Objective To investigate the role of epithelial cell apoptosis in the stress-related changes of intestinal mucosa barrier following traumatic brain injury. Methods Sixty-four health male Wistar rats were divided randomly into two groups: (1) traumatic brain injury model group (n =32) ,in which rats suffered from traumatic brain injury by Feeney's method; (2) control group ( n = 32) , rats suffered from sham operation. Each group were divided into four subgroups according 6 h, 12 h,24 h, and 48 h after operation ( n = 8, for each subgroup ). Ileum tissue were taken to observed the damage of the intestinal mucosa under microscope and electronmicroscope. The early apoptosis rate of intestinal mucosal cells were analyzed with Annexin Ⅴ-PI double stained and detected by flow cytometry. Results The intestinal mucosa were damaged and the intercellular space of intestinal mucosal were found increased in traumatic brain injury group. The early apoptosis rate of intestinal mucosal epithelial cells was significant increased in traumatic brain injury group than that in control group [6 h: (13.5 ±3.7)% vs (6.1 ± 1.7)%, P＜0.05; 12 h:(66.1±6.0)% vs (5.2±1.1)%, P＜0.05; 24 h:(39.8±4.8)% vs (8.4±2.6)%, P＜0.05;48 h: (7.5 ±1.3)% vs (6.6 ±0.5)%]. Conclusion The increased early apoptosis rate of intestinal mucosal epithelial cells might contribute to the stress-damage of the intestinal mucosa barrier in early stage of traumatic brain injury.

Objective To investigate the application of ~(18)F-fluorodeoxyglucose hybrid PET/CT (~(18)F-FDG hPET/CT) imaging in clinical staging of non-small cell lung cancer (NSCLC). Methods Seventy two consecutive patients with NSCLC undergoing ~(18)F-FDG hPET/CT before radiotherapy were analyzed. The results were compared with previous CT scan and conventional clinical staging. The patients were followed-up for at least 6 months. Results Among the 72 patients, the staging grade was changed in 27 patients due to the result of ~(18)F-FDG hPET/CT in whom with 20 patients having their grade raised and 7 lowered. Radical treatment was changed to palliative treatment in view of a raise of staging grade. Because of distant metastasis was detected by ~(18)F-FDG hPET/CT imaging, 14 patients received palliative treatment. Compared with CT, 47 more lymph nodes and 26 distant metastases were found with ~(18)F-FDG hPET/CT imaging, and the patients in question received radiotherapy and palliative treatment accordingly. Conclusion ~(18)F-FDG hPET/CT imaging, by changing the clinical staging in 37.5% (27/72) NSCLC patients, has impact on treatment strategy and treatment planning of radiotherapy in NSCLC patients. Patients were frequently spared unnecessary treatment, and management was more appropriately targeted.

With the development of minimally invasive surgical technology, laparoscopic cholecysteeto-my, endoscopic retrograde cholangiopanereatography, endoscopic sphincterotomy and choledochoscopy were applied increasingly in the clinical practice. Based on the domestic and foreign literatures, this article re-viewes these minimally invasive surgical technologies.

Objective To evaluate the combination influence of the factors such as the ways to putting into the water, addition with multienzyme and temperature of water on the cleaning effect of ultrasonic cleaning of the curettage-aspiration device for uterine cavity. So that we can find out the best condition for cleaning, and provide the scientific evidence for the formulation of the norm of ultrasonic cleaning of the curettage-aspiration device for uterine cavity. Methods According to the factorial design with triple pathogens, three factors were chosen to complete the ultrasonic cleaning of the curettage-aspiration device for uterine cavity, including the sequence of putting into water, addition with multienzyme or not and the temperature of cleaning. The cleaning effect was detected by adopting the eye-measurement or with the hemoglobin reagent. Results The sequence of putting into water first or next had little influence on ultrasonic cleaning;the effect of addition with multienzyme was more significant than without it;the effect of water temperature at 35 centi-degree or 40 centi-degree had no difference. Conclusions It had good benefits for the cleaning effect when the ultrasonic cleaning of the curettage-aspiration device for uterine cavity added multienzyme to the cleansing solution, while the sequence of putting into water first or next and the temperature of water at 35 centi-degree or 40centi-degree shows little influence on the cleaning effect.

Objective To investigate the current status of health education among nursing undergraduates,to analyze the existing problems and to bring up corresponding strategies for improving the health education ability for nursing undergraduates.Methods Totally 381 nursing undergraduates were recruited and investigated with a self-designed questionnaire.Aspects of students' cognition of health education,influencing factors of health education and the implementation of health education in clinic were investigated.Data were processed using SPSS 12.0 and percentages were calculated.Resuits 98.75％ students understood the importance of heath education in nursing work.However,systemic training courses of health education for nursing undergraduates were insufficient in both colleges and hospitals.Meanwhile,clinical teachers' ability of health education was limited.Only 15.59％students provided health education for patients independently.Conclusions Nursing colleges and practicing hospitals should strengthen health education consciousness of nursing undergraduates,enhance faculty construction and should set up related courses to train the health education skills.

Objective To study the clinical efficacy of intra-operative implantation of I125 seeds to treat advanced pancreatic cancer.Methods We retrospectively analyzed the clinical data of 28 patients who underwent intra-operative implantation of I125 between January 2009 and June 2010 to treat advanced pancreatic cancer.Patients who received conservative treatment (n =136) at the same period were used as the control group.Results The mean tumor diameter was (5.7 ± 1.7) cm.The average number of implanted seeds were 50.There were no patients who suffered from pancreatic fistula or post-operative bleeding,and no patient died from the treatment.Twenty-five patients were regularly followed up,and the follow-up rate was 85.7％.The survival rates at one month,half a year and one year were 100％,70.8％ and 26.9％,respectively.The average survival time was (9.9 ± 1.4) months.The survival data were significantly higher than that in the control group.Conclusion Intra-operative implantation of I125 seeds was an efficacious treatment for patients with advanced pancreatic cancer.

Objective To study the value of MSCT angiography(MSCTA)in diagnosing lower extremities arterial disease (LEAD) of diabetic foot ulcers and analyze the possible influential factors on the onset of diabetic foot ulcers.Methods 80 diabetic patients for MSCTA examination were divided into two groups by whether combined with foot ulcers.The tibial artery calcification score (TACS) and peripheral arterial occlusion index (PAOI) were calculated and the possible risk factors of diabetic foot ulcer were analyzed.Results There were 30 cases suffered with foot ulcer and 18 cases occurred lower extremity arterial occlusion (LEAO), the average PAOI was 4.40(3.60, 5.75).Non-foot ulcer cases were 50, and there were 8 cases suffered with LEAO, the average PAOI was 2.05(1.43, 3.10).Compared to patients without foot ulcer, patients with foot ulcer were older, had a lower BMI, and were more likely to have a history of tobacco use.They usually had higher TACS and severer peripheral arterial occlusive disease (PAOD).Stepwise regression model showed that foot ulcers had significant correlation with TACS and PAOI.Partial correlation analysis showed TACS was independent from PAOI in impacting diabetic foot ulcer.Conclusion MSCTA has important clinical value in diagnosing and valuing diabetic foot ulcer LEAD.Age, smoking history,BMI,TACS and PAOI affect the incidence of diabetic foot ulcers, and TACS and PAOI are the independent risk factors for diabetic foot ulcers.

A method for the determination of 9 phenoxy acid herbicides in soil by solid phase extraction and LC/MS/MS with matrix correction was developed. The sample was treated by ultrasonic extraction twice with 1. 5% formic acid in acetonitrile. The extract was cleaned up with NH2 solid phase extraction column. A C18 column with formic acid in pure water/methanol mixture as the mobile phase was used under gradient elution. Mass spectral acquisition was done in negative ion mode by multiple reactions monitoring ( MRM ) . Two transitions per compound were used to provide qualitative and quantitative analysis. There were good linear relationships in the range of 2-250 μg/L for 9 phenoxy acid herbicides. The correlation coefficients were in the range of 0 . 9927-0 . 9972 . The method detection limits were in the range of 1 . 66-3 . 82 μg/kg . The average recoveries at three spiked levels ( 10 , 40 , 200 μg/kg ) ranged from 85 . 3% to 110 . 0% with the relative standard deviations (RSD) of 3. 2%-12%.

Objective To investigate the echocardiographic features in patients with right atrial myxoma and thus evaluate the value of echocardiog?raphy in the diagnosis of right atrial myxoma. Methods The echocardiographic findings of 20 patients with right atrial myxomas were retrospectively analyzed,and the echocardiographic features of these patients were summarized. Results The main clinical symptoms of right atrial myxoma includ?ed chest tightness,shortness of breath,lower limb edema,and syncope. Of these 20 patients,the echocardiography showed that the average size of the right atrial myxomas was 3.11 cm × 2.90 cm to 7.44 cm × 4.52 cm. The myxomas were round or oval shape in 15 patients(75%)and lobulated shape in 5(25%). The myxomas were attached to the atrial septum in 15 patients(75%)and to right atrial free wall in 25%of the patients. The aver?age width of the basement was 1.62±0.30 cm,and the width was greater than 1 cm in 80%of the patients had the width over 1 cm. Some myxomas had internal areas of calcification and anechoic cystic areas. The percentages of patients with the blocking of right atrium,tricuspid and pulmonary hy?pertension were 70%,50%,and 10%,respectively. Conclusion The echocardiographic features of right atrial myxoma were specific. Echocardiog?raphy can accurately assess the tumor and identify the secondary changes in cardiac structure and hemodynamics and thus provide evidence for time?ly and accurate diagnosis of right atrial myxoma.

Objective To effectually record cardiopulmonary resuscitation (CPR) procedure, analyze and compare the CPR performance of all medical and nursing staffs to find out the existed information for the improvement of the quality of CPR and its survival rate. Methods The medical data were collected according to the Utstein Criteria and CPR event was automatically recorded by a digital video-recording system, by which hands-off times within 10 minutes of CPR and times for installation of chest compression machine, establishment of endotracheal intubation and establishment of the venous channel were analyzed. Multiple regression analysis was conducted to analyze the factors affecting CPR effect. Results ① During the period from December 2009 to December 2015, a total of 376 patients with cardiac arrest (CA) was registered, including 248 males and 128 females, with a median age of 68 (53, 78) years. Estimated median time interval from CA to CPR initiation was 5.0 (0.1, 20.0) minutes and there were 189 cases less than or equal to 5 minutes. The acute myocardial infarction (AMI) with 145 cases (38.6%) was the main etiology of CA. Initial shockable rhythm was found in 16 patients (7.0%) out of 230 out-of-hospital cardiac arrest (OHCA) patients, of whom 13 underwent ventricular fibrillation (5.7%), 3 underwent ventricular tachycardia (1.3%). Initial shockable rhythm was found in 47 patients (32.2%) out of 146 in-hospital cardiac arrest (IHCA) patients, of whom 40 underwent ventricular fibrillation (27.4%), and 7 underwent ventricular tachycardia (4.8%). CPR by a mechanical device (Thumper) was performed in 219 patients (58.2%). In 376 patients, 186 patients had return of spontaneous circulation (ROSC, 49.5%), a successful CPR (ROSC ≥ 24 hours) was found in 110 patients (29.3%), 99 patients was hospitalized alive (26.3%) and 40 patients were discharged alive (10.6%). In 146 cases of IHCA, 89 patients had ROSC (61.0%), a successful CPR was found in 63 patients (43.2%), 56 patients were hospitalized alive (38.4%), and 29 patients were discharged alive (19.9%). In 230 patients of OHCA, 89 patients had ROSC (38.7%), 65 patients received pre-hospital CPR (28.3%), a successful CPR was found in 47 patients (20.4%), 43 patients were hospitalized alive (18.7%), and 11 patients were discharged alive (4.8%). There were 37 patients had a successful CPR (69.8%), and 25 patients were discharged alive (47.2%) in 53 patients with ventricular fibrillation. ② There were 77 patients with valid video information for analysis of CPR performance, with 48 patients of OHCA, and 29 patients of IHCA. Delay median time from the patients presence in the resuscitation room to be placed in rescue bed was 22 (0, 33) seconds. Hands-off median times during 10 minutes of CPR was 41 (18, 90) seconds. Thumper installment median times was 43 (31, 69) seconds. Median time for endotracheal intubation was 59 (35, 109) seconds. Median time of venous catheter placement was 112 (70, 165) seconds. It was shown by multivariate regression analysis that there was a significant correlation between estimated time interval from CA to CPR performed, hands-off time and success rate of CPR (t1 = -3.452, t2 = -2.729), rate of discharge alive (t1 = -2.328, t2 = -2.736, all P < 0.05). In 48 OHCA patients, success rate of CPR was significantly correlated with estimated time interval from collapse to CPR performed (t = -2.409, P = 0.021). In 29 IHCA patients, success rate of CPR and rate of discharge alive was significantly correlated with hands-off times (t1 = -3.412, t2 = -2.536, both P < 0.05). Conclusions Survival to hospital discharge following CA is significantly correlated with the time interval from collapse to CPR performed and hands-off times in CPR. Installment and usage of Thumper should be postponed in order to reduce hands-off times during CPR in IHCA.