ObjectiveTo investigate the nursing key points to 8 end-stage ovarian cancer patients with totally implantable venous access ports.Method The totally implantable venous access ports were used in the 8 patients and nursing was carried out to them.Result There were no occurrences of infection,leakage,seepage,pipe obstruction and the needlepoint shift.Conclusions The ovarian cancer patients in the end-stage had very low resistance and high risk of infection.Individualized nursing care to them may ensure the use of the ports in a safe way.

Aim To investigate the effects of miR-122a on blood-spinal cord barrier after spinal cord ischemia-reperfusion injury in rats.Methods Thirty-six SD rats were randomly divided into three groups:group of sham(S group),group of control(C group)and group of miR-122a antagomir(M group).Rats in S group were subjected to exposure of aorta arch but without occlusion.Spinal ischemia-reperfusion injury was induced by clamping the aorta arch for 14 min in C group and M group.Rats in M group and C group were intrathecally injected with miR-122a antagomir or antagomir control daily for three times after injury.The miR-122a expression in injured spinal cord tissue was detected by real-time PCR.The occludin expression in injured spinal cord tissue was detected by Western blot.The permeability of blood-spinal cord barrier was examined using evans blue as a vascular tracer.The neurological motor function was evaluated by Basso Beattie Bresnahan score.Results Compared with S group,the expression of miR-122a was increased,the expression of occludin was decreased,the permeability of blood-spinal cord barrier was increased,and neurological motor function score was decreased significantly in C group(P<0.05).Compared with C group,the expression of miR-122a was decreased,the expression of occludin was increased,the permeability of blood-spinal cord barrier was decreased,and neurological motor function score was increased significantly in M group(P<0.05).Conclusion miR-122a can regulate the expression of occludin and change the permeability of blood-spinal cord barrier.

Objective To observe the difference of sCD40L level in different subtypes of coronary heart disease,and to explore the clinical value of CD40 ligand in identification for the acute coronary syndrome(ACS).Methods The patients with coronary heart disease(CHD)and the heathy controls in the First Affiliated Hospital of Harbin Medical University from Jan,2006 to June,2006 were enrolled in the study.CHD group included ACS and stable angina patients.Enzyme-linked immunosorbent assay was used to measure the serum sCD40L level in three groups;t-test and receiver operateing characteristic curve were used to analyze the results.Results sCD40L level was significantly higher in patients with ACS[(2.39?0.37)?g/L]than stable angina patients[(1.89?0.16)?g/L,P0.05.The ROC curve demonstrated that using the concentration of sCD40L 2.01 ?g/L as the boundary to diagnose ACS,sensitivity of this marker was 0.91 and specificity was 0.80 respectively,and area under the curve(AUC)was 0.907.Conclusion sCD40L level which is more than 2.01 ?g/L has important significance for the diagnosis of ACS.

Objective To observe the effect of comprehensive rehabilitation on breast cancer related lymphedema. Methods 70 patients with breast cancer related lymphedema were divided into experiment group (n=35) and control group (n=35). Both groups received intermittent pneumatic compression, while the experiment group received comprehensive rehabilitation including manual lymphatic drainage, muscle stretching, expanded the range of motion of shoulder, gradual resistance training, high frequency electrical therapy and health education. They were assessed with Disabilities of Arm, Shoulder and Hand Scale (DASH) and development of lymphedema before and 8 weeks after treatment. Results DASH scores and the development of lymphedema improved in both groups after treatment (P<0.05), and improved more in the experiment group than in the control group (P<0.05). Conclusion Comprehensive rehabilitation can further relieve breast cancer related lymphedema, and improve the upper extremity function.

Objective To investigate the surgical treatment and prognosis of bronchial mucoepidermoid cancer. Methods During a 17-year-period, 19 consecutive patients underwent surgery for bronchial mucoepidermoid cancer, and the surgical treatment and prognosis were analyzed retrospectively. Results Among them, 13 cases were treated by lobectomy, 5 by pneumonectomy, and 1 by exploratory thoracotomy. Four cases were proved pathologically to be high malignancy and 15 low malignancy. All patients were followed up postoperatively for about 68.26 months on average. The 1, 3, and 5-year survival rates were 94.44%, 80.00%, and 70.00% respectively. In the low malignancy group, the 1, 3, 5-year survival rates were 100%; in the high malignancy group, the 1-year survival rate was 33.33%, and 3-year survival rate was 0. Conclusion Patients with low malignant grade of cancers can be cured after complete resection, and those with high malignant grade predispose to metastasis and hence result in a poor prognosis.

Kawasaki disease (KD) is an acute systemic vasculitis that primarily affects young children aged from 6 months to 4 years.KD may lead to coronary artery abnormalities in 25％-30％ of the children.The timely use of high dose intravenous immunoglobulin (IVIG) can significantly reduce the incidence of coronary artery aneurysms.Most clinicians use IVIG combined with aspirin as conventional therapy.But how to deal with those IVIG-resistant patients is a dilemma.With the deepening of research,many researchers have found that some second-line or third-line drugs such as corticosteroids,tumor necrosis factor-α inhibitors,and calcineurin inhibitors work better,and can effectively reduce the complication rate.The recent advances of the treatment of KD were summarized in this paper.

ObjectiveTo evaluate the therapeutic effect and toxicities of gemcitabine combined with cisplatin in the treatment of advanced or metastatic transitional cell carcinoma (TCC) of urinary tract. Methods Eighteen patients with advanced or metastatic TCC of urinary tract (15 cases of bladder TCC,2 of renal pelvic TCC,and 1 of ureteral TCC),who were pathologically confirmed,were treated with GC regimen (gemcitabine 1000 mg/m 2,iv infusion on day 1 and day 8;cisplatin 30 mg/m 2,iv infusion on day 2,day 8 and day 9).Before treatment, Karnofsy score for each patient was evaluated with a result of ≥60;liver and renal functions and blood routine test were normal.GC regimen was repeated for 2-3 cycles every 3-4 weeks and the response rate was evaluated.ResultsThree patients (16.7%) had complete response; 7(38.9%), partial response;5(27.8%),no response;and 3(16.7%) had progression.The overall response rate was 55.6%. The main toxic effects included decrease in white cell count (10 cases),anemia (7),nausea and vomiting (10) and constipation (8),which were mild or moderate and disappeared after stopping treatment.No chemotherapy-associated death occurred.ConclusionsGemcitabine combined with cisplatin in the treatment of advanced or metastatic transitional cell carcinoma of urinary tract is effective,and the toxicity is mild and tolerated. It is suggested that GC regimen can be used as the first line chemotherapy.

Objective To observe the clinical efficacy of point injection at Xialiao point (BL 34) for levator ani syndrome. Methods A hundred levator ani syndrome patients were randomly allocated to a treatment group and a control group, 50 cases each. The treatment group received point injection at Xialiao point (BL 34) and the control group was intervened by biofeedback therapy. The Visual Analogue Scale (VAS), component scores of the MOS 36-item Short-From Health Survey (SF-36), anal resting and squeeze pressures were recorded in the two groups before and after the treatment. The therapeutic effects and therapy costs were compared between the two groups.Results The VAS, component scores of SF-36, anal resting and squeeze pressures were significantly changed after intervention in the two groups (P<0.05). After treatment, the VAS, a part of the SF-36 score [physiological function (PF), body pain (BP), vitality (VT) and social function (SF) scores], anal resting and squeeze pressures in the treatment group were significantly different from that in the control group (P<0.05). The total efficacy rate was 88.0% in the treatment group versus 80.0% in the control group, and the difference was statistically significant (P<0.05). The therapy costs in the treatment group were (327.31±13.42) RMB and (408.45±21.56) RMB in the control group, and the difference was statistically significant (P<0.01).Conclusions Point injection at Xialiao point (BL 34) is an effective method for levator ani syndrome.

Objective To retrospective analysis of the clinical effect and complications of the semi-laminectomy approach on the treatment of intra-spinal tumor.To summarize the endoscopic treatment experience of intra-spinal tumor.Methods To retrospective analysis of the clinical data of 24 cases with intra-spinal tumor in Shanxi Provincial People's Hospital from January 2008 to September 2015.The diagnosis of the intra-spinal tumor was confirmed by preoperative MRI examination.Intraoperative application of endoscopic surgery in the resection of tumor.Longterm followed up of patient was implemented and observe the efficacy and complications after surgery.Results Postoperative symptoms of all patients have different degrees of improvement,the degrees of sensory disorder was reduce,the limb muscle strength was increased and alleviate the damages of nerve electrophysiology.No serious complications were found after operation.Of the 24 patients,17 cases were total resection of the tumor and 7 cases were subtoal resection of the tumor.Tethered cord release was operated in patients with tethered spinal cord.Conclusions Endoscopic resection assisted semi-laminectomy approach of intra-spinal tumor has slight damage to the surround structures and the impact to the anatomy of the spine was small.Endoscopic assisted semi-laminectomy approach may have siginficant clinical effect on intra-spinal tumor,and have good security.

Objective To investigate ultrasonographic features of primary and metastatic ovarian yolk sac tumors.Methods Ultrasonographic features of 19 primary lesions and 33 metastatic lesions in 35 patients were retrospectively analyzed.Results Primary tumors were sized (14.6±3.6)cm in maximum diameter,manifesting as cysti-solid masses.Solid components of primary tumors were mainly hypoechoic or isoechoic(16/19)with rich blood supplies.Thirty-three metastatic lesions were located in pelvoceliac cavity(26/33) and liver parenchyma(7/33),sized (9.4±4.5)cm,(9.2±4.9)cm and (5.6±1.6)cm in maximum diameter respectively.Metastatic lesions in pelvoceliac lesions mainly demonstrated as hypoechoic masses(21/26), however lesions in the liver were mainly hyperechoic(5/7).Anechoic regions could be found in 9/26 of the pelvoceliac lesions.Blood supply was found less rich in metastatic masses than that in primary ones.Elevated serum level of alpha fetoprotein (AFP) was observed in all patients; ranging from 217 to 211 682 μg/L.Conclusions Primary and metastatic lesions of ovarian yolk sac tumor have obvious ultrasonographic characteristics.Combined with serum AFP level,the accuracy of diagnosis could be improved.