Objective To explore the clinical significance of the serum cell-free DNA on early diagnosis and prognostic value of patients with cervical carcinoma. Methods Forty-five patients with cervical carcinoma and 50 healthy women from May 2012 to February 2014 were selected from the Central Hospital of Ezhou. Serum cell-free DNA(cf-DNA),carbohydrate antigen125(CA125),carbohydrate antigen19-9(CA19-9), squamous cell carcinoma antigen( SCC ),β-human chorionic gonadotropin( β--HCG ) were detected by electrochemiluminescence analyzer. Results The levels of serum cf-DNA,SCC,β-HCG of patients in the cervical carcinoma group were(178. 8 ± 43. 4)μg/ L,(0. 7 ± 0. 3)μg/ L,(1. 3 ± 0. 4)kU/ L respectively, higher than those in health women((1 354. 7 ± 267. 2)μg/ L,(1. 4 ± 0. 4)μg/ L,(5. 2 ± 0. 6)kU/ L),and the differences were significant(t = 30. 690,9. 709,37. 614;P < 0. 001). Serum cf-DNA level of patients with Ⅱ-Ⅲperiod cervical carcinoma was(2 538. 8 ± 775. 3)μg/ L,higher than patients with Ⅰ period((1 244. 7 ± 253. 6)μg/ L;t = 8. 191,P < 0. 001). The area under the curve of ROC of serum cf-DNA,CA125,CA19-9, SCC,β-HCG were 0. 951 6,0. 638 2,0. 614 4,0. 805 7,0. 753 1 respectively and the AUC of serum cf-DNA was the largest. The sensibility,specificity,accuracy of cf-DNA were 75. 56% ,99. 13% ,93. 36% and 28. 32% , 93. 24% ,64. 26% in terms of CA125. Meanwhile,the sensibility,specificity,accuracy of CA19-9 were 19. 75% , 94. 47% ,67. 28% and 38. 87% ,88. 53% ,80. 16% in terms of SCC. The sensibility,specificity,accuracy of β-HCG were 43. 28% ,86. 21% ,77. 83% respectively. Conclusion Serum cf-DNA has high sensibility, specificity and accuracy in early diagnosis and prognostic value of patients with cervical carcinoma and it is worthy of clinical promotion.

Cytokine-induced killer (CIK) cells are T lymphocytes which have natural killer cell activity and antitumor activity.It is found that CIK cells play an important role in killing tumor cells by secreting cytotoxic granules and cytokines,activating NKG2D receptor and regulating oncogene expression.CIK cells can not only kill the tumor cells,but also can improve immune system and the quality of life of patients.A large number of studies have shown that CIK treatment is a new mode of cancer treatment without obvious adverse reactions and can be widely applied in clinical treatment.

Objective To investigate the dynamic changes and relationship between the serum levels of IL-1 β and sE-selectin in acute pancreatitis (AP) patients, and to study the predicative value for severity of AP.Methods Forty one patients with AP were divided into severe acute pancreatitis (SAP, 19 cases) group and mild acute pancreatitis (MAP, 22 cases) group.Their serum were collected at the 1st, 3rd, 7th, and 14th day after admission and the serum concentrations of IL-1 β and sE-selectin were detected by ELISA.Another 20healthy volunteers were selected as controls.Results The serum concentration of IL-1 β in control group was ( 18.71 ±2.43)ng/L, while they were (61.18 ±7.47)ng/L, (33.03 ±5.85)ng/L, (20.73 ±4.07)ng/L in MAP group at the 1st, 3rd, 7th day;and they were (86.91 ± 13.32) rng/L, (81.35 ± 12.71) ng/L,(64.93 ±5.99)ng/L, (21.40±49.13) ng/L at the 1st, 3rd, 7th and 14th day in SAP group.The serum concentration of IL - 1β of patients with SAP were markedly higher than those with MAP and normal controls on the 1st, 3rd, 7th day (P ＜0.05) and they decreased almost to normal on the 14th day.The serum concentration of sE-selectin was ( 10.69 ± 2.51 ) ng/ml, while they were ( 41.60 ± 6.85 ) ng/ml, ( 14.90 ±3.51)ng/ml, (9.85 ±2.88)ng/ml in MAP group at the 1st, 3rd, 7th day;and they were (84.73 ±15.37)ng/ml, ( 95.65 ± 13.06 ) ng/ml, ( 39.41 ± 3.73 ) ng/ml, ( 12.25 ± 2.29 ) ng/mlon the 1st, 3rd, 7 th and 14th day.The serum concentration of sE-selectin of patients with SAP were significantly higher than those with MAP and normal controls on the 1st, 3rd, 7th day (P ＜0.05 ) and there was no significant difference between SAP and control group on the 14th day.There was a positive correlation between the serum level of IL-1 β and sE-selectin in AP on the 1 st day after admission ( r = 0.851, P ＜ 0.01 ).Conclusions The serum concentrations of IL-1 β and sE-selectin are useful for AP severity predication.

Objective To investigate the relationship between juxtapapillary duodenal diverticular (JPDD) and choledocholithiasis,and the effects of JPDD on endoscopic sphinctemtomy(EST) in treatment of choledocholithiasis.Methods Fifty-one cases of choledocholithiasis combined with JPDD (choledocholithiasis combined with JPDD group) and 210 cases of choledocholithiasis without JPDD (choledocholithiasis without JPDD group) were treated by EST,and the clinical data of patients in the two groups were retrospectively analyzed.The relationship between JPDD and choledocholithiasis was studied.The JPDD' influence on the intubation success rate of endoscopic retrograde cholangiopancreatography (ERCP),the success rate of the stone removal by EST and complication were analyzed.Results The incidences of choledocholithiasis in patients of JPDD diameter ＜ 1 cm,1-3 cm and ＞ 3 cm were 39.3％(11/28),53.2％ (33/62) and 7/8 respectively.The larger the JPDD diameter,the higher the incidence of choledocholithiasis,and there was statistical difference (P ＜ 0.01).The incidence of choledocholithiasis in peripheral type JPDD was significantly higher than that in parallel type and circumvolution type [81.0％(17/21) vs.41.9％(26/62) and 8/15],and there were statistical differences (P ＜0.05).There was no statistical difference in the intubation success rate of ERCP between the two groups (P ＞ 0.05),but the success rate of the stone removal by EST in choledocholithiasis combined with JPDD group was significantly lower than that in choledocholithiasis without JPDD group [91.8％ (45/49) vs.99.5％ (208/209)].The incidence of EST incision bleeding was significantly higher than that in choledocholithiasis without JPDD group [11.1％ (5/45) vs.1.9％ (4/208)],and there was statistical difference (P ＜ 0.01) ; there were statistical differences in the incidences of others complication between the two groups (P ＞ 0.05).Logistic regression analysis showed that JPDD was independent risk factor for EST incision bleeding (P =0.043).Conclusions JPDD is relative with choledocholithiasis.JPDD makes EST a little more difficult and risky,while EST is still a safe and effective therapy for choledocholithiasis patients combined with JPDD.

Objective To investigate the situation of knowledge,attitude and practice of physical restraint from nurses for critical parents in secondary hospitals and tertiary hospitals in Hubei province.Methods 300 nurses from four tertiary hospitals and four secondary hospitals were investigated for the situation of knowledge,attitude and practice of physical restraint by questionnaires.Results It showed that nurses had a good knowledge of physical restraint,(11.02±1.96),their attitude of physical restraint tended to be neutral,(34.99±3.52),the practice of physical restraint turned out to be at meddle-up level,(51.90±6.67).There was a statistically significant difference in the scores of physical restraint knowledge and practice between nurses who receive physical restraint train or not after they got a job,besides,there was also statistically significant difference in the scores of physical restraint knowledge between intensive department and non-intensive department,tertiary hospitals and secondary hospitals,however there was no statistically significant difference in the scores of physical restraint attitude and practice between them.Conclusions Compared with non-intensive department and secondary hospitals,the nurse managers of intensive department and tertiary hospitals should strengthen the training and education of physical restraint of clinical nurses,guide the nurses to build the positive attitude of physical restraint,to reduce the use of preventive physical restraint and then to promote their quality of practice on physical restraint.

Objective To investigate the correlation between expression of human telomerase reverse transcriptase (hTERT) mRNA in peripheral blood and postoperative recurrence and prognosis in the patients with advanced colorectal cancer (CRC).Methods The preoperative and 1 month postoperative quantitative expression of hTERT mRNA in peripheral blood in 85 patients with advanced CRC were detected with real-time fluorescence quantitative real-time fluorescence quantitative polymerase chain reaction (RTPCR).The quantitative expression of hTERT mRNA in peripheral blood in 30 normal controls were also detected.The postoperative prognosis was followed-up,and the quantitative expression of hTERT mRNA in peripheral blood in the patients with recurred CRC and the patients without recurred CRC were detected repeatedly.The factors that affected the preoperative hTERT mRNA expression were analyzed.The relationship was investigated between the hTERT mRNA expression levels and postoperative recurrence and prognosis in the patients with advanced CRC.Results The hTERT mRNA expression levels in peripheral blood in advanced CRC group were significantly higher than those in the normal controls [(6.22 ±5.85)2-△△Ct vs (0.45 ±0.27)2-△△Ct,(P ＜0.01)],and were significantly decreased at the time point of 1 month after the operation (P ＜ 0.01).The hTERT mRNA expression levels in the postoperative recurred CRC group were significantly higher than those in the 1 month postoperation group and no recurrence CRC group [(5.07 ± 2.87)2-△△Ct vs (1.83 ± 1.08)2-△△Ct,(2.15 ± 1.49)2-△△Ct,(P ＜0.01)].Univariate analysis revealed that preoperative high hTERT mRNA expression levels in peripheral blood were related to the differentiated degree of tumor,tumor size,lymph node metastasis ratio,and liver metastasis (P ＜ 0.05 or P ＜ 0.01).Multivariate logistic regression analysis revealed that differentiated degree of the tumor,lymph node metastasis,and liver metastasis were independent risk factors for the elevation of preoperative hTERT mRNA expression in the advanced CRC.Elevated preoperative hTERT mRNA expression was positively related to the postoperative recurrence rate,and was negatively related to postoperative survival rate.Conclusions Preoperative hTERT mRNA expression levels in peripheral blood were related to the important pathologic features in patients with advanced CRC,and might be a valuable prognostic factor.Postoperatively elevated hTERT mRNA expression in peripheral blood was related to recurrence of advanced CRC.

AIM: Stable human macrophage-derived foam cell model is significant for the study on artherosclerosis. This study investigated the feasibility of establishing macrophage-derived foam cell model using U937 cell lines. METHODS: The experiment was performed at Institute of Basic Medicine, Chengde Medical College from March to September 2006. ①U937 cell lines were purchased from Institute of Biochemistry & Cell Biology, Chinese Academy of Sciences. ②Sixteen bottles of U937 cells (109 L-1) were incubated at 37 ℃ in saturated humidity containing 5% CO2 for 72 hours. Among them, eight bottles contained 100 ?g/L phorbol-12-myristate-13-acetate (PMA) and 100 mg/L low-density lipoprotein (LDL) as experimental group, and the other eight bottles only 100 mg/L LDL as control group. ③Cell morphology was studied under light microscope by Wright's and Oil red O staining. Cell total cholesterol (TC) was measured after 72 hours of incubation. RESULTS: A large amount of lipid droplets were found in the cytoplasm by Oil red O staining in cells of the experimental group, but not found in control group cells. TC in cells of the experimental group was significantly higher than in control group [(520.13?37.52), (39.47?9.26) mg/g, t=35.18, P

Objective To investigate and analyze the characteristics and stratified influencing factors of self-directed learning of nursing college students.Methods In November 2016,a total of 304 students from three nursing colleges in Sichuan province were investigated with self-rating scale of self-directedness learning (SRSSDL).304 copies of the questionnaires were issued and recovered.Using SPSS 13.0,the independent sample t test and variance analysis were used to compare the differences between groups.Pearson correlation test and multiple linear regression were used to analyze the influencing factors.Results The average SRSSDL score of key undergraduate students of nursing college was (220.27 ± 30.16),the score of general undergraduate students was (212.37 ± 25.01),the score of Junior college students was (205.26 ± 29.84),The score difference has statistical significance (F=6.191,P=0.002).Students from key undergraduate had the highest self-directed learning ability,and students from general undergraduate and Junior college had the medium self-directed learning ability.The factors such as different levels,whether the one-child,self-study time every day,team learning experience affect students' self-directed learning ability.Conclusions We should create conditions for students to study independently,cultivate professional identity and independent spirit under the premise of clear educational objectives to improve their SDL ability.

ObjectiveTo study the correlation between preoperative serum angiopoietin-2 (Ang2) levels and lymph node metastasis in early gastric cancer(EGC).MethodsPreoperative serum Ang-2 and CEA levels in 62 patients with EGG and 30 normal controls were measured by ELISA technique respectively.The metastasis of lymph node in these cases were determined by HE staining.The relation between preoperative serum Ang-2 levels and lymph node metastasis in EGC and pathologic characterization was investigated.ResultsCompared with normal controls,preoperative serum Ang-2 levels in EGC group were significantly elevated [( 282.5 ± 110.6 ) μg/L vs ( 187.4 ± 32.7 ) μg/L,P ＜ 0.01].Preoperative serum Ang-2 levels in node-positive gastric cancer group was significantly higher than that in the node-negative gastric cancer group [(34 7.2 ± 79.5 ) μg/L vs (265.6 ± 90.2) μg/L,P ＜ 0.01],while CEA levels changed a little.Preoperative serum Ang-2 levels in the EGC group presented marked correlation with the differentiated degree of the tumor tissue,tumor size,depth of tumor invasion but it had no correlation with the histological type.Preoperative serum Ang-2 levels were an independent high-risk factor of lymph node metastasis in EGC according to multivariate logistic regression analysis.ConclusionsPreoperative serum Ang-2 levels may be a good clinical predictor for lymph node metastasis of EGC,which is useful for the treatment direction.

OBJECTIVE:To evaluate the current status and future trend of antibacterials utilization in our hospital.MET-HODS:A retrospective analysis was conducted on the use of antibacterials in our hospital in 2003～2005,covering sales value and application density(AD).RESULTS:Antibacterials as used in our hospital had been high in AD for the three years.In ran-ked order,the top three subcategories were quinolones,macrolides and lincosamides,represented respectively by levofloxacin,azithromycin and clindamycin.CONCLUSIONS:Antibacterials as used in our hospital are high in AD.Administration of antibacterials use during the perioperative period should be specially strengthened to avoid irrational combination medication.