Objective:To explore the result of application of the clinical nursing pathway on percutaneous coronary interventional patient.Methods:One hundred patients were divided into two groups randomly,each group has 50 cases.We used the clinical nursing pathway based on holistic nursing case in experimental group,and the control group used the holistic nursing care.Results:After use the method of the clinical nursing pathway in the hospital,the medical cost and the rates of the nursing errors were less than that in the comparing group while the patients were more satisfied.Conclusion:As a scientific mode,the clinical nursing pathway could improve the working efficiency,guarantee the nursing quality.

The paper,based on a review of the reform of state-owned enterprises,and of the duty positioning and supervision of state-owned assets management committee, described experiences of Shanghai Hospital Development Center (SHDC ) in learning from such reforms. Centering onappropriate separation of ownership and power of management and defining public hospitals as key player of state-owned assets,SDHD explored to build a state-owned assets investor system conforming to the institutional positioning,assets category and operating targets of such hospitals.This way a state-owned assets management mode is gradually set up,featuring to make regulations beforehand,to supervise in the course and to supervise afterwards.

Aged, 80 and over ; Echinocandins ; adverse effects ; therapeutic use ; Humans ; Lipopeptides ; Liver ; drug effects ; Liver Function Tests ; Mycoses ; drug therapy ; Retrospective Studies

Establishment and improvement of rules and regulations will benefit to the management of research institutions.A comprehensive,fair,reasonable,and workable rules and regulations are the basic guarantee for maintaining the orderly,steady,and sustainable development of the institutions.It is also help to fully mobilize the enthusiasm and creativity of all members of the institutes.In this paper,we use an example of a construction of rules and regulations in the military medical research Institutions,to analyze current information and posted suggestions on the rules and regulations formulation principles,making procedure,overall framework and main innovation for the future improvement and implementation of rules and regulations.

Objective To measure serum ghrelin level in elderly Chinese, and investigate the relationship of the serum ghrelin level with age, obesity and other metabolic disorders. Methods A total of 109 men aged over 60 years without history of smoking and alcohol consumption from health examination were enrolled in this study. Subjects were excluded if they had serious diabetic complications, coronary artery disease and hepatic or renal dysfunction. A cross sectional study was made on ghrelin level and the correlated metabolic disorders. Results Compared with ghrelin level in subjects with normal BMI [(823. 57±410.40) ng/L], the ghrelin level was significantly decreased in overweight and obese elderly male, [(442.42 ± 171.10) ng/L and (434.64 ± 177.65) ng/L respectively]. ghrelin was significantly lower in subjects with three or more metabolic disorders (420.84±165.91) ng/L than in those with less disorder. Single factor analysis showed ghrelin was inversely associated with BMI, TG and uric acid (r=-0.359,-0.243,-0.189), but it was not associated with age, blood pressure, fasting glucose and insulin levels. Multivariate analysis revealed only BMI significantly affected the level of ghrelin (β =-0.386). Conclusions BMI is closely associated with ghrelin in elderly male,ghrelin is significantly lower with increased number of metabolic disorders.

Objective To investigate the effect of PKG on the secretion of IL-6, IL-10, and TNF-αin THP-1 macrophage-derived foam cells. Methods THP-1 monocytes were induced to construct macrophages by treating with 160 nmol/L TPA. Then the macrophages were further treated with 50 mg/L ox-LDL to become foam cells. Four groups were set in this study, including the macrophage group, the foam cell group, the group of foam cell treated with PKG agonist 8-Br-cGMP, and the group of foam cell treated with PKG inhibitor KT-5823. The morphology of THP-1 cells, macrophages and foam cells were observed under microscope. The cellular lipid accumulation was detected by oil red ostaining. The secretion of IL-6, IL-10, and TNF-α into the supernatant was detected by ELISA assay. Results The foam cell was obtained after macrophage incubated with ox-LDL for 48 hours. The secretion of IL-6 and TNF-α increased significantly from the foam cells than that from the macrophages (P<0.05). After the THP-1 monocyte-derived macrophages were incubated with 8-Br-cGMP, the secretion of IL-6 in the supernatant decreased significantly ( P < 0 . 05 ) and IL-10 level in the supernatant increased significantly (P < 0.05). After the macrophages were incubated with KT-5823, the secretion of IL-10 decreased significantly (P<0.05), but the secretion of IL-6 was not significantly changed (P>0.05). After incubation with 8-Br-cGMP, the secretion of IL-6 and TNF-α from the macrophage-derived foam cells decreased significantly (P < 0.05), but IL-10 increased significantly (P<0.05). After the foam cells were treated with KT-5823, the secretion of IL-6 and TNF-αwere also decreased significantly (P<0.05), with no significant change of IL-10 secretion (P > 0.05). Conclusions PKG may enhance the expression of anti-inflammatory cytokine IL-10, and inhibit the expression of inflammatory cytokine IL-6 and TNF-α, contributing to prevent the development of inflammation. PKG might have a potential anti-atherosclerosis effect.

Background:Cholangiocarcinoma(CCA)is a fatal digestive system tumor arising from biliary epithelium. Claudin-4,a key constituent of intercellular tight junction,is aberrantly and widely expressed in various epithelial tumors,and is correlated with tumorigenesis and tumor progression. Aims:To investigate the expression of claudin-4 in CCA and its correlation with clinicopathological characteristics of the tumor and patient’s prognosis. Methods:Immunohistochemistry was used to determine the expression rate and intensity of claudin-4 in CCA tissue and matched paracancerous tissue of 77 CCA patients. Correlation of claudin-4 expression in CCA with its clinicopathological characteristics was analyzed,and survival analysis was conducted by using Kaplan-Meier method. Results:Claudin-4 was strongly expressed in CCA tissue and mildly or weakly expressed in matched paracancerous tissue;the immunohistochemical score was significantly higher in cancerous tissue than in paracancerous tissue(9. 22 ± 3. 62 vs. 7. 12 ± 4. 26,P < 0. 05). Claudin-4 expression was significantly correlated with tumor location and tumor differentiation( P all< 0. 05 );the high expression rate was significantly higher in poorly differentiated CCA than in well or moderately differentiated ones(76. 2% vs. 50. 0% ). The 31-month accumulate survival rates of claudin-4 low-expression group and high-expression group were 29. 8% and 21. 1% , respectively( P > 0. 05). Conclusions:Claudin-4 is highly expressed in CCA and negatively correlated with tumor differentiation. It might be a novel diagnostic biomarker and therapeutic target for CCA.

Objective To evaluate the preliminary clinical efficacy of bevacizumab for cerebral radiation necrosis (CRN). Methods Nineteen patients with CRN for whom the treatment with steroids and mannitol failed were retrospectively analyzed with a total of 22 lesions. Except for 5 lesions confirmed by pathological evidence, all lesions were confirmed by the following imaging evidence:1. computed tomography (CT)?or magnetic resonance imaging (MRI)?enhanced lesions showed loss of tension and were accompanied by substantial edema;2. CT?or MRI?enhanced lesions had a low perfusion pressure;3. magnetic resonance spectroscopy indicated that the enhanced areas had a decreased choline peak; 4. positron emission tomography showed that the fluorodeoxyglucose uptake was substantially reduced in the enhanced areas. All patients were given 5 mg/ kg bevacizumab at an interval of 14 days for 2?6 cycles. MRI examination was performed in each cycle before treatment, and the enhanced lesions on T1?weighted images ( T1 WI) and edema on T2?weighted images (T2 WI) were compared before and after treatment. The clinical symptoms, Karnofsky Performance Status ( KPS), and adverse reactions in all patients were evaluated. Comparison before and after treatment was performed by paired t test. Results All 19 patients completed the treatment successfully and there were no severe adverse reactions. The clinical symptoms of patients were substantially improved after the second cycle of treatment, and the KPS score increased by 26?? 8 on average. The visible volume of enhanced lesions on MRI T1 WI was significantly reduced by 54?? 8% after treatment (P= 0?? 000), while the visible volume of edema on MRI T2 WI was reduced by 80?? 7% after treatment (P= 0?? 000). The follow?up time ranged from 3 to 12 months with a mean value of 5?? 6 months. Eleven patients kept clinical improvement in CRN, four patients had recurrence, and four patients died from tumor progression. Conclusions Bevacizumab is preliminarily confirmed to substantially improve the clinical symptoms and quality of life in patients with CRN.

Objective To review the trends of survival rates and complications in extremely low birth weight (ELBW) infants and to improve the prognosis of ELBW infants.Method From January 1999 to December 2015,ELBW infants in our hospital were retrospectively studied.Their survival rates and complications were compared among groups with different birth weight,and the risk factors for survival were identified using multivariate unconditional logistic regression analysis.Result A total of 243 ELBW infant were collected.The median gestational age of ELBW infant was 27.3 weeks (23 ～ 34 weeks),and their median birth weight was 890 g (490 ～ 995 g).Excluding 40 cases refused treatment,the cure and survival rates of the remaining 203 ELBW infants were 43.8％ (89/203) and 65.0％ (132/203),respectively.The survival rate in ELBW infant with birth weight ＜ 600 g was 0/3,increased to 70.8％ (68/96) when birth weight was 900 ～ 999 g,with an ascending trend with increased birth weight (x2 trend =12.673,P ＜0.001).The most common complications of 243 cases were neonatal respiration distress syndrome [87.7％ (213/243)],sepsis [45.3％ (110/243)],intraventricular hemorrhage [37.4％ (91/243)],bronchopulmonary dysplasia [36.6％ (89/243)] and pheumonia [36.6％ (89/243)].The incidence of complications (including intracerebral hemorrhage and hydrocephalus),decreased with increased birth weight.Multivariate unconditional logistic regression analysis found that birth weight below 800 g (＜ 700 g:OR =22.333,95％ CI 1.493 ～ 334.148,P =0.024;700 ～ 799 g:OR =3.573,95％ CI 1.075 ～ 11.874,P =0.038),stage Ⅲ necrotizing enterocolitis (OR =8.803,95％ CI 1.308 ～ 59.244,P =0.025),stage Ⅲ and Ⅳ of intraventricular hemorrhage (OR =8.902,95％ CI 1.127 ～ 70.338,P =0.038) and mechanical ventilation (OR =3.597,95％ CI 1.043 ～ 12.410,P =0.043) were risk factors affecting the ELBW infant's survival.Conclusion As birth weight increases,the survival rate also increases,and the rate of complications decreases.Birth weight,stage Ⅲ necrotizing enterocolitis,stage Ⅲ and Ⅳ intraventricular hemorrhage and mechanical ventilation are risk factors for the ELBW infant's survival.

Objective: To investigate the prevalence of dyslipidemia among adults in Moyu County, Hotan Prefecture, Xinjiang Uygur Autonomous Region, so as to provide insights into the management of dyslipidemia. Methods: The physical examination data of permanent residents at ages of 18 years and older were collected from Moyu County from 2018 to 2019, including demographic features, height, body weight, blood pressure and blood biochemical parameter measurements. The epidemiological characteristics of dyslipidemia were analyzed among residents. Results: Totally 166 142 adults were investigated, with a mean age of (41.08±15.72) years. There were 77 744 men (46.76%), 34 728 obese adults (20.90%), 5 776 adults with diabetes (3.48%) and 26 294 adults with hypertension (15.83%). The levels of triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were (1.38±0.98), (4.13±1.19), (1.31±0.41) and (2.25±0.77) mmol/L, respectively. The prevalence of dyslipidemia was 29.72%, and the detection rates of high TG, high TC, low-HDL-C and high LDL-C were 9.73%, 4.59%, 19.65% and 1.99%, respectively. The prevalence of dyslipidemia was higher in men than in women (33.97% vs. 25.98%; χ2=1 264.729, P<0.001), and the prevalence increased with age (χ2=539.382, P<0.001) and body mass index (χ2=3 601.833, P<0.001). The prevalence of dyslipidemia was 35.48% among patients with hypertension (χ2=497.251, P<0.001) and 46.07% among patients with diabetes (χ2=766.142, P<0.001). There were 9 059 adults with two and more abnormal blood lipid indexes (18.35%), and the detection rates of two and more abnormal blood lipid indexes were 26.50%, 24.14% and 33.15% among patients with obesity, hypertension and diabetes, respectively. Conclusions The prevalence of dyslipidemia among adults in Moyu County is lower than the national level, and low-HDL cholesterolemia is the most common type of dyslipidemia. The prevalence of dyslipidemia is high among patients with obesity, hypertension and diabetes mellitus, in whom abnormality of multiple blood lipid indexes is measured.