Adult ; Blood Glucose ; analysis ; Diabetes Mellitus ; blood ; Electrophoresis, Agar Gel ; Electrophoresis, Paper ; Female ; Hemoglobin A ; analysis ; Humans ; Male

Objective To understand the psychological experience of primary caregivers of patients with cancer-related pain,care to focus on caregivers psychological health, improve life quality and ability to cope with pain. Methods A qualitative, descriptive, semi-structured research were used in this study. Nineteen primary caregivers of cancer patients with cancer-related pain were in-depth interviewed. Colaizzi′s analytical method was adopted to analyze the data, which were then organized into themes and subthemes. Results The primary caregivers confronting cancer-related pain experienced a series of negative psychological changes, worry, fear, anxiety, vexation, sadness, helplessness and powerlessness, their physical and mental health, life were also affected .The primary caregivers were lack of pain related knowledge and pain management skills generally. Conclusion Medical staff should pay high attention to the psychology status of primary caregivers, to provide support, health education and skill training of pain coping strategies, which then might help relieve cancer patients′pain and in turn improve their quality of life.

Objective To evaluate the effect of operation associated with uterine arerial chemotherapy and embolization preoperation.Methods 31 patients with pathologically confirmed cervical carcinoma were treated with interventional therapy,followed by uterectomyandpelvic lymphadenectomy.Results Curative effect was obvious.The lymph metastasis of Ⅱ and Ⅲ stage was 12% and 66.67%respectively.27 patients followedup for 3 years,23 were survived(85.19%).Conclusion For cervical carcinoma,before operation,the interventional therapy can reduce the size of tumor and the metastasis of lymph,improve the ectomy by operation and the survival rate.

Objective To investigate the prevalence of psychological distress and analyze the relevant factors among patients with bladder tumor so as to provide evidence for future clinical practice. Methods Totally 128 patients were recruited from a urological surgery ward of a comprehensive hospital in Beijing in the study by using self-design questionnaire and the psychological distress thermometer (DT) recommended by the U.S. national comprehensive cancer network (NCCN). The acquired data were analyzed by SPSS17.0. Results The average score of the patients was 4.00(1.00~5.00). The identification rate of psychological stress was 55.47%( 71/128 ) , higher than the Chinese normal ( U = 8 . 28 , P < 0 . 05 ) . The relevant factors of psychological stress based on the rank from high to low scores included emotion problems ( 1 . 63 ± 0 . 67 ) , practical problems ( 1 . 42 ± 0 . 64 ) , communication problems (1.29 ± 0.65), physical problems (1.28 ± 0.33) and religion problems (1.00 ± 0.08). Conclusions The prevalence of psychological distress is higher among patients with bladder tumor and the influence factors mainly include emotional problems , practical problems and communication problems. Nurses should pay attention to the psychological distress of patients with bladder tumors and develop targeted interventions so as to relieve their distress.

Objective To determine the optimal injection dose of ozone for the treatment of lumbar intervertebral disc protrusion.Methods A total of 240 patients with lumbar intervertebral disc protrusion were randomly and equally divided into four groups,with 60 patients in each group.Under CT guidance intervertebral injection of ozone was performed.The injection dose of ozone(50 ug/ml)used for patients in group A,B,C and D was 10 ml,20 ml,30 ml and 40 ml respectively.Immediately after the procedure CT scanning was made to check the result. A follow-up lasting 6-12 months was carried out.Clinical observation,including the ablation degree of the nucleus puiposus,the therapeutic results and the adverse reactions,was conducted.The results were statistically analyzed and compared among the four groups.Results A significant difference in the therapeutic effect existed between group A(10 ml)and other three groups(P＜0.05),while no significant difference in the therapeutic effect existed among group B(20 ml),group C(30 ml)and group D(40 ml),with P＞0.05.The occurrence of complications was increasing with the injection dose used.Conclusion The optimal injection dose of ozone for the treatment of lumbar intervertebral disc protrusion is 20 ml.

Objective To discuss the clinical effect of hallux valgus deformity treated with minimally invasive the first metatarsal distal osteotomy. Methods The data of 375 cases (626 feet) treated with minimally invasive the first metatarsal distal osteotomy was retrospectively analyzed. Hallux valgus angle was21°-65°(mean37.61°±9.25°), intermetatarsal (IM) anglewas7° -21° (mean 13.03°± 3.73°). The preoperative American Orthopaedic Foot and Ankle Society (AOFAS) score was (46.5 ± 9.4) pints. Results The patients were followed up 12-30 months [mean (18.5 ± 6.8) months]postoperation, hallux valgus angle was 7.18°±4.55°,intennetatarsal angle was 5.07°± 1.70°,with a mean angle decreasing 30.54° and 12.33°.The AOFAS score was (84.8±7.6) points (P <0.01). Conclusion According to the hallux valgus angle,intermetatarsal angle and the length of the first metatarsal,decide the place and method of osteotomy, the hallux valgus can be corrected in three-dimensional and get an excellent effect.

Objective To Validate the prognostic significance of the European Organization for Research and Treatment of Cancer (EORTC) risk tables in Chinese patients with non-muscle invasive bladder cancer (NMIBC). Methods According to the scoring standard of the EORTC system, 225 NMIBC patients were reviewed and divided into 3 groups: low, intermediate and high risk groups for recurrence and progression respectively. The probabilities of recurrence and progression at 1 year and 5 year for each group were calculated using life-table analysis and then compared with the EORTC risk tables. Log-Rank test and multivariable analysis were used to analyze the possible differences between risk groups and to find independent prognostic factors. Results For low (n= 32, 25), intermediate (n=109, 128) and high (n=84, 72) risk groups, the probabilities of recurrence and progression at 1 year were 15. 1%, 31.2%, 55.5% and 0. 3%, 2. 0%, 15.5% respectively. The probabilities at 5 year were 28. 2%, 55.2%, 75.0% and 1.4%, 12.9%, 54. 7%. All the results were similar to that of EORTC tables except the probability of progression at 5 year for the high progression risk group.The differences between different risk groups were significant (P＜0.01). In a multivariable analysis for recurrence and progression, the EORTC scores had independent significance (P＜0.01). Conclusions EORTC risk tables could stratify NMIBC patients effectively according to the risk of recurrence and progression. It could be a useful tool for Chinese urologists.

Objective To investigate the relationship between tumor location and the risk of developing bladder cancer in pafients treated by nephroureterectomy(NU)for upper urinary tract transitional cell carcinoma(UUT-TCC).Methods The clinical data of 168 UUT-TCC patients who underwent NU were reviewed.Univariate and multivariate analysis were carried out to determine the risk factors for intravesical recurrence after NU.Results The recurrence-free survival rate at 1,3 and 5 years after NU were 88%, 76%and 63%.All patients were followed up for a median period of 45(12-107)months During this period, a total of 49 patients developed bladder tamors after surgery,of which 28 cases were renal pelvic carcinoma, 2 cases were rniddle ureter carcinoma and 19 cases were distal ureter carcinoma.The recurrence-free survival of renal pelvic carcinoma and ureter carcinoma had no significant difference by Log-Rank test(P>0.05).On multivariate analysis,only locating in distal ureter carcinoma was the independent risk predictor for intravesical recurrence after NU (P<0.01).Conclusion Pafients with UUT-TCC at distal ureter carry a higher risk for intraeesieal recunerrce after NU than those with TCC at other location of upper urinary tract.

Objective To investigate the role of surfactant protein (SP)-A and SP-D in urinary tract infection mouse model,and evaluate the effects of SP-A and SP-D absence on urinary tract infection.Methods SP-A and SP-D double knockout (SP-A/D KO) mice were made.SP-A/D KO and wild-type (WT) C57BL/6 female mice were used for this study.The expression of SP-A and SP-D in kidney was detected by immunohistochemistry (IHC).The levels of p-p38 and p38 protein in kidneys were measured by Western blotting.Uropathogenic Escherichia coli or buffer was delivered into the bladder of female mice.At 24 and 48 h after inoculation,CFU of Escherichia coli in the kidney and urine of the treated and control mice were measured.Histological,cellular and molecular analysis were performed by several methods of H/E staining,IHC and Western blotting.The effects of SP-A and SP-D on bacterial growth were studied in vitro.Results SP-A and SP-D in kidney were located in the proximal tubules and collecting tubules.Compared with WT mice,infected SP-A/D KO mice with UPEC had higher CFU in kidneys and urine at 24 h and 48 h,increased inflammatory cells infiltration in kidneys (P＜0.05).Compared with WT mice,SP-A/D KO mice had higher p38 MAPK phosphorylation levels in kidneys (P ＜ 0.05).Growth of Escherichia coli was greatly inhibited by both SP-A and SP-D (P＜0.05).Conclusions Both SP-A and SP-D are expressed in kidney.SP-A and SP-D can attenuate UTI induced by UPEC which may be through inhibiting bacterial growth and modulating renal inflammation.

Objective To study the clinical manifestation,diagnosis,differential diagnosis and the essentials of management and treatment of fibrodysplasia ossificans progressiva (FOP).Methods Three cases of FOP were reported.The features of clinical manifestation and radiography were studied.The literature related to FOP was reviewed.Results FOP affected young children′s age of onset was between 10 days and 2 years (mean age 1 3 years).Mean disease duration was 5 3 years (range 2～11 years),and mean age 5 3 years (range 2～11 years) with sex ratio 1∶2 (boy∶girl).Soft tissue swelling in cervical and dorsal regions with or without local pain and warmth,and low fever were the early clinical manifestations.These nodules usually disappeared spontaneously,but some of nodules gradually developed ossification.The X ray features included ectopiac ossification most frequently in the soft tissue of the upper back and neck,next,the loin,chest and extremities.Two cases showed short hallux and hallux valgus.Exacerbation of the two cases was precipitated after muscle biopsy and careless venepuncture.All patients showed progressive extra articular bony ankylosis of most joints of axial and/or appendicular skeleton with severe movement restriction.Conclusion FOP is a rare and disabling genetic disorder of connective tissue.FOP should be diagnosed as early as possible and non invasively,based upon history,clinical and radiological findings.The finding of abnormalities of the great toe is helpful to diagnose FOP so that management can be early and adequate.Manogement principle includes avoiding conditions potentially provocative of abnormal ossification.The disease should be familiar to pediatricians.