Background and purpose:Literature report of treatment and prognosis in gastrointestinal stromal tumors(GIST) with hepatic metastasis and recur rent metastasis was rare, This study was to discuss the clinicopathological characteristics and the situation of treatment and prognosis in GIST with hepatic metastasis and recurrent again metastasis. Methods:We reviewed two cases of GIST with hepatic metastasis reported from our hospital, and comprehensively analysed the related literature. Results:Two cases of GIST with hepatic metastasis in our hospital were analysed: one case of primary intestinel tumor,13 years after the treatment of the patient was diagnosed with hepatic metastasis. After operation, the patient accepts imatinib mesylate therapy for 400 mg per day and gave up one and a half month later because of serious side reactions. 1 year 10 months later, the patient was diagnosed with liver, kidney, peritoneum and diaphragm metastasis again, after excised lesions the patient continued to accept Imatinib therapy, and persisted takes about 8 months until now. The primary tumor of recowd case came from greater omentum, 2.5 years later after primary tumor excised hepatic metastasis occured, after operation the patient accepted Imatinib therapy for 400 mg per day, until now 15 months. Two cases followed respectively until now was 2.5 and 1.5 years, without recurrence or metastasis again, all are surviving. Conclusions:The patients of GIST with hepatic metastasis and recurrence again, by suitably lengthened Imatinib therapy cycle after the excision of the lesions, it is still to be possible to obtain the good curative effect .

Objective To observe the effects of hyperbaric oxygen (HBO) on the expression of FasL mRNA and caspase-3 protein in renal tissue after renal ischemia-reperfusion injury (IRI) in order to elucidate the underlying mechanisms.Methods Rats were randomly divided into thrcc groups: sham group(n=8),IRI group(n=8) and IRI+HBO group(n=8).The IRI group and the IRI+HBO group recieved 45 minutes hibateral renal ischima and the IRI +HBO group received additional HBO therapy at the 1st,24th and 48th hour after ischemia.The kidneys were removed at the end of HBO therapy.Malondialdehyde (MDA) level and superoxide dismutase (SOD) activity were measured to determine the extent of oxidative stress.The expression of FasL mRNA and caspase-3 protein was detected by quantitative real-time PCR and immunohistochemical staining in renal tissue respectively.Results Compared with the sham group,MDA level increased markedly and SOD activity decreased markedly after ischemia.After HBO treatment,MDA level decreased and SOD activity increased significantly (P ＜0.05).In IRI group,the expression of FasL mRNA and caspase-3 protein were higher than those in the sham group (P＜0.01),which were reduced significantly by HBO treatment (P＜0.01).Conclusion The expression of FasL mRNA and caspase-3 protein increases along with the lasting of reperfusion and HBO exhibites protection against cell apoptosis through improving the antioxidant-oxidant balance and reducing IRI in acute stage of IRI.

Objective To investigate the effects of tetanic stimulation of peripheral nerve on intracranial direct electrical stimulation motor-evoked potentials (MEP) in patients undergoing cerebral functional area operation. Methods Eight patients undergoing elective brain tumor resection under propofol-fentanyl anesthesia with partial neuromuscular blockade were enrolled in the study. Both conventional MEP (C-MEP) monitoring and posttetanic MEP (P-MEP) monitoring were performed throughout the operation for each patient, and the two groups of data were recorded. For one group, direct electrical stimulation with a train of five pulses was delivered to motor cortex and pyramidal tract, C-MEP was unilaterally recorded from the abductor pollicis brevis, and P-MEP was obtained 1 s after tetanic stimulation (frequency 50 Hz, intensity 50 mA, duration 5 s) to the ipsilateral tibial nerve.For the other group, direct electrical stimulation with a train of five pulses was delivered to motor cortex and pyramidal tract, C-MEP was unilaterally recorded from the tibialis anterior, and P-MEP was obtained 1 s after tetanic stimulation (frequency 50 Hz, intensity 50 mA and duration 5 s) to the contralateral tibial nerve. Randomized crossover method was used for C-MEP and P-MEP recording in each group, with an interval of 120 s. The adverse effects were observed. Results Amplitudes of P-MEP from the abductor pollicis brevis and tibialis anterior were significantly higher than those of C-MEP. Three patients had body movement during intraoperative cortex stimulation, while there was no awareness during operation and other electrical stimulation-related nervous system impairment and complications. Conclusion The application of tetanic stimulation of peripheral nerve before direct electrical stimulation can augnent the amplitudes of MEP from the abductor pollicis brevis and tibialis anterior in patients undergoing cerebral functional area operation.

This study designed a studio English classroom which was based on foreign nursing jobs related language.It included high-frequency words,foreign nurse-patient dialogue,and European and American nursing video which was foreign patients’ nursing procedures oriented.The studio classroom was characterized as interactive internet platform.It provided a complete system for input and output in English language,and motivated students to learn nursing English.Therefore,it improved students’ professional verbal competencies.

AIM: To study the effect of ligustrazine on the cardiacmyocyte lesion in rats with type 2 diabetes mellitus.METHODS: Male Wistar rats were injected with STZ via tail vein under high-glucose and high-fat feeding for 4 weeks to establish the animal model of type 2 diabetes mellitus.Ligustrazine at different doses was used to treat the diabetic rats.The body weight, blood glucose and the morphology of heart tissues were observed.The myocardial levels of IL-1β, IL-6 and TNF-α were detected by ELISA, and the protein expression of IKKβ and NF-κB in the myocardium was determined by Westeren blotting.RESULTS: Ligustrazine at high dose alleviated the body weight reduction and blood glucose elevation cause by diabetes, and reduced pro-inflammatory factors IL-1β, TNF-α and IL-6.Moreover, the protein expression of IKKβ and NF-κB was significant decreased by ligustrazine.CONCLUSION: Ligustrazine inhibits the myocardial inflammation caused by diabetes through anti-inflammatory pathway.

[Objective]To explore the experiences of professor ZHENG Qizhong to use classical prescription treating the cold-heat complex pediatric diseases.[Method]By following professor ZHENG Qizhong, gathering the cases that are all treated by professor ZHENG Qizhong to treat pneumonia asthma case using Xiao Qinglong Decoction plus Shigao, abdominal pain and diarrhoea cases using Banxia Xiexin Decoction, diarrhoea and pertussis cases using Wumei pill, pneumonia asthma accompanied by diarrhea case using Mahuang Shengma decoction, analysing the mechanism of the upper prescription and the clinical experiences of treating cold -heat complex paediatric diseases. [Results] Cold -heat complex paediatric diseases are very common in paediatric acute or chronic diseases, professor ZHENG Qizhong has an original idea and in -depth study of classical prescription, and using them flexibly to treat various paediatric diseases such as pneumonia asthma, abdominal pain, diarrhea, pertussis, etc, and always acquires good results. [Conclusion]The clinical experiences of ZHENG Qizhong using the classical prescription to treat Cold-heat Complex Paediatric Diseases is effective and has the value to study, popularization and application.

Objective? To explore the status quo of nurses' dementia care-related literacy, caring behavior and career identity, to discuss the effects of caring behavior and career identity on dementia care-related health literacy, and to provide a basis for nursing management and professional training. Methods? In this cross-sectional study, totally 650 nurses from 10 Class Ⅲ Grade A hospitals in Beijing who had provided care in departments of geriatrics or neurology were selected by convenient sampling between April and November 2017, and investigated with the General Information Questionnaire, Caring Dimensions Inventory(CDI), Career Identity Rating Scale and Dementia Care-related Health Literacy Scale. Totally 650 questionnaires were distributed, and 602 valid questionnaires were collected, with a recovery rate of 92.6%. Results? The 602 nurses' total scores of dementia care-related health literacy, caring behavior and career identity were (74.79±7.96), (88.87±5.02) and (84.35±9.14), respectively. Correlation analysis showed that nurses' caring behavior and career were positively correlated with dementia care-related health literacy, respectively (P＜ 0.01). Hierarchical regression analysis showed that general information, caring behavior and career identity accounted for 74.5% of total variances of dementia care-related health literacy in which caring behavior could account for 33.2% and career identity 34.2%. Conclusions? Nurses' career identity and caring behavior were supplementary to their dementia care-related health literacy, which can enhance their career identity, standardize their caring behavior and improve their dementia care-related health literacy, thus providing better care services for patients with dementia.

Objective To investigate the association of Mycoplasma pneumoniae(MP) infection with disease activity of ankylosing spondylitis. Methods A total of 158 subjects in our hospital were enrolled in this study, including patients with ankylosing spondylitis(AS, n=66), rheumatoid arthritis (RA, n=31),osteoarthritis(OA, n=25) and normal controls(NC, n=36). MP infection was defined as anti-MP IgM antibody positive. Anti-MP IgM antibodies were determined by a mycoplasma pneumoniae(Mac strain)membrane-based agglutination test. AS patients were divided into two groups: MP infection group and non-MP infection group. T-test was used for statistical analysis of age, blood white cells, ESR, CRP, immunoglobulin, BASDAI index, global assessment on VAS scale, Schober test and chest expansion reflecting spinal mobility.χ2-test was used to compare the positive rate of MP infection in different groups. Gender difference and prevalence of clinical infection in past four weeks between MP infection and MP-free group in AS patients was also compared. Ridit analysis was used to analyze the association of MP infection with degree of sacroiliac damage on CT. Results The prevalence of MP infection in AS (52%, 34/66) was much higher than that in rheumatoid arthritis (RA, 6%, P＜0.01 ), osteoarthritis(OA, 4%, P＜0.01 ) and normal controls (NC, 11%, P＜0.01) . Compared with the non-MP infection group, the MP infection group had more active disease in term of BASDAI(4.0±1.1 vs 3.0±1.9, P=0.017), ESR[(44±32) mm/1h vs (28±23) mm/1h, P=0.029], CRP [(40±38) mg/L vs (22±21) mg/L, P=0.025] serum total IgG level [(18±3) g/L vs (16±5) g/L, P=0.027],but not in serum total IgA and IgM. Regarding to the sacroiliac joint and spinal mobility, MP infection group did not exhibit any association with the sacroiliac grading on CT, Schober test and expansion. In AS patients with MP infection, only 44.1%(15/34) was complicated by clinical manifestations of upper respiratory tract in the past 4 weeks. However, a higher prevalence of MP infection was found in AS patients with clinical manifestation of upper respiratory tract, compared with those with negative clinical manifestation(71% vs 42%,P=0.027). Conclusion Mycoplasma pneumoniae is the most common reported pathogen in ankylosing spondylitis and relates to the disease activity of AS. MP infection is probably a principal triggering factor in the pathogenesis of AS.

Objective? To review the meta-analysis of lifestyle risk factors for Alzheimer disease in order to find out the quality of the current articles and to provide evidence for preventing Alzheimer disease. Methods? CNKI,Wanfang,CBM,PubMed、EMBASE、ProQuest、Cochrane Library were searched on computer for Meta-analyses in lifestyle risk factors of Alzheimer disease. Two authors independently selected the articles,extracted data,and used JBI to evaluate the quality of literature system evaluation and the evaluation method of meta-analysis evidence grade for methodological and evidence quality evaluation. Results? A total of 34 articles were included which involved smoking,alcohol consumption,exercise,social activities,sleep, diet,coffee/tea. Among them, the effects of smoking and drinking alcohol and coffee/tea need further support by evidence. Conclusions? Intervention on lifestyle can be effective in preventing Alzheimer disease,however, more high quality original studies are needed to explore more risk factors of Alzheimer disease.

Objective? To explore the status quo of sense of career successfulness, emotional intelligence and psychological resilience and the effects of emotional intelligence and psychological resilience on sense of career successfulness, and to provide a reference for stabilizing and managing the community nursing team. Methods? Totally 380 in-service nurses were selected from a community health service center in Beijing using convenient sampling between April and May 2019. A cross-sectional questionnaire survey was conducted with the self-designed questionnaire, Sense of Career Successfulness Scale (SCSS), Schutte′s Emotional Intelligence Scale-Chinese (SSEIS-C) and Connor Davidson Resilience Scale (CD-RISC). Results? A total of 380 questionnaires were distributed and 352 valid questionnaires were returned. The SCSS score of the 352 community nurses was (73.09±13.61), their total SSEIS-C score was (78.98±12.29), their total CD-RISC score was (88.01±14.79). Univariate analysis results showed that different marital status, with or without children, post satisfaction, job satisfaction, monthly income satisfaction, nurse-patient relationship satisfaction, colleague relationship satisfaction, cooperation relationship satisfaction, interest in management, research or specialty affairs, occupational development, manifestation of self-worth and decision to or not to quit were the influencing factor of the professional success of community nurses(P＜ 0.05). Psychological resilience and emotional intelligence were significantly and positively correlated with sense of career successfulness. A hierarchical regression analysis revealed that general demographic data could account for 32.4% of the total variable of sense of career successfulness in community nurses; emotional intelligence could account for 14.4%;and psychological resilience could account for 11.7%. Conclusions? The sense of career successfulness in community nurses stands at a medium level, which is correlated with multiple factors such as their research work, nurse-patient relationship satisfaction, special interest, emotional intelligence and psychological resilience. Community health services should pay attentional to these factors and improve their sense of career successfulness by enhancing their emotional intelligence and psychological resilience.