Objective To study the effects of BCG-PSN on the expression of the receptor of selectins——one of the important cell adhesion molecules, and the characteristics of cytoskeleton structure in lung cancer cells. Methods The effects of BCG-PSN on the expression of sialyl Lewis X (slex) and the cytoskeleton structure of highly metastatic human pulmonary giant cell carcinoma (PG) cells and lowly metastatic human pulmonary adenocarcinoma (PAa) cells were observed by flow cytometry and transmission electron microscopy. Results Flow cytometric results showed that the expression of slex on the surface of PAa cells (66.8%) was higher than that on PG cells (5.72%). After treatment with BCG-PSN, the expression of slex on PAa cells decreased in a dose-dependent manner. Transmission electron microscopy showed that the microtubules and microfilaments were sparse in the PAa cells and diminished in PG cells. After treatment with BCG-PSN, the microfilaments were more abundant than before in PG cells and showed a branch-like appearance, but still remained sparse in PAa cells. Conclusion Changes in the components of the cytoskeleton structure are associated with the ability of the migration and movement of the tumor cells. The inhibitory effect of BCG-PSN on the adhesiveness of lung cancer cells may not be the cytoskeleton-mediated enhancement of adhesion, but the start-up process resulted from the down-regulation of cell adhesion molecules on the surface of lung cancer cells.

OBJECTIVE To survey the varieties of microorganism on nurse hands and probe into its controlling measure in general hospital.METHODS We sampled microorganism of nurse hands during intravenous fluids infusion in the Respiratory Department,the Cardiovascular Department,the Department of Digestion,Gynecology and Obstetrics Department,the Department of Thoracic Surgery and the Department of Organ Transplantation in our hospital.All samples carried out co-cultures of fungi and bacteria.RESULTS The varieties of microorganism included not only opportunistic pathogens such as Acinetobacter,Corynebacterium,Pantoea agglomerans(Enterobacter agglomerans) former,and Escherichia coli,but also strong pathogenic microorganisms such as Staphylococcus aureus,and it is so common that finding meticillin-resistant coagulase-negative staphylococci.CONCLUSIONS Nursing staff's hands contamination is serious in the process of manipulating operation in general hospital,emphasis should be placed on prophylaxis and control for nosocomial infection.

In order to improve the Interns’ synthetic medical quality of respiratory medicine, based on the teaching practice of respiratory medicine in our hospital, the analysis of admission introduction and requests for high quality medical ability are reviewed in the present article.

Objective To evaluate the efficacy and safety of donepezil in the treatment of cognitive dysfunction caused by radiation-induced encephalopathy.Methods A total of fifty-five patients with radiation-induced cognitive impairment were divided into treatment group with extra donepezil 5-10 mg/d combined with conventional therapy and control group with conventional treatment for 16 weeks.The cognitive function was assessed according to Montreal cognitive assessment (MoCA) and mini-mental state examination (MMSE) before and 16 weeks after treatment.Results After 16 weeks of treatment,the patients in treatment group displayed significantly greater improvement in cognitive function.In treatment group,the scores of patients after donepezil therapy in MoCA and MMSE were obviously higher than the control group (t =5.40,3.88,P ＜ 0.01).The scores in the visual space and executive function,naming,attention,abstract thinking,delayed memories also had improved,which suggested the statistically significant difference(t=-3.55,-3.08,-3.21,-2.58,-3.65,P＜0.05).The scores of control group unchanged accordingly.Conclusions Donepezil combined with conventional treatment was signally effective in the therapy of cognitive dysfunction caused by radiation-induced encephalopathy.

OBJECTIVE: To determine the effect of ulinastatin on plasma thromboxane B(2) and deep vein thrombosis(DVT) in elderly patients after hip joint replacement. METHODS: Eighty ASAI-IIpatients aged 65-81 years undergoing hip joint replacement were randomly divided into 4 groups (n=20): Group U1 (ulinastatin 5 000 U/kg);Group U2 (ulinastatin 10 000 U/kg); Group U3 (ulinastatin 20 000 U/kg); and Group C (the same volume of saline as control).The blood samples were collected at 5 time points: preoperation (T(1)), immediately after the operation (T(2)), 1 d (T(3)), 2 d (T(4)) and 3 d after the operation (T(5)), respectively. Thromboxane B(2) was detected, and DVT was also examined through color Doppler ultrasonography 3 d after the operation. RESULTS: Compared with T(1), the level of thromboxane B(2) significantly increased in Group C at T(2)-5, in Group U1 at T(2-4), in Group U2 and U3 at T(2) (P<0.01). Compared with Group C, the concentration of thromboxane B(2) decreased in Group U1 at T(2-3), in Group U2 and U3 at T(2-4) (P<0.01). Compared with Group U1, thromboxane B(2) significantly decreased in Group U2 and U3 at T(2-4) (P<0.01).The incidence rate of DVT was 40% in Group C, 10% in Group U1. There was no incidence of DVT in the Group U2 and U3 (P>0.05). CONCLUSION Ulinastatin can inhibit blood thromboxane B(2) level in dose dependent manner and prevent DVT in elderly patients after hip joint replacement.
Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Hip ; adverse effects ; Female ; Glycoproteins ; therapeutic use ; Hip Fractures ; surgery ; Humans ; Male ; Thromboxane B2 ; blood ; Trypsin Inhibitors ; therapeutic use ; Ultrasonography ; Venous Thrombosis ; diagnostic imaging ; etiology ; prevention & control

Background:Malnutrition is common in inflammatory bowel disease,especially in Crohn' s disease (CD).Combined partial enteral and parenteral nutrition is effective for nutritional support in patients with severe CD.Aims:To investigate the effect of combined enteral and parenteral nutritional support on body composition and disease activity in severe active CD patients.Methods:A total of 72 patients with severe active CD admitted from July 2015 to August 2016 at Shanghai Tenth People' s Hospital were enrolled.In addition to conventional antibacterial and remission induction therapy,a combined partial enteral and parenteral nutritional support was given after admission.The nutritional status,body composition parameters and disease activity were evaluated and compared on admission and week 1,week 2 and week 3 of hospitalization.Results:The malnutrition rate was 100％ on admission,of which 90.3％ were severe malnutrition.After a 3-week combined enteral and parenteral nutritional support,the proportion of severe malnutrition decreased from 90.3％ to 34.7％ (P ＜0.05).Meanwhile,the body weight,body mass index,muscle mass,fat mass,protein content,and basal metabolic rate gradually increased and the disease activity index gradually decreased (P all ＜ 0.05).Conclusions:Combined enteral and parenteral nutritional support can improve the nutritional status and body composition parameters,reduce disease activity and induce remission effectively in severe active CD patients.

Objective:To investigate the incidence and risk factors of ventilator-associated pneumonia (VAP) in neonatal intensive care unit (NICU), and to provide evidence for the prevention and control of VAP.Methods:A total of 1 872 neonates, who were admitted into NICU of Hunan Provincial Maternal and Child Health Hospital and subjected to mechanical ventilation from October 2016 to June 2018, were enrolled in the study. The neonates who met the diagnostic criteria of VAP were selected as the case group, and those who were treated with ventilator for 48 hours at the same time were regarded as the control group. Multivariate logistic regression model was used to analyze the related factors of VAP.Results:Of the 1 872 neonates who underwent the mechanical ventilation, the VAP occurred in 160 cases with the incidence rate of 8.5% (160 cases). The 227 specimens were collected. Gram-positive bacteria ( n=116, 51.1%) were the main pathogens. The main pathogens were Staphylococcus epidermidis, Enterococcus faecalis, Acinetobacter baumannii. By Chi-square test, birth weight, birth age, Apgar score, duration of ventilator, and whether newborn mothers with pregnancy hypertension were influencing factors. The result of logistic regression analysis showed that compared with no pregnancy included hypertension, the first aid measure at birth was initial resuscitation, and the MV time ≤ 5 days, the risk factors of ventilator-associated pneumonia in neonates included: their mothers with hypertensive disorders complicating pregnancy, using of tracheal intubation and ventilator time more than 5 days. Conclusion:The incidence of VAP in neonates receiving continuous MV therapy in neonatal intensive care unit is higher. Gram-positive bacteria are the main pathogens. VAP in neonates is related to whether newborn mothers with pregnancy hypertension, MV duration and tracheal intubation.

Objective To explore the methods and effects of whole course case management in breast cancer patients.Methods From 11th November 2015 to 11th February 2016 in Department of Breast Surgery in Zhejiang Cancer Hospital , all medical staff organized 164 breast cancer patients who received treatment in the hospital to interact actively , answered patients′questions , carried out health information and medical science popularization, remind the patients′treatment time, made bed appointment and share positive news with patients by the establishment of doctor-nurse-patient WeChat .Results A total of 152 of 164 initial treatment patients were added into WeChat group .The patients′1 085 questions were timely replied , and 30 pieces of health information were released .For bed appointment , waiting time reduced by 6 hours, and patients′compliance and satisfaction were improved .Conclusions WeChat among doctors , nurses and patients provide a platform for the whole course professional nurse case management of breast cancer , which can save time and energy and adapt to the needs of modern medical care .

ObjectiveTo investigate comprehensive treatment and obstruction in adherence of the patients newly diagnosed with breast cancer,and to provide the theoretical basis for improving the comprehensive treatment adherence.Methods A total of 22 patients newly diagnosed with breast cancer received semi-structured interview by phenomenological research approach of qualitative research. Colaizzi′s data analysis method was performed to analyze and conclude the theme.Results Eight themes of the application were obtained from the experience of 22 patients:economic difficulties,weak family support,serious treatment side effects,tortile religious faith,incorrect internet information,indifference in combined treatment,complex formalities and complications. Conclusions The affecting factors,such as economic difficulties,are the most frequently endorsed barrier to combined treatment compliance. The management of affecting factors is critically significant to increase patients′ compliance to comprehensive treatment. Medical staff should offer individual economic and medical information as well as emotion supports,and encourage breast cancer patients to actively complete the comprehensive treatment.

Objective:To investigate the incidence and risk factors of ventilator-associated pneumonia (VAP) in neonatal intensive care unit (NICU), and to provide evidence for the prevention and control of VAP.Methods:A total of 1 872 neonates, who were admitted into NICU of Hunan Provincial Maternal and Child Health Hospital and subjected to mechanical ventilation from October 2016 to June 2018, were enrolled in the study. The neonates who met the diagnostic criteria of VAP were selected as the case group, and those who were treated with ventilator for 48 hours at the same time were regarded as the control group. Multivariate logistic regression model was used to analyze the related factors of VAP.Results:Of the 1 872 neonates who underwent the mechanical ventilation, the VAP occurred in 160 cases with the incidence rate of 8.5% (160 cases). The 227 specimens were collected. Gram-positive bacteria ( n=116, 51.1%) were the main pathogens. The main pathogens were Staphylococcus epidermidis, Enterococcus faecalis, Acinetobacter baumannii. By Chi-square test, birth weight, birth age, Apgar score, duration of ventilator, and whether newborn mothers with pregnancy hypertension were influencing factors. The result of logistic regression analysis showed that compared with no pregnancy included hypertension, the first aid measure at birth was initial resuscitation, and the MV time ≤ 5 days, the risk factors of ventilator-associated pneumonia in neonates included: their mothers with hypertensive disorders complicating pregnancy, using of tracheal intubation and ventilator time more than 5 days. Conclusion:The incidence of VAP in neonates receiving continuous MV therapy in neonatal intensive care unit is higher. Gram-positive bacteria are the main pathogens. VAP in neonates is related to whether newborn mothers with pregnancy hypertension, MV duration and tracheal intubation.