Ninety specimens of pathologically confirmed transitional cell carcinoma of the urinary bladder were studied. The patients consisted of 71 male and 19 female with a male/femai ratio of 3.5:1. Their age was ranged from 32 to 79. 12 specimens were studied with electron microscope. The histopathological and ultrastructural features of transitional cell carcinoma were described. Our fol-lowup data of the cases revealed that the larger a tumor,the lower its differentiation, the deeper its invasion, and the more extensive the involvement of lymphatic and blood vessels, the poorer the prognosis of the tumor. In addition the ultrastructural characteristics of transitional oell carcinoma were briefly discussed.

0.05). Positive medicine group, Qingqinye high dosage group, Qingqinye low dosage group and Qingqinye middle dosage group reduced blood ADA activity and better than model group (P

Objective:To evaluate the effectiveness of hierarchical management for patients with bronchial asthma.Methods:One hundred and eighty seven patients with bronchial asthma were recruited from January 2018 to November 2019 in Daxing District People′s Hospital. Patients were randomly divided into two groups, 94 patients received disease management education and therapeutic guidance from doctors in the community hospital and district hospital (study group), and 93 patients were followed up in outpatient visits only (control group). After one year, the scores of inhalation technique, treatment adherence, disease management awareness, the Asthma Control Test (ACT), the Mini Asthma Quality of Life Questionnaire (MiniAQLQ) and pulmonary function were evaluated and compared between two groups. The annual acute attack times and time to first exacerbation were also compared between the two groups.Results:After one year of management the treatment adherence rate in study group was higher than that in control group [80.85% (76/94) vs. 51.61% (48/93), χ2=2.834, P=0.02]. The scores of inhaled corticosteroids (ICS) inhalation technique [(6.47±1.28) vs. (4.05±1.37), t=2.241, P=0.04], the correct rates of exhaling before ICS inhalation [94.68% (89/94) vs.56.98% (53/93), χ2=4.436, P=0.01],inhalation [90.43%(85/94) vs.68.82% (64/93),χ2=2.943, P=0.04],holding breath after inhalation [89.36% (84/94) vs.58.06% (54/93),χ2=4.098, P=0.02],rinsing mouth after ICS inhalation [92.55%(87/94) vs.65.59%(61/93),χ2=2.876, P=0.04] in study group were higher than those in control group. The awareness rates of chronic inflammatory airway disease [70.21%(66/94) vs.44.08% (41/93),χ2=2.673, P=0.02], causative factors [85.10% (80/94) vs. 56.99% (53/93),χ2=2.760, P=0.02],treatment misunderstanding [88.29%(83/94) vs.53.76%(50/93),χ2=4.874, P<0.01], therapeutic goal [86.17% (81/94) vs. 49.46% (46/93),χ2=4.491, P<0.01] and requiring long-term treatment [90.43% (85/94) vs.48.38% (45/93),χ2=4.503, P<0.01] in study group were higher than those in control group. The scores of ACT [(22.71±2.81) vs. (19.50±5.34), t=2.041, P=0.04] and miniAQLQ [(84.28±11.16) vs. (64.23±14.38), t=3.298, P<0.01] in study group were higher than those in control group. The number of annual acute exacerbation was less [0(0, 1) vs.2(1, 3), Z=-3.237, P<0.01] and the time to first exacerbation was longer [184(96, 284)d vs. 96(59, 177)d, Z=3.873, P<0.01] in study group than those in the control group after one year of management. Conclusion:The hierarchical management can effectively enhance the inhalation technique and treatment adherence of the patients with bronchial asthma, and improve the quality of life of patients.

Objective To study the psychological status of patients having undergone eyeball enucleation,and put forward the corresponding strategy for psychological nursing.Method The symptom checklist-90(SCL-90)was used to investigate their psychological status after eyeball enucleation.Result The scores on interpersonal relationship sensitivity factor,depression factor, anxiety factor and terror factor(28?78±0?61),(40?76±0?65),(33?86±0?62)and(23?88±0?46),respectively.Conclusions Pertinent psychological nursing may help patients to eliminate the adverse emotional and psychological pressures,promoting them to develop a good state of mind,and return to the society better?

The author used five Chinese medicinal herbs,Barbat skullcap,Wolly yam,Anemarrhena,Phellodendron bark,and Dandelion herb,to make up decoctions to treat urinary tract infection(UTI). Ex-trinsic bacteriostatic experiments for colibacillus and bacillus proteus,which commonly occure in urinarytract infection,were observed.The result shows that both Barbat skullcap and Wolly yam are most effectivein treating UTI.So single Chinese medicinal herb can also be used in clinical.

Objective: To investigate the effect of early intervention on the prevention of delirium in patients undergoing elective surgery. Methods: Totally 200 patients scheduled for surgery and admitted to ICU during Oct. 2016 to Jun. 2018 were assigned to two groups (n=100). Both the observation group (group A) and the control group (group B) received routine nursing care from wards, operating room and ICU nurses. In addition, the observation group (group A) were intervened by ICU nurses by means of nursing measures to prevent delirium the day before surgery. The differences of delirium incidence, delirium duration, and length of stay in ICU, satisfaction and anxiety scores between the two groups were measured. Results: The incidence and duration of delirium, length of stay in ICU, satisfaction rate of ICU, S-AI scores between group A and B were 16% (16/100) vs. 29% (29/100), 4(3.1, 10.6) h vs. 12(9.2, 14.6) h, (33.06 ±16.06) h vs. (39.96±25.47) h and (56.25 ±5.74) vs. (41.59 ±4.94), (50.17±1.56) vs.(52.37±3.52) respectively (χ²=4.129, Z=-2.757, t=2.291,-19.349, 5.718, all P < 0.05). Conclusion Early intervention can effectively prevent and reduce the incidence of ICU delirium in patients undergoing elective surgery.

ObjectiveWe conducted a drug resistance and homology analysis of diarrheagenic Escherichia coli （DEC） in Fengxian District of Shanghai in order to provide a basis for clinical rational drug use， risk monitoring and early warning. MethodsDEC were isolated from diarrheal patients in Fengxian District， Shanghai from 2019 to 2022. The minimum inhibitory concentrations （MIC） of 21 drugs to the DEC were determined. Genotyping and homology analysis were conducted with pulsed-field gel electrophoresis （PFGE）. ResultsThe DEC detection rate of diarrhea cases was 18.99% （131/690）， including enteroaggregative E.coli （EAEC） 64.89% （85/131）， enterotoxigenic E.coli （ETEC） 22.14% （29/131）， enteropathogenic E.coli （EPEC） 12.21% （16/131）， and enterohemorrhagic E.coli （EHEC） 0.76%（1/131）. The DEC detection showed obvious seasonal characteristics with a high incidence in summer. The DEC multidrug resistance rate was 66.41% with a total of 65 drug resistance profiles. The five antimicrobial drugs with the highest resistance rate were ampicillin （60.31%）， nalidixic acid （51.91%）， cefazolin （50.38%）， tetracycline （44.27%）， and cotrimoxazole （35.11%）. The rate of DEC resistance to levofloxacin was significantly increased from 2019 to 2022. Cluster analysis showed that the similarity of 85 EAEC cluster was 58.4%‒100.0%， and 69 band patterns were obtained. The similarity of 29 ETEC cluster was 58.5%‒100.0%， and 13 band patterns were obtained， including 2 dominant band types. The similarity of 16 EAEC clusters was 53.9%‒100.0%， and 15 band patterns were obtained. Five groups of homologous strains were found， consistent with the resistance phenotypes. ConclusionAmong the diarrhea cases， the DEC epidemic intensity is high， the drug resistance situation is severe， and the risk of outbreak infection is high in Fengxian District， Shanghai. Therefore， health monitoring and prevention need to be strengthened.

Objective To explore the effect of Numb on tubular epithelial-to-mesenchymal transition (EMT) in rat proximal epithelial cells. Methods NRK52E cells were treated with different concentrations of recombinant human transforming growth factor-β1 (TGF-β1) (0, 1, 5, 10, 15, 20 μg/L) for 48 h or 10 μg/L TGF-β1 for different times (0, 24, 48, 72 h) in vitro. The expressions of E-cadherin, a-smooth muscle actin(α-SMA) and Numb in NRK 52E cells were detected by RT-PCR, Western blot and immunofluorescence staining. Meanwhile Numb siRNA oligo was transfected into NRK 52E cells with lipofectamine before TGF-β1 treatment, then Western blot was applied to detect the protein expression of E-cadherin, α-SMA and Numb in NRK52E cells. Results TGF-β1 could induce EMT in NRK52E cells in dose- and time-dependent manner. During the progress of TGF-β1-induced EMT, the protein expression of Numb in 5, 10, 15, 20 μg/L group was 1.33 folds (P=0.024), 1.39 folds (P=0.035), 1.45 folds (P=0.025), 1.51 folds (P=0.000) respectively as compared to 0 μg/L group. Likewise, the protein and mRNA expression of Numb in 24 h, 48 h, 72 h group was 1.48 folds (P=0.046) and 1.56 folds (P=0.012), 1.54 folds (P=0.011) and 1.82 folds (P=0.008), 1.79 folds (P=0.028) and 1.82 folds (P=0.002) respectively as compared to 0 h group. Moreover, large amount of Numb was accumulated in the cytoplasm. Down-regulation of Numb expression by siRNA transfection did not influence the basal expression of E-cadherin and α-SMA in NRK 52E cells, but attenuated the progression of EMT in NRK52E cells induced by TGF-β1. The up-regulation of α-SMA protein was reduced to 18.1% (P=0.004) while the down-regulation of E-cadherin protein was reversed to 2.19 folds (P=0.004). Conclusion Numb can promote EMT in rat proximal epithelial cells.

Objective To provide evidence for a more reasonable method of determining red bone marrow dose by analyzing and comparing existing simulation methods.Methods By utilizing Monte Carlo simulation software MCNPX,the absorbed doses of red hone marrow of Rensselaer Polytechnic Institute (RPI)adult female voxel phantom were calculated throush 4 different methods:direct energy deposition.dose response function(DRF),King-Spiers factor method and mass-energy absorption coefficient (MEAC).The radiation sources were defined as infinite plate.sources with the energy ranging from 20 keV to 10 MeV.and 23 sources with different energies were simulated in total.The source was placed right next to the front of the RPI model to achieve a homogeneous anteroposterior radiation scenario.The results of different simulated photon energy sources through different methods were compared.Results When the photon energy was lower than 100 key,the direct energy deposition method gave the highest result while the MEAC and King-Spiers factor methods showed more reasonable results.When the photon energy was higher than 150 keV taking into account of the higher absorption ability of red bone marrow at highcr photon energy,the result of the King-Spiers factor method was larger than those of other methods.Conclusions The King-Spiers factor method might be the most reasonable method to estimate the red bone marrow dose from external radiation.

Objective To study the calculation of the room shielding thickness of tomotherapy accelerator,a new type of radiotherapy facility,especially the impact of the beam block on the shielding design.Methods According to the relevant standards,combined with the room geometry,the shielding thickness was calculated without the presence of the beam block,considering the primary beam,the scattered beam and leakage.Meanwhile,the shielding thickness was also calculated as comparison with the presence of the beam block,based on the characteristics of tomotherapy facility and its radiation field.Results There was statistical difference between the shielding thicknesses calculated with the presence of the beam block and those without the beam block,to the primary beam direction including the south wall,north wall,the roof and the floor,the shielding thickness were decreased by 95.59%,63.63% ,80.73%and 51.30% ,respectively.Conclusions For the tomotherapy accelerator,the beam block could be of great help to minify the shielding thickness of the room.The radiation field of the tomotherapy facility could be used for the calculation to improve accuracy,and the shielding thickness can also be estimated by subtracting the initial shielding thickness without beam block of the beam block equivalent thickness in the primary beam direction alternatively.