Objective To discuss the clinical value of high-quality nursing care applicated in patients with advanced pancreatic cancer.Methods 70 patients with pancreatic cancer were randomly divided into the observation group and the control group,35 cases in each group.The control group was given routine nursing measures.The obser-vation group received high-quality nursing care on the basis of routine nursing measures.The hospitalization time, satisfaction degree,treatment compliance and mentality were observed.Results The hospitalization time of the obser-vation group was (33.2 ±6.5)days,which was significantly shorter than (44.5 ±10.3)days of the control group(t=5.269,P<0.05).The satisfaction degree of the observation group was 97.14%,which was significantly lower than 77.12%of the control group (χ2 =8.254, P <0.05 ) .The treatment compliance of the observation group was 94.29%,which was significantly lower than 71.43% of the control group(χ2 =8.323,P<0.05).The SAS,SDS scores of the observation group were (39.71 ±5.22)points,(41.36 ±5.41)points,respectively,which were signifi-cantly lower than (48.98 ±5.56)points,(47.72 ±5.76)points of the control group(t =9.336,8.544,all P<0.05).Conclusion High-quality nursing care can significantly improve the postoperative anxiety and depression, and improve the quality of life of patients with advanced pancreatic cancer.

OBJECTIVETo explore the clinical application value of Provider-Initiated HIV Testing and Counseling (PITC) by analyzing the positive rate of HIV tests for people in need of PITC and that of routine HIV tests.

METHODSWe retrospectively analyzed the demographic and epidemiologic data about the patients seeking PITC services or undergoing routine HIV tests in Nanjing Drum Tower Hospital between January and December 2013.

RESULTSThe positive rate of initial HIV screening was 1.98% in the PITC group and 0.24% in the routine test group, while that of confirmed HIV was 0. 40% in the former and 0.07% in the latter, both with statistically significant differences between the two groups (P < 0.01). The positive rate of HIV was markedly higher in males than in females, particularly in the PITC group.

CONCLUSIONPITC has a high clinical value in HIV detection for targeted subjects and therefore deserves general application in dermatology.

Counseling ; Dermatology ; Female ; HIV Seropositivity ; diagnosis ; epidemiology ; Humans ; Male ; Mass Screening ; methods ; Retrospective Studies ; Sex Factors

OBJECTIVETo explore the mechanisms involved in the ligustrazine alleviation of the pulmonary artery hypertension (PAH) in patients of chronic obstructive pulmonary disease (COPD) associated with chronic cor pulmonale (CCP) during exacerbation.

METHODSSeventy patients of COPD and CCP with acute exacerbation were randomly and equally divided into control group and treatment group. The control group received standard treatment with antibiotics, antiasthmatic and expectorant medications, and oxygenation; and the ligustrazine treatment group received ligustrazine treatment (80 mg/d; i.v.; for 2 weeks) in addition to the standard treatment. Before and at the end of 2 week treatment, the clinic responses of the two regimens were evaluated, plasma levels of endothelin-1 (ET-1) and nitric oxide (NO) were determined; arterial oxygen partial pressure (PaO2, mean pulmonary arterial pressure (mPAP), outflow tract of right ventricle (RVOT), and internal diameter of right ventricle (RV) were measured.

RESULTSGood clinic benefits were achieved in both the standard and ligustrazine regimens, plasma level of ET-1, values of mPAP, RV and RVOT decreased significantly, plasma level of NO and PaO2 values decreased (all P < 0.01 vs pre-treatment to all parameters). Compared with the control group, ligustrazine greatly enhanced the clinic efficacy from 77.1% to 97.1% (P < 0.05), and also resulted in more significant changes of all these parameters (P < 0.01 vs control group for all parameters). For both groups, the levels of plasma ET-1 were positively correlated with values of mPAP, RVOT, and RV (r = 0.710, 0.853, and 0.766, respectively, all P = 0.000), and negatively correlated with plasma NO and PaO2 (r = - 0.823, and - 0.752, respectively, all P = 0.000).

CONCLUSIONLigustrazine is effective in treating pulmonary artery hypertension during acute exacerbation of COPD and CCP in patients from the plateau area. The observed changes in the plasma levels of NO and ET-1 in response to ligustrazine treatment suggest that ligustrazine may act through the selective effect on pulmonary blood vessels to enhance the synthesis and release of NO and suppress those of ET-1 from lung vascular endothelial cells, thus reducing pulmonary artery pressure and decreasing pulmonary arterial hypertension.

Altitude ; Blood Gas Analysis ; Chronic Disease ; Endothelin-1 ; blood ; Humans ; Hypertension, Pulmonary ; drug therapy ; Nitric Oxide ; blood ; Pulmonary Artery ; physiopathology ; Pulmonary Disease, Chronic Obstructive ; drug therapy ; Pyrazines ; therapeutic use ; Respiration

This study on determination of leukemia-specific chromosomal abnormalities and their relationship with prognosis of childhood acute leukemia (AL) had an important significance for childhood acute leukemia. In recent years, the efficacy of treatment of childhood AL has been greatly improved, but relapse is still a main factor affecting prognosis. Treatment based on the risk stratification by cytogenetic abnormalities can improve the prognosis and survival rate. In the past 3 decades, the genetic techniques have developed rapidly and many new genetic abnormalities have been found. This review highlights the main chromosomal and genomic abnormalities of 3 common childhood AL, including B-cell precursor acute lymphoblastic leukemia (BCP-ALL), T-cell acute lymphoblastic leukemia (T-ALL) and acute myeloid leukemia (AML).
Acute Disease ; Child ; Humans ; Leukemia ; genetics ; Leukemia, Myeloid, Acute ; genetics ; Precursor B-Cell Lymphoblastic Leukemia-Lymphoma ; genetics ; Precursor T-Cell Lymphoblastic Leukemia-Lymphoma ; genetics

OBJECTIVETo explore the clinical effect of the sacrococcygeal space injection for the treatment of failed back surgery syndrome.

METHODSFrom July 1998 to October 2012,47 patients with failed back surgery syndrome were treated and included 39 males and 8 females with an average age of 61.5 years old ranging from 35 to 89 years old. Among them,41 patients experienced one time of operation, 6 patients with twice of operation. Forty-one patients underwent single,bilateral fenestration or central laminectomy decompression, discectomy. Six patients underwent total laminectomy discectomy and inter body fusion and pedicle screw fixation. All patients were examined by X-ray plain film, CT or MRI before treatment. The anticoagulation was discontinuation before treatment. The needle was put into the sacrococcygeal gap at prone position in the sense of frustration,suction without cerebrospinal fluid and blood,with injection of Mailuoning (Chinese characters: see text) 15 ml. The pain was assessed by VAS before and after treatment. The Oswestry low back pain disability index and survival quality interference degree were evaluated.

RESULTSAt 1 month after treatment,the pain VAS decreased from 59.24 +/- 17.35 before treatment to 19.19 +/- 11.19 after treatment (P < 0.05); The Oswestry low back pain disability index decreased from (41.35 +/- 9.87)% before treatment to (23.17 +/- 17.56)% after treatment (P < 0.05); The survival quality interference degree decreased from 6.5 +/- 2.2 before treatment to 2.6 +/- 1.4 after treatment (P < 0.05).

CONCLUSIONThe sacrococcygeal gap injection for treatment of failed back surgery syndrome has advantages of simple, safe, fewer complications, and low treatment cost.

Adult ; Aged ; Aged, 80 and over ; Drugs, Chinese Herbal ; administration & dosage ; Failed Back Surgery Syndrome ; diagnostic imaging ; drug therapy ; Female ; Humans ; Male ; Middle Aged ; Radiography ; Sacrococcygeal Region ; diagnostic imaging

Objective To investigate the hepatoprotective effect of silybin-phosphatidylcholine complex(SPC) in sepsis rats.Me-(thods) Fifty Wistar immature rats were randomly divided into 3 groups:normal control(10 cases),septic group(30 cases) and interfe-(rence) group(10 cases).In septic group and interference group,rats were treated by cecal ligation and puncture(CLP).Meanwhile,the interference group was given SPC before 2 hours of CLP and after 2 hours of CLP.Blood of rats was taken from all groups to determine the levels of serum tumor necrosis factor-?(TNF-?),interleukin-1(IL-1),alanine aminotransferase(ALT) and aspartate aminotransferase(AST) at varying intervals.Results The levels of serum TNF-?,IL-1,ALT and AST after CLP were significantly elevated in septic group compared with the normal control group(P

OBJECTIVE: Mitochondrial deoxyribonucleic acid (mtDNA) 8344 A>G (m.8344A>G) mutation is the common mutation associated with mitochondrial myoclonus epilepsy with ragged-red fibers (MERRF) syndrome. Herein we report a rare case with mitochondrial encephalopathy, lactic acidosis and stroke-like episodes/MERRF/Leigh (MELAS/MERRF/Leigh) overlap syndrome caused by m.8344A>G mutation. METHODS: The clinical and imaging data of the patient were collected and an open muscle biopsy was carried out. We further employed molecular genetic analyses to detect mtDNA mutation in the proband and his mother. And then a clinical and neuroimaging follow-up was performed. RESULTS: This patient was a 25-year-old male, who developed exercise intolerance since the age of 6. At age 10, he suffered from acute episodes of hemianopia, and cranial magnetic resonance imaging (MRI) showed occipital stroke-like lesions and cranial magnetic resonance spectroscopy (MRS) revealed a lactate peak corresponding to the lesion. After that the patient presented slowly progressive psychomotor decline. He had myoclonic seizures and cerebellar ataxia since the age of 12. At age 21, he was admitted to our hospital because of confusion and cranial MRI revealed symmetrical lesions in bilateral posterior putamen, thalami and midbrain. Then repeated MRI showed progression of original lesions and new frontal multiple stroke-like lesions. Symptomatic and rehabilitation treatment relieved his condition. Follow-up cranial MRI at age 24 showed the lesions in basal ganglia and thalami diminished, and the midbrain lesions even completely vanished. Muscle pathology indicated the presence of numerous scattered ragged-red fibers (RRF), suggestive of a mitochondrial disorder. Polymerase chain reaction-restricted fragment length polymorphism (PCR-RFLP) detected the m.8344A>G mutation of the MT-TK gene encoding mitochondrial transfer RNA for lysine in the patient's blood. Next generation sequencing (NGS) of the whole mitochondrial genome identified that the proportion of m.8344A>G was 90%, and no other mtDNA mutation was detected. Sanger sequencing further identified this mutation both in the proband and his mother's blood, although the mutation load was much lower in his mother's blood with approximately 10% heteroplasmy. CONCLUSION The present study is the first to describe a patient with m.8344A>G mutation in association with the MELAS/MERRF/Leigh overlap syndrome, which expands the phenotypic spectrum of the m.8344A>G mutation.
Acidosis, Lactic ; Adult ; Child ; DNA, Mitochondrial/genetics* ; Humans ; Male ; Mitochondrial Encephalomyopathies ; Mutation ; Stroke ; Young Adult

OBJECTIVETo explore the clinical efficacy of the arthroscopic Mender II stapler for the treatment of patients with meniscus anterior horn injury needing meniscal suture repair.

METHODSAmong 47 patients with meniscus anterior horn injury, 29 patients were male and 18 patients were female, ranging in age from 12 to 31 years old, with a mean age of (20.53± 4.12) years old. The duration of disease ranged from 3 to 35 days, and the average duration was (12.43±5.74) days. The Mender II stapler was used to carry out arthroscopic suture from outside to inside. The Lysholm knee scoring system was used to evaluate and analyze preoperative and postoperative symptoms, such as pain, limping embolism and so on.

RESULTSForty-six patients were followed up, and the duration ranged from 12 to 48 months, with a mean of (20.53±4.12) years. The incision healed at the first stage without important vessels and nerves injuries. The symptoms of the locked knee joint disappeared, and symptoms such as pain, limp, swelling and limitation of activity improved. The Lysholm score increased from preoperative 52.33±7.31 to postoperative 86.74±6.92.

CONCLUSIONUsing Mender II stapler to treat patients with meniscus anterior horn injury who were treated with arthroscopic suture from outside to inside is effective to improve symptoms, and to obtain good short-term results.

Adolescent ; Adult ; Arthroscopy ; methods ; Child ; Female ; Humans ; Male ; Menisci, Tibial ; surgery ; Suture Techniques ; Tibial Meniscus Injuries

OBJECTIVETo study endothelial damage by observing changes of circulating endothelial cells (CECs) in blood, coagulation and fibrinolysis index in patients with acute respiratory distress syndrome.

METHODSCECs were separated by isopycnic centrifugation method in 14 patients with acute lung injury (ALI), 7 patients with acute respiratory distress syndrome (ARDS), 10 intensive care unit (ICU) controls, and 15 healthy controls. Plasma prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FG), fibrin degradation products (FDP), and D-dimer were examined simultaneously. Acute physiology and chronic health evaluation (APACHE) II and lung injury score (LIS) were recorded to evaluate severity of illness and lung injury.

RESULTS(1) The number of CECs in ALI (10.4 +/- 2.3) and ARDS groups (16.1 +/- 2.7) was higher than that in the healthy (1.9 +/- 0.5) (P < 0.01). In both ALI and ARDS, the number of CECs correlated with APACHE II (r = 0.55, P < 0.05 and r = 0.62, P < 0.05, respectively) and LIS (r = 0.60, P < 0.05 and r = 0.53, P < 0.05, respectively). CEC number was negatively correlated with PaO2 in ALI and ARDS (r = -0.49, P < 0.05 and r = -0.64, P < 0.05, respectively). (2) The level of FDP and D-dimer were higher in ALI and ARDS patients than that in ICU and healthy control groups (P < 0.05). The level of FG in ARDS group was significantly higher than in the ICU and healthy control groups (P < 0.05). But in ALI group, the level of FG was significantly higher than only healthy control group (P < 0.05).

CONCLUSIONSEndothelial cell damage occurs in ARDS patients, which may play a major role in the pathophysiology of ARDS. Changes of endothelial cell activation and damage markers, such as CECs, plasma coagulation and fibrinolysis index, to some extent reflect severity of illness and lung injury in ARDS.

APACHE ; Adult ; Aged ; Blood Coagulation ; Cell Count ; Endothelial Cells ; pathology ; Female ; Fibrin Fibrinogen Degradation Products ; metabolism ; Fibrinogen ; metabolism ; Humans ; Male ; Middle Aged ; Partial Thromboplastin Time ; Prothrombin Time ; Respiratory Distress Syndrome, Adult ; blood ; pathology

AIMTo explore whether endogenous catecholamine participates in the effect of interleukin-2 on the isolated heart.

METHODSThe number of premature ventricular contraction (PVC), left ventricular developed pressure (LVDP), left ventricular end-diastolic pressure(LVEDP), heart rate (HR) and coronary flow(CF)were recorded in isolated Langendorff perfused rat hearts.

RESULTS(1) 50 U/ml IL-2 increased the PVC number, LVDP LVEDP, HR and CF. (2) Pretreatment of reserpine or propranolol abolished the cardiac effect of IL-2 at 50 U/ml, while pretreatment with phentolamine did not change the effect of IL-2. (3) 200 U/ml IL-2 increased the number of PVC,but did not increase LVDP, LVEDP, HR and CF. (4) After pretreatment of reserpine or propranolol, IL-2 failed to increase the number of PVC, but caused decrease of LVDP, HR and CF, and elevation of LVEDP.

CONCLUSIONEndogenous catecholamine mediates the arrhythmogenic, positively chronotropic and inotropic effects of IL-2. IL-2 at 200 U/ml inhibits the cardiac function in the isolated rat heart.

Animals ; Catecholamines ; physiology ; Heart ; drug effects ; physiology ; In Vitro Techniques ; Interleukin-2 ; pharmacology ; Male ; Myocardial Contraction ; drug effects ; Rats ; Rats, Sprague-Dawley