ObjectiveTo discuss the effect of evidence-based nursing in improvement of unhealthy emotion and treatment compliance of patients undergoing painless gastroscopy. Methods134 patients from May 2008 to December 2010 undergoing painless gastroscopy were chosen as study object.According to voluntariness of the patients and their families,they were divided into the evidence-based nursing group (70 cases) and the routine psychological care group (68 cases).The satisfaction degree with nursing,unhealthy emotion,and the compliance during treatment process were evaluated with SAS and SDS.ResultsThe satisfaction degree of patients in the evidence-based nursing group was 92.86％,higher than 79.41％ in the routine psychological care group.No significant difference was shown in SAS and SDS score before treatment between two groups,but unhealthy emotion and treatment compliance after treatment significantly improved,and the improvement degree of the evidence-based nursing group was more evident. ConclusionsApplication of evidence-based care model in painless gastroscopy has more obvious advantages in improvement of unhealthy emotions and treatment compliance compared with routine nursing.It has more important value for clinical practice and is more conducive to improve the quality of life of patients.

Objective To explore the operative treatment of esophageal carcinoma or carcinoma of gastric cardia in patients aged 70 years or older. Methods　One thousand and eighty eight patients with esophageal cancer or carcinoma of gastric cardia were retrospectively reviewed.These patients were divided into 4 groups:aged 41～69,70～74,75～79 and 80～90 years.The postoperative complications,hospjtalization time,prognosis, operative selection and perioperative treatment were analyzed. Results　Incidences of complications of pulmonary infection,arrhythmia,psychiatric symptom and unhealing of surgical incision were obviously increased,and the average hospitalization time were significantly prolonged in patients aged 70 years or older.Incidence of pulmonary infection and the average hospitalization time were significantly increased in patients aged 80～90 years compared with other groups.There were 4 death cases and 1084 cured cases. Conclusions　With regard to elderly patients for esophageal carcinoma or carcinoma of gastric eardia,handling the occurrence of postoperative complications,selecting suitable patients to take operation and appropriate perioperative treatments are the keys for successful operation.

Objective To observe the changes of autophagy in human skin fibroblast (HSF) model for photoaging. Methods HSF model for photoaging was established through repeated exposure to ultraviolet B (UVB). Those HSFs receiving no irradiation served as the control. The degree of aging was evaluated by p-galactosidase assay, and autophagy level was detected. Results After repeated exposure to UVB, most pho-toaged HSFs were deformed and distorted, and some of them even died. The percentage of P-galactosidase-positive cells was 50.60% ± 5.04% and 14.58% ± 2.69%, respectively in photoaged and control HSFs (P< 0.01). Significant difference was also observed in the proportion of cytophagosome-positive cells between photoaged and control HSFs (14.91% ± 4.59% vs 68.45% ± 8.25%, P < 0.01). Conclusion The HSF model for photoaging shows obviously abnormal appearance and stagnant growth with increased degree of senescence and decreased autophagy compared with normal control HSFs.

Objective To investigate the effects of sirolimus and 3-methyladenine (3-MA) on the autophagy in,as well as matrix matalloproteinase (MMP)-1 and MMP-3 secretion by,human skin fibroblasts (HSFs).Methods HSFs were isolated from the circumcised foreskin of a healthy male,and subjected to primary culture.After 3 to 10 passages,HSFs were incubated with sirolimus of 20,50,100,250 nmol/L and 3-MA of 0.5,2.0,5.0,10.0 mmol/L respectively for 4 hours followed by the observation of autophagy and detection of MMP-1 and MMP-3 levels in the supernatant by enzyme linked immunosorbent assay (ELISA).Those HSFs remaining untreated or treated with dimethyl sulfoxide served as the control.Results The percentage of autophagy-positive cells was 59.075％ ± 6.884％,76.350％ ± 5.226％,85.063％ ± 6.002％,86.288％ ± 5.558％ and 96.825％ ± 1.500％ respectively in HSFs treated with sirolimus of 0,20,50,100 and 250 nmol/L; significant differences were observed between the 5 groups (P ＜ 0.01 ) but not between the cells treated with sirolimus of 50 and 100 nmol/L (P ＞ 0.05).After being treated with 3-MA of 0,0.5,2.0,5.0 and 10.0 mmol/L,the percentage of autophagy-positive cells in HSFs was 63.037％ ± 5.876％,34.425％ ± 5.183％,19.700％ ± 3.028％,12.900％ ± 3.334％ and 7.775％ ± 2.293％ respectively with a significant difference between these groups (all P ＜ 0.01 ).Elevated levels of MMP-1 and MMP-3 were observed in the supernatant of HSFs treated with sirolimus of 250 nmol/L and 3-MA of 10.0 mmol/L (all P ＜ 0.05).Conclusions The autophagy in HSFs can be upregulated by sirolimus,but downregulated by 3-MA.For the secretion of MMPs by HSFs,3-MA and high concentrations of sirolimus exert a promotive effect,and the effect of 3-MA is in a concentration-related manner,but the influences of sirolimus at lower concentrations remain unclear.

OBJECTIVE To summarize the experience of prevention and treatment of the deep fungal infection after thoracotomy.METHODS To enhance the prevention of the deep fungal infection after thoracotomy.To watch out for the change of postthoracotomy symptom,when doubtful clinical symptom appeared in the susceptible sufferersand to track the result of culture and adopt early experiential antifungal medication to treat.RESULTS Out of 38 patients 33 were cured,5 were died(13.16%).CONCLUSIONS To enhance the prevention of the deep fungal infection after thoracotomy,the early diagnosis and treatment with experiential antifungal medication are the important measures to improve prognosis in the patients with postthoracotomy infection of deep fungi.

Objective To analyze the imaging characteristics of hepatic involvement in Langerhans cell histiocytosis(LCH) in children on MRCP, MRI and CT. Methods Twenty-nine children from three children hospitals in China, who were diagnosed as hepatic involvement by disseminated LCH during Aug 2008 and Jan 2015 were included in this study. Their MRCP (n=16), MRI (n=22), contrast?enhanced CT (n=15) data were retrospectively analyzed. The stenoses and dilatation of the intrahepatic bile ducts, the common hepatic bile duct and its first order branches and the common bile duct were evaluated on the MRCP image. The size and shape of the liver, the imaging characteristics of the periportal lesions in the Glisson sheath and hepatic parenchymal lesions were also evaluated on the cross?sectional images. Results MRCP indicated alternative stenoses/dilatation of the bile duct tree (n=16), stenoses of the common hepatic duct and its first?order branches (n=15), partialindistinctness of the common bile duct (n=2) and multiple cystic lesions along the biliary tree (n=5). On the cross?sectional images, the periportal lesions in the Glisson sheath were observed in 28 children. On MRI, the periportal lesions were shown in all the 22 children with MRI, presented as hypo-signal intensity on T1WI, hyper?signal intensity on T2WI (n=11) or mixed?signal intensity on T1WI and T2WI (n=11); On CT, the periportal lesions were found in 14 of the 15 children with CT, presenting as low density (n=13) and mixed density (n=1). Multiple nodular or cyst?like parenchymal lesions were observed in 21 patients including 18 patients on MRI and 5 patients on enhanced CT. Sixteen patients presented as hypo?intensity on T1WI, hyper?intensity on T2WI and low density on plain CT, and 5 patients with iso? or hypo?intensity on T1WI, hypo?intensity on T2WI,and milder enhancement relative to the adjacent parenchyma on contrast?enhanced CT. Conclusions The imaging characteristics of hepatic involvement by LCH include alternative stenoses and dilatation of the intrahepatic ducts, stenoses of the common hepatic bile duct and its first?order branches on MRCP, the periportal lesions in the Glisson sheath and hepatic parenchymal nodular or cyst?like lesions on cross?sectional images.

Objective To explore the constitution characteristics of patients with uterine fibroids.MethodsA total of 413 patients with uterine fibroids (patient group) and 413 healthy women (control group) were enrolled in this case-control study. All the participants were required to fill in a questionnaire on Chinese Medicine constitution.The frequency and percentage of indicators were calculated,and analysis of variance and Chi-square test were used to find difference between the two groups.Results The incidence of Qi-stagnation constitution in the patient group was higher than that in the control group (x2 =8.209,P ＜ 0.05 ). The incidence of menstrual abnormalities was increased in patients with constitution of Phlegm-dampness and Dampness-heat,Qi-stagnation and Blood-stasis.The detection rate of hypertension of the patient group was also significantly increased.ConclusionThe most common constitution of patients with uterine fibroid is Oi-stagnation.

[Objective] To observe the effects of autophagy induced by different doses of ultraviolet B (UVB) irradiation on the apeptosis in human skin fibroblasts.[Methods] Skin fibroblasts were isolated from the circumcision specimen of a 23-year-old healthy male,and subjected to a primary culture.After 3 to 10 passages,the cells were collected and applied in the following experiment.Methyl thiazolyl tetrazolium (MTT) assay was performed to evaluate the proliferation of some fibroblasts treated with different concentrations (0,0.5,2.0,5.0and 10.0 mmol/L) of 3-methyladenine (3-MA).To qualitatively and quantitatively detect the autophagy in fibroblasts treated with different concentrations of 3-MA and in fibroblasts treated with 3-MA of 0.5 mmol/Lfollowing UVB irradiation,monodansylcadaverine (MDC) staining was carried out,and immunofluorescence was used to detect the expression of microtubule-associated protein 1 light chain (LC3).Some fibroblasts were classified into 8 groups to remain untreated,be irradiated with UVB of 30,50 and 100 mJ/cm2 alone,treated with 3-MA of 0.5 mmol/L alone,or treated with 0.5 mmol/L 3-MA following irradiation with UVB of 30,50 and 100 mJ/cm2,respectively,then,cell apoptosis was qualitatively detected by Hoechst and propidium iodide (PI)staining,and quantitatively detected by flow cytometry with annexin V and PI.[Results] The percentage of autophagic cells was (63.037 ± 5.876) ％ in fibroblasts treated with starvation condition,significantly decreased to (34.425 ± 5.183) ％ in fibroblasts treated with 3-MA of 0.5 mmol/L.The expression of LC3 showed a gradually increasing trend from untreated fibroblasts,to fibroblasts irradiated with UVB of 30,50 and 100 mJ/cm2,while the increase was attenuated by the 4-hour treatment with 3-MA immediately after the irradiation.Compared with the other concentrations,the 3-MA of 0.5 mmol/L showed the least influence on the viability of fibroblasts.The addition of 3-MA of 0.5 mmol/L increased the percentage of cells both positive for Hoechst and PI staining in fibroblasts irradiated with UVB of 50 mJ/cm2,but decreased that in fibroblasts irradiated with UVB of 100 mJ/cm2.Similarly,the percentage of middle and late apoptotic cells was significantly higher in fibroblasts irradiated with UVB of 50 mJ/cm2 followed by treatment with 3-MA of 0.5 mmol/L than in those irradiated with UVB of 50 mJ/cm2alone ((10.933 ± 0.839) ％ vs.(7.267 ± 0.473) ％,t =5.20,P＜ 0.05),but lower in fibroblasts irradiated with UVB of 100 mJ/cm2 followed by treatment with 3-MA of 0.5 mmol/L than in those irradiated with UVB of 100 mJ/cm2alone ( (7.100 ± 0.781 ) ％ vs.( 1 0.133 ± 0.681 ) ％,t =6.29,P ＜ 0.05 ).[Conclusion]s The irradiation with UVB of 50 mJ/cm2 may protect fibroblasts by inducing autophagy and suppressing apoptosis,while the high level of autophagy induced by UVB of 100 mJ/cm2 may lead to autophagic cell death in fibroblasts.

Type 1 diabetes mellitus is caused by the autoimmune destruction of beta cells within the islets. In recent years, innate immunity has been proposed to play a key role in this process. High-mobility group box 1 (HMGB1), an inflammatory trigger in a number of autoimmune diseases, activates proinflammatory responses following its release from necrotic cells. Our aim was to determine the significance of HMGB1 in the natural history of diabetes in non-obese diabetic (NOD) mice. We observed that the rate of HMGB1 expression in the cytoplasm of islets was much greater in diabetic mice compared with non-diabetic mice. The majority of cells positively stained for toll-like receptor 4 (TLR4) were beta cells; few alpha cells were stained for TLR4. Thus, we examined the effects of anti-TLR4 antibodies on HMGB1 cell surface binding, which confirmed that HMGB1 interacts with TLR4 in isolated islets. Expression changes in HMGB1 and TLR4 were detected throughout the course of diabetes. Our findings indicate that TLR4 is the main receptor on beta cells and that HMGB1 may signal via TLR4 to selectively damage beta cells rather than alpha cells during the development of type 1 diabetes mellitus.
Animals ; Diabetes Mellitus, Type 1/immunology/*metabolism/pathology ; Female ; Gene Expression Regulation ; Glucagon-Secreting Cells/immunology/metabolism/pathology ; HMGB1 Protein/*genetics/metabolism ; Humans ; Immunity, Innate ; Insulin-Secreting Cells/immunology/metabolism/*pathology ; Macrophages/immunology/pathology ; Mice ; Mice, Inbred C57BL ; Mice, Inbred NOD ; Necrosis ; Protein Binding ; Signal Transduction ; Toll-Like Receptor 4/*antagonists & inhibitors/genetics/immunology

Objective To analyze the correlation between CT characteristics and epidermal growth factor receptor (EGFR)mutations in pulmonary adenocarcinoma.Methods 82 patients (87 lesions)with pulmonary adenocarcinoma were retrospectively collected.All patients were underwent CT examination before operation,and EGFR gene were determined after operation.Results EGFR mutations were found in 44 of 87 lesions (50.57%).The EGFR mutations rate was 50.00% in females and 47.50% in males,there was no statistical difference between genders (P=0.821).The EGFR mutations rate was 46.55% in the right lung and 58.62% in the left lung,while no statistically significant difference was found (P=0.289).Among all the CT characteristics,the mutations rate was 63.89% in spiculated lesions and 60.71% in lesions with pleural indentation,the differences was statistically significant (P<0.05).The mutations rate was 59.25% in lesions containing solid component and 36.36% in pure ground glass opacity lesions,the difference was statistically significant (P=0.011). There were no statistically differences in lobulation,cavitation and lymphadenectasis (P>0.05).The pleural indentation was the highest in sensitivity (77.27%)and negative predictive value (67.74%).The spiculation was the highest in specificity (69.77%)and positive predictive value (63.89%).Conclusion Among all the CT characteristics,pleural indentation,spiculation and the lesion containing solid component are prone to EGFR mutations.