Aim To investigate the immunoregulative action of polysacchrides of Spirulina platensis ( PSP ) on peripheral blood mononuclear cells ( PBMCs) in pa-tients with chronic hepatitis B virus infection. Meth-ods Proliferation and cycle of PBMCs from patients with chronic hepatitis B virus infection were measured by MTT colorimetry and flow cytometry respectively. The concentration of IFN-γ, IL-2 , IL-4 in supernatants of PBMCs were examined by ELISA. The mRNA ex-pression of IFN-γin PBMCs from patients with chronic hepatitis B virus infection was detected by RT-PCR. Results PSP could induce proliferation of PBMCs in patients with chronic hepatitis B virus infection. In ad-dition, PSP could increase the protein expression of IFN-γ and IL-2 in supernatants of PBMCs in patients with chronic hepatitis B virus infection, and PSP could also enhance the mRNA expression of IFN-γof PBMCs in patients with chronic hepatitis B virus infection. However, PSP inhibited the protein expression of IL-4 of PBMCs in patients with chronic hepatitis B virus in-fection. Conclusion PSP can promote the immune function and plays an important immunoregulation function on patients with chronic hepatitis B virus in-fection.

Objective To understand the nurses' evaluation of current grading nursing system.Methods Self-questionnaire was designed and used to investigate 141 clinical nurses coming from three general hospitals sampled conveniently.Results (1)Clinical nurses lacked in-depth study of grading nursing instruction principle;(2)Doctors and nurses lacked the cooperation during the process of identifying the level of care;(3)Level of care was not consistent with the patients' condition and self-care ability;(4)Disease inspection and primary care were not consistent with patients' level of care;(5)Health guidance and mental nursing couldn't meet the actual needs of patients;(6)Senior nurses' evaluation of the implementation of grading nursing was lower than Junior nurses; (7)Clinical nurses held positive attitudes to nurses and patients participating in grading nursing.Conclusions Nurses thought poorly of grading nursing system in operation,it was necessary to improve the content of principles about grading nursing manner,health instruction and psychological nursing,and implement grading nursing system correctly.It was also important to take patients' willingness of participating in care into account.

Objective To investigate the morphology,size and density characteristics of adult normal thyroid and to establish the normal reference range of thyroid.Methods 317 patients without thyroid disease underwent head and neck computed tomography angiography (CTA)examination from Jun.2011 to Jun.2012 in the First Affiliated Hospital of Chongqing Medical University.Their data were analyzed.The thyroid morphology including the outside angle,width,thickness,isthmus was observed and measured.Plain scan and arterial phase CT values of thyroid gland were measured.The age and sex of patients were recorded.The left and right lobe on the thyroid dimension and density were investigated,and the index 95％ normal reference range was calculated.Results ① Morphology:normal thyroid glands were butterfly-shaped on the axis,accounting for 95.9％(304/317),and absence of thyroid gland isthmus accounted for 4.1％(13/317).② There was no significant difference for the thyroid lateral angle between the lobes and sexes(P＞0.05).There was significant difference between age groups(P=0.00).The 95％ reference range:the outside angle was 111.7°± 31.6° in patients younger than 60 years old,and 101.3°± 36.7° in patients of or older than 60 years old.③ The dimensions of the right lobe were longer than those of the left.The dimensions of the lobes in males were longer than those in females.There was no statistical difference among decades(P＞ 0.05).There was no significant difference in the thickness of thyroid isthmus between genders and among different age groups (P＞ 0.05).95％ reference range of the thickness of thyroid isthmus was 1.1-7.3 mm.④ There was statistical difference for the plain scan and enhanced CT values between lobes and sexes and among age groups (P＜0.05).95％ reference range needed to be separately formulated between the lobes,sex and age＜30 years and ≥30 years.Conclusion Studying the morphology,size and density characteristics of adult normal thyroids can help to establish normal thyroid imaging anatomical data in this region,and provide reference basis for imaging diagnosis of thyroid disease.

OBJECTIVE:To probe the role of responsible pharmacist on irrational medical order intervention in Pharmacy Intra-venous Admixture Service (PIVAS),and to improve rational drug use in our hospital. METHODS:501 115 medical orders from PIVAS of our hospital during Jan.-Jun. 2012 were analyzed retrospectively. Irrational medical orders of 499 189 medical orders dur-ing Jul.-Dec. 2013 were classified and summarized after the establishment of responsible pharmacists system and pharmacist inter-vention. RESULTS:The number of irrational medical orders was 918(0.183 2%),and decreased to 448(0.089 7%)after interven-tion. Irrational medical orders of solvent selection reduced from 134(0.026 7%)to 69(0.013 8%);irrational medical orders of sol-vent volume reduced from 435(0.086 8%) to 206(0.041 3%);irrational medical orders of drug dosage reduced from 241(0.048 1%)to 117(0.023 4%);irrational medical orders of drug compatibility reduced from 51(0.010 2%)to 28(0.005 6%);irrational medical orders of dosing frequency reduced from 17(0.003 4%)to 2(0.000 4%). CONCLUSIONS:What responsible pharmacists intervened in the irrational doctor’s orders of intravenous drip was effective and feasible in PIVAS,improved rational drug use and guaranteed the safety of drug use.

Appendiceal mucinous adenocarcinoma is a rare disease.The preoperative diagnosis is almostly impossible due to the lack of typical symptoms and inexperienced surgeons.One patient with appendiceal mucinous adenocarcinoma was diagnosed successfully at the 210th Hospital of Chinese PLA,who was misdiagnosed as with periappendiceal abscess by other hospitals.The result of intraoperative frozen pathological section confirmed appendiceal mucinous adenocarcinoma.And then the patient received extended resection and effective recovery.

Objective To compare the differences of lifestyle factors between patients with functional constipation (FC)and constipation-predominant irritable bowel syndrome (IBS-C).Methods From February 2011 to December 2014,255 patients with chronic constipation were enrolled.Among them,there were 170 FC patients and 85 IBS-C patients.At the same period,170 healthy volunteers without symptoms of digestive diseases within one year were recruited as control.The data of demographic information and lifestyle factors were collected.First,single variant analysis was performed for statistical analysis and then the statistically significant variants were analyzed by multivariate logistic regression. Then the factors of FC and IBS-C patients were analyzed by decision tree model and the effects of factors under different categories were analyzed.Results The results of single variant analysis indicated that there was no difference in lifestyle factors between FC group and IBS-C group (all P >0.05).The results of multivariate logistic regression analysis showed that no independent protective or risk factors were found in IBS-C group compared with FC group.According to decision tree model analysis,body mass index (BMI),water intake per day and constipation family history were finally enrolled.The incidence of FC was higher in patients with BMI < 23.56 kg/m2 (except 18.74 to < 19.83 kg/m2 )(79.75 %).The incidence of FC was higher in patients with BMI from 18.74 to <19.83 kg/m2 and water intake <1 L
(66.67%).The incidence of FC was highest in patients with BMI≥23.56 kg/m2 and family history of constipation (70.00%).The total prediction accuracy of this model was 64.6% (42/65 )and area under curve (AUC)value was 0.688.Conclusions FC and IBS-C are related with many lifestyle factors.Low BMI and less water intake per day are influence factors of FC,while higher BMI and family history of constipation are influence factors of IBS-C.

Objective To further understand factors that influence health-related quality of life (HRQOL) in patients with ulcerative colitis (UC),especially the role of perceived stress and coping modes in Chinese patients with UC.Methods This study was a cross-sectional study.Patients with UC were recruited from July 2013 to September 2014 in Peking Union Medical College Hospital.HRQOL was measured using the inflammatory bowel disease questionnaire (IBDQ).Perceived stress was measured by Perceived Stress Scale (PSS).Coping strategy was evaluated using Medical Coping Modes Questionnaire (MCMQ).Demographic data,course of the disease,clinical disease activity,and disease phenotype according to Montreal classification were also collected.Univariate analyses were conducted to determine which variables were associated with HRQOL,and those were statistically significant were entered into a multivariate regression model.Results We recruited 214 patients (response rate 92.2％),whose median age was 37.5 (29.0,49.3) years old and median course of UC was 4 (2,9) years.Through univariate analyses,better HRQOL was significantly associated with regular medical visits,lower number of previous relapses and hospitalizations,no steroid use,Montreal E1,lower Mayo scores,clinical remission,less perceived stress and less acceptance strategy use.However,multivariate analyses revealed that perceived stress (OR =1.112,95％ CI 1.058-1.169),acceptance (OR =0.310,95％ CI 0.141-0.685),number of hospitalizations (OR =2.924,95 ％ CI 1.328-6.437) and clinical activity (OR =5.058,95 ％ CI 2.312-11.066) were most strongly related to HRQOL.Conclusions HRQOL of UC patients are not only associated with clinical activity of the disease,but also associated with coping strategy and perceivedstress.Further research needs to focus on whether or not relieving stress and guiding patients to cope with ulcerative colitis would improve HRQOL.

Objective To screen and identify the colonic adaptation-related proteins.Methods Totally 20 SD rats were equally randomized into 2 groups:ultra-short bowel group (90％ of intestine was resected) and control group (transection and then anastomosis of the intestine).After 21 days of feeding,two-dimensional electrophoresis (2-DE) was performed to separate the total protein from the colon mucous epithelial tissues.Then Image Master 2D Platinum software was use to analyze differential expressional proteins,which were further analyzed by MALDI-TOF-MS and Mascot software to identify these proteins.Results The 2-DE patterns with high resolution were obtained from the colon mucous epithelial tissues of both groups.Four differentially expressed proteins were identified by MALDI-TOF-MS:M2-PK,AGR2,proteasome activator complex subunit 1,and pancreatic triacylglycerol lipase.These proteins were involved in sugar and fat metabolism and cell proliferation.Conclusion The identified proteins may play important roles in the process of colonic adaptation through substance metabolism and by stimulating cell proliferation.

Objective To explore the value of quantitative parameters of spectral CT imaging in the diagnosis of non-small cell lung cancer (NSCLC) with different pathological types. Methods One hundred and thirty-six patients with NSCLC proved by pathology underwent chest plain and enhanced CT scan with gemstone spectral imaging (GSI) mode by Discovery CT750 HD, including 57 cases of squamous cell carcinoma (SQCC) and 79 cases of adenocarcinoma (ADC). All the cases were divided into two groups of tumor diameter>2 cm (120 cases, including 50 cases of SQCC and 70 cases of ADC) and diameter≤2 cm (16 cases, including 7 cases of SQCC and 9 cases of ADC). The slope between 40 and 65 keV(K40-65 keV) of spectral attenuation curve, effective atomic number (Eff-Z) and calcium concentration in plain scan (PS) and K40-65 keV of spectral attenuation curve, iodine concentration and water concentration in arterial phase (AP) of SQCC and ADC in the two groups were measured and compared respectively. Furthermore, all cases were classified according to the trend of spectral attenuation curve in PS. These quantitative parameters satisfying normal distribution were compared by two independent samples t test, while those parameters not satisfying normal distribution were compared by rank sum test. ROC curves was drawn for these parameters with statistical difference and area under the curve (AUC) was used to measure the differential diagnostic performance of each parameter. Chi square test was used to compare the differences of the trend of spectral attenuation curve in PS between SQCC and ADC. Results In the group of diameter>2 cm: (1) Comparison of quantitative parameters of spectral CT in PS:K40-65 keV, Eff-Z and calcium concentration of ADC were 0.69 ± 0.56, 7.76±0.19, and (4.11±2.93) mg/cm3, respectively. The corresponding parameters of SQCC were 0.19± 0.23, 7.59 ± 0.14, and (1.25 ± 1.59) mg/cm3, respectively. These parameters of ADC were significantly higher than SQCC (Z=-7.000,-6.249, t=-6.884, P<0.01). (2) Comparison of quantitative parameters of spectral CT in AP:K40-65 keV, iodine concentration and water concentration of ADC were 2.61 ± 1.72, (1.24 ± 0.77) mg/cm3, and (1024.46 ± 14.06) mg/cm3, respectively. The corresponding parameters of SQCC were 2.00 ± 1.79, (0.94±0.86) mg/cm3, and (1027.77±9.47) mg/cm3, respectively. The difference between ADC and SQCC was statistically significant (Z=-3.082,-2.946,-3.045, P<0.01). (3) ROC curve analysis showed that these quantitative parameters in PS were helpful in differentiating SQCC and ADC, especially K40-65 keV of spectral attenuation curve in PS. The AUC for it was 0.876. The sensitivity and specificity were 91.4%and 80.0%, respectively. (4)According to the trend of spectrum attenuation curve in PS, type Ⅰ was more common in SQCC, while typeⅡwas more common in ADC (χ2=54.208, P<0.01). In the group of diameter≤2 cm:There was no significant difference in all quantitative parameters between ADC and SQCC (P>0.05). The trend of spectrum attenuation curve in PS of all cases showed type Ⅱ. Conclusions Lung ADC and SQCC have different quantitative parameters in spectral CT imaging. These quantitative parameters are valuable in classifying the pathological type of NSCLC with diameter more than 2 cm.

Objective To investigate the clinical value of acoustic radiation force impulse (ARFI) imaging in the evaluation of liver functional reserve in patients with hepatic focal lesions. Methods Eighty-six patients with hepatic focal lesions in General Hospital of the People′s Liberation Army from September 2011 to August 2012 were studied. According to Child-Pugh score, 54 of them were classified as grade A, 18 patients were classiifed as grade B, and 14 patients were classiifed as grade C. Seventy patients underwent surgery and 16 patients underwent non-surgical treatment. Shear wave velocity (SWV) values were measured using ARFI technique, and indocyanine green (ICG) clearance tests were also performed to achieve ICG clearance rate constant (ICGK) and ICG retention rate at 15 minutes (ICG15). Correlation between SWV and ICGK, SWV and ICG15 were studied using Pearson correlation, and correlation between SWV and Child-Pugh score were analyzed using Spearman rank correlation. Difference between SWV values of patients underwent surgery and those of patients underwent non-surgical treatment was compared using t-test for independent samples. Analyses of receiver operating characteristic (ROC) curve were performed to investigate the value of ARFI in the evaluation of surgical feasibility for patients with hepatic focal lesion, with the clinical decisions serving as the golden standard. Results There was correlations between SWV and ICGR15, SWV and ICGK, and SWV and Child-Pugh scores (r=0.764,P <0.001;r=-0.686,P=0.000;r=0.864,P=0.000). The SWV of patients who underwent surgery was (2.46±0.45) m/s, and the SWV of patients who underwent non-surgical treatment was (1.54±0.36) m/s, with a signiifcant difference (t=-0.80, P=0.000). The ROC curve analysis demonstrated a highest Youden′s index of 0.775 when the cut-off was 2.06m/s. The corresponding sensitivity was 87.5% and the specificity was 90.0% for ARFI in the diagnosis liver functional reserve deficiency. Conclusion ARFI can effectively evaluate the liver functional reserve in patients with hepatic focal lesions and thus could be beneifcial in the decision of clinical treatment.