This paper introduces the airway care of a patient with motor neuron disease treated with mechanical ventilation for eight years. The airway care for the patient focused on individualized suctioning,measures to prevent atelectasis such as lung hyperinflation,adjustments of ventilator parameters,regular weaning exercise,as well as measures to prevent ventilator-associated pneumonia such as prevention of aspiration,strict disinfection and isolation,wound care of tracheotomy. The ventilator-associated pneumonia was effectively prevented. Effective nursing care for patients with long-term mechanical ventilation can prevent atelectasis and ventilator-associated pneumonia.

Nowadays,the study of tumor stem cells has become the heatpoint in cancer research.Many experiments have successfully demonstrated the existence of tumor stem cells,which have been isolated from some solid tumors.As the research on the origin of tumor stem cell is developing,the knowledge of the occurrence and development of tumor has become more clear,which will influence the diagnosis and treatment for tumor significantly.Moreover it will bring benefit to the following-up after surgical operation and giving hopes to cancer sufferers.

Adult ; Female ; Humans ; Middle Aged ; Thyroid Diseases ; microbiology ; Tuberculosis, Endocrine

Objective To study the clinical characteristics of thyroid carcinoma in young females,in order to improve the diagnosis and treatment of this disease.Methods The clinical data of 74 consecutive young female patients with thyroid carcinoma treated in our hospital in the recent ten years were analysed.In most of the cases,there was no firm texture or fixation of the thyroid nodules to surrounding structures on physical examination before operation.Ultrasonography was performed in all patients and multiple thyroid nodules were found in 61 cases(82.43%).Thyroid scintiscans were performed in 43 cases,and thyroid nodules were found in 41 cases.The cold,cool and warm nodules were found in 14,18 and 9 cases,respectively,by scintiscans.Fine needle aspiration biopsy(FNAB) was performed in 11 cases,and in 2 cases were negative,1 case showed abnormal cell,3 cases were suspicious of carcinoma,and 5 cases were confirmed papillary carcinoma.Results Papillary carcinoma was found in 70 cases,follicular carcinoma in 3 cases and medullary carcinoma in 1 case by histological examination,and benign disease was also accompanied in most cases.Lymph node metastases was found in 28 cases(37.84%),and the rate of metastases was significantly different than that of older female patients(16.46%) at the same time.There were 2 cases who died 3 years after operation because of metastases.Conclusions The lymph node metastases were prevalent in young female patients with thyroid carcinoma.The texture and mobility of the nodules cannot be used to differentiate benign from malignant nodules.We should carefully analyze every nodule found on ultrasonography.For the solid nodules with diameter larger than 1.0cm,we suggest operation;for the non-solid nodules with diameter larger than 2.0cm,we prefer scintiscans and FNAB for diagnosis.

Objective To analyze the changes of primary disease and demography of patients with end-stage renal disease (ESRD) who started dialysis between 2008 and 2013 in Zhejiang province, in order to provide statistical support for the improvement of dialysis quality.Methods The study retrospectively reviewed all the incident ESRD patients on dialysis registered in Zhejiang Dialysis Quality Control Center from 2008 to 2013.Their demographics and primary cause were investigated.Stratified analysis based on dialysis modality, duration and age were conducted.Results A total of 26 310 incident ESRD patients who started dialysis between 2008 and 2013 in Zhejiang were selected, among which 14 886 cases were male and 11 424 cases were female (male: female: 1.30: 1).The study gave priority to patients aged 45 and above (73.9％), with an average age of (55.7± 16.1) years.The top primary disease was chronic glomerulonephritis (51.3％), followed by diabetic nephropathy (17.3％) and hypertensive nephrosclerosis (6.4％).From 2008 to 2013, the incidence of dialysis was 46.3, 60.1, 71.2, 85.8, 104.1, and 119.9 per million population respectively.The average age of patients was increased year by year, from 52.4, 53.3, 54.8, 56.0, 56.9, to 57.6 years.The share of peritoneal dialysis, as well as the promotion of diabetic nephropathy in primary disease was on the rise.With the increase of age, the proportion of primary diseases such as diabetic nephropathy and hypertension nephrnsclerosis was increased.Conclusions In Zhejiang province, incident dialysis patients increase annually.More males than females are on dialysis.The average age and proportion of peritoneal dialysis are rising.The leading cause is chronic glomerulonephritis, but the incidence of diabetic nephropathy is on the increase, which requires attention.

Environmental Monitoring ; instrumentation

Objective:To explore an improved osteotomy of mandible ascending ramus for the surgical approach to large tumors in parapharyngeal space.Methods:According to the operation of parotid gland, masseter muscle was cut near the border of mandibular angle till subperiosteum dissection to mandibular notch, vertical osteotomy outside mandibular foramen to 1.0 cm under mandibular notch, vertical to posterior border of ascending ramus, tumor was exposed and removed, bone plate was repositioned and fixed with titanium. Results:Tumors were completely removed in this way in 3 patients without complications. Conclusion:This surgical approach is suitable for the surgical removal of parapharyngeal interstitial giantism tumor.

Objective To investigate precision error between Varian auri-point localization system and Tosplane digital-bed localization system. Methods Varian Eclipse localization method and Topslane localization method were used separately to locate one target area for one same patient. Then deviations on the tumor center coordinate were measured under the simu- lation localization machine. Results Under two localization methods, the length error: 1.7mm ?0.3mm; the width error: 0.5mm?0.4mm; the altitude error: 1.2mm?0.4mm. Conclusion The curative effect of radiotherapy would be improved by applying the Topslane localization bed to the Varian Eclipse plan system.

Objective: To develop the ultra performance liquid chromatography tandem mass spectrometry ( UPLC-MS/MS ) for the determination of perfluorocarboxylic acids ( PFCAs ) in fish. Methods: The fish samples were extracted with tert-butyl methyl ether and purified by WAX columns. The WAX cartridges were rinsed with methanol and 25 mmol/L ammonium acetate, and the target compound residues were eluted with 0.5% ammonia methanol and then redissolved with 50% methanol aqueous solution after nitrogen blowing to nearly dry. Nine kinds of PFCAs were simultaneously quantified by UPLC-MS/MS with 1 mmol/L ammonium acetate-methanol solution as the mobile phase. Results: The extraction was separated well in UPLC BEH C18 column. There were good linear correlations of nine kinds of PFCAs in the range of 1.0-200.0 ng/mL, with the coefficients all more than 0.99. The limits of detection and quantification were 0.06-0.19 μg/kg and 0.19-0.62 μg/kg, respectively. The recovery rates were 70.08%-117.24% at different spiked levels ( 5.0, 25.0, 50.0 μg/kg ), and the relative standard deviations were 2.31%-19.68%. Conclusion Through optimizing the pretreatment conditions, the mobile phase of liquid chromatography and the detection conditions of mass spectrometry, the UPLC-MS/MS could meet the monitoring requirements of PFCAs in fish.

During professor SHAO Jing-ming's academic research and medical practice, his academic opinion of focusing spirit is gradually developed. In terms of nurturing the spirit, attention should be paid on persistence as well as everyday health maintenance and exercise to nurture the spirit of physician. In terms of clinical diagnosis and treatment, patients' psychology, employment and life status should be observed and experienced, which could bring more methods to take essential care of patients' spirit. The treatment should work with psychological counseling, advocating that based on patients' qi and spirit, various forms of treatment methods should be properly used, such as acupuncture or moxibustion or combination of acupuncture and medicine, along with simple acupoint selection and harmony medication. Before clinical treatment of acupuncture, calming the mind is critically emphasized to make a clear diagnosis. During the acupuncture, calming and focusing the mind is necessary as well as emphasizing the details, so acupuncture could be integrated with Chi Gong to create a new warming-sensation technique. In a word, the academic opinion of focusing spirit is shedding an inspiring light upon further study.
Acupuncture ; education ; history ; Acupuncture Therapy ; history ; psychology ; China ; History, 20th Century ; History, 21st Century ; Humans