Objective We observed the effect of topical application of mucopolyccharide polysulfate cream (hirudoid) on phlebitis prevention initiated by continuous infusion of 5-Fu with Baxter infusor. Methods 60 untreated patients with nasopharyngeal carcinoma were selected and randomly divided into the control group (28 patients) and the experimental group (32 patients). The patients of the experimental group were gently massaged with hirudoid along the infusion vein since the beginning of 5-Fu infusion, while the control group received no intervention. The incidence of phlebitis was observed in the two groups. Results The incidence of phlebitis in the experimental group was lower and the degree was lighter compared with the control group. Conclusions Hirudoid can decrease the incidence and released the symptoms of phlebitis initiated by continuous infusion of 5-Fu with Baxter infusor, and is effective to prevent and treat phlebitis.

Objective To analyze the clinical manifestation and imaging manifestation of moyamoya disease, and to ex-plore the application value of double source FlashCT angiography and its post-processing technique in the diagnosis of moyamoya disease. Methods Clinical characteristics and data of imaging examination of 21 patients with moyamoya disease who were admitted to our hospital from January 2013 to July 2014 were retrospectively analyzed. Results①Age of onset of moyamoya disease was around 17-42 years old, and patients younger than 40 years old accounted for 90% of the total. The clinical manifestation was mainly ischemia, and weakness of limbs and hemiplegia were the most commonly seen. ②CT indicated that 13 patients were cerebral infarction, 6 patients were cerebral bleeding, and 2 pa-tients were cerebral bleeding complicated with cerebral infarction. CT angiography and DSA showed stenosis or block-ing of bilateral or unilateral internal carotid artery, anterior cerebral artery and middle cerebral artery, and showed the formation of abnormal vessel network at the base of the brain like smoke. Conclusion For children and adults who have repeated occurrence of transient ischemic attack, cerebral bleeding, and cerebral infarction, moyamoya disease should be highly suspected. CT angiography can be selected as the first choice of examination, and DSA examination should be performed timely for clinically suspected cases.

Objective To explore the nursing method for the prevention and treatment of vaginal adhesions in patients treated with full-dose radiotherapy for cervical cancer. Methods From 2015 to 2016, 80 cervical cancer patients who received radiotherapy were treated with domestic vaginal washing, vaginal local use of"Fufangbao", infection control, diet and sexual rehabilitation guidance, and so on, and the nursing outcome was evaluated. Results Of the 80 patients, 6 were lost during follow-up, resulting in a follow-up rate of 925%. Ten, five, and three patients were found to have grade 1, 2, and 3 vaginal toxicity, respectively. The patients with grade 1 vaginal toxicity were not treated with special treatment and were asked to do more vaginal washing. The patients with grade 2 and 3 vaginal toxicity were treated with daily vaginal washing and"Fufangbao" for repairing the vagina;vaginal adhesions disappeared or improved 3 months later. The patients with no vaginal adhesions had regular sexual intercourse and thus had improved quality of life. Conclusions Effective clinical nursing can reduce the incidence of vaginal adhesions and stenosis, improve patients' quality of life, and promote the harmony of family.

Most of the developed countries in the world have established a complete system of training of specialists consistent with their respective national circumstances.On the basis of continuously improving the training of clinical residencies in our country,we have started the formal training of pediatric neurologists.This article introduces the current status of pediatric specialists training in Children Hospital of Chongqing Medical University and the western region in China and puts forward relevant suggestions by comparing itself with that in North America,including:(1) establishing a perfect organizational structure and division of responsibilities of the training base,(2) standardizing the system of admission,(3) prolonging the training time and establishing a comprehensive training mode,(4) formulating strict assessment system and forming a standardized assessment model,(5) ensuring continuous and adequate financial support.

Objective:To construct a cluster care of oral nutrition supplements (ONS) , and to explore its effect in home care of postoperative patients with gastric cancer.Methods:Literature search was conducted to review the status quo of ONS compliance at home in patients with gastric cancer after surgery, and analyze the existing problems. We summarized and formulated the cluster care plan according to the evidence, and established the home ONS management team and process. From November 2020 to October 2021, 107 patients with gastric cancer who needed to implement ONS at home in Gastrointestinal Surgery of Ningbo First Hospital were selected as research objects by convenience sampling. Postoperative patients with gastric cancer from November 2020 to April 2021 were set as the control group ( n=40) , and those from May to October 2021 were set as the observation group ( n=67) . The control group was treated with conventional ONS, and the observation group was treated with home ONS cluster care plan on the basis of the control group. The compliance of nutritional support, weight gain, body mass index increase and follow-up experience between the two groups were evaluated. Results:After six months of intervention, the scores of ONS compliance, weight gain, body mass index increase and follow-up experience in the observation group were significantly higher than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The cluster care plan improves the ONS compliance at home, nutritional status and satisfaction with the follow-up by medical and nursing staff in patients with gastric cancer after surgery, which is worthy of clinical promotion.

Uch37 is a de-ubiquitinating enzyme that is activated by Rpn13 and involved in the proteasomal degradation of proteins. The full-length Uch37 was shown to exhibit low iso-peptidase activity and is thought to be auto-inhibited. Structural comparisons revealed that within a homo-dimer of Uch37, each of the catalytic domains was blocking the other's ubiquitin (Ub)-binding site. This blockage likely prevented Ub from entering the active site of Uch37 and might form the basis of auto-inhibition. To understand the mode of auto-inhibition clearly and shed light on the activation mechanism of Uch37 by Rpn13, we investigated the Uch37-Rpn13 complex using a combination of mutagenesis, biochemical, NMR, and small-angle X-ray scattering (SAXS) techniques. Our results also proved that Uch37 oligomerized in solution and had very low activity against the fluorogenic substrate ubiquitin-7-amino-4-methylcoumarin (Ub-AMC) of de-ubiquitinating enzymes. Uch37Δ(Hb,Hc,KEKE), a truncation removal of the C-terminal extension region (residues 256-329) converted oligomeric Uch37 into a monomeric form that exhibited iso-peptidase activity comparable to that of a truncation-containing the Uch37 catalytic domain only. We also demonstrated that Rpn13C (Rpn13 residues 270-407) could disrupt the oligomerization of Uch37 by sequestering Uch37 and forming a Uch37-Rpn13 complex. Uch37 was activated in such a complex, exhibiting 12-fold-higher activity than Uch37 alone. Time-resolved SAXS (TR-SAXS) and FRET experiments supported the proposed mode of auto-inhibition and the activation mechanism of Uch37 by Rpn13. Rpn13 activated Uch37 by forming a 1:1 stoichiometric complex in which the active site of Uch37 was accessible to Ub.
Binding Sites ; Catalytic Domain ; Chromatography, Gel ; Crystallography, X-Ray ; Humans ; Membrane Glycoproteins ; chemistry ; genetics ; metabolism ; Nuclear Magnetic Resonance, Biomolecular ; Protein Binding ; Protein Conformation ; Protein Multimerization ; Scattering, Small Angle ; Ubiquitin Thiolesterase ; chemistry ; genetics ; metabolism ; Ultracentrifugation