Objective To evaluate the cooperation and nursing during esophageal variceal ligature with painless endoscopy.Methods The cooperation and nursing intervention of 290 patients with esophageal varices treated with painless endoscopic loop ligature from January to December 2009 were analyzed retrospectively.Results The treatment of 290 patients were succeessful.There was no anesthetic accident and serious complication.The treatment was successfully completed in the safe,calm and comfortable painless condition.Conclusions Esophageal variceal ligature with painless endoscopy is a safe and painless method which is easily accepted by patiens.The key point of the successful treatment is close cooperation and the deliberate nursing.

Objective:To analyze the levels of arachidonic acid (AA)and docosahexaenoic acid (DHA)in the breast milk of lactating mothers in Changchun City of Jilin Province, and to explore their influence factors. Methods:The lactating mother’s basic information was collected with questionnaire, and the breast milk of lactating mothers on postpartum 22-25 d was obtained and the 3-day 24-hour dietary recall method was used to investigate the dietary intake information of 514 healthy lactating mothers.The Food Composition Table of China 2009 was used to calculate the intakes of five kinds of polyunsaturated fatty acids (PUFAs) in diet of lactating mothers and the gold key nutrition expert system software for corresponding nutrient analysis was used to calculate the amount of various kinds of foods in the lactating mothers’daily diet.The levels of AA and DHA in breast milk were determined with gas chromatography and the linear regression was used to analyze the related factors of AA and DHA levels in breast milk.Results:①The average concentration of AA in breast milk of 514 lactating mothers was (0.08±0.04)g·100 g-1,and the average concentration of DHA was (0.05±0.04)g·100 g-1. ②The single factor correlation analysis results showed that the oil intake was both positively correlated with AA and DHA levels in milk of lactating mothers (r= 0.360,r=0.354,P<0.001),while the intakes of linoleic acid (LA), alpha linolenic acid (ALA),eicosapentaenoic acid (EPA),DHA,dairy and meats and seafood in diet were both negatively correlated with AA (r= -0.321,r=-0.280,r=-0.255,r=-0.299,r=-0.196 ,r=-0.306,P<0.05)and DHA (r=-0.315,r=-0.279,r=-0.175,r=-0.189,r=-0.248,r=-0.142,P<0.05).③The linear regression analysis results showed regression equation that dairy intake (β=-0.265)and EPA intake (β=-0.144)were both negatively correlated with the level of AA (P=0.009),and dairy intake was also negatively correlated with the level of DHA (β=-0.233,P<0.001).Conclusion:The AA and DHA levels in breast milk of lactating mothers didn’t increase with the increasing of intake of milk or dairy products in the study.Moreover there is a competitive relationship between n-6 and n-3 series polyunsaturated fatty acids in the process of metabolism.

Objective To investigate the association between rs2281951 and rs3798753 in ELOVL fatty acid elongase2 (ELOVL2 gene)and the docosahexenoic acid (DHA)level in breast milk,and to clarify the influence of the polymorphisms of ELOVL2 gene in the DHA level of breast milk.Methods 209 healthy maternals were selected and signed the consent form and completed the 3-day 24-hour dietary recall questionaire on one day during the 22nd-the 25th day after partum,and 20 mL breast milk was collected.The DHA level in breast milk was detected with gas chromatography.The milk DNA was extracted and two single nucleotide polymorphisms (SNPs) of ELOVL2 gene were detected by Sequenom Mass Array System. UNPHASED 3.012 genetics software was adopted to analyze the quantitative trait of haplotype and the DHA level in breast milk.Results The distribution of genotypic frequencies of rs2281591 and rs3798713 sites in ELOVL2 gene was consistent with Hardy-Weinberg equilibrium (P > 0.05).The dietary fatty acid intakes and the milk DHA levels of maternals carrying different genotypes had no statistically significant differences (P > 0.05 ). The DHA levels in breast milk of maternals carring different rs3798713 (CG)-rs2281591 (AG)haplotypes had no statistically significant difference (χ2 =3.422,df =5,P =0.635).Conclusion Rs3798713 and rs2281951 and constructed haplotypes in ELOVL2 gene are not related to the DHA levels in breast milk.

Objective To evaluate vascular surgery and interventional technique applied in Takayasu's arteritis. Methods Data of 26 patients of Takayasu's arteritis admitted between January 2006 and December 2009 were retrospectively analyzed. The sex ratio(M/F) was 1: 4. 2, age averaged at (27±15)y. There were 16 cases of type Ⅰ , 7 cases of type Ⅱ and 3 cases of type Ⅲ according to Lupi-Herrera classification. 25 patients received surgery including 16 patients undergoing pecutaneous transluminal angioplasty operations, 9 patients doing traditional bypass surgery, and one patient was treated conservatively. Results 23 case-times of percutaneous transluminal angioplasty (PTA) were performed in 16 patients, including 12 cases of balloon angioplasty and 4 cases of stent angioplasty. Four significantly stenotic and occluded carotid arteries were revascularized successfully in 5 patients. Thrombosis of the carotid artery was found in one patient after balloon angioplasty. There were 4 patients in which repeated PTA treatment up to a total of 11 times were needed to guarantee vessel patency. Open surgery succeeded in 9 patients, and clinical symptoms were relieved in all cases during peri-operative period. 22 patients were followed up for 12 -46 months,one patient died of cerebral hemorrhage 3 months post-operation, one patient was found pseudoaneurysm at anastomotic stoma, and 2 patients suffered from anastomotic restenosis.Conclusions Vascular surgery played important role in the therapy of Takayasu's arteritis. PTA can be used repeatedly. Surgical bypass operation is difficult in technology, and can be used in cases that fail to response to PTA or in patients with severe cerebral ischemia.

Objective: To analyze the clinical characteristics of patients with relapsed/refractory primary central nervous system lym-phoma (PCNSL) and to explore the factors that influence the prognosis, in order to provide evidence for the clinical diagnosis and treat-ment. Methods: Sixty-four patients with relapsed/refractory PCNSL diagnosed from October 2006 to August 2015 were selected. The clinical features, treatment plans, and laboratory examination data were retrospectively analyzed. Cox regression was used for multi-variate analysis. Results: Univariate and multivariate analyses showed that progression-free survival of first time (PFS1)≤1 year and Kar-nofsky performance status (KPS) score<70 points were independent prognostic factors in patients with first relapsed/refractory PCNSL. The median PFS2 and overall survival of second time (OS2) were 19 and 21 months, respectively, in patients with PFS1≥1 year, where-as the median progression free survival of second time (mPFS2) and OS2 were 10 and 14 months, respectively, in patients with PFS1<1 year. The median PFS2 (mPFS2) in patients with first relapse/refractory KPS score≥70 points and those with KPS score<70 points were 40 and 10 months, respectively, and the median OS2 were 43 and 12 months, respectively. The median PFS for the methotrexate (MTX) and non-MTX groups was 18 and 10 months, respectively. Multivariate analysis showed that the salvage therapy was a relevant factor influencing the patient's PFS. However, univariate analysis showed that the median OS2 in the MTX and non-MTX groups was 23 and 12 months, respectively, with significant difference but without any correlation with prognosis. Conclusions: progression-free sur-vival (PFS)≤1 year and KPS score<70 were independent prognostic factors in patients with first relapsed/refractory PCNSL. Patients with relapsed/refractory PCNSL who continuously received high-dose MTX-based treatment may have improved long-term treatment outcomes.

Objective:Focusing on the medical protection of marine sports events at the 19th Asian Games in Hangzhou. This paper analyzes the effect of the development and implementation of the medical protection program to provide a referable summary of experience for the medical protection of future large-scale international maritime events.Method:This paper retrospectively analyzed the medical protection of Ningbo Xiangshan Yafan Center during the preparation stage of the Asian Games Sailing Competition, and during the period from September 21 to September 27, 2023 when the Asian Games Sailing Competition is held. Analyze the organizational structure and scheme of medical support.Results:During this Asian Games sailing competition, there were a total of 14 paramedics, 4 rescue helicopter crews, 2 ambulances and 1 rescue helicopter in and around the competition venues. In the city, the designated hospital has set up a total of 12 working groups, 15 protection outpatient clinics and a number of various types of clinic areas. There are 129 medical and nursing staff directly participating in the medical protection work of the Asian Games. A total of 44 specialized beds were reserved in the designated hospitals. There were also a number of volunteers and logistic staff who relied on the support work. The top three major disease types were trauma with 66 cases (29.2%), upper respiratory tract infection with 34 cases (15.04%) and skin allergy with 19 cases (8.51%). The top two population groups consulted were staff with 95 visits (44.19%) and technical officers with 89 visits (41.40%).Conclusions:During the sailing competitions of the Asian Games, the medical care was smooth and orderly. Trauma, upper respiratory tract infections and skin allergies are the most prominent diseases. The number of medical consultations for staff and technical officials of the Asian Games Sailing Competition accounted for more than 80% of the total number of consultations for all personnel. They should be given priority care.

Pyridaben is a broad-spectrum acaricide widely used in agriculture, accidental or self-administration of large doses of pyridaben can cause multiple organ failure in patients. Due to its damage to multiple organs and no specific antidote, the mortality rate is high. This paper reports two patients who took a large amount of pyridaben, developed severe metabolic acidosis, hyperlactatemia, toxic encephalopathy, and liver, kidney, heart and digestive tract damage. After timely gastric lavage, catharsis, organ support andblood purification treatment, the condition improved and discharged. It is expected to provide clinical ideas for the treatment of pyridaben poisoning.

Pyridaben is a broad-spectrum acaricide widely used in agriculture, accidental or self-administration of large doses of pyridaben can cause multiple organ failure in patients. Due to its damage to multiple organs and no specific antidote, the mortality rate is high. This paper reports two patients who took a large amount of pyridaben, developed severe metabolic acidosis, hyperlactatemia, toxic encephalopathy, and liver, kidney, heart and digestive tract damage. After timely gastric lavage, catharsis, organ support andblood purification treatment, the condition improved and discharged. It is expected to provide clinical ideas for the treatment of pyridaben poisoning.

Objective:To discuss the effect of the small ubiquitin-like modifier-specific protease 1(SENP-1)/hypoxia-inducible factor 1α(HIF-1α)pathway on chronic intermittent hypoxia(CIH)-induced vascular endothelial injury in the rats,and to clarify the related mechanism.Methods:The SD rats were randomly divided into control group and CIH group,and then the rats in each group were further divided into 2,4,and 6-week subgroups,and there were 8 rats in each subgroup.The rats in CIH group were exposed to CIH in a CIH chamber to induce CIH and create the obstructive sleep apnea hypopnea syndrome(OSAHS)models,while the rats in control group were exposed to normoxic conditions.The serum and thoracic aorta tissue of the rats in various groups were collected at each time point.HE staining was used to observe the thoracic aorta vascular injury of the rats in various groups;ELISA method was used to detect the levels of nitric oxide(NO),endothelin-1(ET-1),von Willebrand factor(vWF),and thrombomodulin(TM)in serum of the rats in various groups;Western blotting method was used to detect the expression levels of SENP-1,HIF-1α,and vascular endothelial growth factor A(VEGFA)proteins in thoracic aorta tissue of the rats in various groups.In vitro,the aortic endothelial cells(rAECs)of the rats were cultured and infected with SENP-1 shRNA adenovirus(sh-SENP-1)to construct the cell line with low expression of SENP-1.The CIH was used to induce the vascular endothelial cell injury,and the cells were divided into CIH group,CIH+sh-NC group,and CIH+sh-SENP-1 group;control group was set up separately.CCK-8 method was used to detect the proliferation activities of the cells in various groups;ELISA method was used to detect the activities of lactate dehydrogenase(LDH)in the supernatant and the levels of NO,ET-1,malondialdehyde(MDA),and activities of superoxide dismutase(SOD)in the cells in various groups;flow cytometry was used to detect the apoptotic rates of the cells in various groups;Western blotting method was used to detect the expression levels of SENP-1,HIF-1α,and VEGFA proteins in the cells in various groups.Results:With the extension of CIH induction time,compared with control group,the thoracic aorta endothelium in CIH group gradually became rough and significantly thickened,the level of serum NO of the rats in CIH group was decreased(P＜0.05),and the levels of serum ET-1,vWF,and TM,and the expression levels of SENP-1,HIF-1α,and VEGFA proteins in thoracic aorta tissue were increased(P＜0.05).Compared with control group,the proliferation activity of the cells in CIH group was decreased(P＜0.05),the LDH activity in the supernatant,the levels of ET-1,MDA,and the apoptotic rate in the cells were increased(P＜0.05),while the levels of NO and activity of SOD in the cells were decreased(P＜0.05),and the expression levels of SENP-1,HIF-1α,and VEGFA proteins in the cells were increased(P＜0.05).Compared with CIH group,the proliferation activity of cells in CIH+sh-SENP-1 group was increased(P＜0.05),the activity of LDH in the supernatant,the levels of ET-1,MDA,and the apoptotic rate of the cells were decreased(P＜0.05),while the level of NO and activity of SOD in the cells were increased(P＜0.05),and the expression levels of SENP-1,HIF-1α,and VEGFA proteins were decreased(P＜0.05).Conclusion:The SENP-1/HIF-1α pathway is highly activated in the thoracic aorta injury tissue of the rats induced by CIH.Silencing SENP-1 expression can reduce CIH-induced vascular endothelial cell injury,and its mechanism may be related to downregulating the activation level of SENP-1/HIF-1α pathway.

Objective:To understand the current status of nurses' work engagement in cancer hospitals, explore its influencing factors and the mediating effect of work acceptance between hospital magnetic level and work engagement.Methods:In September 2019, 420 nurses from a ClassⅢ Grade A cancer hospital were selected as the research object by convenient sampling. The General Information Questionnaire, the Chinese version of the Essentials of Magnetism ScaleⅡ (EOMⅡ) , Work-related Acceptance and Action Questionnaire (WAAQ) and the Utrecht Work Engagement Scale (UWES) were used to conduct a cross-sectional survey of nurses. Single factor analysis, correlation analysis and structural equation model were used to analyze the relationship among hospital magnetic level, work acceptance and work engagement of nurse. A total of 420 questionnaires were distributed and 408 valid questionnaires were collected.Results:Among 408 nurses, the scores of EOM Ⅱ, WAAQ and UWES were (141.53±22.73) , (33.79±8.38) and (45.11±17.27) respectively. Work engagement was positively correlated with hospital magnetic level and work acceptance with statistical differences ( r=0.549, 0.564; P<0.01) . The hospital magnetic level had a positive predictive effect on work acceptance (β=0.39) and work engagement (β=0.40) , and work acceptance had a positive predictive effect on work engagement (β=0.47) . Work acceptance had a partial mediating effect between hospital magnetic level and work engagement, and the mediating effect accounted for 31.49% of the total effect. Conclusions:Work acceptance plays a part of the mediating role between hospital magnetic level and work engagement. Nursing managers can create a magnetic nursing work environment to promote nurses' work acceptance and increase their work engagement.