This article summarizes our experience in nursing 40 gastric carcinoma patients receiving fast track(rapid recovery) surgery,proposing that the emphasis of nursing should be placed on psychological care and health education before the operation,warm-keeping during the operation,pain control,early food intake,early movement and management of complications after the operation,and necessary follow-up after discharge.

Objective To evaluate the value of acute physiology and chronic health condition evaluation Ⅱ(APACHEⅡ) and National Institute of Health Stroke Scale(NIHSS) score in evaluating outcome of patients with acute cerebral infarction(ACI).Methods 399 patients with ACI were scored by APACHEⅡ and NIHSS in 3 d after onset.Prognosis judgement accorded to the patients survival or death during 28 d after onset.Area under of the receiver operator characteristic(ROC) curves was used to scale the ability of APACHEⅡ and NIHSS scoring systems evaluating severity and predicting outcomes of patients with ACI to find best cut-off points of the two scoring systems.Using discriminant analysis method to analysis the two scoring systems and estabished mathematical functional equation to calculate accuracy.Results For prognosis of patients with ACI,the areas under ROC curves were 0.835 and 0.822,and the best cut-off points were 12 and 10 respectively for APACHEⅡand NIHSS.The accuracy rates of APACHEⅡand NIHSS were 74.5% and 76.9%,respectively.The accuracy rate of APACHEⅡcombined NIHSS was 85.5%.Conclusions The APACHEⅡand NIHSS score systems have satisfactory discrimination for patients witn ACI,The predictive accuracy may improve if APACHEⅡ is combined with NIHSS.

Objective To analyze the clinical and pathological characteristics of thyroid carcinoma in patients from Qilu Hospital of Shandong University in last 7 years,and to explore the changes in disease spectrum.Methods Records of 772 patients with thyroid carcinoma,who underwent thyroidectomy and pathological examination,were reviewed from January 2005 to December 2011.Results (1) Individuals suffering from thyroid carcinoma have increased rapidly during these 7 years.(2) The high incidence of the disease resided in the age group of 30-59 for both men and women,with a male-to-female ratio of 1 ∶ 2.73.(3) The proportion of papillary microcarcinoma showed a growing trend,the rising trends were also apparent in papillary thyroid cancer (PTC) coexisting with nodular goiter or Hashimoto's thyroiditis (HT).Papillary microcarcinoma accounted for27.27％ of all PTC in 2005 and reached 54.22％ in 2011.Coexistence of PTC and HT accounted for 12.38％ of the cases with a male-to-female ratio of 1 ∶ 6.Conclusion The occurrence of thyroid carcinoma,especially papillary microcarcinoma has been increasing in recent years.The coexistence of PTC with nodular goiter or HT showed a trend to increase.

Objective: Our aims were to measure DNA content in primary lung cancer and to study the relationship between the DNA content and TNM stage, histological differentiation of tumor cell, cellular proliferation, and apoptosis. Methods: The DNA content and cellular proliferation were analyzed using flow cytometry. Tumor cell apoptosis was detected by using TUNEL method. Results: (1) The DNA index (DI) distribution ranged from 0.829 to 2.514. There were 41 cases (77.4%) of DNA aneuploid. The distribution of DI and DNA aneuploid was independent of histological subtypes（P>0.05）.(2) With the increase of TNM stage, the DI and the rate of DNA aneuploid increased（P<0.05）.(3) There was relationship between DI and histological differentiation of tumor cell. The DI was higher in tumors of poor differentiation than those in tumors of moderate and good differentiation（P<0.05 and P<0.01）. (4) The cellular proliferation index of aneuploid tumors was significantly higher than that of diploid tumors(P<0.01), while apoptosis index of aneuploid tumors was significantly lower than that of diploid tumors (P<0.01). Conclusion: Correlations exist between DNA content and TNM stage, hiological differentiation, cellular proliferation, and apoptosis.

Objective To investigate the changes in the surface-associated protein expression of streptococcus rnutans (Sm) isolated from clinical samples at pH7.0 and pH5.0. Methods The proteins were extracted from cells at pH7.0 and pH5.0 by Homer method. The proteins were separated by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) and two-dimensional gel electrophoresis followed by image analysis. Proteins were identified by matrix-assisted la?ser desorption ionization time of flight mass spectrometry and computer-assisted protein sequence analysis. Results Image analysis revealed that four high expression levels of protein loci and two specific protein loci were existed in two strains at pH7.0. Two high expression levels of protein loci and two specific protein loci were existed in two strains at pH 5.0. Three high expression levels of protein loci and six specific protein loci were existed in Sm593 at pH5.0. Two-component system histidine kinases Lyts and glyceraldehyde-3-phosphate dehydrogenase were highly modulated, and NADH oxidase were modulated specifically. Conclusion The two clinical isolations in acid have high expression of some special proteins, which are presumed to be the resemblance of acid reaction.The difference of protein expression of two clinical isolations in acid may represent their distinct acid resistance.

Objective To observe the temperature-time curve of Shenque(CV8) salt moxibustion and explore the temperature starting mechanism of Shenque moxibustion and itsclinical significance.Method In the subjects treated with Shenque salt moxibustion, periumbilical and umbilical bottom temperatures were measured simultaneously and recorded using a two-channel temperature logger, and the temperature-time curve was drawn and analyzed to preliminarily explore its temperature starting mechanism according to the experimental results.Result Periumbilical temperaturemeasurement showed that the temperature that every cone of moxa produced reached more than 43℃and the maximum temperature reached 44.9℃. The time that 43℃or more lasted was (4.50±2.36) min. The time that 40℃or more lasted was (8.03±2.63) min. Umbilicalbottom temperature measurement showed that the temperature reached more than 43℃at the seventh cone of moxa on average and the maximum temperature reached 44.7℃. The mean value of the maximum temperatures at the seventh to tenth cones of moxa was (43.44±1.05)℃. The time that 43℃or more lasted was (5.53±2.13) min. The time that 40℃or more lasted was(18.44±10.39) min.Conclusion Shenque salt moxibustion has the property of repeated warm stimulations, which can avoid the platform period brought about by stable warm stimulation and promote the maximization of moxibustion intensity to effectively increase clinical moxibustion quantity finally.

ObjectiveTo investigate the effect of controlled low perfusion pressure on expression of phosphor-Akt (p-Akt) and phosphor-ERK1/2 (p-ERK1/2) following spinal ischemia-reperfusion (1/R) in rabbits.MethodsThirty-six Japanese long-ear white rabbits aged 3 months weighing 2.0-2.5 kg were randomly divided into 3 groups ( n ＝ 12 each):group sham operation (group S) ; group spinal I/R (group I/R) and group controlled low perfusion pressure (group LP).Auricular artery and femoral artery were carnulated for proximal and distal BP monitoring.A 4F catheter with a balloon at the tip was inserted into abdominal aorta.The tip was positioned 1 cm below left renal artery.Spinal ischemia was induced by inflating the balloon until the distal MAP < 20 mm Hg,and maintained for 25 min.During the first 10 min of reperfusion the distal MAP was increased to 45-55 mm Hg by partially deflating the balloon.Then the balloon was fully deflated to allow complete reperfusion.The function of lower limbs was assessed with Tarlov score (0 ＝ no detectable movement,4 ＝ normal function) at 1,3,7,28 d of reperfusion.Au the animals were sacrificed at 1 d of reperfusion in each group.The lumbar segment L3-5 of the spinal cord was removed for microscopic examination and determination of expression of p-Akt and p-ERK1/2 by immuno-histochemistry) and detection of neuronal apoptosis in dorsal horn (by TUNEL).ResultsSpinal I/R significantly decreased Tarlov scores,and increased the number of apoptotic cells and expression of p-Akt and pERK1/2 in group I/R as compared with group S.Low perfusion pressure during the 10 min at the beginning of reperfusion significantly increased Tarlov scores,decreased apoptotic index and further increased p-Akt and pERK1/2 expression in group LP compared with group I/R.The histopathological damage in the spinal cord was attenuated in group LP.ConclusionControlled low pcrfusion pressure can reduce the spinal cord I/R injury by activating Akt and ERK1/2 and decreasing neuronal apoptosis.

AIM: To establish a RP-HPLC method to determine the fingerprint of Shentong granules. METHODS: Chromatographic conditions consisted of Alltech ODS column and the mobile phase composed of a mixture of acetonitrile-water(gradient elution),detection wavelength at 270 nm.The flow rate was 1.0 mL/min. RESULTS: A HPLC fingerprint determination with a good reproducibility was established,which could separate main principles of Shentong granules. CONCLUSION: The method can provide more information for the quality control of Shentong granules.

Adefovir dipivoxil (ADV) is commonly used as an anti-viral agent in the treatment of chronic hepatitis B,with a dose-and time-dependent nephrotoxicity.Clinical analysis was made in 4 patients with chronic hepatitis B who developed Fanconi syndrome and hypophosphatemic osteomalacia after long-term use of ADV (10 mg/d).