Abnormal expression of secreted protein acidic and rich in cysteine like 1 (SPARCL1 )gene is closely related to the development,metastasis and prognosis of a variety of tumors.Recent studies show that SPARCL1 gene is high expressed in glioma.The protein product of SPARCL1 gene encoded can interact with collagen,thus affecting the metastasis ability of tumor,which is positively correlated with tumor malignant de-gree.SPARCL1 gene is low expressed in gastric cancer,colorectal cancer,prostate cancer and breast cancer, which is negatively correlated with the invasion and metastasis abilities of tumors.At present,the role of speci-fic molecular mechanisms of SPARCL1 gene remains controversial. The expressions and functions of SPARCL1 gene in tumor tissues seem to depend on the tumor microenvironment.

Objective To study the effects and the mechanism of astragalus menbranaceus (AM) on neonatal lymphocyte apoptosis in cord blood. Methods Cord blood mononuclear cells (CBMC) of 30 full-term neonates were cultured with pure phytohemagglutinin (PHA), PHA combined with IL-6 (PHA + IL-6) or AM (PHA + AM) respectively for 48 hours. The apoptosis index (AI) of lymphocytes of CBMC after cultivation were determined by acridine orange-ethidium bromide dying method. The positive expression of CD38 antigen and CD25 antigen were detected by indirect immunofluorescence procedure. The levels of IL-6 in the supernatants of CBMC were detected by ELISA . Results (1) The AI of the PHA + AM group (16. 5?3. 5)% and PHA+IL-6 group (16. 9?4. 0)% was lower than that of the pure PHA group (32.4?2.8)% (P0. 05). (2) The positive expression rates of CD38 of the PHA+AM group and the PHA+IL-6 group were lower than those of the pure PHA group (P0. 05). The positive expression rates of CD25 of the PHA + AM group and the PHA + IL-6 group were higher than those of the pure PHA group (P0. 05). The positive expression of CD38 of CBMC had positive correlation, but CD25 had negative correlation with the AI of CBMC(r=0. 68, -0. 65,P

Health coaching is a patient-centered intervention process, which had conducted many years in patients with chronic obstructive pulmonary disease (COPD) and made many positive outcomes. This article reviews the concept of health coaching, specific implementation measures, application effects, existing deficiencies and inspiration in patients with COPD, with a view to providing reference for the further development of health coach technology in patients with COPD.

Hepatic eosinophilic granuloma is a rare benign liver lesion,which results from granuloma formation due to chronic inflammation.Two patients were admitted to the Yantaishan Hospital and Yuhuangding Hospital from July 2008 to April 2012,respectively.The results of laboratory examination showed the elevation of peripheral blood eosinophils,and ultrasound examinations revealed low-echo masses in the liver and no blood flow was detected.The results of computed tomography showed hypoattenuation lesions with well-demarcated boundary.After intravenous administration of contrast angent,the lesions demostrated delayed heterogeneous enhancement with internal grid.The results of magnetic resonance imaging of 1 patient showed the lesion had slight hyper-intensity to the surrounding liver parenchyma on T1-weighted images,and slight high signal with low signal separation strip inside on fat-suppressed T2-weighted images.An obvious high signal was detected in diffusion weighted imaging.Familiarity with the imaging characteristics and combination of the elevation of peripheral eosinophil can help surgeons to make a suggestive diagnosis.

ObjectiveTo investigate the relevant factors influencing the incidence and mortality of post cardiac arrest syndrome (PCAS), and to provide the basis of improvement of resuscitation rate.Methods A single center retrospective study of cardiopulmonary resuscitation (CPR) according to Utstein model was conducted. A clinical case report form was designed to collect clinical data. The clinical data of patients whose spontaneous circulation was restored (ROSC)> 24 hours in intensive care unit (ICU) of the First Hospital of Jilin University from January 2008 to June 2014 were collected and analyzed. The relevant risk factors of the incidence and mortality rate of PCAS were screened and analyzed by multivariate logistic regression analysis.Results① Successful CPR was achieved in 93 patients, of whom 83 patients were shown to have systemic inflammatory response syndrome (SIRS), and 75 patients suffered from PCAS (80.65%). Among them 49 died, and 18 patients who did not suffer from PCAS survived.② The age, gender, history of previous chronic disease, site of occurrence of cardiac arrest, type of rhythm when cardiac arrest occurred, and dosage of adrenaline showed no significant influence on the incidence of PCAS. The incidence of PCAS was elevated when defibrillation was done more than 3 times (χ2= 10.806,P= 0.001), SIRS occurred after ROSC (χ2= 46.687,P< 0.001), interval between collapse and first defibrillation over 5 minutes (χ2 = 6.429,P = 0.011), interval between collapse and CPR longer than 5 minutes (χ2 = 4.638,P = 0.031), interval between collapse and administration of first resuscitation medication> 5 minutes (χ2 = 4.190,P = 0.041), and ROSC time was longer than 10 minutes (χ2 = 20.042,P< 0.001). Bivariate correlation showed that interval between collapse and CPR, interval between collapse and administration of first resuscitation medications, and ROSC time were all correlated (r1 = 0.677,r2 = 0.481,r3 = 0.617, allP< 0.001).③ There were no significant relations between the prognosis of PCAS patients and times of defibrillation, the amount of adrenaline used, and interval between collapse and first defibrillation. The mortality rate of PCAS was relatively elevated when interval between collapse and CRP was longer than 5 minutes (χ2 = 10.792,P = 0.001), interval between collapse and administration of first resuscitation medications was longer than 5 minutes (χ2 = 13.841,P< 0.001), ROSC time> 10 minutes (χ2 = 36.451,P< 0.001), the number of dysfunction organ≥ 4 (χ2 = 28.287,P< 0.001), arterial blood lactate levels> 2 mmol/L (χ2 = 28.926, P< 0.001), and acute physiology and chronic health evaluationⅡ (APACHEⅡ) score> 15 (χ2 = 33.558,P< 0.001). Multivariate logistic regression analysis showed that the risk factors affecting the prognosis were ROSC time [odds ratio (OR) after adjustment = 36.643, 95% confidence interval (95%CI) = 2.382-563.767,P = 0.010], the number of organs with dysfunction (OR = 9.010, 95%CI = 1.140-71.199,P = 0.037), and APACHEⅡ score (OR = 10.001, 95%CI =1.336-74.893,P = 0.025).Conclusions ROSC time, the number of organs with dysfunction, and APACHEⅡ score were independent predictors of PCAS prognosis. Efforts should be given to shorten the rescue time, to shorten the time for restoring the spontaneous circulation, to prevent and treat SIRS after ROSC, and to protect the function of organs, in order to improve the prognosis of patients with PCAS.

Objective To study the predictive value of acute gastrointestinal injury (AGI) grading system introduced into Sequential Organ Failure Assessment (SOFA) score in patients with severe acute pancreatitis (SAP) in order to provide a reliable clinical tool for the evaluation of prognosis of SAP.Methods Patients with acute pancreatitis admitted to ICU from July 2012 to July 2014 were enrolled for study.The criteria of exclusion were the age below 18 years old,pregnancy,or patients without consent to the treatment.A total of 63 patients with 37 males and 26 females aged (47 ± 15.3) years were included.The data of their acute physiology and chronic health evaluation (APACHE) Ⅱ score,the highest SOFA score and AGI grade within the first week,and the 28-day mortality rate were collected.Patients without AGI were defined as zero point,and AGI grade Ⅰ-Ⅳ were defined as 1-4 points.The receiver operating characteristic curve (ROC) was used to evaluate the value of APACHE Ⅱ score,SOFA score,and SOFA + AGI score in predicting the prognosis of SAP.The areas under ROC curve (AUC) of the APACHE Ⅱ score,SOFA score,and SOFA + AGI score were compared with MedCalc software,and P value less than 0.01 was considered to be statistical significance.Results (1) The 28-day mortality of the 63 patients with SAP was 20.6％ (13/63),in which 50 patients in the survival group,13 patients in the death group.The APACHEⅡ scores of two groups were (15.62 ± 4.33 vs.12.10 ± 3.74,P=0.0048),the SOFA scores were (14.77 ± 3.09 vs.9.24 ± 2.88,P ＜0.01),and the SOFA + AGI scores were (18.77 ±3.09 vs.10.74 ± 3.17,P＜0.01).(2) The AUC of APACHEⅡ score was0.748 ± 0.084 (95％ CI:0.622-0.849),the AUC of SOFA score was 0.902 ± 0.059 (95％ CI:0.801-0.962),and the AUC of SOFA +AGI score was 0.963 ± 0.037 (95％ CI,0.882-0.994);There was no significant difference in AUC between APACHE Ⅱ score and SOFA score (P =0.10),and there was statistical significance between the AUC of APACHE Ⅱ score and that of SOFA + AGI score (P =0.013),and the difference in AUC between SOFA score and SOFA + AGI score was statistically significant (P =0.008).The Youden index and the positive likelihood ratio of SOFA + AGI score system were the greatest to be 0.863 and 15.38,respectively.Conclusions SOFA scoring system has better predictive value in patients with SAP when AGI grading system was introduced into it.

Objective The study was to find the application effect of high quality nursing service in perioperative treatment of patients with coronary heart disease.Methods Eighty patients were randomly divided into the comfort nursing group and the routine nursing group with 40 patients in each group.The comfort nursing group was given high quality nursing service,and the routine nursing group received the conventional care.The effect in two groups was compared after rehabilitation.The statistical software of SPSS 17.0 was used to analyze the data.Results The degree of anxiety was lower,the number of patients with complication was less,the degree of satisfaction was higher and the time in hospital was less in the comfort nursing group.Conclusions The comfortable nursing care should be used in peri-operative treatment of coronary heart disease,which can make patients keep the best mental state to accept and cooperate with the surgical treatment.It also can improve the care quality and patients' satisfaction degree and shorten the hospital stay.

Virtual reality is the multi-dimensional sensorial environment produced by the computer, Users can play a part in this virtual environment by particular tools. This technology, possessing the characteristics of being lifelike, interactive and imaginative, plays more and more important part in the medical field. For example, in medical training, in physical and psychological treatments, this technology is of great value.
Computer Simulation ; Computer-Assisted Instruction ; General Surgery ; education ; methods ; Humans ; Surgery, Computer-Assisted ; User-Computer Interface

Objective:To explore whether health and wellness coaching can promote healthy lifestyle among highrisk people with stroke.Methods:The highrisk people with stroke admitted to the hospital were randomly divided into a test group (49) and a control group (49) by excel random function method.The control group was given telephone health education once a week, a total of 12 times last 3 months; On this basis, the test group carried out from every week to every months,a total of 8 timeshealth and wellness coaching, measuring the health promotion lifestyle (HPLP-Ⅱ) scale scores of the two groups of subjects at baseline, at the end of the intervention, and 3 months after the end of the intervention.Results:There was no statistical difference in the general demographic data of the two groups of subjects. Repeated measures analysis of variance showed that three months after the intervention, the two groups of subjects had statistically significant differences in nutrition, health responsibilities, physical activity, self-actualization, and health promotion lifestyle scores between the groups, time, and interaction ( F values were 12.131-502.649, P<0.01). There were no statistical differences in interpersonal relationship and stress coping dimensions ( P>0.05). Simple effect analysis found that at the end of the intervention, the two groups of subjects had only statistical differences between the self-actualization dimension and the total score of health promotion lifestyle ( P<0.01). Three months after the end of the intervention, the total scores of nutrition, health responsibilities, sports, self-actualization and health-promoting lifestyles of the two groups of study subjects were significantly different ( P<0.01). Conclusions:Health and wellness coaching can promote healthy lifestyle among highrisk people with stroke.

Ego-depletion is a phenomenon in which an individual's cognitive, emotional and behavioral control ability or willingness declines after long-term self-control. Patients with chronic diseases need to change their lifestyles for a long time, understand and master the knowledge of the disease, and they are prone to self-depletion after diagnosis. This paper summarized the research progress of ego-depletion in patients with chronic diseases through the concept of ego-depletion, subjective measurement tools, and the current research status of ego-depletion in patients with chronic diseases, and provided inspiration for future research directions, with a view to providing ideas for further research on ego-depletion in patients with chronic diseases.