Objective To summarize the nursing points for patients with mid-stage hepatocellular carcinoma who are receiving radiofrequency ablation (RFA) combined with 131I-chTNT treatment. Methods The clinical data of 12 patients with mid-stage hepatocellular carcinoma, who were encountered at authors’ hospital during the period from Aug. 2009 to Sep. 2011, were retrospectively analyzed. RFA combined with 131I-chTNT was carried out in all patients. Preoperative prophylactic anti-allergy medication and protection measure for the thyroid were employed. After the operation strengthened radiation protection and close observation for complications were conducted. The results were analyzed. Results After active treatment and proper nursing, the tumor shrank in all patients. All the patients were followed up for 5 - 48 months with a median follow- up time of 31 months. The median overall survival time was 43 months. No serious complications such as bone marrow suppression or thyroid dysfunction occurred. Conclusion For the treatment of mid-stage hepatocellular carcinoma, 131I-chTNT combined with RFA has satisfactory therapeutic effect. Close observation for the occurrence of complications and careful nursing can improve the quality of life and prolong the survival time.

OBJECTIVE To evaluate the commonly encountered pathogens and drng resistance of bacteria causing secondary infection in patients with malignant tumors and provide reference for clinical antimicrobial usage.METHODS Statistical analysis was made retrospectively in the classification and antimicrobial susceptibility testing in 1 204 strains of pathogens isolated from clinical samples of hospitalized patients with malignant tumors from Jan 2003 to Oct 2005.RESULTS Among 1 204 strains,Gram-positive strains accounted for 31.1%;Gram-negative ones accounted for 52.8%;and fungi accounted for 16.1%.The principal strains were Candida albicans,Escherichia coli,Staphylococcus aureus,Klebsiella pneumoniae,and Pseudomonas aeruginosa.The most frequent infection sites were in respiratory tract,urinary tract and skin-soft tissue.Multiple drug resistant rate of Gram-positive and Gram-negative strains had a tendency of elevation.CONCLUSIONS To reduce the coming of drug resistant strains,etiologic examination should be done in treatment of infectious diseases and antimicrobial therapy should be decided according to the results of susceptibility.

The paper analyzed the impact of the trial for "lump-sum prepayment practice of medical insurance" on tertiary hospitals in Shanghai initiated by Shanghai Medical Insurance Bureau since 2009. Based on the analysis, the authors recommended that the hospitals should adapt to the changes by raising quality of care, improving cost accounting, informationizing and refining medical insurance information management, as well as controlling expenses on a rational basis. These approaches will help them adapt to and promote the ongoing health reform in China.

Objective:To explore the effect and mechanism of AMPK on apoptosis of alveolar epithelial cells induced by endoplasmic reticulum stress in COPD rats.Methods:the rats were divided into three groups:control group,model group,AICAR intervention group,establishment of rat model of chronic obstructive pulmonary disease by smoking smoke inhalation and intratracheal instillation of lipopolysaccharide.The HE staining of rat lung tissue pathological observation,immunohistochemical detection of p-AMPK /AMPK,western blot the expression of Caspase-3,ORP 150,and CHOP.Apoptosis were detected by TUNEL method.Results:the HE staining showed that the model group of pulmonary bullae formation,inflammatory cell infiltration,inflammatory ceils in AICAR group was lower than that of model group.Compared with the normal control group,immunohistochemistry and Western blot showed that p-AMPK/AMPK and ORP150 protein expression decreased in the model group,the difference was statistically significant (P＜0.05),and AICAR in the intervention group p-AMPK/AMPK and ORP150 protein expression were significantly increased compared with the model group,the difference was statistically significant (P＜0.05).Endoplasmic reticulum stress related apoptosis The expression of CHOP and caspase-3 apoptosis index increased significantly in the model group,there was significant difference compared with normal group (P＜0.05),while in group AICAR,apoptosis index down significantly compared with the model group.Conclusion:AMPK can protect alveolar epithelial cells from cigarette smoke induced endoplasmic reticulum stress and apoptosis,it was possible to achieve its protective effect the increase of ORP150.

Objective To explore the effect of apolipoprotein E (ApoE) gene polymorphism on brain volume in healthy young adults.Methods One hundred and ninety-three healthy young volunteers (age:20-40 years) were recruited in Shengjing Hospital of China Medical University between August 2013 and May 2014.Two milliliters of peripheral blood were collected for the determination of ApoE genotype using direct sequencing of polymerase chain reaction (PCR) products.Brain MRI scans were performed using three-dimensional T1-weighted turbo field echo imaging sequence.The diffcrences of brain morphometry between the ε4 carriers group (ε3/ε4 and ε4/ε4 genotype) and the ε4 non-carriers group (ε3/ε3 genotype) were analyzed using voxel based morphometry (VBM).Results The ε4 carriers accounted for 14.51％ (28/193) of the total population.Twenty of ε4 carriers and 45 of ε4 non-carriers were included in the final images analysis.VBM analysis showed that the ApoE ε4 carriers had 10 atrophic brain areas compared with the ε4 non-carriers (P ＜ 0.005,uncorrected,10 continuous voxels),which mainly located in the right anterior cingulate,the bilateral caudates,parietal lobes and lateral temporal lobes.Conclusions The influence of ApoE gene polymorphisms on brain volume has appeared in the youth.The ε4 gene is related to the reductions of the gray matter volume in multiple brain areas.

Objective To translate and revise the Individualized Care Scale-Patient Version(ICS-P) into Chinese,then to assess the reliability and validity of the Chinese version of the Individualized Care Scale-Patient Version (C-ICS-P).Methods Standard forward-back translation techniques were used in the translation of the ICS-P according to the Brislin translation model.Cross-cultural revision of the translated ICS-P was carried out through group discussion and pretesting.Totally 223 patients were recruited through convenience sampling method from a tertiary hospital in Changsha and investigated using general information questionnaire and the C-ICS-P,and its reliability and validity were assessed.Results The C-ICS-P contained two subscales,and both C-ICS-P-A and C-ICS-P-B contained 3 factors explaining 61.330％ and 65.263％ of the total variance.The dimensions of C-ICS-P-A were clinical characteristics (6 items),personal life characteristics (4 items) and participation willingness (5 items);the dimensions of C-ICS-P-B were clinical care (6 items),personal life care (4 items) and decisional control over care (5 items).The Cronbach's α coefficients of C-ICS-P-A and its dimensions were 0.897,and 0.730～0.774;the Cronbach's α coefficients of C-ICS-P-B and its dimensions were 0.909,and 0.688～0.754.Split-half reliability was 0.856 for C-ICS-P-A and 0.688～0.754 for its dimensions;split-half reliability was 0.889 for C-ICS-P-B and 0.750～0.758 for its dimensions.Analysis of content validity of the C-ICS-P indicated that I-CVI was at least 0.83,S-CVI was 0.943.Conclusion The reliability and validity of C-ICS-P are satisfactory and well meet the requirements of psychological measurement,indicating C-ICS-P is a reliable and valid instrument in the context of Chinese culture.

BACKGROUND: Our former studies have shown that bone marrow mesenchymal stem cells (BMMSCs) can be induced differentiation to vascular smooth muscle-like cells (VSMLCs) and vascular endothelium-like cells (VELCs), which are compatible with collagen-embedded polyglycolic acid scaffolds. OBJECTIVE: To investigate the possibility of constructing small diameter tissue-engineered blood vessels via subcutaneous implantation. METHODS: The cells-scaffold complex was produced by separately seeding VSMLCs and VELCs derived from BMMSCs on polyglycolic acid collagen scaffolds. The two layers were separated by ECMgel. The cells-scaffold complex was subcutaneous implanted into small diameter tissue-engineered blood vessels.RESULTS AND CONCLUSION: Histological analysis of the small diameter tissue-engineered blood vessel walls revealed a typical artery structure, which was similar to natural vessels. The tissue-engineered blood vessels were not broken down under a force of 26.6 kPa. Eight weeks after implantation, the Brdu-labeled seed cells were found in the three layers of the vessel walls. The results revealed that the subcutaneous tissue was a good bioreactor to construct small diameter tissue-engineered blood vessels.

To make a portable apparatus for the patient self-doing joint voluntarily exercise that is keeping with the training demand of human body potential and muscle strong. Different kinds of spring belts are used for joint exercise apparatus according to the needs of joint exercise. Though active joint extension and flexion by using the method of Chinese physical and breathing exercises, the exercise was done by drawing the spring belt. The extremity multifunctional training box is easy for carrying and sutble for each mussel be trained. Because of the wide range of back spring power, it is easy to reach the best training mount and to do the continually training under the biggest training mount. It is beneficial to the joint active function improvement. From June 2006 to February 2008, this kind of apparatus was used in 30 patients with footdrop at the Beijing Tongren Hospital, Capital Medical University. The design of the extremity multifunctional training box is reasonable, and it is easy for carrying and operating. It is also helpful for the patient to do muscle exercise themselves, and the joint function can be persisted and improved by continual exercise using this apparatus.

Objective To evaluate the effectiveness, safety and feasibility of the application of trans-radial thrombus aspiration in patient with heavy burden of thrombus receiving primary coronary interventional therapy. Methods 56 patients with acute coronary syndrome receiving primary coronary interventional therapy were enrolled and randomized to two groups. 31 patients received therapy of thrombus aspiration by Thrombuster II, while 25 patients received routine coronary interventional therapy. We compared the rate of major adverse cardiac event (MACE) in hospital, left ventricular ejection fraction (LVEF) one week post procedure and left ventricular end diastolic diameter (LVEDD), TIMI frame before and after procedure between two groups. Results The rate of MACE was signiifcantly (P<0.05) lower in patients receiving thrombus aspiration (3.3%) compared with routine PCI group (12.0%). LVEF and the rate of patients with TIMI Ⅲafter procedure were signiifcantly (P < 0.05) higher in patients receiving thrombus aspiration. There’s no significant difference in LVEDD between two groups. Conclusions There lies good safety and feasibility for applying thrombus aspiration combining direct PCI in patient with heavy burden of thrombus.

Objective To investigate the potential application of targeting at vascular endothelial growh factor (VEGF) induced apoptosis in leukemic cell lines by combined use of Bevacizumab and chemotherapeutic drug. Methods Leukemic cells were treated with several drugs at different concentrations in culture. The effect of VEGF, Bevacizumab and co-treated with Ara-C on leukemic cells proliferation were evaluated by CCK-8 and apoptosis and cell cycle were detected by flow cytometry (FCM). Results VEGF could enhance the proliferation of leukemic cells and caused a dose-dependent manner on U937 cell. It also increased the percentage of cells in S phase, tested by, and Bevacizumab group was decreased. Apoptotic rate of cells treated with Bevacizumab or co-treated with Bevacizumab and Ara-C for 48 h were significantly higher when compared with control or Ara-C group, respectively (P<0.05), but the apoptotic rate of VEGF group or VEGF and Ara-C group was lower (P>0.05). There was no significant difference in apoptotic rate between control and combined use of VEGF, Bevacizumab and Ara-C group(P>0.05). Conclusion VEGF could enhance the proliferation of some leukemic cells, and may contribute to leukemic cells survival and a resultant resistance to chemotherapy-triggered cell death. The study also showed that leukemic cells growth was significantly inhibited by Bevacizumab through directly against VEGF, and the sensitivity of leukemic cells for chemotherapeutic drug was increased.