Objective To study the nursing of totally endoscopic coronary artery bypass grafting (TECAB)using da Vinci robot.Methods 60 patients who accepted TECAB from January 2007 to December 2010 were selected.All patients underwent coronary arteriography,which showed severe stenosis in left anterior descending artery(LAD).8 of them complicated with right coronary artery stenosis or left circumflex coronary (LCX)stenosis.All patients were given education and nursing care from admission to discharge.Results After operation,angina pectoris alleviated in all cases,no surgery-related complications occurred.The bridge vessel was all cleared.All patients were discharged after rehabilitation.Conclusions Totally robotic TECAB is a new minimally-invasive surgery.Perioperative education is important.In early postoperative course,nurses should pay attention to bleeding condition of drainage and pulmonary nursing.Early postoperative exercise is a must,which can promote the recovery of all systems.

OBJECTIVE:To prepare Xiaozhong zhitong cataplasma,establish a method for its quality control and to observe its clinical efficacy on orthopedic patients(30 cases).METHODS:Based on the precompounded prescription order of Xiaozhong zhitong powder with water soluble polymer substance as base material which were evenly mixed with the drug extractives before being applied on non-woven fabric to prepare Xiaozhong zhitong cataplasma.The clinical efficacy was compared between the trial group(Xiaozhong zhitong cataplasma) and the control group(Xiaozhong zhitong powder).RESULTS:The prepared Xiaozhong zhitong cataplasma had smooth surface and uniform thickness,with a satisfactory stability achieved within 3 months at a dosage of 0.715 6 g?100 cm-2.The total effective rate in the trial group(93.3%) was significantly higher than in the control group(76.7%)(P

OBJECTIVE:To investigate the use of antibiotics in the inpatients of our hospital.METHODS:The medical records of inpatients from Jan.2004 to Dec.2006 randomly selected in our hospital were analyzed statistically in respect to the irrational use of antibiotics.RESULTS:Of the total 1,120 inpatient medical records examined,843(75.3%) used antibiotics,56 involved irrational use of antibiotics,which manifested as improper in dosage,dosage regimen,drug combination or solvents selection etc.CONCLUSION:The irrational use of antibiotics is quite common,thus the role of clinical pharmacists should be strengthened to promote rational use of antibiotics in clinical practice.

Objective To investigate the effect of deltaNp63(ΔNp63) silencing on the proliferation of pancreatic cancer PANC1 cells.Methods ΔNp63 mRNA level in 23 pairs of pancreatic cancer and adjacent tissue specimen was detected by real-time PCR, andΔNp63 protein in human normal pancreatic ductal cell line HPDE6-C7 and pancreatic cancer cell line PANC1, CFPAC1 and BXPC3 was detected by Western blot. PANC1 cells were transfectedΔNp63 specific siRNA (ΔNp63-siRNA ) and scramble siRNA ( Con-siRNA ) using liposome, and untransfected cells served as control.ΔNp63 mRNA and protein was detected by real-time PCR and Western blot to validate the silencing ofΔNp63 expression.MTT assay and BrdU method were used to detect the proliferation and DNA synthesis of transfected PANC1 cells.Results TheΔNp63 mRNA expression in pancreatic cancer tissues and matched adjacent normal tissues was 0.99 ± 0.07 and 0.70 ±0.07, respectively.ΔNp63 mRNA expression in pancreatic cancer tissue was significantly up-regulated compared with that in the normal tissue (P=0.0034).TheΔNp63 protein expression in HPDE6-C7, PANC1, CFPAC-1 and BxPC3 cells was 0.97 ±0.09,3.06 ±0.16,2.57 ±0.11 and 2.45 ±0.08, respectively.TheΔNp63 protein level in pancreatic cancer cells were higher than that in HPDE6-C7 cells (P<0.001).ΔNp63 mRNA level in control, Con-siRNA and ΔNp63-siRNA group was 0.97 ±0.07,0.97 ±0.07 and 0.28 ±0.03, respectively, andΔNp63 protein expression level was 0.97 ±0.06,1.00 ±0.10 and 0.26 ±0.03.The expression ofΔNp63 mRNA and protein inΔNp63-siRNA group were significantly down-regulated comparing with those in Con-siRNA group (P<0.01).Significant inhibition on cell proliferation was observed in ΔNp63-siRNA group, which was statistically different from that in control and Con-siRNA group.The A490 value (DNA synthesis) of control, Con-siRNA andΔNp63-siRNA group was 0.55 ±0.04, 0.56 ±0.01 and 0.55 ±0.00 at 24 h after transfection, and 0.84 ±0.05,0.87 ±0.07 and 0.71 ±0.05 at 48 h after transfection.The DNA synthesis inΔNp63-siRNA group was significantly down-regulated compared with that in control and Con-siRNA group (P<0.05).Conclusions Knockdown ofΔNp63 could greatly inhibit the proliferation and DNA synthesis of pancreatic cancer PANC1 cells.

Objective To investigate the effectiveness of problem-based learning in the biochemistry teaching in merging class of minority and Han students.Methods Totally 460 clinical medical students were divided into PBL group which contained 252 students and the traditional teaching group which involved 208 students,respectively.According to each team of seven to eight students,minority and Han students randomly arranged.Control group used classroom teaching mode,experimental group in addition to classroom lectures,had additional 12 hours of PBL teaching,but the theory classes for the two groups of students were taught by the same six teachers with rich teaching experience,and the teaching content and teaching material selection were also the same.At the end of the course,the learning outcomes were evaluated by using descriptive analysis and t test (α=0.05) based on the combination of theoretical examination,experimental practice and the questionnaire survey method.Results Compared with the traditional teaching group,the final scores were higher than those of PBL group (84.72 ± 6.99 and 80.34 ± 7.12,P＜0.05).There were also statistically significant between two groups according to different nationality(Minority:85.65 ± 5.27 and 79.70 ± 7.14;Han:83.91 ± 8.26 and 80.95 ± 7.08;P＜0.05),and interestingly the increased ratio of scores was higher in minority than that in Han.The questionnaire surveys indicated that the PBL teaching method could enhance professional and comprehensive qualities of students and more than 81.83％ students were satisfied with the new teaching mode.Conclusions The combination of tradition and PBL-based teaching methods improved the quality of biochemistry teaching of clinical medicine in merging class of minority and Han students in Xinjiang Medical University.

Objective To evaluate the influences of prostate-specific antigen (PSA) and digital rectal examination (DRE) to the detection rate,stage and Gleason grade of prostate cancer.Methods Retrospective analysis was performed on the prostate biopsy data of Beijing hospital from January 1997 to December 2010.The spearman rank correlation was applied to evaluate the relationship of PSA and DRE to the parameters related to the prostate cancer.Results The PSA had significant correlation with cancer detection rate,stage and Gleason grade (r =0.537,P ＜0.0001; r =0.365,P ＜0.0001; r=0.556,P ＜0.0001).However,DRE had only correlation with cancer detection rate and Gleason grade (r =0.212,P ＜0.0001 ; r =0.126,P =0.02).As the PSA increased,when divided into different groups,the cancer detection rate and the proportion of patients with Gleason 7-10 increased whereas the localized cancer rate decreased.DRE positive patients had higher cancer detection rate when PSA was in 10.0-19.9 μg/L and 20.0-99.9 μg/L groups.The DRE results had no influence to the stage or Gleason grade in same PSA group.Conclusions PSA has significant correlation with prostate cancer detection rate,stage and Gleason grade.However,the DRE results only affect cancer detection rate in some PSA level.

Objective To explore the diagnostic value of 18F-FDG PET/CT delayed imaging after induced diuresis for primary bladder tumor.Methods Fourteen patients (12 males,2 females; age range 35-88 years) with pathologically confirmed primary bladder tumor (clinical stage T1.3N0M0) were retrospectively analyzed.All patients underwent standard 18F-FDG PET/CT followed by a delayed (2.5-3.0 h later)pelvic imaging post intravenous injection of 20 mg furosemide and oral intake of 600 ml water.A positivelesion was defined as the uptake of 18F-FDG greater than the urine radioactivity and negative as equaled to or less than the urine radioactivity.Diagnostic efficacy of 18F-FDG PET/CT was calculated with pathology as the gold standard.Mann-Whitney u test was used to analyze data.Results There were 12 malignant (11 urothelium carcinomas and 1 squamous cell carcinoma) and 2 benign tumors (papillary epitheliomas).On standard PET/CT imaging,3 of 12 malignant lesions showed increased metabolism of 18F-FDG and the other 9 were false negative; while the 2 benign tumors showed no abnormal 18F-FDG uptake.The sensitivity,specificity,and accuracy of 18F-FDG PET/CT were 3/12,2/2 and 5/14,respectively.Sizes of the 3 18F-FDG-avid malignant lesions were greater than those of other 9 18F-FDG-negative lesions (26,30,35 mm vs (15.6±6.3) mm; Z=-2.315,P＜0.05).The sensitivity,specificity,and accuracy of delayed pelvic imaging were 11/12,2/2,13/14,respectively.Conclusion 18F-FDG PET/CT delayed imaging after diuresis has a high diagnostic efficacy for primary bladder tumor.

Objective To explore the diagnostic value of delayed 18 F?FDG PET/CT pelvic imaging after forced diuresis in detecting male patients with locally recurrent rectal cancer. Methods Thirty?two male patients ( 32-79 years) with clinically suspicious recurrences of rectal cancer were retrospectively ana?lyzed. All patients underwent a standard 18 F?FDG PET/CT followed by a delayed pelvic imaging after 2.5 h of administration of 20 mg furosemide intravenously and extra water intake of 500 ml at least. Final diagnosis was made by pathology or clinical follow?up (>10 months ) . Diagnostic efficiency of 18 F?FDG PET/CT standard and delayed pelvic images were calculated and compared. χ2 test was used for data analysis. Re?sults A total of 25 patients were diagnosed with recurrent rectal cancer, including 10 cases with invasion of surrounding tissue, and 5 cases with metastases. Among the 7 patients without local recurrences, 2 had dis?tant metastases. The sensitivity, specificity, and accuracy of standard FDG PET/CT were 92.0%(23/25), 3/7, 81.2%(26/32), respectively. The corresponding values of the delayed imaging were 96.0%(24/25), 6/7, and 93.8%(30/32), respectively. The specificity of delayed imaging was higher than that of standard FDG PET/CT (χ2=14.333, P<0.05) , but no significant differences were found in sensitivity and accuracy between the delalyed imaging and standard FDG PET/CT (χ2=0.085 and 0.966, both P>0.05) . The urina?ry bladder activity reached or approached the background during the delayed imaging. Twenty?two malignant lesions of surrounding invasion were confirmed. The positive rate of delayed imaging was higher than that of standard FDG PET/CT:95.5%(21/22) vs 63.6%(14/22);χ2=6.400, P<0.05. Conclusions 18F?FDG PET/CT delayed pelvic imaging after diuresis and hydration is useful for eliminating the artifacts from urina?ry bladder activity, and for detecting the invasion to the rectal surrounding tissue more effectively. It could be a supplement to standard FDG PET/CT.

Objective:To investigate the effects of Mor-platin, a novel mitochondrial platinum complex, on proliferation and migration of human hepatoma carcinoma HepG2 cells. Methods:Cell counting kit-8 (CCK-8) assay was used to analyze cell proliferation of Mor-platin and classic anticancer drugs, particularly cisplatin, in HepG2 cells. A laser confocal microscope was used to observe whether Mor-platin can target mitochondria. The morphological changes in cellular mitochondria after treatment with Mor-platin were ob-served on a transmission electron microscope. Cell apoptosis was measured by flow cytometry, and cell invasion was evaluated by three-dimensional tumor spheroid model. Results:Mor-platin can inhibit cell proliferation and is dose dependent. The half inhibitory concentration (IC50) of Mor-platin is lower than that of cisplatin. Laser confocal images showed that Mor-platin can target cell mito-chondria and enrich cell mitochondria. Transmission electron microscopy images showed that cell mitochondrial morphology changed after Mor-platin treatment. Furthermore, cell mitochondrial membrane is incomplete and mitochondrial cristae are reduced. Cell apoptosis caused by Mor-platin is dose dependent. The three-dimensional tumor spheroid model showed that the cell areas of the group subjected to Mor-platin treatment are smaller than those of the control group. Conclusion:Mor-platin can target cell mitochon-dria, change the cell mitochondrial morphology, inhibit cell proliferation, and thus promote cell apoptosis. It also showed better anti-cancer effects than cisplatin. Furthermore, Mor-platin can inhibit three-dimensional tumor spheroid invasion. These results suggest that Mor-platin is a potential antitumor drug.

Objective　To verify the safety and feasibility of applying transperitoneal laparoendoscopic single-site surgery (LESS) nephrectomy in the treatment of kidney malignant and benign diseases.Methods　From Nov.2010 to Jun.2012,we had used LESS nephrectomy technique treated four kidney tumors,one renal pelvic tumor and one atrophic kidney. Quadport was introduced into abdominal cavity through a paraumbilical incision. Conventional laparoscopic instruments,prebent laparoscopic instruments and flexible tip 5mm laparoscope were used. The standard laparoscopic transperitoneal nephrectomy technique was then performed.We evaluated this technique in respects of operative time,estimated blood loss,intraoperative complications,1st post-operative day pain (VAPS),drainage time,post-operative hospital stay and pathological results.　Results　The 6 procedures in this group were completed successfully with LESS nephrectomy. There was no additional trocar added,no conversion to conventional laparoscopic or open surgery.Application of Quadport and prebent instruments reduced the clash of instruments,both intracorporally and extracorporally.The average operative time were 181.7 (145.0 -235.0) min,average estimated blood loss were 78.3 (20.0 - 150.0) ml.There was no severe intraoperative complication.The average VAPS in the first post - operative day was 1.7 ( 1.0 - 2.0).The average drainage time was 2.8 ( 1.0 -4.0) d,post-operative hospital stays was 6.8 ( 1.0 - 10.0) d.There was no secondary bleeding or wound infection.Pathological results showed 3 cases of renal clear cell carcinoma,1 case of chromophobic carcinoma,1 case of high-grade urothelial carcinoma and 1 case of atrophic kidney.All the specimens in this group were surgical margin negative.　Conclusions　LESS nephrectomy is a safe and feasible treatment option for the treatment of kidney surgical diseases.