Objective To study the effects of Fluvastatin on the expression of intercellular adhesion molecule-1 (ICAM-1) in human umbilical vein endothelial cells (HUVECs) induced by C-reactive protein (CRP). MethodsThe HUVECs were primary cultured. HUVECs from third to sixth generations were stimulated with different concentrations CRP and at different times. Then the cells were treated with Fluvastatin in different concentration of 10-7,10-6 and 10-5mol/L. The content of ICAM-1 protein was detected with ELISA, the mRNA expression of ICAM-1 was evaluated by RT-PCR. Results In the control group, HUVECs produce ICAM-1 protein and mRNA in low concentrations. In CRP group, the content of ICAM-1 protein was increased significantly (P

Objective To investigate the clinical features and the prognosis after surgical treatment for hilar cholangiocarcinoma (HCC).Methods The surgical therapy and follow-up result were retrospectively analyzed on 98 cases of hilar cholangiocarcinoma admitted into our hospital from January 1995 to January 2005.Differences between groups were evaluated using Chi-square analysis or Student t-test according to the data type.Survival rate was calculated with Kaplan-Meier method,and using the log-rank test.Results Among 98 patients,83 patients underwent surgical treatment (radical resection in 33,palliative resection in 16,and nonresectional internal or external bile duct drainage in 34),15 patients underwent conservative therapy.The 1-,3-,5-year survival rates were 79％,42％,and 17％ in the resection group and 88％,54％,and 24％ in the radical resection group,respectively.The 1-,3-year survival rates were 55％,and 9％ in palliative resection group,respectively,and none of the patient survived for over 5 years.There were significant differences in the survival rate among the radical resection group and the palliative resection group (log-rank test,P ＜ 0.001).Conclusions Radical resection improves the prognosis of hilar cholangiocarcinoma.

Objective? To construct a multidisciplinary nutrition management model of stroke patients with nasal feeding based on Omaha system and to evaluate its effects. Methods? With the core of nutrition management of stroke patients with nasal feeding and based on patients' needs in hospitals, communities and families, we constructed a comprehensive assessment scale which included Omaha nursing problems of patients, intervention and outcome evaluation. And then, we carried out standardized intervention under the guide of the scale. From December 2017 to February 2018, we selected 65 stroke patients with nasal feeding from Taiyuan City Centre Hospital in control group (routine intervention) by convenience sampling. From March to May 2018, we selected 65 patients from Taiyuan City Centre Hospital in intervention group (nutrition management model intervention based on Omaha system). We compared the nutrition condition two weeks after catheterization and incidence of nasal feeding related complications one month after catheterization of patients between two groups respectively. We also evaluated the scores of Omaha cognition, behavior and condition of patients at catheterization, two weeks and one month after catheterization. Results? The serum albumin and nutritional status scores of the two groups of stroke patients were significantly different two weeks after intubation (P＜0.05). One month after intubation, the intervention group had diarrhea, aspiration pneumonia, constipation and accident. The incidence of extubation was significantly lower than that of the control group, and the difference was statistically significant (P＜0.05), but the improvement of vomiting and occlusion was not obvious, and the difference was not statistically significant (P＞0.05). In intervention group, patients' scores of Omaha cognition, behavior and condition of patients two weeks and one month after catheterization all increased with statistical differences (P＜0.05). Conclusions? Problems classification system of Omaha system can systematically and comprehensively evaluate the nursing problems among stroke patients with nasal feeding which helps assessors to find the neglected problems in traditional nursing and provides direction for formulating targeted intervention. Assessment for nursing outcomes promotes nurses to dynamically master patients' needs and improves patients' nutrition condition and incidence of complications. Therefore, nutrition management model of stroke patients with nasal feeding based on Omaha system is suitable for whole process management of stroke patients with nasal feeding which is worthy of being explored and popularized.

AIM: To investigate the relationships between antiproliferative mechanisms of probucol and protein expressions of signaling molecules ERK1/2, MKP-1, HO-1 and Trx-1 in rat aortic smooth muscle cells (RASMCs) stimulated with ox-LDL. METHODS: The effects of probucol on cell cycle, cell proliferation and the expressions of ERK1/2, MKP-1, HO-1 and Trx-1 in the presence of ox-LDL were observed by means of MTT test, FCM and Western blotting. RESULTS: (1) Probucol significantly inhibited the proliferation of RASMCs stimulated with ox-LDL. A value in 100 μmol/L probucol+35 mg/L ox-LDL group was reduced by 34.9% as compared to ox-LDL group (P<0.01). (2) Probucol protected against ox-LDL-induced RASMCs proliferation through inducing cell growth arrest at G_0/G_1 phase and cell apoptosis. (3) ox-LDL increased the expression of p-ERK1/2 by 34.7% (P<0.01) and decreased MKP-1 by 60.0% (P<0.01), respectively, as compared to control. Probucol attenuated the increase in ox-LDL-stimulated p-ERK1/2 level by 15.7%, but increased MKP-1 expression by 2 times (P<0.01). (4)ox-LDL at concentration of 35 mg/L decreased the intracellular Trx-1 expression by 28.9% (P<0.05), and slightly increased the level of HO-1 expression as compared to control (P<0.05). Probucol enhanced the expression of Trx-1 by 91.6% (P<0.01) and HO-1 by 31.9% (P<0.01), respectively as compared to ox-LDL group. CONCLUSION: Probucol inhibits ox-LDL-stimulated the proliferation of RASMCs through increases in MKP-1/HO-1 expression, suppression of cell cycle progression and induction of cell apoptosis.

Elderly stroke patients generally have restricted life space,which increases the incidence of falls,weakness,and dementia,reduces their quality of life,and ultimately leads to an increase in readmission and mortality rates.This article mainly introduces the concept,theoretical model and measuring tools of life space.The level and influencing factors of life space in elderly stroke patients were reviewed in order to provide references for medical staff to carry out relevant research and formulate targeted intervention programs about life space for elderly stroke patients.

The fatality rate of traumatic cardiac arrest (TCA) is extremely high, and it is very different from that of non-traumatic cardiac arrest (NTCA) in resuscitation strategy. Only when the standard resuscitation process is combined with rapid treatment of various reversible causes can the mortality rate of patients be decreased. In this paper, the key factors leading to TCA are reviewed, such as hypovolemic shock, asphyxia, tension pneumothorax, pericardial tamponade, crush syndrome, craniocerebral injury, cerebral hernia, and the control measures are elaborated respectively, so as to provide references for clinical treatment of patients with severe trauma, and reduce TCA incidence and mortality.

Brain edema could be secondary to cerebral lesion caused by a variety of reasons, severe cases may result in brain herniation or even death. Accurate real-time monitoring of cerebral edema, rational application of dehydrating drugs, and timely treatment of cerebral edema were very important for patients. However, there were defects in the monitoring methods commonly used in clinical practice. Noninvasive brain-edema monitoring was a new method, which can quantify the degree of brain edema by electromagnetic disturbance and directly reflect the state of brain edema. This article reviews the application of noninvasive brain-edema monitoring in the treatment of in critically ill patients with traumatic brain injury.

Objective To explore the technical knowhow and experience of mesohepatectomy for central region liver disease.Methods The clinical data of 86 patients with liver disease in central region undergoing mesohepatectomy were retrospectively analysed in Henan Provincial People's Hospital,including 49 males and 37 females.There were 47 cases of central liver cancer,15 cases of hilar cholangiocarcinoma,4 cases of hepatic hemangioma,13 cases of gallbladder cancer,and 7 cases of intrahepatic cholangiolithiasis in central liver.25 cases received accurate hepatectomy (group A) and 61 cases did irregular hepatectomy (group B).Results In group A,15 cases did Ⅳ,Ⅴ and Ⅷ lobectomy,10 cases underwent Ⅳ and Ⅴpartial lobectomy.Among the irregular hepatectomy group (group B),35 were treated with hepatic middle lobe resection,26 with local middle liver resection.There were significant differences in operation time,degree of postoperative liver function damage between the two groups (P ＜ 0.05),while there was no difference in postoperative complications (P ＜ 0.05).Conclusions The accurate mesohepatectomy can reduce the incidence of postoperative liver function damage and surgical complications.

This case report summarizes the experience from diagnosis and treatment of a patient with repeated high fever, hepatosplenomegaly and pancytopenia. Following exclusion of bacterial, viral, fungal infections and hematological diseases, metagenomic next-generation sequencing of the patient’s peripheral blood revealed Leishmania infantum infection, and rK39 rapid diagnostic test showed positive for anti-Leishmania antibody, while microscopic examination of bone marrow smears identified Leishmania amastigotes. Therefore, the case was definitively diagnosed as visceral leishmaniasis, and given anti-infective treatment with sodium antimony gluconate and hormone, hepatoprotection, elevation of white blood cell counts and personalized nursing. Then, the case was cured and discharged from hospital. Metagenomic next-generation sequencing is of great value in etiological detection of fever patients with unknown causes, which deserves widespread clinical applications.

Objective: To investigate the promoting effect of local compression and fixation on the healing of anterior tibial flask-like wound after debridement and suture. Methods: A retrospective case control study was conducted to analyze the clinical data of 57 patients with simple anterior tibial flask-like wound admitted to the Second Hospital of Shandong University from May 2017 to June 2018. There were 32 males and 25 females, aged 20-60 years [(41.4±8.1)years]. The length of wound ranged from 1 to 10 cm. All patients had only acute skin and soft tissue injury, without any fracture, large area skin defect, large area avulsion injury, or chronic diseases such as diabetes mellitus and lower limb vascular disease. The study group contained 37 patients who were treated with local pressure dressing and limb fixation after debridement and suture while the control group included 20 patients who were treated with simple dressing after debridement and suture. At 3, 5, 7, 14, and 21 days after operation, the size of the wound, the type and quantity of exudate, the color of skin around the wound and the type of wound tissue were compared, and the healing time was recorded. Results: All patients were followed up for 30-90 days [(52.2±3.5) days]. Three days after operation, there was no significant difference between the two groups (P>0.05). On the 5th day after operation, the scores of exudate amount, skin color surrounding wound and tissue types of the wound bed in the control group and the study group were (4.2±0.7)points ∶(3.3±0.6)points, (3.5±0.7)points ∶ (2.5±0.6)points, (3.4±0.6)points ∶ (2.5±0.5)points (P<0.05), but there was no significant difference between the two groups in the scores of the size of wound and the type of exudate (P>0.05). On the 7th day after operation, the scores of the size of wound, type of exudate, amount of exudate, skin color around the wound and the type of wound tissue in the control group and study group were (3.5±0.5)points ∶ (2.5±0.7)points, (3.4±0.7)points ∶ (2.4±0.5)points, (4.0±0.8)points ∶ (2.8±0.5)points, (3.4±0.5)points ∶ (1.3±0.5)points, (3.3±0.5)points ∶ (2.1±0.4)points (P<0.05). On the 14th day after operation, the scores of the scores of the size of wound, type of exudate, amount of exudate, skin color around the wound and the type of wound tissue in the control group and study group were (2.9±0.6)points ∶ (1.2±0.7)points, (2.8±0.7)points ∶ 0 point, (3.3±0.7)points ∶ (1.0±0.0)points, (3.1±0.6)points ∶ (1.1±0.4)points, (3.0±0.6)points ∶ (1.2±0.5)points (P<0.05). Twenty-one days after operation, the scores of the scores of the size of wound, type of exudate, amount of exudate, skin color around the wound and the type of wound tissue in the control group and study group were (2.5±0.7)points ∶ 0 point, (2.5±0.5)points ∶ 0 point, (3.0±0.7)points ∶ (1.0±0.0)points, (2.6±0.7)points ∶ (1.1±0.3)points, (2.6±1.1)points ∶ 0 point (P<0.05). The wound healing rate was 100% in both groups. The wound healing time of the control group and the study group was (28.3±6.7)days and (15.2±0.9)days respectively (P<0.05). Conclusion For anterior tibial flask-like wound, local pressure bandaging and fixation after debridement and suture can significantly promote wound healing compared with conventional simple bandaging, with the advantages of better healing quality and shorter healing time.