Objective To investigate the influence of psychological intervention on the anxiety of patients with obstructive jaundice and supply theoretical reference for psychological evaluation and nutsing.Methods 129 patients with obstructive jaundice was divided into the intervention group(64 cases)and the control group(65 cases).The control group adopted routine treatraent method such as anti-infection,liver protection treatment,enhancement of coagulation mechanism and supporting treatment.The intervention group received psychological nursing,relaxation training and distraction of attention based upon routine nursing.The degree of anxiety and pruritus was obseved and recorded in the two groups.Results The degree of anxiety in the intervention group was evidently lower than that of the control group(P＜0.01).The degree of pruritus in the intervention group was 18.75%,which was statistically different from that of the control group(35.38%),P＜0.05.Condusion Adoption of psychological intervention could effectively reduce the degree of anxiety and pruritus of patients with obstructive jaundice.

Objective To summarize our experiences in the long-term continuous maintenance of the peripherally inserted central catheter (PICC) in a patient with intestinal fistula.Method The systematic holistic nursing care has been provided according to the nursing practices to a patient with intestinal fistula since 2006,during which eitht PICCs were used successively.Results The eight PICCs were placed for 3-14 months.The 1 st,3rd,5th,and 7th cathers were retained for 12,13,11,and 14 months.The second catheter was retained for 6 months,and then removed due to increased body temperature (38.7℃).The 4th cather was retained for 3 months,then catheter-related bloodstream infection was suspected due to high body temperature (39℃) ; culture for fungi at the tip showed positive results.The 6th catheter was retained for 7 months,inserting from jugular vein to the superior vena cava; however,it was removed due to puncture point local purulent changes at the puncture site.The 8th catheter was applied for 8 months,but was rmoved due to tube occlusion,which responded poorly to urokinase.Conclusion The application of PICC in patients with fistula can relieve the pain and improve the quality of life.

Objective To investigate the protective effect of compound Danshen dripping pill on cardiac function in elderly patients with advanced breast cancer after radiotherapy and chemotherapy.Methods 150 patients with advanced breast cancer from February 2015 to April 2016in our hospital were selected and randomly divided into observation group and control group,75 cases in each group.The patients in the two groups were treated with CEF chemotherapy(CTX+EPI+5FU),on the basis of observation group,the injection of compound Danshen dripping pill.Two groups of cardiac function E/A,LVEF status were observed and compared.The levels of cTnI,CK,CK-MB,SOD,GSH,MDA and peripheral blood T lymphocyte subsets were detected in the two groups,and observed the occurrence of adverse reactions in the two groups.Results After treatment,the serum levels of CK,MB-CK,cTnI,MDA and CD8+ were significantly decreased in the observation group,the difference was statistically significant(P<0.05),the CD4+,CD4+/CD8+,SOD,GSH,E/A,LVEF were significantly increased in the observation group,the difference was statistically significant(P<0.05).The level of cytokines and T lymphocyte subsets and cardiac function in the observation group were significantly better than those in the control group,the difference was statistically significant(P<0.05).The incidence rate of adverse reactions in the observation group(white blood cells,hair loss,nausea and vomiting)was significantlylower than that of the control group,the difference was statistically significant(P<0.05).Conclusion Compound Danshen dripping pills can protect the heart function of patients with advanced breast cancer after radiotherapy and chemotherapy.

Objective To investigate the value of the manipulative reduction monitored by ultrasound for the intussusception of children.Methods One hundred and three intussusception children were dynamically observed by ultrasound,and were pressed softly beginning with the head of the intussusceptum,and observed whether there was intestinal peristalsis, and whether the intussuseeptum shortened and disappeared finally.The results were analyzed based on the size of the masse, the length of the intussusceptum,and the patients' age,and compared with the X-ray high pressure air enema.Results Fifty (48.5 ％) intussusception children were recovered.The recoverability was related to the size of the mass, the length of the intussusceptum, and the age of the children (level of cooperation).Thirty-nine patients were recovered after reexamined one hour later.The recoverability of manipulative reduction monitored by ultrasound for the mass diameter less than 2.0 cm was obviously higher than that by X-ray high pressure air enema.Conclusions Manipulative reduction monitored by ultrasound could cure almost half of the intussusception children patients directly.It could decrease the number of patients who were treated with high-pressure air enema,it could relieve the pain of the children and reduce their medical expenses.It also could be acted as a screening way to other therapies like high pressure air enema.

Objective To observe the effect of body-weight supported treadmill training (BWSTT) on the lower limb motor function of elderly hemiplegia patients with acute cerebral infarction using semi-quantitative analysis of regional cerebral blood flow (rCBF) through single photon emission computed tomography (SPECT). Methods Seven patients with cerebral infarction were given comprehensive rehabilitation therapy for 10 weeks in three stages: a baseline period of 2 weeks ( conventional rehabilitation therapy), an intervention period of 6 weeks ( conventional rehabilitation therapy plus BWSTT) and a withdrawal period of 2 weeks (conventional rehabilitation therapy). During the intervention period the exercise duration increased gradually from 15 to 30 minutes, once a day, 5 times a week,for 6 consecutive weeks. Dynamic changes in rCBF in the cortex were observed with SPECT before and after treat ment. Results During the baseline period there was no significant change in average MWS (maximum walking speed) or BBS ( Berg balance scale) scores. During the intervention period both scores improved significantly. During the withdrawal period there were some changes in MWS and BBS scores, but they were not significant. There was a significant change in average rCBF in the cortex after treatment compared with before. Conclusions BWSTT is effective for improving the walking speed and balance of elderly patients with acute cerebral infarction. There is a positive correlation between the recovery of lower limb motor function and changes in rCBF in the cortex.

Objective To construct and express human ScFv against keratin in E.coli,and identify its binding activity with antigens and antigenic specificity.Methods By genetic engineering technology,human anti-keratin ScFv was constructed from Fab fragment selected from established semi-synthetic phage antibody library.The binding activity with antigens and antigenic specificity of expressed products were i-dentified by ELISA.Results Results of DNA sequence analysis showed that nucleotide sequence of V?and VH of ScFv gene was similar to that of V?and VH of Fab gene,suggesting that there was no mutation in the construction of ScFv.The soluble anti-keratin ScFv was found to have a good antigenic specificity as well as excellent binding activity with target antigens by ELISA.However,the binding activity of ScFv with keratin was lower than that of Fab.Conclusions The successful expression and identification of human an-ti-keratin ScFv might lay a solid foundation for further observation of biological activities of anti-keratin au-toantibody,manufacture of genetic-engineering anti-keratin products,and promotion of clinical application of genetic-engineering anti-keratin antibodies.

Aim To observe the production of anti-idiotypic antibodies directed against AK auto Ab in the rabbit sera after long-term, high dose allogenic AK auto Ab injection. Methods Allogenic AK auto Ab (5mg/kg)was injected intramuscularly to rabbit once every other day for 90 days. Anti-idiotypic antibodies in rabbit sera were detected by ELISA. Results Rabbits injected with AK auto Ab generated anti-idiotypic antibodies that could react to F(ab′ )2 of AK auto Ab. The titers of anti-idiotypic antibodies reached the highest levels at 4 weeks after the administration of AK auto Ab and then gradually decreased. Conclusion Rabbits could be induced to form immune tolerance when high-does allogenic AK auto Ab is administrated for long-term.

Objective To compare effect of three therapies( modified constraint-induced movement therapy (mCIMT), constraint-induced movement therapy (CIMT) and Bobath therapies)on the recovery of motor function in upper-extremities of patients with apoplexy hemiparalysis. Methods Fifty-seven patients with apoplexy hemiparalysis were randomly divided into CIMT treatment group ( n = 19), mCIMT group (n = 19) and Bobath group (n = 19). Patients in Bobath group exercised 2 h/d, 5 d/week for 6 weeks. CIMT group and mCIMT group had restriction of movement at the unimpaired upper extremity by placing it in a sling a whole day for training using impaired extremity. Patients in CIMT treatment group exercised 6 h/d,5 days a week for 2 weeks in a row; mCIMT treatment group exercised for 1 h/d, 3 days a week, and also exercised in daily life at least 2 hours every day, for ten consecutive weeks. The patients in all three groups were assessed for upper-extremities motor function using FMA of Fugl-Meyer, for recovery of upperextremities motor speed using STEF and for recovery of daily ability at respective time-points of pre-treatment and the second week, sixth week and tenth week of post-treatment. Results In 3 assessments in the 3 groups there was no obvious change before treatment, while the FMA score was 45. 2 ± 5.1 (F = 1. 107 ,P =0. 382), BI score was 63. 1 ± 10. 3 ( F = 0. 930, P = 0. 401 ), STEF score was 63.4 ± 8.6 ( F = 1. 843, P =0. 168). At the second week, sixth week and tenth week of the treatment, the difference of assessment in the three groups was significant. The improvement in CIMT group was better after 2 weeks treatment compared with Bobath and mCIMT group, while the Bobath group showed better results than mCIMT group did after 6 weeks treatment. After 10 weeks treatment, the FMA, STEF in mCIMT and CIMT groups were improved better than Bobath group, while the BI score in mCIMT group was better than that in Bobath and CIMT group. Conclusions The mCIMT and CIMT therapy are better in improving the upper limb function in stroke patients compared with Bobath, while the mCIMT therapy is more effective in improving the abilities of daily life in stroke patients compared with the other two treatments.

Objective To examine the clinical effect of phacoemulsification with foldable posterior chamber intraocular lens implantation (PC-IOL) in management of angle-closure glaucoma (ACG) with cataract. Methods Phacoemulsification with foldable PC-IOL implantation was performed in 31 eyes with ACG. The best corrected visual acuity (BCVA), intraocular pressure (IOP), anterior chamber depth (ACD) and anteior chamber angle width were measured and recorded preoperatively, 1 day, 1 week, 1 month and 3 months postoperatively. Results The mean IOP decreased significantly after surgery (P

Objective To investigate the role of transmembrane protein C0-029 in epithelial mesenchymal transition (EMT) induced by tumor necrosis factor alpha (TNFα) of intrahepatic cholangiocarcinoma (ICC) cells.Methods RT-PCR and Western blot were conducted to detect the CO-029 expression in ICC cells and tissues.The effect of CO-029 silencing by lenti-virus on EMT induced by TNFα was investigated.Western blot and mass spectrometry after immunoprecipitation were used to confirm whether TNFαR1 can directly or indirectly bind with CO-029 to form complexes in ICC.Results Differential expression of CO-029 was observed in ICC cells and tissues.The expression of CO-029 was significantly reduced by lenti-viral interference in ICC cells,resulting in the failure of TNFα to induce EMT.TNFαR1 in ICC could directly or indirectly form complexes with CO-029.Conclusion CO-029 mediates TNFα/TNFαR1 induced EMT in ICC,which might play an important role in the invasion and metastasis.