Objective To explore the effect of cognitive intervention based on conception of knowledge and belief on cognition level and negative moods in the lung cancer patients undergoing radiotherapy. Methods Toally 84 lung cancer patients hospitalized in our hospital from March 2014 to November 2015 were equally divided into the study group and the control group by a random digit table. The control group received the traditional model of nursing, while the study group was treated with cognition intervention based on conception of knowledge and belief as well as the same routine care as in the control group for 4 weeks. Before and after 4 weeks intervention, the two groups were compared in terms of their knowledge, belief, behaviors, self care ability, depression and anxiety. Results Before intervention, there were no significant differences between the two groups in terms of their knowledge, belief, behaviors, self care ability, depression and anxiety (all P>0.05). After the intervention, the scores on knowledge, belief, behavior and self care ability in the study group were all significantly higher than those of the control group and the scores on anxiety and depression were both statistically significantly lower than those of the control group (all P<0.05). Conclusion The cognition intervention based on conception of knowledge and belief on cognition level and negative moods to the lung cancer patients is effective in improvement of their knowledge, belief, behavior as well as in alleviation of their anxiety and depression.

Pancreatic adenocarcinoma is a highly lethal disease with a high morbidity and dismal prognosis.A multidisciplinary consultation based on evidence-based medicine has become the main modality for treatment of pancreatic adenocarcinoma.National Comprehensive Cancer Network (NCCN) clinical practice guidelines in oncology has been widely recognized and implemented.Recently,the guidelines (version 1.2017) in oncology have been published by NCCN.This article will summarize and interpret the updates of the new version of the NCCN guideline for pancreatic adenocarcinoma.

Objective To investigate the clinical efficacy of atlantoaxial pedicle screw fixation plus bony fusion in treatment of traumatic upper cervical instability.Methods From October 2009 to August 2013,29 patients with traumatic upper cervical spine instability were treated with posterior atlantoaxial pedicle screws.The patients underwent autografting (n =19) and allografting (n =10) for spinal fusion.Surrcal outcomes were recorded including intraopcrativc blood loss,operation time,with or without nerve,blood vessel and spinal cord injury,wound healing and bone fusion rate.Results All operations were completed smoothly with operation time of 110 minutes (range,85-135 minutes) and blood loss of 150 ml (range,80-500 ml).At the follow-up of 10 months to 5 years (mean 18 months),bony fusion was detected for all the patients.Postoperative radiographs verified all patients were bony fusion with satisfactory cervical spine stability.No complications of reduction loss,fixation failure,and spinal cord or vertebral artery injury were observed except for 1 patient with low viruleut infection and 2 with delayed wound healing.Conclusion Single posterior atlantoaxial pedicle screw fixation provides security and reliable stability in treatment of upper cervical instability,however wound healing problems should be taken seriously.

BACKGROUND:Some scholars have found that cervical vertebral body bone trabecula was reduced,became thin,even perforated in old patients with osteoporosis.Whether this change will induce cervical vertebral body deformation,and what relationship to the onset of cervical syndromeOBJECTIVE:To study the relation of cervical spondylotic myelopathy and osteoporosis by measuring and comparing.METHODS:A totaI of 40 subjects with normal lumbar vertebra density and without cervical spondylosis were enrolled as control group,averagely 32 5 years.A total of 30 patients with cervical spondylosis served as cervical spondylosis group,averagely 43.6 years.Totally 46 patients with cervical spondylosis and osteoporosis served as combined with osteoporosis group,averagely 58.6 years.116 subjects underwent radiograph Height and sagittal diameter of the vertebral body ratio of height to sagittal diameter of the vertebral body.and ratio of sagittal diameter of cervical canal/vertebra body were measured.RESULTS AND CONCLUSION:Compared with the control group.vertebral height was decreased.and sagittal diameter became longer(P＜0.05),and the ratio of sagittal diameter of cervical canal/vertebra body became smaller(P＜0.05)in the combined with osteoporosis group.Vertebral body deformation was characterized by decreased vertebral height and prolonged sagittal diameter became flat.Results suggested that osteoporosis induced cervical vertebral deformation,correlation between osteoporosis and cervical spondylosis,which may be a factor for cervical spondylosis development.

Objective To explore the clinical features of chronic granulomatous diseases and Mcleod syndrome caused by continuous X chromosome deletion. Methods The clinical data of two children diagnosed as chronic granulomatous disease and Mcleod syndrome by gene detection were retrospectively analyzed. Results Two males, 4 year 1 month and 1 year 9 month old, were both hospitalized due to persistent pulmonary infections. Both of them had a history of repeated severe infections and BCG vaccine associated lymphadenitis, and were diagnosed as X-linked chronic granulomatous disease for respiratory burst defects and deletion of all CYBB exons. Both of them had retarded motor development, and were diagnosed as DMD for detection of DMD gene exons and muscle speciifc promoter region and exon 1-2 deletion by MLPA. One case was found with obvious echinocytes, the other case showed whole exons deletion of XK gene. Both of them were diagnosed as Mcleod syndrome. Conclusion Continuous X chromosome deletion could lead to combination of Mcleod syndrome, DMD, and X-CGD, which may complicate the condition. Due to the lack of Kx antigen, repeated common blood transfusion can produce relative antibody, which lead to severe hemolytic crisis.

Objective To observe the effect of ulinastatin in the treatment of children with severe pneumonia. Methods 86 children with severe pneumonia were divided into two groups according to the hospital card number:treatment group(n=45) and control group(n=41).All of them were given routine treatment,while the patients of the treatment group were given ulinastatin(5 000 U· kg-1 · time-1 ,1-2times/d,7d) in addition.The time of tem-perature drop to normal,the time of dyspnea improve,the time of dyspnea disappear,the time of lung rale disappear and length of hospital stay were observed.Then,the therapeutic effect was evaluated after treatment for 7 days.Results The treatment group had 21 cases excellence,21 cases improvement and 3 cases failure, the total effective rate was 93.33%,the control group had 17 cases excellence,15 cases improvement and 9 cases failure,the total effective rate was 78.04%,there was significant difference between the two groups(χ2 =4.17,P<0.05).The time of temperature drop to normal,the time of dyspnea improve,the time of dyspnea disappear,the time of lung rale disappear and length of hospital stay in the treatment group were (3.37 ±1.51)d,(3.12 ±1.72)d,(7.15 ±2.45)d,(10.75 ±2.47)d, respectively,which in the control group were (5.02 ±1.78)d,(4.82 ±1.51)d,(9.08 ±2.85)d,(13.22 ±2.85)d, there were significant differences between the two groups(t=4.71,4.91,3.42,4.41,all P<0.01).Conclusion Ulinastatin has good effect on children with severe pneumonia.It has value in application.

Objective This study is to summarize the experience of microsurgical reconstruction for donor liver anatomical variations of hepatic arteries in orthotopic liver transplantation. Methods During the bench surgery, the anatomy of donors′ hepatic arteries was carefully examined and microsurgical techniques were used for the anomalous arteries. The graft arterial flow was checked by Doppler ultrasound daily in the first week in postoperative period and periodically thereafter. Results The arterial anatomy was anomalousin 20 out of 141 (14%) donor livers. Nine cases (6.3%) needed arterial reconstruction. In these cases, 7(4.9%) aberrant right hepatic arteries originating from superior mesenteric artery were anastomosed to gastro-duodenal arteries and another two aberrant hepatic left or right arteries were anastomosed to the stump of the donor splenic arteries. Conclusions The variations of hepatic arteries in donors are common. To obtain the ideal arterial supply of liver graft, both careful checking on the origin of donor's artery and appropriate plastic performance with refined microsurgical techniques are necessary.

Objective To improve the understanding of neonatal-onset pulmonary tuberculosis.Methods The clinical features,laboratory examination and imaging were analyzed in 2 cases with neonatal-onset pulmonary tuberculosis in the Respiratory Department of Beijing Children's Hospital,Capital Medical University.Results The 2 patients were premature twins,were born at 33 +3 weeks of gestation,presented with intermittent cough and transient fever on 26 days after birth.Chest CT scan showed pulmonary multifocal nodules.One case was complicated with pleural effusion,atelectasis and no effectiveness with antibiotics.The untypical pathogen infection was considered.The result of PPD was negative,the result of interferon gamma release array,gastric acid fast staining and mycobacterium tuberculosis culture were positive,finally they were diagnosed with pulmonary tuberculosis.Conclusions The clinical features and imaging of neonatal tuberculosis are always untypical and PPD is negative,which brings difficulties to clinical diagnosis.We should take untypical pathogens into account,such as tuberculosis,when some diseases cannot be explained by common pathogens.

The healing training was an important method to improve living ability and quality of life of patients with schizophrenia.This article introduced a living skill training scheme applied in out-patients whose course of disease shorter than 5 years.

Objective:To investigate the prevalence of malnutrition in hospitalized patients with ulcerative colitis (UC) using the Global Leadership Initiative on Malnutrition (GLIM) criteria, compare the body composition, clinical indicators, and occurrence of poor UC outcomes between the malnutrition group and the non-malnutrition group, and analyze the risk factors of malnutrition.Methods:A total of 104 UC patients hospitalized in the Affiliated Hospital of Qingdao University during 2019 to 2021 and with relevant data collected through UC-sarcopenia Prospective Study were included. Data including nutritional risk screening 2002 (NRS 2002) scores, diagnosis of malnutrition per GLIM criteria, body composition data, clinical data and occurrence of poor outcomes were extracted. All patients were screened for nutritional risk using NRS 2002 at admission, and those at nutritional risk were further evaluated for malnutrition diagnosis per GLIM criteria. The prevalence of malnutrition in UC inpatients, the differences in indicators between malnutrition and non-malnutrition groups, and the risk factors of malnutrition were analyzed.Results:Among the enrolled UC patients , 35 (33.7%) were at nutritional risk, and 30 (28.8%) were diagnosed as malnutrition by GLIM criteria. Compared with the non-malnutrition group, the body composition indexes, including body fat mass, protein, skeletal muscle mass, segmental muscle mass, body water, waist circumference, arm circumference, visceral fat area, basal metabolic rate and body cell mass, all decreased to some extent in the malnutrition group ( P < 0.05). Prealbumin and albumin levels were lower ( P < 0.01). The modified Mayo endoscopic score (MMES), C-reactive protein level and erythrocyte sedimentation rate were higher ( P < 0.01). The rates of re-admission and surgery due to disease activity at 90 days were higher ( P < 0.05). High MMES ( OR =1.534, P = 0.044) and low albumin level ( OR =0.781, P = 0.013) were risk factors for malnutrition in UC patients. Conclusions:GLIM criteria is suitable for the diagnosis of malnutrition in hospitalized UC patients, and malnutrition patients are more likely to experience poor outcomes such as short-term re-admission and surgery. UC patients with higher MMES and lower albumin level are more likely to suffer from malnutrition.