Comorbid depression and chronic pain are highly prevalent in individuals suffering from physical illness .Here, we critically examine that inflammation is the possible mechanism of comorbidity of pain and depression .These mechanisms include direct effects of cytokines on the neuronal environment or indirect effects via downregulation of G protein -coupled receptor kinase 2, activation of the tryptophan-degrading enzyme indoleamine 2,3-dioxygenase that generates toxic kynurenine metabolites .We review the role of in-flammation in the mechanism of the commorbidity of depression and pain .

The content of carboxylate ions in marine sulfate polysaccharide 911 was determined by conductometric titration. In the mean while, the sample was transformed with cation exchange resin,the molar ratio of sufate ions to carboxylate ions was determined. The results showed that conductometric titration is a simple,rapid and accurate method.

Objective To discuss the significance of different types of human rhinovirus (HRV) as pathogen and the clinical features of different types of HRV in pediatric intensive care unit(PICU).Methods Eight hundred and fifty-two nasopharyngeal aspirates specimen (NPA) were collected from children who were admitted to PICU,the Second Affiliated Hospital of Shantou University Medical College from November 2010 to October 2015 and were tested by using nested reverse transcription-polymerase chain reaction (RT-PCR).Gene fragments for VP4/VP2 capsid protein amplified from HRV positive specimens were sequenced for HRV genotype confirmation.Then clinical characteristics of these HRV positive cases were analyzed.Results Among these 852 specimens tested,214 (25.12％) were HRV positive,including 95 samples(44.39％) positive for HRV-A,17 samples (7.94％) for HRV-B,and 55 samples(25.70％)for HRV-C determined by sequence analysis;while the species of 47 samples (21.96％) of the total were unclassified clearly.HRV-A,HRV-B,HRV-C co-infection with other respiratory viruses accounted for 33.68％ (32/95 cases),29.41％ (5/17 cases),and 29.09％ (16/55 cases),respectively.The clinical characteristics of children infected with HRV-A,HRV-B,HRV-C were similar,and wheezing and polypnea were more common with HRV-C infections than HRV-A and HRV-B infections.The severity among children positive for different groups HRV showed no significant difference (H =0.631,P ＞ 0.05),as well as that between children co-infected with HRV and other viruses and those infected with HRV only (H =0.886,P ＞ 0.05).Conclusions Different types of HRV were major causes of infectious disease in pediatric critical disease.The clinical characteristics of children infected with HRV-A,HRV-B,HRV-C were similar.Wheezing and polypnea were more common with HRV-C infections than HRV-A and HRV-B infections.

Objective To discuss the etiology and clinical characteristics of human rhinovirus (HRV) as pathogen of central nervous system infection .Methods Two hundred and five cerebrospinal fluid (CSF) specimens were collected from children with fever and convulsions who were admitted to the pediatric intensive care unit with suspicion of central nervous system infection from June 2011 to December 2012 .Genome Lab Genetic Analysis System (GeXP) was applied to detect HRV from CSF .Specimens with positive results were amplified by nested reverse transcription‐polymerase chain reaction and followed by gene sequencing . Clinical data of HRV positive cases were analyzed . Results Of the 205 CSF specimens ,7 samples were positive for HRV ,which were composed of 2 HRV‐A ,1 HRV‐B and 4 HRV‐C (including 1 HRV‐Ca) .There were 6 boys and 1 girl among the 7 positive cases for HRV .Six children were less than 3 years old ,except one was 9 years old .The onset time was mainly concentrated between September and October . The main clinical manifestations were fever and convulsions . The clinical diagnosis before the pathogen confirmation included viral encephalitis ,epilepsy ,febrile convulsion ,benign infantile convulsions with mild gastroenteritis (CwG ) and hand‐foot‐and‐mouth disease ( HFMD ) . Although the disease severity of the 7 cases varied ,all ended with favorable prognosis .Conclusions HRV is one of pathogens of viral central nervous system infection .All types of HRV can cause central nervous system infection ,among which HRV‐C accounts for the majority .The clinical manifestations of HRV central nervous system infection could mimic febrile convulsion ,CwG and HFMD .

Background and purpose: With the application of laparoscopy in the liver surgery increasingly widely used, the safety and feasibility of laparoscopic liver resection is gaining recognition gradually. This study aimed to explore the laparoscopic liver resection for the tumor and the feasibility of open liver tumor resection and clinical curative effect. Methods: We retrospectively analysed the clinical data from 37 cases of laparoscopic hepatectomy and 74 patients with open liver resection from Mar. 2015 to Mar. 2016. Measurement data by covariance analysis were obtained, and comparison between groups were made using independent sample with Wilcoxon rank test and statistical value of Z. We collected data including operation time, intra-operative blood loss, post-operative recovery time of gastrointestinal tract, surgical drainage tube after extubation time, length of hospital stay, postoperative complications, hospitalization expenses and other clinical data. Laparoscopic group had 20 males and 17 female aged 18 to 76 (median age 55). Open group had 42 males and 32 females aged 26 to 74 (median age 54). The hepatectomy included ultrasonic knife + unipolar electric coagulation, combined with laparoscopic incision suture. Surgery procedures included 13 cases of local excision in laparoscopic group and 24 cases of liver segment or lobe anatomical resection. Open group had 33 cases of local excision and 41 cases of liver segment or lobe anatomical resection. Results: The average duration of laparoscopic hepatectomy was 149 min (40-204 min). The average duration of open hepatectomy was 142 min (45-190 min). The average intra-operative blood loss was 220 mL (30-570 mL) in laparoscopic group and 360 mL (90-970 mL) in open group. The average length of hospital stay was 4.9 d (3-6 d) in laparoscopic group and 6.8 d (5-9 d) in open group. Gastrointestinal average recovery time was 1.1 days in laparoscopic group and 2.3 days in open group. The average hospitalization expenses were 38760 yuan in laparoscopic group and 39145 yuan in open group. Conclusion:Laparoscopic hepatectomy is a safe, effective and minimally invasive surgery, can be safely used in local, liver segment and half liver resection, worthy of promotion.

ObjectiveTo investigate the association of high-density lipoprotein cholesterol (HDL-C) with the prognosis of patients with alcohol-related hepatocellular carcinoma (HCC) after radical treatment. MethodsA retrospective analysis was performed for the clinical data of 43 patients with alcohol-related HCC who were admitted to The Fifth Medical Center of Chinese PLA General Hospital and underwent radical treatment from January 2008 to July 2015, and according to HDL-C level, the patients were divided into normal group with 26 patients and abnormal group with 17 patients. The two groups were compared in terms of basic information, laboratory markers, imaging indices, Barcelona Clinic Liver Cancer tumor stage, and Child-Pugh class of liver function. The t-test test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between two groups. The Kaplan-Meier method was used to plot survival curves and the log-rank test was used for comparison between groups. Univariate and multivariate Cox proportional hazards models were used to analyze independent risk factors for prognosis. ResultsThere was a significant difference in prealbumin between the two groups (162.38±60.86 mg/L vs 120.06±64.08 mg/L, t=2.184, P=0.035). Number of tumors (hazard ratio ［HR］=2.839, 95%confidence interval ［CI］: 1.120~7.200,P=0.028), tumor size (HR=2.634, 95%CI: 1.062~6.529,P=0037), and HDL-C level (HR=2.400, 95%CI: 1.040~5.537,P=0.040) were independent risk factors for the overall survival of patients with alcohol-related HCC. There were significant differences in 1-, 3-, and 5-year cumulative survival rates between the normal group and the abnormal group (88.5%/72.4%/55.7% vs 70.6%/43.7%/17.5%, χ2=5.881, P=0.015). ConclusionThe reduction in HDL-C level might indicate poor prognosis of patients with alcohol-related HCC.

Objective To explore the application effects of nurse-physician combined outpatient service in peptic ulcer patients. Methods A total of 108 cases of peptic ulcer patients who were being treated in the digestive center of the Affiliated Hospital of Medical College of Ningbo University from January 2015 to February 2017 were recruited in the research by purposive sampling method, and randomly divided into experimental group and control group, with 54 cases in each. Nurse-physician combined outpatient service was provided to the patients in the experimental group, while the patients in the control group received traditional outpatient mode. Disease knowledge, medication compliance and lifestyle were compared between the two groups. Results In the 1st, 2nd and 6th week, patients' disease knowledge in the experimental group was better than that in the control group, and the difference was statistically significant (P<0.01). In the 2nd week, the medication compliance of the experimental group was better than that of the control group, with statistically significant (P<0.05). In the 1st, 2nd and 6th week, the number of smoking and drinking people was less than that of the control group, and the difference was statistically significant (P<0.05). Conclusions The nurse-physician combined outpatient service is beneficial to improve the knowledge level and medication compliance of patients and plays an important role in changing unhealthy living habits.

Objective? To evaluate and summarize the best evidence for management of peristomal irritant dermatitis in patients with a urostomy. Methods? Clinical practice guidelines, evidence summary and systematic review related to peristomal irritant dermatitis were retrieved and screened from various guideline websites and databases (from their founding to July 2018). The quality of these literatures were evaluated with the Appraisal of Guidelines for Research & Evaluation Ⅱ (AGREE Ⅱ) and the Joanna Briggs Institute Critical Appraisal Tools. Evidence was extracted and summarized from high-quality literatures. Results? Totally 7 literatures were included, including 5 clinical practice guidelines, 1 evidence summary and 1 systematic review. Evidence for recognition, evaluation, prevention, treatment, health education and follow-up visits of peristomal irritant dermatitis was summarized. Conclusions? It is recommended that medical institutions refer to the content of evidence summary, make evidence-based practice plans based on the conditions of clinical departments, use the evidence efficiently, and bridge the gap between evidence and practice.

In recent decades, the research on clinical nursing pathways for breast cancer in China mainly explores their nursing benefits when applied in breast cancer patients who undergo surgery, chemotherapy and radiation therapy. However, there is no official clinical nursing pathway for breast cancer yet in China and the pathway formulation methods and norms are uneven in the existing research. Since the research on the formulation of clinical nursing pathways are relatively lacking in China, this article reviews the domestic and foreign literatures from the formulation and clinical application of clinical nursing pathways for breast cancer, with a view to providing reference for the subsequent research on clinical nursing pathways for breast cancer.

OBJECTIVE: To explore the genetic basis for a child with facial dysmorphism and multiple malformations. METHODS: The child, born at 34⁺⁶ weeks' gestation due to premature rupture of amniotic membrane, dichorionic diamniotic twinning and gestational diabetes, was subjected to chromosomal karyotyping analysis and copy number variations sequencing (CNV-seq). RESULTS: The child was found to have facial dysmorphism, hypospadia, cryptorchidism and hypotonia. He was found to have a 46,XY,del(3)(p26) karyotype in addition with a 9.80 Mb deletion (chr3: 60 000-9 860 000) encompassing 33 protein coding genes. CONCLUSION The 3p26.3p25.3 deletion probably underlay the multiple malformations in this child. Continuous follow-up is required to improve his quality of life.
Humans ; Male ; Chromosome Deletion ; DNA Copy Number Variations ; Quality of Life ; Abnormalities, Multiple/genetics* ; Phenotype