Objective To investigate the relationship between the serum levels of CEA,cAl25,CA19-9 and clinical pathological characteristics in gastric cancel patients.Method The serum levels of CEA,CA125 and CA19-9 in 107 gastric cancer patients before the surgery were detected by electrochemiluminescence immunoassay.Results The preoperative seurm levels of CEA,CA125 and CA19-9 were not correlated with sex,age and the location of the tumor.The serum level of CEA,CA125 and CA19-9 in patients with lymph node metastasis were higher than those in patients without lymph node metastasis.The serum levels of CEA,CA125 and CA19-9 were positively correlated with the depth of tumor invasion and the size of the tumor.The serum levels of CA125 were correlated with the degrees of differentiation.Thehigher the CA125 levels,the lower the degrees of differentiation.But the levels of CEA and CA19-9 were not correlated with differentiation.There were positive.correlations among the serum levels of CEA,CA125 and CA19-9.The correlation coefficient of CA125 and CA19-9 was 0.623(P<0.01),CA125 and CEA was 0.572(P<0.01),CA19-9 and CEA was 0.412(P<0.01).Conclusions The serum levels of CEA,CA125 and CA19-9 in gastric cancer patients are significantly related with the size of the tumor,the depta of tumor invasion and lymph node metastasis.The preoperative serum levels of CEA,CA125 and CA19-9 can provide some reference for formulating the treatment of the gastric cancer patients.

Objective To evaluate CTP,MELD,MELD-AS,MELD-Na,i-MELD and MESO in prognosis of cirrhosis patients who underwent endoscopic injection sclerotherapy (EIS). Methods Seventy-eight cirrhosis patients with integral clinical and follow-up data were enrolled into the study. The area under the receiver operating characteristic (ROC) curve (AUC) was used to compare these six models in predicting mortality risk. The optimal threshold of them to determine the prognostic death risk was calculated by ROC curves. Results Eight patients died within half one year, 11 patients died within the first year. There was no significant difference in gender and age between the survival and death groups. The AUC of the six models higher than 0.800 were. that, 6-month: MELD-AS (0.837), MESO (0.830), MELD (0.830) ; 12-month: MELD (0.822),MELD-AS (0.821),MESO (0.814). Conclusions MELD-AS,MESO,MELD and so on are all accurate predictive systems for 6-month and 12-month of patients who underwent EIS. The value of them are very important in the selection of patients for EIS, and have a certain clinical significance.

Objective To observe the changes of the depressive behavior and amygdaloid nucleus nerve growth factor(NGF)expression in estro?gen?deprived female rats and explore the possible mechanism and targets of estradiol in depression treatment. Methods A total of 30 adult SD fe?male rats were randomly assigned to 3 groups:sham operation group(SHAM,n=10);ovariectomized group(OVX,n=10)and ovariectomized rats treated with estradiol group(OVX+E,n=10). The behavior changes were observed by tail suspension test(TST)and sucrose preference test (SPT) after 8?week estradiol treatment. Subsequently ,immunohistochemical staining detect NGF expression in amygdaloid nucleus. Results Compared with the SHAM group rats,sucrose preference ratio significantly decreased in SPT(P<0.01),immobile time prolonged in TST(P<0.01),serum estradiol level and amygdaloid NGF expression significantly decreased(all P<0.01). 8?week estradiol treatment ameliorated depres?sion?like behavior and increased serum E2 level and NGF expression in amygdaloid nucleus in OVX+E group rats when compared with the OVX group(all P<0.01). Conclusion Estradiol treatment can improve the depressive behavior of ovariectomized rats ,which may be related to the in?crease of serum estradiol level and the expression of NGF in amygdaloid nucleus.

Objective To evaluate the capability of model for end-stage liver disease (MELD)combined with serum sodium (MELD- Na,MELDNa and MESO scores) in predicting the prognosis of patients with decompensated liver cirrhosis in 6 and 12 months.Methods One hundred and nineteen patients with decompensated liver cirrhosis and completed follow-up data were retrospectively studied.The MELD,MELD- Na,MELDNa and MESO scores were calculated according to the clinical data of each patient.Receiver operating characteristic (ROC) curve and the area under the curve (AUC) was used to measure the values of the four models in predicting the 6 and 12 months survival,and Z-test was used to compare their predictive values.Results MELD,MELD-Na,MELDNa and MESO scores were significantly different between patients who survived and those who died within 6 and 12 months follow-up.The AUC for the MELD- Na,MELDNa and MESO scores were all more than 0.8 in predicting 6 and 12 months survival.However the differences of the AUC between the MELD score and MELD-Na,MELDNa,MESO scores were not significant in predicting 6 and 12 months survival.Conclusion The model for MELD combined with serum sodium can accurately predict the prognosis of patients with decompensated liver cirrhosis in 6 and 12 months,while these scores are not superior to MELD score.

ObjectiveTo observe the efficacy of wrist-ankle acupuncture plus auricular point sticking in treating pre-exam anxiety syndrome.MethodSixty patients with pre-exam anxiety syndrome were randomized into a treatment group to receive wrist-ankle acupuncture plus auricular point sticking (30 cases, 11 cases dropped out) and a control group to receive auricular point sticking (30 cases, 1 dropped out). In the treatment group, the bilateral Upper 1 zones were punctured regarding the wrist-ankle acupuncture, and for the auricular point sticking, Heart (CO 15), ear Shenmen (TF 4), Endocrine (CO 18), Adrenal Gland (TG 2p), Subcortex (AT 4) were selected. In the controlgroup, the same auricular points were treated. For both groups, the intervention began from 1 week prior to the exam, 3 d as a treatment course, and the therapeutic efficacy was evaluated after 2 successive courses. The Sarason Test Anxiety Scale (TAS) and autonomic function test were used to assess the anxiety severity before and after treatment. ResultThe total effective rate was 84.2% (16/19) in the treatment group versus 82.8% (24/29) in the control group, and the difference was statistically insignificant (P>0.05). The TAS score dropped significantly in the control group after intervention (P<0.01).ConclusionWrist-ankle acupuncture plus auricular point sticking and auricular point sticking alone both can effectively improve the symptoms of pre-exam anxietysyndrome.

Objective To explore hemopurification clinical nurse specialist's effects and barriers,in order to provide evidences to define their value,to remove their barriers,to promote their effects.Methods A qualitative study was adopted in this study.In-depth interviews were conducted on 3 charge nurses in hemopurification and 10 hemopurification clinical nurse specialists.Results The effects of hemopurification clinical nurse specialist can be concluded as effects to patients,to nursing,to medical systems and to hemopurification clinical nurse specialist themselves.Barriers of hemopurification clinical nurse specialist can be concluded as medical environments,the process of nursing developing,ambiguous role of clinical nurse specialist.Conclusions The practice of hemopurification clinical nurse specialists have played various effects,but there were some barriers in their practice.The roles of clinical nurse specialist should be clarified,and guarantees in managements and regulations should be provided for their practice.

Objective To investigate the effect of rapid rehabilitation nursing mode on postoperative complications in elderly patients with appendicitis. Methods Forty-eight elderly patients with appendicitis underwent surgery from July 2013 to June 2014 were set as the control group, and another fifty-three elderly patients from July 2014 to June 2015 as observation group. The patients in the control group were treated with routine care while the patients in the observation group with rapid rehabilitation nursing. Operative complications, gastrointestinal tumor recovery and postoperative hospitalization time were compared within one week after the operations between two groups. Result The rates of constipation, abdominal distention, chills and dysuria in the observation group were significantly lower than those of the control and the time of anal first exhaust, defecation and postoperative hospitalization in the observation group were significantly lower or shorter than those in the control group (all P<0.05). Conclusion The rapid rehabilitation nursing mode based on evidence can reduce surgery complications in elderly patients, promoter recovery and shorten hospitalization time.

Background:The prevalence rate of diabetes mellitus ( DM ) associated with gastroesophageal reflux disease ( GERD)is increasing recently,and the relationship between DM and GERD has become a research hotspot. Aims:To study clinical features and influential factors of therapeutic efficacy of reflux esophagitis( RE)in elderly patients with type 2 DM(T2DM). Methods:Two hundred elderly patients with RE diagnosed by gastroscopy from March 2011 to October 2013 were enrolled,and divided into T2DM associated with RE( T2DM)group and RE group. The clinical features, endoscopic findings and therapeutic efficacy of the two groups were analyzed,and the influences of DM course and control of blood glucose on efficacy of RE were also analyzed. Results:The main manifestations of RE were extraesophageal symptoms,typical esophageal symptoms were less common. The overall efficacy rate decreased with the increase of endoscopic grade of RE,however,extraesophageal symptoms improved significantly. With the prolonging of DM course,the endoscopic grade of RE was increased,and the control of blood glucose was worse. The overall therapeutic efficacy was significantly reduced with the prolonging of DM course in patients with well controlled blood glucose. Conclusions:Extraesophageal symptoms are common,endoscopic grade of RE is worse and blood glucose is difficult to control in elderly T2DM patients associated with RE. DM course and status of blood glucose control have influences on the therapeutic efficacy of RE.

Objective: To assess the quality of syphilis case reporting from hospitals in Hunan Province .Methods The syphilis cases reported by 126 middle second-class and above hospitals in the year 2010 and 2017 were retrieved from unified infectious case reporting network and compared with original reporting cards,medical records and laboratory testing records according to the Diagnostic Criteria for Syphilis （WS 273-2018）and the Guidelines for the Clinical Diagnosis and Treatment of Sexually Transmitted Diseases. The accuracy of syphilis diagnosis and classification were evaluated between different reporting years,types of hospitals,levels of hospitals and departments . Methods: The syphilis cases reported by 126 middle second-class and above hospitals in the year 2010 and 2017 were retrieved from unified infectious case reporting network and compared with original reporting cards,medical records and laboratory testing records according to the Diagnostic Criteria for Syphilis （WS 273-2018）and the Guidelines for the Clinical Diagnosis and Treatment of Sexually Transmitted Diseases. The accuracy of syphilis diagnosis and classification were evaluated between different reporting years,types of hospitals,levels of hospitals and departments . Results: There were 8 947 syphilis cases reported in 2010 and 13 552 syphilis cases reported in 2017. The accuracy of syphilis diagnosis and classification were 98.81% and 98.66% in 2017,which were higher than 36.39% and 36.10% in 2010 （P<0.01）. The accuracy of syphilis diagnosis in the provincial,municipal and county-level hospitals in 2017 were 99.07%,99.20% and 98.17%;the accuracy of syphilis classification were 98.91%,99.03% and 97.99%;the accuracy of syphilis diagnosis and classification were significantly different in different levels of hospitals（P<0.01）. The accuracy of syphilis diagnosis in the general hospitals,traditional Chinese medicine hospitals and maternal & child health hospitals in 2017 were 99.25%,96.92% and 97.57%;the accuracy of syphilis classification were 99.13%,96.72% and 97.30%;the accuracy of syphilis diagnosis and classification were significantly different in different types of hospitals（P<0.01）. The accuracy of syphilis diagnosis in the department of dermatology and non- dermatology in 2017 were 99.13% and 98.74%;the accuracy of syphilis classification were 99.02% and 98.58%;the accuracy of syphilis diagnosis and classification were not significantly different in different departments（P>0.05） . Conclusion The accuracy of syphilis diagnosis and classification have been improved in 2017,which varies in different levels and types of hospitals.

Objective To determine the prevalence rates of nucleotide reverse-transcriptase inhibitor (NRTI) and nonnucleoside reverse transcriptase inhibitor (NNRTI) TDRs among HIV-1 ART-na?ve patients in Hunan province using the ultra deep sequencing(UDS) technique. Methods ART-na?ve subjects diagnosed in Hunan between 2010 and 2011 were evaluated by both UDS technique and Sanger sequencing techniques,to the 1%variant level. Mutations were scored using the Stanford HIVdb algorithm to infer the status on drug resistance. Results UDS method was performed on 90 ART-na?ve subjects that seeking service of care,in Hunan. In total,42.2%(38/90)of the subjects showed major NRTI or nonnucleoside reverse transcriptase inhibitor NNRTI TDRs by UDS technique,at a HIV variant frequency level of≥1%,15.6%(14/90)showed NRTI TDR,16.7%(15/90) showed a major NNRTI TDR and 10%(9/90)were both resistant to NRTI and NNRTI when variants were analyzed by Stanford HIVdb. Conclusion ART-na?ve subjects from Hunan province, which had been predominately infected by subtype AE,would frequently possess HIV variants with NRTI/NNRTI TDRs that would affect the use of first line ART in the region,identified by the UDS technique. Further studies were needed to describe the prevalence of TDRs and to gather related information.