Objectives:To observe the effect of rhGH in the treatment of chronic wasting diseases. Methods:Twenty two cases of chronic wasting diseases needing nutrition support were chosen,including 10 cases of COPD,12 cases of cerebral infarction or cerebral hemorrhage with decubital ulcer in recovery phase.They were in the age of 60～75,in combination with morderate malnutrition.These patients were divided into control group and experimental group.In the experimental group,rhGH(4.5 U/d) was given hypodermically for 10 days.Serum albumin,prealbumin,transferin,24 h urea nitrogen in urine,the surface area of decubital ulcer and mental state were monitored before and after the treatment. Results:In the experimental group,many nutritional indices were increased markedly,24 h urea nitrogen excretion was decreased,the healing of decubitus was faster and mental state was better when compared with control group. Conclusions:The rhGH plays an important role in improving the nutritional status and mental state in patients with chronic wasting diseases. On the base of supplying enough nutrients, rhGH can promote anabolism,reduce the excretion of urea nitrogen in urine, accelerate the healing of decubital ulcer and improve the prognosis.

Objective To investigate the expression of Smac/DIABLO, XIAP mRNA in acute pancreatitis (AP) and the relationship with the severity in rats.Methods Fifty-four SD rats were randomly divided into three groups:sham-operation (SO) group, acute edematous pancreatitis (AEP) group and acute necrotizing pancreatitis (ANP) group.The models of AEP and ANP were induced by retrograde injection of 1％ and 3.5％ sodium deoxycholate into the pancreaticobiliary duct respectively.The specimens of pancreatic tissue at 3 h, 6 h, 12 h were collected, pathological changes of the pancreas were observed, apeptosis in pancreas were detected by TUNEL method and the expression of Smac/DIABLO, XIAP mRNA were analyzed by real-time PCR.Results Pathological changes of the pancreas confirmed the establishment of AEP and ANP.Apeptosis indexes in SO group, AEP group and ANP group were 0.67±0.82, 6.62 ±0.78 and 4.70 ±0.82, and the differences were significant (P< 0.05).The expression of Smac/DIABLO mRNA of AEP group increased with time, while the expression of ANP group decreased with time.Compared with SO group, Smac/DIABLO mRNA expressions at 6 h in AEP and ANP group were 2.41 ± 0.92 and 1.47± 0.53, and the differences were significant (P<0.05).By contrast, the expressions of XIAP mRNA in AEP group decreased with time,while the expressions in ANP group increased with time.The expressionsof XIAP mRNA at 6 h in AEP and ANP group were 5.51 ± 1.07 and 6.99 ± 1.00, and the differences were significant (P<0.05).Conclusions In acute pancreatitis, the expression of Smac/DIABLO mRNA was consistent with the apoptosis of pancreatic acinar cells, but not consistent with the severity of pancreatitis.The expression of XIAP mRNA was consistent with the severity of pancreatitis.Smac/DIABLO, XIAP mRNA is associated with regulation of apoptosis.

Objective: To investigate the treatment effect of rational enteral nutrition in stress ulcer bleeding after severe brain injuries.Methods: 30 cases with severe brain injuries accompanied with stress ulcer bleeding were supported by enteral nutrition as clinical treatment group.50 cases with the same conditions were managed with traditional treatment methods as control.Results: All patients in clinical treatment group had no stress ulcer bleeding any more. The nutritional state was improved. On the other hand,the stress ulcer bleeding occurred again and again and the nutritional state was poor.Conclusion: Rational enteral nutrition can treat upper gastrointestinal stress ulcer bleeding in severe brain injuries effectively.

To study the cost-effectiveness of temozolomide combined with radiotherapy in the treatment of glioblasto-ma. Methods:According to the clinical trial data, cost-effectiveness and sensitivity of the results was analyzed based on the domestic cost and consumption level. Results:Temozolomide combined with radiotherapy could prolong one month of overall survival with the additional cost of RMB 58 959. 7 yuan in each case when compared with radiotherapy alone. Conclusion:Temozolomide combined with radiotherapy has no advantage on cost-effectiveness when compared with radiotherapy alone.

Objective To discuss the clinical characteristics and prognosis of lipoprotein glomerulopathy (LPG) in chil-dren. Method Clinical data of one pediatric LPG patient were retrospectively analyzed. The clinical features and prognosis of childhood LPG were summarized based on literature review. Results A nine years old girl presented with frequent urination. The ifrst urine test revealed hematuria and proteinuria. After one week anti-infection treatment, the hematuria and proteinuria were continued. The serum albumin was slightly reduced. The hyperlipidemia and mild anemia were emerged. Kidney biopsy showed that enlarged glomeruli, with dilated capillary loops and weak eosinophilic lipoprotein thrombi in the capillary lumina under the light microscope;layered or tuftedemboluscontaining particulated lipid vacuoles under electron microscope. Gene sequencing identified APOE Tokyo (Leu141-Lys143→0). The diagnosis of LPG was confirmed. The lipid-lowering therapy was administrated and the disease was alleviated. Conclusion LPG is a rare disease in children. The level of blood lipid was signiifcantly increased, and the hormone therapy was ineffective. Kidney biopsy is the main basis for diagnosis. The genetic testing can prompt the genetic background. Lipid lowering therapy can relieve the progress of the disease.

OBJECTIVETo investigate the main allergens in patients with allergic rhinitis in Zhengzhou district.

METHODSTwenty standardization allergens were used to perform skin prick test in 1 139 patients with allergic rhinitis. The samples were divided into four groups according to the age of the patients. The distributions of different allergens in the four groups were analyzed.

RESULTSThe top five inhaled allergens were dermatophagoides farina (920 cases, 80.8%), dermatophagoides pteronyssinus (870 cases, 76.4%), cat hair (517 cases, 45.4%), herbs (397 cases, 34.9%) and poaceae (353 cases, 31.0%); the top five ingestive ones were shrimp (143 cases, 12.6%), peanut (66 cases, 5.8%), egg (56 cases, 4.9%), carp (51 cases, 4.5%) and meat (48 cases, 4.2%). The distribution of allergens was different among the different age groups.

CONCLUSIONDust mites, cat hair, herbs and poaceae were the most common allergens in Zhengzhou district.

Allergens ; Animals ; Cats ; Dermatophagoides pteronyssinus ; Hair ; Humans ; Prevalence ; Pyroglyphidae ; Rhinitis, Allergic ; epidemiology ; Skin Tests

Objective:To establish a new nurse standardized training management index system based on training transfer theory, and to provide reference for objective evaluation of standardized training management for new nurses.Methods:From August 2020 to April 2021, guided by the theory of training transfer, the standardized training management indexs for new nurses were preliminarily drawn up through literature review, semi-structured interviews. The Delphi method was used to conduct two rounds of expert consultation.Results:The effective questionnaire recovery rate of the two rounds of expert consultation was 92.00% (23/25) and 95.65% (22/23), respectively. The expert authority coefficients were 0.904 and 0.905, respectively. Kendall′s harmony coefficients were 0.228 and 0.250, respectively, both P<0.01. The final index system of standardized training management for new nurses based on training transfer theory included 4 first-level indexes, 14 second-level indexes and 59 third-level indexes. Conclusions:The new nurse standardized training management index system based on training transfer theory is scientific and reliable. It provides a tool for evaluating standardized training management of new nurses and a reference for perfecting the training management system of new nurses.

Objective To investigate the risk factors for occult pneumonia(OP) in children with primary nephrotic syndrome(PNS).Methods The clinical data of 115 children with PNS and findings of chest CT from July 2010 to June 2016 at the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed.Based on the findings of chest CT,the subjects were divided into 2 groups:OP group and unoccult pneumonia (UOP) group.The comparisons were made between 2 groups,including gender,age,season,course of disease before admitting to hospital,formation of ascites,white blood cells,C-reactive protein,erythrocyte sedimentation rate,total protein (TP),albumin (ALB),total cholesterol,immunoglobulin G (IgG),immunoglobulin E,urine N-acetyl-beta-D-glucosaminidase (NAG) and 24 h urinary protein quantity/body weight.The single factor analysis was performed to analyze above indicators between 2 groups,and the indicators which had statistical significance were analyzed by single factor analysis were analyzed by the multifactor Logistic regression.The receiver operator characteristic (ROC) curve was drawn to evaluate the predicting ability of the indicators for PNS combined with OP.Results Among 1 15 cases,68 (59.1％) PNS patients were complicated with OP.The result of single factor analysis indicated that the risk factors were the formation of ascites,TP,ALB,IgG and NAG (all P ＜0.05).The multifactor Logistic regression showed that ascites,TP and ALB were the risk factors for OP in children with PNS(P =0.003,0.004,0.003).The area under curve (AUC) of ALB was 0.709,and the critical value was 18.55 g/L(P =0.000);the AUC of TP was 0.658,and the critical value was 39.15 g/L(P =0.004).Conclusion The incidence rate of PNS combined with OP was high.With the presence of formation of ascites,TP ＜39.15 g/L and ALB ＜ 18.55 g/L,it may indicate OP for the PNS children which require special consideration clinically and earlier chest CT examination.

Objective:To analyze the correlation of epidermal growth factor receptor (EGFR) expression in esophageal cancer tissues with sensitivity of radical radiotherapy and prognosis of patients.Methods:A total of 98 esophageal cancer patients admitted to the Affiliated Hospital of Jiangnan University from January 2017 to July 2019 were selected, and all patients received radical radiotherapy. The efficacy was assessed after 4 weeks of radiotherapy, partial remission (PR) + complete remission (CR) was treated as the sensitive group and disease progression (PD) + stable disease (SD) was treated as the tolerated group. The expression of EGFR in cancer tissues and paraneoplastic tissues (more than 5cm from the margin of cancer tissues) was measured by using immunohistochemistry. The expression of EGFR in cancer tissues and paraneoplastic tissues and the clinicopathological characteristics of the sensitive and tolerant groups were compared. Cox proportional risk model was used to analyze the factors influencing the prognosis of esophageal cancer patients; the Kaplan-Meier method was used to analyze the relationship between EGFR expression in cancer tissues and prognosis of patients.Results:The positive expression rate of EGFR in esophageal cancer tissues (66.3%, 65/98) was higher than that in paraneoplastic tissues (29.6%, 29/98), and the difference between the two groups was statistically significant (χ 2=26.49, P < 0.001). All 98 patients successfully completed radical radiotherapy, including 4 cases of CR, 60 cases of PR, 26 cases of SD and 8 cases of PD. The proportion of patients with highly differentiated and tumor length ≤1.5 cm in the sensitive group was higher than that in the tolerant group, and the differences were statistically significant (all P < 0.05). The positive expression rate of EGFR in cancer tissues in the sensitive group (56.3%, 36/64) was lower than that in the tolerant group (85.3%, 29/34), and the difference between the two groups was statistically significant ( χ2=8.39, P < 0.001). Multifactorial Cox regression analysis showed that poor differentiation, tumor long diameter >1.5 cm, and positive EGFR expression were independent risk factors for overall survival in patients with esophageal cancer (all P < 0.05). The difference in overall survival between patients with positive and negative EGFR expression was statistically significant ( χ2=9.70, P = 0.002). Conclusions:Highly-expressed EGFR in esophageal cancer tissues may suggest low sensitivity of radical radiotherapy and poor prognosis of patients.

Objective To explore the effect and safety of mycophenolate mofetil (MMF) and glucocorticoid on Henoch-Schonlein purpura nephritis in children and compared with cyclophosphamide (CTX).Methods The data of 48 patients diagnosed as Henoch-Schonlein purpura by renal biopsy were retrospectively analyzed.Median follow-up time was 22(7,48) months.The subjects were divided into 2 groups.34 cases were in the MMF group:MMF (15-20 mg · kg-1 · d-1 or 800-1200 mg/m2)+prednisone,and 14 cases in the CTX group:CTX (8-12 mg · kg-1 · d-1) + prednisone.Clinical and laboratory data were collected at baseline and 1,3,6 months after treatment.During follow-up,cumulative retreatment rate and adverse reactions after treatment were recorded.Results In two groups after treatment for 1,3,6 months,24 hours urinary protein quantitative was significantly lower than the baseline value,serum albumin (sAlb) was significantly higher than the baseline value,and serum creatinine (Scr) indicated no statistically significant difference during the follow-up period.After the treatment of 1 month,the efficient rate of MMF group was higher than the CTX group (MMF 73.5 ％ vs 42.9％,P=0.046),the effective treatment of 3,6 months at the end of the follow-up,no statistically significant difference were observed in the accumulative remission rate.The total rate of retreatment was 10.4％ (5/48),where MMF group was lower that of the than CTX group (3.0％ vs 28.6％,P＜0.001).The retreatment often occurred after discontinuation of prednisone and CTX,MMF reduction process.Eleven children received IMPDH2 gene polymorphisms test in MMF group,9 AA children had shorter time for drugs to be effective than that of the AG and GG children.The incidence of adverse reactions of MMF group was obviously lower than CTX group at the end of the follow-up (8.8％ vs 35.7％,P=0.025),where two groups developed fungal infection.Conclusions The short-term effect of both groups are the same,but the recurrent rate and incidence of adverse reactions of MMF group are lower than those of the CTX group.The preliminary study shows that IMPDH2 gene polymorphisms is associated with MMF curative effect and adverse reactions.