The etiology of familial gastric cancer (FGC) are E-cadherin (CDH1) mutations,helicobacter pylori infection,etc.The median age of patients with FGC is 50-65 years old.The male-female sex ratio is 2 ∶ 1.The most of tumors of FGC locate in distal stomach and present diffuse type in histological classification.It is reported that the people who has a family history of gastric cancer especially for those parents has an increased risk of gastric cancer.It is difficult to find FGC in early stage by current technology.The preventive methods include eradication of helicobacter pylori and prophylactic total gastrectomy,etc.

Objective To explore the perfect operation method for patients with vaginal vault prolapse.Methods Twenty six patients with vaginal vault prolapse who underwent transvaginal mesh repair by Prolift from January 2008 to June 2010 were analyzed retrospectively.Results The interval time between the first operation and this morbidity of ten patients who had underwent total hysterectomy for none FPFD ( ie:hysteromyoma et al) was ( 115.2 ±51.67) months,but the interval of sixteen patients who had underwent traditional repair operation (ie:transvaginal hysteromyoma and/or colporrhaphia anterior-posterior) for FPFD was (24.38 ± 13.43) months,which was markedly shorter ( t =6.75,P ＜0.01).The interval time between the first operation and the 2nd operation of the ten patients was ( 142.8 ±59.04) months,but that of the sixteen patients was (62.13 ± 44.51 ) months,which was significantly shorter ( t =3.97,P ＜0.01 ).Their age and POP-Q staging had no difference ( P ＞0.05).All operations were successfully performed by one gynecologist.The average operation time was ( 60.96 ± 7.88 ) minutes,the average blood loss was ( 119.23 ±27.53) ml,and there was no concomitant injury.All patients were followed up of 3 ～24 months.No vaginal erosion and prolapse recurrence happened,and the cure rate was 100％.Conclusions The Prolift system appeared to be a relatively safe and effective alternative to conventional surgeries for the treatment of vaginal vault prolapse.However,long-term follow-up still need to be performed.

Objective To explore the predicative value of transvaginal ultrasonography and 48 hours blood HCG ratio for ectopic pregnancy(EP).Methods A total of 90 patients in our hospital from June 2014 to May 2016 were selected as the object according to the pregnancy result and postoperative pathology (40 cases in EP group and 50 cases in control group).The endometrial thickness was measured through transvaginal ultrasonography while blood HCG was detected by chemiluminescence technique and 48 hours blood HCG ratio was calculated.To evaluate the individual and combined predicative value of endometrial thickness and 48 hours blood HCG ratio for EP,receiver operating characteristic curves(ROC) were generated and logistic regression analysis was conducted.Results The endometriam thickness and 48 h blood HCG ratio of EP group were (11.75 ± 3.42) mm and (1.06 ± 0.38) ％,respectively,which were lower than (15.52 ± 3.98) mm and (1.46 ± 0.20)％ of control group,the differences were statistically significant (P =0.000).The AUCs and their corresponding 95％ confidential intervals(CI) were 0.77[95％ CI(0.67,0.87)] and 0.82[95％ CI(0.73,0.91)],respectively.Combined ROC analysis based on the 2 indexes revealed an elevated AUC of 0.89 [95％ CI(0.83,0.95)],the differences were statistically significant(P =0.04).Conclusion The endometrial thickness and 48 hours blood HCG ratio can be acted as useful predicative biomarkers for detection of EP.A combination of the two indexes could be a useful predicative biomarker for future clinical trials with EP and may act as a suitable add-on biomarker to the panel of methods already existing for EP.

Objective:To discuss the regulation of berberine and dioscin extracted from traditional Chinese medicine in the expression of protein moleculer related with glucose metabolism in trophoblast cells,such as IRS-1,P1-3K,Glut1,PPAR ?. Methods:To culture the chorion trophoblast cell in the early pregnancy,to induce cells to suffer glucose metabolism obstacle with the use of WortmaninnTake advantage of berberine and dioscin extracted from the Chinese traditional medicine with intervention,simultaneously set the troglitazone(T) and dimthyl(R) for the control group. Detect the gene expression with the use of RT-PCT,simutaniously detect the protein expression in molecular level. Examine the expression in the protein level with the technique of Western blot in combination with the technique of LSM for the expression location of protein moleculer related.Results:① With the induction of WT,the glucose metabolism inside the tropholast cells becomes abnormal,compared with normal(P

This study is to observe the effects of sequoyitol on the expression of NADPH oxidase subunits p22 phox and p47 phox in rats with type 2 diabetic liver diseases. The model of high fat and high sugar diet as well as intraperitoneal injection of small dose of streptozotocin (STZ, 35 mg x kg(-1)) induced diabetic rat liver disease was used. After sequoyitol (50, 25 and 12.5 mg x kg(-1)) was administrated for 6 weeks, the contents of blood glucose (BG), alanine aminotransferase (ALT), aspartate aminotransferase (AST), total antioxidant capacity (T-AOC), hydrogen peroxide (H2O2), NO and insulin (Ins) were measured, liver p22 phox and p47 phox mRNA content was determined with real-time PCR and the expression of p22 phox and p47 phox protein was examined by Western blotting. In addition, pathological changes in liver were observed with HE staining. Sequoyitol could reduce the content of fasting blood glucose, ALT, AST, Ins and H2O2, restore insulin sensitive index (ISI) and weight, elevate liver tissue T-AOC and NO content, reduce the NADPH oxidase subunit liver tissue p22 phox and p47 phox mRNA and protein expression, as well as ameliorate liver pathologic lesions. The results showed that sequoyitol can ease the type 2 diabetic rat liver oxidative stress by lowering NADPH oxidase expression.

Objective The optimal community nursing intervention methods for community patients with primary hypertension was discussed in order to promote their health. Methods System management and community intervention were applied to 140 community patients with primary hypertension for 2 years, including strengthing community communication, popularizing health knowledge, improving cognition of danger of hypertension, hypertensive disease project management, tracking and monitoring the patients with primary hypertension and medication supervision.The cognition rate of prevention and control knowledge for hypertension, hypertension-related cardiovascular complication and formation rote of hypertension control behavior were compared before and after intervention. Results The prevalence rate of the knowledge on hypertension was increased, accompanied with promoting regular medication in patients with hypertension, decreasing cardiovascular complication caused by hypertension and heightening formation rate of controlling behavior in hypertension patients.Conclusions Applying community nursing intervention is practically effective in prevention and treatment of primary hypertension, deserving promotion and application in community medical institute.

Objective: To investigate the effect of noninvasive positive pressure ventilation(NIPPV) in the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD) complicated with type Ⅱ respiratory failure and its influence on blood gas index. Methods: From August 2014 to December 2016, the clinical data of 79 patients with AECOPD complicated with type Ⅱ respiratory failure in the Central Hospital of Shanxi Coal were retrospectively analyzed.The patients were divided into two groups according to different treatment methods.Thirty-five patients in the control group were treated with conventional therapy, 44 patients in the observation group were treated with conventional NIPPV.The blood gas index, nutritional index, plasma N-terminal brain natriuretic peptide precursor(NT-proBNP), lactate(Lac) and the changes of procalcitonin (PCT), soluble myeloid cell trigger receptor-1(sTREM-1) level were compared between the two groups. Results: There were no statistically significant differences in respiratory frequency, blood gas index and APACHE Ⅱ score between the two groups before treatment(P=0.282, 0.177, 0.485, 0.472, 0.485). The levels of pH (7.41±0.07) and PaO₂[(82.30±6.99)mmHg]in the observation group were higher than those in the control group(t=9.357, 5.328, P=0.000, 0.000). The respiratory frequency[(20.02±2.15)times/min], PaCO₂[(52.36±5.15)mmHg]and APACHE Ⅱ score[(18.20±1.01)points]in the observation group were lower than those in the control group(t=7.782, 10.608, 9.360, P=0.000, 0.000, 0.000). There were no statistically significant differences between the two groups in the levels of nutritional indicators before treatment(t=0.027, 0.039, 0.068, P=0.488, 0.485, 0.473). After treatment, the serum total protein level in the observation group was higher than that in the control group, but the levels of serum albumin and hemoglobin had no statistically significant differences compared with those in the control group(t=3.606, 1.659, 0.034, P=0.000, 0.051, 0.486). There were no statistically significant differences in the levels of Lac, NT-proBNP, inflammatory factors between the two groups before treatment(P=0.465, 0.477, 0.451, 0.493). The levels of Lac[(1.57±0.55)mmol/L], NT-proBNP[(130.25±42.36)ng/L], PCT[(0.16 ±0.09)g/L], sTREM-1[(66.36±12.87)ng/L]in the observation group were lower than those in the control group(t=7.662, 2.248, 4.030, 2.709, P=0.000, 0.014, 0.000, 0.004). After treatment, the respiratory rate, blood gas index and APACHE Ⅱ score of the two groups were improved compared with those of the control group(all P<0.05). The respiratory rate per minute, pH, PaO₂, PaCO₂ and APACHE Ⅱ scores in the observation group were better than those in the control group(all P<0.05). The levels of serum total protein, hemoglobin and Lac, NT-proBNP, inflammatory factors in the two groups were lower than those before treatment, and the levels of serum total protein and Lac, NT-proBNP, PCT, sTREM-1 in the observation group were higher than those in the control group(all P<0.05). The serum albumin level in the control group after treatment was lower than that before treatment, and there was no statistically significant difference between the two groups after treatment(P>0.05). Conclusion NIPPV in the treatment of AECOPD complicated with type Ⅱ respiratory failure can effectively improve the blood gas status and nutritional status of patients, and reduce the body Lac and NT-proBNP levels.

Objective To develop a scale of assessing inpatient′s risk factors of chemotherapy drugs permeability. Methods Designed a questionnaire for expert information collecting based on literature review,and employed the Delphi method to develop a set of indicators to measure inpatient′s effective store seepage risk factors. Fifteen experts finished the 2-round survey. Results Expert's enthusiasm was high, the two rounds of enquiry for effective questionnaire recovery rate was 100%. Expert's authority was very high, the average duration of clinical practice was 23.8 years, the average duration of nursing management was 13.1 years, the rate of familiarity about this kind of research was 100%, the recognition degree in the accumulation of theoretical knowledge, the clinical practice and the home or abroad research degree was 93%, 100%and 73%respectively. Two rounds of enquiry for expert advice of Cronbach's alpha coefficient was 0.96 and 0.98 respectively, experts tend to agree that the scale had good consistency, high credibility, delivery system eventually formed contains, vein, the static drop time (static) chemotherapy, more routine chemotherapy, liquid type, drug factors, social support, cooperation degree, liquid volume, mission 11 dimensions such as level of understanding, the nurse puncture store effective seepage risk factors assessment of 42 items. Conclusion The inpatient′s effective store seepage risk factor assessment scale developed by using the Delphi method is reliable for assessing effective store seepage risk factor of hospitalized patients .

Objective To understand a cancer hospital inpatient care Ningxia quality of service perceived status quo.Methods Servqual model-based,self-designed Expect Inpatient Nursing Service Quality Perception Questionnaire was used to investigate 160 hospitalized patients and expected to build expectations oncology inpatients quality of care and services-dimensional perception matrix (IPA matrix).Results By analyzing sensible quality (SQ) value and IPA matrix of the Servqual questionnaire,all items except for treating equally and recommend the hospital showed SQ＜0,that was,the actual feelings of patients were less than expected,and there was statistical difference between the actual feelings and expected feelings in the quiet ward,health guide,care level (t=2.963,2.020,2.020,P ＜0.05).IPA matrix showed that ward quiet,health guidance,care level was the priority problems for the hospital.Life Care,protection of privacy,psychological care,level of service,pay the money reached care were the minor priority problems.Conclusions Servqual Model and IPA matrix combination can help to understand the gap between expectations and perception of nursing service,identify problems improvement priorities,identify weaknesses in care for hospital managers,and develop fine effective theory.