Objective To investigate the influence of support and intervention technique with multi-dimensions on uncertainty in illness for cancer children′s parents. Methods With convenience sampling method, a total of 74 cases of hematological malignant and solid tumor patients′ parents in Hematology and Tumor Centre of Children′s Hospital of Fudan University were selected. There were 35 cases in the intervention group, which were given multi-dimension-support and intervention technique for 8 weeks as well as regular chemotherapy and nursing care. There were 39 cases in the control group, who were only given regular chemotherapy and nursing care. The level of uncertainty in illness in both groups were evaluated after 8 weeks of the base-line investigation. Results The scores of uncertainty in illness reduced over time in both groups (F=95.402,P<0.01). After 8 weeks, the scores of the intervention group were lower than those of the control group (F=24.079,P < 0.01). Conclusions The all-round, multi-dimension and real-time techniques of support and intervention could decrease the level of uncertainty in illness for cancer children′s parents.

Objective To observe the changes of PECAM-1,Bcl-2 and Bax expressed by ischemic cerebrum of adult rats after focal cerebral ischemia. Methods Middle cerebral artery occlusion (MCAO) models were made by operation with Longa suture method in Wistar rats. The expression levels of PECAM-1,Bcl-2 and Bax at the 6th,12th,18th,24th,48th,72nd hour after MCAO were detected by immunohistochemistry staining. Results The expression levels of PECAM-1,Bcl-2 and Bax in cerebrum were significantly increased after MCAO. The expression levels of Bcl-2 we、re up to the peak at the 12th hour after MCAO, while the levels of Bax and PECAM-1 were up to the peak at the 24th and 48th hour after MCAO. At the 72nd hour after MCAO, the expression levels of PECAM.1.Bcl-2 and Bax were still higher than that in the control group(all P＜0.001).Conclusions PECAM-1,Bcl-2 and Bax participate in the different pathological stages of focal cerebral ischemia.

Objective To formulate job evaluation index system for clinical nurse specialist in comprehensive children′s hospital. Methods A total of 19 experts were consulted by two-round Delphi method to ensure the item of index system, the order and weight of each index was determined by hierarchy analysis. Results The evaluation index system included 5 level-1 dimensions, 13 level-2 dimensions and 30 level-3 items. The authority of the expert advisory coefficient was 0.84, determine coefficient was 0.91, familiarity cofficient was 0.77. The coordination coefficient of one, two, three indexes were 0.44, 0.52, 0.51, with statistical significance (P < 0. 05). Conclusions The job evaluation index system is reliable and valid, which can provide basis on job management.

Objective To introduce extrapedicular infiltration anesthesia as an improved method of local anesthesia which applied to unipedicular percutaneous vertebroplasty or percutaneous kyphoplasty.Methods From March 2015 to March 2016,20 patients in our hospital received percutaneous vertebroplasty or percutaneous kyphoplasty with 1％ lidocaine local infiltration anesthesia and extrapedicular infiltration anesthesia.The visual analogue score of patients during the operation and whether they needed additional sedative anesthesia were evaluated.The anaesthetic effect of nerve root block was observed.Results The visual analogue score of all the patients ranged from 1 point to 3 point,averagely (2.5 ± 0.7) point.Among the 20 patients,there were 2 cases of 1 point,7 cases of 2 point and 11 cases of 3 point.No patients required additional sedative anesthesia,and no nerve root block effects were observed.Conclusion Extrapedicular infiltration anesthesia provides good local anesthetic effects without significant complications,which deserved further use in unipedicular percutaneous vertebroplasty and percutaneous kyphoplasty.

Objective To explore the association of COX-2 Gly587Arg polymorphism with the risk of primary liver cancer.Methods Two hundred and seventy patients with primary liver cancer and 540 health people were selected as our subjects.DNA were extracted from peripheral blood lymphocytes,and genotypes were measured by polymerase chain reaction-restriction fragment length polymorphism method.Odds ratios(OR) and 95％ confidence intervals(CI) were estimated by logistic regression.Results Two kinds of genotype (587Gly/ Gly and Gly/Arg) were found in all participants.No one carried 587Arg/Arg genotype.Among primary liver cancer patients,91.5％ (247/270,) 8.5％ (23/270) of individuals carried 587Gly/Arg and Gly/Arg genotype,which was significantly higher than that of controls (96.5％ (521/540,) 3.5％ (19/540)).Multivariate Logistic regression analysis showed that individual carried 587Gly/Arg genotype had an increased risk of developing primary liver cancer (OR =2.56,95％ CI =1.37-4.79,P =0.003) compared with 587Gly/Gly carriers.Conclusion COX-2 Gly587Arg polymorphism is a risk factor for primary liver cancer in Han.

Objective To study the effect of intratumor angiogenesis and vascular growth factor(VEGF), basic fibroblase growth factor(bFGF), Platelet-derived growth factor (PDGF), and their receptors(flt-1 bFGFR.PDGFR) on the invasion, metaslasis of pancreatic carcimoma(PC) and the relationship between the expressions of three kinds of angiogenic factors, their receptors and microvessel count(MVC). Methods Tis- sue sections of 51 PC and 32 acute or chronic pancreatitis were examined by in situ hybridization for the expression of VEGF bFGF.PDGF, and by immunohistochemistry for the expression of the three kinds of angiogenic factor receptors and MVC. The correlation of the expressions and pathological characteristics of PC were also studied. Results The positive rate of VEGF mRNA,bFGF mRNA, PDGF mRNA and their receptors in PC were significantly higher than that in acute or chronic pancreatistis( P

Objective To compare the efficacy and safety of singular double antithrombotie therapy (DT) using warfarin plus clopidogrel and the combined antithrombotie therapy of 3-month triple antithrombotie therapy (TT) using warfarin, aspirinand clopidogrel and 9-month double antithrombotie therapy (DT) for the patients with atrial fibrillation undergoing PCI. Methods Ninety patients with atrial fibrillation undergoing PCI were randomly divided into two groups evenly: one group was treated with dual antithrombotic therapy group (DT) and the other group with the combined therapy, e. g. 3-month triple antithrombotie therapy (TT) and 9-month double antithrombotie therapy (DT + TT for short). All patients were followed-up by 12 months. The two groups were compared in terms of incidences of death , myocardial infarction , stroke , target-vessel revascularisation , stent thrombosis and bleeding adverse events. Results The incidences of myocardial infarction, stroke, target-vessel revascularisation , stent thrombosis and bleeding adverse events in the TT + DT group were all significantly lower than the DT group (P < 0.05). The follow-up on the safety indicated that the rate of bleeding in the TT +DT group was insignificantly higher than the DT group (P > 0.05). Conclusion There is no significant difference in safety between the two groups. However, the therapy of TT + DT is more effective.

Objective To compare the advantages and disadvantages of 3D BRAVO and TRICKS for detecting cerebral venous sinus thrombosis (CVST) and to explore the MR scanning methods on CVST.Methods A retrospective analysis was conducted on 40 patients who were diagnosed with CVST in the Fourth Affiliated Hospital of Kunming Medical University from January 2011 to June,2014.All the patients underwent TRICKS scan and 3D BRAVO examination and were classified into 3 groups based on dural venous sinuses,deep cerebral vein and superficial cerebral vein.Detection rates of TRICKS and BRAVO were evaluated and the results were analyzed.Result Detection rates of dural venous sinuses by TRICKS and BRAVO were 98.0％ and 100％ respectively.Detection rates of deep cerebral vein were 92.9％ and 100％ respectively.No significant difference was found (P＞0.05).Detection rates of superficial cerebral vein were 66.7％ and 100％ respectively.Significant difference was found between the two (P＜0.05) Conclusion BRAVO technology can clearly demonstrate the details of CVST,especially in superficial cerebral vein.With the combination use of TRICKS sequences,it will be of higher diagnostic value.

tomography angiography ( CTA) and T12-S1 vertebral computed tomography three-dimensional reconstruction were selected .The operative win-dows of L1 ~L2 OLIF were observed:the vascular window ,bare window ,psoas major window ,ideal operative window and actual operative win-dow.The operative windows ’ percentage accounted for ideal operative window were calculated ,the actual operative window based on an actual operative window of <1 cm,≥1 cm were statistically analyzed ,and the positions of the left renal artery and renal vein in front of operative window of L1 ~L2 OLIF were observed.Results The actual operative window was <1 cm in 2 cases (3.3%) and ≥1 cm in 58 cases (96.7%).In 58 cases,the difference was significant(P=0.008) in gender and men were more than women.The vascular window,bare win-dow and psoas major window accounted for the ideal operative window by 45%,43%and 12%,respectively ,and the actual operative window accounted for the ideal operative window by 55%.The left renal artery and renal vein's walking planes were at between the middle 1/3 of L1 to up 1/3 of L2 .There were 31 cases (51.7%) of the left renal artery being behind the left renal vein .Conclusion The regional anatomy of the operative window of L1 ~L2 OLIF has its own peculiarities,and not all L1 ~L2 levels are suitable for OLIF.The left renal vessels’ walk-ing planes were in front of L 1 ~L2 .Before L1 ~L2 OLIF surgery,surgeons should analyze the imaging anatomimy through imaging .

Objective:To study the efficacy of laparoscopic ovarian cyst aspiration in the treatment of neonatal simple ovarian cyst.Methods:From August 2019 to December 2021, infants with neonatal simple ovarian cyst receiving laparoscopic ovarian cyst aspiration in the Department of Pediatrics of Gansu Provincial Maternity and Child-care Hospital were retrospectively studied. The clinical characteristics, age of surgery, operation duration, length of hospital stay, complications and follow-up were analyzed.Results:A total of 6 full-term infants were included. Simple ovarian cysts were located on the right side of the body in 5 cases and on the left in 1 case. The average cyst diameter was (6.1±1.4) cm, the surgery were performed at 2~5 d of age, the average duration of the surgery was (18.8±2.4) min and the average hospital stay was (5.3±1.0) d. No complications occurred before or after surgery. All the 6 infants had favorable growth and development. The ovarian cysts were all enlarged again in 1 month after surgery, then gradually shrunk at 3 to 6 months after surgery and completely resolved in 2 cases.Conclusions:Neonatal simple ovarian cysts are more common on the right side of the body and laparoscopic ovarian cyst aspiration has good and safe clinical efficacy.