ObjectiveTo disuss the effect of clinical nursing pathway on rehabilitation effect,hospitalization cost and satidaction degree of patients with acute stroke.Methods100 cases of acute cerebral stroke patients in our hospital from December 2009 to June 2010 were divided into the observation group and the contro group with 50 cases in each group.The control group was given conventional nursing,while the observation group was given clinical nursing pathway.Nursing effect was compared between two groups.ResultsNeural function defect score,daily life ability improvement hospitalization time and cost,the compliance rate of health education content,satisfaction degree with nursing quality in the observation group were significantly better than those in the control group.ConclusionsClinical nursing pathway for patients with acute stroke can shorten hospitalization time,reduce hospitalization cost and improve the rehabilitation effect.

Purpose To investigate the 18F-FDG PET/CT manifestation ofextranodal NK/T-cell lymphoma (ENKTCL) for providing important reference for the early diagnosis,accurate staging and guiding treatment of the disease.Materials and Methods The imagings and clinical data of twenty-six patients with nasal ENKTCL were analyzed retrospectively.The diagnosis was confirmed by pathological biopsy and immunohistochemistry.The distribution and metabolic signs of the lesions were summarized,and the influence of PET/CT on nasal ENKTCL staging was analyzed.Results Totally 102 positive lesions were detected in 26 patients.The SUVmax of all lesions was 12.2±5.4 (3.2-28.5).The primary lesions were mainly located in the nasal cavity (16/26,61.5％).Facial soft tissue and paranasal sinus tissue involvement were most common adjacent invasions.The distribution of the remaining affected tissues and organs in the whole body showed no obvious regularity.Lymph node involvement was most common in cervical lymph nodes.The lesion detection rates of PET/CT and conventional imaging (plain scan/enhanced CT,plain scar/ enhanced MRI,ultrasound,etc.) in lymph node and extranodal organ involvement were 96.7％ and 65.5％,respectively,and the accuracy of staging were 92.3％ and 73.1％,respectively.Clinical stages were changed in 15 patients (57.7％)because of PET/CT examination,among which,the staging was improved in twelve cases for finding more lesions,the staging of the suspicious lesions were reduced and the nature was defined in three cases because of their lack of metabolism on the PET/CT,and the treatment plan was affected in nine cases for staging adjustment.Conclusion 18F-FDG PET/CT can accurately show the distribution of nasal ENKTCL lesions.Compared with the conventional imaging methods,more lymph nodes and extranodal organ involvement can be detected by 18F-FDG PET/CT,which makes the staging more accurate and guides the clinical treatment more effectively.

This article was aimed to study the optimum extraction process of paeonol. The extraction yield of paeonol was taken as investigation index. And the best extraction process was screened by orthogonal experimental design. The results showed that the optimum condition of extraction process was to soak coarse powder of Paeonia suffruti-cosa into 15-fold water for 0.5 h, and then the distillation lasted for 2.5 h. The distillate was collected and cooled to room temperature. The crystallization lasted for 24 h at 4℃, and then filtered and dried for 48 h at room tempera-ture. It was concluded that the selected technology was stable, reasonable and feasible. The extraction yield of paeonol is over 80%.

This article is aimed to study the optimal process of preparation of Golden water-soluble gel, and to establish its quality control method. Taking the gel forming properties, stability, water loss rate, pH as investigation index, the best extraction process was screened by single factor and orthogonal test design. TLC method was used to identify the product of trichosanthin, rhubarb, and the content of paeoniflorin was determined by HPLC method. The optimal condition of preparation process is to use 1% carbomer as gel matrix, 10% glycerol as humectants, and 0.5%triethanolamine as pH modulators; trichosanthes and rhubarb could be detected by TLC method, with pH range 5.00 - 5.15. The linear range of paeoniflorin was 29.04-945.20μg·mL-1, the average recovery was 98.80%, and RSD was 2.91% (n=9). Golden gel forming process is simple and quality controllable with reliability and good stability.

Objective To investigate the molecular genetic changes of anaplastic lymphoma kinase (ALK) gene and c-myc gene in anaplastic large cell lymphoma (ALCL). Methods The structural aberrations and changes of copy numbers in ALK and c-myc genes in 72 paraffin-embedded ALCL specimens were detected by interphase fluorescence in situ hybridization (FISH). Results Among 72 ALCL specimens, ALK protein was expressed in 42, ALK gene translocation was detected in 40 specimens in which extra copies of ALK gene were detected in 17. ALK gene translocation was not found in all 30 ALK negative specimens, but extra copies of ALK gene were detected in 14 cases. The difference of incidence rates of extra copies in ALK gene between ALK positive and ALK negative specimens was not significant (P＞0.05). c-myc gene translocation was not found in any of 72 ALCL specimens, but extra copies were detected in 24 cases.Conclusion Most (75.0%) ALCL have ALK gene aberration, in which ALK gene translocations are most common (55.6%), and the extra copies of ALK gene are relatively common genetic changes (43.1%). The ALK gene aberration is only detected in ALK positive ALCL and the gene translocations are in either ALK positive and negative ALCL. There is no or rare c-myc gene translocation in ALCL, but extra copies of c-myc gene are relatively common (33.3%).

Objective: To investigate the clinical characteristics, cell morphology, genetics, gene mutations of the patients with chronic neutrophilic leukemia (CNL). Methods: Five CNL patients from the Second Hospital of Shanxi Medical University between May 2011 and May 2017 who conformed to 2016 World Health Organization (WHO) diagnostic criteria were retrospectively analyzed from clinical characteristics, laboratory features and treatment methods. Results: The peripheral blood white blood cell count (WBC) of 5 CNL patients was significantly increased, and the average WBC was 81.26×10⁹/L [(29-217)×10⁹/L]. Morphological analysis of peripheral blood cell showed a sustained increasing number of matured neutrophilia (0.80-0.85). Neutrophil alkaline phosphatase (NAP) activity was increased (144-266). Bone marrow cell morphology typically showed granulocyte proliferation without obvious dysplasia. Gene detection showed 3 patients with CSF3R T618I mutation and 2 patients with JAK2 V617F mutation in 5 WHO-defined CNL patients. Bone marrow biopsy with reticular staining showed that marrow fibrosis (MF) degree in patients with JAK2 V617F mutation (MF≥2) was higher than that in patients with CSF3R T618I mutation(MF<2). Conclusions CNL is a rare type of chronic leukemia, and CSF3R T618I mutation is a specific diagnostic index for CNL. JAK2 V617F mutations alone may be related to myelofibrosis, which remains to be further studied.

Objective To investigate the clinicopathological features of long?term tumor?free survival in patients with untreated primary diffuse large B?cell lymphoma (DLBCL) of the tonsil. Methods The study included 80 consultation cases of primary tonsillar DLBCL from April 2006 to July 2017 in the Department of Pathology, Beijing Friendship Hospital, Capital Medical University. The patients were divided into two groups: experimental groups of 10 untreated patients with long?term tumor?free survival, and 70 patients who had been treated (control group). The clinical data, histopathological features, immunohistochemical staining, and molecular biology test results of the patients were analyzed retrospectively. Results Patients who had long?term tumor?free survival with untreated primary diffuse large B?cell lymphoma had the disease mostly confined to the tonsil. Biopsy showed that the tonsil structure was only partially effaced and the lesions were relatively "fresh". EBER and FISH test for t (14;18) results were negative. Gene rearrangement detection showed monoclonality. There was statistically significant difference between the age, bcl?2 expression, CMYC protein expression and co?expression of CMYC and bcl?2 between the untreated group and the treated group(P<0.05). Patient gender, tumor site, histological type and clinical stage showed no difference between the untreated group and the treated group (P>0.05);The median overall survival of the untreated group and treated group was 81 months and 20 months, respectively, and the difference was not statistically significant (P>0.05).In patients younger than 40 years of age, the untreated group had a statistically significant difference in primary site and CMYC protein expression compared with the treated group (P<0.05), and there was no statistical significance in other aspects. Conclusions Long?term tumor?free survival patients with untreated tonsillar primary DLBCL have relatively unique clinical characteristics. There is no significant difference in the prognosis between the untreated and treated groups, indicating radiotherapy and chemotherapy may not be required and therefore, avoiding related side effects.

Objective:To investigate the early predictive value of lupus anticoagulant (LA) ratio, D-dimer (D-D) and soluble endothelial protein C receptor (sEPCR) on deep vein thrombosis (DVT).Methods:Thirty hundred and fifty patients who performed surgery for lower extremity fracture and suspected DVT in Zhejiang Rongjun Hospital from October 2018 to October 2019 were enrolled. With deep vein contrast of the lower extremity as the gold standard, 82 patients with confirmed DVT were treated as the observation group and 268 patients without DVT as the control group. The levels of LA, D-D and sEPCR of two groups were detected by coagulation, immunoturbidimetry and enzyme linked immunosorbent assay—sandwich technique respectively. Indexes of the two groups were compared. Pearson correlation was used to analyze the relationship between plasma levels of LA, D-D and sEPCR, and the predictive value of plasma sEPCR, LA ratio and D-D level on DVT was evaluated by receiver operator characteristic (ROC) curve.Results:The plasma sEPCR, LA ratio and D-D levels in the observation group were significantly higher than those in the control group [(143.30 ± 11.28) μg/L vs.(112.56 ± 14.62) μg/L, 1.51 ± 0.24 vs. 1.22 ± 0.18, (1 013.00 ± 319.54) μg/L vs. (425.17 ± 100.36) μg/L] with statistically significant differences ( P < 0.05). There was no significant differences in activated partial thromboplastin time (APTT), prothrombin time (PT) and thrombin time (TT) between the two groups ( P > 0.05). In the observation group, plasma sEPCR level was positively correlated with LA ratio and D-D level ( r = 0.280, P = 0.011; r = 0.563, P < 0.001), and LA ratio was positively correlated with D-D level( r = 0.741, P < 0.001). The area under curve (AUC) of D-D in diagnosis of DVT was 0.940, and the sensitivity and specificity were 87.80% and 87.69% when the cut-off value was 569.43 μg/L. The AUC of LA ratio in the diagnosis of DVT was the smallest, which was 0.912, the sensitivity and specificity were 87.80% and 91.25% when the cut-off value was 1.23. The sensitivity was 95.12% and specificity was 95.00% of sEPCR and LA ratio combined with DD in diagnosis of DVT. Conclusions:LA and D-D combined with sEPCR has high predictive value for DVT.

Objective:By analyzing the patent literature of medical research institutions in Sichuan Province, the current status of patent development in each institution were analyzed to identify existing problems, according to which countermeasures were put forward.Methods:Using IncoPat as the retrieval tool, the patent documents of Sichuan medical scientific research institutions were searched, data about the overall application trend, applicant, patent type, legal events were analyzed, and relevant countermeasures were proposed based on the current patent development situation.Results:At present, the overall development of patents in Sichuan medical scientific research institutions is good, however, there are still some problems and challenges, such as weak awareness of patent protection, low patent quality, insufficient transformation of patent achievements and so on.Conclusions:By analyzing the present situation of patent development of medical scientific research institutions in Sichuan Province, this study put forward some countermeasures, including strengthening publicity on intellectual property protection, improving the driving mechanism, reforming intellectual property management and achievement transformation mechanism, to provide reference for promoting the benign development of patents at medical scientific research institutions, as well as promote the development of medical science and technology innovation.