Primary breast lymphoma is a rare form of extranodal lymphoma with distinct characteristics.It comprises diverse histologic subtypes with diffuse large B-cell lymphoma (DLBCL) as the most common one.In this review,the primary breast DLBCL was focused and the definition,staging,the role of systemic chemotherapy,local adjuvant radiotherapy and rituximab in treatment of primary breast DLBCL were described.

Objective To discuss the systematic training method for new nurses in central sterile supply department(CSSD),in order to improve the training effects of new nurses and special practice ability,and make them to be qualified for jobs in CSSD.Methods 18 new nurses in CSSD were divided into the control group and the experimental group with 9 nurses in each group.The experimental group adopted systematic training method combining with unit tests and comprehensive evaluation.The control group chose the traditional training method.The testing results were compared between two groups.Results The experimental group all passed through the unit evaluation and comprehensive evaluation,could work independently after the training,got excellent achievement in comprehensive assessment of the department after 3 months on-the-job,and could finish all the work and solve various emergencies.4 passengers failed in unit assessment in the control group,and 3 failed in the comprehensive evaluation.The average results in the experimental group were obviously higher than that of the control group.Conclusions Scientific training content,the systematic training method,comprehensive evaluation method can avoid the blindness and arbitrariness in training and improve training effect.The implementation of unit access system and post access system in standardized training of new nurses can improve the study enthusiasm and strengthen the risk and responsibility consciousness of nurses,which is beneficial to the growth of new nurses and professional value guidance.

Acute respiratory distress syndrome (ARDS) patients experiencing protective mechanical ventilation, is associated with a marked mortality reduction. However, the incidence of acute cor pulmonale (ACP) in ARDS patients has recently been reported to range between 22% and 25%, as well as a trend for higher mortality. Therefore, the mechanical ventilation strategy is proposed, not only based on the protection of the lung, but also focused on the impact on the right ventricle function. Currently, point-of-care ultrasound has been widely practiced in a variety of clinical setting, which plays more and more important role in the early detection and management of ARDS and its complications. A retrospective study concerning the incidence, pathophysiology and risk factors for ACP patients in ARDS was done to analysis the application of lung ultrasound and echocardiography combined with lung ultrasound in clinical hemodynamics monitoring, and so as to optimize the ventilation setting to protect the function of lung and right ventricle. Further exploration of effective improvement of the pulmonary vascular and right ventricle function the goal-directed ultrasound approach, and the diagnosis and treatment flow is expected.

Mechanical ventilation is not only an important treatment method of acute respiratory distress syndrome (ARDS),but also one of the basic treatments in the intensive care unit (ICU).However,mechanical ventilation itself can cause or aggravate acute lung injury,which is called ventilator-induced lung injury (VILI).Currently,clinical pathogenesis of VILI includes four categories such as barotrauma,volutrauma,atelectrauma and hiotrauma.The pathogenesis of mechanical injury has been widely accepted,but the biological injury pathogenesis is unclear.With further research,we found that in the late stage VILI patients occured proliferation of puhnonary fibrosis,which may be formed by partial epithelial-mesenchymal transdifferentiation (EMT).Further study of specific pathogenesis of biotrauma and ARDS pulmonary fibrosis proliferation could provide new ideas for the clinical treatment of VILI.

AIM:To detect the muscle strength and endurance of healthy young people with different sport levels using isokinetic testing technique,so as to explore the characteristics of trunk muscle function. METHODS:①120 volunteer freshmen of Grade 2005 including 60 males and 60 females were selected from Capital Institute of Physical Education,and were divided into three groups:general group,physical training group and second-class athlete group(n =40,half male and female). Cybex6000 isokinetic testing system(U.S.A) was used. ②The muscle strength of flexors and extensors trunk muscle was measured at 60?/second and 120?/second and the endurance at 120?/second. ③Peak torque,flexors/extensors peak torque ratio,endurance ratio and recovery ratio were evaluated. RESULTS:①The peak torque values of male extensors in 3 groups were higher than those of flexors;with the increase in testing velocity,the peak torque value of extensor and flexors was decreased,especially the extensor. The peak torque value of general group was lower than that of physical training group and second class athlete group(P 0.05). The change in peak torque value of female extensor and flexors was the same to males. The flexors/extensors peak torque ratio at 60?/second and 120?/second of males was less than 1,but females more than 1. ②Under the same testing velocity,the endurance ratio and recovery ratio of extensor in 3 groups were higher than those of flexors. CONCLUSION:Compared with physical training students and second class athletes,significant decrease in the waist and back muscle strength and unbalance of extensor and flexors strength are found in general students. The muscle strength and endurance of extensor in students with different sport levels are inferior to those of flexors.

To observe the effect of Astragali Radix polysaccharides (APS) on the learning and memory functions of aged rats, in order to explore its mechanism for improving the learning and memory functions. Natural aging female SD rats were selected in the animal model and randomly divided into the control group, the APS low-dose group (50 mg x kg(-1)), the APS high-dose group (150 mg x kg(-1)) and the piracetam-treated group (560 mg x kg(-1)). They were orally administered with the corresponding drugs for consecutively 60 days. Besides, a young control group was set. The learning and memory functions of the rats were tested by the open-field test and the Morris water maze task. The Western-blot method was used to observe the levels of relevant neural plasticity protein N-methyl-D-aspartate receptor (NMDA receptor) in hippocampus, calcium/calmodulin dependent protein kinase II (CaMK II), protein kinase (PKA), the phosphorylation level of CAMP response element binding protein (CREB) and the protein expression of brain derived neurotrophic factor(BDNF). In this study, the authors found that the learning and memory functions and the hippocampus neural plasticity protein expression of the aged rat group were much lower than that of the young control group (P < 0.01). Compared with the aged rat group, the APS group showed the significant improvement in the impaired learning and memory functions of aged rats and the up-regulation in the hippocampus neural plasticity protein expression. The results showed that APS may improve the learning and memory functions of aged rats by increasing the expressions of relevant neural plasticity proteins.
Aging ; drug effects ; metabolism ; psychology ; Animals ; Astragalus Plant ; chemistry ; Brain-Derived Neurotrophic Factor ; metabolism ; Cyclic AMP Response Element-Binding Protein ; metabolism ; Drugs, Chinese Herbal ; chemistry ; pharmacology ; Female ; Hippocampus ; drug effects ; metabolism ; Humans ; Learning ; drug effects ; Memory ; drug effects ; Polysaccharides ; pharmacology ; Rats ; Rats, Sprague-Dawley ; Receptors, N-Methyl-D-Aspartate ; metabolism

To investigate the effect of propofol on the release of glutamate and gamma-aminobutyric acid (GABA) from rat hippocampal synatosomes, synaptosomes was made from hippocampus and incubated with artificial cerebrospinal fluid (aCSF). With the experiment of Ca(2+)-dependent release of glutamate and GABA, dihydrokainic acid (DHK) and nipectic acid were added into aCSF. For the observation of Ca(2+)-independent release of glutamate and GABA, no DHK, nipectic acid and Ca2+ were added from aCSF. The release of glutamate and GABA were evoked by 20 micromol/L veratridine or 30 mmol/L KCI. The concentration of glutamate and GABA in aCSF was measured by using high-performance liquid chromatography (HPLC). 30, 100 and 300 micromol/L propofol significantly inhibited veratridine-evoked Ca(2+)-dependent release of glutamate and GABA (P < 0.01 or P < 0. 05). However, propofol showed no effect on elevated KCl-evoked Ca(2+)-dependent release of glutamate and GABA (P > 0.05). Veratridine or elevated KCI evoked Ca(2+)-independent release of glutamate and GABA was not affected significantly by propofol (P > 0.05). Propofol could inhibit Ca(2+)-dependent release of glutamate and GABA. However, it has no effect on the Ca(2+)-independent release of glutamate and GABA.
Anesthetics, Intravenous/pharmacology ; Calcium/metabolism ; Glutamic Acid/*biosynthesis ; Hippocampus/*metabolism ; Propofol/*pharmacology ; Rats, Sprague-Dawley ; Synaptosomes/*metabolism ; gamma-Aminobutyric Acid/*biosynthesis

Objective:To establish the median databases of serum markers for Down's syndrome screening during the second trimester of pregnancy women in the north-central area of Jiangxi Province.Methods:Time-resolved fluorometry was used to detect the serum contents of AFP free β-hCG and uE3 in 57 548 pregnant women during 15-20 gestational weeks.Risk evaluation was conducted by LifeCycle 4.0.SAS 9.2 software was used to establish a model of the median fitted equation.The newly constructed median system was used to reassess the risk of Down's syndrome development in pregnant women.Results:The medianand built in medianof north-central region in Jiangxi Province are significantly different (Z=2.201,P=0.028).The relationship between the median of the triple index and the gestational age was analyzed by the weight regression model.The relationship between the MoM value and the weight was used to calculate the reciprocal model.The median of the new system was more efficiency than the built in median.In the median of the new system than the reference,the detection rate improved from 62.75％ to 72.55％,false positive rate reduced by 5.84％ to 4.94％.Conclusion:The newly constructed median system is suitable for Down's syndrome screening in the north-central region of Jiangxi Province.

Objective To explore the causes of nosocomial infections in ICU as to provide scientific evidence for the corresponding intervention measures.Methods The retrospective survey was used to investigate and analyze the incidence of nosocomial infections in ICU from 2013 to 2014.Results The total of 1225 patients investigated,182 patients suffered from nosocomial infections and the nosocomial infections rate was 14.86％.The etiology of ICU specimen was 95.22％.Gram negative bacilli,Gram positive bacteria and fungi,which accounted for 69.16％,18.22％ and 12.62％ respectively.The main infection site were respiratory tract,blood and urinary tract,which accounted for 70.43％,11.30％ and 4.78％ respectively.Conclusion The hospital infection rate of ICU in our hospital is kept the same level of the hospital in the same area.Etiology specimens rate comply with national standards.Main pathogens are gram negative bacilli,and the main site of infection is respiratory.

Objective To investigate the effect of circadian rhythm on the duration of neuromuscular blockade (NMB) elicited by atracurium. Methods Sixty-one ASA Ⅰ or Ⅱ patients aged 18-55 yr with body mass index of 18-24 kg/m2 undergoing general anesthesia were enrolled in this study. Anesthesia was induced with fentanyl 2 μg/kg and propofol 2 mg/kg. Atracurium 0.75 mg/kg was injected iv as soon as the patients lost consciousness . NMB was assessed by TOF-stimulation of ulnar nerve using TOF-Watch(R) SX. Tracheal intubation was performed as soon as the first twitch (T1) disappeared. The patients were mechanically ventilation (VT 6-8 ml/kg, RR 12 bpm, I ∶ E 1.0 ∶1.5). PETCO2 was maintained at 35-45 mm Hg. Anesthesia was maintained with continuous infusion of propofol 6-8 mg·kg-1·-1·-1and remifentanil 0.25-0.50 μg·kg-1·min-1 . Anesthesia was performed at 5 time periods: (1) 8:00-11:00, (2) 11:00-14:00, (3) 14:00-17:00, (4) 17:00-20:00 and (5) 20:00-23:00. The duration of NMB produced by atracurium was defined as the interval between the end of atracurium injection and 3% recovery of T2 . The data were analysed using generalised linear models (GLMs) and cosinor method. Results Fifty-three cases completed the study. GLM analysis showed that the duration of NMB was longest at 20:00-23:00 (53 min (95% confidence interval 50-56 min)) and shortest at 11:00-14:00 (43 min (95% confidence interval 39-46 min)), suggesting that there is a significant diurnal variation in the duration of NMB elicited by atracurium. Cosinor method analysis showed that equation of the duration of NMB and time point of atracurium administration was y = 48.05 + 15cos( 15t + 52.66). Conclusion Circadian rhythm can affect the duration of NMB elicited by atracurium, which shows that the duration of NMB is longest at 20:00-23:00 and shortest at 11:00-14:00.