Objective To investigate application of local anesthesia on the success rate of PICC. Methods A retrospective analysis was carried out in patients (120 cases)receiving PICC from March 2004 to January 2006. Randomly selected 120 cases were divided into 2 groups, each with 60 cases and PICC was im-plemented with the conventional method or under local anesthesia respectively in the two groups. Psychological changes of patients and nurses,adverse reactions of pain, success rate and incidence rate of complications were observed. Results The two groups were different in the following aspect, success rate, psychological changes, adverse reactions of pain,etc (P<0.01). Conclusions Local anesthesia during PICC is conducive to raise the success rate of tube insertion and the elimination of other adverse factors, especially for coarse PICC suite.

Objective To observe the clinical efficacy and adverse drug reactions of three dimensional-conformal radiotherapy combined with oral capecitabine in the treatment of stage Ⅱ , Ⅲ rectal cancer after operation. Methods Sixty-three patients of stage Ⅱ ,Ⅲ rectal eancer after operation with informed consent were divided into two groups by random digits table, 33 cases of observation group were treated by three dimensional-conformal radiotherapy combined with oral capecitabine, 30 cases of control group were treated by three dimensional-conformal radiotherapy only. Results The total effective rate in observation group was 84.8% (28/33), it was higher than that in control group [63.3% (19/30)], the difference between the two groups was statistically significant (P < 0.05). The occurrence rate of adverse reactions in two groups were compared, the difference was not statistically significant [57.6%(19/33) vs.50.0% (15/30)] (P>0.05). Conclusion Three dimensional-conformal radiotherapy combined with oral capecitabine in the treatment of stage Ⅱ,Ⅲrectal cancer after operation has satisfactory effect and acceptable adverse reaction, it is worth generalizing and applying.

The primary immunotherapy for gastric cancer includes cytokine therapy,monoclonal antibody therapy, and cancer vaccines. A lot of researches are being conducted to study gene immunotherapy. It has found that Cbl-b gene plays an important role in regulating anti-tumor immunity and Cbl-b protein is involved in the lymph node metastasis of gastric cancer. Silencing Cbl-b gene in T lymphocytes can enhance anti-tumor immunity,therefore may become an effective treatment for patients with advanced gastric cancer.

Objective To study the significance of combined detection of lung resistance protein(LRP),P-glycoprotein(P-gp),glutathione S-transferace-?(GST-?) and topoisomeraseⅡ(TopoⅡ) in gastric cancer prognosis judgment.Methods One hundred and thirty-six patients with human gastric carcinomas were studied for the expression of LRP,P-gp,GST-?and TopoⅡ by using immunohistochemistry.Results There were significant relationships in the positive expression rate of LRP,P-gp,GST-?between high-Medium differentiated adenocarcinoma and Poorly differentiated adenocarcinoma,Mucinous carcinoma,and Undifferentiated carcinoma(P

Objective To observe the role of mesenteric lymphatic pathway in severe acute pancreatitis (SAP)by detection of inflammatory factors levels and mesenteric lymph duct ligation in rats.Methods Twenty-four SD male rats were randomly divided into group A (SAP group),group B (SAP + mesenteric lymph duct ligation group)and group C(sham operation group),with eight rats in each group.Samples of portal vein blood and mesenter-ic lymph were collected for measuring the level of tumor necrosis factor α(TNF-α),interleukin 1β(IL-1β),interleu-kin 6(IL-6)and endotoxin at twelfth hour.The blood CDl b was tested at sixth hour.24h lactulose /mannitol excretion ratios(L/M)were taken as the intestinal mucosal permeability index by gavage of 100mg lactulose and 50mg mannitol solution.The terminal ileums were collected for pathological examination.Results The blood levels of endotoxin and cytokines(TNF-α,IL-1β,IL-6)were significantly increased in group A compared with group C(all P <0.01).Each factor′s concentration in lymph was much higher than that in portal vein blood,especially in group A.The endotoxin and cytokines(TNF-α,IL-1β,IL-6)levels in portal vein blood of group B were significantly decreased compared with group A(all P <0.05),but still higher than that of group C(all P <0.05).CDl b expression in group A was the highest,followed by group B,group C was the lowest (P <0.01).24h L/M in group A was significantly higher than that in group C (P <0.01),and L/Min group B decreased significantly compared with those in A group(P <0.05). Conclusion Lymphatic pathway is an important pathway of systemic inflammatory response induced by SAP,and ligation of mesenteric lymph duct has a protective effect on the organism.

Erythropoitin producing hepatocellular receptors(Ephs) and their ligands ephrins,the largest subset of tyrosine protein kinase receptor family,play a key role in the adhesion,orientation,migration and differentiation of cells.Eph and Ephrins are found closely correlated with tumorigenesis and development in human gastrointestinal tumors,especially colorectal cancer.The members of Ephs and ephrins show diverse expression in intestinal epithelial cells.Studying the mechanism and role of Ephs and ephrins on the malignant tumor occurrence and development will provide more accurate clinical basis for the treatment of colorectal cancer.

Objective To investigate the clinical efficiency and security of Fe(OH) 3-sncrose-compond combined with erythropoietin on renal anemia.Methods 30 cases of oral iron combined with erythropoietin in the unsatisfactory uremia patients undergoing maintenance hemodialysis,the cases were randomly divided into two groups:the treatment group(n =16) using intravenous sucrose iron 100mg,twice a week,after a total of 1000mg,then l00mg,once 1 -2 weeks;the control group(n =14) continue to oral:ferrous succinate 0.2g,three times everyday,erythropoietin dose was the same in lothgroups for g weeks.Results Hemoglobin was significantly higher(P ＜ 0.01) and hematocrit was significantly higher(P ＜0.01),and serum ferritin significant increased(P ＜0.0l) in sucrose iron treatment group than these of the control group;the patients of treatment group have obviously improved in spirit,appetite,physical and life quality and so on.Sometimes,nausea,vomiting,skin itching were complained lut without significant side effects.While in the control group limited increase in the level of hemoglobin was seen,the majority had nausea,abdominal discomfort,poor appetite.Conclusion The efficiency of intravenous sucmfer combined with erythropoietin in treatment of renal anemia was effective than conventional oral iron combined with erythropoietin and with fewe adverse reactions.

Objective To acknowledge the psychological authority status under the foundation of autho0rization management,in order to analyze the effectiveness of authorization management.Methods 364 clinical nurses were investigated with Psychological Empowerment Scale and the results were performed statistic analysis through descriptive statistical method and variance analysis.Results The average score of clinical nurses was(3.22±0.70),which was at the moderate point.The four dimensional scores listed in descending order were self efficient,career significance,autonomy and job influence.Clinical nurses of different ages,different ranking,different working period,different marriage status had statistical outstanding variance.But nurses of different education background showed no significant difference in score of each dimension.Conclusions The nursing management shall not only focus on the authorization management itself,but also on the psychological authority status of clinical nurses.Through an efficacious incentive,we can enhance the psychological recognition and experience on authorization and activate the working motivation,maximize the working initiative and thus promote the innovation and expansion of nursing work.

Abscess ; Anus Diseases ; Cough ; Fever ; Humans

Klebsiella pneumoniae is one of the most important gram-negative bacteria clinically. Klebsiella infections are seen mostly in people with a weakened immune system.Klebsiella can cause infec-tions in the respiratory tract,urinary tract,lower biliary tract,and surgical wound sites.The range of clinical diseases includes pneumonia,thrombophlebitis,urinary tract infection,pyogenic liver abscess,cholecystitis,di-arrhea,upper respiratory tract infection,wound infection,osteomyelitis,meningitis,and bacteremia and septi-cemia.The most common condition caused by Klebsiella bacteria is pneumonia,and the worst condition is septic shock.Klebsiella organisms are often resistant to multiple antibiotics.Klebsiella with the ability to pro-duce extended-spectrum beta-lactamases is resistant to many classes of antibiotics.Therefore,prevent sprea-ding Klebsiella infections and give effective treatment to patients are most important task for us.