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Objective To explore and clarify the clinical features and management of patients with Castleman disease.Methods The clinicopathological features and therapeutic method of 65 patients with Castleman disease admitted to our hospital continuously from 2005 to 2012 were analyzed retrospectively.The mean follow-up time for the entire series was 40 (15-71) months.Results In contrast to Localized Castleman disease(LCD),Multicentric Castleman disease (MCD) patients were relatively older and exhibit various symptoms and abnormal laboratory tests.We found 44 tumor in LCD group.LCD ones,most of which were hyaline vascular (33/42,78.6％),were more likely originated in retroperitoneum,enterocoelia(10/44,22.7％) or mediastinum(10/44,22.7％).The initial treatment for LCD patients was complete surgical resection and all patients are current alive with no evidence of recurrence.MCD ones always accompanied by fever(9/23,39.1％),anemia(9/23,39.1％)and splenomegaly,and most of MCD patients were plasmacytic variants(14/23,60.9％) or mixed cellular variants (5/23,21.7％).We found 66 tumor in MCD group and they were more likely originated in neck (16/66,24.2％) and groin area (12/66,18.2％).Surgery combined with CHOP-like chemotherapy or CHOP-like chemotherapy alone was the mainstream treatment for MCD ones.21 patients achieved complete remission or partial remission,and only 2 patients died of lung infection.Whether patients could tolerate long-term chemotherapy or not was an important prognostic factor.Conclusions LCD patients had no typical clinical symptoms and could be cured by surgery.Most of MCD patients always had a good prognosis after receiving CHOP-like chemotherapy.

Objective To investigate the status of clinical nursing teaching in the department of infection.Method To investigated the teachers and nursing students in the department of infection with a self-designed questionnaire.Results The evaluation from students to the teachers are:overall satisfaction score is(4?90±0?04),the lowest points are the advanced nursing of common diseases and the teaching attitude.While the evaluations from teachers are:overall satisfaction score is(4?45+0?04),the lowest are communication with patients and their families,conducting basic nursing operation and familiarity of common drugs.Conclusions To enhance teaching quality of clinical nursing teaching in the department of infection,it is efficient by improving the quality of teachers and their teaching methods,consolidating students’knowledge,and exercising their skills?

Objective To study the inhibitory effect of knocking down miR-30a-5p on the U87 human glioma xenograft growth and its possible mechanism.Methods Nude mice bearing subcutaneous U87 human glioblastoma were established and separated into three groups (eight for each group) by randomized digital table method,including control group,scr-ODN treated group and AS-miR-30a-5p treated group.After relevant subcutaneous injection treatment,tumor size was measured every other day until the observation period ended.Researchers executed the animals after the treatment,stripped tumor tissues and extracted RNA and protein.Real-time PCR was conducted to detect the expression of miR-30a-5p.The histopathological characteristics and proliferation and apoptosis biological characters (including SEPT7,PCNA,cyclin D1,MMP-2,apoptosis related factor P53,bcl-2 and caspase3) were evaluated by HE and immunohistochemical staining,Westem blot analysis respectively,and the cell apoptosis was detected by TUNEL method.Results In AS-miR-30a-5p treated group,the tumor growth was delayed and the final tumor volume was smaller than that in the control and scr-ODN treated group (F =7.167,P ＜0.05),and the expression of miR-30a-5p was knocked down.The expression of PCNA,cyclin D1 were significantly downregulated while P53,SEPT7 and caspase3 up-regulated.Apoptotic index was increased significantly.Conclusion As-miR-30a-5p suppresses the growth of U87 human gliomas xenografts significantly.Malignant phenotype of tumors are reversed to a considerable degree.Therefore,miR-30a-5p can be a candidate for targeted therapy of human glioma.

Objective To identify the expression of CD68-tumor-associated macrophages (TAMs) and proliferative marker Ki-67 in retroperitoneal malignant fibrous histiocytoma (MFH) and their clinical significance. Methods Clinical data about 35 patients with retroperitoneal MFH managed with surgery from February 2002 to December 2015 were retrospectively analyzed and all patients were followed up. There were 24 male and 11 female patients, and they were 18-71 years old, with mean age (53.0 ± 10.8) years old. Patients were divided into CD68 positive group (21 patients) and CD68 negative group (14 patients), while they were also divided into Ki-67 low expression (< 20%) group and Ki-67 high expression ( ≥ 20%) group, according to the immunohistochemical staining results. The overall survival time and all clinical data between two groups were compared. Kaplan-Meier estimations, Cox regression analysis, Fisher exact probabilities and Spearman correlations were performed. Results Of the 35 patients, 18 patients received radical resection, and 17 patients received palliative operation. The overall 1-, 3-, 5-year survival rates were 65.7%, 22.9%and 8.6%and the median survival was 17 (1-86) months. Factors associated with postoperative survival were FNCLCC grade (x2=7.002, P=0.008), modusoperandi of the tumor resection(x2=7.134, P=0.008), and CD68(x2=4.634, P=0.031) and Ki-67 overexpression (≥20%) (x2=8.898, P=0.003 ) . The difference between gender, age, tumor size, blood loss, removal of the joint organs and adjuvant therapy got no statistical significances (P > 0.05). Multivariate analysis showed that survival was associated with modusoperandi of the tumor resection and Ki-67 overexpression (P=0.003, 0.002, respectively). Conclusions Retroperitoneal malignant fibrous histiocytoma is a rare malignancy that display poor prognosis and high mortality. Complete resection remains the mainstream for retroperitoneal malignant fibrous histiocytoma. The patients' life span in CD68 positive or Ki-67 high expression is shorter. CD68 and Ki-67 plays a critical role in retroperitoneal malignant fibrous histiocytoma carcinogenesis and their high expression may be used as a potential survival predictor in patients with retroperitoneal MFH.

Objective To observe the expression of triggering receptor expressed on myeloid cells (TREM),Caspase-3 and interleukin (IL)-6 in optic nerve tissue of ischemic optic neuropathy (ION).Methods Twenty Sprague-Dawley rats were randomly divided into control group and model group,10 rats in each group.The permanent ligation of bilateral internal carotid arteries (BICA) was performed for 14 days to establish subacute ION model as model group.The control group were separated BICA without ligation.The expressions of TREM-1,TREM-2,Caspase-3 and IL-6 in rat retina were detected by reverse transcription PCR and Western blot,respectively.Results Compared with the control group,the expressions of TREM-1,Caspase-3,IL-6mRNA (t=6.058,7.86,6.055) and protein (t=9.671,9.524,14.501) in the optic nerve tissue of the model group were increased,while the expression ofTREM-2 mRNA and protein (t=9.283) was decreased,and the difference was statistically significant (P＜0.05).Conclusion In ischemic optic nerve tissue,TREM-1 mRNA and protein were significantly expressed,the expressions of TREM-2 mRNA and protein decreased significantly.

Objective:To provide a reference for the choice of electronic data capture system used in clinical research, the function and performance of some tool software were expounded and compared.Methods:We selected three freely available systems of REDCap, Commcare, and OpenEDC as research objects, describing and comparing their user license acquisition path, data capture related functions, and information security assurance measures. This article reflected how the three kinds of tool software ensure research data privacy and scientificity, and presented the consideration of system security and accessibility.Results:REDCap was the most mature system of the three, which had a fairly comprehensive design in functional integrity, data security, user friendliness, and system scalability. Commcare system featured in the mobile collection, and supported the most abundant types of collected data, while OpenEDC was characteristic of low threshold and flexible deployment.Conclusions:REDCap system is widely applicable to small and medium scale medical research, including clinical trials, retrospective studies, cohort studies, and translational research. Commcare system is the preferred option for medical investigations represented by epidemiologic surveys, while OpenEDC is particularly suitable for investigator initiated studies.

Objective:To observe the clinical effect of Shenfu injection in preventing septic cardiomyopathy (SIC) in septic patients.Methods:From June 2022 to January 2023, patients with sepsis or septic shock who did not develop SIC were randomly divided into treatment group and control group according to the ratio of 1:1. In the treatment group, Shenfu injection (50 mL) was pumped intravenously once every 12 hours for 5 days. In the control group, 50 mL of normal saline was pumped intravenously once every 12 hours, and the course of treatment was 5 days. The primary end point was the incidence of SIC in the first 5 days. The secondary end points were the application time of vasoactive drugs, fluid balance in the previous week, hospitalization time in ICU, total ventilation time and 28-day mortality.Results:112 patients were randomly divided into two groups. Seven patients in the treatment group were excluded twice, and finally 49 patients were included in the analysis, while six patients in the control group were excluded twice and 50 patients included in the analysis. The total incidence of SIC in the treatment group within 5 days was significantly lower than that in the control group (42.9% vs. 64.0%, P = 0.035). Among them, the left ventricular systolic dysfunction in the treatment group was significantly lower than that in the control group (24.5% vs 52.0%, P=0.005), and there was no significant difference in the incidence of left ventricular diastolic dysfunction between the two groups. The incidence of right ventricular dysfunction in the control group was 28.0%, which was significantly higher than 10.2% in the treatment group ( P = 0.025). The duration of using vasoconstrictors in the treatment group was 75(48, 97) hours, which was significantly lower than 97(66, 28) hours in the control group ( P = 0.039). The duration of inotropic drugs use in the treatment group was 32(18, 49) h, which was also significantly shorter than 44(25, 61) h in the control group ( P=0.046). The fluid balance of the control group in the first week was (1 260±850) mL, which was significantly higher than (450±520) mL in the treatment group ( P=0.008). There was no statistical difference in ICU stay, total ventilation time and 28-day mortality between the two groups (all P > 0.05). Conclusion:Early application of Shenfu injection can significantly reduce the incidence of SIC, accompanied by less use of vasoactive drugs and positive fluid balance, which has a good clinical application prospect.

To summarize the reform measures of nursing vertical management in our hospital under the background of diagnosis related groups,including refined performance management,cancellation of nursing main pharmacy classes,implementation of attending nursing working group,establishment of DRGs nursing quality control coder position,head nurse responsible for bed allocation,deepening nursing quality management and other measures,so as to provide references for other hospitals to carry out the reform of nursing vertical management under the background of DRGs.

Objective To investigate the evaluation and suggestion of the courses of Chinese Medicine for clinical students majoring in medical college. Methods In January 2017, at the end of the Chinese Medicine courses, a total of 35 clinical students of Capital Medical University were investigated through a questionnaire, mainly related to students' understanding of Chinese medicine; evaluation and suggestions for Chinese Medicine education and teaching. Results The majority of students believed that Chinese medicine was safe and effective. The proportion of believing worthing learning that the Chinese medicine accounted for 94.3% (33/35), and who believed Chinese medicine helpful for the clinical work accounted for 82.9% (29/35). However, the proportion of satisfaction with the current teaching method was 60% (21/35). Conclusions Most of the clinical students in this investigation have recognized the role of Chinese medicine, and have shown great interest in studying the course, but they are not satisfied with the current teaching. To improve the teaching quality of Chinese Medicine through the reform should be the direction of teachers' efforts in the future.