Purpose To explore the role of expression of MMP-9 and MMP-13 in non-small cell lung cancer ( NSCLC) , and to investi-gate their association with the clinicopathologic feactures and prognosis of NSCLC. Methods The expression of MMP-9 and MMP-13 was detected in 88 NSCLC tissues and 18 adjacent normal tissues by immunohistochemistry SP method. Results The expression of MMP-9 and MMP-13 was higher in NSCLC than that in adjacent normal tissues (P<0. 05), which was positively correlated with dif-ferentiation and lymph node metastasis (P<0. 05). The expression of MMP-9 was positively correlated with age (P<0. 05), which was positively correlated with the expression of MMP-13 in NSCLC ( P <0. 05 ) . The survival rates in positive expression group of MMP-9 and MMP-13 were significantly lower than that of the negative expression group by log-rank method comparing survival curves (P<0. 05). Cox model analysis showed that the tumor size, lymph node metastasis and MMP-13 positive expression were closely relat-ed with the prognosis of NSCLC (P<0. 05). Conclusion MMP-9 and MMP-13 both are associated with the metastasis, invasion and prognosis of NSCLC, and MMP-13 may mainly activate MMP-9 to participate the invasion and metastasis of NSCLC.

Objective To investigate the risk factors for postoperative cognitive dysfunction (POCD) and nursing intervention in patients undergoing laparoscopic radical hysterectomy. Methods One hundred patients undergoing laparoscopic radical hysterectomy were included, surgical history, general anesthetics way, education, family factors(alone), body mass index, age, duration of anesthesia, dose of sufentanyl, hematocrit, the time for regaining orientation, dysphoria, postoperative pain degree were recorded. The occurrence of POCD was observed at 7 days (early period) and 3 months (later period) after surgery. Logistic regression analysis was used to examine the risk factors for POCD at early period and later period. Results The incidence of POCD at early period was 29.0%(29/100). Logistic regression analysis of surgical history, general anesthetics way, body mass index, age, hematocrit, the time for regaining orientation, postoperative pain degree in patients, general anesthetics way (OR=2.821, 95%CI 1.099-7.240) and postoperative pain degree(OR=2.292, 95%CI 1.129-4.654) were the significant risk factors for POCD at early period. The incidence of POCD at later period was 7.0%(7/100). Logistic regression analysis of education and family factors(alone) in patients, family factors(alone) was the significant risk factor for POCD at later period (OR=5.517, 95%CI 1.010-30.126). Conclusions General anesthetics way and postoperative pain degree are the significant predictors for POCD in patients undergoing laparoscopic radical hysterectomy during hospitalization, and family factors(alone) is the risk factor for POCD at 3 months after surgery, and active nursing intervention could reduce the occurrence of POCD.

Objective To observe the clinical curative effect of selective bronchial arterial embolization for severe hemoptysis.Methods Thirty-eight hospitalized patients with severe hemoptysis was enrolled in this study.Of which 31 patients were recurrent hemoptysis,27 patients were with bronchiectasis,4 patients were with bronchial lung cysts,4 patients had unknown causes,3 patients were with tuberculosis.All patients were diagnosed by chest imaging examination,fiber bronchoscopy,bronchial arteriography,and they were all treated by selective bronchial arterial embolization.Results The most times of embolization was 3,and bronchial arterial imaging were performed for vascular malformation.After having bronchial arterial embolization,35 patients were immediately released of bleeding.Postoperative 24 h,8 patients had hemoptysis again,of which 1 case was performed with conservative treatment and subsequently had pneumonectomy,5 patients had effective conservative treatment,2 cases were performed embolization again after failed conservative treatments.Hemoptysis completely disappeared within 1 week.The total effective rate was 97.4％(37/38).Patients were followed up for 1 year,of which 13 patients relapsed again,11 patients'annual and each time's quantity of hemoptysis reduced 50％.Two patients had pneumonectomy after a number of embolization.The total effective rate was 94.7％ (36/38).After treatment,3 patients had mild chest pain in short time,2 patients had shoulder pain,3 patients had chest tightness,and 3 patients had subcutaneous passive congestion.After being treated for short-term,these symptoms disappeared eventually.Conclusion Selective bronchial arterial embolization for the treatment of acute or recurrent severe hemoptysis is very effective,and can avoid the risk of surgery.It is effective for recurrent cases and worthy of clinical application.

Objective To analyze computed tomography imaging features of primary adrenal schwannoma.Methods The clinical and radiological data of six cases of adrenal schwannoma confirmed by histopathology were analyzed in this study.Results All six cases of adrenal schwannoma were well-circumscribed,round-like or oval-like,solid and cystic tumors,in which two cases were with calcification,and three cases with septations.On the enhanced CT images,all six tumors displayed progressive enhancement.Conclusion Adrenal schwannoma usually presents a well-defined heterogeneous mass with cystic degeneration,sepations,calcification and characteristic progressive contrast enhancement.

Objective:To study the factors influencing the happiness of dementia patients and their caregivers,provide guidance for improving their well-being.Methods:A total of 94 pairs of patients and their caregivers who were admitted to the neurology department of Peking Union Medical College Hospital from April 2015 to April 2016 were selected, the demographics of each patient and their caregivers were recorded. The Mini-Mental State Examination(MMSE) of patients with dementia, Role of Overload Scale(ROS) of caregivers, Dyadic Relationship Strain(DRS), Quality of Life for Dementia(QOL-D), Self-Evaluation Scale-Depression(CES-D) were recorded. Layered linear model was used to make regression analysis between the influencing factors and the scores of QOL-D and CES-D.Results:The results of the multi-layer linear model of uncontrolled variables in the fixed effect model: the results of QOL-D suggested that the score of patients with dementia was β 1j= 31.01±0.77, and the score of caregivers was β 2j= 35.15±0.88; the results of CES-D suggested that the scores of dementia patients and caregivers were β 1j = 14.55 ± 1.03 and β 2j = 13.11 ± 1.44, respectively. The random effects model suggested that there were statistical differences in the heterogeneity of the QOL-D score and the CES-D score variance component for dementia patients and caregivers (χ 2 values were 98.94-168.06, P<0.01). It indicated that the data was heterogeneous, adjusting the level 2 model, and the final results in the adjusted regression analysis suggested: caregiver relationship pressure (DRS), dementia patient self-awareness assessment (MMSE), caregiver care-related stress (ROS), dementia patient relationship stress (DRS) significantly affected the quality of life score (QOL-D) in both well-being ( β values were -3.22-0.43, P<0.05). Dementia patient relationship stress (DRS), caregiver-related stress (ROS), and caregiver relationship stress (DRS) significantly affected depressive symptoms in both well-being ( β values were 5.34, 3.26, 1.62, P<0.05). Conclusions:A comprehensive assessment of dementia patients and caregivers is needed. The combined family relationship is tense and the pressure associated with caregivers needs to be psychologically counseled.

Objeetive To analyze the effect of treatment of rhegmatogenous retinal detachment(RRD) by scleral bucking as well as the relative risk factors affecting the anatomical reattachment and visual recovery.Methods One hundred and fortyeight patients (148 eyes) with RRD treated by sclera buckling surgery in our hospital during January 2012 to January 2016 were retrospectively analyzed.The rate of postoperative retinal anatomic reattachment,the best corrected visual acuity (BCVA) and complications were observed.Logistic regression analysis was performed to analyze the correlative factors affecting the anatomical reattachment and postoperative vision restoration.R~ults Retinal reattachment achieved in 91.9％ after initial surgery and the final success rate for anatomic reattachment was 97.3％ assessed with ophthalmoscope and fundus photography.But these two rates were assessed with the optical coherence tomography (OCT) were 60.1％ and 80.4％ respectively.Single factor Logistic regression analysis showed that retinal detachment was affected by multiple breaks and Grade C1 PVR(all P ＜0.05);Single factor Logistic regression analysis showed that preoperative BCVA,course of disease,retinal detachment range,macular involvement or not had an impact on the postoperative recovery of BCVA (all P ＜ 0.05),preoperative age,refractive status,releasing retinal fluid or not,intravitreal gas injection,combined scleral buckling,and postoperative subretinal fluid,all of these factors had no effect on BCVA recovery after surgery (all P ＞ 0.05).And through multiple factors Logistic regression analysis,preoperative BCVA was an independent risk factor for BCVA recovery after surgery (P ＜ 0.05).Conclusion Scleral bucking is an effective technique for managing RRD,but multiple breaks and Grade C1 PVR are significant risk factors for anatomic.Preoperative BCVA,course of disease,retinal detachment range,macular involvement or not have the impact on the BCVA recovery after scleral buckling,and the preoperative BCVA is the key factor.Early diagnosis and early treatment as well as protecting the preoperative visual acuity can improve prognosis.

BACKGROUND:The previous literatures have reported that the aneurysmal bone cyst has a high recurrence rate after curettage treatment.
OBJECTIVE:To investigate the effect of less invasive stabilization system plate fixation combined with bone cement in the treatment of distal femoral aneurysmal bone cyst.
METHODS:A retrospective analysis was conducted in 19 patients with distal femoral aneurysmal bone cyst who treated with less invasive stabilization system plate fixation combined with bone cement in the First Hospital of Qinhuangdao between January 2002 and January 2012. The purpose of the treatment of aneurysmal bone cyst was to completely remove the cyst and prevent recurrence, and to repair and reconstruct the structure and function of the damaged tissues through implant fixation.
RESUTLS AND CONCLUSION:The 19 patients were fol owed-up for 1-3 years after treated with less invasive stabilization system plate fixation combined with bone cement, and 18 cases recovered wel , one case had recurrence at 2 years after treatment. Complete removal of aneurysmal bone cyst is the key for the prevention of recurrence. The less invasive stabilization system plate is the combination of advantages of intramedul ary nail and the biological locking plate technology, which has many advantages in the treatment of aneurysmal bone cyst. Fil ing the lesion area with bone cement had certain kil ing effect on tumor, and can increase the bone strength in the lesion area. The surgical treatment of distal femoral aneurysmal bone cyst is to clear the cystic lesions firstly, and then to prevent the recurrence through less invasive stabilization system plate fixation combined with bone cement.

To compare the changes of serum osteocalcin (OC), interleukin-18 (IL-18) in patients with different glucose tolerance and to explore their relationship to carotid atherosclerosis in type 2 diabetes mellitus (T2DM). Methods: According to the result of oral glucose tolerance test (OGTT), 140 research subjects were divided into 3 groups: Normal control group, n=50, Pre-diabetes group, n=30 and T2DM group, n=60 which included in 2 subgroups:Normal carotid intima-media thickness (IMT) subgroup, n=26 and Carotid IMT thickening subgroup, n=34. Carotid IMT, serum OC, IL-18 and glycosylated hemoglobin (HbA1c), fasting glucose, OGTT 2-hour blood glucose (2hPG), TC, TG, LDL-C, HDL-C, body mass index (BMI), insulin resistance index (HOMA-IR) and insulin cell function index (HOMA-β) were measured in all subjects. Pearson correlation and multi liner regression model were conducted to analyze the relevant parameters. Results: From Normal control to Pre-diabetes to T2DM groups, serum OC was decreased and IL-18 was increased gradually, all P<0.05. OC was negatively related to HbA1c (r=-0.426), fasting glucose (r=-0.582), 2hPG (r=-0.489), HOMA-IR (r=-0.456), TC (r=-0.451) and carotid IMT (r=-0.559), all P<0.05; while positively related to HOMA-β (r=0.439), P<0.05. IL-18 was positively related to BMI (r=0.395), HbA1c (r=0.693), fasting glucose (r=0.880), 2hPG (r=0.715), HOMA-IR (r=0.667), TC (r=0.734), TG (r=0.326), LDL-C (r=0.471) and carotid IMT (r=0.857), all P<0.05; while negatively related to HOMA-β (r=-0.678), P<0.05. In T2DM group, carotid IMT was positively related to IL-18 (r=0.817), fasting glucose (r=0.415), HOMA-IR (r=0.356), TC (r=0.396) and TG (r=0.362), all P<0.05; while negatively related to OC (r=-0.588), P<0.05. Multi liner regression analysis indicated that IL-18, OC, TC and fasting glucose were the independent impact factors for carotid IMT (regression coefficients were 0.013, -0.011, 0.044 and 0.044 respectively), P<0.05. Conclusion: Serum OC and IL-18 had been involved in glucolipid metabolism and closely related to the occurrence and development of carotid atherosclerosis in T2DM patients.

Objective:To design an intra-abdominal pressure measuring device applied to children on peritoneal dialysis (PD), and evaluate the feasibility and safety of the application of the device.Methods:The device consisted of a three-way stopcock with extension tubing, a three-way stopcock, a manometer tube, and a "Y" system peritoneal dialysis bag. The intraperitoneal pressure of different fill volumes was measured when a child was supine and relaxed in a horizontal position. The subjects of the study were children who received PD at the Pediatric Hospital of Fudan University from May 2019 to February 2020 and had PD dialysis age of>1 month. The children's demographic and clinical information were collected. During the measurement, the child’s complaints of pain, bloating, vital signs, and catheter-related contamination were recorded. Additionally, the occurrence of dialysis-related infections and complications during the hospitalization and outcomes of PD after three months of the measurement were tracked. A scatter plot and Pearson correlation test were used to explore the correlation between fill volumes and the intraperitoneal pressure.Results:Nine PD children were included in our study. The age of the children was (8.4±4.7) years old. The body surface area is (0.84±0.29) m 2. The intraperitoneal pressure was (12.6±1.9) cmH 2O at the fill volume of 1 000 ml/m 2 and (13.8±1.9) cmH 2O at the fill volume of 1 200 ml/m 2. The measurement was smoothly and safely taken without any case of contamination and dialysis-related infections during the hospitalization. After three months of the measurement, one child was transferred to temporary hemodialysis due to the aggravation of the umbilical hernia. Conclusions:The intraperitoneal pressure measuring device is feasible and safe to perform among children with PD. It can achieve non-invasive and continuous measurement of intra-abdominal pressure, and has guiding significance for the dialysis prescription of children with PD.

Objective To analyze the clinical effects, complications and prognosis of primary chemotherapy combined with postoperative intraperitoneal hyperthermic perfusion chemotherapy in the treatment of advanced ovarian cancer. Methods The clinical data of 64 patients with advanced ovarian cancer in Shanxi Provincial Cancer Hospital from May 2015 to May 2017 were analyzed retrospectively. Conventional cytoreductive surgery (CDS) was performed in all patients. According to the different therapeutic regimen before and after operation, the patients were divided into 2 groups, including 32 cases treated with primary chemotherapy combined with postoperative intraperitoneal hyperthermic perfusion chemotherapy (the observation group), and 32 cases treated with intraperitoneal hyperthermic perfusion chemotherapy after operation (the control group). The clinical effect, complications and prognosis were compared between the two groups. Results The blood loss in the observation group [(512±165) ml] was lower than that in the control group [(815±186) ml]. The amount of ascites in the observation group [(716±160) ml ] was lower than that in the control group [(1 279±236) ml], and the differences were statistically significant (t= 6.890, t= 11.153 respectively, both P＜ 0.05). Moreover, the duration of surgery in the observation group was shorter than that in the control group [(125 ±15) min vs. (185 ±24) min; t = 18.572, P＜ 0.05]. The total incidence of complications and 2-year recurrence rate in the observation group were lower than those in the control group, and the 2-year survival rate in the observation group was higher than that in the control group (both P＜0.05). Conclusion Primary chemotherapy combined with postoperative intraperitoneal hyperthermic perfusion chemotherapy for advanced ovarian cancer has a favorable effect with less complications and good prognosis, which is worthy of clinical application.