Objective To assess the efficacy,comfort and tolerability of high-flow nasal cannula oxygen therapy in patients with acute respiratory failure (ARF).Methods The literature of RCTs concerning high-flow nasal cannula (HFNC) versus usual oxygen care (UOC) in ARF patients was searched using the national and international electronic databases.All relevant studies were screened according to inclusion and exclusion criteria,and then the included studies were evaluated,and finally,the extracted data were analyzed using Rev Man 5.3 software provided by the Cochrane Collaboration.Results eleven RCTs were included in 3 170 patients,of those 1 550 patients were in HFNC group,while 1 620 patients were in UOC group.There was no statistical difference in mortality among in HFNC and UOC group (OR =0.92,95％ CI:0.70-1.2,P =0.53),neither was the incidence of nosocomial infection (OR =0.85,95％ CI:0.63-1.15,P =0.3).The incidence of endotracheal intubation was lower in HFNC group than in UOC group.The comfort and tolerablity was greater in HFNC group than that in UOC group.Conclusions No difference in mortality or nosocomial infection was detected in patients with ARF treated with HFNC compared with UOC.However,HFNC seem well tolerated by patients and showed a lower rate of endotracheal intubation.

Objective To evaluate the use of endoscopy in assessment of invasion depth of colorectal flat lesions and in choice of treatment strategy. Methods The invasion depth of 222 colorectal flat lesions from 188 patients was endoscopically estimated by pit patterns, air-induced deformation testing and/or lifting sign. The lesion was endoscopically rosected if both tests were positive, otherwise, surgery was applied. The pathological evaluation of resected lesion was made according to WHO criteria and was used as a reference of tumor invasion depth. The sensitivity, specificity, positive and negative predictive value of airinduced deformation testing and lifting sign in prediction of invasion depth of tumors were calculated. Results The air-induced deformation testing and lifting sign were both positive in 212 cases, in which 192 were treated with endoscopic mucosal resection (EMR), 15 with endoscopic piecemeal mucosal resection (EPMR), 2 with additional surgery after EPMR and 3 with surgery only. Either air-induced deformation tesring or lifting sign was negative in 10, in which 4 cases underwent surgical resection. The sensitivity, specificity, positive and negative predictive value of air-induced deformation testing and lifting sign in prediction of invasion depth of tumors were 97.2%, 44. 4%, 97.6% and 40. 0%, respectively. Conclusion Endoscopic air-induced deformation testing and lifting sign can be used to predict invasion depth of colorectal flat tumors, which can guide instant therapeutic strategies and avoid excessive or insufficient treatments.

Objective To observe the effect of home nursing based upon protocol nursing theory on liq-uid intake compliance improvement of patients undergoing hemedialysis. Methods Forty-eight HD patients of hquid intake un-compliance were randomized into the observation group and the control group with 24 cases in each group. The control group received routine nursing, the observation group was given home care instruc-tion based upon protocol nursing theory for 1 month. The two groups both received follow-up for 3 months and their liquid intake comphance were evaluated before and after intervention. The relationship between family sup-port and relative increase of body weight during hemodialysis was also evaluated. Results The IDGW relative magnitude was lower, the compliance of liquid intake was higher, the level of family support was higher in the observation group than those of the control group. There was negative correlation between the family support and the IDGW relative magnitude the IDGW relative magnitude, family support, comphance of liquid intake. Conclusions Home care nursing based upon nursing theory facilitate patients to get effect family support, increase the compliance of hquid intake and make IDGW within desirable range.

Objective To study the genetic regulation mechanism of colorectal LST,polypoid adenomas and clolrectal cancer by detecting the expression of p53,c-myc and Ki-67 in these three lesions.Methods The expressions of p53,c-myc,Ki-67 were determined via two-step of immunohistochemistry method in LST,polypoid adenomas,invasive colorectal cancer and their significant difference were compared.Statistical analyses were used to analyze the correlation among Ki-67 expression and p53,c-myc expression in these three group lesions.Results Immunohistochemical staining was performed in 38 LST,62polypoid adenomas and 36 colorectal cancer.For p53 and c-myc,the positive rates in LST,polypoid adenomas and colorectal cancer were significantly different from each other.For Ki-67,the positive rates in LST and polypoid adenomas were significantly lower than that in colorectal cancer,but there was no statistical significant difference between LST and polypoid adenomas.The expression of Ki-67 did not correlate with p53and c-myc both in LST and polypoid adenomas.But in colorectal cancer,the expression of Ki-67 was strongly related to p53 and c-myc.Conclusion The expressions of p53,c-myc and Ki-67 were different in LST,polypoid adenomas and colorectal cancer,indicating that their genetic regulation mechanism might be different,and the genetic avenue for LST may be different from polypoid adenomas.

Objective Comparing three screening schemes of colorectal cancer in general population to provide scientific basis for coiorectal cancer screening in communities. Methods Questionnaire screening among high-risk population and immunoassay fecal occult blood test (FOBT) were used for colorectal cancer detection. Colonescopy and pathological test were considered as gold standard of screening results. Results Nine coloreetal cancers and 796 colorectal adenomas were detected in 68 953 participants. Mean onset age of coloreetal adenoma was 7. 7 years earlier than colorectal cancer. For questionnaire and FOBT,the sensitivity was 44.4% ,77.8% and 100.0% ,while the specificity was 98.6%, 95.5% and 94.4%, respectively. The Youden index of questionnaire, FOBT, and questionnaire-FOBT sequential method was 0.4,0.7,and 0.9,and the likelihood ratio ( +/- ) was 32.7/0.6,17. 2/0.2,and 17.8/0.0,respectively. When 50 was used as initial age of screening, screening receivers accounted for 9.7% ,and 66. 7% colorectal cancer could be detected. When 40 was used as initial age of screening, screening receivers and cost increased by 57.1% ,and only 11.1% more patients with colorectal cancer could be detected. Conclusions Questionnaire-FOBT sequential method has high sensitivity and specificity of colorectal cancer screening. Screening at 50 year-old may be better for community residents. The time of colorectal adenoma developed to colorectal cancer is about 8 years.

Objective: To investigate the pathological changes of human hepatocellular carcinoma (HCC) after continuous passaging in nude mice. Methods: The mice model of HCC SMMU-LTMN were continuously observed for 20 years (1987-2007) . The subcutaneously transplanted carcinoma had been passaged for 228 generations. The pathological data of abdominally transplanted HCC, orthotopically transplanted HCC in nude mice, and orthotopically transplanted HCC in NOD-SCID mice were recorded. The pathological studies were conducted by light microscope, electron microscope, image analysis, chromosomal analysis, and measurement of alpha-fetoprotein (AFP) in peripheral blood. Results: (1) The local invasion and metastasis of of tumors were present in all the above 4 models for a long time. The local invasion rate and the pulmonary metastasis rate of subcutaneously transplanted tumors were 59.70% (40/67) and 37.10% (23/62), respectively. The pulmonary metastasis rate of abdominally transplanted tumors was 59.02%(36/61). The intra-hepatic and pulmonary metastasis rate of the othotopically transplanted tumors were 18.18%(4/22) and 31.82% (7/22), respectively. The pulmonary metastasis rate of HCC in NOD-SCID mice was 53.85%. (2) The tissue structure and the differentiation of the 10th generation tumor cells was similar to those of primary HCC, with grade 2 differentiation and coarse trabecular pattern as the main characteristics. From the 11th generation to the 228th generation, the main characteristics of tumor cells were grade 3 differentiation and lump pattern. Electron microscope also showed worse differentiation. (3)The AFP level was 92 500 ?g/L in cells before the 32th generation; it decreased to 6 729?g/L from the 33th-130th generation cells; and the level of the 220th generation was 1 000-5 000 ?g/L.(4)The DNA contents had a wide distribution (from 2c to 6c) in abdominally transplanted tumors and the pulmonary metastatic tumors; the mean DNA index in the former tumors (2.60?0.20) was wider than the that in the latter (2.10?0.26) . (5)From the 55th generation to 206th generation, it was found that tumor cells had integrated into the chromosome of the nude mice. Conclusion: The subcutaneously transplanted HCC in nude mice can be stably expressed for 20 years, with no change in the local invasion and metastasis ability of HCC. The differentiation of the tumor cells worsenes and the AFP level is decreased in the blood; some chromosome of tumor cells integrate into the chromosome of nude mice, which may be related to the internal environment of nude mice and the multi-potential differentiation of the tumor cells.

Objective To compare the effect of different gastrointestinal motility drugs on capsule endoscopy. Methods Seventy-one patients with suspected small bowel disease were randomly divided into metoclopramide group (24 patients), mosapride group(25 patients) and control group (22 group). The patients in metoclopramide group swallowed capsule endoscopy immediately after intramuscularly injecting 10 mg metoclopramide, the patients in mosapride group swallowed capsule endoscopy 15 min after taking 5 mg mosapride, and the patients in control group did not take any of the gastrointestinal motility drugs. Three groups had the same bowel preparation before checking. The finishing rate of small bowel examinations, stomach and small intestinal transit time, intestinal cleanliness and the detection rates of lesions in three groups were compared. Results The total small bowel examination finishing rate was 94.4%(67/71). The small bowel examination finishing rate in metoclopramide group, mosapride group, and control group was 95.8%(23/24), 96.0%(24/25), and 90.9% (20/22), and there was no significant difference(P>0.05). The stomach transit time in metoclopramide group, mosapride group and control group was(27.5 ± 20.7), (28.1 ± 20.9) and (52.3 ± 33.5) min. The stomach transit time in metoclopramide group and mosapride group had no significant difference (P>0.05), but it was significantly lower than that in control group (P<0.05). The small intestinal transit time in three groups had no significant difference (P>0.05). The image class scores in metoclopramide group, mosapride group and control group was (2.5 ± 0.4), (2.7 ± 0.4) and (1.7 ± 0.3) scores.The scores in metoclopramide group and mosapride group had no significant difference (P>0.05), but they were significantly higher than that in control group (P<0.05). The detection rate of lesions in metoclopramide group, mosapride group and control group was 45.8%(11/24), 56.0%(14/25) and 18.2%(4/22). The detection rate of lesions in metoclopramide group and mosapride group had no significant difference (P>0.05), but it was significantly higher than that in control group (P<0.05). Conclusions The use of gastrointestinal motility drugs before capsule endoscopy can improve the quality of inspection, and metoclopramide and mosapride shows no significant difference.

Objective To study the diagnostic evaluation of spiral CT for acute pulmonary embolism(PE).Methods 24 patients with PE were scanned with SCT(Philips AVEL.)pre-and post-injection of 100 ml contrast medium(Ultravist or Omnipaque 300 mgI/ml)from elbow vein.Enhanced CT scans were started after injection of 15 and 30 seconds respecting.Results The indirect signs on plain CT image were:lung-making sparse in 12 cases;lesion of pulmonary infarction in 11 cases;pulmonary hypertension signs in 3 cases;pleural thickening in 4 cases;pleural effusions in 8 cases.The direct signs on enhanced CT images were:Intraluminal filling defect (mural filling defect in 32 vessels;partial filling defect in 30 vessels;total occlusion in 92 vessels and central filling defect that was railway-track sign in 15 vessels)and smaller caliber of pulmonary artery in 14 vessels.Conclusion Enhanced pulmonary SCT angiography is the safe,quick and effective imagilogic examination for acute PE.

Objective To explore the diagnosis and treatment of female bladder outlet obstruction (BOO) with bladder pain as major symptom.Methods From November 2008 to December 2012,21 female patients suffered from urinary frequency,urgency,pain in suprapubic area during bladder filling phase were enrolled in the study.Video-urodynamics (VUD) study combined with free urinary flow rate andresidual urine were performed in all patients in order to make the diagnosis of BOO clearly.The mean maximum urinary flow rate was (11.5±3.6) ml/s,and the mean maximal detrusor pressure was (39.1±17.8) cmH2O.Combining with the voiding radiography,19 patients were diagnosed as bladder neck obstruction,and the other 2 were diagnosed as urethral stricture.All patients were accepted the hydrodistension under the epidural anesthesia.The bladder biopsy was performed if the typical glomerulations were observed under the cystoscopy.Bladder neck incision and urethral dilatation were performed on these patients respectively.Symptom changes of bladder pain were recorded by using O'Leary-Sant scale,the pain,urgency,frequency symptom (PUF) scale and quality of Life (QOL) Scale.The data were collected within 48 months postoperation,respectively.Results The pathological findings of bladder mucosa biopsy showed acute or chronic inflammation in all patients.The mean follow-up was 6.7±5.9 months.We compared the corresponding data such as:voiding times per day,nocturnal frequency,O'Leary Sant scores,PUF and QOL between pre and post-treatment.Significant differences were observed during all corresponding data (P＜0.05).The voiding times per day changed from 24.3± 11.8 to 13.0±5.9.The nocturnal frequency decreased from 6.5±2.7 to 3.3± 1.6.O'Leary Sant scores changed from 24.6±7.3 to 14.7±7.4.The PUF scores changed from 22.9±6.2 to 12.0± 7.1.And the QOL scores changed from 5.0±0.8 to 2.9±1.5.Conclusions Free urinary flow rate and residual urine combined with VUD are very important in diagnosing female BOO with bladder pain as major symptom.Bladder pain symptoms will be significantly improved after the obstruction was relieved according to VUD results.

In this paper, the antigens of both Vibrio cholerae on 55 strains of El Tor and on 28 strains obtained with genetical method were studied by ELISA method using 12 strains of McAb against Vibrio cholerae (VCOMcAb). The results indicated that the 55 strains of Vibrio cholerae El Tor were expressed 11(A-K) of the recognized antigenic determinants, and fell into XⅧ(Ⅰ-XⅧ) distinct McAb reactivity types or groups, and the 28 varients of Vibrio cholerae from genetical method were expressed 9 (A-Ⅰ) of the recognized antigenic determinants, and fell into Ⅹ (Ⅰ-Ⅹ) distinct McAb reactivity types or groups. From those VCOMcAbs, the “F3” could recognize all 55 strains of Vibrio cholerae El Tor, indicating it has specificity; other 11 strains of VCOMcAb have a variety of reactivity to antigens on the 55 strains of Vibrio cholerae El Tor in both Inaba and Ogawa and their percentages of reactivity are different. This shows that these strains may have subtypes or subgroups.