To summarize the experience about the preoperative and postoperative nursing of 11 cases with neurogenic bladder treated by sacral neuromodulation. The main nursing interventions of this procedure involved accurate recording of voiding diaries and postvoid residual, effective psychological nursing and health education of related disease information, standard videourodynamic examination. 11 patients acquired more or less benefit after the screening test and were discharged successfully, among them 2 cases had the permanent implantation of the stimulation device.

Objective To conduct an empirical analysis of constitutes and changes of type 2 diabetes patients′ hospitalization expenses and find out the differences and influencing factors so as to provide hospitals and related departments with the decision basis of controlling medical costs, arranging medical resources and optimizing systems.Methods Information of type 2 diabetes patients who had been admitted to a certain first-class grade one hospital in Ningxia from 2013 to 2016 were collected and categorized.Hospitalization costs and influencing factors of the patients were comprehensively analyzed through descriptive statistics, variance analysis and regression analysis.Results The medicine and examination costs as the constitutes of hospitalization expenses were too high.Gender, length of stay, age and diabetic complications were main contributory factors of type 2 diabetes patients′ hospitalization expenses.Conclusion The costs of hospitalization of patients with type 2 diabetes are unreasonable and need to optimize.Type 2 diabetes patients′ hospitalization expenses should be effectively controlled and medical resources should be reasonably used through standardizing treatment behavior, shortening length of stay, intensifying publicity and education, enhancing prevention and reinforcing follow-ups, expanding health insurance coverage and upgrading its level.

Objective To analyze and evaluate the efficay of split liver transplantation in children.Method From September 2006 to December 2014,210 children were treated with liver transplantation in Tianjin First Central Hospital.The clinical data were retrospectively analyzed and the difference in postoperative survival was compared between the groups.The 210 childrens were categorized into living donor liver transplantation group (183 cases) and split liver transplantation group (27 cases) based on their operation styles.In living group,all donors to recipients were immediate relatives within three generations.In split group,all donors were men,and livers were obtained from no heartbeat donors.Postoperatively,tacrolimus combined a duplex of prednisolone served as immunosuppression scheme.The survival and incidence of complications were observed.Result There was significant difference in the sex ratio between two groups (P＜0.05).The donor liver cold ischemia time was significantly longer in split group than in living group (P＜0.05).The 1-month,6-month,1-year and 2-year overall survival rate in 210 recipients was 99.5％,98.1％,96.2％ and 94.2％ respectively.The median follow-up time in living group and split group was 15.2months and 26.1 months,respectively.The 1-mont,6-month,1-year and 2-year survival rate was 99.5％,96.7％,92.6％ and 74.1 ％ in living group,and 97.8％,96.2％,77.8％ and 74.0％ in split group,respectively (P＜0.05).During the follow-up period,8 cases died (29.6％) in split group (5deaths due to infection and sepsis,and 3 deaths due to multiple organ failure),and 10 cases died (5.5％) in living group (6 deaths due to infection and sepsis,and 4 deaths due to multiple organ failure).Conclusion In the case of strict selection of donors,split liver transplantation can obtain good effect,but the incidence of complications is higher than living donor liver transplantation.Especially,the biliary complications should be prevented and managed actively.

Objective:This study aims to analyze the differences in the alternative splicing pattern of ADAR2 among glioma cell lines U87, U251, A172, and normal human astrocyte HA1800. Methods:A-to-I editing level at the Q/R-Site of GluR-2 was analyzed by RT-PCR and sequencing. Real-time PCR was performed to detect the expression level of each alternatively splicing variant using a specific primer that was confirmed to amplify only the targeted template and not other alternatively spliced variant fragments. Results:We verified that the Q/R-Site of GluR-2 is under-edited in glioma cell lines. Real-time PCR revealed that the ADAR2 pre-mRNA splic-ing pattern has no significant difference at exons 1a and 2 between glioma cell lines and normal human astrocyte. We also detected that the amount of alternative splicing variants, including exon 5a, was higher than that of alternative splicing variants not including exon 5a in human glioma cell lines. However, the expression of alternative splicing variants, including exon 5a, was lower than that of alterna-tive splicing variants not including exon 5a in human astrocyte. Conclusion:Evident differences in splicing were observed at the site of exon 5a between glioma cell lines and normal human astrocytes. The difference in the alternatively splicing pattern at exon 5a may be attributed to the decreased activity of ADAR2.

Female ; Humans ; Infant, Newborn ; Mastocytosis, Systemic ; diagnosis ; pathology

ObjectiveTo analyze the clinical characteristic of the nasal type extranodal NK/T cell lymphoma(ENKL)as well as the therapeutic effects for different treatment methods and element that would affect prognosis.MethodsReview and analyze the 27 patients with pathologically confirmed ENKL patients received radiotherapy (3 cases),chemotherapy (9 cases),combination of radiotherapy and chemotherapy (15 cases),3 of whom received auto-HSCT.Detailed B symptoms,lactate dehydrogenase (LDH),performance status(PS)scores,international prognostic index(IPI),Ann Arbor stage and therapeutic modality were included in univariate analysis.ResultsThe average overall survival time was 32 (2-42) months.The 1,2and 3 year overall survival (OS) rates were 79.5 ％,71.6 ％,53.7 ％,respectively.The 2-year overall survival of patients who was early stage (stage Ⅰ + Ⅱ ) was 83.3 ％,and those who was advanced stage(stage Ⅲ+Ⅳ) was 62.3 ％ (P =0.368).Among the patients in early stage,after radiotherapy or chemotherapy,4 cases achieved OR (overall response) which is complete remission (CR) or partial remission (PR),9/10 in combination of radiotherapy and chemotherapy achieved OR. While among those in their advantage stage,the OR in chemotherapy is 2 cases,2/5 in combination of radiotherapy and chemotherapy.In univariate analysis,age and short-term response were main factors of survival(P ＜0.05).ConclusionTo treat the nasal ENKL in the early stage,radiotherapy can achieve a better effect,while combination of radiotherapy and chemotherapy is an important method for patients in advantage stage.Age and short-term response may be.prognostic factors of nasal type ENKL.

Objective To explore the normal range of cingulate cortex volumes of Chinese adults of the Han nationality and its relationship with age, which provide morphological data for the construction of database for Chinese Standard Brain.Methods This is a clinical multi-center study.One thousand Chinese healthy volunteers ( age range = 18 to 70) recruited from 15 hospitals were divided into 5 groups, i.e.,Group A (age range = 18 to 30), B (age range=31 to 40), C (age range =41 to 50), D (age range =51 to 60), and E (age range =61 to 70).Each group contained 100 males and 100 females.All of the volunteers were scanned by MR using T1 weighted three-dimensional magnetization prepared rapid acquisition gradient echo sequence.Cingulate cortex volume (including bulk volume and the left/right volume) was measured semi-manually using 3D volume analysis software.Cingulate cortex volumes among age groups were compared by one-way ANOVA.Right and left cingnlate cortex volumes between sexualities were analyzed by paired samples t test.The relationship between cingulate cortex volume and age was analyzed by Pearson correlations and regression analysis.Results Cingulate cortex volumes of male and female were (20 347 ± 2504) and ( 19 432 ± 2184) mm3 respectively, and the male's was significantly larger than that of female's (two sample t'-test for independent samples, t'= 6.156, P < 0.05 ).Right and left cingnlate cortex volumes of male were ( 10 717 ± 1629) and (9630 ± 1498) mm3 respectively, and those of female's were ( 10 064 ± 1407 ) and ( 9368 ± 1441 )mm3 respectively.The volumes of cingulate cortex were significantly different between right and left in male or female ( t = - 12.960, - 8.511, P < 0.05 ),and right was larger than left.Bilateral cingulate cortex volume in male among group A, B, C, D and E[left: ( 10 132 ± 1291 ), ( 10 113 ± 1638), (9599 ± 1576), (9594 ± 1288), (8710 ± 1212) mm3 ; right:(11 212±1442), (11 096±1602), (11 040±1403), (10 633±1638), (9604±1522) mm3] had statistical differences (F = 16.738, 18.707, P < 0.01 ) ; and those in female among five age groups[left:(9689 ± 1426), (9652 ± 1676), (9347 ± 1500), (9098 ± 1225), (9053 ± 1233) mm3 ; fight: ( 10 558 ±1325), ( 10 266 ± 1463), ( 10 100 ± 1497), (9779 ± 1304), (9617 ± 1254) mm3] also had significant differences (F = 16.859,7.528,P <0.01 ).Bilateral cingnlate cortex volume in both male and female were negatively correlated with age ( r = - 0.330, - 0.324, - 0.169, - 0.243, P < 0.05 ), though the correlation coefficient is not high.Conclusions Cingnlate cortex volume could be accurately measured on the high-resolution MRI with 3D volume analysis software, which can provide morphological data for the construction of database for Chinese Standard Brain.The results may provide normal range for the diagnosis of the volumetric deficits of cingulate cortex.

Objective To analyze the incidence and risk factors of de novo hepatitis B virus (HBV) infection from anti-HBc-positive donors in pediatric living donor liver transplantation and to explore the diagnosis and treatment.Method A retrospective analysis was conducted on 105 cases of pediatric living donor liver transplantaions (LT) perfomed during September 2006 to December 2013.HBV markers,including hepatitis B surface antigen (HBsAg) and antibody (anti-HBs),anti-HBc,hepatitis B e antigen (HBeAg) and antibody (anti-HBe) were determined in both donors and recipients before LT and in recipients after LT.HBV DNA titer was measured if the recipients were strongly suspected of de novo HBV infection.Result After 4 perioperative deaths were excluded,101 cases were studied.The median follow-up period of all the patients was 20.5 months (2.7-97.7 months).de novo HBV infection occurred in 6 of 101 recipients (5.9％) 3.5 18 months after LT.Forty-four (43.6％) of the children received HBcAb-positive allografts,and 11.4％ (5/44) of the children were had de novo hepatitis B infection.All five of the HBV-infected children received HBcAb-positive allografts without preventive treatment in 11 cases (5/11,45.5 ％),57 (56.4％) of the children received HBcAb-negtive allografts,and 1.7％ (1/57) of the children had de novo hepatitis B infection.Conclusion Anti-HBc-positive donors can significantly increase the incidence of de novo HBV infection in HBsAg-negative recipients without preventive treatment.with the appropriate treatment strategy,HBcAb allografts can safely used in pediatric recipients.

Background and purpose: Sorafenib hepatocellular carcinoma assessment randomized protocol (SHARP) and sorafenib in patients in Asia-Pacific region with hepatocellular carcinoma (ORIENTAL) had indicated that multi-kinase inhibitor sorafenib could prolong overall survival (OS) and time to progression (TTP) as well as improve progress free survival (PFS) in patients with advanced stage hepatocellular carcinoma. Drug-related adverse events in the course of treatment restricted its clinical application to a certain degree. This study was aimed to summerize the adverse events as well as the management of sorafenib in our clinic. Methods: Twenty-five cases clinically diagnosed as advanced hepatocellular carcinoma were enrolled from January 2008 to October 2009. All the patients who received sorafenib treatment met inclusion criteria as followed: (1) Progression of disease after trans-hepatic arterial chemoembolization therapy; (2) Extensive portal vein cancerous thrombus formation; (3) Portal zone or retroperitoneal lymph node metastasis or multiple remote metastasis, such as lung or bone; (4) Diffused poor blood supply to tumor; (5) Inform consent was obtained. All adverse events with different grade were observed during the beginning 12 weeks, and clinical treatment were carried out relatively. Results: Total of 25 cases were enrolled. Nine patients died of the disease, 3 of them died during the first 12 weeks, 3 patients abandoned sorafenib treatment, among them 2 died before the finish of 12 weeks treatment and 1 patient discontinued 5 months after the sorafenib treatment. Twenty cases finally assigned. Number of patients encountered drug-related adverse events were: HFSR (hand-foot-skin-reaction) 4(4/20), diarrhea 4(4/20), alopecia 5(5/20), rasb 4(4/20), fatigue 8(8/20), leukopenia and Thrombocytopenia 4(4/20), elevated blood pressure 1(1/20) and abdominal pain 1(1/20). After clinical management, 20 patients' sorafenib treatment were eventually not affected by adverse events. Conclusion: Sorafenib was well-tolerated and is a safe option of treatment for patients with advanced hepatocellular carcinoma.

Objective To investigate the protective effects of lentivirus mediated Bcl-2-associated athanogene 1L (BAG-1L) over-expression on human neuroblastoma cells (SH-SYSY) induced by hypoxia/re-oxygenation,and to study its effect on the phosphoinositide 3 kinase serine/threonine protein kinase (PI3K/AKT) pathway.Methods SH-SYSY cells were cultured in vitro,and the cells at logarithmic phase were collected,and they were divided into recombined lentiviral infection group [infected by lentivirus containing BAG-1L and green fluorescent protein (GFP) gene],vector control group (infected by lentivirus containing GFP without BAG-1L gene) and cell control group (non-infection).Western Blot was used to detect the expression of BAG-1L in target cells after infection for 48 hours.SH-SY5Y cells were subjected to hypoxia for 8 hours and re-oxygenation for 24 hours,then the cell counting kit-8(CCK-8) was used to detect the cell activity,and the apoptosis was detected by flow cytometry after allophycocyanin labeled annexin V/7-amino actinomycin D (Annexin V-APC/7-AAD) staining.Western Blot was used to detect the protein expressions of BAG-1L,heat shock protein 70 (HSP70),AKT and phosphorylated AKT (p-AKT).Results After infection for 48 hours,exogenous BAG-1L protein bands were observed in recombined lentiviral infection group,but not observed in cell control group and vector control group.After hypoxia/re-oxygenation treatment,the cell viability in recombined lentiviral infection group was significantly higher than that in cell control group and vector control group (A value:0.689 ± 0.036 vs.0.425 ± 0.013,0.400 ± 0.012),apoptosis was significantly decreased [apoptosis rate:(26.97 ± 1.82)％ vs.(36.60± 1.45)％,(35.77 ± 3.74)％],the protein levels of BAG-1L,HSP70 and p-AKT were significantly increased [BAG-1L protein (gray value):2.405 ± 0.167 vs.0.529 ± 0.141,0.601 ± 0.099;HSP70protein (gray value):0.997±0.123 vs.0.634±0.091,0.584±0.106;p-AKT protein (gray value):1.234±0.118 vs.0.661 ± 0.210,0.712 ± 0.199,all P ＜ 0.01],but the protein level of AKT was slightly increased (gray value:1.103 ± 0.269vs.0.646 ± 0.188,0.791 ± 0.326) without statistically significant differences (both P ＞ 0.05).There was no significant difference in all parameters between cell control group and vector control group (all P ＞ 0.05).Conclusion Lentivirus mediated BAG-1L gene over-expression can protect nerve cells against hypoxic injury and apoptosis,and the protective effect may be related to the activation increase of pathway on PI3K/AKT.