Objective To discuss the application effect of clinical nursing pathway (CNP) in patients with laparoscopic cholecystectomy(LC). Methods 168 patients with laparoscopic cholecystectomy were analyzed from January 2009 to March 2011.They were randomly divided into the experimental group and the control group with 84 patients in each group.The control group adopted traditional nursing mode,and the experimental group adopted clinical nursing pathway.Hospitalization time,hospital expenses,untoward effect,mastering of health knowledge,satisfaction degree of patients were analyzed. Results Hospitalization time,hospital expenses,untoward effect,mastering of health knowledge and satisfaction degree were better in the experimental group than those of the control group. Conclusions Application of clinical nursing pathway in nursing quality management can shorten hospitalization time,and reduce hospital expenses,promote mastering of health knowledge,and improve satisfaction degree of patients and their families with nursing service.

OBJECTIVE: To optimize the preparation process of Xiangsha Liujun Granule. METHODS: By the orthogonal design. taking the rates of recovery of volatile oil, Ginsenoside Re and qualified granules as the indexes, we optimized the oil extracting conditions, the decocting conditions and the conditions of granulation by spayer. RESULTS: The optimum oil ex- tracting conditions for four kinds of herbs(Pericarpium Citri Reticulatae etc.) were that water was 30 times of herbs in weight, soaking time was 3 hours and extracting time 15 hours. The optimum decocting conditions for four kinds of herbs(Fuling etc.) were that water was 15 times of herbs in weight, soaking time was 3 hours and decocting time 4 hours, herbs were decocted twice. The optimum conditions of granulation by sprayer were that the fliud extract was 2 times of Dextrin in weight, the rel- ative density of the fliud extract was 1. 30(measured at 25℃), the voltage of sprayer was 120 volts, the period of shaking bag was 65 times(shaking bag back and forth twice in each period). CONCLUSION: The results of the experiment make it clear that the preparation process of Xiangsha Liu jun Granule is stable and feasible.

ObjectivesTo study the relationship between the allele frequencies and genotype distribution of transforming growth factor-beta 1(TGF-β1) gene promoter polymorphisms in Chinese patients with heptocellular carcinoma(HCC),and to analyze the association of the serum levels and genotype of TGF-β1 with HCC.MethodsThe polymorphisms of TGF-β gene,including polymorphisms of TGF-[β1 gene -800G/A、-509C/T,were analyzed by the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP)methods in 102 patients with HCC and 110 healthy controls,and the serum level of TGF-β1 was determined by enzyme-linked immunosorbent assay (ELISA). ResultsThe HCC group showed significantly higher serum levels of TGF-β1 than control group [(51.06 ± 9.74)μg/L,(22.12 ± 8.67 )μg/L,t=22.884, P＜0.01], The distributions of TGF-β gene -800G/A polymorphisms were not different significantly between HCC group and control group, but TGF-β1 -509C/T gene polymorphism was significantly different. The relative risk suffered from HCC of C allele was 1.822 times of the T allele (OR=1.822,95 ％CI:1.238-2.682,t=22.884,P＜0.01), the serum level of TGF-β1 T allele carriers was significantly higher than that of no carriers [(53.52:±:10.07)μg/L,(43.57±9.89)μ.g/L,t=3.898, P＜0.01]. ConclusionTGF-β1 gene -509C/T polymorphism is associated with HCC, and T allele may be a risk factor for HCC, in which the TGF-β1 T allele carriers may have increased risk by enhancing the TGF-β1 expression in the pathogenesis of HCC.

D (A:the amount of water added. B: the alcohol concentration in the fluidextract of herbs. C: decoction time, D: decoction times). The optimum decoction condition obtained was: adding water (12 times as much as medicine), decocting twice 1.5 hours each time, merging the filtrate, concentrating the merged filtrate into extract with a relative density of 1.20 (measured at 85℃), then adding alcohol slowly, and making the concentration of alcohol in the fluidextract come to 80%. Conclusion: The optimized process is stable and feasible.

Objective To measure and define the distribution of left gastric lymph nodes.Meth- ods From Jan.2004 to Apr.2005,silver clips were set around the root of the left gastric artery in 124 pa- tients with esophageal and gastric cardia carcinoma,X-ray films at 0?and 90?simulator gantry in the radio- therapeutic position were taken.Then,the data of the superior,lower,left,right,anterior and posterior bor- der in each patient was recorded.With SAS 8.02 software,data of minimum area which covered the left gas- tric lymph node in different incidences were obtained.Results According to the analysis of Shapiro- Wilk,Kolmogorov-Smimov,Cramer-von Mises and Anderson-Darling tests,each border was of normal distri- bution,with equal frequency in the male and female,despite the actual results in different genders.Pearson Correlation Coefficients analysis did not suggest a significant relationship between the border and height, weight and size of vertebrae,which formed the minimum area covering the left gastric area at frequency of 100%,95%,90% and 85%,which were drawn out through the calculation.Conclusions Aiming at completely identifying the normal distribution of the left gastric lymph node,more patients are required to be in the pool.For the time being,location in the left gastric area can be obtained from details of the results in the present study.

Objective To investigate the frequency of CD4~+CD25~+FOXP3~+Treg cells in the peripheral blood of systemic lupus erythematosus(SLE)patients and its association with disease activity.Methods Pe- ripheral blood mononuclear cells(PBMC)from 28 patients(including 18 active SLE)and 22 healthy controls were counted and stained for CD4,CD25 and intracellular FOXP3.Cells were examined by 3-color staining on the Epics XL-MC and data were analyzed using EXPO32 software.Disease activity was assessed by systemic lupus erythematousus activity index(SLEDAI).Results The frequency of CD4~+CD25~+FOXP3~+Treg cells was significantly decreased in patients with active SLE compared with patients with inactive SEE and controls [(1.08?0.43)%,(1.58?0.45)% and(1.66?0.34)%,P

OBJECTIVETo investigate regulation function of anodonta glucan HBP-A on chondrocytes through Wnt pathway in vitro.

METHODSRat chondrocytes were cultured and differentiated induced with IL-1beta (10 ng/ml) in vitro. Chondrocytes were divided into five groups:IL-13 group,IL-1beta + IWP-2 (5 microM,Wnt pathway inhibitor) group, IL-1beta + HBP-A (0.3 mg/ml) group and IL-1beta + IWP-2 + HBP-A group. Wnt-3a, beta-catenin (24 h,48 h,72 h) and MMP-13(72 h) genes expression were detected by Rt-PCR, while beta-catenin, MMP-13, Sox-9 and coll-II (48 h) protein expression were measured by Western-blot.

RESULTSAfter induction of IL-1beta, gene expression of Wnt-3a, beta-catenin and MMP-13 were increased,so were the protein expression of beta-catenin and MMP-13. In contrast,protein expression of Sox-9 and Coll-II were declined. Following addition of HBP-A, Wnt-3a, beta-catenin and MMP-13 were shown as induction of IL-1beta, but protein expression of Sox-9 and Coll-II were upgraded. Combining HBP-A with IWP-2 led to the lowest level in Wnt-3a, beta-catenin gene and beta-catenin protein expression and highest expression of Sox-9 protein.

CONCLUSIONHBP-A could not only delay the differentiation of chondrocytes through downgrading the signal expression of Wnt/beta-catenin,but also adjust the expression of Wnt-3a, beta-catenin and Sox-9 when combinated with the Wnt inhibitor.

Animals ; Anodonta ; chemistry ; Cell Differentiation ; drug effects ; Cells, Cultured ; Chondrocytes ; cytology ; drug effects ; metabolism ; Glucans ; pharmacology ; Interleukin-1beta ; metabolism ; Rats ; Wnt Signaling Pathway ; drug effects ; Wnt3A Protein ; genetics ; metabolism ; beta Catenin ; metabolism

Objective To investigate the prevalence change of drinking water type of endemic fluorosis and the effect of control measures implemented in Huangyuan county of Qinghai province. Methods In 2009, all the endemic fluorosis villages in Huangyuan county were divided into two degrees, light and medium, according to the water fluorosis content before implementing the improving water project, 1 to 2 villages were selected from each degree village, respectively,as monitoring sites, and a total of 3 villages were selected. Source water and tap water samples were collected from each village and water fluoride concentration was determined. Dental fluorosis of all children aged 8 to 12 of monitoring villages was examined, and urine samples were collected by age group of children for determination of urinary fluoride. Clinical skeletal fluorosis of adults over 16 years of age was examined, and 20 copies of adults urine samples were collected to determine urinary fluoride. One village was selected in the 3 villages monitored to conduct X-rays examination of skeletal fluorosis. Water fluoride was tested in accordance with the "Non-metallic Targets Test Methods for Drinking Water" (GB/T 5750.6-2006); urinary fluoride was tested by fluoride ion-selective electrode method (WS/T 89-1996); dental fluorosis was diagnosed using Dean method;adult skeletal fluorosis was diagnosed by "Clinical Diagnostic Criteria for Endemic Skeletal Fluorosis"(WS 192-2008). Results Twelve water samples were assayed, water fluoride was (0.35 ± 0.43) mg/L. The detectable rate of dental fluorosis of 122 children aged 8-12 was 34.43%(42/122) and the geometric mean urinary fluoride was 0.89 mg/L of the 96 children. Of the 834 adults aged 16 and over, clinical detection of skeletal fluorosis was 47.72% (398/836) and geometric mean urinary fluoride was 1.10 mg/L of the 65 cases of adult urine samples assayed, detection rate of X-rays was 31.4% (11/35) in Gangou village of the 35 adults examined.Conclusions In Huangyuan county, water fluoride of the 3 surveyed villages are normal but the endemic fluorosis is still serious. It should strengthen monitoring and analyze the causes and improve prevention measures.

Objective To evaluate the changes of the right atrium,right ventriculum,left atrium and left ventriculum after transcatheter closure of atrial septal defect(ASD) during a short to mid-term follow-up.Methods The right ventricular end-diastolic anterior-posterior diameter(RVEDD),right atrial long diameter(RADl),right atrial transverse diameter(RADt),left ventricular end-diastolic ante-posterior diameter(LVEDD),left ventricular end-diastolic volume(LVEDV) and left atrial anterior-posterior diameter(LAD) in 36 patients with secundum ASD were measured before ASD closure,after 3 days,3 months and 6 months of ASD closure with transthoracic echocardiography(TTE).Results RVEDD,RADl and RADt were significantly decreased,while LVEDD,LVEDV and LAD significantly increased 3 days after ASD closure.During 3 months follow-up,RVEDD,RADl and RADt continuously became smaller;LVEDD,LVEDV and LAD continuously became larger.At 6 months,RVEDD was significantly smaller and LVEDD,LVEDV were significantly larger than those at 3 months.No remarkable difference of RADl,RADt and LAD was found between 6 months and 3months follow-up.Conclusion Transcatheter closure of ASD not only decreases the preload of right heart and causes right atrium and right ventriculum become smaller,but also improves the geometry of left heart and causes the narrowed left atrium and left ventriculum gradually return to almost normal status.

OBJECTIVETo study the clinical value of digital 3D technique combined with nanocarbon-aided navigation in endoscopic sentinel lymph node biopsy for breast cancer.

METHODSThirty-nine female patients with stage I/II breast cancer admitted in our hospital between September 2014 and September 2015 were recruited. CT lymphography data of the patients were segmented to reconstruct digital 3D models, which were imported into FreeForm Modeling Surgical System Platform for visual simulation surgery before operation. Endoscopic sentinel lymph node biopsy and endoscopic axillary lymph node dissection were then carried out, and the accuracy and clinical value of digital 3D technique in endoscopic sentinel lymph node biopsy were analyzed.

RESULTSs The 3D models faithfully represented the surgical anatomy of the patients and clearly displayed the 3D relationship among the sentinel lymph nodes, axillary lymph nodes, axillary vein, pectoralis major, pectoralis minor muscle and latissimus dorsi. In the biopsy, the detection rate of sentinel lymph nodes was 100% in the patients with a coincidence rate of 87.18% (34/39), a sensitivity of 91.67% (11/12), and a false negative rate of 8.33% (1/12). Complications such as limb pain, swelling, wound infection, and subcutaneouseroma were not found in these patients 6 months after the operation.

CONCLUSIONEndoscopic sentinel lymph node biopsy assisted by digital 3D technique and nanocarbon-aided navigation allows a high detection rate of sentinel lymph nodes with a high sensitivity and a low false negative rate and can serve as a new method for sentinel lymph node biopsy for breast cancer.

Axilla ; Breast Neoplasms ; diagnosis ; Endoscopy ; Female ; Humans ; Imaging, Three-Dimensional ; Lymph Node Excision ; Lymphatic Metastasis ; Nanoparticles ; Sentinel Lymph Node ; pathology ; Sentinel Lymph Node Biopsy