ObjectiveTo investigate the nursing key points to 8 end-stage ovarian cancer patients with totally implantable venous access ports.Method The totally implantable venous access ports were used in the 8 patients and nursing was carried out to them.Result There were no occurrences of infection,leakage,seepage,pipe obstruction and the needlepoint shift.Conclusions The ovarian cancer patients in the end-stage had very low resistance and high risk of infection.Individualized nursing care to them may ensure the use of the ports in a safe way.

Objective To observe the difference of sCD40L level in different subtypes of coronary heart disease,and to explore the clinical value of CD40 ligand in identification for the acute coronary syndrome(ACS).Methods The patients with coronary heart disease(CHD)and the heathy controls in the First Affiliated Hospital of Harbin Medical University from Jan,2006 to June,2006 were enrolled in the study.CHD group included ACS and stable angina patients.Enzyme-linked immunosorbent assay was used to measure the serum sCD40L level in three groups;t-test and receiver operateing characteristic curve were used to analyze the results.Results sCD40L level was significantly higher in patients with ACS[(2.39?0.37)?g/L]than stable angina patients[(1.89?0.16)?g/L,P0.05.The ROC curve demonstrated that using the concentration of sCD40L 2.01 ?g/L as the boundary to diagnose ACS,sensitivity of this marker was 0.91 and specificity was 0.80 respectively,and area under the curve(AUC)was 0.907.Conclusion sCD40L level which is more than 2.01 ?g/L has important significance for the diagnosis of ACS.

Objective To observe the effect of comprehensive rehabilitation on breast cancer related lymphedema. Methods 70 patients with breast cancer related lymphedema were divided into experiment group (n=35) and control group (n=35). Both groups received intermittent pneumatic compression, while the experiment group received comprehensive rehabilitation including manual lymphatic drainage, muscle stretching, expanded the range of motion of shoulder, gradual resistance training, high frequency electrical therapy and health education. They were assessed with Disabilities of Arm, Shoulder and Hand Scale (DASH) and development of lymphedema before and 8 weeks after treatment. Results DASH scores and the development of lymphedema improved in both groups after treatment (P<0.05), and improved more in the experiment group than in the control group (P<0.05). Conclusion Comprehensive rehabilitation can further relieve breast cancer related lymphedema, and improve the upper extremity function.

Aim To investigate the effects of miR-122a on blood-spinal cord barrier after spinal cord ischemia-reperfusion injury in rats.Methods Thirty-six SD rats were randomly divided into three groups:group of sham(S group),group of control(C group)and group of miR-122a antagomir(M group).Rats in S group were subjected to exposure of aorta arch but without occlusion.Spinal ischemia-reperfusion injury was induced by clamping the aorta arch for 14 min in C group and M group.Rats in M group and C group were intrathecally injected with miR-122a antagomir or antagomir control daily for three times after injury.The miR-122a expression in injured spinal cord tissue was detected by real-time PCR.The occludin expression in injured spinal cord tissue was detected by Western blot.The permeability of blood-spinal cord barrier was examined using evans blue as a vascular tracer.The neurological motor function was evaluated by Basso Beattie Bresnahan score.Results Compared with S group,the expression of miR-122a was increased,the expression of occludin was decreased,the permeability of blood-spinal cord barrier was increased,and neurological motor function score was decreased significantly in C group(P<0.05).Compared with C group,the expression of miR-122a was decreased,the expression of occludin was increased,the permeability of blood-spinal cord barrier was decreased,and neurological motor function score was increased significantly in M group(P<0.05).Conclusion miR-122a can regulate the expression of occludin and change the permeability of blood-spinal cord barrier.

Kawasaki disease (KD) is an acute systemic vasculitis that primarily affects young children aged from 6 months to 4 years.KD may lead to coronary artery abnormalities in 25％-30％ of the children.The timely use of high dose intravenous immunoglobulin (IVIG) can significantly reduce the incidence of coronary artery aneurysms.Most clinicians use IVIG combined with aspirin as conventional therapy.But how to deal with those IVIG-resistant patients is a dilemma.With the deepening of research,many researchers have found that some second-line or third-line drugs such as corticosteroids,tumor necrosis factor-α inhibitors,and calcineurin inhibitors work better,and can effectively reduce the complication rate.The recent advances of the treatment of KD were summarized in this paper.

Objective To investigate the surgical treatment and prognosis of bronchial mucoepidermoid cancer. Methods During a 17-year-period, 19 consecutive patients underwent surgery for bronchial mucoepidermoid cancer, and the surgical treatment and prognosis were analyzed retrospectively. Results Among them, 13 cases were treated by lobectomy, 5 by pneumonectomy, and 1 by exploratory thoracotomy. Four cases were proved pathologically to be high malignancy and 15 low malignancy. All patients were followed up postoperatively for about 68.26 months on average. The 1, 3, and 5-year survival rates were 94.44%, 80.00%, and 70.00% respectively. In the low malignancy group, the 1, 3, 5-year survival rates were 100%; in the high malignancy group, the 1-year survival rate was 33.33%, and 3-year survival rate was 0. Conclusion Patients with low malignant grade of cancers can be cured after complete resection, and those with high malignant grade predispose to metastasis and hence result in a poor prognosis.

Objective To investigate the effects of intrathecal transplantation of bone marrow stromal cells (BMSCs) on inter cellular cell adhesion molecule-1 (ICAM-1) expression and blood spinal cord barrier following spinal cord ischemia reperfusion injury.Methods Ninety Sprague Dawley rats were randomly divided into three groups:sham (Sham group),ischemia-reperfusion injury (I/ R group),and BMSCs transplantation (BMSCs group).Spinal I/R injury was induced by clamping the aortic arch between left common carotid artery and left subclavian artery for 14 min in I/R group and BMSCs group.Sham group was subjected to exposure of aortic arch but without occlusion.I/R group and BMSCs group were intrathecally injected with phosphate buffered saline (PBS) or BMSCs (2 × 106) two days before injury.At 1 d,3 d,and 7 d after injury,neurological function was evaluated and damaged lumbosacral seg ment was removed for measurement of blood spinal cord barrier permeability and ICAM-1 protein expression.Results Compared with Sham group,neurological function score was significantly lower:1 d (F =38:59,P =0.001),3 d (F =31.34,P =0.001),and 7 d (F =27.71,P =0.001) ; ICAM-1 expression was increased 1 d (F =34.33,P =0.001),3 d (F =29.76,P =0.001),and 7 d (F =23.65,P =0.001),and blood spinal cord barrier permeability was higher:1 d (F =42.57,P =0.001),3 d (F =32.75,P =0.001),and 7 d (F =26.89,P =0.001) in I/R group.Compared with I/R group,neurological function score was increased:1 d (F =16.62,P =0.001),3 d (F =21.54,P =0.001),and 7 d (F =12.84,P =0.002) ; ICAM-1 expression was decreased:1 d (F =19.84,P =0.018),3 d (F =17.38,P =0.008),and 7 d (F =22.46,P =0.007),and blood spinal cord barrier permeability was lower:1 d (F =22.38,P =0.016),3 d (F =27.59,P =0.009),and 7 d (F =23.25,P =0.001) in BMSCs group.Conclusions Intrathecal transplantation of BMSCs inhibited ICAM-1 expression and decreased blood spinal cord barrier permeability,and then attenuated spinal cord ischemia-reperfusion injury.

Objective To summarize the application of ATP bioluminescence assay in surveillance of terminal disinfection of effects ,so as to provide the basis for intervention of disinfected effects .Methods ATP bioluminescence assay were employed to randomly test the surfaces of operating objects in therapeutic rooms and beside tables in wards ,total 144 object surfaces ,of each clinical departments in the whole hospital .The values of ATP bioluminescence assay were read on‐site ,0-250 RLU was recognized as qualification ,while disqualification when >250 RLU .The disqualified object surfaces were performed on‐site intervention that all of them were re‐disinfected ,the results were compared .Results Both the surfaces of operating objects and beside tables were dis‐qualified before disinfection ,and the values of ATP bioluminescence assay were 780 ± 10 .34 RL and 853 ± 13 .29 RLU respectively . The pass rates of ATP bioluminescence assay was 61 .97% of operating surfaces and 79 .45% of beside table surfaces the first dis‐infection .The disqualified sites were retested following on‐site intervention .The values of ATP bioluminescence assay were 431 .02 ± 0 .53 before intervention and 1 .43 ± 0 .59 after intervention ,and the difference was statistically significant .Conclusion ATP bi‐oluminescence assay can get more immediately ,simple and timesaving in evaluating the effect of disinfection and estimate the effi‐ciency of disinfection timely ,which can also provide the scientific basis on on‐site intervention so as to improve the execution power of hospital infection management .

Purpose To evaluate the clinical and pathological features of extramammary Paget’ s disease ( EMPD) and to investigate the related prognostic factors. Methods The clinical and pathological data of 30 patients with EMPD were reviewed retrospectively. The HE slides in the file were rechecked. Immunohistochemical stains were performed on archival paraffin-embedded sections with En-Vision method in 20 cases. Follow-up data were recorded. The relationship between the clinicopathological parameters and prognosis was statistically analyzed. Results Among the 30 patients, there were 26 males and 4 females, aged from 53 to 88 years with median age 70. Macroscopically, typical presentations of EMPD were eczematoid lesions. Microscopically, Paget’s cells were distributed sin-gly or in groups ( as glandular or nests patterns) within the epidermis. Immunohistochemical stains showed that Paget’ s cells were pos-itive for CK7, and negative for CK5/6 and p63. Follow-up data were available in 23 cases, 8 cases recurred resection, among them, 6 patients had positive resected margin and 4 died. The recurrent rate and mortality between the groups of dermal invasion and no der-mal invasion (P<0. 01 and P<0. 05), the groups of lymphatic metastasis and no lymphatic metastasis (P<0. 01), and the groups of positive and negative resected margin (P<0. 01 and P<0. 05) were statistically different. There were no statistically different with age and extent of lesion (P>0. 05). Conclusions CK7 is a sensitive and specific marker of Paget’s cells. Dermal invasion, lymphatic metastasis and positive resected margin are poor prognostic factors in EMPD.

ObjectiveTo evaluate the therapeutic effect and toxicities of gemcitabine combined with cisplatin in the treatment of advanced or metastatic transitional cell carcinoma (TCC) of urinary tract. Methods Eighteen patients with advanced or metastatic TCC of urinary tract (15 cases of bladder TCC,2 of renal pelvic TCC,and 1 of ureteral TCC),who were pathologically confirmed,were treated with GC regimen (gemcitabine 1000 mg/m 2,iv infusion on day 1 and day 8;cisplatin 30 mg/m 2,iv infusion on day 2,day 8 and day 9).Before treatment, Karnofsy score for each patient was evaluated with a result of ≥60;liver and renal functions and blood routine test were normal.GC regimen was repeated for 2-3 cycles every 3-4 weeks and the response rate was evaluated.ResultsThree patients (16.7%) had complete response; 7(38.9%), partial response;5(27.8%),no response;and 3(16.7%) had progression.The overall response rate was 55.6%. The main toxic effects included decrease in white cell count (10 cases),anemia (7),nausea and vomiting (10) and constipation (8),which were mild or moderate and disappeared after stopping treatment.No chemotherapy-associated death occurred.ConclusionsGemcitabine combined with cisplatin in the treatment of advanced or metastatic transitional cell carcinoma of urinary tract is effective,and the toxicity is mild and tolerated. It is suggested that GC regimen can be used as the first line chemotherapy.