Objective To explore the clinical effect of pressured rapid volume expansion in the treatment of hemorrhagic shock under the monitoring of central venous pressure(CVP).Methods Forty patients with hemorrhagic shock were randomly divided into two groups: the study group (groupⅠ,n=20) and the control group(groupⅡ,n=20).In groupⅠ,the patients were treated with rapid intravenous infusion by pressured soft fluid in bags under the CVP,and the patients received traditional transfusion method in groupⅡ.Results The average amount of transfusion in 30 minutes and the total amount in perioperative period were(1271?170) ml and(5311?410) ml in groupⅠrespectively,and in groupⅡ,the results were(721?140) ml and(3273?330) ml respectively.The recovery of systolic blood pressure(SBP),diastolic blood pressure(DBP),central venous pressure(CVP) and pulse oxygen saturation(SpO_2),the time of recovered urination and cure rate in groupⅠ were significantly better than those in groupⅡ.The mortality reduced in the study group.Conclusion With the monitoring of CVP,the pressured rapid volume expansion is an effective treatment for hemorrhagic shock.With the pressured rapid volume expansion,the circulating blood volume of patients can be recovered rapidly and the perfusion of important organs,tissues and cells be maintained.

Objective To explore the effects of health education combined with WeChat′s public platform in the management of risk factors in patients with coronary heart disease. Methods A total of 100 coronary heart disease patients were randomly divided into intervention group and control group and there were 50 cases in each group by the random number table. The intervention group received health education about risk factors combined with WeChat′s public platform for 6 months. The control group received routine health education. Evaluate the control rate of blood pressure, blood glucose and blood lipid and the score of coronary heart disease self-management scale of the two groups before and after the intervention. Results At the 6th month after intervention, the control rate of blood pressure of the intervention group was 88.0％(44/50) and it of the case group was 70.0％(35/50).The difference between the 2 groups was statistically significant (χ2=4.882, P < 0.05). The score of coronary heart disease self-management scale of the intervention group was (102.44±8.22) points and it of the case group was (89.82±8.01) points . The difference between the 2 groups was statistically significant(t=7.776, P < 0.05). Conclusions The health education combined with WeChat′ s public platform contributed to help coronary heart disease patients to establish good self-management behavior and it can be widely used in the management of coronary heart disease risk factors.

Objective To investigate the difference of gene expression in two human gastric adenocarcinoma cell lines, 5-fluorouracil resistant cell line SGC7901/R and its parental cell line SGC7901, and to screen related genes of JAK/STAT signaling pathway by gene chip. Methods The mRNAs of two cell lines were extracted and purified. The two cDNA probes were made from these two mRNAs which were labelled by (biotin-)16-dUTP, hybridized with human JAK/STAT signaling pathway gene array and scanned for intensity, respectively. The acquired images were analyzed by software. Different expression genes were then screened out. The mRNA expressions of Stat3, NF-?B1 and bcl-x were analyzed by semi-quantitative RT-PCR, (respectively.) Results A parallel comparison between the gene profiles of JAK/STAT signalling pathway in two cell lines showed that a total of 70 genes were screened out whose expressive level was more than 2 folds in 5-flurouracil resistant cell line SGC7901/R and its parental cell line SGC7901. Among these genes, 40 were upregulated and the other 30 were down-regulated. The results of RT-PCR were consistent with those of microarray scanning. Conclusions The knowledge of gene expression profile of JAK/STAT signaling pathway, which was changed in 5-fluorouracil resistant cell line of human gastric adenocarcinoma, has proven to be useful for illustrating the multi-drug resistance mechanisms of gastric cancer.

Objective To compare the effects of peripherally inserted central catheter(PICC)and venous port access (VPA)on the complication incidence of breast cancer.Methods A total of 191 breast cancer patients with VPA and 218 ones with PICC for chemotherapy from January 2012 to January 2014 were involved.The two groups were compared in respect of incidence of complications during intubation.Result The complication incidence in the VPA group was lower than the PICC group(P<0.05). Conclusion VPA is an ideal pathway for intravenous infusion in breast cancer patients undergoing chemotherapy.

Objective To analyse the clinical manifestations of mycoplasma pneumoniae pneumonia(MPP) with 23SrRNA A2063G gene mutation,and improve the ability of diagnosis and treatment of patient infected with MPP.Methods MP-DNA was detected by fluorescent quantitative real-time PCR in sputum specimens from 36 children with MPP,then we detected the drug resistance gene mutation sites by nest-PCR and DNA sequencing,on this basis we classified into two groups of macrolide-resistant MP and macrolide-sensitive MP,and compared the clinical manifestations,laboratory findings,chest imagings and treatment between two groups.Results Of these 36 cases of MPP,24 cases had macrolide-resistant gene mutation with an A2063G transition in domain V of the 23SrRNA,12 cases had no macrolide-resistant gene mutation.Compared to macrolide-sensitive MP group,macrolide-resistant MP group had longer hospitalization duration,longer total cough period,longer total febrile period,longer fever duration after macrolide therapy,longer course of disease,and had higher white blood cells counts and CRP.In the macrolide-resistant MP group,the temperature subsided within 5 days after macrolide treatment alone of 12 cases,3 cases needed switch to fluoroquinolones therapy,10 cases combined with glucocorticoids and 6 cases combined with intravenous immunoglobulin,all 24 patients had good outcomes.While in macrolide-sensitive MP group,the temperature susided between 12 hours to 3 days after macrolide treatment of 8 cases.Conclusions Compared to patients infected by macrolide-sensitive MP,those mycoplasma pneumoniae pneumonia patients with 23SrRNA A2063G gene mutation have longer hospitalization duration,longer total cough period,longer total febrile period,longer fever duration after macrolide therapy,longer course of disease,and have higher white blood cells counts and CRP.Some macrolide-resistant MPP patients have good response to macrolide antibiotics treatment,while the severe cases need combined with glucocorticoids and immunoglobulin,or should change antibiotics.

Objective To study the effect of sodium ferulate (SF) on the expressions of nuclear factor-?B (NF-?B) and inhibitory ?B? (I?B?) in rat brain microvascular endothelial cells (BMEC) injured by hypoxia. Methods Brain microvascular endothelial cells from Wistar rat cerebral cortex were isolated and cultured, and then cultivated in 95%N_2 and 5% CO_2 for 12 h to induce hypoxia injury. The cells were divided into normal group, hypoxia group, and SF group. BMEC activity was assayed by MTT assay. Endothelin-1(ET-1) concentration was evaluated by radioimmunoassay.The expression of NF-?B and I?B? of BMEC were assessed by immunocytochemistry. Results The content of ET-1 in BMEC media was increased after hypoxia, while sodium ferulate (100 ?g/ml) significantly decreased the content compared with hypoxia group. Immunocytochemistry indicated I?B? expression were significantly decreased in hypoxia BMEC in consistent with NF-?B expression. Conclusion Sodium ferulate may significantly reduce NF-?B of hypoxia BMEC and nuclear translocation, and increase I?B? expression and BMEC activity. It is a potent inhibitor of NF-?B in endothelial cells, which might explain its beneficial effect on injured BMEC by hypoxia.

Objective To retrospectively investigate the clinical features of localized primary small bowel stromal tumors (SBSTs) and the impacting factors for prognosis.Methods The clinical and pathological data of 89 consecutive SBSTs patients,with pathologically confirmed,who underwent complete resection in Ruijin hospital between January 2003 and September 2007 were collected and analyzed.All patients were followed up for assessment of tumor recurrence and metastasis.The impacts of clinical and pathologic factors on rate of disease free survival (DFS) of the patients was evaluated.Results In total of 89 follow-up patients,15 patients were diagnosed with tumor recurrence and 9 of them died.The tumor size,mitotic index and pathological risk stratification were statistically related with DFS (P=0.000,P=0.006,P=0.000,respectively) by using Kaplan-Meier univaritate analysis.Tumor size and mitotic index were proved to be independent prognostic factors for tumor recurrence by multivariate analysis COX regression model.Conclusions Tumor size and mitotic index are related with tumor recurrence,and can be regarded as independent predictive factors of tumor recurrence.

Objective To investigate current status of knowledge-attitude-behavior about unplanned extubation (UEX) of central venous catheter among infusion nurses in Guangdong Province.Methods The nurses who attended the 2015 intravenous therapy nursing training provided by Guangdong Nursing Association were selected as participants.A self-designed questionnaire about nurses' knowledge-attitude-behavior about UEX of central venous catheter was used to investigate 450 nurses.Results The proportion of nurses who reached good level in knowledge were 41.1％,nurses who had positive attitude were 71.0％,nurses who had positive behaviors were 30.0％.There were significant differences among nurses with different educational background,different titles and different hospital ranks(P＜0.05).Conclusion The knowledge-attitude-behavior of nurses are not satisfactory,especially those who are junior or have lower education or work in non-tertiary hospital.

Objective To evaluate the clinical value of double-balloon enteroscopy( DBE)in as-sessing the effect of mucosal healing in patients with moderate small bowel Crohn's disease( CD)treated with low-dose azathioprine. Methods CD patients who were naive to any immunomodulators or biological a-gents with lesions mainly located in ileu were screened by multislice CT enterography and anal-route DBE at baseline. Lesions at 150 cm proximal to ileocecal valve were assessed by DBE with Simple Endoscopic Score for CD( SES-CD)after 12 and 24 months of low-dose azathioprine treatment,respectively. Results A total of 36 patients were enrolled and the average tolerated dose of azathioprine was(61. 8 ± 17. 2)mg/day. The total rates of complete,near-complete,partial and no mucosal healing in 36 patients were 19. 4%(7/36), 5. 6%(2/36),27. 8%(10/36),and 47. 2%(17/36)at month 12 and 30. 6%(11/36),25. 0%(9/36), 33. 3%(12/36),and 11. 1%(4/36)at month 24,respectively. The baseline SES-CD score(OR=2. 71, 95%CI:1. 11-6. 63,P=0. 029)and duration of disease(OR=1. 27,95%CI:1. 10-1. 47,P =0. 001) were two relevant factors associated with mucosal healing of small bowel CD. Conclusion DBE has a signif-icant advantage in assessing post-therapy mucosal healing for patients with small bowel CD. The optimal time point for the first follow-up by DBE is at least 12 months after low-dose azathioprine treatment.

ObjectiveThe clinical features, bacteria distribution and antibiotic resistance proifle of blood stream infection(BSI) were investigated in the patients with decompensated liver cirrhosis for better management of such infections.MethodsThe clinical data of BSI were collected in the patients with decompensated liver cirrhosis between January, 2012 and December, 2014, and reviewed retrospectively in terms of risk factors, diagnosis and treatment, pathogen distribution and prognosis.ResultsOf the 1 071 patients with decompensated liver cirrhosis and suspected bacterial infection, 154 (14.4%) were diagnosed as BSI evidenced by blood culture. Of these patients, the leukocyte count in the peripheral blood was higher than 10×109/L in only 48 (31.2%) patients; neutrophil proportion>0.75 in 133 patients (86.4%); serum procalcitonin level>0.5 ng/mL in 74 patients (68.5%). A total of 155 bacterial strains were isolated, including 115 strains of gram-negative bacilli and 40 strains of gram-positive cocci. Most patients (68.8%) recovered and 31.2% died or discharged from hospital voluntarily. All these BSI patients had Child-Pugh grade C liver function. Some patients also had other serious systemic diseases or repeated hospitalization.ConclusionThe prevalence of BSI is high in the decompensated liver cirrhosis patients with poor prognosis. Gram-negative bacilli are the major pathogens of such septicemia. Early diagnosis and proper use of antibiotics based on antimicrobial susceptibility testing are important to improve patient outcome.