Objective: To evaluate the efficacy and safety of bevacizumab in the treatment of radiation brain necrosis, and to provide guidance for rational clinical application. Methods: A retrospective analysis was made of 14 patients with radiation brain necrosis who had failed to receive mannitol and hormone treatment or had been treated for the first time. All the patients were divided into two groups according to different treatment regimens (5.0 mg/kg repeated every 14 d and 7.5 mg/kg repeated every 21 d). The changes of enhanced lesions in MRI T1W1 phase and edema in T2W1 phase were compared separately in the two groups. The clinical symptoms, changes of KPS score and adverse drug reactions were recorded. Results: Totally 14 patients completed at least two cycles of treatment. After two cycles of treatment, the KPS scores of both groups were improved. The KPS scores of 5.0 mg/kg group were increased by 31.66 points on average compared with those before treatment. The KPS scores of 7.5 mg/kg group were increased by 27.50 points on average compared with those before treatment. The volume of CRN lesions were decreased(46.0±9.4)%(t=6.57, P<0.05) and the volume of edema lesions decreased(68.9±8.9)%(t=3.32, P<0.05) in 5.0 mg/kg group. In 7.5 mg/kg group, these two parameters were reduced by(53.9±10.7)%(t=7.89, P<0.05 and (77.1±14.3)%(t=4.22, P<0.05), respectively. There was no significant difference in the reduction of the mean volume of CRN lesions and the volume of edema area between the two groups (P>0.05). In this study, the incidence of adverse events in the 5.0 mg/kg group was similar to that in the 7.5 mg/kg group, with no significant difference(P>0.05). Conclusions Bevacizumab can significantly improve the clinical symptoms and quality of life of patients with radiation brain necrosis. The safety of 5.0 mg/kg treatment regimen repeated every 14 d is similar to that of 7.5 mg/kg treatment regimen repeated every 21 d, which can be used for reference in the treatment of CRN.

Objective: To observe the clinical efficacy of different dialysis frequency and methods in the treatment of chronic renal failure uremia patients, and to provide a reliable reference for clinical practice. Methods: From February 2016 to February 2017, 140 chronic renal failure uremic patients who admitted to the Department of Nephrology at Taizhou Central Hospital were selected and divided into the observation group and the control group by complete random distribution method, with 70 cases in each group.The patients in the control group received 3 times of regular hemodialysis treatment per week, while the observation group received 3 times of regular hemodialysis combined with 1 time of hemodiafiltration treatment per week.The clinical treatment effects and complications of the two groups were compared. Results: Compared with blood uric acid(BUA)[(532.09±71.05)mmol/L], serum creatinine(Scr)[(734.34±63.08)μmol/L], blood urea(BUN)[(23.84±2.58)mmol/L], serum phosphorus[(1.98±0.37)mmol/L], parathyroid hormone(PTH)[(464.37±113.92)ng/L], β₂ microglobulin(β₂-MG)[(13.48±6.38)mg/L]in the control group, BUA[(495.89±58.23)mmol/L], Scr[(684.34±77.32)μmol/L], BUN[(20.62±1.77)mmol/L], serum phosphorus[(1.74±0.44)mmol/L], PTH[(352.14±123.25)ng/L], β₂-MG[(9.58±5.45)mg/L] were significantly lower in the observation group, the differences were statistically significant (t=3.29, 4.19, 8.61, 3.49, 5.59, 3.88, all P<0.01). Compared with the incidence rate of pruritus in the control group(61.43%), the incidence rate of pruritus in the observation group(34.29%) was significantly lower (χ²=9.72, P<0.01), the incidence of other complications had no statistically significant differences(χ²=1.14, 1.58, 3.08, all P>0.05). Conclusion Hemodialysis 3 times combined with 1 time of hemodiafiltration per week has significant advantage in the treatment of chronic renal failure uremia patients, which can effectively remove urine toxin molecules and reduce the incidence of complications, and it is worthy of clinical application.

Objective To analyze the working stress related factors of nurses in intensive care unit (ICU), and put forward the corresponding counter measures.Methods During January to March 2016, a questionnaire survey was conducted with a commonly used nurses working pressure source scale on 110 ICU nurses in three People's Liberation Army (PLA) 3A grade hospitals in Beijing. The questionnaire survey involved 35 items within 5 main categories, including nursing professional issues, nursing workload and time allocation, working environment and resources, special care for critical patients and inter-personnel relationships between the head of nurses and other nurses. The correlations between the ICU nursing working stress and alternative factors were analyzed.Results Ninety-six nurses said the job was stressful, and 88.5% of them expressed that the degree of pressure was more than medium. The correlation analysis showed that ICU nurse working stress was correlated with 29 items in the survey scale (allP < 0.05), of which the top 6 items the mostly closely related were the frequent working shift (r = 0.58,P = 0.000), low nursing social status (r = 0.54,P = 0.000), less promotion opportunities (r = 0.54,P = 0.000), less opportunities to pursue further study (r = 0.53, P = 0.000), nurse low salary (r = 0.52,P = 0.000) and excessive workload (r= 0.50,P = 0.000).Conclusions ICU nurses face a lot of pressure in their work, the management departments should pay more attention to them, and actively energetically improve the nurse system construction, raise ICU nurses' pride, enhance the quality of nurse care and promote the healthy development of nursing profession.

Objective:To discuss the autoimmune response on the mechanism and clinical significance of nerve root injury induced by the non-compressive nucleus pulposus protrusion.Methods:Forty-eight female SD rats were randomly divided.Twenty-four female SD rats were recruited as model group,and the others as control.After ten days,twenty days and forty days,the pain threshold of left hind leg and the levels of TNF-α, CD4+, CD8+T cells were measured, the nerve root changes in morphology were observed by HE.Results:Compared with the control group,model group in ten days,twenty days,which left hind leg pain threshold,the proportion of CD4,CD8+T cell and the expression of TNF-αare significantly different.After forty days,these two groups have no statistical differ-ence.After ten days,lumbar nerve root cross-sectional myelin of model group was partial disintegrated.The worst damage happened in twenty days,and almost recovered to normal in forty days.Conclusion:T cell-mediated autoimmunity and TNF-αplay an important role to the nerve root injury in the early time of the non-compressive nucleus pulposus protrusion.

Aim To confirm the inhibitory effect of chronic intermittent hypobaric hypoxia ( CIHH) on my-ocardial apoptosis induced by metabolism syndrome ( MS) , and to investigate its mechanism. Methods A rat model of MS induced by fructose was used. The blood pressure and the plasma content of glucose, tri-glyceride, cholesterol, and insulin after 12 h fasting were detected. HE stain were used to detect the cardi-ac structure. The TUNEL staining and activity of caspase-3 were used to detect the apoptosis of myocar-dium. The protein expression of Bcl-2 and Bax was detected by Western blot . Results Compared with the control rats, the blood pressure and the plasma content of glucose, triglyceride, cholesterol, and insu-lin were all increased in rats with MS. In rats with MS, the impairment of cardiac structure and the increase of apoptosis were also observed. The protein expression of Bcl-2 was significantly down-regulated, and that of Bax was significantly up-regulated in MS rats. The ratio of Bcl-2/Bax was also significantly decreased. Interest-ingly, CIHH could ameliorate all of the above issues. There was no significant difference between control group and CIHH group. Conclusion CIHH may im-prove the increased apoptosis in rats with MS via inhib-iting the mitochondrial pathway of apoptosis. This stud-y might provide new targets for therapy and the preven-tion of MS patients.

Through comparative study on Naotaifang containing serum and plasma proteomics (peptide), this article revealed differential proteins (peptides) in the Naotaifang. The characteristics of differential proteins were identified with mass spectrometry. It provides scientific evidences for the pharmacodynamic material basis and Chinese herbal medicine plasma pharmacological method development in the exploration of Naotaifang. A total of 20 healthy adult SD rats were randomly divided into the control group, Naotaifang treatment group according to their weights. Ten rats in each group. Intragastric administration of medication was given for seven consecutive days. Before surgery, rats were fed with water but without food. One hour after the last drug administration, 10% chloral hydrate was injected for intraperitoneal anesthesia. Blood was taken through the common carotid artery. Serum and plasma samples were made after blood was taken from each rat. Serum and plasma samples of five rats were randomly selected from each group. And the two-dimensional electrophoresis (2-DE) technique was used in the comparative study of serum pro-teomics (peptide). The 300 DPI scanning and PDQuest 7.3.0 were used in the analysis. The ESI-MS/MS was used to identify important differences in proteins and screen characteristic serum and plasma protein. The results showed that 20 differential proteins of 5 plasma samples were identified. There were 15 types of proteins expressing up-regulation and 5 types expressing down-regulation. Comparative analysis on the 2-DE gel pictures of Naotaifang containing serum, 19 differential proteins of 5 plasma samples were identified, among which 15 types of proteins express up-regulation and 4 down-regulation. Comparative analysis on the 2-DE gel pictures of Naotaifang containing serum and Naotaifang containing plasma showed that 24 differential proteins of 5 plasma samples were identified, among which 9 types of proteins express up-regulation and 15 down-regulation. The highly expressed proteins were selected to MALDI-TOF-MS between Naotaifang containing serum and Naotaifang containing plasma. There were six successful-ly identified proteins, which were inter-alpha trypsin inhibitor, heavy chain 3, group-specific component, comple-ment factor B, Receptor Complexed with A Heterodimeric Fc, isoform CRA-d, Transferrin. It was concluded that protein with obvious changes in the Naotaifang containing serum and plasma may be related with fibrinolysis and an-ticoagulant. These proteins are involved in angiogenesis, inflammation and other pathological regulations of physiolog-ical processes. They are of great significance in the study of effective target and its signal transduction pathway of Naotaifang.