Objective To investigate the current status and the related influencing factors of humanistic care quality of nurses in department of aged homes in Guangzhou,for the future to carry out humanistic care education,and provide a reference for improving humanistic care quality of nurses.Methods 270 nurses from 8 department of aged homes in Guangzhou were investigated by convenience sampling and evaluation table on humanistic care quality of nurses.The affected factors were analyzed by multiple stepwise regression.Results The aggregate score of humanistic care quality of nurses in this study was (113.59±9.78),which was lower than the reference score (118.36±16.75) of humanistic care quality of nurses of some general hospitals in Shanghai in 2010,offered by Liu Yuxiao,the designer of the evaluation table.The scores were correlated with 4 impact factors including home,politics status,care index of colleagues,whether to accept the education and training of humanistic care;multiple stepwise regression analysis indicated that care index of colleagues and whether to accept the education and training of humanistic care were the main factors.Conclusions Humanistic care quality of nurses in department of aged homes in Guangzhou was in lower level,and especially caring ability and the attitude towards caring.Department of aged homes should cooperate with universities,to establish a set of training courses on humanistic care quality of nurses in department of aged homes.Through the systematic,standardized training,to improve humanistic care quality of nurses and the quality of nursing service.

Objective To evaluate the value of combining PCT, BNP, D-Dimer and PCIS score in predicting the prognosis of pediatric severe pneumonia in the early stage. Methods 80 cases of children with severe pneumonia were selected, 49 cases were boys , 31 cases were girls, with a median age of 7.5 months (1 month to 156 months). According to the final outcome, the cases are divided into treatment group and poor prognosis group. The score of PCIS, PCT, BNP and D-dimer within 24 hours after admission were recorded. According to the indicators, ROC curve was drawn independently and integrated with the four indicators,and the corresponding areas under ROC curve (AUC) were calculated to compare the accuracy of the assessment. Results The AUC of PCIS, PCT, BNP and D-dimer were between 0.7 and 0.9. The ROC curve integrated the four indicators showed the AUC were 0.932, which improved sensitivity and specificity. Conclusions The integration of PCIS, PCT, BNP and D-Dimer could improve the accuracy of prediction in the prognosis of severe pediatric pneumonia.

Objective To analyze the efficacy of prophylactic dexamethasone in the treatment of aortic dissection with stent graft.Methods The clinical data of 87 patients who received aortic dissection with stent implantation were retrospectively analyzed.The treatment group(39 cases)was treated with dexamethasone on the basis of antibiotic prophylaxis to prevent infection,and the control group(48 cases)received antibiotics to prevent infection perioperatively.The curative effect was compared between the two groups.Results The degree of inflammatory reaction in the treatment group significantly reduced,and the treatment group had obvious curative effect(x2=54.88,P<0.01).The total effective rate,significant effective rate and effective rate of the treatment group were 92.31%,61.52%,7.70%,respectively,which were significantly higher than those of the control group(13.00%,6.25%,6.25%),the difference was statistically significant(x2=54.88,P<0.01).Conclusion Prophylactic use of dexamethasone in the treatment of systemic inflammatory response after aortic dissection with stent implantation has significant effect.

Objective To explore the effect of extracellular regulated protein kinases (ERK) signaling pathway on early brain injury and autophagy of nerve cell in hippocampus area in rats with subarachnoid hemorrhage (SAH). Methods Forty-eight adult male Sprague-Daw-ley rats were randomly divided into sham group, SAH group, SAH+dimethyl sulfoxide (DMSO) group and SAH+U0126 group, with 12 rats in each group. The SAH model was established with puncture of internal carotid artery. The SAH+U0126 group was injected with U0126 0.05 mg/kg;the sham group and SAH group were injected with normal saline, and the SAH+DMSO group was injected with DMSO 30 min-utes before modeling. They were sacrificed 24 hours after modeling. The brain water content was measured with wet and dry method. The morphology changes of neural cells in hippocampus CA1 were observed by HE staining. The expression of phosphorylation ERK (p-ERK), Beclin-1 and LC3-Ⅱwere detected with immunohistochemical method and Western blotting. Results Compared with the sham group, the brain water content increased (P<0.05), the number of survival neurons decreased (P<0.05), the expression of p-ERK, Beclin-1 and LC3-Ⅱincreased in SAH group (P<0.05). Compared with SAH group, the brain water content increased, the number of survival neurons decreased (P<0.05), the expression of p-ERK, Beclin-1 and LC3-Ⅱ decreased in SAH+U0126 group (P<0.05); and no significant difference was found in SAH+DMSO group (P>0.05). Conclusion The activation of ERK signaling pathway may alleviate early brain injury after SAH by regulation of autophagy.

Objective:To explore the indications and effect of surgical treatment of autoimmune pancreatitis.Methods:Clinical data of these 15 patients with autoimmune pancreatitis diagnosed and treated at the Department of General Surgery, the First Hospital of Peking University from 2010 to 2021 were retrospectively analyzed.Results:The main clinical symptoms were obstructive jaundice, abdominal pain, distension and weight loss. The diagnosis of AIP was confirmed by EUS-FNA in 6 patients,among them, 4 did not relapse after oral hormone treatment, 2 did not receive relevant treatment, and 1 developed gastric cancer one year later. Under a suspicion of malignancy, 9 patients underwent surgical laparotomy ,and the diagnosis was established by pathology. There was no recurrence after oral hormone therapy in 1 patient who underwent laparotomy and pancreatic biopsy. One out of the 3 patients with choledochojejunostomy relapsed after 3 years. Of the 5 patients who underwent pancreatectomy, 4 had no obvious recurrence, and 1 had recurrence after 3 years.Conclusions:Untypical autoimmune pancreatitis is likely to be misdiagnosed as pancreatic cancer. For patients with suspicious malignancy, operational management and biopsy may benefit.

Objective To evaluate the effects of laparoscopic splenectomy and esophagogastric devascularization(LSPD) vs.open procedure(OSPD) on stress and immune function in patients with portal hypertension due to cirrhosis.Methods From June 2015 to June 2017 a total of 66 patients underwent LSPD or OSPD procedures.Results Plasma cortisol concentration in the LSPD group was lower than that in the OSPD group (Fgroup =18.85,P =0.020).Cortisol concentration in the two groups increased firstly and then decreased with time extension (Ftime =532.08,P =0.000).The level of CD3 +,CD4 +,CD4 +/CD8 + in LSPD group was higher than that in OSPD group,and the level of CD8 + was lower than that in OSPD group (Fgroup =3.55,21.47,154.84,64.29,P ＜ 0.05),the levels of CD3 +,CD4 + and CD4 +/CD8 + in the two groups first decreased and then increased with the extension of time,and the levels of CD8 + increased firstly and then decreased (Ftime =199.22,298.48,864.33,510.23,P ＜ 0.05),the increase range of CD3 +,CD4 +,and CD4 +/CD8 + in LSED group was higher than that in OSPD group (Finteraction =19.27,18.21,79.55,35.21,P ＜ 0.05);there was no statistical significance in the complications such as:rebleeding,thrombosis and splenic fever in the two groups (x2 =0.05,0.67,0.07,0.16,P=0.829,0.413,0.789,0.693).But the postoperative chest/cavity effusion and fever (＞ 38.0 ℃,and ＞ 3 days) is OSPD group is higher than in the LSPD group(x2 =5.49,6.68,P =0.019,0.010).Conclusion LSPD effectively reduces postoperative stress,protects immune function,decreases postoperative pleural and abdominal effusion and fever.

Objective:To investigate the effect of HLA-Cw*0602 and LCE3B_LCE3C-del allele interaction on the risk of psoriasis vulgaris in a population of Mongolian nationality in Inner Mongolia. Methods:A total of 365 Mongolian patients with psoriasis vulgaris who received treatment in The Affiliated Hospital of Inner Mongolia Medical University from January 2006 to December 2015 (case group) and 284 healthy subjects who concurrently received physical examination in the same hospital (control group) were included in this study. After sex and age matching, and quality control, the correlations between HLA-Cw*0602 and LCE3B_LCE3C-del allele and psoriasis vulgaris in a population of Mongolian nationality were analyzed using SPSS 20.0 software. The interaction between HLA-Cw*0602 and LCE3B_LCE3C-del alleles (adjusting for potential confounders including age and sex) was analyzed using logistic regression. Results:Logistic regression interaction item Int of dominant inheritance mode HLA-Cw*0602 allele and recessive inheritance mode LCE3C_LCE3B-del allele revealed OR = 2.38, P = 0.033, and interaction index S = 1.21, indicating that there was a synergistic effect between the two alleles. Conclusion:The co-existence of HLA-Cw*0602 and LCE3B_LCE3C-del may increase the risk of psoriasis vulgaris in a population of Mongolian nationality in Inner Mongolia.

This paper reports the clinical data of a patient with recurrent metastatic parathyroid carcinoma. The causes, clinical manifestation, diagnose, treatment and prognosis of parathyroid carcinoma were discussed in order to perfect the experience of diagnosis and treatment and improve the survival rate of such patients.

Objective:To compare the dosimetry and efficacy of intracavitary brachytherapy (ICBT) and intracavitary/interstitial brachytherapy (IC+ ISBT) based on CT image guidance in the treatment of stage Ⅲ B cervical cancer. Methods:Clinical data of 93 patients with stage Ⅲ B cervical cancer treated in Department of Radiotherapy of Jilin Cancer Hospital from June 2014 to February 2017 were analyzed retrospectively. According to the results of Gynecological examination and pelvic MRI before brachytherapy, confirming the size of residual tumor and the degree of parauterine infiltration, all patients were divided into the ICBT and IC+ ISBT groups. The D 90%, D 100%, V 100% and D 2cm 3 of bladder and rectum were compared, and the short-term and long-term efficacy was observed between two groups. Results:The median follow-up time was 60 months. The 5-year local control rate, distant metastasis-free survival rate and overall survival rate of all patients were 83%, 71% and 68%, respectively. Compared with the ICBT group, HR-CTV D 90% in the IC+ ISBT group was all more than 85 Gy, while there was no significant difference between two groups ( P=0.188). The D 2cm 3 of bladder and rectum in the IC+ ISBT group was significantly decreased by 7 Gy and 8 Gy (both P<0.01), and the distant metastasis-free survival rate was significantly improved ( P=0.009). The 5-year local control rate in the HR-CTV volume>60 cm 3 in the IC+ ISBT group was significantly higher than that in the IC group ( P=0.029). Conclusion:For patients with Ⅲ B cervical cancer, IC+ ISBT can not only ensure target coverage, but also significantly reduce the incidence of distant metastasis and the dose of organs at risk, and significantly improve the local control rate of large tumors.

Liver cholesterol metabolism disorder plays an important role in the development of non-alcoholic fatty liver disease (NAFLD).In order to reveal the molecular mechanism of cholesterol homeostasis imbalance induced by saturated fatty acids, HepG2 cells were stimulated with palmitic acid (PA).Lipids accumulation was analyzed by Oil Red O staining, intracellular triglyceride and cholesterol quantification.The level of genes and proteins related to cholesterol homeostasis was measured by RT-qPCR and western blotting.Additionally, intracellular bile acids and mitochondrial oxysterols were detected by LC-MS/MS.The results demonstrated that intracellular lipids such as TG and TC were significantly increased in the model with PA stimulation.Although no significant difference was detected in genes related to cholesterol synthesis and uptake, the protein expression of ABCG5 and LXRα were significantly down-regulated, indicating a decrease in cholesterol efflux.Meanwhile, the gene expression of STARD1 and CYP7B1, which are responsible for bile acid alternative synthesis, were markedly enhanced, along with a significant increase of cholesterol and 27-OHC in mitochondria and CDCA in cells.These results suggested that PA overload may disrupt cholesterol homeostasis by inhibiting cholesterol efflux and promoting bile acids synthesis.