Objective To explore the clinical effect of IPL combined with tranexamic acid in the treatment of chloasma.Methods 50 patientss with chloasma were selected,and they were randomly divided into two groups by odd-and-even grouping method.The control group received IPL treatment,the study group was given photorejuvenation combined with tranexamic acid treatment.The MASI score,clinical efficacy and adverse reactions were compared between the two groups.Results The MASI score[(8.71 ± 0.82) points] and the total effective rate (92.00％) of the study group were significantly better than those of the control group [(11.35 ± 1.03) points,68.00％,t =3.10,x2 =4.39,all P ＜ 0.05].The incidence rate of adverse reaction betweem the two groups (16.00％,16.00％) had no significant difference (x2 =0.00,P ＞ 0.05).Conclusion Photorejuvenation combined with tranexamic acid has significant clinical effect in the treatment of chloasma.

Objective To investigate the effect of treatment with endostatin combined with siRNA targeting VEGF on rats with collagen-induced arthritis (CIA).Methods Two mg/ml bovinetype Ⅱ collagen was injected into the rat footpad to build up the animal model of CIA.The experimental animal models were treated with endostatin combined with siRNA targeting VEGF 18 days later after immunization and the treatment ended 32 day later.The efficacy was evaluated by the weight,foot and ankle volume of rats.The levels of VEGF in plasma were detected by enzyme-linked immunosorbent assay (ELISA).The VEGF distribution within synovial tissue was detected and examined by immunohistochemical technique.The pathological changes of CIA were evaluated by the pathological changes of the biopsied ankle joints.Student's t test was used to evaluate the experimental data.Results The ELISA test showed that comparing with the model group (17.5±0.3),the endostatin group (15.7±0.3) ng/L and the endostatin combined siRNA targeting VEGF group (14.7±0.5) ng/L showed a significant efficacy in the treatment of CIA in rats (P＜0.05).The endostatin group (135±27) and the endostatin combined siRNA targeting VEGF group (126±71) were different in the number of VEGF in plasma and the VEGF distribution within synovial tissue (P＜0.05),the symptoms of arthritis in these rats were reduced than the model group.Conclusion Endostatin combined siRNA targeting VEGF has good therapeutic effect on rats with CIA.

Objective:To detect the pain status and the pain management of home-based advanced cancer patients, and to investigate the key factors impacting the satisfaction on pain management.Methods:Totally the data of 138 cases from the hospice department in the duration from Jan. 2019 to Jun. 2019 were collected and analyzed by χ2 test with SPSS 23.0. Results:109 cases in 138 cases received analgesics treatment before, 54.13% of these participants expressed satisfaction with the effect of their pain management, and 45.87% showed unsatisfied on their pain management. Cancer clinical stage and PMI (pain management index) were both detected to be the significant factors for satisfaction of pain management ( P<0.05, P=0.029; P<0.01, P=0.001) . Conclusions:Cancer clinical stage and PMI are found to be related to the satisfaction for pain management. The percentage of patients who use opioids increased. while there was still a part of patients suffering from inadequacy of pain management. The pain management for home-based advanced patients needs to be paid more attention by medical staff.

Objective:To analyze the detection of gallbladder polyps among shift nurses in Shengjing Hospital of China Medical University in physical examination and its related influencing factors, so as to provide scientific basis for shift nurses to prevent gallbladder polyps.Methods:A total of 1 119 shift nurses who had physical examination in Shengjing Hospital of China Medical University from January 1 to March 31, 2018 were selected. The patients with gallbladder polyps diagnosed by ultrasound were included in the case group, and those without gallbladder polyps were taken as the control group. Age, gender, body mass index (BMI), night shift frequency, education level, Department, meal regularity, drinking history, smoking history, serum triglyceride, serum total cholesterol, hepatitis B surface antigen, serum alanine aminotransferase and serum aspartate aminotransferase levels were compared between the two groups.Results:Univariate analysis showed that age ( P<0.001), gender ( P=0.028), BMI ( P=0.005), night shift frequency ( P=0.021) were the factors with statistically significant difference between the case group and the control group. There were no statistically significant differences between the case group and the control group in terms of education level, department, dining regularity, drinking history, smoking history, hepatitis B surface antigen, serum triacylglycerol, serum total cholesterol, serum alanine aminotransferase, serum aspartate aminotransferase levels ( P>0.05). Logistic regression analysis showed that age, BMI and night shift frequency were the influencing factors in the regression equation ( P<0.05). Conclusion:Age, BMI and night shift frequency may be related risk factors of gallbladder polyps in shift nurses.

Objective To evaluate neurodevelopmental outcome of very preterm(gestational age ＜ 32 weeks) and very low birth weight infant (VLBWI) (weight ＜ 1 500 g) and to examine the effectiveness of an early intervention program till 12 months corrected age.Methods Seventy followed-up very preterms and VLB-WI in Jinan Maternity and Childcare Hospital were enrolled in this study from January 2012 to and were divided into two groups by birth weight.All infants received 20 items of behavioral neurological assessment at 1 to 12 months corrected age and tested mental and psychomotor development with the use of CDCC at 6,12 months corrected age.The preterms who were abnomal in the 20 items of behavioral neurological assessment would receive early intervention (including kinesitherapy, physiotherapy, cereal circulation therapeutic equipment) by physiotherapists and their parents who received an intervention program training and were strongly encouraged to participate in the intervention sessions.The intervention method was adjusted according to the neurological assessment.The SPSS statistical software package for Windows, version 15.0, was used to run Fisher's exact test and t-test on the data presented,and P value of less than 0.05 was regarded as statistically significant.Results The average gestational age of infants was (30.4 ± 1.8) weeks,and average birth weight (1 463.7 ± 307.5) g.The incidence of extrauterine growth restriction was 57.1％ at first follow-up.The incidence of neurodevelpmental impairment NDI) and cerebral palsy tendency at 6 corrected months were 14.3％ ,8.6％ respectively.At 12 months corrected age,the incidence of NDI decreased to 2.9％ and cerebral palsy to 2.9％.There was significant difference in the incidence of NDI between 6 and 12 corrected months.There was no significant difference in the incidence of psychomotor developmental index ＜ 70, mental developmental index ＜ 70, NDI and cerebral palsy between the two groups.Conclusion The early intervention program can improve VLBWI neurodevelopmental outcomes at 12 months' corrected age and reduce the incidence of cerebral palsy.

Objective To investigate the effect of mucolytic agents during endoscopic sinus surgery.Methods 84 patients of chronic rhinosinusitis were employed in the study,which were randomly divided into the control group(41 subjects) and study group(43 subjects) according to the digital table.The patients in the control group adopted regular therapies,and study group were received regular therapies as well as mucolytic agents(eucalyptol-limonene-pinene soft capsule,300 mg,three times a day) application for 8 weeks.Followed visiting lasted for 6 months.The VAS scores,Lund-Mackay scores and efficient rate were compared.Results The VAS scores and Lund -Mackay scores in the control group after treatment were (3.63 ± 1.71)points and (8.34 ±4.68) points,and which in study group were (2.03 ± 1.67) points and (6.48 ± 3.59) points,and the difference was statistic significant (t =4.338 and t =2.049,P ＜ 0.05).According to CPOS-2012,in the control group,19 cases were controlled,14 cases were partly controlled,and 8 cases were uncontrolled,the whole efficient rate was 80.5％.in the study group,24 cases were controlled,17 cases were partly controlled,and 2 cases were uncontrolled,the whole efficient rate was 95.3％.Compared to the control group,the efficient rate of the study group was higher,the result showed statistical significance (x2 =4.420,P ＜ 0.05).Conclusion Using mucolytic agent after surgery can improve the controlled rate and affect the success of treatment of chronic rhinosinusitis.

Aged ; Humans ; Lung Diseases, Fungal ; complications ; Silicosis ; complications ; microbiology ; Tuberculosis, Pulmonary ; complications

Objective To observe the clinical efficacy of cytokine-induced killer cells (CIK) combined with three dimensional conformal radiotherapy synchronization XELOX regimen in the treatment of local recurrence of rectal neoplasms.Methods A total of 81 patients with local recurrence of rectal neoplasms were divided into treatment group (41 patients) and control group (40 patients) by random digits table method.In treatment group,41 patients received simultaneous three dimensional conformal radiotherapy combined with XELOX chemotherapy,then received CIK treatment.In control group,40 patients received concurrent chemoradiotherapy.The immune function,quality of life (QOL) scores,recent efficacy,survival rate and adverse reactions were analyzed.Results In treatment group,the level of CD3+,CD4+,CD4+/CD8+ and CD16+ CD56+ increased and the level of CD8+ decreased significantly after treatment than those before treatment (0.671 ± 0.012 vs.0.625 ± 0.022,0.378 ± 0.043 vs.0.315 ± 0.035,1.59 ± 1.41 vs.1.02 ± 1.14,0.184 ±0.008 vs.0.121 +0.023,0.237 ±0.030 vs.0.308 ±0.031,P ＜0.05).Compared with those in control group after treatment,the level of CD3+,CD4+,CD4+/CD8+ and CD16+ CD56+ in treatment group increased and the level of CD8+ decreased significantly (P ＜ 0.05).QOL scores of 70.7％ (29/41) patients in treatment group was improved,significantly higher than the 32.5％ (13/40) in conctol group (P =0.001).The response rate(RR) in treatment group was 92.7％(38/41),significantly higher than that in control group [75.0％ (30/40)] (P =0.030).The 1-year survival rate in treatment group and control group were 90.2％(37/41) and 85.0％(34/40),there was no significant difference (P =0.473).The side effect in treatment group and control group showed no significant difference (P＞0.05).Conclusion CIK combined with concurrent chemoradiotherapy in the treatment of local recurrence of rectal neoplasms can improve patients 'immune function,QOL and recent efficacy.

Objective The aim of study is to evaluate the efficacy of a new complementary midurethral sling surgery in treating recurrent or persist female stress urinary incontinence (SUI) after primary Synthetic mid-urethral slings (MUSs).Methods The methods was used in 32 patients who had suffered recurrent or persist SUI patients after primary MUSs during June 2005 and July 2011.Their primary MUSs were:TVT 2 cases,IVS 4 cases,TVT-O 17 cases,TOT 3 cases,T-sling 1case,other MUSs 5 cases.9 cases complained SUI symptoms continued after primary surgery and had no improvement after 6 months following up.23 cases reported SUI symptoms recurrent and aggravated in 6 months after primary operation and had no improvement 1 year after operation.All these patients have been treated with surgery,a trans-vaginal mid-urethral sling on descending pubic ramus.In this study we followed up these patients for one year after this complementary operation and evaluated operating time,blood loss,efficacy and complications.Results In this study the operating time was 41.1±13.1 minutes,blood loss was 70.6±23.8 ml.30 patients kept urinary catheter 6 h after operation and 2 kept urinary catheter 48 h after operation.All patients could micturate after removed urinary catheter and average residual urine was 23.8 ± 21.4 ml (range 0-80 ml).The average in-patients duration was 4.8± 1.1days.SUI symptoms still persisted in two patients after second operation,subjective cure was achieved in 26 patients and the symptoms obviously improved in 4 patients when they left hospital.The efficient rate was 93.8％ (30/32) left hospital and after 3 months,93.3％ (28/30) after 6 months and 86.2％ (25/29) after 1 year.There were 2 cases of recurrence and 1 case of mesh erosion after 1 year,no other operative complications were reported.Conclusions Our study found that it is a efficient operation to treat SUI recur or persist after primary.

The early of nutritional support (parenteral and enteral) in the very/extremely low birth weight infants improve the survival rate and avoid extrauterine growth restriction.The practice of early nutritional strategy,appropriate enteral feeding and the individualized care and assessment program can result in catch-up growth and avoid growth and development deficits.