Objective To discuss the effective nursing method of severe erythema multiforma exudativum children patients complicated with bronchopneumonia.Methods Two cases of erythema multiforma exudativum were reviewed,and the nursing methods were summarized,including protective isolation,care of wound surface,care of intravenous infusions,psychological care,oral care,eyes care,perineal care,care of fever,and discharge instructions.Results Two children patients were both cured.Conclusions For severe erythema multiforma exudativum children patients complicated with bronchopneumonia,proper nursing method and careful observation can decrease the complications and help patients to cure quickly.

BACKGROUND:Damage to nasal ciliated epithelial cels can lead to a severe injury in nasal biological function. Compared with other adult stem cels, human umbilical cord blood stem cels have better differentiation potential.
OBJECTIVE: To explore the feasibility of human umbilical cord blood stem cels differentiating into nasal ciliated epithelial cels through in vitro culture and induction techniques.
METHODS:Normal and healthy umbilical cord blood samples were colected to isolate human umbilical cord blood stem cels, folowed by identification and subculturein vitro. Umbilical cord blood stem cels at passage 3 were infected with recombinant adeno-associated virus carrying enhanced green fluorescent protein and cultured using air liquid interface culture method. Thereafter, PCR assay was employed for detecting MUCS expression in cultured stem cels at 1 and 2 weeks after induction, and immunofluorescent staining for FOXJ1 was performed at 3 weeks.
RESULTS AND CONCLUSION:After subculture, passage 3 umbilical cord blood stem cels that could express stem cel surface markers were visible in a uniform shape and had good refraction. After 3 hours of gene transfection, green fluorescence issued from the passage 3 cels were visible, and the cel positive rate was up to 96.2% until 48 hours, indicating good transfection efficiency. RT-PCR findings showed that MUC8 mRNA had no expression in the umbilical cord blood stem cels, but expressed strongly in the nasal ciliated epithelial cels, whose expression was weak at 1 week of culture and increased at 2 weeks. Additionaly, the positive expression of FOXJ1 red fluorescence was observed under the transfection of green fluorescent protein. These results suggest that human umbilical cord blood stem cels could differentiate into nasal epithelial cels under suitable conditions.

Objective To evaluate the effectiveness of Percu Twist (PT) tracheostomy comparing with that of operative tracheostomy(OT)in intensive care unit(ICU). Methods Related data were retrieved from CBM,CNKI,Wanfang Data,VIP,PubMed,EMBASE,CENTRAL,and Web of Science from the time of their establishment to May 15th 2014,and the data of randomized controlled trials(RCTs)concerning PT and OT were selected. The risk of bias assessment and data extraction were performed by two independent reviewers. Meta analysis was conducted using RevMan 5.2 software. Results A total of 12 RCTs were identified,and 893 patients in ICU were involved. The results of Meta-analysis showed that PT could significantly shorten the operation time〔mean difference (MD)=-15.11,95% confidence interval(95%CI)=-17.14 to -13.07,P<0.000 01〕,reduce the volume of blood loss(MD=-17.59,95%CI=-21.90 to-13.28,P<0.000 01),reduce the size of incision(MD=-2.20, 95%CI=-2.57 to -1.82,P<0.000 01),shor ten the time of healing(MD=-3.60,95%CI=-4.15 to -3.05, P<0.000 01),and reduce complications such as infection of the wound〔odds ratio(OR)=0.20,95%CI=0.10-0.44,P<0.000 1〕and cutaneous emphysema/mediastinal emphysema(OR=0.22,95%CI=0.10-0.47,P<0.000 1)compared with OT group. The funnel plot suggested that publication bias might be found among 12 researches. Conclusions PT was shown to be more effective than OT in ICU with lower incidence of complications. As number of RCT cases is still small with unsatis factory quality,further clinical use is warranted for a better assessment.

Ex-vivo liver resection and liver autotransplantation offers a chance to cure extensive regional liver diseases which are otherwise deemed untreatable in selected cases. A 33-year-old male patient with advanced alveolar echinococcosis (AE) which invaded the right lobes and adjacent retrohepatic inferior vena cava, while the left lobes were free from lesion and had proliferated to over 1200 ml in size except for a 1 cm × 1 cm solid lesion in the segment Ⅳ. No extrahepatic metastases were found in this patient. A lesion with a size of 4300 ml and other small lesions in the right lobes were removed extracorporeally,and the retrohepatic vena cava was repaired, then the remaining AE-free left lobes (more than 700 ml in size) and the retrohepatic inferior vena cava were re-implanted in situ. A temporary end-to-end cavo-caval shunt with interposition of a blood vessel prosthesis and end-to-side portocaval shunt were established to keep the blood flow during the four-hour anhepatic phase. The patient was followed up for six months, and he had no signs of residual liver disease with good hepatic function.

ObjectiveTo find out the incidence of triple-negative breast cancer(TNBC) in all kinds of breast cancers.To compare and analyze the clinicopathological features,recurrence,metastasis,and prognosis of patients with TNBC and non-triple negative breast cancer (non-TNBC).MethodsThe clinicopathological features and follow-up data of 387 patients with primary breast cancer histopathologically conffirmed in our hospital from Sep.2004 to Sep.2006 were retrospectively analyzed.The 387 patients were divided into 2 groups:79 cases of TNBC and 308 cases of non-TNBC.The clinical features and prognosis of the 2 groups were compared.Results Compared with non-TNBC group,patients in TNBC group had their special features:1.higher ratio of patients ＜ 35 years( P =0.012 ) ; 2.higher ratio of patients with family history of breast cancer( P =0.031 ) ; 3.higher ratio of tumors with maximum diameter ≥ 5 cm ( P =0.044 ) ; 4. higher ratio of patients with positive lymph nodes(P =0.011 ) ; 5.higher ratio of tumors in clinical stage Ⅲ(P =0.007) ; 6.higher ratio of tumors in histological stage Ⅲ(P =0.028 ).The 5-year-disease-free survival (DFS) and overall survival (OS) rate for patients with TNBC were 72.15％ and 88.61％ respectively,lower than those of non-TNBC ( P =0.003 and 0.031 respectively).ConclusionsCompared with non-TNBC patients,patients with TNBC have the features of younger age,more advanced clinical stage upon diagnose,higher rate of lymph node metastasis,larger tumors,higher histological grade,faster and easier recurrence and metastasis,and lower rate of DFS and OS.The information of age,the maximum diameter of the tumor,lymph node status,clinical stage,histological grade and pathological types,especially the age and lymph node status,play an important role in predicting the prognosis of TNBC.

OBJECTIVE: To study the regulatory effect of IL-35 on the balance of Treg/Th17 cells in AR patients. METHOD: In this study, 30 cases were randomly selected from outpatients of otolaryngological department in the second hospital of Hebei Medical university who were diagnosed as AR. Another 20 healthy cases enrolled from physical examination branch of our hospital were control group. The expression level of IL-35 and IL-17 in peripheral blood were detected by using ELISA and defeced CD4+CD25+Foxp3+ T cell and CD4+IL-17+T cell expression level were identified via flow cytometry. RESULT: The expression level of IL-35 in AR group was obviously lower than that in control group, and the difference was a statistically significance (t = -8.145, P < 0.01). The expression level of IL-17 in AR group was obviously higher than that in control group, and the difference was a statistically significance (t = 14.969, P < 0.01). There was a remarkable negative correlation between the IL-35 and IL-17 expression in the serum of AR group (r = -0.773, P < 0.01). The percentage of CD4+CD25+Foxp3+ T cell in CD4+ T cell was significant lower in AR group than that in control group (t = -13.678, P < 0.01). The percentage of CD4+IL-17+ T cell in CD4+ T cell was much higher in AR group than that in control group (t = 5.632, P < 0.01). There was a remarkable negative correlation between the Treg and Th17 expression in the peripheral blood of AR group (r = -0.613, P < 0.01). There was a positive correlation between the expression of CD4+ CD25+Foxp3+ T cell and IL-35. There was a negative correlation between the IL-35 and Th17 in AR group (r = 0. -594, P < 0.01). CONCLUSION The lower expression of IL-35 was related to the incidence of AR, and it was an important cytokines for that. The lower expression of IL-35 may inhibit the proliferation of Treg cells, lead to hyper function of Th17 cells, increase secretion of s IL-17 and result in unbalance of Treg/Th17 cells; these may be the important mechanism of the occurrence of AR, thus regulation of IL-35 may become a new target for the immunological therapy of AR.
Case-Control Studies ; Enzyme-Linked Immunosorbent Assay ; Flow Cytometry ; Humans ; Interleukin-17 ; blood ; Interleukins ; Rhinitis, Allergic ; immunology ; T-Lymphocytes, Regulatory ; immunology ; Th17 Cells ; immunology

Objective To study the effect of clinical pharmacist interventions on the rational use of antibiot-ics.Methods 1 000 hospitalized patients before the implementation of intervention in April 2012 to April 2013 (control group)and the other 1 000 cases of hospitalized patients in May 2013 to May 2014 after the implementation of the intervention (study group)were selected,the antibiotics use rate,hospitalization time and cost,cost of using antibacterial drugs were compared between the two groups.Results The antibiotics use rate of the study group was 56.0%(560/1 000),significantly lower than 78%(780/1 000)of the control group,with significant differences between the two groups(χ2 =11.089,P=0.032),the hospitalization time,cost of using antibacterial drugs of the study group were (12.6 ±0.8)days,(912.2 ±13.2)yuan,significantly better than (16.9 ±0.7)days,(1 528.1 ± 32.5)yuan of the control group,with significant differences between the two groups (t=9.892,10.142,P=0.028, 0.014);The two groups of hospitalization expenses showed no statistical significance (t =4.984,P =0.072 ). Conclusion Clinical pharmacist intervention has a positive effect on the application of antibacterial drugs,which can significantly reduce the use of antimicrobial drugs and reduce the hospitalization days.

Objective To study and monitor the situation of femomaternal hemorrhage (FMH) in RhD-negative pregnant women in Tianjin, obtain the FMH data of such population, and analyze the relationship between FMH and age, blood type, gestational age, hemolytic disease of postpartum neonates, etc. Methods The FMH level was detected by flow cytometry with FITC-anti-HbF monoclonal antibody. The blood type was detected by blood serum method. The irregular antibody was identified by saline method and indirect anti-human ball method. The hemolysis of postpartum neonates was detected by three tests of hemolysis. Results The FMH volume of 86 RhD negative pregnant women was between 0 and 11.48 ml, with an average of 1.82 ml. There were 63.95％of pregnant women showed a volume of FMH<2.0 ml, 23.26％between 2 and 4 ml, 11.63％between 4.0 and 10.0 ml, and 1.16％>10 ml. The proportion of lower FMH in pregnant women≤30 years old was>11.71％higher than that in the pregnant women>30 years old, but the difference was no statistical significant. There was no significant difference in FMH of pregnant women with O, A, B and AB types. The proportion of higher FMH in pregnant women with compatible ABO blood type with her husband was 12.46％ lower than that of the heterozygous cases, but the difference was no statistical significant. The proportion of higher FMH in the pregnant women with 28 to 32 weeks gestational age was 14.55％ higher than that of ≤28 weeks and was 35.32％ higher than that of >32 weeks, and the differences were statistical significant. Three samples in the 86 samples were positive for anti-D antibody, and their three hemolytic test results were strongly positive with the anti-D titer from 1:2 to 1:32 and the FMH volume from 1.50 to 6.93 ml. The proportion of lower FMH in the 10 pregnant women without postpartum hemolysis was 70％ higher than that in 5 pregnant women with postpartum hemolysis, but the differences were not statistical significant. Conclusions The results suggest that monitoring FMH content by flow cytometry can reflect FMH in Rh-negative pregnant women. The studies on the relationship between FMH and age, blood type, pregnant time and hemolytic disease of postpartum neonates can provide basically experimental data for standard use of anti-D immunoglobulin in pregnant women.

Objective:To explore the clinical effect and application value of simultaneous modulated accelerated radiotherapy (SMART) in the suspicious positive lymph nodes of head and neck.Methods:From January 2017 to February 2019, 60 patients with suspected positive lymph nodes in the head and neck in the Hanzhong Central Hospital of Shaanxi Province were divided into experimental group and control group according to different treatment plans, and 30 patients in each group were included. In the experimental group, 63.36 to 66.66 Gy patients were treated with SMART, while in the control group, 54.12 to 60.06 Gy patients were treated with conventional neck prophylactic radiation. In order to evaluate the feasibility of the method, the change of the short diameter of the largest cross section of the suspicious positive lymph nodes in the two groups were observed, and the adverse reactions in the treatment of the two groups were analyzed.Results:There was no significant difference between the two groups before treatment ( P>0.05). After treatment, the size of short diameter of lymph nodes in the two groups was smaller than that before treatment. The maximum short diameter of the largest cross section of lymph nodes in the experimental group was smaller than that before treatment: (0.43 ± 0.07) cm vs. (0.72 ± 0.10) cm, and the difference was statistically significant ( P<0.05). In the control group, the maximum short diameter of the largest cross section of lymph node decreased after treatment, and the difference was not statistically significant ( P>0.05). After treatment, the reduction of the short diameter in the experimental group was more obvious than that in the control group. The maximum short diameter of the largest cross section between the two groups: (0.43±0.07) cm vs. (0.66±0.08)cm was statistically significant ( t = 11.523, P<0.05). Before treatment, hemoglobin (HGB) levels of the two groups were in the normal physiological range, and there was no significant difference between the two groups ( P>0.05); the white blood cell (WBC) levels of the two groups at different time after treatment were compared: in the first week (7.83 ± 2.53) × 10 9/L vs. (8.26 ± 3.16) × 10 9/L, in the third week (7.14 ± 3.65) × 10 9/L vs. (7.08 ± 2.53) × 10 9/L, in the fifth week (5.47 ± 2.81) × 10 9/L vs. (6.41 ± 2.57) × 10 9/L, and in the seventh week (4.36 ± 2.59) × 10 9/L vs. (4.98 ± 1.64) × 10 9/L, and there were statistical differences ( P<0.05), which indicated that the WBC index levels of the two groups were gradually decreased during the treatment, and the decreased degree of the experimental group was higher than that of the control group. The levels of HGB and PLT were maintained in the normal physiological range before and after treatment, and there was no significant difference between the two groups ( P>0.05). The main complications in the treatment of the experimental group were xerostomia and stomatitis. The adverse reactions in the control group were pain in the target area of radiotherapy. There was no significant difference between the two groups ( P>0.05). Conclusions:The application of IMRT is an effective method for the treatment of occult lymph node metastasis, and it is also a therapeutic diagnostic method, which can provide evidence for the study of the law of lymph node metastasis in the head and neck. The safety and tissue tolerance of IMRT in the treatment of suspicious positive lymph nodes in the head and neck are good, which can be used for the suspicious lymph nodes in the head and neck. The treatment of positive lymph nodes and the evaluation of patients′ prognosis provide an effective way of clinical treatment.

Objective: To observe the effect of olfactory training on mice with olfactory dysfunction induced by 3-methylindole (3-MI). Methods: Thirty-one male BALB/c mice were randomly divided into 3 groups by random digits table: control group (group A, n=10), olfactory dysfunction group (group B, n=10) and olfactory dysfunction+olfactory training group (group C, n=11). Mice in group B and group C were intraperitoneally injected with 150 mg/kg 3-MI to induce olfactory dysfunction model, while mice in group A were intraperitoneally injected with corn oil of the same volume. From the first day after injection, mice in group C were treated with 4 kinds of odors by inhalation, while mice in group B were treated with distilled water by inhalation, with 2 times/d, 30 min/time/kind of odor, and continuous training for 28 d. Group A was not treated. Buried food pellet tests were conducted before injection and at 7, 14, 21 and 28 days after injection, respectively. The olfactory epithelium was harvested for observation of the number of olfactory marker protein (OMP) and the thickness of olfactory epithelium on the 28th day after injection. SPSS 23.0 software was used for statistical analysis. Results: Before injection, all mice in each group had no olfactory dysfunction. At the 7th, 14th, 21st and 28th days after injection, the food finding time of mice in group C was shorter than that in group B, and the difference was statistically significant ((175.88±100.50) s vs (266.73±46.83) s, (132.00±84.62) s vs (264.10±48.50) s, (103.57±77.43) s vs (197.43±69.78) s, (67.79±32.54) s vs (176.63±61.06) s, all P<0.05), but food finding time of mice in group B and C was longer than that in group A (the food finding time of group A at the 7th, 14th, 21st and 28th days after injection was (27.13±5.36) s, (25.83±7.28) s, (23.13±2.72) s, (26.63±7.60) s, respectively, all P<0.05). At the 28th day after olfactory training, the number of OMP positive cells in group B and C were fewer than that in group A, and the difference was statistically significant ((108.00±28.19)/HP vs (288.22±84.06)/HP, (199.33±58.55)/HP vs (288.22±84.06)/HP, all P<0.05). The number of OMP positive cells in group C were higher than that in group B (P<0.05). The number of OMP positive cells had negative correlation with food finding time (r=-0.886, P<0.01). As for the thickness of the olfactory epithelium, the thickness of group B was thinner than that in group A and C, and the difference was statistically significant ((59.57±31.27) μm vs (114.55±40.70)μm vs (90.54±37.72) μm, all P<0.05). Conclusion Olfactory training can accelerate the recovery of olfactory function in 3-MI-induced olfactory impaired mice.