Objective To explore the pressure of hospitalized patients and protrudent problem of mental stress.Methods Choosing 150 non-psychiatric patients in random for investigation using mental status scale in non-psychiatric patients.At last, data were analyzed to find out the stressors they were bear-ing in hospital.Results There existed mental pressures in hospitalized patients in some degree."to ex-pect to recover health early" was the highest score (7.21±3.17), and "to worry about their position de-creased after disease" got the lowest score, (2.56±2.15).The mental stress of hospitalized patients was cor-related with age, sex, education degree, income and marital status.Conclusions There existed mental pressures in hospitalized patients in some degree.Different mental stressor shows different psychological re-action, we should take different measures to improve the life and nursing quality of hospitalized patients.

Objective To observe the effect of physical factors and promotion canalization on closed injury of brain.Method 68 cases of closed injury of brain were given the comprehensive rehabilitation therapy with many physical factors and promoting canalization technique.Result The patients' consciousnesses were significantly improved after treatment.The motorial function of hemiplegic limbs was distinctly improved(P< 0.05).The balance functions were distinctly improved(P< 0.001).The activities of daily living abilities were significantly improved(P< 0.05).Conclusion The physical factors and promoting canalization treatment on the closed injury of brain are functionally effective.

Objective To study the force and pressure transmission through normal wrist,and the effect of transverse carpal ligament release on the biomechanics of carpal tunnel.Methods A 3-D finite element model of the wrist based on CT scan images was established.The load transmission of carpus and the distribution of contact stress on radiocarpal joint under axial compressive force on metacarpals as well as the effect of transverse carpal ligament(TCL)release on the displacement of carpal bones were computed and analyzed.Results The computational results of force and pressure transmission through normal carpus matched well with previous studies.The release of TCL resulted in radial and palmar displacement of the scaphoid,flexion and radial rotation of radiocarpal joint as well as a further radial deviation of the whole carpal tunnel.Conclusion A 3-D finite element model of the wrist that includes the carpal tunnel,distal radius and ulna and proximal metacarpals is developed.This model may simulate the load transmission better and contact stress distribution of carpal tunnel and radiocarpal joint,as well as provide an operational plateform for further deeply studing on biomechanical behavior of carpal structure.The computed and analyzed results of the effect of TCL release on the displacements of carpal bones can be served as related theoratic base on carpal tunnel syndrome,carpal tunnel release surgery and recovery after operation.

From 1975 to 1976,in Linxian county of Henan province,52 patients with early stage easophageal carcinoma were treated by radiotherapy alone. After 10-year follow-up, the 5-and 10-year surving rates were 73.1%(38/52) and 50.0%(56/52), respectively. Local recurrence was considered as the major cause of death and distance metastasis as the minor. We believe that it is very important to do the "three early "(find early, diagnose early and treat early ) and D T5000～5500cGy/5～5.5wks may be the best dose for radiotherapy alone for early easophageal carcinoma.

Objective To investigate the correlation between Dishevelled protein expression and the proliferation and invasion of glioma cells.Methods 67 cases of brain glioma specimens were collected.The expression of Dishevelled protein was detected with immunohistochemical method.The immunoreactivity score (IRS) of Dishevelled protein,and proliferation index (PⅠ) and invasion index (Ⅱ) were measured and their correlations were analyzed.Results The positive rate of Dishevelled protein in glioma was 65.7 ％ (44/67).IRS,PⅠ and Ⅱ were 4.15±3.13,(30.93±17.92) ％,(20.38±13.36) ％,respectively.Both PⅠ and Ⅱ significantly increased with an increase in the pathological grade of brain glioma (P ＜ 0.001).Furthermore,PⅠ and Ⅱ were significantly higher in the Dishevelled protein-positive group than those in the Dishevelled protein-negative group [(38.27±17.60) ％ vs (16.02±8.92) ％ of PⅠ and (30.03±13.81) ％ vs (10.63±4.41) ％ of Ⅱ,respectively,P ＜ 0.001].PⅠ and Ⅱ of glioma cells were positively correlated with IRS of Dishevelled protein (r =0.940 between PⅠ and IRS,and r =0.953 between Ⅱ and IRS,respectively).Conclusion Dishevelled protein plays an important role in the proliferation and invasion of brain malignant glioma.

Objective To explore and evaluate the efficacy and safety of mechanical thrombectomy with the Solitaire AB Revascularization Device in acute basilar artery occlusion.Methods Nine patients with basilar artery occlusion were treated with direct thrombectomy by using Solitaire AB stent retrievers between August 2010 and October 2012.Stent angioplasty was performed for patients with serious residual stenosis.Neurologic status was evaluated before and after treatment according to the National Institutes of Health Stroke Scale (NIHSS) and modified Rankin scales (mRs).Neurologic status was evaluated after treatment according to the NIHSS and mRs 6 months after stent placement.Stent patency at follow-up was assessed by MR angiography,or DSA 6 months after stent placement.Results Successful revascularization was achieved in all patients.Stenting and angioplasty were performed in 6 patients with serious residual stenosis.The complication of cerebral hemorrhage did not occur in any patient.Acute thrombosis happened in one patient one day after procedure.Emergent angiography showed re-occlusion of basilar artery.Intraarterial thrombolytic therapy was given,and reperfusion was achieved,but the patient died 6 days later.One patient developed coma at 4th month of follow-up.MRA showed acute basilar artery occlusion again and magnetic resonance imaging showed extensive ischemic damage of the brainstem.The patient died during the conservative treatment period.The mean NIHSS scores were 2.4 ± 1.2 at discharge.The mRs scores were 0 in 2 patients,1 in 4 patients,2 in one patient,and 3 in 1 patient at discharge.Conclusion Mechanical thrombectomy with the Solitaire AB stent in acute basilar artery occlusion is relatively safe and effective.

Objective To investigate the expression and signification of B-cell lymphoma/leukemia-2(bcl-2),bax and ER proteins in epithelial cells in different depth of adenomyosis.Methods Expression and correlation of bcl-2,bax and ER proteins were detected by immunohistochemistry staining in 36 adenomyosis cases with superficial (＜ 1/2 depth of penetration) and deep (≥ 1/2 depth of penetration)ectopic endometrium and eutopic endometrial tissues matched with 30 cases with benign ovarian tumor,uterine septum,pelvic floor dysfunction without adenomyosis as controls.Results (1) The expression of ER protein in superficial and deep ectopic tissues (5.04 ±0.24,4.91 ±0.16) were found significantly lower than 6.06 ± 0.36 in eutopic tissues (P ＜ 0.01) and higher than 3.70 ± 0.58 in control group (P ＜ 0.05).There was no statistical difference of ER expression in superficial and deep ectopic endometrium (P ＞ 0.05).(2) The level of bcl-2 protein of 5.6 ± 0.4 in superficial and 6.0 ± 0.3 in deep myometrium of ectopic tissues were significantly higher than 3.6 ± 0.4 in eutopic tissues and 1.9 ± 0.4 in control group (P ＜ 0.01).(3) The level of bax protein of 3.50 ± 0.28 in superficial and 4.80 ± 0.29 in deep myometrial ectopic and 4.43 ± 0.37 in eutopic tissues were significantly lower than 6.18 ± 0.65 in control groups (P ＜0.05).The expression of bax in superficial myometrium is significantly lower than deep myometrium in ectopic tissues (P ＜0.01).(4) The positive correlation between the expression of ER and bcl-2 protein at superficial myometrium of ectopic tissues (r =0.720,P ＜ 0.01).And there was no significant correlation with the expression of ER and bax protein at superficial myometrium (r =0.008,P ＞ 0.05).As well as,there was not significant correlation with the expression of bcl-2,bax and ER protein at deep myometrium (r =0.089,r =-0.023,P ＞ 0.05).The expression of bax protein in ectopic endometrium was positive correlation with the depth of adenomyosis penetration (r =0.736,P ＜ 0.01).There was positive correlation between the expression of ER and bcl-2 protein at normal endometrium (r =0.453,P ＜ 0.05).And there was negative correlation between the expression of ER and bax protein at control group (r =-0.514,P =0.05).Conclusion The bax protein expression of ectopic endometrium in deep adenomyosis was higher than superficial adenomyosis.

Objective To study the feasibility of endoscopically subcutaneous mastectomy and immediate mammary prosthesis reconstruction.Methods From December 2006 to October 2007，9 breast cancer patients underwent endoscopic skin sparing mastectomy and immediate implanting breast reconstruction，with preoperatively performed systemic TE chemotherapy two to six times.Whether or not the nipple-areola complexes were preserved depended on the results of frozen pathological examination.Results Of 9 patients，bilateral skin sparing mastectomy were performed in two patients，and others underwent single lateral masteetomy with the nipple-areola complexes，at the same time sentinel lymph node biopsy was done in 8 cases of all.Combined level Ⅰ and Ⅱ axillary dissections were carried out vvia the sarne incisions underthe axillaries in 7 patients，and 2 patients spared axillary dissections.8 of them got satisfactory results，one patient did not.The postoperation complications included subcutaneous seromas 1 case，epidermic nipple necrosis 1 case and bleeding of skin flap 1 case.No local reeurrence occurred during the follow-up ranged 1～10 months.Conclusion It is technically safe and feasible that endoscopically subcutaneous mastectomy with immediate mammary prosthesis reconstruction.The technique can minimize skin incision With little trauma,and offers a greater esthetic advantage tomostpatients.

Objective To explore the effect of the improved abdominal rotation card method in insulin injection. Methods A total of 100 hospitalized diabetes patients were randomly divided into control group (n=50) and observational group (n=50) according to the random number method. In the control group, insulin was injected to the subcutaneous tissue of abdomen with traditional method annular rotating method. Insulin was injected using improved abdominal rotation card method in the observational group. Compare accuracy and mastery rate of injection site rotation between the two groups. Compare fasting blood glucose (FBG), postprandial 2H blood glucose (PBG), HbA1c, the incidence of hypoglycemia and endermic induration between the two groups after three months. Results The nurses in the observation group had higher accuracy rate of the injection site rotation compared to the control group [98.6%(690/700) vs. 38.6%(270/700),χ2=584.66, P<0.01]. Mastery rate of the injection site rotation for the patients in the observation group were significantly higher than the control group [70.0% (35/50) vs. 20.0% (10/50), χ2=25.74, P < 0.01]. The incidence of endermic induration were significantly lower in observation group compared to the control group [2.0% (1/50) vs.16.0% (8/50), χ2=5.98, P < 0.01]. The incidence of hypoglycemia were significantly lower in observation group compared to the control group [4.0%(2/50) vs. 16.0%(8/50),χ2=4.00, P<0.01]. Conclusions The new abdominal rotation method in insulin injection can be a safe and effective therapy in patients with type 2 diabetes.

Objective To explore the relationship of thyrotropin receptor antibody (TRAb) and soluble intercellular adhesion molecule-1 ( sICAM-1 ) in patients with thyroid-associated ophthalmopathy ( TAO), and the role played by TRAb and sICAM-1 in the pathogenesis of TAO. Method Twenty-three TAO patients were assigned to groups according to the clinical activity score and EUGOGO. All patients were treated with intravenous methylprednisolone pulse. The levels of serum TRAb and sICAM-1 were evaluated by a competitive radioimmunoassay and enzyme-linked immunosorbent assay respectively before treatment and by the end of each methylprednisolone pulse. Results The differernce in serum TRAb levels was associated with activity scores of TAO (P=0. 020). The change in serum sICAM-1 was associated with durations of TAO ( P = 0.015). During methylprednisolone treatment in active TAO patients, the levels of TRAb kept on decreasing gradually and markedly declined after the third methylprednisolone pulse in active TAO patients (P＜0.05). The trends of changes in serum TRAb and sICAM-1 levels were both different in active and inactive TAO patients by tendency analysis. Conclusion TRAb level was related to the activity of TAO and might serve as a significant predictor of response to methylprednisolone therapy. The negative correlation between sICAM-1 levels and duration of TAO corroborates the role played by ICAM-1 during the early stage of TAO. Higher sICAM-1 levels are not expected to be specific to TAO and may not predict a response to methylprednisolone therapy.