Objective To detect the expression of BMI-1, and to discuss its role in the development of gastric cancer. Methods The expression of BMI-1 protein and mRNA in gastric cancer and adjacent tissues was detected by immunohistochemical P-V method (78 cases) and semi-quantitative RT-PCR (30 cases). Results The positive expression rate of BMI-1 protein in gastric cancer patients was 66.7 % (52/78), and it was 19.2 % (15/78) in adjacent tissues, the difference was statistically significant (χ2= 35.815, P= 0.000). The expression of BMI-1 mRNA in 30 gastric cancer tissues was 0.23 ± 0.12, it was 0.03 ± 0.12 in adjacent tissues, the difference was statistically significant (t=8.372, P=0.000). The expression of BMI-1 protein and mRNA was correlated with the degree of tumor differentiation, depth of invasion, lymph node metastasis and TNM staging (all P< 0.05). Conclusion The expression of BMI-1 is closely related to the occurrence and development of gastric cancer, which may provide guidance for molecular pathogenesis, targeted therapy and prognosis of gastric cancer.

Objective To explore the clinical features of hepatolenticular degeneration (HLD) with hemolytic anemia as the first manifestation, and its relationship with ichthyosis.Method The clinical manifestations, course, diagnosis, and treatment of HLD combined with ichthyosis in one child who presented with hemolytic anemia as the ifrst manifestation, were retrospectively analyzed.Results In ten-year-old girl, the ifrst symptom was fatigue and jaundice, and then progressed to abdominal distension 5 days after admission. The reticulocyte percentage was 8.5%. Coombs test was negative. The K-F rings appeared on the cornea. The CT scan of Abdomen showed pleural and peritoneal effusion, abnormal substance deposition in liver and splenomegaly. There were mutations inATP7B andTGM1 genes, both of which were located on fourteenth of chromosomes. The diagnosis of HLD combined with ichthyosis was conifrmed. After symptomatic and supportive treatments such as removal of copper, prevention of the copper absorption and supplement of vitamin A, the disease was brought to remission.Conclusion HLD with hemolytic anemia as the ifrst manifestation, combined with ichthyosis was extremely rare.

Objective To sum up the experience of position nursing of patients with ankylosing spondylitis and severe kyphosis. Methods Eleven patients with ankylosing spondylitis and severe kyphosis underwent surgery. The patients′spine and head were kept in a line during anesthesia to avoid spinal cord injury. The eye mask was used to make sure the eyelid close, so the bulbar conjunctiva and corneal did become dry. The angle of operation bed in time during operation was adjusted. The crushed area was observed and the position was changed to avoid pressure sores and edema. After surgery, they were keep inactive to make sure the spine stable and relieve the pressure. Results The 11 patients′surgery were successful. There were no pressure ulcer, fracture, spinal cord injury or eye injury occurs. The operation time was 9.3 ± 2.9 h. Conclusion Position nursing is very important to improve the success rate of surgery and reduce complications.

Objective:To investigate the ways of pharmaceutical care performed by clinical pharmacists for the patients with severe infection. Methods:Through deciding the anti-infection therapeutic regimen, providing drug counselling and pharmacy education and focusing on adverse drug reactions, pharmacists offered suggestions for one patient with severe legionella pneumonia complicated with AECOPD. Results:The pharmaceutical care performed by clinical pharmacists could solve the problems and improve the compliance, safety, effectiveness and rationality in the drug treatment of the patient. Conclusion:According to the individual condition of patients, clinical pharmacists can realize their own values through looking for the breakthrough points of pharmaceutical care and participating in clinical practice.

Objective To explore the effects of Jin's Three-needle Acupuncture combined with occupational therapy on function of upper limbs for stroke patients with hemiplegia. Methods 90 patients with stroke were randomly divided into control group (n=30), observation group (n=30) and experiment group (n=30). The control group received routine rehabilitation, the observation group received occupational therapy in addition, and the experiment group received Jin's Three-needle Acupuncture and occupational therapy in addition. They were assessed with Fugl-Meyer Assessment (FMA) of upper limbs and Barthel index (BI) before and 4 weeks after treatment. Results The scores of FMA and BI improved in all the groups after treatment (P<0.001). The difference of scores of FMA and BI before and after treatment were more in the experiment group than in the observation group (P<0.001), observation group than the control group (P<0.001). Conclusion Jin's Three-needle Acupuncture combined with occupational therapy can further improve the motor function of upper limbs and activities of daily living for stroke patients with hemiplegia.

Objective To measure the displacement of the silver clips guided by kV-plain film at state of moderate deep inspiration hold(mDIBH) assisted by active breathing control(ABC) and to explore the margin of clinical target volume(CTV) to planning target volume(PTV) for breast cancer patients treated with three-dimensional conformal external-beam partial breast irradiation (EB-PBI) assisted by ABC. Methods The patients undertook CT simulation assisted by ABC to get the CT images on the respiratory condition of mDIBH. Four selected silver clips in breast cavity were delineated and the cavity based on all of the clips were delineated as gross tumor volume (GTV). Before each irradiation, two orthogonal kV-plain films were taken for the patients in the respiratory condition of mDIBH assisted by ABC device. 2D-2D auto-matie registration was performed based on pixel between the kV-plain films and the digital reconstructed radi-ographs(DRR). Then manual registration was undertook to get the shifts of the four clips separately at LAT, LNG,and VRT directions. Based on the shift data,the margins of CTV to PTV at LAT,LNG and VRT direc-tions were calculated. Results The margins from CTV to PTV were 5.00 mm,7.78 mm and 9.30 mm at LAT,LNG and VRT directions based on the clip at cephal border of the cavity. The corresponding margins were 4.40 mm,6.43 mm and 6.73 mm based on the clip at bottom of the cavity;5.04 mm,8.63 mm and 10.54 mm based on the clip at lateral border of the cavity;5.40 mm,8.59 ram and 10.81 mm based on the clip at pedal border of the cavity. Conclusions The silver clips in breast cavity can be clearly showed on the kV-plain film. The displacement of the clips can be exactly measured by registration of kV-plain film and planning DRR in condition of mDIBH assisted by ABC. The margins from CTV to PTV for EB-PBI can be calculated based on the displacement of the clips.

Objective To evaluate the efficacy of caudal block with dexmedetomidine mixed with lidocaine for management of perioperative analgesia in children. Methods Thirty pediatric patients, aged 2-6 yr, weighing 8-23 kg, scheduled for elective unilateral high ligation of hernial sac, were equally and randomly assigned into either lidocaine group ( group L ) or dexmedetomidine mixed with lidocaine group ( group DL) using a random number table. Each patient received a single caudal dose of 1% lidocaine 1 ml∕kg in group L. Each patient received a single caudal dose of 1% lidocaine 1 ml∕kg mixed with dexmedetomidine 1 μg∕kg in group DL. Postoperative analgesia was assessed using FLACC scale. When FLACC score ≥4, ibuprofen suspension 10 mg∕kg was given orally. The consumption of ibuprofen was recorded within 8 h after operation. The onset time of caudal block and duration of analgesia were recorded, and adverse effects were observed. Results Compared with group L, the onset time of caudal block was significantly shortened, the duration of analgesia was prolonged, and the requirement for ibuprofen was decreased in group L. There was no significant difference in adverse effects between the two groups. Conclusion Addition of dexmedetomidine 1 μg∕kg to caudal lidocaine can significantly optimize the efficacy of caudal block with lidocaine alone for the management of perioperative analgesia in children.

Objective To investigate the value of initial absolute lymphocyte counts (ALC) in predicting the prognosis of children with primary immune thrombocytopenia(ITP).Methods The initial clinical data of 214 children with incipient ITP were retrospectively analyzed and followed up for more than one year.Statistical analysis was made to find out the influence factors for the prognosis of patients with ITP in children to evaluate the predictive value of ALC on assessing the prognosis of ITP in children,and to analyze the association between ALC and outcomes and the clinical value of prognostic stratification.Results The remission rate of children with ITP was 71.5％ in 12 months.Multivariate unconditioned Logistic analysis showed that disease duration,the infection history,response to treatment and ALC were independent risk factors for chronic ITP(all P ＜ 0.05).Cutoff value of initial ALC was 3.005 × 109/L,sensitivity and specificity of value were 71.9％,83.6％.Three months and 12 months no remission rate of ITP in children between ALC ＞ 3.005 × 109/L and ≤ 3.005 × 109/L had statistical significant difference (24.2％ vs 64.9％,8.3％ vs 54.2％,x2 =42.13,P ＜0.001).There was no statistical difference in therapy efficacy between 2 groups(x2 =5.098,P ＞ 0.05).Remission rate between the ≤5 years old group and ＞ 5 years old group was statistical difference based on age stratification(x2 =22.371,22.177,all P ＜ 0.01).ITP in children were stratified into low risk group,intermediate risk group,high risk group based on the initial ALC and infection history,with remission rates in 3 month respectively 75.8％,54.1％,22.8％,respectively,and 91.6％,68.4％,31.6％ in 12 months,respectively;there were statistically significant differences (x2 =44.867,68.802,all P ＜ 0.001).Conclusions Initial ALC is an independent effecting factor in the prognosis of children with ITP.Initial ALC could be used for stratifying patients with the infection history before 6 weeks and supposed to be a predictive index for the prognosis of ITP in children.