Objoctive To investigate circulating leveh of soluble vascular cell adhesion molecule-1(sVCAM-1)in the peripheral of intrahepatic cholestasis of pregnancy(ICP).To reveal the pathogenesis of ICP.Methods Maternal scram sVCAM-1 levels were determined in 49 women which 15 eases were normal pregnant women and 34 with ICP.The latter were composed of 14 women with mild,20 with severe ICP.sVCAM-1 was measured by ELISA.Results The levels of serum sVCAM-1 was significantly elevated in women with mild and severe compared with control subjects(P＜0.01),and markedly decreased to normal 5 days after dilively(P＞0.05).The sVCAM-1 level were negatively correlated with weight of neonatal(r=-0.643,P＜0.01).Conclusion Elevated levels of sVCAM-1 indicate that a primary endothelial cell dysfunction play an important role in the ICP.And it influences the neonatal.

Objective To observe the effect of modified electroconvulsive therapy combined with venlafaxine on cognitive function and its efficacy in patients with depression.Methods 60 patients with depressive disorder were selected,and they were randomly divided into study group and control group according to the random number table method,30 cases in each group.The patients in the study group accepted modified electroconvulsive therapy for 10 times combined with venlafaxine sustained-release tablets treatment,while the patients in the control group were only treated with venlafaxine.Both two groups were treated for 6 weeks.The cognitive function was assessed by the Repeat able Battery for the Assessment of Neuropsycholgical Status (RBANS) and the therapeutic effect was evaluated by Hamilton Depression(HAMD) Scale before and after treatment.Results The scores of immediate memory,delayed memory,speech function,visual breadth and attention of both two groups after treatment were significantly higher than those before treatment(all P ＜ 0.05),and the attention score of the study group was (109.96 ± 19.01) points,which was higher than (100.32 ± 17.13)points of the control group (t =2.062,P ＜ 0.05).The HAMD scores after treatment in both two groups were significantly lower compared with those before treatment (all P ＜ 0.05),and the HAMD score of the study group was (7.23 ± 4.19)points,which was lower than (10.27 ± 5.99)points of the control group (t =2.273,P ＜ 0.05).The total effective rate of the study group(96.7％) was significantly higher than that of the control group (86.7 ％) (x2 =6.546,P ＜ 0.05),and the cure rate of the study group (60.0％) was also higher than that of the control group (36.7％) (x2 =10.901,P ＜ 0.05).Conclusion Modified electroconvulsive therapy combined with venlafaxine treatment can effectively improve the cognitive function of depressive patients,and its effect is significantly better than monotherapy.

Objective To explore the effect of health education on improving awareness of preven-tion of upper respiratory tract infection of parents of leukemia children. Methods 25 parents were ran-domly chosen, and comprehensive health education interventions were provided, including lectures, advisory guidance and brochures. The awareness of prevention of upper respiratory tract infection of parents was e-valuated before and after health education,and the results underwent χ<'2> test. Results After health educa-tion, the awareness of prevention of upper respiratory tract infection of parents significantly improved com-pared with that before. Conclusions Health education can improve awareness of prevention of upper res-piratory tract infection of parents and decrease the incidence of upper respiratory tract infections.

Objective:To assess the nursing care experiences and curative effects of the application of wound care technologies combined with other multiple treatments in the hepatolithiasis patient who suffered from postoperative severe intestinal fistula.Methods:The wound care difficult points were analyzed,the wound care technologies combined with other multiple treatments including multiple debridement methods were applied according to the severity of the intestinal fistula:multiple debridement, new skin protection, continuous flushing and drainage with double cannula, improved negative pressure closure drainage and wound pull-in technology, combined with systemic treatment and nursing intervention.Results:The intestinal fistula was treated for 12 days, and the wound infection was controlled for 24 days. Finally the wound was healed after 43 days and patient was discharged from hospital.Conclusions:In the case of severe intestinal fistula after hepatolithiasis operation, the application of wound nursing technology combined with treatment scheme provides a new treatment idea and scheme for intestinal fistula and wound healing.

A 76?year?old female patient complained of right chest pain for three months. CT scan showed a clump?like high?density shadow measuring 4.8 cm × 3.0 cm in size in the dorsal portion of the right lower lobe of the lung. Aspiration biopsy was performed, and biopsy samples were subjected to fungal culture and histopathological examination. Histopathological examination showed chronic granulomatous inflammation with hyaline septate hyphae. After 4?day culture, white villous dense colonies were formed on the Sabouraud′s agar medium. The center of the colonies was slightly elevated with wrinkles or radiating striae on the surface, and the bottom of the colonies was faint yellow in color. Microculture yielded abundant septate branched hyphae, and very few colorless hyaline quasi?circular spores. DNA sequencing of rDNA internal transcribed spacer (ITS) regions and β?tubulin genes was performed to identify the isolate, and antifungal susceptibility testing was carried out in vitro. The MEGA7.0 software was used to build phylogenetic trees of Aspergillus fumigatus complex and its closely related species. The isolate was identified as Aspergillus fumigatus by molecular biologic sequencing. The patient was diagnosed with pulmonary aspergilloma. After administration of itraconazole oral solution and vorionazole tablets, the condition got better obviously.

OBJECTIVETo study the clinicopathologic features and diagnosis of metastatic carcinoma to the spleen (MCS).

METHODSFour patients (1 man and 3 women, mean age 43.5 years) with MCS were analyzed clinicopathologically.

RESULTSThe four MCS patients accounted for 1.3% of 308 patients having spleen biopsy from 1959 to 1999. Their chief presentations were pain and mass in the left upper quadrant of the abdomen. The mass was located in the upper pole of the spleen (1 patient), the lower pole of the spleen (2), or the lower pole and hilum of the spleen (1). Macroscopically, all of the lesions were nodular. Histologic type of these MCSs included acinar cell carcinoma of the pancreas (2 patients), transverse colon adenocarcinoma (1), and hepatic cell carcinoma (1). Clinically, 1 patient was diagnosed as having MCS and 3 were misdiagnosed. According to Chinese literature, the clinicopathologic features of MCS were as follows: (1) 66.7% of the patients with MCS were aged 30 approximately 60 years, with a mean of 51.2 years. (2) 76.3% of the patients presented with pain in the left upper quadrant of the abdomen and 63.2% with splenomegaly and splenic masses. (3) Macroscopically, nodular lesions accounted for 68.4%. (4) Microscopically, 84.2% of the lesions were adenocarcinomas and 70.3% originated from carcinomas of the colon, liver, ovary and pancreas. (5) B-mode ultrasonography and/or CT showed occupying lesions or masses in the spleen in 76.7%, and MCS in 11.8%. (6) Clinically, 73.7% of the patients were misdiagnosed.

CONCLUSIONSMCS is uncommon but its clinical misdiagnosis rate is high. Image examination is of value in clinical diagnosis. Cooperation of clinicians and pathologists may enhance the diagnostic level of MCS.

Adult ; Female ; Humans ; Male ; Middle Aged ; Splenic Neoplasms ; diagnosis ; pathology ; secondary

Objective:To investigate the expression of microRNA (miRNA, miR)-4699-3p in ovarian cancer cell lines, and observe its ability to regulate the expression of mitochondrial ribosomal protein S23 (MRPS23) and its effect on the migration and proliferation of ovarian cancer cells.Methods:Real-time fluorescence quantitative polymerase chain reaction (qRT-PCR) was used to detect the expression of miR-4699-3p in ovarian cancer cell lines (OVCAR-3, SKOV-3, HO-8910, OC3, A2780) and normal ovarian epithelial cells (IOSE80). The liposome transfection method was used to transfect miR-4699-3p mimic or negative control miR-NC to the cell line with the lowest miR-4699-3p expression, which was defined as the experimental group and the control group. qRT-PCR was used to verify transfection efficiency. Bioinformatics technology predicted the candidate target gene of miR-4699-3p, and the dual luciferase reporter gene experiment identified its ability to regulate the target gene. qRT-PCR and Western blot were used to detect the expression of target genes at the mRNA and protein levels. Cell counting method (CCK-8) and transwell migration experiment were used to detect the effect of miR-4699-3p on the proliferation and migration of ovarian cancer cells.Results:The expression of miR-4699-3p in ovarian cancer cell lines was significantly lower than that of normal ovarian epithelial cells ( P<0.05), and the lowest expression in OVCAR-3 cells ( P<0.01). After transfection of miR-4699-3p, the expression of miR-4699-3p in OVCAR-3 cells in the experimental group was significantly increased ( P<0.01), which proved that the transfection was successful. Bioinformatics technology predicted that the candidate target gene of miR-4699-3p may be MRPS23. The dual luciferase reporter gene experiment confirmed that miR-4699-3p can directly target the 3′-UTR of MRPS23 gene mRNA ( P<0.01). Compared with the OVCAR-3 cells in the control group, the mRNA and protein expression levels of the MRPS23 gene were significantly reduced, while the expressions of Twist, Slug, CDK6 and Cyclin D3 were significantly decreased ( P<0.01) in the experimental group after up-regulating miR-4699-3p expression ( P<0.01). After up-regulating miR-4699-3p expression, the proliferation ability of OVCAR-3 cells decreased ( P<0.05) and the migration ability of OVCAR-3 cells was reduced ( P<0.01). Conclusions:miR-4699-3p is under-expressed in ovarian cancer cell lines. Up-regulation of miR-4699-3p expression in OVCAR-3 cells can inhibit ovarian cancer cell proliferation and migration by interfering with MRPS23 gene expression.

Objective: To explore the psychological experience of the caregivers of Hepatocellular Carcinoma with Hepatitis B virus. Methods: Semi-structured Interviews were performed in a total of 12 main caregivers of Hepatocellular Carcinoma with Hepatitis B in the Chinese Academy of Medical Sciences from October 2016 to March 2017, and the original data was analyzed according to the Colaizzi 7-step method. Results: A total of five topics were extracted, including Awareness of relief stress when the diagnosis was informed, Indebtedness and self-blame, fear and sadness of possible loss of loved ones, stressful anxiety (stress of economy, loss of function, worrying about being infected), and joint stigma. Conclusions Many psychological experiences of main caregivers of patients with hepatocellular carcinoma combined with hepatitis B coexist in the course of care. Exploring and providing effective care support based on the psychological experience and needs of caregivers is one way to improve physical and mental health and the quality of care for patients.