Adolescent ; Adult ; Aged ; Emergency Treatment ; Female ; Gas Poisoning ; nursing ; therapy ; Humans ; Male ; Middle Aged ; Young Adult

Objective To evaluate the perioperative period safety of improved transurethral plasma kinetic enucleation of prostate (TUPKEP) in high-risk benign prostatic hyperplasia (BPH) patients with coronary heart disease (CHD).Methods One hundred and twenty-eight BPH patients were selected,24 patients had CHD (with CHD group),among whom 10 patients were given transurethral vapor-resection of prostate (TUVP),and 14 patients were given improved TUPKEP; 104 patients didn't have CHD,among whom 22 patients were given TUVP,and 82 patients were given improved TUPKEP.The serum endothelin (ET)-1 was measured by specific radioimmunoassay at preoperative 2 h and postoperative 1,2,6 d,and complication was observed.Results All the patients were cured by operation,and left hospital smoothly.There were no statistical differences in the preoperative 2 h serum ET-1 in with CHD group and without CHD group (including all TUVP patients and improved TUPKEP patients) (P ＞ 0.05).The postoperative 1 and 2 d serum ET-1 levels of TUVP patients were significantly higher than those of improved TUPKEP patients,in with CHD group:(114.09 ± 15.33) ng/L vs.(94.77 ± 12.14) ng/L and (99.67 ± 9.87) ng/L vs.(88.21 ± 9.55) ng/L; in without CHD group:(70.21 ± 12.44) ng/L vs.(53.67 ± 9.02) ng/L and (61.18 ± 9.52) ng/L vs.(48.54 ± 9.15) ng/L,and there were statistical differences (P ＜ 0.05).There were no statistical differences in postoperative 6 d serum ET-1 in TUVP patients and improved TURKEP patients (P ＞ 0.05).In with CHD group,5 patients had ischemic ST-T change in the early postoperative period,and 3 patients had angina pectoris.They all were promptly treated,and the events were controlled.Serious complications did not present such as acute myocardial infarction (AMI),acute heart failure and sudden cardiac death,etc.Conclusions The postoperative BPH patients have vascular endothelial injury catholically,especially the high-risk patients with CHD.Furthermore,it might be one of the causes of the postoperative adverse cardiovascular events.Compared with TUVP,improved TUPKEP has a minor impact on vascular endothelial function,and it can reduce the postoperative adverse cardiovascular events in the BPH patients with CHD.Improved TUPKEP is a relatively safer surgical method for high-risk BPH with CHD.

Objective To study the CT findings of traumatic bone cyst and to improve the knowledge of that disease.Methods CT features of 8 cases of traumatic bone cyst confirmed by clinical and pathology were reviewed retrospectively.There were 4 females and 4 males,from 26 to 76 years (the median age was 53 years old)of age.Three patients had traffic accidents,2 patients had trauma unrelated,1 patient had boulder crushing,1 had patient stick wounded and 1 patient had high jump wounding.The bone cyst occurred from 18 to 36 months after trauma(2 at 18 months,4 at 24 months,1 at 30 months and 1 case at 36 months).Results There were 6 fractures,1 joint dislocation and 1 frontal soft tissue hematoma in trauma.The cyst located in the ilium of 3 cases,in the calcaneus of 2 cases,in the frontal bone of 1 case,in the hooked bone of 1 case,in the lunate bone of 1 case.The cyst size was 2.0 cm × 2.6 cm to 3.0 cm × 6.0 cm (average 2.7 cm × 4.0 cm).8 cases all single capsule change,all clear boundaries.6 cystic destruction and 2 cystic expansion destruction of bone.Two see separated and 6 no divider of the cyst region.Five bone sclerosis and 3 no hardening of the cyst edge.Three sclerosis and Five no sclerosis of the adjacent bone.Four osteoporosis decalcification and 4 no osteoporosis decalcification of he adjacent bone.Conclusion The traumatic bone cyst is closely related to trauma,CT manifestations with certain characteristics,combined with a history of trauma can make a definite diagnosis.

Objective To explore the relationship between the expression of P53 protein and the radiosensitivity in patients with advanced maxillary squamous cell carcinoma.Methods An immunohistochomical method wag used to detect the expression of P53 protein in patients with advanced maxillary squamous cell carcinoma.The follow up time was 2 years.The local recurrence of the patients having been treated with radical surgery and affiliated radiotheraphy were analyzed.Results The overexpression of P53 protein in 26 cages was 65.4% (17/26).In the P53 overexpression group,the local recurrence after systiem therapy wag occurred in one case within 6 months,6 cages between 7～12 months.3 cages between 13～18 months and 2 cases between 19～24 months.In the P53 low expression group,there were no recurrence within 6 and 12 months and one case ocurred within 18 months.5 cages between 19～24 months.The difference of recurrence within 18 months after system therapy between the expression of P53 Wag statistically significant(P＜0.05),but it Wag not significant for those within 24 months(P＞0.05).Conclusions The expression of P53 protein Wag correlated with the radiosensitivity in patient with advaneed maxillary squamous cell carciaoma,especially for the resid.rod cells in mitosis phase.The affiliated radiotherapy after radical surgery Wag limited effect.

9).Renal pathology revealed 3 patients with class Ⅳ, 1 patient with class Ⅱ. Image results showed diffuse pulmonary infiltration lesions. Bronchial lavage fluid was hemorrhage. Three patients recovered after treatment with corticosteroid and intravenous cyclophosphamide therapy. Conclusions Diffuse alveolar hemorrhage is rare serious complications of lupus nephritis. Aggressive immunosuppressive therapy should be started early for a favorable outcome.

Objective To investigate the influence of Chinese medicine ( CM) treatment on life span of middle-late primary hepatic carcinoma (PHC) patients. Results A multicenter retrospective cohort study was carried out in 489 PHC patients at the stages of Ⅱb, Ⅲa and Ⅲb collected from 15 domestic hospitals. With CM treatment as the exposure factor, the enrolled patients were divided into CM group, western medicine (WM) group and the CM-WM combination group. The main outcomes included median survival time (MST) and survival rate, and the effects of CM treatment and minimally invasive therapy on MST were observed. Results Half-a-year survival rate, one-year survival rate and two-year survival rate were 50%, 9%, 1% in CM group, 70%, 30%, 6% in CM-WM combination group, and 50%, 10%, 0% in WM group, respectively. The survival rates in CM-WM combination group differed from those in CM group and WM group (P<0.01), but the differences of survival rates between CM group and WM group were insignificant (P>0.05) . MST at the stages of Ⅱb, Ⅲa, Ⅲb in CM-WM group was obviously prolonged as compared with the other two groups (P<0.01), and MST at the stages of Ⅲa, Ⅲb in CM group was also obviously prolonged as compared with WM group (P<0.05) . The difference of MST at the stage of Ⅱb was insignificant between CM group and WM group ( P>0.05) . CM treatment and minimally invasive therapy were effective on prolonging the survival time of PHC patients ( P<0.01) . The results of COX regressionanalysis showed that Karnofsky scores, CM treatment and minimally invasive therapy were the preventive factors for the prognosis. Conclusion CM-WM combination group has the best long -term therapeutic effect. CM -WM combination treatment is effective on increasing MST and long-term survival rate, in particular for PHC patients at the stages ofⅡb, Ⅲa and Ⅲb. CM treatment and minimally invasive therapy are helpful for the prolongation of the survival time of PHC patients.

Objective To investigate the effect of teaching mode innovation based on the tech-nology of digital orthopedic in orthopedic clinical teaching for eight-year program medical students. Methods 40 eight-year program medical students who took part in orthopedic clinical trainee in the 2015 school year were chosen and divided into two groups:traditional teaching group and digital tech-nology teaching group. The digital technology teaching group adopted a digital model of orthopedic technology, printing aids, use of auxiliary aids and simulate actual cases operative teaching while an-other group used traditional teaching. After the novitiate, questionnaire investigations were used to evaluate the effect of the orthopedic clinical teaching in both groups. At the same time an examination after the course was used to examine the teaching effect of the two groups, and SPSS 19.0 software was used to do chi-square test and t test to the result of the examination of both groups. Results Compared with the traditional teaching group students, the digital technology teaching group students more agreed with the new teaching mode for their interest in learning and hands-on ability bring positive influence (P<0.05), overall satisfaction of teaching method was significantly higher (P=0.03). The operation ex-amination result [(92.1±9.1) vs. (70.5±9.6)] and the comprehensive examination result (84.6±10.1) vs. (72.3±10.6)were more outstanding, the t test showed that the difference was statistically signifi-cant (P<0.05). Conclusion Teaching mode innovation based on the technology of digital orthopedic in eight-year program medical students has showed obvious advantages in orthopedic clinical teaching, which can stimulate students' interest in learning, improve the teaching effect and have broad applica-tion prospects in orthopedic clinical teaching.

Objective:To construct a esophageal cancer module with Chinese characteristics based on MD Anderson Symptom Inventory (MDASI) public scale, develop the Perioperative Esophageal Cancer Symptoms Assessment Scale combining above two parts.Methods:The original item pool was formulated through literature review, clinical interviews, and reference of existing symptoms assessment tools. After two rounds of expert evaluation and pilot survey, the preliminary Perioperative Esophageal Cancer Symptoms Assessmment Scale was developed combining Chinese MDASI (MDASI-C). A total of 150 perioperative esophageal cancer patients was assessed using the new scale, the included items were analyzed one by one, the reliability, validity and sensitivity of scale were checked.Results:Feasibility: the scale recovery was 100%, the completion rate of scale was 93.75%, the average completion time was 10 min. Reliability: the value of Cronbach α of the esophageal cancer module, MDASI-C, the combined scale were 0.747, 0.894, 0.883, respectively. Validity: the range of content validity index of items was 0.83-1.00, the scale-level content validity index average value was 0.93. Two common factors, which explained for 67.994% of variance, were extracted by exploratory factor analysis, the validity of criterion had statistical significance ( P<0.05). Sensitivity: the scores of the esophageal cancer module were significantly different among perioperative esophageal cancer patients with different Eastern Cooperative Oncology Group performance status ( H value was 9.264, P<0.05). Conclusions:The Perioperative Esophageal Cancer Symptoms Assessment Scale has good feasibility, reliability, validity and sensitivity, it is suitable for symptoms assessment of Chinese perioperative esophageal cancer patients.

Objective To study the intervention effectiveness of intensive training in medical interns’occupational exposure protection.Methods Medical interns in seven colleges and universities in Wuhan between 2011 and 2015 were chosen and divided into control group (675 medical interns in 2011 - 2013,comprehensive training about healthcare-associated infection control was conducted for once before internship )and intervention group (682 medical interns in 2014 - 2015,hospital-department-tutor three steps of intensive training was conducted),the occurrence of occupational exposure and exposure knowledge awareness between two groups were compared. Results The awareness rate of knowledge about occupational exposure protection and the implementation rate of protective measures in intervention group were both higher than control group (all P <0.05).Incidence of occupa-tional exposure in intervention group was lower than control group (21 .70%[n=148]vs 65.33%[n=441 ],χ2 =262.91 ,P <0.01);percentage of interns who conducted active serological virus detection and intensified vaccination of hepatitis B virus were both higher than control group (14.66%[n=100]vs 2.96%[n=20];11 .73%[n=80]vs 2.67%[n=18],respectively).Occupational exposure before and after intervention occurred most frequently when interns were preparing medicine,occupational exposure reporting rate in intervention group was higher than control group (72.97%[108/148]vs 50.11 % [221/441 ],χ2 =52.78,P <0.01 ).Conclusion The intensive training of occupational exposure protection among medical interns can improve the awareness and skills of occupational protec-tion,and reduce the occurrence of occupational exposure.

The global incidence rate of nonalcoholic steatohepatitis (NASH) continues to rise. The pathogenesis of NASH is complex, and there is no effective clinical treatment. Previous study has shown that DEAD box protein 5 (DDX5) can significantly alleviate the NASH process in mice. This study screened the natural product library of the research group and found that the active compound hypercalin B (HB) in Hypericum beanii N. Robson, a traditional Chinese medicine, can upregulate the expression of DDX5 protein in a dose-dependent manner. In this study, an in vitro model of NASH stimulated by palmitic acid (PA) and an animal model of NASH induced by the methionine- and choline-deficient diet (MCD) were constructed. Different concentrations of HB were used to investigate the effect and mechanism of HB in alleviating NASH progression. All animal experiments in this paper were approved by the Ethics Committee of China Pharmaceutical University (NO: 2021-02-003). In vitro model results showed that HB significantly reduced the intracellular lipid deposition induced by free fatty acid (FFA). Animal experiments showed that HB improved liver injury by significantly reducing lipid accumulation in the liver of NASH mice, and reducing serum aspartate transaminase (AST) and alanine transaminase (ALT) levels. Moreover, HB could inhibit liver inflammation by reducing the mRNA levels of liver pro-inflammatory cytokines including interleukin 6 (IL-6), interleukin 1β (IL-1β), and tumor necrosis factor α (TNFα). Further research showed that HB could reduce the phosphorylation level of the mechanical target of rapamycin (mTOR) and reduce the expression of sterol regulatory element binding protein 1 (SREBP1) and fatty acid synthase (FASN), thereby improving lipid metabolism and alleviating NASH progression, and the effects of HB against NASH were dependent on DDX5. In conclusion, HB can improve lipid metabolism and inhibit inflammatory activation by suppressing mTORC1 pathway via upregulating DDX5 protein, and showed promising anti-NASH activity in vitro and in vivo.