Objective To simply coloclysis procedure,lower material consumption and relieve nurses'work burden.Methods 30 patients and 30 nurses were divided into three groups with 10 patients and 10 nurses in each group and three enemators were applied in these three groups.The safety,conveniece,operation time,cubic capacity,flow rate and skin reaction to coloclysis chemical reagents were observed.Results The results of the above mentioned factors were different among three groups(P<0.01).The traditional enemator had less satisfying degree for its operation procedure,more time and material consumption than the other enemators.Conclusion The medical portable hand-pressure enemator proved to be safe,convenient,and portable.It reduced material consumption and alleviated the nurses'work burden.

Objective To study the asepsis security of the interior cover of polypropylene plastic dropping bottle.Methods The whole samples were divided randomly into two groups,each group included 42 polypropylene plastic dropping bottles,Samples of the control group were collected from the interior covers of dropping bottles wiping with sterile normal saline cotton swabs.Samples of the experimental group were also collected from the interior covers wiping with sterile normal saline cotton swabs aher disinfected by 0.5%iodophors and 75%alcohol respectively.All samples were inoculated on the aseptic plain agar nutrition flat plate.then incubated in 37℃ incubaton to observe the growth of bacteria.Results There Was statistical significance between the two groups in the growth of bacteria,χ2=46.791,P<0.01.Conclusions The interior covers of polypropylene plastic dropping bottle should be disinfected strictly before they are used in clinic.

Objective To investigate the positive influence of telephone follow-up on primiparas′exclusive breastfeeding during puerperal period. Methods By using convenience sampling method, 90 primiparas were selected who had given birth in the integration ward of our hospital from October to December 2015 as the control group, and 60 primiparas were selected who had given birth in the integration ward of our hospital from December 2015 to January 2016 as the experimental group. For the experimental group, every 2 weeks, a telephone follow-up was executed according to primiparas′parturition time after leaving hospital. For the control group, telephone follow-up was not executed. The influence of periodic telephone follow-up on primiparas′ exclusive breastfeeding was observed. Results The exclusive breastfeeding rate of primiparas in the experimental group was increased as the telephone follow-up was executed. It was up to 91.7%(55/60) 6 weeks since parturition. The exclusive breastfeeding rate of primiparas in the control group was 71.1% (64/90). The difference was significant (χ2=9.28, P<0.01). Conclusions Periodic telephone follow- up according to necessity provides breastfeeding publicity and guidance after parturition, maintaining the continuous education and caring for the primiparas after leaving hospital which efficiently increased the pure breastfeeding rate of primiparas during puerperal period.

OBJECTIVE:To explore the effects of pioglitazone on secreation and mRNA expressions of TNF-? in adipocytes of high-cholesterol model rats.METHODS:30 rats fed with high-cholesterol diet for 8 weeks were randomly assigned to receive high cholesterol diet alone(high-cholesterol group,n=15) or high-cholesterol diet plus pioglitazone(3 mg?kg-1?d-1) (pioglitazone group,n=15) for 4 weeks.Another 15 rats were assigned to control group and fed with common diet for 12 weeks.Then the rats were sacrificed,with indexes such as blood lipid,serum concentration and mRNA expression of TNF-? in adipocytes of high-cholesterol rats determined.Besides,normal adipocytes were taken and treated with lipopolysaccharide and different concentrations of pioglitazone (0.1,1.0,10.0 ?mol?L-1) followed by a determination of TNF-? level and mRNA expression level.RESULTS:Compared with high-cholesterol group,serum concentration and mRNA expression of TNF-? in pioglitazone group were significantly lowered,but pioglitazone treatment showed little impact on blood sugar level and blood lipid level.Pioglitazone(0.1,1.0,10.0 ?mol?L-1) dose-dependently inhibited lipopolysaccharide-induced TNF-? secretion and mRNA expression in cultured adipocytes.CONCLUSION:Pioglitazone can reduce TNF-? level of fatty tissue and serum in high-cholesterol model rats.

Objective To explore the nursing strategies for preoperative ventilator-dependent patients undergoing discontinuing mechanical ventilation after lung transplantation.Methods The clinical data and nursing experiences of 10 preoperative ventilator-dependent patients undergoing discontinuing mechanical ventilation after lung transplantation from September 2002 to December 2008 were retrospectively analyzed.Results The time of discontinuing mechanical ventilation ranged from 7 to 30 days and the average time was 16.5 days.Conclusion The key points to ensure the success of discontinuing mechanical ventilation were careful observation of ventilation modes,preparations before discontinuing,airway management,nutritional support and psychological nursing.

OBJECTIVE To study the clinical effect of preventing and treating sterile phlebitis(abacterial phlebitis,SP) by infrared irradiation after peripherally inserted central catheterization(PICC).METHODS Totally 122 inpatients from the Zhejiang Provincial People′s Hospital were divided into two groups randomly,the control group and the experimental group.The control group was only treated with usual care after PICC,while the experimental group with both infrared irradiation and usual care.The incidence rate of SP and its correlation factor were compared between the two groups.RESULTS None in the experimental group got SP.Nevertheless,the control group got a 21.9%incidence rate.The development of SP mostly own to impassable intubation or repeating intubation.CONCLUSIONS For those patients with impassable intubation or repeating intubation during PICC operation,infrared irradiation shows greatly helpful and can obviously prevent the SP and diminish patients′ fee.

0.05)Both the anticoagulants and the anti-platelet agents can reduce MES. During 1.5 year, s follow-up, the recurrent rate of ischemic event in the MES positive group was markedly higher than that in the MES negative group(P

Objective To evaluate the diagnostic value of the combination of serum DKK1 (Dickkopf-1 )and P53 autoantibodies in patients with esophageal squamous cell carcinoma (ESCC).Methods Serum levels of DKK1 and P53 autoantibodies were measured by enzyme-linked immunosorbent assay (ELISA) for the 1 26 patients with ESCC and 60 normal controls.Receiver operating characteristics (ROC)was used to calculate the diagnostic efficiency.Results The serum levels of DKK1 and P53 autoantibodies were signifi-cantly higher in ESCC than those in normal controls [(673.09 ±343.82)pg/ml vs (362.05 ±1 48.07)pg/ml, Z =6.1 58,P <0.000 1 ;(0.398 ±0.546)vs (0.069 ±0.050),Z =3.832,P <0.000 1 ].ROC curves showed the optimum diagnostic cutoff for serum DKK1 was 588.77 pg/ml,with an area under curve (AUC)of 0.780 (95%CI:0.71 5 ~0.844,61 .9% sensitivity,95.0% specificity).Measurement of P53 autoantibodies demonstrated an AUC of 0.674 (95%CI:0.598 ~0.750,45.3% sensitivity,95.0% specificity).The com-bination of DKK1 and P53 autoantibodies yielded an AUC of 0.843 (95%CI:0.788 ~0.897,73.8% sensitiv-ity,95.0% specificity).In early-stage ESCC,combined detection of DKK1 and P53 autoantibodies improved the diagnostic power,with an AUC of 0.903 (95%CI:0.845 ~0.961 ,81 .0% sensitivity,95.0% specifici-ty).Conclusion Serum DKK1 and P53 autoantibodies can be used as potential diagnostic biomarkers for the ESCC.Combined detection of them might aid the early diagnosis of ESCC.

Objective To investigate the safety and effectiveness of endoscopic resection of tumors originated from gastric fundus muscularis propria.Methods Data of 53 patients with tumors originated from gastric fundus muscularis propria detected by endoscopic ultrasonograpy,treated by endoscopic resection and followed up at our hospital between January 2012 and June 2014 were reviewed.The postoperative pathology and complications were retrospectively analyzed to evaluate the therapeutic effect and safety.Results The procedure was successfully performed on all patients and all lesions were removed in one procedure.The lesion size ranged from 0.5 to 4.5 cm and the operation time was 25-155 min[mean(46.7 ±18.2)min].Mild bleeding (5 ~150 ml)occurred in all cases,which was successfully managed by argon plasma coagulation,hot biopsy probe or endoclip.Perforation occurred in 8 patients(8 /53),seven of whom were closed with titanium clips and titanium clips combined with nylon cord.Laparoscopic intervention was applied to 1 case because of severe perforation.Gastrointestinal decompression,acid suppression with proton pump inhibitors and antibiotics were performed on all cases.No severe hemorrhage occurred.The average length of hospitalization was (5.3 ± 1.4)days(3-14 d).Pathology confirmed 46 cases of gastrointestinal stromal tumors and 7 cases of leiomyoma. The patients were followed up for 3 to 27 months,and no tumor residue or recurrence was observed. Conclusion Endoscopic resection is a method not only to get the accurate pathologic diagnosis but also to meet principle of the local resection for stomach.It is safe,effective and worthy of recommendation.

Objective To evaluate the value of MR threedimensional arterial spin labeling (3D-ASL) perfusion imaging and intravoxel incoherent motion(IVIM) DWI in differential diagnosis and quantitative analysis of musculoskeletal tumors.Methods Forty-four patients with musculoskeletal tumors were included.According to pathologic results,there were 12 cases of benign tumors,10cases of intermediate tumors and 22 cases of malignant tumors.3D-ASL and IVIM DWI were both performed on forty-four patients to gain tumor blood flow (TBF),standard ADC (ADCstandard),slow ADC (ADCslow)and fast ADC (ADCfast).Immunohistochemical staining of specimens was performed by using CD34 monoclonal antibody to calculate microvessel density (MVD) counts.MVD,TBF,ADCfast and ADCslow of different groups were compared by one-way ANOVA analysis.ADCstandard was compared by Kruskal-Wallis test.ROC curve was used to analyze ASL and IVIM DWI,in order to determine the threshold and diagnostic reliability.Results The MVD of benign tumors was 10±4,the MVD of intermediate tumors was 15±6,and malignant tumors was 33 ± 1 1.There was significant difference among three groups of MVD(F=28.33,P＜0.05).There was better intra-observer agreement for ADCstandard,ADCfast,ADCslow and TBF(ICC=0.970,0.885,0.778,0.891,respectively,P＜0.05).The TBF of benign tumors was(30±10)ml· min-1· 100 g-1,intermediate tumors was(30± 12) ml·min 1· 100 g-1,and malignant tumors was(84±29)ml·min 1· 100 g-1.There was significant difference among three groups of TBF(F=32.34,P＜0.05).According to the ROC analysis,when the cut-offvalue of TBF was 45.5 ml·min-1· 100 g-1,the area under ROC curve was 0.95 1,and the sensitivity and specificity of TBF in diagnosing malignant tumors were 90.9％ and 95.5％ respectively.There was no significant difference among three groups of ADCstandard,ADCfastand ADCslow of benign tumors were(9.9±5.1)× 10-3,(1.9±0.5) × 10-3mm2/s respectively.ADCfast and ADCalow of intermediate tumors were(8.2 ± 3.6) × 10-3,(1.5 ± 0.6) × 10-3mm2/s respectively.ADCfast and ADCalow of malignant tumors were (16.9 ± 5.8) × 10 3,(1.4 ± 0.6) × 10-3mm2/s respectively.There were significant difference of ADCfast and ADCslow among three groups (F=12.75,5.60,P＜ 0.05).According to the ROC analysis,when the cut-off value of ADCfast was 9.4× 10-3mm2/s,the area under ROC curve was 0.861,the sensitivity and specificity of them in diagnosing malignant tumors were 95.5％ and 68.2％ respectively.Conclusion 3D-ASL and IVIM DWI are valuable in the differential diagnosis of musculoskeletal tumors.