang City from Jan. 2012 to Dec. 2015 were cultured and identified,pathogen detection was compared,and results of drug sensitivity test for pathogen in BALF specimen was analyzed. RESULTS:The positive rates of sputum and BALF specimen of 136 inpatients were 22.06%and 47.79%,with statistical significance(P<0.01);a total of 32 and 72 strains were isolated,they mainly were Ste-notrophomonas maltophilia,Pseudomonas aeruginosa,Acinetobacter baumannii and Staphylococcus aureus. S. maltophilia in BALF was sensitive to minocycline and levofloxacin;resistance rate of P. aeruginosa to common antibiotics was lower than 50%;A. baumannii was sensitive to imipenem,ampicillin sodium and sulbactam sodium,amikacin and minocycline;S. aureus was sen-sitive to linezolid,chloramphenicol and vancomycin. CONCLUSIONS:The positive rate of BALF specimen is higher than spu-tum,the pathogens are mainly Gram-negative bacteria. Clinic should rationally select antibiotics based on the drug sensitivity test and clinical symptoms.

Objective To investigate the nursing cooperation in clinical application of RetCamⅢ wide-field digital pediatric retinal imaging system.Methods 119 patients were given pointed nursing guidance while they underwent RetCamⅢ wide-field digital pediatric retinal imaging system examination.Results All patients accomplished the examination.29 cases had adverse reactions after using mydriatic.27 cases felt discomfort during the examination.22 cases appeared adverse reactions after examination,but relieved after nursing cooperation and guidance.Conclusions RetCamⅢ wide-field digital pediatric retinal imaging system is a rapid,safe and effective method for pediatric fundus examination.Favorable nursing cooperation and guidance is the guarantee of accurate and effective examination and harmonious relationship between doctor-nurse-patient.

Objective To explore the clinical significance of serum vascular endothelial growth factor (VEGF) level in nasopharyngeal carcinoma patients. Methods Serum VEGF level of 55 nasopharyngeal carcinoma patients were measured by sandwich enzyme?- linked immunosorbent assay (ELISA). 40 normal healthy volunteers served as control. Results Serum VEGF level of nasopharyngeal carcinoma patients was significantly higher than that of control group (P =0.000); Serum VEGF level was significantly higher in advanced nasopharyngeal carcinoma stage (stage Ⅲ ~Ⅳ) than that in early stage(stageⅠ ~Ⅱ) (P =0.003); Serum VEGF level with nasopharyngeal carcinoma patients with lymphnode metastasis was significantly higher than that of patients without lymphnode metastasis. There was no significant relationship compared serum VEGF level in nasopharyngeal carcinoma patient's gender, age and pathological types. Conclusions Serum VEGF can be used as a marker of nasopharyngeal carcinoma for diagnosis and monitoring the progress and the prognosis of the disease.

Objective To study the value of ultrasonographic diagnosis of galactostasis in lactation.MethodsPatients in lactation and post-lactation were examined by color Doppler ultrasonography.Combined puncture,operation and pathology,the imaging features of different stage were summarized.Results The type of galactostasis included ductal ectasia,galactocele,infection and consolidation.The ultrasonographic examination with imaging features can determine the diagnosis and judge the type and the course of disease.Conclusions Ultrasonography is a first choice in diagnosing galactostasis in lactation.

Objective To observe the ultrasonic features of cystic renal cell carcinoma. Methods Ultrasonic features of 18 patients of cystic renal cell carcinoma confirmed with operation and pathology were analyzed retrospectively.Results Among 18 patients, 7 were clear-cell carcinoma of cystis degeneration, 5 were cystic renal cell carcinoma (clear cell type), 3 were multilocular renal cell carcinoma, 1 was corpora mammillaria renal cell carcinoma, and one clear-cell carcinoma was on capsule wall of cyst and 1 was nephroblastoma. Ultrasound diagnosed 15 patients and misdiagnosed 3 with a diagnostic rate of 83.33%.Conclusion Cystic renal cell carcinoma has specific ultrasonic characteristics, and having an intimate knowledge of these characteristics may be helpful to diagnosis.

Objective To explore the ultrasonographic appearance of dermatofibrosarcoma protuberans. Methods Clinical data, sonographic features and color Doppler flow imaging characteristics of 12 patients surgically and pathologically confirmed dermatofibrosarcoma protuberans were retrospectively analyzed.Results Single mass was detected in 11 patients (11/12, 91.67%) with the diameter ranged 0.9-8.0 cm. The tumors distributed in the trunk (8/12, 66.67%), proximal limbs (2/12, 16.67%) or face and neck (2/12, 16.67%). Most of the tumors (10/12, 83.33%) developed from skin and subcutaneous fat layer of the trunk and limbs and were hypoechoic and heterogeneous (11/12, 91.67%), some (8/12,66.67%) with distinct boundary and regular shape without liquification, calcification nor regional lymph node metastasis. Affluent color Doppler flow signals of tumor were found in 11 patients (91.67%).Conclusion Ultrasonographic characteristics of dermatofibrosarcoma protuberans include distinct boundary, regular shape, heterogeneous hypoechogenicity and rich color Doppler flow signals without regional lymph node metastasis.

Objective To investigate the characteristics of medicine taking,the type and ratio of long-term medication and treatment satisfaction in patients with gastroesophageal reflux disease (GERD),to analyze the effects of GERD combined with functional bowel disease (FBD) on the treatment satisfaction,and to compare the changes of type of medication and treatment satisfaction in patients with GERD in recent years.Methods From April to June in 2011,the questionnaire survey was conducted in gastroenterology clinic of People's Hospital of Peking University.The incidence of typical GERD symptoms was investigated by a validated reflux disease questionnaire (RDQ),the score between one and five was considered there might be reflux symptoms and the score over 12 was diagnosed as GERD.FBD was diagnosed according to Rome Ⅲ criteria.The information of GERD related medication taking within one year before the survey,long-term medication taking (≥ 1 year)and the treatment satisfaction of patients whose RDQ score over zero was recorded and compared with the data collected in the same method in 2004.The chi-square test was performed for data statistical analyses with SPSS 17.0 software.Results Among 1074 patients who completed questionnaire survey in 2011,the percentage of patients with reflux symptoms was 32.7％ (351/1074),the percentage of diagnosed GERD was 10.0％ (107/1074),and GERD combined with FBD was 25.2％ (27/107) of GERD.A total of 304 cases (86.6％) of patients with reflux symptoms had information of medication taking; 78.0％ (237/304) of whom had taken GERD related medication within one year before the survey.The rate of GERD related medication taking especially proton pump inhibitor (PPI) and antiacid medication taking increased along with RDQ score (x2 =24.2,13.1 and 18.2,all P＜0.05).A total of 104 cases of GERD patients had information of medication taking; 88.5 ％ (92/104) GERD patients had taken GERD related medication within one year before the survey,52.9％ (55/104) GERD patients had taken PPI medication,30.8％ (32/104) needed long-term medication and 20.2％ (21/104) needed longterm PPI treatment.There was no significant difference in treatment satisfaction between different RDQ score ranges (x2 =3.3,P＞0.05).Among GERD patients who appraised the effects of treatment,the percentage of satisfied,acceptable and not satified with the treatment was 37.1％(26/70),48.6％ (34/70)and 14.3％(10/70),respectively.There was no significant difference in treatment satisfation between GERD with and without FBD (x2 =3.1,P＞0.05).In 2011,the rates of medication taking (88.5％,92/104) and PPI taking (52.9％,55/104) in GERD patients significantly increased compared with those in 2004 (57.3％,98/171; 7.6％,13/171,x2 =29.4,71.4,both P＜0.05).The percentage of treatment satisfaction in 2011(37.1％,26/70) increased compared with that in 2004(25.7％,18/70,x2 =12.8,P＜0.01).Conclusions Some of patients with GERD symptoms need long-term medication,especially PPI treatment.In recent years,the rate of medication taking in GERD patients increased in outpatients department,PPI taking significantly increased and the treatment satisfaction also increased.Maybe the treatment satisfaction is not affected by GERD combined with FBD.

Objective To explore the characteristics of endothelial progenitor cells (EPCs) on different scaffolds and to find a new bio-engineered synthetic hybrid scaffold for artificial bio-engineered blood vessels. Methods EPCs were induced from mesenchymal stem cells isolated from rat bone marrow and seeded on ECM scaffold. The surface structure of the scaffold and growth status of EPCs on the scaffold were observed and analysed by electron microscopy. The characteristics and number of those EPCs on different kinds of scaffolds were studied with EPC-specific VWF by immunofluorescence, Western blotting and real-time PCR technique at different time points. Results The cell adhesion rate at 1,3,5 h after seeded on pressed scaffold were higher than that on unpressed scaffolds( P < 0. 01 ). Pressed scaffolds has got a larger cell number( P < 0. 05 )at DIV1, DIV3, DIV7, but there was no significant difference after DIV10. Furthermore, cell shapes of EPCs on pressed scaffolds were more mature and more similar to endothelial cells. A level cell surface on pressed scaffolds was achieved. Western blotting assays revealed EPCs on pressed scaffolds expressed more protein VWF at DIV3, DIV7, DIV10. Real-time PCR results showed EPCs on the two different groups of scaffolds all expressed VWF gene, The quantity of their expression in the two groups were all enhanced after DIV7 (P < 0. 05 ). The quantity of VWF gene expression in the pressed group was much higher than that in the unpressed group at DIV3 ,DIV7,DIV10 (P <0, 01), but there was no significant difference after DIV14. Conclusions Pressed ECM scaffolds can promote adhesion, proliferation and differentiation on EPCs. Pressed scaffolds can be used as the matrix for EPC and fabricated into a novel synthetic tissue bio-engineered vascular scaffold.