This paper summarizes the observation and nursing of patients with postoperative complications following percuta-neous transhepatic cholangogrphic drainage(PTCD) and biliary tract stent implantation for malignant obstructive jaundice. A-mong thirty-two patients,eight had postoperative complications,including two with biliary tract hemorrhage,four with biliary tract infection,one with pneumothorax and one with bile leakage. All the thirty-two patients recovered well in clinical symptoms and quality of life. To attach importance to psychological nursing and postoperative health education are the key points in nursing care of patients with PTCD,which play important roles in alleviating clinical symptoms,improving treatment outcome and pro-moting the patients' quality of life.

Objective To investigate the catalysis of Co - Cu /SiO2 in oxidation of sodium percarbonate (SPC ) for o-nitrochlorobenzene. Methods The solution of o-nitrochlorobenzene was prepared, acetic acid was used to adjust acidity, sodium percarbonate was applied as the oxidant, the self-prepared Co-Cu/SiO2 was used as the catalyzer to catalyze the degradation reaction of o-nitrochlorobenzene and the effect of reaction condition on degradation was researched. Results In the condition of loading amount of metal was 5%, nCo:nCu= 4:1,nCo-Cu=1.90?10-3mol,nSPC=6.36?10-3 mol,cOCNB=50 mg/L and t=80 ℃,pH=4,the degradation efficiency of o-nitrochlorobenzen could reach 92% . Conclusion Co-Cu/SiO2 is efficient in catalyzing the oxidative degradation of sodium percarbonate for o-nitrochlorobenzene and is applicable to the waste water treatment for eliminating o-nitrochlorobenzene

Based on a study of children’s behavior and psychological characteristics,the article introduced Maslow’s hierarchy of needs to discuss children’s special needs for medical environment.Hence the authors proposed to meet children’s physiological needs,security needs,social needs,esteem needs,and self-realization needs.Shanghai Children’s Hospital was cited as an example,to present the humanistic expression practices in designing children’s medical environment.

Objective To investigate the clinical effect and safety of three dimensional conformal radiotherapy (3D-CRT)for patients with cervical cancer after radical operation in stage ⅠA to ⅡA.Methods The data of 119 patients of cervical cancer in ⅠA-ⅡA with postoperative radiotherapy in our hospital were analyzed retrospectively.Of which 56 patients were treated with 3D-CRT radiotherapy (3D-CRT group),63 patients were treated with conventional radiotherapy (conventional group).The differences radiation reactions and quality of life between two groups were compared.Results The local control rate of 3D-CRT group in the first 12 and 18 months after surgery were 87.50% and 82.14%,respectively,which were significantly higher than those of conventional group(71.43%,65.08%),the difference was statistical significance(P <0.05).The survival rate of 3D-CRT group after 1 year,2 years,3 years were respectively 91.07%,83.93%, 71.43%,compared with the conventional group (84.13%,73.02%,65.08%),the difference was not statistically significant (P >0.05). Patients of 3D-CRT group were followed up for 3 years,the median survival time was 34.29 months,which was longer than the 31.08-month of conventional group,the difference was statistically significant(χ2 =4.116,P =0.042).Quality of life of 3D-CRT group (60.81 ±4.28) point was lower than that of conventional group (63.75 ±5.03)point,and the difference was statistically significant(P <0.05).The rate of early radiation reaction(rectal reaction,vaginitis)and late radiation reaction (mild or moderate radiation proctitis)in 3D-CRT group were lower than those in the conventional group,the difference was statistically significant(P <0.05 ).Conclusion The 3D-CRT has effect on the long-term prognosis of patients with cervical cancer in stage ⅠA-ⅡA,which can significantly reduce the radiation reaction and improve the quality of life of patients.

AIM: To explore the mechanism of myocardium protection after ischemia/reperfusion (I/R) injury by preconditioning with ischemia in human. METHODS: Thirty - six patients underwent valve replacement were divided into ischemic preconditioning group (IP group, 20 cases) and non -ischemic preconditioning group (control group, 16 cases) according to whether they were given single cycle reperfusion before cardioplegia or not. Serum levels of interleukin -8 and 10 were measured with ELISA. Expressions of myocardial Bel -2 and caspase -3 were analyzed. RESULTS: The inflammatory factors IL - 8 and IL - 10 increased to the highest level in serum at 6 h after declamping and recovered to normal level on 5 d after declamping. On 6 h, 1 d and 2 d after declamping, serum level of IL -8 was significantly lower in IP group than that in control group ( P < 0.05 ) , but serum level of IL -10 was higher in IP group (P < 0.05 ). Expression of myocardial Bel - 2 and caspase - 3 increased in both groups after reperfusion, and Bel - 2 was lower in the control group than that in IP group while the level of caspase - 3 was higher (P < 0.05). Expression of myocardial Bel - 2 had positive correlation with IL - 10 and negative correlation with IL - 8.CONCLUSION: Ischemic preconditioning has the effect of protection of human myocardial cells after ischemia/reperfusion injury through decreasing systemic inflammatory response following ischemia reperfusion injury.

Objective To identity the risk factors for supine hypotension syndrome (SHS) after spinal anesthesia in parturients.Methods A total of 204 parturients,scheduled for elective cesarean section,were divided into either control group or SHS group depending on whether or not SHS (systolic blood pressure [SBP] in the upper extremity decreased by ＞ 30 mmHg or decreased to ＜ 80 mmHg) developed after spinal anesthesia.The baseline patient characteristics such as age,body height and weight,gestational weeks and biparietal diameter were recorded.Supine stress test (SST) was performed.Heart rate,blood pressure in upper and lower extremities,perfusion index,pleth variability index and intravesical pressure were recorded when patients were in supine position and in left lateral position before spinal anesthesia.The risk factors of which P values were less than 0.05 would enter the multi-factor logistic regression analysis to stratify the risk factors for SHS.Results Among the 204 patients,99 cases developed SHS after spinal anesthesia,and the incidence was 48.5％.Logistic regression analysis showed that maternal body weight,biparietal diameter,the difference in SBP between upper and lower extremities in supine position,the difference in SBP in upper extremities caused by changing position and positive SST were risk factors for SHS after spinal anesthesia (P＜0.05 or 0.01).Conclusion Maternal body weight,biparietal diameter,the difference in SBP between the upper and lower extremities in supine position,the difference in SBP in upper extremities caused by changing position and positive SST are risk factors for SHS after spinal anesthesia in parturients.

Objective To observe the effect of Chinese yam polysaccharide on the expression of hypoxia inducible factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF) in rats with renal ischemia reperfusion injury. Methods SD rats were randomly divided into sham operation group, model group and Chinese yam polysaccharide group. Renal ischemia reperfusion injury model in rats was prepared. Seven days before operation, Chinese yam polysaccharide group was gastrically administrated with yam polysaccharide (200 mg/kg) daily, sham operation group and model group with same volume of saline respectively. BUN and SCr were detected postoperative 6 h, the protein expression of HIF-1αin renal tissue was detected by Western Blot, and HIF-1αand VEGF mRNA expression in renal tissue were detected by RT-PCR. Results Compared with sham operation group, serum levels of BUN and SCr of model group and Chinese yam polysaccharides group increased (P<0.01), and the mRNA and protein expression of HIF-1α, mRNA expression of VEGF in renal tissue increased (P<0.01). Compared with model group, serum levels of BUN and SCr of Chinese yam polysaccharide group decreased (P<0.01), and HIF-1α mRNA and protein expression, VEGF mRNA expression in renal tissue increased (P<0.01). Conclusion Chinese yam polysaccharide has obvious protective effect on renal ischemia reperfusion injury, which may be related with up-regulation of HIF-1αexpression and induction of VEGF expression.

Objective To discuss the mechanism of Liuwei Dihuang Decoction against renal interstitial fibrosis. Methods The rat models of renal interstitial fibrosis were induced by 5/6 nephrectomy, and were randomly divided into sham-operation group, model group, Liuwei Dihuang Decoction group and enalapril group. Liuwei Dihuang Decoction group was given 6.25 g/(kg?d) of Liuwei Dihuang Decoction for gavage, enalapril group was given 10 mg/(kg?d) enalapril for gavage, sham-operation group and model group were given 10 mL/(kg?d) of distilled water for gavage, 1 time per day for 12 weeks. Expressions of HIF-1α, CollI, and CollIII in kidney tissue were detected by immunohistochemistry. Results Compared with the sham-operation group, the expressions of HIF-1α, CollI, and CollIII of renal tissue in the model group significantly increased (P<0.05). Compared with the model group, Liuwei Dihuang Decoction group and enalapril group can inhibit the expressions of HIF-1α, CollI, and CollIII (P<0.05), and Liuwei Dihuang Decoction group was better than enalapril group (P<0.05). Conclusion The mechanism of Liuwei Dihuang Decoction against renal interstitial fibrosis may improve the renal tissue of chronic hypoxia to play the role of preventing renal interstitial fibrosis by decreasing the expressions of HIF-1α, CollI, and CollIII.

Objective To explore the pulsed wave Doppler (PWD) manifestations of acute experimental incomplete testicular torsion. Methods Eight healthy dogs were surgically modeled to obtain unilateral acute testis torsion from 180° to 630°, respectively. The peak systole velocity (PSV) and resistance index (RI) of intratesticular artery, capsular artery and arteria spermatica interna were measured with PWD before torsion, 2 h, 4 h and 6 h after torsion. Testes were examined pathologically after the experiment. Results PSV and RI of capsular artery and intratesticular artery decreased gradually with the extension of torsional time (P<0.05). PSV and RI of superior, torsional and inferior segments of arteria spermatica interna varied greatly and showed no strong regularity (P＞0.05) . The pathological results of testes showed no distinct changes or just mild interstitial hyperemia and edema. Conclusion The decrease of PSV and RI of capsular artery and intratesticular artery, especially RI have referential value in the judgement of acute experimental incomplete testicular torsion, whereas changes of PSV and RI of superior, torsional and inferior segments of arteria spermatica interna are not reliable.

Objective To evaluate the difference of the surrounding normal tissue and lesion apparent diffusion coefficient (appar-ent diffusion coefficient,ADC)value in identify malignant and benign breast lesions.Methods There were 65 suspicious malignant breast lesions received by DWI scan and dynamic contrast-enhanced MRI (DEC-MRI)in 64 patients.The ADC value of breast lesions and peripherial glands were respectively measured,and then the difference was calculated.Receiver operating characteristic curve (ROC)analysis was used to evaluate the difference’s performance in identification between benign and malignant breast lesions.Re-sults There were 35 malignant lesions and 30 benign lesions.For the malignant lesions,the optimal threshold values for ADC of breast lesions were 1.28×10-3 mm2/s.The area under the ROC was 92.2%,the sensitivity and specificity were 76.7% and 94.3%.While the optimal threshold values for ADC were 0.63×10 -3 mm2/s in the benign lesions.The area under the ROC was 94.9%,the sensitivity and specificity were 88.6% and 96.7%.Conclusion ADC difference can reduce the influences of individual physiological factors,different machine,scanning parameters,which play an important role in identification between benign and malignant breast lesions.