Objective To investigate the relationship of hypersensitive C reactive protein with carotid atherosclerosis and serum calcium and phosphorus in elderly patients with type 2 diabetes mellitus plus hypertension and increased homocysteine . Methods A total of 105 subjects were enrolled .Carotid intima-media thickness(CIMT) was determined by doppler ultrasound .All the participants were divided into three groups :control group (n=30 ,CIMT<0.9 mm) ,common carotid sclerosis group (n=30 ,0.9 mm≤CIMT<1.2 mm) and common carotid plaque group (n=45 ,CIMT ≥1.2 mm) .Common carotid plaque group was again divided into stable plaque subgroup (n= 20)and unstable plaque subgroup (n=25) .Serum hypersensitive C reactive protein (hsC‐RP ) , homocysteine (Hcy ) ,calcium and phosphorus levels were detected .Logistic regression was used to evaluate the risk factors for CIMT . Results The level of hsC‐RP [(16.88 ± 5.31 ) vs (11.56 ± 5.52 ) mg/L ] ,Hcy [(19.47 ± 10.18 ) vs (14.93 ± 3.41 )μmol/L] and CIMT[(0.98 ± 0.09) vs (0.93 ± 0.05) mm] were significantly higher in common carotid plaque group than in common carotid sclerosis group (P<0.05). There were no significant difference in Ca2+ [(2.24 ± 0.3) vs(2.26 ± 0.16) mmol/L] ,P3 - [(1.19 ± 0.25) vs (1.13 ± 1.14) mmol/L] between the two groups(P>0.05).The levels of lipoproteins (LP) and HbA1 c were significantly higher in common carotid sclerosis group and common carotid plaque group than in the control group (P<0.05).The TC was higher in common carotid plaque group than in the control group[(4.32 ± 1.10) vs (3.69 ± 0.67)mmol/L , P<0.05].Pearson correlation analysis showed than CIM T was positively associated with hsC‐RP and Hcy (r=0.560 ,0.452 ,P<0.01). Logistic regression analysis showed that CIMT is independently associated with hsC‐RP and Hcy(OR=1.501 ,1.523 ,P<0.01). Conclusion The levels of serum hsC‐RP and Hcy were not only independent risk factors for carotid artery atherosclerosis but also related to the stability of atherosclerosis plaque in the patients with type 2 diabetes mellitus with hypertension .

Objective To investigate the expression and clinical significance of fibroblast growth factor-2 (FGF-2) and human teclomerase reverse transcriptase (hTERT) in non-small cell lung cancer (NSCLC) tissues and analyze the correlation between them.Methods The expression of FGF-2 and hTERT were detected by immunohistochemistry in 90 NSCLC tissues and 20 non-lung carcinoma tissues.The correlation between the expression and clinicopathological features was also analyzed.Results The positive expressions of FGF-2(66.7％ ) and hTERT (75.6％) in NSCLC tissues were significantly higher than that in nonlung carcinoma tissues (15％ and 20％,respectively),P ＜0.01.The expression of FGF-2 and hTERT were significantly related to TNM stages and lymph node metastasis (P ＜ 0.01 ),but not to histological types,sex and age of NSCLC patients ( P ＞ 0.05 ).A positive correlation was found between the expressions of FGF-2 and hTERT in NSCLC(P ＜ 0.01 ).Conclusion The expression of FGF-2 and hTERT in NSCLC,which can be regarded as important references for prognosis of NSCLC,play important roles in the initiation and development of NSCLC.

Objective To investigate the association between the expression of RASSF1A and Survivin proteins and clinicopathological characteristics in non-small cell lung cancer (NSCLC) and their clinical significance. Methods Expression of RASSF1A and Survivin proteins in the NSCLC tissue microarrays was detected by S-P Immunohistochemistry. Results The positive expression of RASSF1A in NSCLC (46.8 %) was significantly lower than that of in the normal lung tissues (92.9 %) (P < 0.001), but the positive expression of Survivin in NSCLC (78.5 %) was significantly higher than that of in the normal lung tissues (0%) (P<0.001). The percentage of RASSFI A protein expression in the stage Ⅰ and stage Ⅱ of NSCLC was evidently higher than that of in the stage Ⅲ (P<0.001, respectively), however, the percentage of Survivin protein expression in the stage Ⅰ and stage Ⅱ of NSCLC was significantly lower than that of in the stage Ⅲ (P=0.003, P=0.001). The percentage of RASSF1A in NSCLC with lymph node metastasis was observably lower than that of in cases without lymph node metastasis (P<0.05). Furthermore, there was observably negative correlation between expression of RASSF1A protein and that of Survivin protein in NSCLC (r=-0.780, P<0.001). Conclusion The loss expression of RASSF1A protein, over expression of Survivin protein and loss balance of expression of both RASSF1A and Survivin proteins in NSCLC might play important roles in the development and progression of NSCLC; RASSF1A and Survivin proteins might be acted as one helpful molecular marker to predict the lymph node metastasis and the prognosis of NSCLC.

Objective:To explore the effect of ICE regimen (ifosfamide, carboplatin, VP16) combined with methotrexate on the clinical efficacy and expression of miR-451a and miR-15a in patients with diffuse large B cell lymphoma (DLBCL).Methods:A total of 56 patients with DLBCL in the Third Hospital of Changsha from March 2013 to may 2018 were prospectively selected and randomly divided into observation group and control group, 28 cases in each group. The control group was treated with ICE regimen, and the observation group was treated with ICE regimen combined with methotrexate. The tumor control rate, toxic and side effects, the expression of miR-451a and miR-15a, immune function (CD3 +, CD4 +, CD8 +, CD4 +/CD8 +), serum tumor markers [β 2 microglobulin (β 2-MG), carbohydrate antigen 125 (CA125), and lactate dehydrogenase (LDH)] levels were compared before and after treatment between the two groups, follow-up for 6 to 12 months was used to calculate the survival rate of the two groups. Results:The tumor control rate in the observation group (92.86%) was higher than that in the control group (71.43%) ( P<0.05); After treatment, the miR-15a decreased and miR-451a increased in the two groups, and the miR-15a in the observation group was lower than that in the control group, while miR-451a was higher than that in the control group ( P<0.05); After treatment, the CD3 +, CD4 +, CD4 +/CD8 + of the two groups were lower than before treatment, and CD8 + was higher than before treatment ( P<0.05), but there was no significant difference between the two groups ( P>0.05); After treatment, the serum CA125, LDH, and β 2-MG in the two groups were lower than before treatment, and the above indexes in the observation group were lower than those in the control group ( P<0.05); There was no significant difference between the two groups in the incidence of side effects and the survival rates of 6, 9 and 12 months after treatment ( P>0.05). Conclusions:ICE regimen combined with methotrexate in the treatment of DLBCL can further improve the therapeutic effect and reduce the serum tumor marker levels by regulating the expression of miR-451a and miR-15a, with less toxic side effects and less immune damage, and high safety.

OBJECTIVE:To investigate the current abroad market state of the cephalosporin and its trend of develop?ment.METHODS:The cephalosporin abroad was analyzed in aspects of general sales situation,products structure,research and development,and the manufacture situation.RESULTS&CONCLUSION:The sales volume of the cephalosporin abroad has been decreasing annually,its predominance position over the other antibiotics has been losing.The future development&re?search trend of antibiotics is broad-spectrum,high-effective slow-released oral preparations.

Objective To explore the effect of different temperature of the forced- air warming system on the prevention of hypothermia during laparotomy of infants. Methods A total of 60 infants undergoing laparotomy under general anesthesia were recruited and divided into three groups by random digits table method with 20 cases each according to admitting time; when used the force- air warming system intraoperatively, the three groups were respectively setting on 45℃(automatic adjustment for 43 ℃ after 45 minutes), 43 ℃ and 38 ℃.The core temperature were respectively recorded before anesthesia and 15, 30, 45, 60 minutes after anesthesia (every 30 minutes after 1 hour).The hypothermia incidence and anesthesia recovery conditions were recorded simultaneously. Results There was no significant difference on the core temperature among three groups before anesthesia (P > 0.05). 30 minutes after the anesthetic, the core temperature of 45 ℃ group was (36.31±0.20) ℃,43 ℃ group was (36.32±0.24) ℃ and 38 ℃ group was (36.08±0.21) ℃.The differences among three groups was statistically significant (F=8.12, P < 0.01), but there was no significant difference between 45 ℃ group and 43 ℃ group (P > 0.05). 60 minutes after the anesthetic, the core temperature of 45 ℃ group was (36.39±0.26) ℃,43 ℃ group was (36.19±0.22) ℃ and 38 ℃ group was (35.92±0.15) ℃. The differences among three groups was statistically significant(F=25.19, P<0.01).The hypothermia incidence of 45℃group, 43℃ group,38℃ group was 10.0%(2/20), 25.0%(5/20), 50.0%(10/20)respectively and the differences among three groups was statistically significant( χ2=8.04, P<0.05). The time to complete consciousness of 45 ℃ group was (15.40±5.09) minutes,43 ℃ group was (19.80±4.10) minutes and 38 ℃ group was (22.00±4.36) minutes. The differences among three groups was statistically significant (F=10.96, P<0.01). The time to tracheal extubation of 45 ℃ group was (18.10±5.97) minutes, 43 ℃ group was (21.85±4.02) minutes and 38 ℃ group was (24.90±5.54) minutes.The differences among three groups was statistically significant (F=9.83, P<0.01). Conclusions The forced-air warming system can increase the infants′peripheral tissue heat content and reduce the heat losing.So that it will help decrease the intraoperative hypothermia incidence and shorten the anesthesia recovery period.Meanwhile the higher temperature of the forced-air warming system is setted ,the better effect it is.

Objective To investigate the clinical efficacy of biological dressing A covering bandage of Ⅲ° burn wounds given comprehensive treatment including dermabrasion.Methods For patients of non Ⅲ° ° burn wounds (deep Ⅱ ° and partial superficial Ⅲ ° wounds),28 cases in the treatment group,were given improved dermabrasion with tangential excision plus thin layer of skin graft from the body,the wounds were covered with biological dressing A bandage.21 patients in the control group were treated by traditional tangential excision,escharectomy and self-skin grafting.The clinical treatment effect was observed and compared between the two groups.Results The wounds were healed 2 ～ 3 weeks after surgery in treatment group,the cure rate of burns in patients with a total area of 40％ ～ 50％ TBSA was 99％,and after treatment the scar formation significantly reduced,self-donated skin significantly reduced,the hospital stay and postoperative recovery time of the patients were significantly shorter,patients were easier to accept.In the control group,the operation time was longer,the blood loss was more,the wounds had more scar healing wounds.The wound healing time of the treatment group was (14.8 ± 1.8) d,which was significantly shorter than (19.4 ± 3.0) d of the control group (P ＜ 0.05).Conclusion The improved grinding A scab plus biological dressings covering bandage has the advantages of simple operation,light damage,less complications,need less skin,to maximize retention of healthy tissue,wound healing speed up,healing scar lessened.

Objective:To investigate the training status of robotic-assisted surgery nurses in hospitals with robotic-assisted surgery system in China, and to provide reference for the training and management of robotic-assisted surgery nurses.Methods:From August to December in 2021, hospitals with robotic-assisted surgery system in China were surveyed by a self-designed questionnaire distributed online.Results:The participants in the survey of 111 hospitals in 30 provinces, cities, autonomous regions and municipalities directly under the central government, nurses cooperated with robotic-assisted surgery exist the phenomenon of their own training was up to 96.40% (107/111) of hospital, 47.75% (53/111) of the hospital said the current training content also need to add other aspects of the course. Training duration of theoretical courses was 0-13 (2.86 ± 3.03) periods arranged by hospitals, and the training duration of practical courses was 1-60 (8.38 ± 9.91) d. 35.14% (39/111) of hospitals set up regular assessment after training, and the assessment cycle of them was 1-12 (4.08 ± 3.31) months. Many hospitals put forward suggestions on strengthening English training and attaching importance to team cooperation and so on.Conclusions:In our country, Robotic-assisted surgery nurses′ training has turned to that training themselves in operating rooms, the training time, form, content and other aspects have no uniform standard, strict admittance, standardization of specialist training , these are questions need to solve.

Objective:To identify differences in association among visceral fat, body mass index, and waist circumference in Hans and Tibetans, and to investigate the associations between visceral adipose tissue and adipokine concentrations in the two ethnics.Methods:This is a mono-centric, cross-sectional observational study including 148 Hans and 150 Tibetans between 18 and 65 years old. The multivariate regression analysis was used in the study.Results:After adjustment of confounders, every 1 kg/m 2 increment of body mass index was coexisted with a larger increment of visceral adipose tissue in Han ethnic group than that in Tibetan [ β: 6.87(95% CI 4.25-9.49) vs 4.84(95% CI 2.57-7.11), P<0.01]. And increased waist circumference with 1 cm was accompanied by larger increment of visceral adipose tissue in Hans than in Tibetans [ β: 4.02(95% CI 3.15-4.89) vs 2.06(95% CI 1.75-3.44), P<0.01]. Tibetan ethnic group had higher levels of adiponectin and leptin than Han ethnic group [(57.06±32.52 vs 75.56±43.95) ng/ml, P<0.01; (98.55±100.46 vs 124.83±111.97) pg/ml, P=0.024]. After adjustment, significant association was documented between adiponectin levels and the presence of metabolic syndrome in Tibetans ( OR=0.97, 95% CI 0.95-0.99, P=0.007), whereas no association was observed in Hans ( OR=0.99, 95% CI 0.98-1.01, P=0.268). Conclusions:The ethnicity significantly affects the adipose distribution, with the same increase of body mass index or waist circumference, the Tibetans′ increase of visceral adipose tissue is less than that of Hans. The two ethnic groups may have their own unique metabolic characteristics.