Objective To evaluate the influence of the duration of patient-controlled intravenous analgesia (PCIA)on pain and gastrointestinal function after gynecological abdominal surgery.Methods Patients who received gynecological abdominal surgery were divided into 3 groups according to using time of PCIA for 24 hours,48 hours,72 hours.There were 30 cases in each group.Pain intensity,gastrointestinal peristalsis time,anal exhaust time,getting out-of-bed time,voluntary micturition time,nausea and vomiting were compared among three groups after stopping PCIA.Results There were no significant differences in VAS score among three groups at each time point.There were no significant differences in voluntary micturition time among three groups.The anal exhaust time,getting out-of-bed time in 24-hour group were earlier than those of the other two groups,the differences were significant; The nausea and vomiting in 24-hour group were lower than the other two groups,the difference was significant.Conclusions The application of PCIA can effectively relieve acute pain 24 hours after surgery,but the effect was not obvious on pain induced by activities after 24 hours.But the side effects induced by analgesia pump(anesthetic)still work,such as vomiting,long duration of discharge,activity inconvenience.So PCIA should be stopped at right time in order to reduce complications and facilitate for recovery of patients after the surgery.

Objective To provide solid data for TCM treatment and research of triple negative breast cancer (TNBC) by investigating its syndromes distribution.Methods 180 patients diagnosed of TNBC in Department of Oncology,Guang'anmen Hospital from Janurary 2007 to November 2012 participated in this clinical trial.Eight principals syndrome differentiation,and Qi,Blood and viscal syndrome differentiation were used.According to the syndromes diagnosis standard,the differentiation of one single syndrome firstly and then multi-syndrome were conducted and related variables were analyzed finally Results 404 symptoms presented in all 180 patients.Qi deficiency syndrome (35.89％) and blood stasis syndrome (32.18％) showed statistical difference when compared with blood deficiency syndrome (3.22％),yin deficiency syndrome (4.95％),yang deficiency syndrome (3.96％),spleen-dampness syndrome (3.47％),qi stagnation syndrome (7.43％),toxic heat syndrome (4.95％) and dampness-heat syndrome (1.49％) (P＜0.01,x2=124.709,116.007,127.813,126.913,105.411,116.007,140.015; 118.273,105.447,117.630,120.445,97.411,105.447,110.273respectively).92.22％ syndroms were multi-syndrome including 23.89％ bi-syndrome,32.22％ tri-syndrome and 25.56％ qua-syndrome.Conclusion The syndromes of TNBC were complicated but with predominant Qi dificency and Blood stasis; single syndrome identification should be put in the first place and then combining them together may be practical approaches; Replenishing Qi and activating blood circulation might be breaking through in TNBC treatment.

OBJECTIVE: To investigate the influence of signal transducer and activator of transcription 3 (Stat3) and hypoxia-inducible factor-lα (HIF-1α) on the resistance effect of laryngeal squamous cell carcinoma to radiation therapy and chemotherapy under the hypoxia circumstances. METHOD: Western blot was used to test the expression of p-Stat3 and HIF-1α in the Hep-2 cells under the hypoxia conditions. MTT assay was used to test the proliferation of Hep-2 cells after radiation therapy and chemotherapy; the Hep-2 cells were suppressed expression of Stat3 and/or HIF-1α. RESULT: (1) AG490 induced significant proliferation inhibition on Hep-2 cells and Hep-2HIF-1α-/- cells in vitro underthe hypoxia environments (P < 0.05); (2) Suppressing expression of Stat3 reduced the expression of HIF-1α protein (P < 0.05); (3) Combined inhibition of Stat3 and HIF-1α enhanced radio- and chemo-sensitivity in laryngeal squamous carcinoma cells under hypoxia. CONCLUSION Combined inhibition of Stat3 and HIF-1α can further enhance radio- and chemo-sensitivity in laryngeal squamous carcinoma cells under hypixia compare than inhibiting Stat3 or HIF-1α alone. Effectively blocking of HIF-1α pathway and suppressing the expression of Stat3, would be an effective method to enhance radio- and chemo-sensitivity in laryngeal squamous carcinoma cells, which provides a new thought to reduce the resistance to treatment.
Blotting, Western ; Carcinoma, Squamous Cell ; Cell Hypoxia ; Cell Line, Tumor ; Humans ; Hypoxia ; Hypoxia-Inducible Factor 1, alpha Subunit ; Laryngeal Neoplasms ; STAT3 Transcription Factor

Objective To study the effect of red cell and plasma protein parameters on progression, prognosis and recurrence of cerebral infarction. Methods Clinical data from 105 patients with cerebral infarction were analyzed. The pa?tients were divided into four paired groups:progressive stroke group and complete stroke group, short-term favorable progno?sis group and short-term unfavorable prognosis group, long-term favorable prognosis group and long-term unfavorable prog?nosis group, relapsed cerebral infarction group and not relapsed group by different criterion. The red cell and plasma protein parameters were compared between groups. Results There were significantly higher mean corpuscular volume(fL:85.92± 4.50 vs 83.79±4.64,t=2.164,P<0.05), red cell distribution width(fL:13.50±2.45 vs 11.90±2.90,t=2.694,P<0.01), globu?lin(g/L:27.46±4.33 vs 24.79±4.03,t=3.029,P<0.01)and lower albumin(g/L:39.00±3.86 vs 42.89±4.45,t=4.242,P<0.01)in progressive stroke group than those of complete stroke group. The elevated red cell distribution width, reduced albu?min were the risk factors of progressive stroke. In the short-term unfavorable prognosis group, red cell distribution width was significantly higher than that in short-term favorable prognosis group(fL:13.90 ± 2.45 vs 12.00 ± 2.12,t=2.905,P<0.01). The red cell distribution width was positively correlated with mRS scores assessed 3 months and 18 months after cerebral in?farction(P<0.01). Conclusion Progressive stroke rate increases in cerebral infarction patients with elevated red cell distri?bution and reduced albumin;Red cell distribution width has a certain reference value for forecasting the prognosis of cere?bral infarction .

OBJECTIVE:To promote standard management of drugs in ICU area. METHODS:The change of work mode in ICU area of our hospital was analyzed and compared after the application of automated drug dispensing system(ADDS)as well as the change of related indicators 3 months before and after the application of ADDS;the effect of ADDS was evaluated. RESULTS& CONCLUSIONS:After the application of ADDS,the management of base drugs changed from open management to intelligent, closed-off and authority management;drug storage and cost management became more scientific,and staff allocation became more optimal. Under the condition of zero difference in the number of medical orders,initial medication time shortened from 170 min to 131 min (P<0.05),time of daily drug preparation and drug repercussion shortened from (81.20 ± 3.56)min to (30.04 ± 7.55) min,and (9.18 ± 2.79)min to (6.47 ± 4.66) min (P<0.05). The application of ADDS can improve work efficiency,standardize drug management,promote medical safety,and provide reference for initiating a new mode of drug management in wards.

Objective:To explore the efficacy and safety of endoscopic esophageal varix ligation (EVL) combined with omeprazole and octreotide in the treatment of esophageal variceal bleeding.Methods:127 patients with cirrhosis complicated with esophageal variceal hemorrhage diagnosed and treated in our hospital from May 2014 to May 2016 were divided into the study group and the control group.The control group was treated with omeprazole and octreotide on the basis of conventional therapy,while the study group was treated with endoscopic esophageal variceal ligation (EVL) on the basis of control group.The clinical efficacy,hospitalization condition,incidence of adverse reactions and rebleeding rate after treatment of the two groups were analyzed.Results:All the patients in the study group were successfully operated.In the control group,10 patients showed hematemesis and melena,among which 1 patient wastreated with surgery.After treatment,the c lini cal effi cacy of the study group was superi or to the control group,and the di fference was stati sti cally significant (P＜0.05).During the treatment period,the hemostasis time,blood transfusion time,hospital stay and hospitalization expenses of the study gronp were significantly lower than those of the control group (P＜0.05).In the study group and the control group,10 cases and 7 cases respectively had nausea and vomiting,esophageal foreign body sensation,dizziness,palpitations,pain,bloating,increased facces frequency,fever and other adverse reactions,and the incidence of increased faeces frequency of control group was significantly higher than that of the study group (P＜0.05),but the incidence of other adverse reactions and the total incidence showed no significant difference between two groups (P＞0.05).The rate of rebl eeding was si gni fi cantly lower in the study group at 0.5,1,3,6 and 12 months after treatment than those in the control group(P＜0.05).Conclusion:Endoscopic ligation combined with omeprazole and octreotide was effective in the treatment of esophageal variceal bleeding,which could be effective,rapid hemostasis,reduce the hospital stay,hospitalization cost and rebleeding rate with high safety.

Objective To compare the fatigue characteristics between people with fatigue-predominant sub-health and patients with ulcerative colitis.Methods Fatigue Self-assessment Scale (FSAS) was applied in people with fatigue-predominant sub-health and patients with ulcerative colitis.By using the multivariate statistical analysis,the fatigue characteristics of them were analyzed.Results The fatigue characteristics of two groups of people were different.The scores of physical fatigue,mental fatigue,fatigue consequences,total fatigue,reaction of fatigue after sleep and rest,situation of fatigue in people with fatigue-predominant sub-health were 31.06 ± 17.08,24.63 ± 14.50,24.38±13.39,26.36 ± 11.97,30.63 ± 22.70,42.89 ± 21.47,and in patients with ulcerative colitis were 25.60 ± 22.98,17.80 ± 18.44,20.54 ± 18.53,21.20 ± 17.15,18.18 ± 25.47,41.21 ± 25.70.There were statistical differences on the two groups (P ＜ 0.05 ).There were statistical differences between the percents of four degrees ( unconspicuous,mild,moderate,heavy) of physical fatigue,mental fatigue,fatigue consequences between in people with fatigue-predominant sub-health and in patients with ulcerative colitis (P ＜ 0.05 ).There were statistical differences on the percents of five degrees ( no obvious,slightly,less obvious,obvious,very obvious) of unrelieved fatigue after sleep and rest,situation of fatigue between in people with fatigue-predominant sub-health and in patients with ulcerative colitis (P ＜ 0.05 ).Conclusion The type,severity of fatigue,and characteristics ( such as unrelieved fatigue after sleep and rest,situation of fatigue) are different between people with fatigue-predominant sub-health and patients with ulcerative colitis.

{L-End}Objective To investigate the current status of academic procrastination, psychological resilience, and emotional intelligence among undergraduate nursing students in Hebei Province. {L-End}Methods A total of 2 121 undergraduate nursing students from seven medical universities in Hebei Province were selected as the research subjects using a convenient sampling method. The Academic Procrastination Scale, Psychological Resilience Scale, and Emotional Intelligence Scale were used to investigate their academic procrastination, psychological resilience, and emotional intelligence. {L-End}Results The median score for academic procrastination among undergraduate nursing students was 62.5 points. The scores for psychological resilience and emotional intelligence were (79.9±10.1) and (100.7±11.6) points, respectively. The results of the multiple logistic regression analysis showed that students from urban areas experienced more severe academic procrastination than those from rural areas (P<0.05). Students with indifferent family relationships experienced more severe academic procrastination than those with close family relationships (P<0.05). Higher grade levels, lower scores in psychological resilience, and lower scores in emotional intelligence were associated with more severe academic procrastination among these nursing students (all P<0.05). {L-End}Conclusion The overall degree of academic procrastination among undergraduate nursing students in Hebei Province is at a moderate level. The level of psychological resilience and emotional intelligence can negatively affect the degree of academic procrastination among these undergraduate nursing students.

Objective To investigate the expression of miRNA associated with hepatic fibrosis induced by Schistosoma ja-ponicum soluble egg antigen stimulation in mouse hepatocytes(AML12),so as to lay the foundation for clarifying the mecha-nism of schistosome infection leading to hepatic fibrosis. Methods The expressions of miR-122,miR-182,miR-23b,miR-27b and KSRP in AML12 cells treated with SEA were measured by q-PCR. KSRP protein in cell lyses was measured by Western blotting. AML12 cells were transfected with miR-27b precursor or anti-miR-27b for 24 h,then q-PCR was adopted to determine KSRP mRNA,and KSRP protein was detected by Western blotting. Results The expressions of miR-182,miR-23b and miR-27b were decreased and miR-122 was increased in AML12 cells following SEA treatment(all P<0.05). An increase of mRNA and protein of KSRP expression was also observed in AML12 cells after SEA stimulation(both P<0.05). In addition,KSRP mRNA expression was not changed significantly in AML12 cells transfected with anti-miR-27b or miR-27b precursor,and miR-27b precursor reduced KSRP protein expression as compared with the control. In contrast,the expression of KSRP protein was increased in the anti-miR-27b group and decreased in the miR-27b precursor group. Conclusions After the stimulation of SEA,the expressions of a variety of liver fibrosis-related miRNAs and KSRP change in murine hepatocytes,including miR-27b. And miR-27b can regulate the expression of KSRP. These findings might lay a foundation for further study on the molecular mechanism of fibrosis induced by schistosome infection.

The standardized training of resident physicians of Chinese medicine specialized graduate students (standardized training) is a great reform of clinical postgraduate education and a major initiative to improve professional degree graduates education. It contributes to higher professional qualities of clinicians in China. At this stage, the standardized training in our school just started and some problems existed such as department arrangement, training and checking system, curriculum and tutors instruction. Here, taking the standardized training in our school as an example, this paper discussed some issues on the training and put forward suggestion. This will help standardize our training, improve the training quality of our graduate students and develope medical professional talents.