Objective To apply the feedback closed-loop management systemin the telephone follow-up service for discharged patients to increase patient satisfaction and improve the quality of nursing. Methods From January 2015,telephone return visit to discharged patients were analyzed, a summary of dissatisfaction events, analyze the causes every month. Then,the improvement measures for nursing quality were put forward and the effects were evaluated to form a closed-loop management system. Results After the application of feedback closed-loop management system,there was a significant difference in patients' satisfaction with nursing service between the first half (with the incidence of 91.77%,3657/3985) and the second half (with the incidence of 95.76%,3610/3770) of 2015 (χ2=52.22, P < 0.01). Of the 9 items of dissatisfaction recorded in the questionnaire, significant difference was observed in 8 items, as service attitude, hospitalizing education, personal care, question answering, nurse's operation, health education, respect, clean environment and the discharge instructions. The incidence of each item was 2.11%(84/3985), 0.23%(9/3985), 0.35%(14/3985), 0.33%(13/3985), 0.30%(12/3985), 2.99%(119/3985), 0.33%(13/3985), 0.58%(23/3985), 2.58%(103/3985) in the first half of 2015 respectively, compared to 1.09%(41/3770), 0.05%(2/3770), 0.05%(2/3770), 0.08%(3/3770), 0.21%(8/3770), 0.64%(24/3770), 0.85%(32/3770), 0.21%(8/3770), 1.25%(47/3770) in the second half of 2015 respectively (χ2=4.084-59.088,P<0.01 or 0.05). However, no significant difference was observed in the nurse operational between the first half (0.30%) and the second half (0.21%) in 2015 (χ2=0.596, P>0.05). Conclusions Feedback closed-loop management systemic a scientific management theory. It can increase patient satisfaction with nursing service,improve the quality of nursing,and make quality management more scientific and effective .

Objective To investigate the clinical characteristics of children with medulloblastoma (MB). Methods The correlations amongst MB histopathological subtype,age at diagnosis,gender,primary tumor locations, relapsed tumor and relapsed tumor locations were analyzed retrospectively in 83 children who were diagnosed as MB by histopathology subtypes from February 2012 to April 2015 in Beijing Shijitan Hospital Affiliated to Capital Medical Uni-versity.The data was conducted by using SPSS 22.0 statistical software.Results Among the 83 cases (53 boys and 30 girls),there were 14 patients younger than 3 years old (9 boys and 5 girls)and 69 patients (44 boys and 25 girls)ol-der than 3 years old,including 28 relapsed (19 boys and 9 girls)and 55 non -relapsed cases (34 boys and 21 girls). The median age was 80.2 (13.1 -184.7)months at diagnosis.Of these 83 cases,48.2% (40 /83 cases)was classic medulloblastoma (CMB)(2 cases less than 3 years old),24.1 % (20 /83 cases)was desmoplastic /nodular medullo-blastoma (DMB)(6 cases less than 3 years old),12.1 % (10 /83 cases)was large cell/anaplastic medulloblastoma (LC /AMB)(1 case less than 3 years old),3.6% (3 /83 cases)was extensive nodular medulloblastoma (MBEN)(1 case less than 3 years old),and 12.1 % (10 /83 cases)(3 cases less than 3 years old)was mixed subtype.The rela-tionships between age at diagnosis and histopathological subtype,gender and primary tumor location were all statistically significant (χ2 =0.014,0.013,all P <0.05).Conclusions The incidence of boys with MB is higher than girls.CMB is the main histopathologic subtype in children over 3 years old.The primary tumor location involving the cerebellar vermis or cerebellar vermis and the fourth ventricle is higher in girls with MB.The primary tumor location involving the fourth ventricle,the fourth ventricle and other parts of the central nervous system,Cerebellar vermis and other parts of the central nervous system or other parts of the central nervous system is higher in boys with MB.

Objective To investigate the changes of serum miR-21 expression level in patients with HCC before and after transcatheter arterial chemoembolization (TACE) and to discuss its clinical significance. Methods Before and after TACE the levels of serum miR-21 in 42 patients with HCC and 42 healthy subjects were determined by reverse transcriptase quantitative PCR (RT-PCR), and the levels of serum AFP were also estimated by enzyme-linked immunosorbent assay (ELISA). The results were analyzed. Results The serum miR-21 level in patients with HCC was (12.9 ± 3.5) times of that in normal subjects(t=19.430 7, P < 0.01). One month after TACE, the serum miR-21 level became (7.2 ± 1.7) times of that of normal reference value, which was remarkably lower than that obtained before the treatment (t=9.493 7, P<0.01). The serum miR-21 level was closely correlated with the tumor size, the presence of tumor thrombus and HBV infection. One month after TACE the serum miR-21 levels in patient groups showing partial response, stable disease and progressive disease were (4.0 ± 0.3), (6.0 ± 1.5) and (8.6 ± 1.5) times, respectively, of that of normal reference value, and statistically significant difference existed between each other among the three groups (F=38.168, P=0.000). ROC-AUC value of MiR-21 in diagnosing HCC was 0.910 ± 0.041, which was significantly higher than that of AFP (0.860 ± 0.037, t=6.3042, P<0.01). The specificity of miR-21 in detecting HCC was 88.1%, which was remarkably higher than that of AFP (69%, χ2= 4.5253, P = 0.033).Conclusion After TACE the serum MiR-21 level in HCC patients is significantly decreased, which is very helpful in predicting the therapeutic efficacy of TACE. Therefore, MiR- 21 can be regarded as a potential molecular marker of HCC.

Purpose To evaluate the expression of miR-21 in the tissues and cell lines of hepatocellular carcinoma,and to try to find its possible target genes.Methods The expression profile of miR-21 was detected in hepatocellular carcinoma tissues and cell lines.Mter miR-21 inhibitor was used,the alterations in the vitality and invasion of hepatocellular carcinoma cells were observed.The possible target gene of miR-21 was predicted by bioinformatics analysis.The influence of miR-21 inhibitors on the target gene activity was evaluated by dual luciferase reporting gene system.Results The expression level of miR-21 was significantly higher in hepatocellular carcinoma tissues than that in the adjacent ones (P ＜0.05).The expression level of miR-21 in hepatocellular carcinoma cells was significantly higher than that in the hepatic cells (P ＜0.01).After inhibiting miR-21,the viability and invasion ability of hepatocellular carcinoma cells were decreased (P ＜ 0.01).The expression level of programmed cell death 4 (PDCD4) in hepatocellular carcinoma tissues was significantly lower than that in the adjacent tissues (P ＜ 0.01).Its expression level in hepatocellular carcinoma cells was significantly lower than that in the hepatic cells (P ＜ 0.01).After interfering with PDCD4,the vitality and invasion ability of liver cancer cells were increased (P ＜ 0.05).Dual luciferase reporter gene assay indicated that by inhibiting miR-21,the expression level of PDCD4 was up-regulated (P ＜ 0.01).The vitality and invasion ability of liver cancer cells were reduced (P ＜ 0.001).Conclusion MiR-21 can regulate the growth and invasion of liver cancer cells through targeting PDCD4.

OBJECTIVETo investigate the effect of early oral feeding with enteral nutrition preparation after surgery on clinical outcomes in patients with gastric cancer.

METHODSSixty patients with gastric cancer undergoing radical operation between July 2010 and May 2011 were randomly divided into two groups using random digit table: experimental group(n=30, administration of water and enteral nutrition early after surgery) and control group(n=30, conventional postoperative care protocol). Clinical outcomes, immune function, and nutritional status between the two groups were compared.

RESULTSAs compared to the control group, duration of fever was significantly shorter in the experimental group [(81.1±6.4) h vs. (87.3±8.0) h, P<0.05], as were postoperative time of flatus [(79.9±9.5) h vs. (86.6±8.7) h, P<0.05] and postoperative hospital stay [(7.83±2.23) d vs. (9.57±1.96) d, P<0.01]. The medical cost [(30,220±3,220) RMB vs.(34,600±32,120) RMB, P<0.01] was lower than that in the control group. There was no significant difference in morbidity between the two groups[13.3%(4/30) vs. 16.7%(5/30), P>0.05]. The levels of CD3(+)T, CD4(+)T, NK cell, CD4(+)T/CD8(+)T, albumin, and prealbumin were higher in the experimental group as compared to the control group on postoperative day 3 and 7(P<0.05).

CONCLUSIONEarly oral feeding with enteral nutrition preparation after surgery can improve the nutritional status and immune function, and accelerate the rehabilitation for patients with gastric cancer.

Aged ; Enteral Nutrition ; methods ; Female ; Humans ; Male ; Middle Aged ; Postoperative Care ; Stomach Neoplasms ; therapy

OBJECTIVETo investigate the effect of growth hormone (GH) on penile erection after reconstruction of cavernous nerves using sural nerve as an interposition nerve graft in rats.

METHODSTwenty-four male Sprague-Dawley rats (3-4 ms of age and 300-400 g in weight) were randomly divided into 2 groups: nerve graft group and GH group, each electrostimulated to determine the erectile potency 2 and 4 months after nerve graft (followed by hypodermic GH injection). The nNOS-positive nerve fibers in the corpora cavemosa were examined by streptavidin-peroxidase immunohistochemistry technique (SP method). Image analysis was used to calculate the area stained in pixel.

RESULTSElectrostimulation at 2 months produced 31.25% of erections in the GH group but none in the grafted rats. There was a significant difference in the erection rate produced by electrostimulation between the two groups at 2 months (P < 0.05). The pixel of the expression of nNOS-positive nerve fibers in the GH group (38971 +/- 7692) was also greater than that of the graft group (16538 +/- 3179, P < 0.05). At 4 months, 43.75% of the graft group and 75% of the GH group produced erections upon electrostimulation, with no significant difference between the two groups (P > 0.05). The pixels of the expression of nNOS-positive nerve fibers were 79276 +/- 12,021 and 91348 +/- 18965, respectively (P > 0.05).

CONCLUSIONGH can accelerate the regeneration of cavernous nerves after bilateral nerve grafting, and GH administration may present a new physiological approach to the treatment of erectile dysfunction after radical pelvic surgery.

Animals ; Growth Hormone ; pharmacology ; Male ; Nerve Regeneration ; drug effects ; Nitric Oxide Synthase ; analysis ; Penile Erection ; drug effects ; Penis ; enzymology ; innervation ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Sural Nerve ; transplantation

OBJECTIVESTo discuss the new classification of epididymal malformation in cryptorchidism.

METHODSOne hundred and fifty-three boys who were two to four year old underwent orchidopexy for cryptorchidism and 144 hydroceles who were two to eight year old were enrolled into control. Based on the observation of the status between testis and epididymia, the length of epididymis and the configuration of epididymis as well as spermaduct, we divided epididymal malformations in cryptorchidism into three types. Type I: obstruction of sperm transport, including I A, I B and I C; Type II: possible obstruction of sperm transport, defined by II A and II B; Type III: no obstruction of sperm transport, classified into III A and III B.

RESULTSThere were 47 (23.4%) out of 201 undescended testes with malformation of epididymides and 16 (10.3%) out of 155 testes in the control(P < 0.05). 11 of 48 cases of bilateral cryptorchidism had the same malformations, with 2 cases of type IB, 2 of IC, 1 of II A, 4 of III A and 2 of IV B underwent orchidopexy or orchiectomy.

CONCLUSIONSThese data showed that the incidence of epididymal abnormalities in cryptorchidism was higher than that in the hydroceles and it's not essential to have orchiectomy unlimitedly to serious epididymal abnormalities.

Child ; Child, Preschool ; Cryptorchidism ; classification ; pathology ; surgery ; Epididymis ; abnormalities ; Humans ; Male ; Testicular Hydrocele ; pathology

Adult ; Aged ; Carcinoma, Renal Cell ; complications ; mortality ; Humans ; Kidney Neoplasms ; complications ; mortality ; Male ; Neoplastic Cells, Circulating ; Prognosis ; Thrombosis ; etiology ; Vena Cava, Inferior

OBJECTIVETo investigate whether the single nucleotide polymorphisms (SNPs) at -1082, -819 and -592 of interleukin-10 gene and its haplotype are associated with cachexia in patients with gastric cancer.

METHODSRadioimmunoassay was used to examine the serum levels of IL-10 in 223 patients with gastric cancer. The single nucleotide polymorphisms (SNPs) of IL-10 gene -1082G/A, -819T/C and -592A/C were analyzed using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP).

RESULTSThe serum levels of IL-10 were significantly higher in patients with cachexia than those without (P < 0.001). An increased frequency of -1082G allele was noted in patients with cachexia (P = 0.049). The frequencies of -1082AG and -819CC genotypes were elevated in patients with cachexia than those without (P = 0.036, 0.024). In a logistic regression analysis adjusted for actual weight, carcinoma location and stage, the -1082AG genotype was associated with an odds ratio of 1.989 (95%CI, 1.041 - 3.802, P = 0.037), and the -819CC genotype with an odds ratio of 3.393 (95%CI, 1.298 - 8.871, P = 0.013) for cachexia. Furthermore, haplotype analysis revealed that G1082C819C592 haplotype was associated with a significantly increased risk of cachexia (OR = 2.21; 95%CI, 1.14 - 4.30; P = 0.02).

CONCLUSIONOur results suggest that the gene haplotype of IL-10 contributes to the occurrence of cachexia in patients with gastric cancer in Chinese population.

Aged ; Alleles ; Asian Continental Ancestry Group ; genetics ; Cachexia ; blood ; complications ; genetics ; Female ; Genetic Predisposition to Disease ; Haplotypes ; Humans ; Interleukin-10 ; blood ; genetics ; Male ; Middle Aged ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Polymorphism, Single Nucleotide ; Stomach Neoplasms ; blood ; complications ; genetics

OBJECTIVETo evaluate the predicators of survival and recurrence after curative resection for gastric cancer patients with serosal invasion.

METHODSClinical and follow-up data of 280 patients with T4a gastric cancer(according to the 7th UICC TNM Classification for gastric cancer) who underwent curative resection for gastric cancer between January 1997 and December 2003 were analyzed retrospectively.

RESULTSFive-year survival rate of these 280 patients was 50.0% and 158 patients (56.4%) presented with recurrence after surgery. The 3-year disease-free survival rate was 57.5%. The number of lymph node metastasis and metastatic lymph node ratio(MLR) were identified as the independent predicators for overall survival(P<0.05). The extent of lymph node metastasis was identified as the independent predicators for disease free survival (P<0.05). The extent of lymph node metastasis, the number of lymph node metastasis, and MLR were identified as the independent predicators for recurrence after surgery(P<0.05).

CONCLUSIONSThe number of lymph node metastases, extent of lymph node metastasis and MLR are independent predictors of overall survival and recurrence in T4a gastric cancer patients after curative resection.

Disease-Free Survival ; Gastrectomy ; Humans ; Lymphatic Metastasis ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Prognosis ; Retrospective Studies ; Stomach Neoplasms ; diagnosis ; surgery ; Survival Rate