Objective The objective of this study was to explore the difference factors for PHC patients by transcatheter arterial chemoembolization of different age groups of senior people in China and support reference for individualized intervention by clinical medical workers.Methods 153 cases of PHC patients by TACE were selected by convenience sampling method from October 2013 to June 2014.The data were collected using general data questionnaire,Health Promotion Strategy Scale,QOL-LC,Memorial Symptom Assessment Scales and Social Support Scale to evaluate the physical,psychological and social aspects of the PHC patients.We divided the patients into young,middle-aged and elderly groups.Single factor and multiple factors regression analysis were used to compare the status and influencing factors.Results Psychological function,value of blood AFP,marital status entered the model and were self-care efficacy and correlated factors of young-aged patients,which could explain 50.6％ of the total varience.Physical symptoms,exploitation degree of support and intervention treatment times entered the model and were self-care efficacy and correlated factors of middle-aged patients,which could explain 47.8％ of the total varience.Symptom distress,degree of cuhural and psychological function entered the model and were self-care efficacy and correlated factors of elderly-aged patients,which could explain 42.4％ of the total varience.Conclusions The self-care efficacy were low in all ages of PHC patients by TACE,it is associated with a variety of factors.Doctors and nurses should pay more attention to the self-care efficacy for PHC patients by transcatheter arterial chemoembolization with different age groups.Also we should evaluate and make well-targeted policies and personalized inter-ventions to promote self-management self-efficacy.

Objective:To consolidate ten years of clinical experience on the application of breast fiberoptic ductoscopy (FDS) in breast intra-ductal lesion. Methods:The clinical data of 1 368 cases of patients with nipple discharge were retrospectively collected and analyzed. Results:Significant differences were observed in the FDS diagnoses of patients with nipple discharge. The rates of tumor de-tection by FDS diagnosis were significantly higher when bloody and serous nipple discharge was used rather than milky and watery nip-ple discharge. For non-tumor nipple discharge, local drug perfusion via FDS was an effective treatment. A total of 303 patients had tu-mor resection or segmentectomy under localization via FDS, and 44 had segmentectomy after breast duct infusion of methylene blue. The diagnostic rate of localization via FDS (97.0%) was higher than that of breast duct infusion of methylene blue (86.4%). Conclu-sion:FDS is an accurate method for diagnosing patients with nipple discharge. In addition, it is also a good local drug perfusion method for patients with breast inflammatory nipple discharge ductoscopy. For patients with tumorous nipple discharge, localization via FDS can help improve the detection of the lesions, which can be removed by surgery.

Objective To explore glycogen synthase kinase -3β( GSK-3β) activity and Toll-like receptor 4 ( TLR4 ) proteins expression of microglia were tested in vitro experiments, and the possible mechanism of postoperative cognitive dysfunction(POCD).Methods The cell morphology of primary culture microglia was observed by inverted microscope;microglia were identified by glial fibrillary acidic protein ( GFAP ) immunofluorescence;the best POCD modeling conditions of microglia injury induced by lipopolysaccharides( LPS) were screened ; microglia vigor was assayed by MTT ; the proteins expressions of GSK-3βand TLR4 of microglia were detected by Western blot.Results GFAP immunofluorescence showed a positive result that primary culture of rat microglia was successful;MTT result showed that the best PODC modeling conditions of microglia injury induced by LPS (100 ng/mL) was 7h; Western blot results showed that the preotein expressions of GSK-3βand TLR4 of microglial cells were up-regulated by LPS compared with the control group,and there were significantly differences (P<0.01).Conclusion PODC pathogenesis may be associated with LPS that could up-regulat the protein expression of GSK-3βand TLR4 in microglial cells.

Newcastle disease virus-like particles (NDV VLPs) are composed of matrix protein (M) as the skeleton,with the insertion of hemagglutinin-neuraminidase and/or fusion protein.NDV VLPs are reported to be immunogenic and can induce specific humoral and cellular immune responses.However,its relationship with innate immunity remains elusive.Dendritic cells (DCs) are a group of specialized antigen presenting cells,which are crucial in connecting innate immunity and adaptive immunity.In this study,NDV VLPs and murine DCs were used to investigate the connection between NDV VLPs and innate immunity.The DC maturation induced by NDV VLPs (M+ HN) was evaluated.The results showed that NDV VLPs could be effectively taken up by DC and presented to naive T cells.NDV VLPs-induced DC significantly up-regulated the expression of MHC Ⅱ and costimulatory molecules on DC surface,and subsequently promoted the secretion of proinflammatory cytokines.This experiments also showed that different assembled NDV VLPs induced significant stimulating ability in cytokine levels.In summary,NDV VLPs can induce DC maturation,which gives insights to better understanding of VLPs-mediated innate immunity and provide information in selecting preferred NDV VLPs candidate.

BACKGROUND:Postoperative acute mental disorders refer to patients without mental disorders suffer from neurological dysfunction after surgery. OBJECTIVE:To analyze the association between psychological resilience and postoperative acute mental disorders after total knee arthroplasty (TKA). METHODS:Convenience sampling, the Chinese Version of Connor and Davidson's resilience scale (CD-RISC), was used to measure the levels of psychological resilience in 832 patients undergoing TKA. The questionnaire covered three dimensions:tenacity, self-improvement and optimism. The incidence of postoperative acute mental disorders was observed after operation. RESULTS AND CONCLUSION:(1) The CD-RISC scores of the patients with TKA surgery were (57.64±10.07), lower than the average scores of the elderly community in China. 20 (2.4%) patients had postoperative acute mental disorders. (2) Pearson correlation analysis demonstrated the negative correlation between the levels ofresilience and the incidence of postoperative acute mental disorders (r=-2.43, P<0.05). (3) Patients with lower psychological resilience levels had a higher incidence of postoperative acute mental disorders. Developing psychological resilience may become an important strategy to reduce the occurrence of postoperative acute mental disorders.

Objective To study the relationship between plasma TGF-β, TNF-α, IL-10 levels and radiation pneumonitis (RP) in patients received thoracic irradiation with 3DCRT. Methods Sixty-nine patients of lung cancer stage Ⅲ or esophageal carcinoma were evaluated prospectively by EUSA for plasma TNF-α, TGF- β, IL-10 levels and IL-10/TNF-α before 3DCRT, after 40 - 50 Gy and after 3DCRT. Results Twenty-eight patients had RP. In RP patients, the plasma TGF-β, TNF-α, IL-10 levels and IL-10/TNF-α was (15.2 ± 13.4) μg/L, (28.4 ± 13.4), (24. 1 ± 17. 1) ng/L and 1.01 ± 0.86 before 3DCRT, respectively;TNF-α increased to (36.1 ± 15.5) ng/L(t = 2.01, P = 0.040), IL-10 and IL-10/TNF-α decreased to (18.8 ± 10.8) ng/L (t =1.40, P = 0.166) and 0.62 0.55 (t = 1.90, P = 0.063)after 40-50 Gy. After 3DCRT TNF-α was higher (36.9 ± 15.5) ng/L than that before 3DCRT(t = - 2.20, P = 0.032) ,but IL-10 and IL-10/TNF-α were lower than that before 3DCRT [(13.7 ± 6.2) ng/L, t = 3.03, P = 0.005 ;0.41 ± 0.21, t = 3.60, P = 0.001]. TGF-β was not change in three times(P > 0.05) .In non-RP patients, TGF-β,TNF-α, IL-10 and IL-10/TNF-α was not yet change in three times(P > 0.05) respectively. TGF-β was not yet change between RP and non-RP patients before 3DCRT (t = 0.54, P = 0.594), and TNF-α was higher in RP group than that in non-RP group after 40-50 Gy(t = 2.02, P = 0.048), but IL-10 and IL-10/TNF-α was less in RP group than that in non-RP group after 3DCRT(t=2.50,P=0.015;t=4.63,P=0.000). Conclusions The levels of TNF-α and IL-10 are closely related to the occurrence of RP. Monitoring the changes in dynamic state could predict the generation of RP, which could be employed as a sensitive index for indicating risks for acute RP.

Objective To investigate the relationship between nutritional status and quality of life ( QOL) in patients with nasopharyngeal carcinoma undergoing concurrent chemoradiotherapy, and to identify the optimal indices of body composition for evaluation of malnutrition. Methods Based on the European Society Parenteral and Enteral Nutrition ( ESPEN) consensus on the diagnosis of malnutrition and patient?generated subjective global assessment (PG?SGA), a prospective study was performed in 48 patients with nasopharyngeal carcinoma who received concurrent chemoradiotherapy in our hospital from 2014 to 2015. Changes in body composition and nutritional status were evaluated in those patients. The relationship between nutritional status and QOL was studied. The predictive factors for nutritional status in patients with nasopharyngeal carcinoma were explored. The correlation between datasets was evaluated by the Pearson correlation coefficient. The influencing factors for nutritional status were analyzed by Logistic regression. Results During concurrent chemoradiotherapy, some indices of body composition, including weight, body mass index ( BMI) , fat mass index ( FMI) , fat?free mass index ( FFMI) , body cell mass ( BCM) , skeletal muscle mass ( SM) , and phase angle ( PA) had different degrees of reduction ( P=0?00) , while the PG?SGA score gradually increased. The incidence of malnutrition in patients with nasopharyngeal carcinoma during radiotherapy was 2?1%?39?6% based on 2015 ESPEN consensus on the diagnosis of malnutrition and 12?5%?41?7% based on PG?SGA. These two methods showed good agreement at the fourth and sixth weeks of radiotherapy ( Kappa=0?911;Kappa=0?957) . The changes in QOL score were correlated with changes in FFMI and weight during radiotherapy ( r= 0?805, P= 0?00;r= 0?777, P= 0?00 ) . Logistic regression indicated that age, FMI, and FFMI were influencing factors for nutritional status ( P= 0?035, 0?013, 0?043) . Conclusions Patients with nasopharyngeal carcinoma have substantial nutritional deterioration during chemoradiotherapy. The nutritional status is closely associated with QOL. A prediction model of nutritional status can provide a comprehensive and accurate judgment of nutritional status in patients.

Objective To determine the optimum dose of normal saline (NS) for preloading epidural space required to prevent the injury to blood vessel by epidural catheter placement for caesarean section.Methods Two hundred ASA Ⅰ or Ⅱ parturients with a single baby at full term in vertex presentation,aged 24-35 yr,weighing 63-78 kg,scheduled for caesarean section under continuous epidural anesthesia,were randomly divided into4 groups (n-50 each):control group (group Ⅰ),NS2 ml group (group Ⅱ),NS5 ml group (group Ⅲ)and NS 10 ml group (group Ⅳ).The epidural puncture was performed at L2-3 interspace with a Tuohy needle attached to a 5 ml syringe.Loss of resistance was used to identify the epidural space.In group C no fluid was injected into the epidural space before insertion of the catheter,while in groups Ⅱ,Ⅲ and Ⅳ NS 2,5 and 10 ml were injected into the epidural space before the catheter insertion respectively.After a test dose of 3 ml 1.5％ lidocaine,0.75％ ropivacaine 10-20 ml was administered through the epidural catheter.MAP and HR were recorded before epidural puncture (T0),at 10 and 20 min after the end of epidural administration (T1.2),and at the end of surgery (T3).The number of patients in whom blood or blood tinted fluid was withdrawn from the epidural catheter was recorded.The amount of ropivacaine consumed was recorded.The upper level of anesthesia was measured by pin-prick and the degree of motor block was assessed using modified Bromagc scale at T2.Results The hemodynamic parameters were in the normal range in the four groups.MAP was significantly lower at T2,the upper level of anesthesia was significantly higher,and the degree of motor block was significantly smaller in group Ⅳ than in groups Ⅰ,Ⅱ and Ⅲ (P ＜ 0.05).There was no significant difference in MAP among groups Ⅰ,Ⅱ and Ⅲ (P ＞ 0.05).There was no significant difference in HR and the amount of ropivacaine consumed among the four groups (P ＞ 0.05).The number of patients in whom blood or blood tinted fluid was withdrawn fiom epidural catheter was significantly smaller in groups Ⅲ and Ⅳ compared with groups Ⅰ and Ⅱ (P ＜ 0.05).Conclusion Preloading the epidural space with NS 5 ml can prevent the occurrence of injury to blood vessel induced by insertion of epidural catheter with no influence on the efficacy of anesthesia and NS 5 ml is the optimum dose.

BACKGROUND:Foreign studies have found that the magnesium alloy stent is safe and effective, but there are few studies on the degradation performance of magnesium alloy stents in China.OBJECTIVE:To investigate the degradation of degradable AZ31 magnesium alloy stent in the rabbit abdominal aorta and the effect of degradation process on vascularization.METHODS:Twenty-eight rabbits were enrolled, and the degradable AZ31 magnesium alloy stent was implanted into the rabbit abdominal aorta. Postoperative abdominal aortic X-ray examination and histological observation were done at 30, 60, 90, 120 days after implantation.RESULTS AND CONCLUSION:(1) X-ray examination: 30 days after implantation, the stent expanded completely with structural integrity; 60 days after implantation, the stent deformation, partial stent fracture, and lose of support were found; 90 days after implantation, only a small amount of support rod residues were found, and the majority of the stent was degraded; and 120 days after implantation, there was no support rod residual, and the stent was degraded completely. (2) Histological observation: 60 days after implantation, the number of residual support rods was less than that 30 days after implantation (P< 0.05), the number value at 90 days after implantation was lower than that at 30 and 60 days after implantation (P< 0.05), and the number value at 120 days after implantation was lower than that at 30, 60, 90 days after implantation (P < 0.05), indicating that the number of residual support rods was negatively correlated with post-implantation days. The time for complete stent degradation was 124.8 days. The intimal area at 90 days after implantation was higher than that at 30, 60, 120 days after implantation (P < 0.05), while the lumen area was smaler than that at 30, 60, 120 days after implantation (P < 0.05). There was no significant difference in the intimal area and lumen area at latter three time points after implantation. To conclude, the degradation of the degradable AZ31 magnesium alloy stent in the rabbit abdominal aorta can be completed within 124.8 days, and at 90 days after the stent is implanted, vascular intimal hyperplasia and lumen stenosis are most serious, and then gradualy reduced.

Objective To explore the impact of folate on MeCP2 expression and cervical cancer cells growth.Methods Cervical cancer cell lines Caski (HPV16-positive) and C33A (HPV-negative) were treated with different concentrations of folate.MTT,flow cytometry,Western blott and real-time PCR were used to detect the cells’ viability,apoptosis,the expression of MeCP2 protein and mRNA expressions respectively.Results The inhibitions of both cell growth were upgraded with the folate concentration increasing.The differences were significant between the experimental groups and the control group.With increasing of folate concentration,apoptosis ratio of C33A and Caski increased gradually (C33A:r =0.965,P ＜ 0.001; Caski:r =0.973,P ＜ 0.001) and the expression of MeCP2 protein downgraded gradually,presenting significantly negative correlations between them (C33A:r =-0.952,P ＜ 0.001; Caski:r =-0.947,P ＜ 0.001).There was significantly difference for mRNA expression in different concentration groups of Caski and C33A (C33A:F =77.041,P ＜ 0.001; Caski:F =59.885,P ＜ 0.001).In the same concentration group,the expression of MeCP2 protein and mRNA were higher in Caski than that of C33A,and the difference was significant in the concentration of 500 μg/ml group.There was a negative correlation between the expression of MeCP2 protein and cells’ apoptosis ratio (C33A:r =-0.970,P ＜ 0.001; Caski:r =-0.93,P ＜ 0.001).Conclusion Folic acid can inhibit the growth of cerical cancer cells,promote apoptosis and reduce the expression of MeCP2.The aberrant high-expression of MeCP2 can inhibit apoptosis of Caski and C33A.