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 evaluate the effect of sevoflurane anesthesia on activation of gliocytes in aged rat hippocampi.Methods One hundred and four male Wistar rats,weighing 600-650 g,were randomly divided into 2 groups (n =52 each) using a random number table:control group (group C) and sevoflurane group (group S).Group S inhaled 3.6％ sevoflurane for 2 h,and open reduction and internal fixation was performed after tibial fracture was induced.Y-maze test and fear conditioning test were carried out on days 1,3 and 7 after surgery.Six rats of each group were chosen on days 1,3 and 7 after surgery and hippocampi were removed to detect the activation of microglias and astrocytes (by immunofluorescence) and expression of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) (by Western blot).Results Compared with group C,the number of entries into each arm was significantly reduced,the duration of N arm stay was shortened,the percentage of time spent freezing induced by condition and the percentage of time spent freezing induced by context were decreased,and the activation of microglias and astrocytes was increased,and the expression of IL-6 and TNF-α was up-regulated in S groups (P ＜ 0.05).Conclusion Sevoflurane-induced postoperative cognitive dysfunction may be related to enhanced activation of gliocytes in aged rat hippocampi.

Objective To investigate the methods of reducing radiation dose in CT coronary angiography through optimizing individualized scan dosage protocol.Methods Two hundred patients (group A)underwent coronary CTA examination which was performed with fixed 120 kV and variable mA according to their BMI.The mA was set as 150-300 mA(BMI ＜ 18.5 kg/m2),300-500 mA (18.5 kg/m2 ≤ BMI ＜ 25.0 kg/m2),and 500-800 mA(BMI ≥ 25.0 kg/m2).When all examinations were finished,a linear regression was employed to analyze the correlation between mA and BMI,body surface(Suf),image noise(SD)respectively.The results of the analysis were used to formulate a regression equation,which was further used to establish a table list for quick search on how much mA that individualized coronary CTA scan would need.Another 200 patients(group B)enrolled for the individualized scan were scanned under new protocol that previous study established.The tube voltage was 100 and 120 kV.The tube current was variable according to the data in the table list.One-way ANOVA and Kruskal-wallis H test were used for statistics.Results Regression equation between mA and BMI,Suf,SD was:mA =17.984 × BMI + 169.149 × Suf-2.282 × SD-361.039.The SD(group A:32.08 ± 5.80,group B:28.60±4.47),dose index volume(CTDIvol)[group A:(41.97 ± 11.37)mGy,group B:(33.18±10.07)mGy],effective dose(ED)[group A:(10.91 ±3.07)mSy,group B:(8.83 ±2.72)mSv]had significant differences between the two groups(F =43.45,63.71,49.07 respectively,P ＜0.01 for all).The SD and ED results obtained in group B were better than those in group A.Conclusion Better performances were obtained when BMI combined Suf was used as a new individualized protocol than when BMI was used only,which means good image quality and lower radiation dosage in coronary CTA examination.

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.

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.