Objective To investigate the expression and significance of Syndecan-1 and E-Cadherin proteins in human sporadic colorectal carcinoma(SCC). Methods Immunohistochemical SP method was used to determine the expression of Syndecan-1 and E-Cadherin in 52 cases of SCC and 18 normal colorectal tissues. Results The positive expression rates of Syndecan-1 and E-Cadherin proteins were 65.38%,100% and 61.54%, 100% in SCC and normal colorectal tissues, respectively, the difference of which between SCC and normal colorectal tissues was statistically significant(P

Objective To investigate the effect of promoter hypermethylation of O 6 methylguanine DNA methyltransferase (MGMT) gene on colorectal tumorigenesis and progression. Methods The promoter hypermethylation of O 6 methylguanine DNA methyltransferase gene was assayed in 27 sporadic colorectal adenomas, 62 sporadic colorectal carcinomas and 20 normal colorectal mucosa tissues by methylation specific PCR. At the same time, the expression of MGMT protein was studied in the same samples using immunohistochemistry. Results None of the normal colorectal mucosa tissues showed methylated bands. Promoter hypermethylation was detected in 40.7%(11/27) of adenomas and 43.5% (27/62) of carcinomas, respectively. MGMT proteins were expressed in nucleus and cytoplasm of normal colorectal mucosa tissues. Loss of MGMT expression was found in 22.2% (6/27) of adenomas and 45.2% (28/62) of carcinomas, respectively. There were significant difference among them ( P =0.041). Methylation was detected in 5 of the 6 adenomas( P =0.027) and 24 of the 28 carcinomas( P

Objective To observe the therapeutic effect of extracorporeal shock wave therapy on the pain caused by soft tissue injury.MethodsThere were 63 cases with tennis elbow, 106 cases with frozen shoulder, and 45 cases with the pain syndrome. All the 214 cases were divide into study group and control group, 107 cases in each group. The study group received extracorporeal shock wave therapy around the pain point; the control group recieved partial closure, massage, and drugs treatment. Visual Analogue Scale (VAS) were assessed before and 4 weeks, 8 weeks and 12 weeks after treatment.ResultsThe scores of VAS showed no difference between the two groups before and 4 weeks after the treatment (P＞0.05). The study group improved in VAS 8 weeks and 12 weeks after the treatment compared to the control group (P＜0.01); the overall efficacy rate was higher in the study group than in the control group (P＜0.01).ConclusionExtracorporeal shock wave therapy is effective to treat the pain caused by soft tissue injury.

Objective To investigate the influence of parental compliance on the therapeutic effect of children with epilepsy.Methods Two hundred and sixty children with epilepsy and their parents admitted to the First People's Hospital of Wenling from December 2013 to June 2016 were enrolled,and the classical Morisky medication adherence questionnaire (MMAS-8) was applied to evaluate the compliance of parents for treatment of their children with epilepsy;after the patient taking drug for 3 days,fasting venous blood was collected in the morning,the concentration of the blood drug was tested and the influence of parent compliance on the blood drug concentration of the child with epilepsy was evaluated.Results In 260 patients,122 cases took karma form,and 138 cases took valproate orally.There were parents with good medication compliance in 130 cases (50％),medium medication compliance 80 cases (30.76％) and poor adherence to the doctor order in 50 cases (19.23％).In cases using medication irregularly,there were 26 cases sometimes without taking any drug (10.0％),17 patients' medication being interrupted (6.54％) and 10 cases having excessive medication (3.85％);no relationships were found between parental compliance and each of the following items,family role,occupation and age (all P ＞ 0.05);and the compliance was related to gender,indicating that women's good compliance level was higher than that of males';the education level was positively proportional to the compliance,and the compliance of parents with senior high school or above degree was higher than those with primary school and junior secondary school levels (83 cases vs.9 cases,38 cases,both P ＜ 0.01).Under situation of parents with poor compliance,their children had blood drug concentration higher or lower than proper range of drug level (high in 22 cases,low in 41 cases,higher than the result in good compliance 0 cases and 17 cases respectively),thus seriously affected the safety and efficacy of the treatment;the patients' frequency of irregular medication in parents' good compliance group was significantly lower than that in parents' poor compliance group [3.08％ (4/130) vs.72.0％ (36/50),P ＜ 0.05].Conclusion To improve the therapeutic effect of epileptic children,their parental good cooperation is necessary.

Objective To investigate the clinical value of color doppler ultrasound in the diagnosis of thrombus of lower extremity veins. Methods A total of 84 patients with thrombus of lower extremity veins(DVT) underwent color Doppler ultrasound and digital subtraction angiography (DSA), and analyzed the test results comparatively. Results Color doppler ultrasound diagnosed deep vein thrombosis(DVT) in 68 cases of all 84 patients, 49 cases were in the left low-er extremity (72.1%), 19 cases were in the right lower extremity (27.9%),patients were in the left more than in the right;In all 68 patients,39 cases were in acute stage,20 cases were in sub acute stage, 9 cases were in chronic period. DSA diagnosed lower extremity DVT in 66 cases in 68 cases diagnosed by color doppler ultrasound,DSA diagnosed lower extremity DVT in 64 cases, 4 cases that examined by DSA were negative. Color doppler ultrasound diagnosed normal in 18 cases, DSA found lower extremity DVT in 2 cases. Compared with the results of DSA examination, the sensitivity and the specificity of color doppler ultrasound for diagnosing DVT were 96.97% and 88.9%, the diagnostic consistency of both methods was high (Kappa=0.78). Conclusion Color doppler ultrasound is simple, fast and repro-ducible, it is high in consistency with DSA and has important value in the diagnosis of lower extremity DVT.

Objective:The aim of the study was to develop a transcultural adaptation of Scrub Practitioners ′ List of Intraoperative Non-technical Skills to Chinese. Methods:The translation of SPLINTS was based on the Brislin ′s translation model and expert consultation were conducted for cultural adaptation before the Chinese version was accomplished. The content validity of Chinese version scale was evaluated by Delphi method. The applicability and observer reliability of the tool was tested by behavioral observation of simulate videos. Results:The positive coefficients of experts in the first and second rounds were both 100% and the authority coefficients were 0.802 and 0.906 respectively. The concordancy coefficients of expert Kendall were 0.282-0.433( P<0.05). The results of Delphi expert consultation showed that the average content validity index (S-CVI/Ave) of the scale level was 0.93, and the item level (I-CVI) content validity index was 0.87-1.00. The rater training showed that the intra-observer reliability was 0.75-0.96 and inter-observer reliability (Kendall W) was 0.502-0.557( P<0.01). Conclusion:The cross-cultural adaptation of SPLINTS-Chinese version is scientific and reliable. The content validation and observer reliability are in-line with scale evaluation criteria. Further psychometric measurement can be conducted in the group of scrub nurses in the operating room.

bjective? To deeply understand the psychological needs of patients with postpartum depression and to provide a reference for medical and nursing workers to improve preventive healthcare and interventive therapy for patients with postpartum depression. Methods? Totally 12 patients with postpartum depression from the Department of Obstetrics of a Class Ⅲ Grade A general hospital in Shanghai were selected using purposive sampling and interviewed face-to-face in-depth semi-structurally using phenomenological methods in qualitative studies from October 2017 to April 2018. Colaizzi data analysis principle was used to organize and analyze the data and refine the themes. Results? Totally 3 themes were refined, namely, support needs of consistent culture among family members, obtainment needs for care knowledge, and anticipation needs for medical and nursing workers in obstetrics. Conclusions? Patients with postpartum depression show extensive psychological needs. Medical and nursing workers should guide their family members to provide cultural support consistent with the puerpera according to their psychological needs, provide care knowledge from multiple perspectives, maintain beneficial folk care habits, enhance the psychological health service capability of themselves, and set up psychological counselling outpatient service for pregnant women so as to meet the psychological needs of patients with postpartum depression.

Objective? To understand the self-management status among elderly chronic heart failure (CHF) patients and to compare the regional differences of self-management. Methods? By random cluster sampling, we investigated 6 124 elderly CHF patients from 102 hospitals in five regions, East China (Jiangxi Province, Shanghai Municipality, Zhejiang Province), West China (Qinghai Province, Xinjiang Uygur Autonomous Region, Shaanxi Province, Gansu Province, Ningxia Hui Autonomous Region, Yunnan Province), South China (Hainan Province, Guangxi Zhuang Autonomous Region), North China (Heilongjiang Province, Inner Mongolia Autonomous Region), Central China (Henan Province, Hubei Province, Hunan Province). The investigation result statistics were carried out and regional differences were compared. Results? The self-management of elderly CHF patients had a low to medium level with 61.25% (49/80) ＜80% for the scoring rate. The scores of East China and Central China were higher and the score of West China was low; the regional differences were statistical (H=59.07, P＜0.01). The score of diet management was highest with 66.67% for the scoring rate (8/12); East China had the highest score, and West China had the lowest score; the regional differences were statistical (H=92.49, P＜0.01). The scoring rate of medication management was 65.00% (13/20) with the highest in East China and low in North China and West China; the regional differences were statistical (H=351.10, P＜0.01). Mental/social adjustment management was poor with 60.00% (12/20) for the scoring rate; the scores of Ease China were higher than those of North and West China; the regional differences were statistical (H=8.84, P＜0.01). Symptom management was the worst with 57.14% (16/28) for the scoring rate; the scores of East and Central China were high;the regional differences were also statistical (H=17.62,P＜0.01). Conclusions? Self-management of elderly CHF patients needs to be improved. Systematic and targeted health education for different regions should be carried out to improve patients' self-management and to reduce the disease burden.

Objective:To investigate the early predictive factors of periprocedural thrombus migration and the relationship between periprocedural thrombus migration and prognosis after mechanical thrombectomy (MT) in stroke patients.Methods:The patients with anterior circulation acute large vessel occlusion stroke (ALVOS) who underwent MT in the Stroke Center of Yijishan Hospital of Wannan Medical College from May 2015 to December 2019 were retrospectively analyzed. The baseline characteristics, procedural and clinical outcomes were collected. Univariate and multivariate regression analysis was used to explore the risk factors of thrombus migration and the relationship between thrombus migration and prognosis of patients.Results:There were 302 ALVOS patients [(68.8±11.0) years old and 166 males (55.0%)] included, of whom thrombus migration was identified in 80 patients (26.5%), including 60 cases (75.0%) of proximal migration. Cardiogenic stroke ( OR=2.722, 95% CI 1.367-5.418, P=0.004) and clot burden score (CBS; OR=0.849, 95% CI 0.745-0.968, P=0.015) were independent risk factors of thrombus migration. Proximal migration ( OR=2.822, 95% CI 1.220-6.528, P=0.015) was an independent risk factor of 90-day clinical outcome, while the effect of distal migration on 90-day clinical outcome was not statistically significant. Conclusions:Cardiogenic stroke and lower CBS score are independent predictors of periprocedural thrombus migration in ALVOS patients who underwent MT. Proximal migration is an independent risk factor for the prognosis of patients, which has important clinical intervention significance.

Objective:To observe the incidence, risk factors of malignant brain edema (MBE) and the influence of MBE on outcomes after early successful recanalization of acute large vascular occlusion stroke (ALVOS).Methods:A total of 149 patients (age (68±11) years, male 85 (57.0%)) with ALVOS who underwent early endovascular treatment and achieved successful recanalization at the First Affiliated Hospital of Wannan Medical College from July 2014 to February 2019 were retrospectively analyzed. Baseline data, perioperative data, and 90-day prognostic information were collected from patients enrolled in the study. Univariate and multivariate analyses were used to explore the relationship between MBE and outcomes, and the risk factors of MBE.Results:Among the 149 patients, baseline National Institutes of Health Stroke Scale score was 16 (13, 20), baseline Alberta Stroke Project early CT score was 9 (8, 10), the time of onset-to-puncture was (248.3±61.3) minutes, and the onset-to-recanalization time was (312.4±69.7) minutes. MBE occurred in 23 patients (15.4%, 23/149). The 90-day favorable outcome (90-day modified Rankin Scale score≤ 2) in patients with MBE was significantly lower than those without MBE (17.4% (4/23) vs 61.1% (77/126), χ 2=14.985, P<0.001), and the 90-day mortality in patients with MBE was significantly higher than those without MBE (43.5% (10/23) vs14.3% (18/126), χ 2=10.861, P=0.003). MBE was shown to be an independent predictor of 90-day poor outcome (adjusted OR=12.078, 95 %CI 1.934-75.443, P=0.008) and death (adjusted OR=4.146, 95 %CI 1.060-16.216, P=0.041). Multivariate Logistic regression analysis showed that the collateral circulation status was related to the incidence of MBE in patients with ALVOS after successful recanalization (level 2 vs level 0, adjusted OR=0.109, 95 %CI 0.021-0.563, P=0.008). Conclusions:MBE is an independent risk factor of ALVOS patients with poor outcome or death in 90 days. For patients with ALVOS, even if the occlusive vessels have been successfully recanalized after early endovascular treatment, MBE is still not uncommon. The collateral circulation state is an independent predictive factor of the development of MBE after recanalization by early endovascular treatment in patients with ALVOS.