Objective To observe the effects of pituitary adenylate cyclase-activating polypeptide (PACAP) on the expressions of caspase-3 and X-linked inhibitor of apoptosis protein (XIAP) after hypoxic-ischemic brain damage (HIBD) in neonatal rats and to investigate its neuroprotection and effective dose. Methods Sixty neonatal rats were randomly allocated to one of three groups: sham operation, saline control and PACAP groups. The PACAP group was redivided into high (10-8 mol), medium (10-9 mol) and low (10-12 mol) dose groups. An animal model of HIBD was established. Real-time fluorescent quantitative polymerase chain re-action method was used to detect the expressions of caspase-3 mRNA and XIAP mRNA on af-fected side of brain 24 hours after HIBD in neonatal rats, and spectrophotometry was used to detect the activities of caspase-3. Results Twenty-four hours after HIBD, caspase-3 mRNA expression and enzyme activity, as well as XIAP mRNA expression in the saline control group were increased significantly compared to the sham operation group (all P <0.01). Caspase-3 mRNA expression and enzyme activity in all the PACAP groups were significantly lower than those in the saline control group (all P <0.01), while XIAP mRNA expression was significantly higher than that in the saline control group (all P < 0.01 ). Conclusions PACAP may upregu-late XIAP mRNA expression, inhibit caspase-3 mRNA expression and enzyme activity. It has neuroprotective effect on HIBD in neonatal rats, and it is effective with high, medium and low doses.

Objective To know the influence of preoperative respiratory function exercise on the postoperative pulmonary function among patients with lung cancer. Methods Divided 80 patients with lung cancer into the observation group and the control group, there were 40 cases in the each group. Routine perioperative nursing cares was used in the control group, while a two weeks respiratory function exercise was used in the observation group. Compared the incidence rate of complications be-tween the two groups after the intervention, some indexes which can indicate the respiratory function were compared before and after the exercise in the observation group. Results The indexes such as PaO_2, SpO_2, MVV, TCL and FEV in the observation group after the respiratory function exercise were better than before significantly. The incidence rate of complications in the control group was more than in the observa-tion group. Conclusions Strengthen respiratory function exercise can effective improve the respiratory func-tion for patients with lung cancer when cured by thoractomy, which can promote patients' compliance, and then avoid certain postoperative complications.

Objective　To determine the expression and the change of vascular endothelial growth factor(VEGF) and it's acceptor Flt-1 during maxillofacial blast injury at early stage,and to evaluate the effect of VEGF on traumatic wound healing.Methods　The rabbit model of maxillofacial blast injury was made by KTY-04 blasting cap. The expression of VEGF and Flt-1 in wound tissue was determined by ABC immunohistochemistry after injury 6h,1d,2d,3d,5d,and 7d. Also,the results were compared with preinjury groups.Results　In the wound tissue of maxillofacial blast injury, the expression of VEGF was rising steadily at the first week after injury. Comparing with normal tissue,it showed different from the first day after injury, and showed very different from the third day(P<0.01).It reached the peak at the seventh day after injury.The expression of Flt-1 showed no difference within 3 days after injury comparing with normal tissue.After injury 5d-7d,the protein expressed strengthly.Conclusion　The stage of the VEGF expression at maxillofacial blast injury is similar to the angiogenic stage during wound healing, and the Flt-1 expression is also occurring at that period.It illustrates that VEGF take part in angiogenic cascades of traumatic wound healing and product auxo-action to the regeneration of blood vessel.

OBJECTIVE To explore the clinical and etiological characteristics in patients with ventilator-associated pneumonia(VAP) in emergency intensive care unit(EICU),and improve the prevention and treatment level of VAP.METHODS To analyze the clinical information of 54 patients with VAP,and to compare the clinical information with the incidence rate of VAP.Bacterial culture of airway secretion and drug sensitive test were used to analyze etiology.RESULTS Totally 148 patients were enrolled in this study,of which 54 were diagnosed as VAP.The incidence rate of VAP group was 36.5%.Respirator used time of VAP group was obviously longer than that of non VAP one.Antibiotic prophylaxis could not lower the incidence rate.A total of 59 pathogen strains were isolated by bacteria culture.The major pathogenic bacteria in VAP were Pseudomonas aeruginosa(22.0%),Acinetobacter baumannii(16.9%),Staphylococcus aureus(15.3%),Escherichia coli(10.1%),and Klebsiella pneumonia(10.1%).CONCLUSIONS VAP is one of the significant reasons for failed mechanical ventilation treatment.To prevent and treat VAP should pay attention to disinfection and aseptic manipulation,and make the rational use of antimicrobial agents.

Objective To evaluate the association between serum cystatin C and carotid atherosclerosis in patients with type 2 diabetes mellitus.Methods A total of 318 patients with type 2 diabetes mellitus were enrolled in this study.According to the results of carotid color Doppler ultrasound in the patients were randomly divided into two groups:CIMT abnormal group (CIMT was equal to or larger than 0.9 mm,with or without associated with carotid artery plaque formation)CIMT and normal group (CIMT <0.9 mm,and it was not associated with carotid artery atherosclerotic plaque formation.Differences in serum cystatin C,serum lipid and lipoprotein,fasting plasma glucose and other biochemical markers between the two groups were analyzed by using Student's t test.The correlated factors of the carotid thickness and plaque appearance were analyzed by Logistic regression analysis.Results The serum cystatin C levels of the CIMT abnormal group were higher than the normal CIMT group[(1.24 ±0.22)mg/L vs.(1.05 ±0.41)mg/L, t =4.949,P <0.001).Multivariate logistic regression analysis showed adjusted for gender,age and other factors,ser-um cystatin C was independently associated factor of CIMT (OR =2.563,95% CI:1.026 ~6.403,P =0.044). Conclusion Our data suggest that serum cystatin C is significantly associated with carotid atherosclerosis.

Objective To investigate the clinical features of skin cancer.Methods Clinical data of skin cancer and precancerous skin lesions confirmed pathologically from 2005 to 2008 in Peking University First Hospital were retrospectively analyzed by using statistical methods.Results A total of 632 cases of skin cancer and precancerous skin lesions were studied.The most common skin cancer was basal cell carcinoma and squamous cell carcinoma (invasive and in situ) which accounted for 29.3%and 24.2%,respectively.The average age at onset was older than 60 years in 55.4%of the patients,between 35 and 59 years in 34.3%,younger than 35 years in 10.3%.The concordance between clinical and pathological diagnosis reached nearly 90.O%for Paget's disease,70.0% for other common skin cancer and precancerous skin lesions.Conclusions Skin cancer and precancerous skin lesions have a predilection for scalp and face.Patients aged from 35 to 59 years account for a significant proportion not only in cutaneous lymphoma but also in melanoma and epithelium-derived nonmelanoma skin cancer.

Objective To discuss the clinical application value of Omaha system-based targeting nursing care for patients with hepatocellular carcinoma (HCC) who were treated with transcatheter arterial chemoembolization (TACE).Methods A total of 60 advanced HCC patients,who were planned to receive TACE,were prospectively and randomly divided into the control group (n=30) and the observation group (n=30).Routine nursing mode was adopted for the patients in the control group,while Omaha system nursing model was employed for the patients in the observation group.The patients of the observation group were evaluated with Omaha system at the time of admission,the key common problems were screened out and targeted nursing measures were employed.Meanwhile,on the days of admission and discharge all the patients of both groups were asked to fill in the forms of Hamilton depression scale (HAMD-17),Hamilton anxiety scale (HAMA),social support rating scale (SSQ) and numerical pain rating scale (NRS);and the degrees of depression,anxiety,social support and pain were respectively assessed.Results Both nursing modes could improve the degrees of depression and anxiety as well as the social support system of HCC patients,but the curative effect of these two aspects in the observation group were obviously better than those in the control group (P＜0.05).No statistically significant difference in the improvement of pain degree existed between the two nursing models,but Omaha system-based targeting nursing mode could alleviate the patient's pain to a certain extent.Conclusion For patients with advanced HCC,Omaha system-based targeting nursing care can alleviate the patient's negative emotion and promote the patients to establish effective social support system,this nursing mode is superior to conventional nursing mode.Therefore,Omaha system-based targeting nursing has great application potential in clinical practice.

OBJECTIVE:To investigate the relationship between Tacrolimus blood concentration and effectiveness after renal transplantation and to find factors affecting Tacrolimus blood concentration METHODS:Steady-state trough concentrations of Tacrolimus were collected from 80 renal transplantation patients RESULTS:The effective blood concentration of Tacrolimus was associated with course of treatment CONCLUSIONS:The therapeutic concentration of Tacrolimus was between 12ng/ml and 15ng/ml during the first 2 weeks after renal transplantation,then should be 8ng/ml～15ng/ml

Objective To investigate the effects of self-efficacy-oriented nursing intervention on postoperative quality of life of lung tumor patients. Methods Ninety patients with lung tumors undergoing chest surgery in our hospital from March 2010 to March 2012 , involved in the study. The nursing data were retrospectively analyzed for investigation of the nursing strategies. The patients were randomized into two group with random digits table in equal number: The control group received routine nursing and the intervention group with self-efficacy-oriented nursing intervention beside routine nursing care. 3 months after nursing intervention , the two groups were compared by Self-rating Depression Scale (SDS) and Self-rating Anxiety Scale (SAS) in terms of quality of life and psychological state. Results The scores of the intervention group by SDS and SAS were both significantly higher than those of the control group (P < 0.05). The scores of the intervention group on self efficacy and quality of life were significantly higher than those of the control (P < 0.05). Conclusion The self-efficacy-oriented nursing intervention applied in the postoperative nursing care to lung cancer patients can significantly improve the postoperative symptoms and psychological status. It can also improve their self efficacy and then enhance their quality of life.

Objective: To investigate the proportion of achieving the blood lipid control target and its influencing factors among residents at a high risk of atherosclerotic cardiovascular disease (ASCVD), so as to provide insights into management of blood lipid among residents at a high risk of ASCVD. Methods: Residents at a high risk of ASCVD and at ages of 35 to 70 years were sampled using a multi-stage cluster sampling method from 6 counties (districts) in Shaoxing City from May to July 2021. The residents' demographics, smoking, alcohol consumption and medical history of chronic diseases were collected using questionnaires, the height, weight, waist circumference (WC) and blood pressure were measured, and the total cholesterol (TC), triacylglycerol (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and fasting blood glucose were detected. The proportion of blood lipids achieving the control target was analyzed, and factors affecting the proportion of blood lipids achieving the control target were identified using a multivariable logistic regression model. Results: A total of 1 695 individuals at a high risk of ASCVD were enrolled, including 940 men (55.46%) and 755 women (44.54%), with a mean age of (62.56±6.08) years. There were 285 participants that achieved the target of blood lipid control (16.81%). Multivariable logistic regression analysis identified gender (male, OR=1.962, 95%CI: 1.396-2.758), age (OR=1.037, 95%CI: 1.013-1.061), WC (OR=0.979, 95%CI: 0.964-0.995), diastolic blood pressure (OR=0.981, 95%CI: 0.967-0.994), smoking (OR=1.485, 95%CI: 1.034-2.133), alcohol consumption (OR=0.684, 95%CI: 0.498-0.941), hypertension (OR=1.428, 95%CI: 1.006-2.207), administration of hypoglycemic drugs (OR=2.326, 95%CI: 1.720-3.144) as factors affecting the achievement of the target for blood lipid control among residents at a high risk of ASCVD. Conclusions Individuals at a high risk of ASCVD with higher WC, higher diastolic blood pressure and alcohol consumption are less likely to achieve the target for blood lipid control, while male individuals with older age, hypertension and administration of hypogcemic drugs are more likely to achieve the target for blood lipid control.