Heparin-induced thrombocytopenia is a profoundly dangerous,potentially lethal,immunologically mediated adverse drug reaction to unfractionated heparin or low-molecular weight heparin.Clinical vigilance of this disease process is important to ensure its recognition,diagnosis,and treatment.Misdiagnosis of the syndrome,as well as misunderstanding of the disease process,continues to contribute to its morbidity and mortality.In this comprehensive review,the authors highlight heparin-induced thrombocytopenia's clinical presentation,diagnostic principles,and treatment.

Objectives:To study the relationship between angiogenesis,proliferation and lymph node metastasis in rectal cancer. Methods: Forty six rectal cancer specimens were examined immunohistochemically. The intratumor microvessel density(MVD), vascular endothelial growth factor (VEGF)expression positive rate and Ki 67 label index(Ki 67 LI) were detected and their relationship with tumor invasion and lymph node metastasis were analyzed. Results: The MVD, VEGF expression positive rate and Ki 67 LI increased significantly( P

Objective To explore the effect of preoperative radiotherapy on angiogenesis of rectal cancer. Methods Twenty patients with advanced lower rectal carcinoma received preoperative radiation with a dosage of 30～40 Gy each time for a total of 15～20 sessions during a period of 3～4 weeks. The definitive surgery was performed 7～10 days after radiotherapy. Another 20 patients undergoing tumor resection without preoperative radiotherapy served as control. Tumor sample was sent for pathology. The expression of vascular endothelial growth factor (VEGF) and CD34 in the rectal cancer were detected immunohistochemically. The intratumoral microvessel density (MVD) was measured. Results Fifteen patients were found with grade Ⅱ and five patients with grade Ⅲ tissue response in radiotherapy group. The diameter of intratumoral microvessel was smaller in radiotherapy group than in control group( P

Object To extract and purify a novel fibrinolytic enzyme from Perinereis aibuhitensis Grube Methods The enzyme was precipitated from the extract by ammonium sulfate, dialyzed, chromatographed on Sephadex G 100 column, and then purified by polyacrylamide gel electrophoresis Its fibrinolytic activity was assessed with fibrin plate method Results The purified enzyme showed an isoelectric point (PI) around 4 5 as tested by gel isoelectric focusing It consisted of two polypeptide chains with molecular weights around 33 000 u and 14 400 u, respectively Conclusion This was a novel fibrinolytic enzyme discovered from P aibuhitensis for the first time

Objectives：To investigate the pathological and clinical effect of preoperative arterial infusion chemotherapy on breast cancers.Methods:Twenty patients with breast carcinoma received regional arterial angiography by Seldinger's procedure followed by arterial infusion chemotherapy.Sixteen patients who didn't undergo preoperative chemotherapy were selected as controls.All the operation specimens were analyzed by the same pathologist.Results:Histological analysis of the two groups revealed the following results:① cancer tissue necrosis increased in the arterial chemotherapy group;②karyopyknosis,karyorrhexis coagulation and necrosis of cytoplasm around the vascular vessels as well as interstitial edema were found in the tumor tissue,invasion of inflammatory cells,intimal proliferation thrombus and inflammation of vessels could also be seen.All the changes were much severe in the infusion chemotherapy group than in the controlled group;Conclusions:Histological changes are significant after preoperative arterial infusion chemotherapy for breast carcinoma.

Objective To explore nurses' bonus assessment and distribution methods based on the information technology platform and to improve the efficiency of nursing management. Methods We build a hospital informa-tion platform in order to collect nursing work efficiency data by using existing computer information network. We distributed the bonus through the information platform according to evaluate nursing quality and performance effi-ciency. Results After the information flatform used for 2 years,the satisfaction of nurses with different professional titles and different experience showed no significant difference (P>0.05). The time of department management person-nel collecting and distributing data change from [103.75 (180.00,215.00)] min per month to [42.50 (60.00,90.00)] min per month.The difference showed statistical significance(P<0.05). Conclusion The technology platform can im-prove the satisfaction and the nursing management efficiency.

Objective To introduce the experience of prophylaxis and management of the complications of carotid endarterectomy (CEA) during perioperative period because those complications can not be avoided yet.Methods During Oct 2000 to Jan 2013,318 patients were performed CEA.There were 213 men and 105 women with an average age of 74.8 years ranged from 48 to 85y.There were 186 patients in the left,120 patients in the right,and 12 patients in two sides.Simply,CEA are performed in 166 patients,CEA and patch in 140,and 12 patients were performed bypass with the autogenously great saphenous vein after the lesions removal.Results The perioperative complications were preoperative stroke in 3 cases,hypotension during operation in 16,after-operation deaths in 3,hyperperfusion syndrome in 18,postoperative severe cerebral infarction in 1,hoarseness in 14,and hematoma in 28.Conclusions Perioperative complications of CEA can be decreased by cautious surgical procedure and postoperative observation.

Objective To explore the behavior characteristics ofamyloid precursor protein / tau protein / presenilin-1 (APP/Tau/PS1) transgenic mice in different months of age and study the progress of inflammation and the changes of autophagy level in brain of these APP/Tau/PS1 Alzheimer's disease(AD) mice.Methods Four-month-old wild-type (WT) mice (B6:129SF2/J) and Tau/APP/PS1 transgenic mice at 2,4,6,8 and 12 months old (n=8) were chosen in our study.Morris water maze was used to detect the spatial learning and memory abilities ofAPP/Tau/PS1 AD mice.After the paraffin section,immunohistochemical fluorescence technology was used to detect the expression and distribution of glial fibrillary acidic protein (GFAP) in the brain of mice in the above 6 groups.The expression changes of GFAP,CD45 (inflammation marker) and LC3 (autophagy marker) in the hippocampal tissues of 6 groups were detected by Western blotting.Results In the morris water maze test,the escape latency increased obviously following the increasing of months:the latency of 6 months old mice was significantly prolonged as compared with that of 2 months old mice (P＜0.05),which was further significantly increased in 12-month-old mice (P＜0.05).In the exploring experiment,with the increasing of months,the times of crossing the original table in mice showed a trend of decline,time ofresidencing in the original platform quadrant was significantly reduced.As compared with that in the WT mice,the GFAP expression in the hippocampus of 8 and 12 months old AD mice was significantly increased (P＜0.05); meanwhile,the GFAP expression in 8-month-old mice was also significantly higher than that in 2 months old AD mice (P＜0.05).The CD45 expression in 6 months old AD mice was obviously increased as compared with that of WT mice (P＜0.05).As to the level of LC3-Ⅱ/Lc-Ⅰ,there was a significant increase in 2 months old AD mice as compared with WT mice (P＜0.05),which was further increased in 4 months old AD mice (P＜0.05),but decreased in 6 and 8 months old AD mice.Conclusion With the gradually loss of the leaming and memory abilities,inflammatory reaction is significantly increased,and the autophagy level increases at first,and then,decreases in the brain ofAPP/Tau/PS1 AD mice.

Objective:To investigate the correlation between the evidence-based practice competence of undergraduate nursing interns and hospital evidence-based culture, and to provide a reference for the design of evidence-based practice activities in the internship program for undergraduate nursing interns in the future.Methods:From December 2021 to February 2022, the nursing interns in Hunan province of China were selected as subjects, and the evidence-based practice competence scale for nursing interns and the hospital evidence-based practice culture scale were used to investigate the evidence-based practice ability of nursing interns and hospital evidence-based practice culture. SPSS 26.0 was used for statistical analysis and inference.Results:The total score of evidence-based practice competence was 84.67±27.17 among the nursing interns, and the total score of hospital evidence-based practice culture was 79.65±15.92. Evidence-based practice competence was positively correlated with the total score of hospital evidence-based practice culture and the scores of each dimension ( r=0.635-0.813, P<0.01). Conclusions:The evidence-based practice competence of undergraduate nursing interns needs to be improved, which is positively correlated with hospital evidence-based practice culture. Schools should cooperate with teaching hospitals to create a good hospital evidence-based practice culture, systematically optimize the clinical practice arrangements of nursing interns, and promote the development of the evidence-based practice competence of nursing interns.

Objective: To compare the clinical effects of laparoscopic repair and open repair of gastroduodenal ulcer perforation. Methods: Retrospective analysis was performed on 117 patients with perforated gastroduodenal ulcer admitted to Sijing Hospital of Shanghai Songjiang District from October 2005 to February 2018, including 86 males and 31 females. The average age was 35.56 years with a range from 17 to 68 years. Patients were divided into two groups according to different surgical methods: laparoscopic group (n=56) and open group (n=61). Patients in the laparoscopic group were received laparoscopic repair for perforated gastroduodenal ulcer, while patients in the open group received open repair for perforated gastroduodenal ulcer. Comparison of two groups of patients with operation time, intraoperative blood loss, postoperative first anal exhaust time, analgesic utilization rate, length of hospital stay, the body′s inflammatory response [preoperative and 24 h, 72 h, 120 h of postoperative peripheral white blood cell (WBC)], C-reactive protein level (CRP), postoperative complications (postoperative incision infection, incision dehiscence, gastric duodenal fistula, abdominal abscess, adhesion intestinal obstruction and lung infection). Measurement data were expressed as mean±standard deviation (Mean±SD), and t-test was used for comparison between groups; count data were compared by Chi-square test. Results: All the patients in the two groups successfully completed the operation, and there were no cases transferred to laparotomy in the laparoscopic group. Intraoperative blood loss[(15.3±9.5) ml vs (30.5±11.3) ml, P<0.001], time of first anal exhaust[(56.5±9.8) h vs (83.8±15.6) h, P<0.001], analygesic utilization rate (10.71% vs 52.46%, P<0.005), and length of hospital stay [(7.5±1.5) d vs (10.0±3.4) d, P<0.001] of the laparoscopic group were significantly better in the open group, the differences were statistically significant. The WBC and CRP at 24 h, 72 h and 120 h after surgery of the laparoscopic group were also significantly better than in the open group [WBC: 24 h, (14.55±3.44) ×10⁹/L vs (16.02±4.12) ×10⁹/L, P=0.020; 72 h, (10.25±2.32) ×10⁹/L vs (14.22±3.29) ×10⁹/L, P<0.001; 120 h, (8.12±3.11)×10⁹/L vs (11.58±2.33) ×10⁹/L, P<0.001. CRP: 24 h, (50.35±13.73) mg/L vs (80.11±13.56) mg/L, P<0.001; 72 h, (29.37±7.81) mg/L vs (53.57±8.05) mg/L, P<0.001; 120 h, (17.71±7.01) mg/L vs (34.35±7.72) mg/L, P<0.001], the differences were statistically significant. There was no significant difference in operation time and postoperative complications between the two groups (P>0.05). Conclusion Compared with open gastroduodenal ulcer perforation repair, laparoscopic gastroduodenal ulcer perforation repair surgery trauma are smaller, and the body′s inflammatory response are lighter, postoperative complications is no statistical significance, but will look from actual data, the cases of complications is less, is now a better surgical treatment of gastroduodenal ulcer perforation.