Objective To explore the risk factors for hospital acquired pneumonia (HAP) in patients with neural-intensive care unit (NICU).Methods The clinical data were analyzed retrospectively for 207 patients in NICU ≥ 5 d,to determine possible risk factors with HAP.Results The incidence of HAP was 14.01％(29/207).Correlation analysis showed that old age,disturbance of consciousness,dysphagia,vomiting,low pre albumin,NICU residence time ≥ 30 d,indwelling nasogastric tube,the use of the acid-blocking drugs,tracheal intubation,tracheal incision,mechanical ventilation and deep bronchoscopic suctioning were the related factors of HAP (P ＜ 0.05 or ＜ 0.01),but blood glucose,sedative drugs were unrelated with HAP (P ＞ 0.05).Conclusion There is a high incidence of NICU in patients with HAP,taking comprehensive measures actively,reduce risk factors,can effectively control the occurrence of HAP in NICU.

Objective To investigate the effects of recombinant human erythropoietin βinjection on levels of superoxide dismutase ( SOD ) , glutathione peroxidase ( GSH-PX ) , malondialdehyde ( MDA ) and homocysteine ( Hcy ) in patients with diabetic peritoneal dialysis.Methods 92 patients of parallel peritoneal dialysis in diabetic nephropathy who received therapy from September 2014 to September 2016 in our hospital were selected and randomly divided into the observation group and the control group with 46 cases in each group.The control group was treated with peritoneal dialysis routine treatment, while the observation group was treated with recombinant human erythropoietin βinjection on this basis.The levels of hemoglobin (Hb), hematocrit (Hct), renal function, SOD, GSH-PX, MDA and Hcy were compared.Results After treatment, the levels of Hb and Hct in the observation group were higher than the control group, the difference was statistically significant (P<0.05), the urinary albumin excretion rate (UAER) and serum creatinine (SCr) in the observation group were lower than the control group, the difference was statistically significant (P<0.05), the levels of SOD and GSH-PX in the observation group were higher than the control group, the levels of MDA and Hcy were lower the control group, the difference was statistically significant (P<0.05).Conclusion The effect of recombinant human erythropoietin βinjection on diabetic nephropathy patients with peritoneal dialysis was significant, which could improve the levels of SOD, GSH-PX, MDA and Hcy.

To investigate the diagnostic value of magnetic resonance cholangiopancreatography (MRCP) for di-agnosing low choledochal joint and its complications. MRCP results of 29 low choledochal joint patients con-firmed were analyzed retrospectively, and then compared with those by endoscopic retrograde cholaniopancreatography (ERCP). MRCP could display clearly the location of low choledochal joint, and the patients with complications involved 4 ones with cholecystolithiasis, 5 ones with cholangiolithiasis, 15 ones with cholecystolithiasis and cholangiolithi-asis, 3 ones with Mirizz syndrome, 2 ones with pancreatitis, 1 case with carcinoma of head of pancreas after cholecystec-tomy and 1 case of Vater ampullary carcinoma. Interoperative and ERCP findings proved that MRCP could be used for the diagnosis of low choledochal joint and its complications with no missed diagnosis. MRCP can be involved for the diagnosis of low choledochal joint and its complications, and thus can be used for preoperative planning and treat-ment of the complications.

Objective:This study aimed to establish an eXtreme Gradient Boosting(XGBoost) model that can predict the recurrence of hepatocellular carcinoma(HCC)patients after laparoscopic hepatectomy (LH) surgery.Methods:A total of 440 patients with primary HCC who received LH treatment for the first time from January 2013 to September 2016 in Affiliated Hospital of Chengde Medical University were selected as the research objects. The diagnosis method was pathological diagnosis. Research objects were divided into training group ( n=88) and verification group ( n=352) at a ratio of 2∶8 by random number table method. The Kaplan-Meier method was used to draw the recurrence-free survival curve, and the Log-rank test was used to compare the survival of the two groups; the training group was used to establish the COX regression model and the XGBoost model to screen independent predictors of recurrence after LH; receiver operating characteristic(ROC) curve was used to analyze the predictive abilities of the two models, and conducted internal verification in the verification group; Hosmer and Lemeshow Test was used to evaluate the calibration of the two models, and P>0.05 was used as a good fit between the model and the actual situation. Results:Both the COX regression model and the XGBoost model screened out tumor thrombus, low degree of differentiation, tumor microvascular infiltration (MVI), number of tumors, large tumors, and positive hepatitis B surface antigen were independent predictors of tumor recurrence( HR=2.477, 0.769, 1.786, 1.905, 1.544, 1.805; 95% CI: 1.465-4.251, 0.619-0.819, 1.263-2.546, 1.354-2.704, 1.272-1.816, 1.055-2.555). The XGboost model scores were 32 points, 29 points, 24 points, 18 points, 16 points, 11 points, respectively. In the training group, the area under the curve (AUC) of the COX regression model and XGBoost model for predicting recurrence were 0.746 (0.730-0.762) and 0.802 (0.785-0.818), respectively. The XGBoost model had strong predictive ability and was confirmed in the validation cohort. Conclusions:This study had established and verified the XGBoost model that can predict the recurrence of HCC patients after receiving LH for the first time. It can be used in clinics to assist doctors in formulating personalized postoperative monitoring programs for patients. Early detection, early diagnosis and early treatment of tumors and strengthening of postoperative follow-up are important measures to improve the prognosis of patients.

Based on the introduction and cultivation of Alisma germplasm which were from Fujian, Jiangxi and Sichuan provinces, the biological characteristics, morphological characteristics and quality were observed and studied. After three-year continuous experiment and monographic study, there were remarkable difference in the biological characteristics, morphological characteristics and product quality of Fujian Alisma, Sichuan Alisma and Jiangxi Alisma. Fujian Alisma and Jiangxi Alisma were the same plant species of A. orientalis, whereas Sichuan Alisma and Fujian Alisma were the different plant species of A. plantago-aquatica. The study results will provide the theoretical and practical basis for the genuine medicinal materials research and good agricultural practice (GAP) of Alisma.
Alisma ; chemistry ; genetics ; growth & development ; China ; Drugs, Chinese Herbal ; analysis ; Quality Control

Objective To investigate the relationship between Ct value of mice liver and postmortem interval (PMI) under various ambient temperatures. Methods mice were stored at 10℃, 15℃, 20℃, 25℃ and 30℃ after execution, and total RNA was extracted from mice liver every 6 hours (PMI 6h to 72h). The levels of 18s rRNA were examined using real-time PCR. The results were expressed by cycle threshold (Ct) value to explore relationship between PMI and Ct value, and the interpolation functions were established to estimate PMI. Results In each group, Ct value increased with PMI increased. Surface equation was obtained after interpolation analysis on temperature range 10℃~30℃. The three-variable quintic surface equation was f(x, y)=-426.9+30.82x+44.48y-1.297x2-1.837xy-1.388y2+0.034 38x3+0.038 17x2y+0.038 67xy2+0.028 77y3-0.000 612 9x4-3.897e-7x3y-0.001 223x2y2+0.000 256 6xy3-0.000 537 4y4+3.606e-6x5-2.846e-6x4y+1.009e-5x3y2-3.439e-6x2y3-2.556e-7xy4+2.664e-6y5(r2=0.999 4). Conclusion The rule of Ct value changes at ambient temperature complied with three-variable quintic surface equation distribution. Measurement of interpolation function may be used for PMI estimation at ambient temperature.

Objective To explore the effect of continuous nursing intervention in tumor pa-tients with PICC.Methods A total of 116 hospitalized tumor patients with PICC from March 2012 to February 2013 were in the observation group and 102 tumor patients with PICC from Jan-uary 2011 to February 2012 were in the control group.The two groups were both given conven-tional nursing and the observation group was given continuous nursing intervention by continuous nursing team after discharged from the hospital on the basis of conventional nursing.The complica-tions and command condition of PICC related knowledge in the two groups were compared,and consultation patients and their families and settlement conditions in the observation group were cal-culated.Results The differences in incidence rate of complications and PICC command condition of related knowledge were statistically significant (P <0.05).Patients and their families in the ob-servation group consulted 1048 questions and 1037 cases were effectively solved,effective solving rate was 98.95%.Conclusion Continuous nursing intervention can improve PICC related knowl-edge and skills in patients and their families and can reduce the incidence of complications.So it is worthy of application.

Objective: To investigate the effects and the underlying molecular mechanisms of curcumin on pulmonary artery smooth muscle cells in rat model with chronic obstructive pulmonary disease (COPD).Methods: A total of 75 male Wistar rats were randomly divided into control group (group CN), model group (group M), low-dose curcumin group (group CL), medium-dose curcumin group(group CM) and high-dose curcumin group ( group CH ) . HE staining was used to observe the morphology of pulmonary artery .Proliferating cell nuclear antigen ( PCNA) , apoptosis-related protein Bcl-2 and Bax were detected by immunohistochemical staining .TUNEL kit was used to analyze the effects of curcumin on apoptosis of smooth muscle cells , and the protein expressions of SOCS-3/JAK2/STAT pathway in lung tissues were determined by western blot . Results: Right ventricular systolic pressure ( RVSP ) and right ventricular hypertrophy index ( RVMI) in group M were significantly higher than those in group CN , group CH and group CM ( all P<0.05 ) .HE staining and TUNEL kit test showed that the number of pulmonary artery smooth muscle cells had a significant increase in group M , while the pulmonary artery tube became thin , and the smooth muscle cells shrinked in group CM and group CH .Immunohistochemistry showed that PCNA and Bcl-2 in group M were significantly higher than those in group CN ( all P<0.05 ) , while Bax expression was significantly lower than that in group CN ( P <0.05 ) .PCNA in group CM and group CH were significantly lower than that in group M ( all P<0.05 ) , while Bax expression was significantly higher than that in group M ( P<0.05 ) .Western blot showed that SOCS-3 protein was significantly decreased in group M, while the p-JAK2, p-STAT1, p-STAT 3 were significantly increased (all P<0.05 ) .Compared with group M , SOCS-3 protein in group CM and group CH were significantly increased ( all P<0.05 ) , while the p-JAK2 , p-STAT3 were significantly reduced ( all P<0.05 ) .Conclusion:Curcumin could promote the apoptosis of smooth muscle cells in rats with COPD , and improve the mean pulmonary artery pressure and RVMI through stimulating SOCS-3/JAK2/STAT signaling pathway .

Objective To explore the effect of continuous nursing intervention in tumor pa-tients with PICC.Methods A total of 116 hospitalized tumor patients with PICC from March 2012 to February 2013 were in the observation group and 102 tumor patients with PICC from Jan-uary 2011 to February 2012 were in the control group.The two groups were both given conven-tional nursing and the observation group was given continuous nursing intervention by continuous nursing team after discharged from the hospital on the basis of conventional nursing.The complica-tions and command condition of PICC related knowledge in the two groups were compared,and consultation patients and their families and settlement conditions in the observation group were cal-culated.Results The differences in incidence rate of complications and PICC command condition of related knowledge were statistically significant (P <0.05).Patients and their families in the ob-servation group consulted 1048 questions and 1037 cases were effectively solved,effective solving rate was 98.95%.Conclusion Continuous nursing intervention can improve PICC related knowl-edge and skills in patients and their families and can reduce the incidence of complications.So it is worthy of application.

Objective To investigate the effects of preoperative mental care on patients undergoing local anesthesia cataract extirpation .Methods One hundred cataract patients were randomly divided into the control group (n=50) and the experimental group (n=50).The control group was in conventional nursing care, while the experimental group was with preoperative mental care .The state of anxiety , discomfort during operation and the satisfaction rate of the operation were compared between groups .Results Before intervention , the blood pressure ( BP ) , heart rate ( HR ) , body temperature , oxygen saturation and SAS score had no significant differences (P>0.05).After implement the mental care, the score of SAS in the experimental group was (46.3 ±5.32), which was lower than that of the control group (57.6 ±6.18), the difference was statistically significant (t =9.798, P <0.01).During the operation, in the control group, 14 patients (28.0%) had a palpitation or chest distress , 8 patients(16.0%) had nausea, which was much more frequent than those in the experimental group (6.0%,4.0%),the difference was statistically significant (χ2 =8.575, 4.002, respectively;P<0.05).The score of satisfaction in the control group was (74.5 ±7.25) significantly lower than (82.6 ±8.32) in the experimental group (t=5.192, P<0.01).Conclusions Mental care can decrease the fluctuation of patients ’ BP and HR, furthermore it is benefit in achieving the operation and improving patients’ satisfaction.