Objective:To explore the therapeutic effect of comprehensive rehabilitation nursing on patients with cere-bral infarction (CI)complicated type 2 diabetes mellitus (T2DM).Methods:According to number table,a total of 118 CI + T2DM patients were randomly and equally divided into comprehensive nursing group and routine nursing group.Comprehensive nursing group received comprehensive nursing based on routine nursing.The evaluating inde-xes included fasting blood glucose (FBG)concentration,limb muscle strength recovery and score of activity of daily living of two groups before hospitalization and discharge.Results:Compared with routine treatment group before discharge,there was significant reduction [(7.9±4.2)mmol/L vs.(5.9±2.8)mmol/L]in FBG concentration in comprehensive nursing group;limb muscle strength recovery of comprehensive nursing group was significantly better than that of routine nursing group (≥ grade III,upper limb 83.1% vs.64.4%,lower limb 76.3% vs.55.9%);percentage of patients with activity of daily living score > 60 scores (33.9%)in comprehensive nursing group was significantly higher than that of routine nursing group (15.2%),P <0.05 all. Conclusion:Comprehensive rehabili-tation nursing could promote the rehabilitation of physical function in patients with cerebral infarction complicated type 2 diabetes mellitus.

Objective Esophageal spindle cell carcinoma is a rare type of esophageal squamous cell carcinoma , which was usually named esophageal carcinosarcoma .This article was to discuss the clinical characteristics , treatment and prognostic factors of e-sophageal spindle cell carcinoma . Methods The clinical and pathological data of 28 cases of esophageal spindle cell carcinoma were retrospectively analyzed .The prognostic factors was analyzed for various factors including gender , age, smoking history , tumor loca-tion, tumor size, lymph node metastasis, histological type, pathological staging and adjuvant treatment regimen .Kaplan-Meier method was applied to calculate the survival rate , log rank method for single prognostic factor analysis and Cox proportional hazard regression model for multivariate analysis of prognosis . Results One-year, three-year, and five-year survival rates were 89.3%(25/28), 67.1%(19/28), 38.5%(10/28)respectively.Single factor analysis showed that the pathological type , N stage, T stage, pTNM stage were the factors influencing the prognosis(P﹤0.05), while gender, age, smoking and drinking history, tumor location, tumor size, operation incision selection , adjuvant treatment regimen were not .Multivariate analysis showed pTNM stage were the independent fac-tors affecting the prognosis of esophageal spindle cell carcinoma (χ2 =13.104, P=0.000). Conclusion Esophageal spindle cell carcinoma is a rare kind of esophageal squamous cell carcinoma with less invasiveness , low rate of lymph node metastasis and good progno-sis.Radical operation is the preferred treatment .

Actins ; metabolism ; Angiotensins ; pharmacology ; Animals ; Breast Neoplasms ; blood supply ; drug therapy ; metabolism ; pathology ; Cell Proliferation ; Female ; Fibroblasts ; metabolism ; pathology ; physiology ; Humans ; Interferon-gamma ; therapeutic use ; Neoplasm Invasiveness ; Neoplasm Metastasis ; Neovascularization, Pathologic ; Prognosis ; Transforming Growth Factor beta1 ; metabolism

Objective To investigate the relationship between inflammatory factors,including C-reactive protein( CRP),tumor necrosis factor alpha (TNF-α),adiponectin,leptin and gestational diabetes mellitus (GDM) and their changes in puerperiunr Methods From June 2008 to May 2010,40 cases with gestational diabetes mellitus,40 cases of normal pregnancy were enrolled in this study.Fasting venous blood were obtained at early pregnancy (10 - 12 weeks),late pregnancy (36 -38 weeks) and day 3 and 42 of postpartum.Serumal adiponectin,leptin and TNF-α were measured by ELISA,and serumal CRP were measured by particle enhanced immunoturbidimetric method.The levels of those 4 cytokines and homeostasis model assessment insulin resistance (HOMA-IR) index were compared between two groups.And the changes of 4 cytokines were calculated in puerperium.The receiver operating characteristic (ROC) for TNF-α predicting GDM was designed.Results ( 1 ) The relationship between cytokines and HOMA-IR:the levels of adiponectin of (5.7 ± 1.8 ) mg/L in the GDM group were significantly lower than ( 8.1 ± 2.7 ) mg/L in control group in early pregnancy,and the level of adiponectin was negatively correlated with HOMA-IR (r=-0.333,P＜0.05).The levels of (28 ± 10) μg/L of leptin,( 10.0 ±3.4) ng/L of TNF-α and (4.7 ± 1.1 ) mg/L of CRP in GDM group were significantly higher than ( 20 ± 8 ) μ,g/L of leptin,(4.6 ±2.7) ng/L of TNF-α,(2.4 ± 1.2 ) mg/L of CRP in control group,which were positively correlated with HOMA-IR ( r =0.411,0.529,0.308,all P ＜ 0.05 ).In late pregnancy,the level of adiponectin ( 3.9 ±2.2) mg/L in the GDM group was significantly lower than ( 6.6 ± 2.7 ) mg/L in control group,and the level of adiponectin was negatively correlated with HOMA-IR ( r =- 0.344,P ＜ 0.05 ).The levels of ( 37 ±13) μg/L of leptin,( 12.7 ±2.6) ng/L of TNF-α and (6.7 ±3.6) mg/L of CRP in the GDM group were significantly higher than ( 30 ± 13 ) μg/L of leptin,(5.8 ± 2.1 ) ng/L of TNF-α,( 4.4 ± 3.1 ) mg/L of CRP in control group,which were positively correlated with HOMA-IR (r =0.414,0.487,0.285,all P ＜0.05).Multiple linear regression analysis showed that the level of TNF-α at early and late pregnancy was most correlated with HOMA-IR ( r =0.390,0.284,all P ＜ 0.05 ).( 2 ) The level of the cytokines and HOMA-IR in puerperium:at day 3 of postpartum,the level of adiponectin of (3.3 ± 1.1) mg/L in the GDM group was significantly lower than (6.2 ± 1.5 ) mg/L in control group,which was negatively correlated with HOMA-1R (r =- 0.283,P ＜ 0.05 ).The levels of ( 31 ± 13 ) μg/L of leptin,( 10.1 ± 5.7 ) ng/L of TNF-α and (35.1 ±6.5) mg/L of CRP in the GDM group were significantly higher than (21 ± 15) μg/L of leptin,(5.6 ± 3.0) ng/L of TNF-α,(30.5 ± 8.5) mg/L of CRP in control group.And leptin and TNF-α levels were positively correlated with HOMA-IR (r=0.372,0.494,all P ＜0.05).At day 42 of postpartum,the level of adiponectin in GDM group was negatively correlated with HOMA-IR ( r =- 0.299,P ＜ 0.05 ),and the levels of leptin and TNF-α were positively correlated with HOMA-IR ( r =0.401,0.442,all P ＜0.05 ).Multiple linear regression analysis showed that the level of TNF-αt at day 3 and day 42 was most correlated with HOMA-IR ( r =0.363,0.274,all P ＜ 0.05 ).( 3 ) ROC analysis of data from early pregnancy showed that the threshold for TNF-α to predict GDM was 5.45 ug/L.Conclusion TNF-ot might be the index to predict GDM and evaluate prognosis.

APACHE ; Adult ; Female ; Humans ; Male ; Organophosphate Poisoning ; Young Adult

Acupuncture Therapy ; Chest Pain ; therapy ; Female ; Humans ; Middle Aged ; Stroke ; therapy

Objective To investigate the high risk factors,pathology and clinical features in fatal pulmonary embolism in the elderly patients with malignant tumor,and to analyze the characters of the embolus and provide experimental data for clinical prevention and treatment offatal pulmonary embolism.Methods Autopsy and clinical data of 19 malignancy cases with fatal pulmonary embolism admitted to Beijing Hospital from 1975 to 2006 were retrospectively analyzed.Results 33.9％ of total pulmonary embolism were from malignant diseases (19/56).Saddle and massive pulmonary embolism were in 84.2％ of total 19 cases,and micro-embolism cases were in only 15.8％.The 84.2％ of embolisms were from pulmonary thromboembolism,15.8％ from tumor emboli,and 5.26％ from fungi emboli.Pulmonary adenocarcinoma was the most common (36.5％),the second was pancreatic cancer (15.8％).In all the clinical symptoms,78.9％ of symptoms were dyspnea,15.8％ were syncope.Tachycardia and cyanosis were the common physical signs.Conclusions Malignant tumor is an important risk factor for pulmonary embolism in elderly patients.There are various kinds of emboli in pulmonary embolism in elderly patients with malignant tumor.We should comprehensively consider the causes of pulmonary embolism and give the reasonable and effective treatment to the patients.

Objective To investigate the value of CD5 molecule-like protein(CD5L) and partial pressure of CO2 in arterial blood(PaCO2) in predicting the survival of patients with severe asthma and mechanical ventilation.Methods From Jan.2013 to Jan.2016,a total of 38 patients with severe asthma and mechanical ventilation were enrolled.Acute Physiology and Chronic Health EvaluationⅡ(APACHE II)were used to assess the severity.Enzyme linked immunosorbent assay was used to detect serum levels of CD5L at admission and 6 h after treatment.PaCO2 were also detected.Pearson correlation analysis was used to analyze the correlation between APACHEⅡ score and CD5L and PaCO2 levels.Receiver operation characteristic(ROC) curve was used to evaluate the value of CD5L and PaCO2 in predicting the survival of patients.Results APACHEⅡscores of survival patients were significantly higher than dead patients(P<0.05).CD5L level of survival patients after treatment was significantly lower than dead patients,while PaCO2 level was significantly higher(P<0.05).APACHEⅡ score was negatively correlated with serum CD5L level(r=-0.347,P<0.05),while positively correlated with PaCO2 level(r=0.573,P<0.05).ROC curve analysis showed that serum CD5L and PaCO2 were with predictive value for prediction the survival of patients,with sensitivity of 93.33%,specificity of 75.00%,accuracy of 89.47%,positive predictive value of 93.33%,and negative predictive value of 75.00% for CD5L,and those for PaCO2 were 90.00%,87.50%,89.47%,97.42% and 70.00%.Conclusion With the decreasing of CD5L level and increasing of PaCO2 level,severity of disease in patients with severe asthma and mechanical ventilation could be more serious condition,indicating poor prognosis.CD5L and PaCO2 could be with fine predictive value of survival of patients with severe asthma and mechanical ventilation.

Objective To investigate the value of wide-detector Revolution CTA with 70 kV tube voltage and prospective ECG-gated technique in diagnosis of congenital heart disease (CHD) in infants and children.Methods Forty-five infants and children with complicated CHD underwent echocardiography and wide-detector Revolution CTA.According to the sur gical findings,the diagnostic efficiency of Revolution CTA and echocardiography were calculated and compared.The radiation effective dose (ED) and iodine dose were calculated.The quality of CT images was also evaluated.Results There were 25 separate cardiovascular anomalies including 6 congenital cardiac structure anomalies and 19 congenital extracardiac vascular anomalies.For congenital extracardiac vascular anomalies,there was significant difference of diagnostic accuracy and the detectable rate between CTA (99.77％ [853/855],97.73％ [86/88]) and echocardiography (98.71％ [844/855],88.64％ [78/88];x2 =6.28,5.72,both P＜0.05).The average of ED was (0.20±0.05)mSv and the mean iodine dose was (2.06± 1.09)g.All CT images were qualified for diagnosis.Conclusion The wide-detector Revolution CTA,with the prospective ECG-gated technique and 70 kV tube voltage,can provide high accuracy for assessment of CHD in infants and children,which can keep good image quality,with the low radiation dose.

Objective To study the efficacy of transcatheter arterial chemoembolization (TACE )and continuous portal vein perfusion chemothepary (VPC) on advanced hepatocellular carcinoma cells (HCC). Methods The patients in group A (n=83) received the epirubicin (EPI) 40 mg and the cisplatin (CDDP) 80mg, lipiodol-anticancer drug emulsion was injected into the feeding arteries of tumors followed by embolization with gelatin sponge (GS) particles. Patients in group B (n=59) after receiving the same as the group A then VPC was carried out. Results The response rate ( CR + PR) in group A and B was 45.8% and 61.0%(P