Objective To discuss the nursing management for patients receiving percutaneous fluoroscopy - guided gastrostomy (PFG) for the treatment of dysphagia caused by head and neck cancer. Methods A total of 15 patients with dysphagia caused by head and neck cancer received PFG. Before PFG sufficient preparation and psychological nursing care were carried out for all the 15 patients. After the operation the patients were kept under close observation for any changes in his or her clinical conditions. Proper prevention measures against complications were adopted. Results PFG procedure was successfully accomplished in all 15 patients. Postoperative complications included gastric bleeding (n = 1), stoma infection (n = 1) and proctoptosis (n = 2), and the disorders were recovered after clinical management. After PFG intravenous nutrition was no longer employed in all patients, and enteral nutrition was conducted. The quality of life was significantly improved in all patients. Conclusion PFG is technically - simple and minimally- invasive with fewer complications. This technique provides a new way to give enteral nutrition for patients with dysphagia caused by head and neck cancer. Excellent psychological nursing, sufficient preoperative preparation, comprehensive postoperative nursing care and medical advices at the time of discharge are the key points to ensure a successful PFG.

BACKGROUND: Previous studies suggest that vascular endothelial growth factor 121 may be an optimal target gene for thetreatment of acute myocardial infarction.OBJECTIVE: To investigate effect of direct myocardial injection of adenovirus recombinant human vascular endothelial growthfactor 121 gene (Ad-hVEGF121) on myocardial infracted rat heart structure, function and angiogenesis.METHODS: Totally 78 male SD rats were randomly divided into the sham-surgery (n=18), acute myocardial infarction (n=24),Ad-VEGF121 (n=19) and normal saline (n=17) groups. Among them, left anterior descending coronary arteries of the latter threegroups were ligated to prepare acute myocardial infarction models and rats were randomly selected to receive Ad-hVEGF12 ornormal saline via three points in the cardiac muscle at the 10-15 minutes after ligation. The chest was exposed without ligation inthe sham-surgery group.RESULTS AND CONCLUSION: At 2 weeks after injection, cardiac ultrasound showed that, compared with the sham-surgerygroup, the number of new capillaries, body weight and left ventricular mass / body weight of the acute myocardial infarction,Ad-hVEGF121 and normal saline groups were obviously increased (P < 0.05 or P < 0.01), especially those received transfectedrAd-hVEGF12, had higher density of blood capillaries than those of the normal saline and acute myocardial infarction groups.However, there were no obviously differences between each group in infarct size, cardiac structure or functions. The directmyocardial injection of Ad-VEGF121 can significantly promote the formation of new blood vessels within the myocardium.

Objective To investigate the curative effect of damage control theory in treating severe polytrauma patients combined with bone and joint injury. Methods A retrospective study was done on data including complication, death rate, fracture healing and joint function recovery of 63 patients with severe polytrauma combined with bone and joint injury( average ISS ≥27 points) admitted to our hospital from January 2006 to June 2009. Results Of all the patients, 57 shock patients were cured,three died of hemorrhagic shock within two hours after admission and one patient died of severe traumatic brain injury 11 hours after admission. One patient died of ARDS at 24 hours postoperatively and one died of multiple organ failure at day 6 after injury. Fracture healing was achieved in 52 patients, with satisfactory recovery of the limb function. Amputation was performed in two patients and three patients had mild claudication and pain walking. Conclusion Damage control strategy has great clinical significance in guidance of treatment of severe polytrauma combined with bone and joint injury.

Objective To determine the cardiac structure and function by transthoracic highfrequency ultrasonography in Wistar rats, and to explore the patterns of age-related changes.Methods Male Wistar rats aged 1, 2, 5, 12, and 20 months (n= 12 each group) underwent transthoracic echocardiographic analysis to examine the parameters of cardiac structure and function.Finally, the rats were sacrificed and the left ventricles were weighed. Results The left atrial dimension (LAD), left ventricular end-diastolic diameter (LVEDD), interventricular septum thickness at diastole (IVSD), left ventricular posterior wall thickness (LVPWd) and left ventricular mass (LVM) increased with age (all P ＜ 0.05 ) . There was a positive relationship between echocardiographic value and the autopsy weight LVM (r=0. 78, P＜0.01). There were no statistical significances in ejection fraction and fractional shortening among groups (all P＞0.05). Isovolumic relaxation time (IVRT) prolonged with age (P＜0. 01). After 2 month-old, tissue Doppler imaging Ea gradually decreased with age, Aa tended to increase with age. Ea/Aa ratio was more than 1 value in 1-, 2- and 5-months-old group, and it was less than 1 value in 12-, and 20-month-old group.Multivariate analysis showed that age was the influence factor of LAD, LVEDd and Ea. Conclusions Transthoracic high-frequency ultrasonography can be used to evaluate cardiac structure and function in rats; In aged rats, the wall-thickness, LAD and LVEDd are significantly increased. There is no significant change in systolic function, but diastolic function is decreased.

Objective To investigate the clinical characteristics of cervical spine injury associated with chest injury by contrast with simple cervical spine injury.Methods A retrospective analysis was performed on records of 116 patients with cervical spine injury hospitalized from March 2009 to September 2014.There were 65 patients with simple cervical spine injury (simple injury group) and 51 patients with associated chest injury (associated injury group).Data recorded were the causes of injury, injury segment, treatment choices (tracheotomy rate, mechanical ventilation use and non-operative treatment), treatment time (operation rate at different time, time from injury to operation and length of hospital stay) , complications (electrolyte disorder, respiratory infection, respiratory dysfunction or failure, urinary tract infection, gastrointestinal bleeding and multiple organ dysfunction syndrome), and treatment outcome.Results The main cause of injury for the two groups was high falling.Lower cervical segment was the most likely to be affected.Significant differences were detected between the simple injury group and associated injury group with regard to tracheotomy rate (63％ vs.42％), rate of mechanical ventilation (41％ vs.25％), rate of early surgery (29％ vs.58％), rate of delayed surgery (69％ vs.30％), time from injury to operation [(7.2 ± 3.7) d vs.(3.1 ± 1.3) d], length of hospital stay [(22.6-± 5.5) d vs.(17.3 ± 3.7)d], electrolyte disorder rate (35％ vs.17％), incidence of respiratory system infection (55％ vs.35％), and respiratory dysfunction (43％ vs.25％) (P ＜0.05).After treatment, American Spinal Injury Association (ASIA) scale for grade D was significantly lower in associated injury group than in simple injury group (25％ vs.39％ P ＜ 0.05).Conclusion Cervical spine injury associated with chest injury is severe injury, often requiring tracheotomy and mechanical ventilation, and demonstrates difficulties to be effectively treated in the early phase, long hospitalization, various complications and high morbidity.

Objective:To investigate the effect of chronic alcohol consumption on both left ventricular myocardial collagen and diastolic function in rats,and their relationship thereof.Methods:Twenty-four male Wistar rats were randomly divided into 2 groups:control group(n=12)and ethanol group(n=12).The changes in cardiac diastolic function were evaluated by echocardiography and tissue Doppler imaging(TDI).The value of myocardial hydroxyproline content was determined by hydroxyproline reagent kit.The expressions of collagen Ⅰ and collagen Ⅲ mRNA were detected by RT-PCR analysis.Results:It was found that mitral E and mitral annulus Ea were decreased,mitral annulus Aa was increased,and isovolumic relaxation time(IVRT)was prolonged in the ethanol group compared with those in control group(P＜0.05).The value of Ea/Aa ratio was greater than 1 in control group and less than 1 in ethanol group(P＜0.01).It was found that myocardial hydroxyproline content,collagen Ⅰ,collagen Ⅲ mRNA expression and their ratio significantly increased in ethanol group compared with those in the control group(P＜0.01).There was positive correlation between hydroxyproline content,collagen Ⅰ,collagen Ⅲ mRNA expression,and collagen Ⅰ /collagen Ⅲ mRNA ratio with IVRT(P＜0.05),and negative correlation between hydroxyproline content,collagen Ⅰ,collagen Ⅲ mRNA expression,and collagen Ⅰ /collagen Ⅲ mRNA ratio with the Ea/Aa ratio(P＜0.01).Conclusion:Chronic ethanol consumption can induce increase in left ventricular myocardial collagen synthesis and impairment in diastolic function in rats.Left ventricular diastolic dysfunction correlates with increase in myocardial collagen synthesis positively.