Objective To investigate the key points of nursing during the course of breast tumor excision by endoscope. Method Summarized the nursing points of 24 patients who have accepted the breast tumor excision by endoscope. Results The key points of successful operation were sufficient preparation before the operation, the special skills of nurses, exactly and quickly transfer instruments and expert cooperation. Conclusion Paving attention on psychological nursing, the correct and skillful nursing care can reduce the operation time, and then make sure the successful operation.

Objective To investigate the value of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in the diagnosis of pulmonary cryptococcosis.Methods 15 patients who were diagnosed as pulmonary cryptococcosis were retrospectively studied,all of them were examined by sputum smear,X ray,CT and EBUS-TBNA.Results 15 patients who received EBUS-TBNA were diagnosed pulmonary cryptococcosis by pathological methods and germiculture,during the process no complication was detected.Conclusion EBUS-TBNA is a safe and effective means in the diagnosis of pulmonary cryptococcosis for pulmonary cryptococcosis patients hard to be diagnosed clinically.

Chronic constipation(CC)is one of the most common gastrointestinal disorders. Treatment of CC includes drug and non-drug treatment. Biofeedback(BF)is a psychological behavior therapy and has become the first-line therapy of CC. However,the efficacy of BF reported varied substantially. This article reviewed the evaluation of efficacy of BF on CC.

Fetal hydrocephalus is a kind of congenital malformation,which is characterized by the enlargement of the ventricular system and the obstruction of cerebrospinal fluid.It is not accompanied by a primary brain atrophy,with or without the increase of head circumference.Early diagnosis and early treatment is very important.Without the timely inter-vention,most of the patients will die during the perinatal and infant period,and even the survivors often suffer from cere-bral palsy and mental retardation.However,the long -term prognosis and clinical course of patients with hydrocephalus is not yet fully understood.There is controversy on the factors which influence the long -term outcome,such as the timing of diagnosis of hydrocephalus,the severity of ventricular dilatation,the basic disease and accompanying anomalies.So,should establish comprehensive protocols to avoid and decrease fetal hydrocephalus,as well as pay attention to the clinicopatho-logical research,prenatal diagnosis,perinatal management and early treatment of fetal hydrocephalus.

Objective To compare clinical value of peripheral blood collection and venous blood collection methods in blood tests.Methods 467 patients who received blood test were selected.The venous blood and peripher-al blood were collected,the indicators of blood test were detected,and the test results were analyzed.Results The white blood cell count (WBC),red blood cell count (RBC),platelet count (PLT),red blood cell hematocrit (HCT),hemoglobin (HB)of venous blood were (5.7 ±1.2)×109 /L,(3.72 ±0.48)×109 /L,(218.0 ±57.5)× 109 /L,(41.8 ±19.8)g/L,(115.7 ±13.8)g/L respectively,those of peripheral blood were (6.7 ±3.4)×109 /L, (3.62 ±0.72)×109 /L,(204.0 ±87.7)×109 /L,(32.7 ±20.7)g/L,(103.6 ±19.6),the differences were statis-tically significant (t =5.994,2.497,2.885,6.865,10.908,all P <0.05).The mean red cell hemoglobin concentra-tion (MCHC),mean red cell volume (MCV),mean erythrocyte hemoglobin (MCH)and other indexes had no signifi-cant differences(all P >0.05).Conclusion The test results in patients with venous and peripheral blood was quite different,venous blood test results obtained with greater value in clinical use,it is recommended that routine blood test used venous blood.

Objective To explore the effects of micro channel (mPCNL)and standard channel percutaneous lithotripsy (sPCNL)on hemodynamics and blood gas analysis in patients with renal calculi.Methods From March 2007 to June 2015,180 patients with kidney stones were selected as the research subjects,through digital said method,the patients were randomly divided into MPCNL group and sPCNL group,the former F16 plastics through established channels of percutaneous nephrolithotomy.The latter F24 plastics through established channels of percuta-neous nephrolithotomy.The changes of hemodynamics and blood gas analysis were observed and compared in the two groups during perioperative period .Results In MPCNL group ,theoperation time was significantly shorter in sPCNL group(t =-6.018),the perfusion fluid was higher than that of sPCNL group(t =20.506,P <0.05).The perfusion of MAP and CVP of the two groups were significantly lower than those before anesthesia,and irrigation flow after dif-ferent time and postoperative were significantly higher than those before hemoperfusion,60 min,120min,after opera-tion MAP value of MPCNL group,test value was as follows(t60min =5.878,t120min =6.802,tpostoperative =7.070,all P <0.05);60min,120min,after operation CVP value of MPCNL group,test value was as follows (t60min =5.987,t120min =6.505,tpostoperative =7.180,all P <0.05).60min,120min,postoperative MAP value of sPCNL group,test value was as follows (t60min =5.613,t120min =7.238,tpostoperative =7.170,all P <0.05);60min,120min,postoperative the CVP value of sPCNL group,test value was as follows (t60min =7.682,t120min =7.135,t[postoperative]=9.218,all P <0.05). Blood gas analysis showed that the two groups of postoperative Na +,Cl - compared with before anesthesia had no sta-tistically significant difference(P >0.05).Two groups of postoperative K +,pH,BE,Hb were lower than before anes-thesia,the differences were statistically significant (P <0.05).The two groups of patients with no postoperative urina-ry sepsis and other serious complications.Conclusion With the increase of operation time filling fluid absorption on hemodynamics and arterial blood gas analysis of influence gradually increased;in heart,lung and normal renal function patients,due to the compensatory organ function,caused by MPCNL and sPCNL irrigation fluid absorption differences in the amount is not enough to cause different hemodynamics and blood gas analysis.

Objective To investigate the receptor involved in the TNF?induced HO-1 expression and the related signal transduction mechanisms in the brain microvessel endothelial cells.Methods TNF? receptor 1(TNFR1)knockout murine brain microvessel endothelial cells(BMVECs)in vitro culture were stimulated respectively by TNF?(5ng/ml).After 24 hours,the level of HO-1 gene mRNA were detected by semi-quantitative RT-PCR,the effect of TNF?on JNK 、ERK or transcription factor AP-1 were analyzed by Western blot,while ERK inhibitor(PD98059)or JNK inhibitor(SP600125)were used.Results Exposure of wild-type BMVECs and TNFR1(p55)knockout BMVECs [BVEC/TNF-RI(-/-)] to TNF?(5ng/ml,24 h)caused a marked increase in HO-1 mRNA expression.Furthermore,TNF? stimulation also lead to the activation of JNK,ERK and the transcription factor AP-1 in the BVEC/TNF-RI(-/-),However,incubation with the JNK inhibitor SP600125 but not the ERK inhibitor PD98095 attenuated the TNF?-induction of HO-1 in the BVEC/TNF-RI(-/-).Conclusions TNFR2 and JNK activation but not TNFR1 might be essential for mediating the TNF?-induction of the HO-1 in the endothelial cells.

This paper essentializes the pertinent discussion regarding the treating incontinent syndrome with dredging method in traditional Chinese medical literature. It illustrates 2 medical records of famous doctors as prove, and brings forward 6 gains from clinical experiences in the light of traditional Chinese medical articles and the author and precursors’ clinical experiences.

Aim To investigate the protective effects and mechanisms of a 5-lipoxygenase (5-LO) inhibitor zileuton on the acute lung injury (ALI) induced by focal cerebral ischemia-reperfusion injury (CIRI) in rats.Methods The right middle cerebral artery in rats were occluded by inserting a thread through internal carotid artery for 2 h,and then reperfused for 24 h.Zileuton(10,50 mg?kg-1) was orally administered 2h before ischemia and 0,5,10 h after reperfusion.Morphological changes of the lung tissue were observed by hematoxylin-eosin (HE)staining technique. Lung wet/dry weight ratios were detected to observe the water content of the lung. The mRNA of cysteinyl leukotrienes recepor1 (CysLTR1) was detected by RT-PCR. The content of Leukotriene B4 (LTB4) in serum was measured by enzyme linked immunosorbent assay (ELISA) technique. The expression of TNF-? protein was measured by immunohistochemical technique. The activities of MPO, T-AOC, and Na+,K+-ATPase from the lung tissue were measured by biochemical method.Results With the use of zileuton 10, 50 mg?kg-1,the pathological changes of the lung were alleviated. and the wet/dry weight in the lung tissue was reduced(P

Objective To screen the influencing factors related to prolonged mechanical ventilation (PMV). Methods Series of parameters of 154 elderly patients with pneumonia or COPD exacerbation were collected before using ventilator, after weaning of ventilator or at the 21st day of ventilating, respectively. Results By single factor analysis, PMV related to not only age, lying on bed, white blood cell, neutrophil, P (A-a)O 2, BUN, Cr, upper digestive tract bleeding, heart rate(HR), and blood pressure(BP) before using ventilator, but also related to heart function and consciousness after ventilator weaning or ventilating for 21 days. By multiple factor analysis, age, P (A-a) O 2 , heart function when ventilating for 21 days were related to PMV. Age≥82.0, P (A-a)O 2 ≥95.0 mm Hg, heart function≥grade 3 were high risk factors of PMV. Furthermore, it was found that the accuracy rate for meeting with those three parameters among 8 elderly patients with PMV was 87.5%. Conclusions Age, P (A-a)O 2 and heart function when ventilating for 21 days might be the independent factors of PMV.