Objective To assess the effect of transitional empowerment education on the quality of life of patients with inflammatory bowel disease (IBD) and to analyze the factors affecting the quality of life, so as to pro-vide clinicians with information on effective intervention strategy. Methods From January 2015 to June 2016, 155 IBD patients were randomly divided into traditional care group (n=78) and transitional empowerment educa-tion group (n=77). The patients in the traditional care group received clinic outpatient follow-up, and the patients in the transitional empowerment education group received follow-up led by IBD management team. IBD patients in the two groups were investigated with self-management ability questionnaire, self-efficacy scale, and quality of life questionnaire before discharge and the six month after intervention. Results After the sixth month, the total scores on self-management ability (t=7.219, P=0.000), self-efficacy (t=2.845, P=0.005) and quality of life (t=7.705, P=0.000) in the transitional empowerment education group were higher than those of the traditional care group. Conclusion The transitional empowerment education can improve self-management ability, self-efficacy, quality of life of IBD patients.

Objective To explore the clinical characteristics of pancytopenic acute leukemia(PAL) and hyperleukocytic acute leukemia(HAL). Methods 183 patients with primary AL were analyzed retrospectively and divided into three groups according to patients' hemogram. Results Among these patients, 38 cases(20 8%) were PAL(group A), 42 cases(23 0%) were HAL(group B) and 103 cases(56 3%) were generic type(group C). 23 0% cases of acute myeloid leukemia(AML), 56 3% acute promyelocytic leukemia and 16 9% acute lymphoblastic leukemia( ALL) appeared PAL. The manifestations of group A were mainly milder infiltration of extra-bone marrow, more severe cytopenias. The early mortality, short and long-term effectiveness were similar to those of group C. 23 8% AML, 51 2% acute monoblastic leukemia and 18 6% ALL presented HAL. There were higher tumor burden,obviously infiltration of extra-bone marrow, higher early mortality, more refractory treatment, poorer prognosis in group B as compared with group A or C. Conclusions Pancytopenia or hyperleukocytosis were common manifestations in primary AL. It is important to understand these features of patients' hemogram for diagnosis, treatment and prognosis evaluation of leukemia.

Objective To evaluate the agreement between colposcopic diagnosis with 2011 colposcopic terminology of the International Federation for Cervical Pathology and Colposcopy (IFCPC) and cervical pathology in cervical lesions. Methods A retrospective cohort study was performed, which included 376 patients who underwent colposcopy with 2011 international terminology of colposcopy at Obstetrics and Gynecology Hospital of Fudan University from September 2014 to November 2014. With conization or cervical biopsy pathology as the gold standard, the agreement between colposcopic diagnosis and pathologic diagnosis was calculated and correlations between variables were analyzed. Results With 2011 international terminology of colposcopy, agreement of colposcopic diagnosis and cervical pathology was 60.9%(229/376)perfectly matched, and the strength of agreement with weighted Kappa statistic was 0.401 (P<0.01), and agreement within one grade was 97.6%(367/376), which were improved compared with traditional methods. Colposcopic diagnosis were 19.9%(75/376) overestimated and 19.1%(72/376) underestimated. There were no significant difference between agreements in various grade lesions (χ2=1.996, P=0.573). Positive predictive value of high grade colposcopy or more was 84.4%, the negative predictive value of low grade colposcopy or less was 88.8%, whereas false positives were 3.5%and false negatives were 39.3%. A linear trend among three types of transformation zone and patient ages was found (χ2=45.910, P<0.01), whereas lesion sizes were not linearly correlated with lesion degrees (χ2=0.690, P=0.406). In grade 1, grade 2 and nonspecific findings, thin acetowhite epithelium, dense acetowhite epithelium and Lugol′s non-staining were most frequent, the Youden indexes of each were 0.170, 0.373 and 0.145, 0.069 respectively. Positive predictive value of some other findings (such as fine mosaic) and two new signs (inner border sign and ridge sign) were 100.0%. There were no significant difference between agreements in examiners with different levels of experience (χ2=1.197,P=0.550). Conclusions Compared to traditional methods (such as Reid index), 2011 international terminology of colposcopy could improve the agreement between colposcopic diagnosis and pathologic diagnosis, without significant differences by the severity of lesion and the level of examiners′experience. Common findings were classified reasonably, and some signs were highly reliable, which is important for guiding biopsy. However, the reproducibility of transformation zone types and the implication of lesion size need to be further discussed.

Background and purpose:MicroRNA (miRNA) belongs to a class of 19 to 30 nucleotide-long, endogenous noncoding RNA expressed in eukaryotes and predominantly inhibits gene expression at the post-transcriptional level. The miRNAs play critical roles in cell proliferation and differentiation, apoptosis, metabolism, and immune regulation. This study aimed to detect the expression of miR-216a-5p in lung cancer tissues and lung cancer cell lines, and to discuss the effects of miR-216a-5p on the invasion ability of lung cancer cells and the mechanism.Methods:Quantitative real-time PCR (qRT-PCR) was used to detect the expression of miR-216a-5p in lung cancer tissues of 55 cases and 7 lung cancer cell lines. Three lung cancer cell lines of A549, 95D and H460 were transiently transfected by miR-216a-5p, and Transwell was used to detect the effects of miR-216a-5p on the invasion of lung cancer cell lines. The dual luciferase reporter plasmids containing the miR-216a-5p candidate target gene and the gene of matrix metalloproteinase 16 (MMP16) were predicted and constructed. qRT-PCR and Western blot were used to detect the changes in mRNA and protein levels of target geneMMP16 by miR-216a-5p. The interference of MMP16 by siRNA and up-regulation miR-216a-5p by transfection were compared on the invasion of lung cancer cells.Results:The miR-216a-5p expression levels were all signiifcantly reduced in 90.91% (50 of 55 patients) tumor tissues compared with corresponding adjacent normal lung tissues (P<0.05). The miR-216a-5p expression levels were only 7.00%-32.00%in 7 lung cancer cells compared with the control group (P<0.05). Up-regulation of the expression of miR-216a-5p inhibited the invasion of lung cancer cells; interference of MMP16 by siRNA, as well as up-regulating miR-216a-5p by transfection, inhibited the expression of MMP16 in lung cancer leading to inhibition of the invasion of lung cancer cells. Conclusion:miR-216a-5p can be a candidate marker in clinical diagnosis and it can inhibit the invasion of lung cancer cells by down-regulating the expression of MMP16.

Objective To observe the changes of abdominal oxygen saturation in very low birth weight infants (VLBWI)with feeding intolerance (FI)within 1 4 days after birth monitored by near infrared spectroscopy (NIRS).Methods VLBWI fitting entry criteria were enrolled into this study.NIRS monitoring was carried out to detect cerebral oxygen saturation (ScO2 )and abdominal oxygen saturation (SsO2 ).Data were analyzed between FI infants and feeding tolerance (FT)infants.FI was defined as follows:gastric residual of more than 50% of the previous feeding volume;emesis or abdominal distention or both;decrease,delay or discontinuation of enteral feedings. Results 93 VLBWI were enrolled.52 cases(55.91 %)presented with FI,including 29 cases(31 .1 9%)of gastric residual increasing and 23 cases(24.73%)of emesis with or without abdominal distention within 1 4 days after birth. The levels of SsO2 and SsO2 /ScO2 showed no differences in infants with FT and with FI within 24h after birth (P >0.05).The change rates of the median of SsO2 and SsO2 /ScO2 in FT infants were similar during 1 4 days (P >0.05).While both the change rates of SsO2 and SsO2 /ScO2 were markedly decreased 1 day before and the day of FI (P <0.01 ).The decreasing degree of SsO2 was similar between infants with gastric residual increasing and infants with emesis with or without abdominal distention[(1 6.2 ±5.1 )vs (1 7.4 ±3.6)%,t =0.733,P =0.476]. Conclusion Abdominal oxygen saturation measured by NIRS may be a useful method for infants adjusting the feeding plan.

Objective To investigate effects of different ventilation methods during pulmonary surfactant(PS) administration on cerebral oxygen metabolism in preterm infants with neonatal respiratory distress syndrome.Methods Newborns met the inclusion criteria were enrolled into this study,and they were randomly divided into manual group and mechanical group.During PS administration,the proximal end of the tracheal tube was connected to a bag valve mask device in the manual group or a mechanical ventilator in the mechanical group.Brain near infrared spectroscopy monitoring was carried out to detect the cerebral oxygen saturation(ScO2),and the mean arterial blood pressure (MABP) was simultaneously recorded.Results For all 49 preterm infants,PS was administered to preterm infants with severe respiratory distress syndrome treated with mechanical ventilation,including 24 cases of manual ventilation and 25 cases of mechanical ventilation.The left cerebral ScO2 and correlation coefficient of ScO2 and MABP(rScO2-MABP) showed no difference in both groups before PS administration.During administration,ScO2 dramatically increased in both groups [manual group:(85.88 ± 5.54) ％ vs.(77.31 ± 5.40) ％,t =5.521,P =0.000;mechanical group:(83.88 ± 3.18) ％ vs.(76.53 ±4.38)％,t =6.741,P =0.000],and gradually decreased after administration,the level of ScO2 didn't return to the baseline till the 2nd 5 minutes after PS administration [manual group:(79.25 ± 3.02) ％ vs.(77.31 ± 5.40) ％,t =1.560,P =0.220;mechanical group:(78.59 ± 3.45) ％ vs.(76.53 ± 4.38) ％,t =1.832,P =0.074].The same trend of ScO2 change rate was shown simultaneously in both groups.The rScO2-MABP markedly increased during administration in both groups (manual group:2.34 ±0.16 vs.1.86 ±0.21,t =9.022,P =0.000;mechanical group:2.12 ± 0.15 vs.1.87 ±0.21,t =4.810,P =0.000).The rScO2-MABt,in mechanical group rapidly decreased to baseline during the 1st5 minutes (1.84 ± 0.18 vs.1.87 ± 0.21,t =0.538,P =0.635) but went back to baseline in manual group during the 2nd 5 minutes(1.84 ±0.19 vs.1.86-0.21,t =0.350,P =0.809).Change rates of rScO2-MABP were markedly higher in manual group than those in mechanical group during the 1 st 5 minutes (1.15 ± 0.13 vs.1.00 ± 0.15,t =4.943,P =0.000).Conclusions ScO2 could be affected transiently by PS administration with different methods of ventilation.The effect on cerebral autoregulation in mechanical group is shorter than that in manual group.

Objective To analyze the clinical significance of lymph node metastasis-related indexes in evaluating the prognosis of initially treated stage N2b colorectal cancer. Methods Two hundred and six patients with initially treated stage N2b colorectal cancer in Shenzhen People′s Hospital from January 2009 to November 2013 were retrospectively analyzed. All patients underwent radical resection of colorectal cancer. The correlation between lymph node metastasis-related indexes and postoperative 5-year overall survival rate was analyzed, including number of negative lymph nodes, number of positive lymph nodes, lymph nodes ratio (LNR), log odds of positive lymph nodes (LODDS). Results The postoperative 5-year overall survival rate was 54.4% (112/206), and the postoperative 5-year recurrence-free survival rate was 48.1% (99/206). Univariate analysis result showed that angioma thrombus or nerve invasion, T stage, postoperative adjuvant therapy, number of positive lymph nodes, number of negative lymph nodes, LNR and LODDS were significantly correlated with the postoperative 5-year overall survival rate (P＜0.01 or ＜0.05). Multivariate analysis result showed that number of negative lymph nodes, number of positive lymph nodes, LNR and LODDS were independent risk factors of postoperative the 5-year overall survival rate ( RR=2.371, 2.295, 2.758 and 2.671; 95% CI 1.598 to 3.485, 1.556 to 3.360, 1.880 to 4.058 and 1.814 to 3.915; P＜0.01). The areas under curve of negative lymph nodes, number of positive lymph nodes LNR and LODDS in predicting postoperative the 5-year overall survival rate were 0.668, 0.657, 0.692 and 0.684, and there was no statistical difference (P＞0.05). Conclusions The number of negative lymph nodes, number of positive lymph nodes, LNR and LODDS in initially treated stage N2b colorectal cancer patients are independent prognostic factors.

Objective To investigate effects of permissive hypercapnia ventilation on cerebral oxygen metabolism and postoperative cognitive function in laparoscopy in elderly patients with mild COPD.Methods Sixty elderly patients with mild obstructive pulmonary disease undergoing elective laparoscopy under general anesthesia were randomly divided into routine ventilation group (group N) and permissive hypercapnia ventilation group(group H).Blood samples were collected to implement blood gas analysis at 10 min(T0) after endotracheal intubation,50 min (T1) and 100 min (T2) after pneumoperitoneum,and 10 min after exhaust (T3).Blood oxygen content differences of arterial-internal jugular vein (Da-jv02) and cerebral oxygen extraction rate (CERO2) were calculated at the same time.Cerebral oxygen saturation (rSO2) was monitored all the time.Cognitive function was assessed by Montreal Cognitive Assessment Scale (MoCA) at 1 d before operation,and 1d and 3d after operation.Results Compared with group N,p(CO2) and rSO2were significantly increased,and pH value,Da-jvO2 and CERO2 were significantly decreased,MoCA score was significantly increased after operation,and the incidence of post-operative cognitive dysfunction was significantly decreased after operation (P ＜ 0.05).Compared with the baseline value at T0,Da-jvO2 and CERO2 were significantly decreased,rSO2 were significantly increased,and MoCA scores at 1 to 3 d were reduced in two groups.Compared with baseline at To,group H had increased p(CO2),rSO2,increased pH value,Da-jvO2 and CERO2,at T1 ～3 (P ＜ 0.05).Conclusion Permissive hypercapnia ventilation can improve the cerebral oxygen metabolism during laparoscopic surgery,and reduce post-operative cognitive dysfunction in the elderly patients with mild chronic obstructive pulmonary disease.

Objective To investigate effects of permissive hypercapnia ventilation on cerebral oxygen metabolism and postoperative cognitive function in laparoscopy in elderly patients with mild COPD.Methods Sixty elderly patients with mild obstructive pulmonary disease undergoing elective laparoscopy under general anesthesia were randomly divided into routine ventilation group (group N) and permissive hypercapnia ventilation group(group H).Blood samples were collected to implement blood gas analysis at 10 min(T0) after endotracheal intubation,50 min (T1) and 100 min (T2) after pneumoperitoneum,and 10 min after exhaust (T3).Blood oxygen content differences of arterial-internal jugular vein (Da-jv02) and cerebral oxygen extraction rate (CERO2) were calculated at the same time.Cerebral oxygen saturation (rSO2) was monitored all the time.Cognitive function was assessed by Montreal Cognitive Assessment Scale (MoCA) at 1 d before operation,and 1d and 3d after operation.Results Compared with group N,p(CO2) and rSO2were significantly increased,and pH value,Da-jvO2 and CERO2 were significantly decreased,MoCA score was significantly increased after operation,and the incidence of post-operative cognitive dysfunction was significantly decreased after operation (P ＜ 0.05).Compared with the baseline value at T0,Da-jvO2 and CERO2 were significantly decreased,rSO2 were significantly increased,and MoCA scores at 1 to 3 d were reduced in two groups.Compared with baseline at To,group H had increased p(CO2),rSO2,increased pH value,Da-jvO2 and CERO2,at T1 ～3 (P ＜ 0.05).Conclusion Permissive hypercapnia ventilation can improve the cerebral oxygen metabolism during laparoscopic surgery,and reduce post-operative cognitive dysfunction in the elderly patients with mild chronic obstructive pulmonary disease.

Objective:To establish an HPLC method for the determination of ginsenoside Rg1 ,ginsenoside Re and ginsenoside Rb1 in Xueluotong capsules. Methods:A column of Waters Symmetry C18 ( 250 mm × 4. 6 mm,5 μm) at the temperature of 35 ℃ was used to separate the target components, the mobile phase consisted of acetonitrile-water with gradient elution, the flow rate was 1. 0 ml ·min-1 , the detection wavelength was 203 nm and the injection volume was 10 μl. Results:The linear range of ginsenoside Rg1 was 0. 055-2. 732 μg(r=0. 9998), and the average recovery was 107. 23% with RSD of 1. 17%(n=6). The linear range of ginsenoside Re was 0. 341-8. 542 μg(r=0. 9999), and the average recovery was 101. 63% with RSD of 3. 52%(n=6). The linear range of gin-senoside Rb1 was 0. 717-14. 336 μg(r=0. 9997), and the average recovery was 100. 63% with the RSD of 3. 79%(n=6). Conclu-sion:The method is simple, accurate and reliable, which can be used for the quality control of Xueluotong capsules.