Objective To explore the application of implantable venous access port(IVAP)in tumor patients.Methods Overall,246 tumor patients were enrolled.The clinical application and nursing of IVAPs were reviewed retrospectively.Results IVAPs were implanted successfully in all 246 patients.Complications included thrombosis in 10 patients,infection in 6,blockage in 1 and leakage in another.IVAPs were removed from 15 patients with complications.Conclusions The prevention and management of complications in IVAP are important for the patients embedded with IVAP.

Objective To evaluate the feasibility of retroperitoneal laparoscopic adrenalectomy for large (≥6 cm in diameter) adrenal tumors. Methods Between June 2002 and June 2008,30 patients with large adrenal tumors underwent retroperitoneal laparoscopic adrenalectomy in our hospital. With the patients being placed in the lateral position at the uninjured side,a self-made balloon was used to dilate the retroperitoneal space. Afterwards,3 trocars were inserted via the costal margin at the posterior axillary line and the anterior axillary line,and 2 cm above the anterior superior iliac spine at the middle axillary line to remove the tumors. After resection of the tumor,an drainage tube was indwelled. Results Retroperitoneal laparoscopic surgery was performed successfully in the 30 cases without conversion to open surgery. The mean operation time was 100 min (range,65 to 185 min),and the mean blood loss was 80 ml (range,50 to 250 ml). Over a mean of 18.5-month follow-up (range,3 to 36 months) was achieved in the cases,during which no one had local recurrence. Conclusions Retroperitoneal laparoscopic adrenalectomy is feasible and safe for patients with large adrenal tumors as long as no contraindication of the surgery is found. The diameter of the tumor does not play a role when determining the surgery.

ObjectiveTo investigate the protective effect of combination of triptolide and irbesartan on the podocytes in a type 2 diabetic(T2DM) rat model,and evaluate its mechanism.Methods T2DM rats were induced by fed with high-sucrose-high-fat diet combined with a low dose of streptozocin.The rats were randomly divided into 5 groups:normal control group ( NC,n =10),diabetes group ( DM,n =11),triptolide treatment group (DT,n =12),irbesartan treatment group (DI,n =12) and triptolide combined with irbesartan treatment group (DTI,n =13). Ultrastructure of podocytes was observed by electronic microscopy and urinary albumin (UAL) excretion by ELISA was determined after 8 weeks.The expression of nephrin and bone morphogenetic protein-7(BMP-7), connective tissue growth factor (CTGF),transforming growth factor (TGF)β1 mRNA and proteins were detected by immunohistochemistry,real-time PCR and Western blot. Results Increased UAL was significantly attenuated in all treatment groups.Compared to NC group,UAL in DM group was increased significantly (0.45 ± 0.09 vs 6.36 ± 0.87,P ＜ 0.01 ),while decreased in triptolide or irbesartan alone treatment group (2.48 ± 0.37 and 2.68 ±0.42,both P ＜ 0.01 ).Compared with those in control groups,kidney expression of nephrin,BMP-7 mRNA and proteins were downregulated while CTGF, TGFβ1 mRNA and proteins were significantly upregulated in T2DM rats. Triptolide or irbesartan each alone moderately ameliorated albuminuria and podocyte damage.However,their combined usage showed a dramatic therapeutic synergism,manifested by prevention of progressive albuminuria,restoration of the glomerular filtration barrier,reversal of the decline in slit diaphragm proteins,reduction expression of CTGF,TGFβ1,and upregulation of BMP-7.Conclusion Our findings show that triptolide can increase the efficacy of irbesartan,leading to a more effective prevention of kidney disease in T2DM rat model,which may through upregulation of BMP-7 and inhibition the overexpression of CTGF and TGFβ1.

Objective To assess the relationship between lactate clearance and prognosis of patients with multiple organ dysfunction syndrome following resuscitation.Methods Data of 42 eligible patients with multiple organ dysfunction syndrome after resuscitation admitted from January 2009 to December 2011 were collected for retrospective analysis.The patients included were adult patients who survived more 24 hours after CPR for cardiac arrest with subsequent multi-organ failure.Exclusion criteria were traumatic heart arrest and the end-stage diseases.All the patients were divided into survival group and death group on the 3rd day and the 7th day after restoration of spontaneous circulation.The differences in the age,gender,mean arterial pressure,oxygenation index (PaO2/FiO2),APACHE Ⅱ score,white blood cell count (WBC),initial lactate level and 6h lactate clearance rate between the two groups were compared by using the Mann-Whitney U-tests and logistic regression analysis.Results Of 42 patients,the mean age was (59.57±14.68) years and mean APACHE Ⅱ score was (26.79 ±7.77),and 23 (54.8％) patients survived until the 3rd day and 14 (33.3％) patients survived to the 7th day after restoration of spontaneous circulation (ROSC).Univariate analysis showed that APACHE Ⅱ score in death group was significantly higher and 6 h lactate clearance was significantly lower than those in survival group (P ＜ 0.05) on the 3rd day and the 7th day after ROSC,and other biomarkers were not significantly different between the two groups.The results from logistic regression analysis showed that there were statistically significant difference in APACHE Ⅱ score (RR =2.143,P =0.028) and 6-h lactate clearance (RR =0.887,P =0.040) between survival group and death group on the 7th day after ROSC,although no significant differences in APACHE Ⅱ score and 6 h lactate clearance were found between the two groups on the 3rd day after ROSC.Conlusions Post-cardiac arrest patients with low lactate clearance in the early stage after ROSC have a poor prognosis.Lactate clearance may be an independent predictor of mortality in post-cardiac arrest patients in the recovery phase.

Objective To improve the stability and practicability of field liquid transfusion control system.Methods SPCE062A 's high accurate AD was used to acquire the dropping speed,and a new method for weight sensor 's self proofread was applied.Results The infrared photoelectric sensor was removed,so the monitoring part could work with any appropriate sensor.Conclusion The system cost is decreased and its stability and availability are enhanced.[Chinese Medical Equipment Journal,2008,29(2):66-67]

Objective To estimate the prevalence of thyroid dysfunction among the retired staffs of a petrochemical corporation in Ningbo. Methods The 1709 retired staffs at 60 years of age and over were enrolled in the census. Their medical history were investigated by questionnaires,and blood samples were collected for thyroid function detection. Results In this elderly cohort, the morbidity of diagnosed thyroid diseases was 3.8% (65/1709), with 6.7% (39/584) in females and 2. 3% (26/ 1125) in males. The morbidity of unrecognized thyroid dysfunctions was 6.7% (110/1644), with 9.7% (53/545) in females and 5.2% (57/1099) in males. The prevalence of total thyroid dysfunctions was 10. 2%(175/1709), with 15.8% (92/584) in females and 7.4% (83/1125) in males. Subclinical hypothyroidism accounted for 87. 3% of unrecognized thyroid dysfunctions. Conclusions The prevalence of thyroid dysfunctions is over 10. 2% in the elderly retired staffs of the petrochemical corporation in Ningbo. Subclinical hypothyroidism is the most popular form in all kinds of unrecognized thyroid functional disorders, and its prevalence is higher in females than in males.

ObjectiveTo investigate the relevant factors influencing the incidence and mortality of post cardiac arrest syndrome (PCAS), and to provide the basis of improvement of resuscitation rate.Methods A single center retrospective study of cardiopulmonary resuscitation (CPR) according to Utstein model was conducted. A clinical case report form was designed to collect clinical data. The clinical data of patients whose spontaneous circulation was restored (ROSC)> 24 hours in intensive care unit (ICU) of the First Hospital of Jilin University from January 2008 to June 2014 were collected and analyzed. The relevant risk factors of the incidence and mortality rate of PCAS were screened and analyzed by multivariate logistic regression analysis.Results① Successful CPR was achieved in 93 patients, of whom 83 patients were shown to have systemic inflammatory response syndrome (SIRS), and 75 patients suffered from PCAS (80.65%). Among them 49 died, and 18 patients who did not suffer from PCAS survived.② The age, gender, history of previous chronic disease, site of occurrence of cardiac arrest, type of rhythm when cardiac arrest occurred, and dosage of adrenaline showed no significant influence on the incidence of PCAS. The incidence of PCAS was elevated when defibrillation was done more than 3 times (χ2= 10.806,P= 0.001), SIRS occurred after ROSC (χ2= 46.687,P< 0.001), interval between collapse and first defibrillation over 5 minutes (χ2 = 6.429,P = 0.011), interval between collapse and CPR longer than 5 minutes (χ2 = 4.638,P = 0.031), interval between collapse and administration of first resuscitation medication> 5 minutes (χ2 = 4.190,P = 0.041), and ROSC time was longer than 10 minutes (χ2 = 20.042,P< 0.001). Bivariate correlation showed that interval between collapse and CPR, interval between collapse and administration of first resuscitation medications, and ROSC time were all correlated (r1 = 0.677,r2 = 0.481,r3 = 0.617, allP< 0.001).③ There were no significant relations between the prognosis of PCAS patients and times of defibrillation, the amount of adrenaline used, and interval between collapse and first defibrillation. The mortality rate of PCAS was relatively elevated when interval between collapse and CRP was longer than 5 minutes (χ2 = 10.792,P = 0.001), interval between collapse and administration of first resuscitation medications was longer than 5 minutes (χ2 = 13.841,P< 0.001), ROSC time> 10 minutes (χ2 = 36.451,P< 0.001), the number of dysfunction organ≥ 4 (χ2 = 28.287,P< 0.001), arterial blood lactate levels> 2 mmol/L (χ2 = 28.926, P< 0.001), and acute physiology and chronic health evaluationⅡ (APACHEⅡ) score> 15 (χ2 = 33.558,P< 0.001). Multivariate logistic regression analysis showed that the risk factors affecting the prognosis were ROSC time [odds ratio (OR) after adjustment = 36.643, 95% confidence interval (95%CI) = 2.382-563.767,P = 0.010], the number of organs with dysfunction (OR = 9.010, 95%CI = 1.140-71.199,P = 0.037), and APACHEⅡ score (OR = 10.001, 95%CI =1.336-74.893,P = 0.025).Conclusions ROSC time, the number of organs with dysfunction, and APACHEⅡ score were independent predictors of PCAS prognosis. Efforts should be given to shorten the rescue time, to shorten the time for restoring the spontaneous circulation, to prevent and treat SIRS after ROSC, and to protect the function of organs, in order to improve the prognosis of patients with PCAS.

Objective: To compare effects of drug and psychotherapy in the treatment of depressive disorder. Methods: 63 depressive patients were randomly divided into two treatment groups: drug or psychotherapy. MMPI, SDSS and HAMD were used for assessing treatment effects on personality and social functions. Results: The effects of psychotherapy and drug were compatible for controlling symptoms of depression. Psychotherapy was superior to drug in preventing relapses, as well as improving cognitive and social functions. Conclusion: Psychotherapy should be applied to depressive patients. Dosage and duration of administering sedative antidepressants should be reduced in the treatment of depression.

Objective To compare the difference of prospective memory(PM) between schizophrenia patients and normal people,and to analyze the internal component of prospective memory using multinomial processing tree(MPT) model.Methods 17 schizophrenia patients and 17 age-and education-matched control participants completed an event-based PM task which was embedded within an ongoing computer-based color-matching task.Internal component of prospective memory was analyzed using multinomial processing tree(MPT) model.Results The scores of prospective memory performance in schizophrenia patients and normal controls were (21.83± 2.46) ％ and (38.81±2.26) ％, and the difference was statistically significant (t=2.11, P＜0.05).The difference of ongoing task between schizophrenia patients ((75.88±0.43) ％) and controls ((71.44±0.45) ％) was statistically significant (t=2.79, P＜0.05).The reaction time of schizophrenia patients was significantly longer than that of normal controls((2.34±1.41) s vs (1.81± 1.19) s, t=11.24, P＜ 0.05).The MPT model revealed a significant group difference in the prospective component (0.82 vs 0.97, G2(1)=14.17, P＜ 0.01) and retrospective component (0.54 vs 0.41 ,G2(1) 14.17, P＜0.01).Conclusion The prospective component of event-based prospective memory of schizophrenia patients was lower than normal controls,which may result in the impairment of PM performance.

Objective To study the intake of iodine and iodine nutritional status of adults and provide a scientific basis for choosing appropriate salt iodine content in the region.Methods By using multi stage random sampling method,according to the four corners of 4 directions,4 non water iodine counties or districts were selected from Nankai District,Jixian County,Dagang District and Hangu District.Totally 1 to 4 administrative villages were selected (neighborhood committees) from each district or county as the survey points.Ten to 15 households were selected from each survey points.All the members more than 18 years old of each household were investigated (excluding pregnant and lactating women).Of the 225 households,404 people,salt iodine of the family,urinary iodine and water iodine were detected.The questionnaire survey was used to investigate the daily salt intake of residents per capita.The daily intake of iodine was calculated by the method of dietary frequency.Salt iodine content was detected by direct titration method;iodine in water was detected by cerium sulfate catalytic spectrophotometry;urinary iodine was detected by arsenic cerium catalytic spectrophotometry.Results A total of 24 drinking water samples were tested,the median water iodine was 8.0 μg/L.A total of 225 salt samples and 404urine samples were tested,the medians of family salt and urinary iodine were 23.30 mg/kg and 149.0 μg/L,respectively.Investigation was done on salt intake and dietary intake of 393 people,the per capita consumption of salt intake was (11.45 ± 5.70) g/d.Salt supplied 148.75 μg/d iodine and food supplied 82.47 μg/d iodine.The total contribution rate of iodized salt to the total iodine intake was 68.99％ (193.18/280.00) in the population of iodized salt consumer.The value of urinary iodine and iodine intake were correlated (r =0.170,P ＜ 0.05).Conclusions The adult iodine nutrition in Tianjin city is in the appropriate level.Iodized salt is the main source of iodine intake for adults,so salt iodine is a indispensable iodine nutrition source for adults.