ObjectiveTo summarize the clinical features of ulcerative eolitis (UC) complicated by toxic megacolon for early diagnosis and proper treatment. MethodsSix cases of toxic megacolon in the patients suffered from UC in Peking Union Medical College Hospital from 1983 to 2010 were analyzed,and related literature was searched and reviewed.ResultsThe incidence of the toxic megacolon in the patients with UC in our center was 0.7％ (6/824),which was lower than those reported in the literature.There were always risk factors triggering the disease.The prognosis of the patients was poor,even after medical care and surgery intervention.Evaluation of the patients and making right timing to perform the surgery would improve the prognosis of the patients in foreign literature. ConclusionIt's crucial to make early diagnosis of the toxic megacolon in the patients suffered from UC. The right choice and timing to perform urgent surgery or selective surgery may improve their prognosis.

Objective To explore the clinical features and possible carcinogenesis mechanism of the ulcerative colitis (UC)-associated colorectal cancer. Methods From 1984 to 2008, 6 clinical cases of UC-associated colorectal cancer were collected at Peking Union Medical College Hospital. The characters of morbidity, clinical features, pathology type, treatment and prognosis were analyzed.Immunohistochemistry(IHC) was performed to study the protein expression of adenomatous polyposis coli protein(APC), β-catenin, P53 and Wnt-1 in the specimens. Results The canceration of UC was 1.1 %, higher in female cases (5/6), the average duration was 14.3 years. All cases presented typical UC manifestation, most involved total colon (5/6) and none of them complicated with primary sclerosing cholangitis (PSC). There were 4 rectal cancers and 2 descending colon caners the UC cases collected. The major pathology type was adenocarcinoma with poor prognosis. The positive protein expression ratio of APC, β-catenin, P53 and Wnt-1 were 6/6, 6/6, 5/6 and 6/6 respectively.Conclusion The rectal cancer should be monitored and prevented in UC patients with total colon involved and long disease duration. Multi-pathway may possibly be involved in the carcinogenesis.

Objective:To construct a new home nursing service model based on information platform grid management, in order to effectively solve the medical care needs of home rehabilitation groups.Methods:In November 2018, Taizhou City, Zhejiang Province established the Municipal Home Care Service Center and Home Rehabilitation Nursing Skills Training Center, and established a gridding home nursing service model, and implemented the sinking of high-quality nursing resources, and made community nurses the main force of home care. In November 2019, a home nursing service information platform was established to create an online and offline integrated home nursing grading management system. The high quality, convenience and safety of home nursing services was ensured through information sharing and graded orders. We recorded the development of gridding home nursing services and patient satisfaction from January to May 2020, and evaluated the implementation effects. χ 2 test was used for statistical analysis. Results:Totals of 28 hospitals above ClassⅡ, 123 primary medical institutions, and 1 171 community nurses in Taizhou have settled on the home nursing information platform. From January to May 2020, nursing staff provided 5 274 cases of home care, including 4 472 cases of home care and 802 cases of online care. The patient satisfaction of home care was 98.73% (4 415/4 472) , and the patient satisfaction of online care was 98.25% (788/802) , there was no significant difference between the satisfaction of two service types (χ 2=1.136, P=0.286) . No complaints, adverse events and nurse safety issues occurred. Conclusions:The gridding home nursing service model based on information platform can give full play to the role of community nurses, broaden the scope of home care services, rationally allocate medical resources, solve medical care problems for home rehabilitation groups, and effectively promote hierarchical diagnosis and treatment.

Objective:To investigate the effect of transcranial clipping in the treatment of intracranial aneurysms and its influence on hemodynamics, neuron specific enolase(NSE) and S100B expression.Methods:A retrospective analysis was made in 47 patients with intracranial aneurysms who admitted to Taizhou Hospital of Zhejiang Province from January 2017 to June 2019, all patients were treated by transcranial clipping.The hemodynamics, NSE and S100B levels were compared before operation and 1 week after operation.All patients were followed up for 6 months to evaluate the prognosis.Results:All patients completed the operation, the operation time was (2.79±0.43)h, the intraoperative bleeding volume was (243.51±28.73)mL, the incidence of postoperative complications was 6.38%(3/47), and the average hospitalization time was (16.74±1.86)d.One week after operation, the cerebral blood volume [(27.98±3.24)mL/100g] and cerebral blood flow [(2.08±0.34)mL·100g -1·min -1] were higher than those before operation [(23.41±2.36)mL/100g and (1.56±0.27)mL·100g -1·min -1] ( t=7.816, 8.211, all P<0.05). The serum NSE[(15.28±2.18)μg/L] and S100B[(0.83±0.16)μg/L] were lower than those before operation [(26.39±4.25)μg/L and (1.59±0.27)μg/L]( t=15.946, 16.601, all P<0.05). After follow-up for 6 months, 38 cases(80.85%) had a good prognosis. Conclusion:Transcranial clipping is effective in the treatment of intracranial aneurysms, and can improve hemodynamics, reduce the expression of NSE and S100B in serum, and reduce complications.