ObjectiveTo investigate the nursing scheme to prevent infection,thromboembolism,accidental shedding during application of permanent deep venous catheter in hemodialysis. Methods28 patients undergoing maintenance hemodialysis from January 2007 to February 2009 were randomly divided into the observation group and the control group with 14 patients in each group.The control group took conventional care only,the observation group was given pertinent nursing intervention.After treatment the number of patients with infection and thromboembolism were compared in both groups. ResultsAll patients were successfully placed catheters.Number of patients with infection,thromboembolism and accidental shedding in the observation group were less than those in the control group.But there was no significant difference in average indwelling time of catheters between two groups. ConclusionsApplication of permanent deep venous catheter in hemodialysis shows good effect,it can decrease the incidence of complication and should be widely applied.

BACKGROUND: At present, researches have been proved that nerve growth factor (NGF) plays an important role in repairing neural regeneration after spinal cord injuries. Poor ability of neural regeneration is related to lack of microenvironment for neuronal growth at local injured site. Whether electro-acupuncture can protect nerve after spinal cord injuries through increasing NGF level in injured spinal cord or not is lack of experimental data on the view of molecule.OBJECTIVE: To observe the effect of electro-acupuncture on motor function, morphology of spinal cord and mRNA expression of NGF in rats with experimental spinal cord injuries through morphology and hybridization in situ.DESIGN: Randomized controlled animal study.SETTING: Department of Acupuncture and Moxibustion, the Tenth People's Hospital Affiliated to Tongji University; Shanghai Institute of Acupuncture and Meridian.MATERIALS: The experiment was completed in the Shanghai Institute of Acupuncture and Meridian from January 1999 to February 2002. A total of 15 male SD rats weighing (260±9.52) g were randomly divided into sham operation group, injured control group and acupuncture group with 5 in each group.METHODS: Models of spinal cord injuries were established in injured control group and electro-acupuncture group, and rats in sham operation group were just treated with resection of lamina of vertebra. Two hours after operation, rats in electro-acupuncture group were treated with electroacupuncture at Daczhui (GV14) and Mingmen (GV4), L2 Jiaji (Ex-B2-L2)and Huantiao (GB30), alternatively. Then, G6805 electro-acupuncture apparatus was used with distant wave, 0.8 Hz, 0.3-0.6 mA, and slight shake on muscle was regarded as proper response. The electro-acupuncture was performed every 30 minutes a day for 30 days. Rats in injured control group and sham operation group were not treated with any way, and motor functions 2 hours and 30 days after operation were observed with modified Tarlov scale and Rivlin method. ① Modified Tarlov scale: Pamplegia and irresponsivity of lower limbs during electro-acupuncture were scored from 0 to 6 points. ② Modified Rivlin method: Tiltboard was consisted of two rectangular alloy boards which was connected to one end through hinge.Board turned around axis at the beginning of horizontal position (0°) and the angle of ram could be measured. Rats faced towards front were put vertically as longitudinal axis of body to longitudinal axis of tiltboard.Angle was increased gradually when rats were not able to keep the primary position for 5 seconds, and the critical angle was recorded. Hybridization in situ assay: Amount of positive NGF cells was recorded under light microscope and photographs were completed at the same time.MAIN OUTCOME MEASURES: Scale of motor function (modified Tarlov score), critical angle of ram test (modified Rivlin method) and changes of amount of positive NGF mRNA cells in rats with spinal cord injuries.RESULTS: A total of 15 experimental rats were involved in the final analysis. ① Two hours after spinal cord injuries of rats in injured control group and electro-acupuncture group, score of motor function and critical angle of ram which was measured with modified Rivlin method were decreased remarkably; 30 days later, score of motor function measured with modified Tarlov scale and critical angle of ram were increased at various degrees, especially those in electro-acupuncture group were increased remarkably, and there was significant difference from those in injured control group [35.40±6.62, 27.80±1.10; (35.40±6.62)°, (27.80±1.10)°, P ＜ 0.05]. ② Thirty days after injury, pathological lesion of rats in electroacupuncture group was milder than that in injured control group, and morphological injury of spinal cord and amount of positive NGF mRNA cells were obvious as compared with those in injured control group (28.13±1.64,12.63±1.41, P ＜ 0.01).CONCLUSION: Electro-acupuncture can improve mRNA expression of NGF in spinal cord, relieve morphological injury of spinal cord, accelerate recovery of motor function of rats with spinal cord injuries, and protect nerve through mRNA expression of NGF.

Objective To investigate paclitaxel cross resistance and provide information for clinical therapy by establishing a paclitaxel resistant human lung adenocarcinoma cell line.Method A paclitaxel resistant human lung adenocarcinoma cell line named with SPC-A1/Taxol was developed by intermittent exposure to gradually increasing concentration of taxol.Resistant index was calculated from median inhibitory concentration(IC50)which was evaluated by MTT assay.Results SPC-A1/Taxol cell line displayed high resistance to taxotere,vinorelbine,vincristine and doxorubicin.It also displayed median or low resistance to camptothecins and podophyllotoxins.No cross resistance was observed to antitumor platinum and antimetabolite drugs and elemene emusion.Conclusion SPC-A1/Taxol cell line is a typical multidrug-resistant cell line in vitro.It could be useful for studing the cross resistance and direct clinical medication.

OBJECTIVE To investigate the isolation rate and drug-resistance of Stenotrophomonas maltophilia so as to provide evidence for clinical rational use of drugs.METHODS The strains of S.maltophilia isolated from clinical specimens were identified and tested on drug sensitivity by the VITEK-32 system.Parts of the isolates were tested by disc diffusion method.RESULTS A total of 295 strains were identified during from Jan 2005 to Dec 2008.The most of the were isolated from sputum in clinical samples,and ICU was the main distribution department.The result showed that S.maltophilia had higher resistance rate to most drugs.Levofloxacin had the lowest resistance rate followed by trimethoprim-sulfamethoxazole and ciprofloxacin.CONCLUSIONS S.maltophilia has serious resistance rate to common antimicrobial agent showing mult-drug resistance.We should pay more attention to the status,and rationally choose antibiotics according to the drug susceptibility.

Objective Antiangiogenesis therapy has been shown to prolong survival for patients with malignant tumor .However the present study has not been observed the clinical benefit of antiangiogenesis therapy combination with chemotherapy treated with gastric canc-er.Human recombinant vascular endothelial inhibition (endostar) as a multi-targeted anti-angiogenesis drug, the mechanism is different from other Antiangiogenesis drugs.It can block different pathways of signal transduction to inhibit angiogenesis .This study aimed to observe the effect of combined application of endostar and paclitaxel on biological behavior of gastric cancer cell lines . Methods MMT assay and Tr-answell invasion assay were respectively used to examine the inhibition rate of cell growth and invasion ability when cells were treated with va-rious concentrations of endostar and paclitaxel alone or in combination.The protein expressions of VEGF,MMP-2 and MMP-9 were examined by Western blot. Results Endostar or paclitaxel effectively inhibited the growth of MGC803 cells and the in vitro invasion of MGC803 cells in a concentration-dependent manner.The proliferation and invasion ability of combined treatment with endostar and paclitaxel was significantly lower than that of endostar or paclitaxel alone (P<0.05).Compared with con-trol group, the VEGF,MMP-2 and MMP-9 protein expressions were de-creased in experimental groups ( P <0.05).Compared with paclitaxel group, the VEGF, MMP-2 and MMP-9 protein expressions were relatively reduced in combination groups (P<0.05). Conclusion Endostar combined with paclitaxel can suppress the growth and invasion of MGC803 cells, and the decreasing VEGF , MMP-2 and MMP-9 expressions may be involved in the mechanism .

Objective To establish a predictive model and to find the preoperative predictors for the nature of lesion in the setting of chronic pancreatitis. Methods The 121 patients from 7 tertiary medical centers in Shanghai from July 1998 to April 2007 with focal mass lesions in the setting of chronic pancreatitis were selected as the study population. The final diagnosis had to be confirmed histologically by surgical specimens (n =97) or by follow-up (n = 24). A case control study was conducted; the patients were divided into pancreatic cancer group and chronic pancreatitis group. The age, sex, past history, initial clinical presentations, lab results and imaging exams were collected by reviewing the medical records of these patients. χ~2 test and t test was used for univariate analysis, then the factors with P≤0. 25 were selected for further multivariate analysis, and multivariate logistic regression model was used to estimate odds ratio and 95% CI. Results Of 121 , 21 patients had a final diagnosis of pancreatic cancer and other 90 patients had a final diagnosis of chronic pancreatitis. Abdominal tenderness, direct bilirubin, CA19-9 and CEA were independent predictors of cancer in patients with focal mass lesions. Their odds ratios (95% CI) were 5. 691 (1.468, 22.070) , 1.011 (1.001 , 1.021) , 1.003 (1.001, 1.005) , 101.9 (0.988, 1.051) , respectively. Their P values were 0. 012, 0. 030, 0.003 and 0. 23 , respectively. Conclusions The logistic regression model may accurately predict the nature of lesion in the setting of chronic pancreatitis and may have certain clinical implication.

Objective : To learn the situation of vaccine management in Zhejiang Province by SWOT analysis,so as to provide basis for normalization and standardization of vaccine management. Methods: Through supervision and investigation,the data of vaccine management related human resources and information construction of the CDCs in Zhejiang Province were collected. The comprehensive evaluation of vaccine management in Zhejiang Province was carried out by SWOT analysis,and the SWOT matrix was established for suggestions. Results: The advantages of vaccine management in Zhejiang Province lay in the standardized management of purchase and supply,the construction of vaccine management information system and the guarantee of cold chain system;the disadvantages lay in the insufficient allocation of human resources,new problems of cold chain management,the lack of standardized vaccine management mode and the incomplete coverage of vaccine and vaccination information system;the opportunities lay in the legalization of vaccine management,“Healthy Zhejiang”initiative and the “one run at most”reform in healthcare services;the threats lay in the shortage of vaccine,the gap between the expectation of the public on vaccine management and the current situation,and the reduced capacity of vaccine deployment in the provincial CDC. We should constantly improve the construction of vaccine management system,strengthen the standardized administration,regularly carry out risk assessment on vaccine management,accelerate the full coverage of vaccine and vaccination management information system,and explore the standard operation procedure of vaccine management in Zhejiang Province. Conclusions Although some achievements have been made in vaccine management in Zhejiang Province,there is still a gap from the goals of high-efficiency,high-level,normalization and standardization. The standardization and full coverage of the information system of vaccine management should be strengthen in the next stage.

ObjectiveTo explore the effects of ziprasidone and risperidone on cognitive inhibition function through visual pathway of patients with paranoid schizophrenia.MethodsIn the open-label,flexible-dosage trial,124 patients with paranoid schizophrenia were randomly divided into ziprasidone group (120-160 mg/d)and risperidone group(4-8 mg/d) for treatment of 8 weeks.They were assessed with computerized Color Word Test (CWT) and Continuous Performance Test(CPT) through visual pathway for cognitive inhibition function,Positive and Negative Syndrome Scale for efficacy on baseline and 8th weekend.ResultsAfter treatment with ziprasidone,the error number (3.12 ± 5.23 ),the time per correct answer( ( 1.92 ± 1.38 ) s) of CWT,as well as the doubledigit mistaken number (2.31 ± 3.76)and the three-figure mistaken number( 3.15 ±2.80) of CPT reduced more than those before medication ( (4.60 ± 6.80),( 2.74 ± 1.52 ) s,(3.85 ± 3.62 ),(4.42 ± 3.53 ) ) (P ＜ 0.05 ).In risperidone.group,the double-digit mistake number of CPT(3.39 ± 3.59) after pharmacotherapy reduced more than that before pharmacotherapy(4.23 ± 3.88) (P＜ 0.05).After treatment the time per correct answer of CWT and the mistaken numbers of CPT in ziprasidone group were less than those in risperidone group(P＜ 0.05 ),meanwhile,the scores of PANSS in two groups were significantly lower than those before treatment (P ＜ 0.01 ).ConclusionIt is effective for ziprasidone and risperidone to improve the function of cognitive inhibition on patients with paranoid schizophrenia,but there is more dramatic for ziprasidone in short-term treatment.

Objective To summarize the clinical and imaging characteristics of Rosai-Dorfman disease (RDD) in order to improve the diagnosis of the disease.Methods The clinical and imaging features of 10 patients with RDD proved by pathology were retrospectively analyzed and the related literatures were reviewed.Results Ten patients including 7 males and 3 females,aged 8 to 54 years old,with average of 32 years old.White blood cells (BCA) and erythrocyte sedimentation rate (ESR) in 8 cases were normal.Eight cases manifested as painless enlarged lymph node or mass,of which 4 cases were accompanied with multisystem involvement.Three lesions involved lymph nodes,5 lesions were located in extranodal sites,while 2 lesions involved both lymph node and extranodal sites.RDD occurred in lymph nodes (n=3) manifested as multiple enlarged lymph nodes on CT imaging,showing mild or moderate the enhancement,or a heterogeneous ring-enhancement.Of 5 extranodal RDD lesions,3 cases underwent MR exmination.2 lesions manifested as subcutaneous soft tissue mass on left shoulder and anterior abdominal wall,1 lesion manifested as intracranial mass accompany with localised cranial bone destruction.Lesions in all 3 cases had poor margins and showed scatted areas of high signal on diffusion weighted images.Lesions exhibited remarkable heterogeneous enhancement on Gd-DTPA enhanced MR imaging,dural/fascia tail sign and dilated blood vessels could be found around the lesions.Intrahepatic RDD lesion showed fast washing out phenomenon on CT enhanced imaging.In 2 cases involved both lymph node and extranodal sites,1 case manifested as swelling pharyngeal lymph chain and nasopharynx,enlargement of lymph nodes in bilateral submandibular and cervical region abdominal cavity on CT imaging,the enhancement is mild and moderate,accompany with osteolytic lesions in right proximal humerus on X-ray.For the other case,CT images manifested as bilateral neck lymphadenopathy,accompanied with soft tissue mass in nasal cavity,the lesion showed mild/moderate enhancement.Conclusions RDD mostly appears in young and middle-aged men,and is rarely preoperatively diagnosed.RDD mainly manifests as painless enlarged lymph node or mass.RDD has a broad spectrum of radiographic appearance,varied according to different location of lesion.Scatted higher signal areas on diffusion weighted images in the masses and significantly heterogeneity enhancement with dilated blood vessels around the lesion could be helpful in diagnosing of extranodal RDD.

Objective:To explore the risk factors for tubal patency after partial salpingectomy and end-to-end anastomosis,and their impact on pregnancy outcomes.Methods:A total of 300 patients with tubal pregnancy who underwent partial salpingectomy and end-to-end anastomosis in Zhengzhou Maternal and Child Health Hospital from January 2020 to April 2023 were enrolled in the study.Hysterosalpingography was performed after surgical treatment to examine the tubal patency.Lasso-Logistic regression was used to analyze the risk factors for postoperative tubal patency,and Spearman's correlation was used to analyze the impact of each risk factor on the pregnancy rate.Results:Hysterosalpingography showed that the fallopian tube was not obstructed in 225 cases(unobstructed group),the tube was not completely patent(n=54)or blocked(n=21)(obstructed group).Univariate analysis showed that age,diameter of the tubal pregnancy sac,location of tubal pregnancy,timing of surgery,pelvic adhesion,anastomotic method,length of remaining tubal,history of pelvic surgery,number of intraoperative electrocoagulation,intraoperative blood loss,and experience of surgeons were factors affecting postoperative tubal patency(all P＜0.01).Lasso regression analysis identified location of tubal pregnancy,pelvic adhesion,anastomotic method,length of remaining tubal,history of pelvic surgery,number of intraoperative electrocoagulation,and experience of surgeons as influencing factors.Multivariate Logistic regression analysis showed that tubal isthmus pregnancy,pelvic adhesion,open anastomosis surgery,history of pelvic surgery,and number of intraoperative electrocoagulation were independent risk factors for postoperative tubal patency,while length of remaining tubal and years of surgeon's work experience were independent protective factors for postoperative tubal patency(all P＜0.01).A total of 295 patients were followed up for 1 year,192 cases(65.08%)were pregnant,including 172 cases of intrauterine pregnancy(89.58%)and 20 cases of ectopic pregnancy(10.42%).Spearman correlation analysis showed that tubal isthmus pregnancy,pelvic adhesion,open abdominal anastomosis surgery,pelvic surgery history,and times of intraoperative electrocoagulation were negatively correlated with postoperative pregnancy,while the remaining tubal length and years of surgeon's working experience were positively correlated with postoperative pregnancy rate(all P＜0.01).Conclusions:For tubal patency of patients after partial salpingectomy combined with end-to-end anastomosis,the history of tubal isthmus pregnancy,pelvic adhesion,open abdominal anastomosis,pelvic surgery,and the number of intraoperative electrocoagulation are independent risk factors,which are negatively correlated with postoperative pregnancy.The remaining tubal length and the years of surgeon's work experience are independent protective factors,which are positively correlated with postoperative pregnancy.