Objective:Through the construction of the Bank-Hospital connecting project, the enduring problems in clinic such as the long waiting time at registration, check out, payment, and other non-clinic issues are solved. Meanwhile, the clinic medication procedure is further regulated, which provides a faster medical assistance service for patients and elevates the ability to apply medical informationization.Methods:Based on the current HIS platform, the banking and mobile systems connected as a whole network and constructed the banking-medication platform. Results: The waiting time of patients is largely reduced by expanding the channels of registration, applying multiple cards as medication card, and introducing local charging, self-payment systems at every floor, and mobile intelligent platform.Conclusion: The Bank-Hospital connecting project brings convenience to patients and increases our efficiency.

OBJECTIVE: To explore the expression and significance of programmed cell death 5 (PDCD5) and Bcelllymphoma/lewkmia-2(Bcl-2) in sinonasal squamous cell carcinoma (SNSCC). METHOD: Immunohistochemical method and Western Blot method was used to determine the expression of PDCD5 and Bcl-2 in specimen of SNSCC in thirty cases, sinonasal inverted papillomas (SNIP) in thirty-eight cases, and normal nasal mucosa in twenty cases. RESULT: (1) The expression of PDCD5 protein in SNSCC significantly decreased compared with SNIP and normal nasal mucosa. (2) The expression of Bcl-2 protein in SNSCC up-regulated obviously compared with SNIP and normal nasal mucosa. (3) Positive rate of PDCD5 protein and Bcl-2 protein in well, moderate and low differentiatied group is respectively 100.00%, 83.33%, 38.89% and 50.00%, 70.83% and 100.00%, the difference was statistically significant (P < 0.05). (4) In the follow-up cases, the survival rate of the patients with higher expression of PDCD5 protein was higher, but that with lower expression of Bcl-2 protein was higher. CONCLUSION The inactivation of PDCD5 protein and the activation of Bcl-2 protein may play an important role in the development of SNSCC, and there are a positive correlation between PDCD5 and Bcl-2 protein in SNSCC, which may be identified as a new therapeutic target.
Apoptosis Regulatory Proteins ; metabolism ; Carcinoma, Squamous Cell ; metabolism ; mortality ; Head and Neck Neoplasms ; metabolism ; mortality ; Humans ; Neoplasm Proteins ; metabolism ; Papilloma, Inverted ; metabolism ; Paranasal Sinus Neoplasms ; metabolism ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Squamous Cell Carcinoma of Head and Neck ; Survival Rate

Objective:To explore the effect of therapeutic communication on infusion safety, disease uncertainty, coping styles, anxiety and depression in patients with emergency infusion.Methods:A total of 126 patients treated with infusion patients in emergency department in Jiangsu Provincial People's Hospital, the First Affiliated Hospital of Nanjing Medical University from July 2019 to December 2019 were selected and divided into two groups by random digits table method with 63 cases in each group. Patients in the control group received routine nursing, and patients in the intervention group received therapeutic communication nursing intervention on this basis. The incidence of adverse events of infusion during the intervention of the two groups of patients was observed. The disease uncertainty, coping styles, anxiety and depression were evaluated by Mishel's Uncertainty in Illness Scale (MUIS), Medical Coping Mode Questionnaire (MCMQ), Self-rating Anxiety Scale (SAS) and Self-rating Depressive Scale (SDS) before and after intervention.Results:The final collection of 109 patients with complete questionnaire, the recovery rate was 86.51% (109/126), including 55 cases in the intervention group, 54 cases in the control group. The incidence of adverse events of infusion was 16.36%(9/55) in the intervention group and 29.63%(16/54) in the control group, and there was significant difference( χ2 value was 5.057, P<0.05). There was no significant difference in the score of MUIS, MCMQ, SAS, SDS before the intervention between the two groups ( P>0.05). After the intervention, the uncertainty, unpredictability, lack of information and complexity dimension of the intervention group patients' MUIS scores were respectively (17.76 ± 2.49), (12.03 ± 2.51), (11.82 ± 2.12), (11.74 ± 2.24), which were lower than those in the control group (24.72 ± 2.94), (16.31 ± 2.27), (16.13 ± 2.51), (15.39 ± 2.31), the differences were significant( t values were -13.346- -8.375, P<0.05). The confront score of the intervention group patients' MCMQ was (19.13 ± 2.62) higher than that in the control group(13.79 ± 1.96), the avoidance and yield scores were respectively (8.71 ± 1.34), (9.81 ± 1.17), which were lower than those in the control group (14.57 ± 1.93), (15.12 ± 1.86), the differences were significant( t values were 12.031, -18.441, -17.875, P<0.05). The scores of SAS and SDS in the intervention group were (29.43 ± 3.62), (27.67 ± 3.11) respectively, which were lower than those in the control group (37.44 ± 5.31), (40.12 ± 4.92), the differences were significant( t values were -9.216, -15.821, P<0.05). Conclusions:Therapeutic communication can reduce the risk of emergency infusion, reduce the uncertainty of patients to the disease, improve patients' countermeasures to the disease, relieve patients' anxiety and depression, and improve the nursing quality of emergency infusion patients.

Objective To standardize the job training and improve the basic professional quality and induction ability of practitioners in Blood Services by setting up job training assessment standardized model.Methods Using the standardize model to carry out the application of standardized model of job training assessment for the practitioners in Blood Services.July 2016-June 2017,focusing on the standardize training materials and training standards to carry out the centralized training,establishing a unified teacher library of the province and the centralized training will be taught by those teachers,evaluating result by standardize theoretical test and the conformity standard,then evaluating and supervising the assessment results.Results 356 practitioners participated in centralized training,379 practitioners participated in the theoretical test,and 339 practitioners were qualified of the actual operation during these two years.The total qualified rate is 89.4％.There was no significant difference in the qualified rate between two years (P＞0.05).Among them,the qualified rate of category Ⅰ personnel was 85.1％,category Ⅱ personnel was 98.7％,category Ⅲ personnel was 94.8％,and the qualified rate of category Ⅱand Ⅲ was higher than that of category Ⅰ (P＜0.05).Conclusion Through the application of the standardized model to promote the standardization of education and training resource standard,and carry on standardized training evaluation as well as strictly grasp the examination and evaluation standards,it will be conducive to improving the quality of education and training,will also be conducive to improving the professional quality of employees and supply institutions.

Objective To compare the different response of dermal fibroblasts from normal and scar-ring skin to cytokines,extracellular matrix and collagen promoter.Methods Human dermal fibroblast cul-ture was established by explanting tissue specimens from normal and scarring skin.Cellular proliferative ac-tivities were determined with BrdU-ELISA after treatment with IFN-?A,hIFN-?,TNF?and laminin for24hours.Reporter genes driven by collagen promoters were analyzed in two types of dermal fibroblasts trans-fected with consensus constructs48hours later.Results Dermal fibroblasts from normal and scarring skins showed different proliferative responses to IFN-?A,hIFN-?,TNF?and laminin,with stimulatory effects pre-sented in normal fibroblasts treated with IFN-?A,hIFN-?,TNF?and laminin,inhibitory effects presented in scarring fibroblasts treated with IFN-?A and laminin,and reduced or resistant effects presented in scar-ring fibroblasts to hIFN-?and TNF?.The5'flanking sequences(-2483~+42bp,-1448~+42bp)from human?1(Ⅰ)procollagen gene had lower activity of promoter in scarring fibroblasts compared with that in normal fibroblasts.Conclusion Compared with normal dermal fibroblasts,scarring dermal fibroblasts have reduced response or are resistant to some cytokines.Lower collagen production capacity is anticipated since collagen promoter activity is low in scarring dermal fibroblasts.The pathological mechanism of scarring for-mation might be related to the change of responses of dermal fibroblasts.

Objective To assess the correlation between tenosynovitis or rupture of the flexor hallucis longus (FHL) and pes planus in patients with rheumatoid arthritis (RA).Methods The data of 47 RA patients (97 feet) with painful feet was retrospectively analyzed which was collected From February 2008 to June 2011.In accordance with the results of the FHL changes got by ultrasonography,the patients were divided into 3 groups.Group A consisted of those with normal FHL (27 feet).Group B consisted of those with FHL tenosynovitis (40 feet),and Group C eonsisted of those with FHL rupture (27 feet).Load bearing lateral radiographs were taken for all the patients.The correlation study was carried out based on the pes planus-related parameters,such as the measurement of heel pitch angle (HPA) and tarsal and 1st metatarsal angle (TM1).Factors like patients' age and course of disease were also taken into the consideration during the study.Results The mean age of those in group A was 49.9±9.2 years vs.56.2±9.2 years in group B and 54.7±8.0 years in group C.The mean duration was 4.7±2.6 years in Group A vs.16.2±7.4 years in Group B 5°±3.6° in Group C.The mean TM1 was 2.5°±2.2° in Group A vs.6.5°±3.2° in Group B and 11.2°±4.9° in Group C.Significant statistics difference were found among the three groups in these parameters.HPA＜ 20° was found among 6/27 feet in group A,31/40 in group B and 27/27 in group C.TM1 ＞4° was found among 5/27 feet in group A,30/40 in group B and 27/27 in group C.Conclusion FHL changes were common in RA patients and its severitv had positive correlation to pes planus.These changes were affected by age and duration,and could be evaluated effectively by ultrasound.

OBJECTIVETo study the effect of peri-implantitis inflammatory microenvironment on the biological function of jaw bone osteoblasts.

METHODSPrimary mandible osteoblasts from peri-implantitis and normal tissue were isolated and cultured. Third-generation purified osteoblasts were identified and detected. The proliferative activity of osteoblasts was evaluated through MTT assay. Osteocalcin (OCN), Runx2, and collagen I (Col I) mRNA levels were examined by real-time quantitative polymerase chain reaction. OCN protein levels were determined by Western blot.

RESULTS: After 4 d of culture, the proliferative activity of osteoblasts from peri-implantitis became lower than that of normal tissue ( P <0.05). After 7 d of culture, OCN, Runx2, and Col I mRNA expression decreased ( P <0.05). The OCN protein levels also decreased ( P <0.05).

CONCLUSIONPeri-implantitis inflammatory microenvironment can decrease the proliferation and differentiation activity of mandible osteoblasts.

Objective:To analyze the clinical characteristics and diagnosis and treatment of children with Kasabach-Merritt phenomenon (KMP).Methods:A retrospective analysis was conducted on the clinical data and follow-up data of 8 patients diagnosed KMP in Beijing Children′s Hospital, Capital Medical University from January 2016 to January 2019.The clinical data included laboratory examination, diagnosis, treatment and prognosis.Results:Among the 8 children with KMP, 6 cases were male and 2 cases were female.The median onset age was 4 (0-17) months, 2 cases of neonatal onset.The median onset to the diagnosis time was 59 (34-140) days; 6 cases with bone destruction; 6 cases had misdiagnosis and mistreatment history, they were misdiagnosed as idiopathic thrombocytopenic purpura, Evans syndrome, abnormal bone and joint development; 4 cases were Kaposiform hemangioendothelioma; 8 cases were used alone or combined with the application of hormones, Sirolimus, and Vincristine, 7 patients underwent interventional therapy.All patients survived with a median follow-up period of 487 (112-1 033) days.Median time of platelet count returned to normal was 24.5 (7-60) days, and median time of fibrinogen returned to normal was 20 (7-30) days.Median time of D-dimer dropped to a normal was 105 (40-240) days.Conclusions:Children with concurrent platelet count and coagulation abnormalities should be considered with KMP.Doctors need to identify the potential visceral vascular lesions.Early diagnosis and treatment are important, which can improve the clinical prognosis of patients.

The clinical and laboratory data of a patient with chronic refractory immune thrombocytopenia (ITP) who had a significant increase in the proportion of inhibitory T cells in the hematological oncology center of Beijing Children′s Hospital Affiliated to Capital Medical University in February 2018 and regularly followed up in the outpatient department received a retrospective analysis.This 8-year-old patient′s clinical features were 6 years of skin and mucous membrane bleeding spots and petechiae recurring, with occasionally nasal epistaxis.Physical examination: cardiopulmonary abdomen and nervous system examinations are normal, and no superficial lymphadenopathy is touched.Blood routine indicated that the platelets were 2.00×10 9/L, and white blood cell count and hemoglobin level were normal.Bone marrow suggested that hyperplasia was significantly active, with more than 300 megakaryocytes.The patient was diagnosed with ITP, and he was treated with first-line treatment with gamma globulin and oral Corticosteroids.The first-line treatment with high-dose Dexamethasone therapy was repeated, and the second-line treatment was low-dose Rituximab combined with high-dose Dexamethasone.Evaluations had been conducted with every relapsed course, and Cyclosporine was administered orally on the basis of the highly suppressive T cells.After half a month, the child achieved partial remission and continued for 3 months, and then reached a complete remission of 6 months (till this paper). It is suggested that, with ITP as an immunological disease with high heterogeneity, the immune abnormality index is expected to become a breakthrough in the development of precise treatment.

Objective To explore the correlation between the fluctuation of blood glucose levels and brain damage in neonates with hypoglycemia. Methods The clinical data of 58 cases of neonatal hypoglycemia diagnosed from September 2013 to August 2016 were analyzed retrospectively. According to the results of neonatal cranial MRI and/or amplitude integrated electroencephalogram (aEEG), the neonates were divided into brain injury group and non-brain injury group. The fluctuation index of blood glucose was compared between two groups, and the correlation between the fluctuation of blood glucose level and brain injury was analyzed. Results In these 58 cases, 13 cases were in brain injury group (8 males and 5 females) and 45 cases were in non-brain injury group (27 males and 18 females). The lowest blood glucose (LBG) value in brain injury group was lower than that in non-brain injury group, while the duration of hypoglycemia, maximum blood glucose fluctuations (LAGE), standard deviation of blood glucose (SDBG), and average blood glucose fluctuations (MAGE) were higher than those in non-brain injury group, and they were all significantly different (P all<0.001). Conclusions Whether the hypoglycemia in newborn could lead to the brain injury or not depends not only on the minimum hypoglycaemia level and duration of hypoglycemia, but also on the indicators of glucose variation, such as LAGE, SDBG and MAGE.